P. D. F. - Ayurlog

Transcription

P. D. F. - Ayurlog

ISBN 978-93-5173-179-3
ISSN 2320-7329
http://www.ayurlog.com
Special issue*- 16th Feb. 2015
Vol. 3
Ayurlog: National Journal of Research in Ayurved Science
A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
“Sthanik chikitsa a boon to stree roga in ayurveda”
Thorat Priti Vishwanath1, More S.K. 2, Kulkarni C. J. 3
___________________________________________________________________________
1. PG scholar, Streerog-Prasuti-Tantra Dept, S.V.N.H.T’s Ayurved College, Rahuri,
2.Asso. Professor of Streerog-Prasuti-Tantra Dept, S.V.N.H.T’s Ayurved College, Rahuri,
3. H.O.D. Streerog-Prasuti-Tantra Dept, S.V.N.H.T’s Ayurved College, Rahuri.
___________________________________________________________________________
*Corresponding Author: 9763648194, 9011071045; E-mail – pritivt22@gmail.com
___________________________________________________________________________
ABSTRACT:
Pichudharan(tampoon
soaked
in
There are some Sthanik Chikitsa (
medicated oil or liquid is placed into the
Local Therapies) in Ayurvedic Stree
vagina ), Uttar -Basti ( Medicated oil or
Rogas described by Ancient Acharyas
decoction is pushed into the
that possess outstanding and satisfactory
cavity through vagina ), Yoni -Dhupan
outcomes in the management of Stree-
(Fumigation of vagina,with medicated
Rogas . Some of these local therapies
smoke),Yoni-Varti
shows amazing results in the management
medicated wick into the vagina), Yoni-
of Stree Rogas like ‘Vandhyatava ‘These
Puran (vaginal packing),Yoni-Lepan (
extraordinary local therapies should be
vaginal painting), Yoni-Parisheka, Pinda
highlighted and of course used in the
Chikitsa etc. In the present study all these
management of Stree Rogas for the
local therapies are revised through ancient
fruiful outcomes. These loacal therapies
samhitas and these therapies are reviewed
basically play an important role in the
with
disorders
application procedure, application site of
Chikitsa
of
TryavartaYoni.Sthanik
preferably
their
(Insertion
meanings,
uterine
of
indications,
includes
the local therapy. The procedure of each
Yonidhawan (Douche of vagina), Yoni-
local therapy is discussed considering all
1
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aseptic precautions. Through this study it
has to go into different phases to turn
is my hopeful and truthful effort to
into a beautiful flower, similarly a young
motivate most of the Vaidyas towards
girl has to go through different stages to
Sthanik Chikitsa in the management of
turn into a mature
Stree Rogas.This study with its simple
thereafter. The anatomical, physiological,
and appropriate terms will definitely help
emotional changes occur in the body of
the Vaidyas to reach to the depth of the
women at different stages. The women
concept and will subsequently prove to
who takes the extreme care of her family
be
and
members is always found to be careless
outcomes to Vaidyas. The
about her own health. These women who
use of absolute Sthanik Chikitsa(Local
are busy in their household as well as
Therapy) skillfully in the management of
career issues face many gynecological
Stree Rogas would surely prove to be
problems and even after the diagnosis of
boon to Stree Roga.
these gynecological
helpful
satisfactory
to
give
admirable
women and even
problems these
women don’t go for regular follow up to
Key Words – Sthanik
Chikitsa, Stree
doctor
Roga
Yoni-Vyapada,
always face very common gynecological
Uttar
basti,
Prathamavarta.
at
regular
intervals.Womens
problems like white discharge, itching at
vulva, foul smelling vaginal discharge,
INTRODUCTION:
burning
The divine are extremely delighted where
problems Sthanik Chikitsa have given
women are respected and where they are
excellent results and these local therapies
not respected all actions ( projects ) are
should be practiced for admirable results
fruitless. Owing to the very fact that a
in the above mentioned
women alone has the power to give birth
problems.
to life, it can be assumed the Shristi
(creation) is a result of Shakti (power).
AIM
We observe in the nature that even a bud
2
micturation etc.
In such
gynacological
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
To study and adopt the usefullness
mouth of uterus is washed with medicated
of Sthanik Chikitsa
decoction or other liquids. Dhawana
( Local
Therapies) in
means cleaning or purification of wound
Ayurvedic Stree Rogas.
with
water
and
other
medicated
material.[1][2]
OBJECTIVES:


To study Sthanik Chikitsa from
Sthana (Application site of Yonidhawan )
various Ayurvedic texts.
- Prathamavarta (Vagina)[3]
To study the operating procedure
Duration: 8 days[3]
of each local therapy in detail.
Material and Methods:
Timing for Yonidhawana - Rutukala
This is a conceptual type of study.
(From 6th day of menstrual cycle for 8
Textual materials are used for the study
days )
from which various references have been
collected. Main Ayurvedic texts used in
Time limit of the Yonidhawana- 1to1.5
this study are Charak Samhita, Sushrata
Min. [3]
Samhita, Ashtang-Sangraha.
Medicines for Yonidhawana applicable
Comentries are also included in it.
in the form of -Kwatha (Decoction),
The Sthanik Chikitsa (Local Therapies)
Kshirpak (Medicated Milk), Siddha Jala
are described as follows:
(Purified Medicated water), Oil. [3]
a)
Yonidhawana
(vaginal
cleaning)
Dhawana is deep cleaning of wound
Indications:
under aseptic precautions and making the
1.Yoni Kandu(Vaginal Itching)
wound clean and aseptic with water and
2.Kunapgandhi Artavdushti[4]
medicinal preparations. It is a procedure
3.Kaphaja Artava Dushti[5]
in which the vagina, vaginal passage and
4.Yoni Strava[6] (Vaginal Discharge)
3
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5.Yoni Kleda[7]
decoction prathamavarta (Vagina) is
6.Yoni Paicchilya
[8]
washed out.[3]
7.Yoni Arsha(Vaginal Polyps)
Amount
of
Medicine
6. After the procedure the vulva is dried
used
with cotton.
for
Yonidhawana- 1 lit of Kwatha, 250 ml of
7. Then procedure is repeated on the
oil.
respective days. The drugs used for
Yonidhawana are antiseptic, and have the
benefit of healing the wound.
Instruments Required:
1.Enema Pot
2.Sterile Catheter
b)UTTARBASTI
3.Cotton
Medicated
4.Maincentosh
Uterine cavity though
5.Hand Gloves
which is given through uttarmarga i.e
oil,
-
(
Insertion
decoction
into
of
Intra
vagina ) Basti
through the passages located above or
Procedure:
infront part (urethra or vagina) of anus is
1. The patient is advised to lie down on
known as uttarbasti.[10] It also refers to the
the bed in lithotomy position. The enema
urinary bladder of pig or goat, because in
pot is filled with luke warm decoction to
ancient days
which catheter is connected.
were used for this purpose but now a days
2.The rubber
maincentosh
underneath patients
is placed
bladder of these animals
5cc dispovan syrienge attached with a
waist, one end of
thin cannula
is
used
for
injecting
which lies in the bucket.
Uttarbasti. Basti possessing superior
3. Minimum 2 litres of decoction is
qualities is known as Uttarbasti. [11]
required to wash the vaginal passage.
4. Sterile rubber catheter is inserted into
Indications:
vagina.
The suppression of vayu by Uttarbasti
5. Enema pot filled with decoction is kept
helps women to conceive immediately.[12]
at 5 feet distance and with luke warm
It is indicated in diseases of urinary
4
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bladder such as retention of urine,
These preparations are benficial in
dysuria, utero-vaginal prolapse, severe
cervical mucous disorders like
vaginal pain,
gynaecological
altered
(yonivyapada),
cellularity etc.
various
disorders
viscosity,
increased
Asrigadara(menometrorrhagia),
ammenorrhoea,
dysenorrhoea
retention of placenta.
and
C) Uttarbasti in Endometrial disorders:
[13]
Uttarbasti plays magnificient role in
treating the endometrial conditions. It
helps
Vaginal
commonly
infectionsfound
improving the texture of
endometria.
A)Uttarbasti in vaginal disorders:

in
The
commonly
used
preparations include the Ghritas prepared
The
from Brihan dravyas.
vaginal
infections are bacterial and fungal
D)Uttarbasti in Tubal Disorders:
infections. The commonly used

preparations in such infections are
Jatyadi Ghrita or Jatyadi tail.
Tubal block- Brihan Ghritas are
used if tubal spasm is due to
fibrosis. When the Tubal Block is
due to adhesions Kshar taila
B)Uttarbasti in Cervical disorders:

Uttarbasti is given.
Cervical Erosions- The commonly
used
preparations
in

cervical
Hydrosalphinx- The commonly
erosions are medicated ghrita like
used
Triphala Ghrita, Phala Ghrita,
conditions are Nirgundi Taila,
Shatavari
Yashtimadhu Taila, Til Taila.
Ghrita.
Cervical
preparations
in
this
Erosions can be treated by using

Ropana drugs in Uttarbasti.
Time of administration:
Cervical Mucous disorders- It can
The previous infections should be ruled
be treated with preparations like
out and cured completely before giving
Jatyadi Ghrita, Shatavari Ghrita.
Uttarbasti.
5
It
is
given
after
the
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administration of two or three Asthapana
one angula in urethral passage[15] while
Basties.
in women the nozzle should be inserted
It
is
administered
during
Artavakala or Ritukala (after menstrual
up to four angula(finger breadth).
bleeding stops). During this period the
mouth of uterus is open and it readily
Basti Dravya:
receives the fluids injected.[13] It should
According to Sushruta, Kashaya or Taila
be carried out under aseptic precautions
can be used for Uttarbasti. In charak
in operation theatre.
Samhita, charaka insists the use of only
taila in uttarbasti.
Uttarbasti Yantra:
It has a bag for holding the preparation
Quantity and frequency:
and a nozzle for injecting the fluid. The
The quantity mentioned by Charaka is
length of nozzle with pipe should be 14
half pala (20gms).[17] Charaka insists
angula with the measurement of patient’s
uttarbasti three times a day for three
fingers. The tip should be resembling the
days.
pedicle of jasmine flower and the opening
measurement for both sexes. For males
should be made in such a way that a
the amount of decoction is one Prasrita
mustard seed should pass.[14][15] In women
(96gms) and two Prasrita (192gms) for
the Pushpa (nozzle) should be 10 angulas
females. [17] The sneha should be taken in
in length. Circumference should be of
double quantity for uterine douche or
size of urethral canal. In ancient days the
cleaning. [18]
Acharyas had suggested the use of
Decoction: Male-
Sushruta
bladder of sheep, pig or goat for giving
has
given
separate
1 Prasrita(96gms)
Female- 2 Prasrita(192gms)
batsi. In their absence skin of bird’s neck
or bottom of leather water bag can be
Sneha: Male-
used.[16] Charakacharya have given the
(48gms)
use of Ajabasti (Bladder of Goat)[17] In
Female-
young girls the nozzle should be inserted
6
1
Prakuncha
1 Prasrita(96gms)
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Method
of
Administration
4. Sim’s speculum
of
5. IUI cannula / infant feeding tube
Uttarbasti:
1. Women should be given supine
6. 5cc syrienge
position with thighs flexed and
7. Sterile phalaghrita
knees elevated.
8. Cotton
2. The nozzle is inserted in urinary
9. Gauze pieces
or vaginal passage slowly and
10.Gloves
steadily.
11. Towel clips
3. In 24 hours two, three or four
12. Kidney tray
bastis are given. After resting for
13. Good light source.
three days again the procedure is
repeated for the next three days.
4. Karnikas
(rings)
should
Poorva Karma:
be
1.Vaman
introduced and vaginal openings
2.Virechana
pressed properly, then the basti
3.Dashamoolaniruha and Anuvasanana
bag
should
be
pressed
On alternate day for 3 to 5 days
properly.[19][20][21]
Pradhan Karma
Contraindications:
1. Lithotomy position
1. Cervical cancer
2. Painting and draping
2. Virginity
3. Cleaning of vulva and vagina with
3. Vesicovaginal fistula
savlon and betadine
4. Hypersensitive disorders
4. Insertion of
sim’s speculum
and
anterior vaginal wall retractor .
Instruments required for uttarbasti
5. Proper visualization of external os with
1. Sterile drepping and painting material
light source
2. Swab holder.
6. Insertion of IUI cannula.
3. Anterior vaginal wall retractor
7
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7.
Fix
5cc
syrienge
filled
with
2. Elongated -
phalaghrita
1 finger breadh and 4
finger long
8. Slowly push the piston and administer
3 to 5cc of phalaghrita as required.
Site of Pichu dharan:[22]
9. Pichudharan.
1. Prathamavarta - Elongated pichu
dharan
2. Dwitiyavarta - circular pichu dharan
Paschat Karma:
1. Ask the patient to lie down for 20 to 30
minutes.
Duration of Pichu dharan:[22]
2. Avoid biking or travelling just after the
5 to 6 hours up to retention of urine.
procedure.
1.Yonidaha and Yoni kandu[23]
3. Light diet, soup or meat juice in the
2.Yoni Paka[23]
evening
3.Vivritta Yonivyapada[23]
4. Tell the patient to remove pichu after
4.Yoni Paichilya and Yoni Srava[24]
12 hours.
5.Yoni Karkashata[25]
6.Vataja Yonivyapada[26]
c)YONI PICHU DHARAN: (Placing a
7.Pittaja Yonivyapada[27]
Tampoon soaked in medicinal oil or
8.Vamini and Upapluta Yonivyapada[28]
liquid).Pichu is made up of cotton swab
9.Nine Month Pregnancy[29]
2x3 cm (1 inch) is wrapped with gauze
10.Retained Placenta[30]
piece and tied with long thread. It should
11.Yoni Bhransha [31]
be immersed in medicated oil or liquid.
Oils are mostly preferred due to its
Procedure of Pichu Dharana
retention ability.
1. Autoclaved pichu should be used.
2. Patient should be given supine position
Shapes of Tampoons:[22]
with knees flexed
1. Circular - 1 inch length and breadth
3.The aseptic, sterile pichu soaked in oil
or liquid is inserted into the vagina with
8
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index finger of gloved hands in such a
7.Raktagulma[35]
way that thread of the pichu should come
8.Santati
out of vagina which helps in easy removal
[35]
of pichu after 5 to 6 hours.
Dhupana Drugs:
Pratibandhak(Contraceptive)
Kushta ( Saussure acostus ), Agaru (
d)YONIDHUPAN
vagina
with
:
(Fumigation
medicated
of
Aqillarla
smoke)
agallocha
),
Guggul
(Comiphera mukul ), Vacha ( Acorus
Yonidhupan is the practical procedure in
calamus
)
Vidang
(Embelia
which fumigation of vagina is performed
Ribes),Nimbapatra Azadirachtaindica )
by giving the disinfected and medicated
smoke.
Procedure:
1. A chair having hole in the middle is
Site of Yonidhupan- Bhaya yoni( outer
used for this procedure.
surface of vagina )
2. Patient is asked to sit on this chair after
Time limit of Yoni dhuphan- 3 to 5
voiding the urine.
minutes
3. The dhupan dravyas are lit in dhupan
apparatus which is placed just below the
Types of Yoni dhupan -
chair.
1. In the form of treatment
4. The smoke coming from the dhupan
2. For the protection of health.
drugs must reach upto the expected
genitalia for fumigation.
Indications
5. Otherwise even Nadi Dhupan can be
1.Shweta Pradara
done
2.Yoni Kandu[32]
expected genital organs.
3.Apara Sanga
[33]
by giving
fumigation to the
6. We should be very careful while
4.Garbha Sanga [34]
performing this procedure because the
5.Upapluta Yonivyapad[35]
temperature rises and there may be
6.Sutika Paricharya [35]
9
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danger of burn of the genital organs from
1. Painting or the expected part with
the fumes of the smoke.
savlon and betadine.
2. Freshly prepared lepa should be
e) YONI LEPANA (vaginal painting )
applied evenly and uniformly on the
Lepas are used as external application.
affected areas.
The finely powdered churna is mixed
3.
with water or medicated liquid and paste
immediately after drying as the skin is
with uniform consistency is made.This
very sensitive organ and very dried lepa
paste is then applied to the expected and
kept on the skin can cause allergic
affected areas locally.
eactions on the skin like rashes, burning,
The
lepa
should
be
removed
irritation of the skin.
Types of Lepas.
1. Pralepa - Thin lepa
f) YONIVARTI (Yoniwick)
2. Pradeha - Thick lepa - non drying
Vartis are wicks made by mixing finely
3. Alepa - Medium thick lepa.
powdered drugs with adhesive drugs or
Site - Prathamavarta /Breast
binding agents.
Time limit - 3 to 4 hours or until the lepa
Time limit of retention of Yonivarti- 2
dries
to 3 hours.
Indications:
Indications:
1. Yoni shaithilya.
1.Dushta vrana
2. Apara sang
2.Karnini yonivyapad[36]
3. Stana vidradhi
3.Upapluta yonivyapad
4. Yoni Arsha( vaginal Polyp )
4.Kaphaja yonivyapad[37]
5. Rakta pradara
6. Anartava
Procedure:
10
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Types of Varti
used
form
of
medications
in
1. Karpas varti
procedure are the kalkas or pastes.
this
2. Kalka varti
h) YONI PARISHEK
Procedure.
It is hot fomentations to all sides of the
1. Painting of the expected area with
vagina.
savlon and betadine
2.Varti should be made of size which is
Site - Bahya Yoni (external part of
equal to the circumference of index finger
vagina)
3. Vartis should be kept to dry in shade
4. There after vartis are wrapped in gauze
Time limit of Yoni Parishek- 5 to 10
piece and thread is tied o it.
min.
5. Vartis used should be autoclaved.
6. For good lubrication,to avoid pricking
Drugs used for Yoni Parishek - Oil or
of the vartis, these vartis should be
medicated oil.
soaked in oil, ghrita, honey or milk.
7. Vartis should be inserted into the
Indications-
vagina in such a way that the thread
YoniShotha.
YoniVrana,
YoniPitika,
should remain out of the vagina. As soon
as the urgency of micturation occurs the
Procedure:
varti should be removed and vagina is
1)Patient should be given supine position
washed with luke warm water.
with the knees flexed.
2)Medicated Oil or lukewarm water is
g) YONI PURAN (vaginal packing)
poured from the height of 4 to 5 inch over
This procedure is defined as filling the
the vagina.
cavity of vagina completely with oils,
pastes, powder or bolus. The commonly
i) PINDA CHIKITSA
11
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 This freshly prepared Pinda is
1. This procedure consist of insertion of
medicinal boiled drug in the form of
then
circular paste wrapped in disinfectant
Prathamavarta.
in
to
the
 It should be removed out after 3 to
cloth into the vagina. This chikitsa is
Ushna Veeryatmak
inserted
because of actual
4 hours.
contact with heat.
ConclusionSite- Prathamavarta.
Sthanik Chikitsa can be helpful to prove
like a boon to Stree rogas in Ayurveda
Time limit of Pinda Chikitsa - 3 to 4
when the Vaidyas apply these therapies in
hours ( until frequency of micturation )
there gynecological
practice logically
and carefully but ofcourse under all
aseptic
Procedure:
 Finely powdered medicinal drug
and
water
mixed
precautions.
Each
Sthanik
Chikitsa hold its own importance and
thoroughly
shows marvellous results when applied
should be boiled.
with proper indications, strict aseptic
 There after oil should be mixed to
precautions and extreme carefulness.
this mixture.
 The heating should be stopped
after
the
expected
paka
REFERENCES:
of
1.Lalchand
prepared mixture is achieved .
Ashtangasangraha.
 This hot semisolid medicinal paste
formed
is
kept
Shastri
Vaidya,
2nd
ed.
editor,
Nagpur:
Baidyanath Ayurved Bhavan Limited.,
in
1981. P.965.
disinfected,sterile cloth and tied in
2.Yadavji Trikamji Acharya, Narayan
circular shape with thread at the
Ram Acharya, editors.Sushrutasamhita
upper end.
with Nimbandhasangraha
7th
ed.
Varanasi:
Orientalia, 2002,P.35
12
Commentary
Chaukhambha
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
3.Jaymala Shirke, editor. Ayurvediya
10.Lalchand
Strirogavigyan, 1st ed. Pune: Tathagat
Ashtangasangraha.2nd
P:rakashan 2003 P. 159.
4.K.R.
Shrikantha
Murthy,
editor.
Shastri
Vaidya,
ed.
editor,
Nagpur:
1981. P.776
Ashtangasangraha vol.II, Sharirasthan
11.Yadavji Trikamji Acharya, editor.
2nd
Charaksaamhita
ed.
Varansi:
Chaukhambha
Chikitsaashan3rd ed.
Orientalia. 1999.P:.13-15
Varanasi:
5.K.R.ShrikanthaMurthy,editor.Ashtanga
Prakashan; 1941. P.720
sangraha vol.II, Sharirasthan2nd ed.
12. Yadavji Trikamji Acharya, editor.
Varansi:ChaukhambhaOrientalia.
Charaksaamhita Chikitsaashan 3rd ed.
1999.P:.14
Varanasi:
6.Yadavji
Trikamji
Acharya,
editor.
Chaukhambha
Surbharati
Chaukhambha
Surbharati
Prakashan; 1941.Verse 9/63-65.P.721.
13. Lalchand Shastri Vaidya, editor,
Varanasi:Chaukhambha
Ashtangasangraha
Surbharati
.2nd
ed.
Nagpur:
7.Harishastri Paradkar Vaidya, editor.
1981. P.803.806
Ashtangahridaya Uttarsthana 7th ed.
14 Yadavji Trikamji Acharya, Narayan
Varanasi:
Chaukhambha
Orientalia.
1982.P.900
with Nimbandhasangraha
7th
Orientalia, 2002,P.537
with
Commentary
Nimbandhasangraha
7th
ed.
Varanasi:
ed.
Varanasi:
Varanasi:
9.Lalchand
Ashtangasangraha.2nd
Vaidya,
ed.
Chaukhambha
ChaukhambhaOrientalia, 2002,P.350
Shastri
Commentary
editor,
Chaukhambha
Surbharati
Nagpur:
16. Yadavji Trikamji Acharya, Narayan
1981. P.675
with Nimbandhasangraha Commentary
13
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Vol. 3
7th
ed.
Varanasi:
23.
Sastri
Brahmashankar
ChaukhambhaOrientalia, 2002,P.538
Yogaratnakar.
Chaukhambha
1993.P.426
Varanasi:
Chaukhambha
Surbharati
5th
ed.
editor.
Varanasi:
Sanskrit
Sansthan
Charak samhita Chikitsasthan. 3rd ed.
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Cite this article
Sthanik chikitsa a boon to stree roga in ayurveda
Thorat Priti Vishwanath, More S.K. , Kulkarni C. J.
Ayurlog: National Journal of Research in Ayurved Science-2014; 3(2): 1-15
15

P. D. F. - Ayurlog

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