ARSHA - Dravya Prayoga.pptx

Dravya Prayoga in Arsha (Piles)

1. ARSHA – Dravya Prayoga Presented by – Dr. Aditi Gandhi, Final Year Post Graduate Scholar Department of Dravyaguna, SDMCAH, Hassan 03-06-2022 1 Dr. Aditi Gandhi

2. Reference Charaka Samhita Chi. 14 Sushruta Samhita Ni. 2 + Chi. 6 Ashtanga Hrdaya Ni. 7 + Chi. 8 Madhava Nidana 5 Bhava Prakash 5 03-06-2022 2 Dr. Aditi Gandhi

3. ARSHA Nirukti – अरिवत्प्राणिनो मांसकीलका विशसन्ति यत्| अर्शांसि तस्मादुच्यन्ते गुदमार्गनिरोधतः||१|| (A.H.) Sthana - देशमुपदिशन्त्यर्शसां- शिश्नमपत्यपथं गल तालु मुख नासिका कर्णाक्षिवर्त्मानि त्वक् चेति| (Ch.) Shishna (pudendum), Apatyapatha (yoni), Gala (throat), Talu (palate), Mukha (mouth), Nasika (nose), Karna (ears), Vartma (eyelids), Twak (skin) Paryaya : Guda kilaka Guda ankura Durnama Hatanama Adhimamsa 03-06-2022 3 Arsha – Gudavali Dr. Aditi Gandhi

4. Corelation = PILES / HAEMORRHOIDS Haemorrhoids, Greek word, Haima – bleed , Rhoos – flowering / blood to ooze = bleeding Piles, Latin word, ‘pila’ – ball/ mass It is defined as the downward sliding of anal cushions abnormally due to straining or other causes. (SRB) Main cause – Weakening of the park’s ligament which is the lower end of external sphincter. 03-06-2022 4 Dr. Aditi Gandhi

5. 03-06-2022 5 Anal Cushions – aggregation of blood vessels, smooth muscles and elastic connective tissue in the submucosa that normally reside in Left lateral, Right Posterolateral and Right Anterolateral anal canal. ( = Gudavalli traya ) Dr. Aditi Gandhi

6. Samanya Nidana – Causative Factors (Ch.) Guru, Madhura, shita , abhishyandi , vidahi , viruddha bhojana Ajirnashana , pramitasana Asatmya bhojana sevana Meat of cow, fish, pig, buffalo, sheep, goat Intake of Masha, ikshu , shrngataka , newly harvested shooka and shami dhanya Improper samshodhana / panchakarma Improper maithuna Lack of exercise Diwaswapna , Vishamasana 03-06-2022 6 Dr. Aditi Gandhi

7. Purva roopa – Prodromal Symptoms Vistambha - indigestion Atopa - flatulence Dourbalya - weakness Vibandha - constipation Karshya - emaciation Udgar bahulya – excessive bleeding Sakthi sadana – pain in thighs Grahani dosha - sprue Pandu - Anaemia Udara roga – Abdominal disorder Pipasa - Polydypsia Alpa vit – Less qty of stools 03-06-2022 7 विष्टम्भोऽन्नस्य दौर्बल्यं कुक्षेराटोप एव च | कार्श्यमुद्गारबाहुल्यं सक्थिसादोऽल्पविट्कता ||२१|| ग्रहणीदोषपाण्ड्वर्तेराशङ्का चोदरस्य च | पूर्वरूपाणि निर्दिष्टान्यर्शसामभिवृद्धये||२२|| (Ch.) Dr. Aditi Gandhi

8. Samanya Lakshana - Symptoms Prevalence rate – 4.4% in world, in about 10 million people May occur in any age, mostly seen in the age between 30-65 years Incidence – equal in either gender Bleeding / anum – pain and burning sensation – ‘splash in the pan’ Mass/ anum Constipation Diarrhoea Flatulence 03-06-2022 8 Dr. Aditi Gandhi

9. 03-06-2022 9 Samprapti Dr. Aditi Gandhi

10. Samprapti Ghataka Dosha Dushya Srotas Adhishthana Srotodushti Agni Udbhava Swabhava Sadhyasadhyata Tridosha Mamsa , Rakta , Meda , Twak Mamsavaha , Raktavaha , Purishavaha Gudavalli Sanga Mandagni Amashaya Daruna Krchrasadhya 03-06-2022 10 Dr. Aditi Gandhi

11. Bheda - Types 03-06-2022 11 Vataja Bahya Shushka Sahaja Primary 1 st Degree Pittaja Abhyantara Ardra / Sravi Jatottara Secondary 2 nd Degree Kaphaja 3 rd Degree Raktaja 4 th Degree Sannipataja Dr. Aditi Gandhi

12. Chikitsa - Rx 03-06-2022 12 Dr. Aditi Gandhi

13. Chikitsa - Rx चतुर्विधोऽर्शसां साधनोपायः | तद्यथा- भेषजं क्षारोऽग्निः शस्त्रमिति | तत्र, अचिरकालजातान्यल्पदोषलिङ्गोपद्रवाणि भेषज साध्यानि, मृदुप्रसृतावगाढान्युच्छ्रितानि क्षारेण , कर्कशस्थिरपृथुकठिनान्य ग्नि ना, तनुमूलान्युच्छ्रितानि क्लेदवन्ति च शस्त्रेण | ( Su .) 03-06-2022 13 Rx. Bheshaja Recent origin, Alpa dosha and alpa upadrava yukta arsha Kshara Soft, extensive, deep and raised piles Agni Rough, fixed, large and hard Shastra Narrow pedicle, elevated and moist Dr. Aditi Gandhi

14. Samanya Rx Sutra यद्वातस्यानुलोम्याय यदग्निबलवृद्धये । अन्नपानौषधं सर्व तत्सेव्यं नित्यमर्शसैः ॥४७॥ (BP) Vata Anulomana Dravya Agni bala vrrdhi kara anna- pana For Nitya sevana Samyaka Rakta Poorti (Proper blood supply to the haemorrhoidal plexus) Sroto Shodhanam (Improve venous/ arterial drainage to the plexus) Sroto Balyam (Strengthen the sinusoidal walls in the haemorrhoidal plexus) Dhatu Balyam (Strengthen the muscles/ tissues of the anal canal) Rakta Stambhanam (Stop the bleeding) Anulomanam (Regularize the bowels) Shotha vedana hara (Manage the inflammation and pain) Samkramana hara (Manage the secondary infection) Sthanika Chikitsa (Topical management) 03-06-2022 14 Dr. Aditi Gandhi

15. DRAVYA PRAYOGA 03-06-2022 15 Dr. Aditi Gandhi

16. Agrya चित्रकमूलं यावशूकः तक्रा भ्यासो क्रव्यान्मांसरसा भ्यासो दीपनीयपाचनीयगुदशोथा र्शः शूलहराणां स्रंसनीयपाचनीया र्शो घ्नानां ग्रहणीदोषशोफा र्शो घृतव्यापत्प्रशमनानां ग्रहणीदोषशोषा र्शो घ्नानां 03-06-2022 16 Dr. Aditi Gandhi

17. Arshoghna Mahakashaya / Gana कुटजबिल्वचित्रकनागरातिविषाभयाधन्वयासकदारुहरिद्रावचाचव्यानीति दशेमान्यर्शोघ्नानि भवन्ति | (Ch.) कटजफलबिल्वचित्रकमहौषधप्रतिविषावचाचविकाः| धन्वयवासं पथ्या दारुहरिद्रा गणोऽयमर्शोघ्नः | (A.S.) 1. Kutaja 2. Bilva 3. Chitraka 4. Nagara 5. Ativisha 6. Abhaya 7. Dhanvayasa 8. Daruharidra 9. Vacha 10. Chavya 03-06-2022 17 Dr. Aditi Gandhi

18. Dravya Prayoga Ref – ASTG 03-06-2022 18 Dravya Dosage Form Matra Sevana Kala Avadhi Anupana Haritaki Churna 2-4gm Empty stomach/ Bed time or Early morning 2-3 weeks Sukhoshna jala Triphala Churna 2-4gm 1-2 weeks Sukhoshna jala Draksha Dried fruit 10-20gm 1-2 weeks Aragwadha Churna 2-4gm 1-2 weeks Eranda Taila 10-20ml Dr. Aditi Gandhi

19. Parisheka / Avasechana 03-06-2022 19 Vasa Arka Eranda Bilva Dr. Aditi Gandhi

20. Avagaha (Tub-Bath recepie ) (Ch.) In case of shoola in mamsa ankura – apply taila and do avagahana with Kwatha of Mulaka , Triphala , Arka , Venu patra , Varuna patra , Agnimantha patra , Shigru patra , Ashmantaka patra . Kola patra kwatha Bilva kwatha Takra Dadhimanda Amla kanji Gomutra Koshna (Luke warm) sauviraka Tushodaka 03-06-2022 20 Dr. Aditi Gandhi

21. Dhoopana Ghrita of Brhati , Ashwagandha, Pippali , Tulasi (Ch.) Go Ghrita prepared from Tumburu , Vidanga , Devadaru , Akshata ( yava ) (Ch.) 03-06-2022 21 Dr. Aditi Gandhi

22. Lepa Snuhi kshira + haridra churna ( Su .) Pippali , Saindhava , Kustha , Shirisha phala + Snuhikshira pishta / Arka kshira ( Su .) Haridra Churna + Snuhi kshira lepa (Ch.) Shirisha beeja , Kushtha , Pippali , Saindhava lavana + guda lepa (Ch.) 03-06-2022 22 Dr. Aditi Gandhi

23. YAVAGU = Shati beeja , Palasha beeja , Pippali , Shunthi Kalka sadhita yavagu + amla rasa yukta takra + maricha churna . (Ch.) YUSHA = 1. Shushka Mulaka ( Raphanus sativus ) 2. Kulattha 3. Kapittha + Bilva 4. Kulattha + Makushtha (Ch.) 03-06-2022 23 Dr. Aditi Gandhi

24. Bhallataka Vidhana / Kalpa (Su.Chi.6/17) Day   Day   1 1 19 65 2 2 20 60 3 3 21 55 4 4 22 50 5 5 23 45 6 10 24 40 7 15 25 35 8 20 26 30 9 25 27 25 10 30 28 20 11 35 29 15 12 40 30 10 13 45 31 5 14 50 32 4 15 55 33 3 16 60 34 2 17 65 35 1 18 70       535   465 03-06-2022 24 +1 +5 -5 -1 = 1000 Bhallataka Dr. Aditi Gandhi

25. अत ऊर्ध्वं भल्लातकविधानमुपदेक्ष्यामः - भल्लातकानि परिपक्वान्यनुपहता न्याहृत्य तत एकमादाय द्विधा त्रिधा चतुर्धा वा छेदयित्वा कषायकल्पेन विपाच्य तस्य कषायस्य शुक्ति मनुष्णां घृताभ्यक्ततालुजिह्वौष्ठः प्रातः प्रातरुपसेवेत, ततोऽपराह्णे क्षीरं सर्पिरोदन इत्याहारः; एवमेकैकं वर्धयेद्यावत् पञ्चति, ततः पञ्च पञ्चाभिवर्धयेद्यावत् सप्ततिरिति, प्राप्य च सप्ततिमपकर्षयेद्भूयः पञ्च पञ्च यावत् पञ्चेति, पञ्चभ्यस्त्वेकैकं यावदेकमिति | एवं भल्लातकसहस्रमुपयुज्य सर्वकुष्ठार्शोभिर्विमुक्तो बलवानरोगः शतायुर्भवति ||१७|| 03-06-2022 25 Dr. Aditi Gandhi

26. Other Dravya Prayoga … ALABU – Alabu beeja and audhbhida lavana are pounded with sour gruel and made into 3 pellets. ( Chakradatta ) APAMARGA – moola with rice + madhu – daily ( Su .) SHATAVARI – moola kalka with milk ( Su .) CHITRAKA – Churna yukta sidhu ( Su .) BHALLATAKA – Churna yukta saktu mantha (without lavana ) with takra . ( Su .) 03-06-2022 26 Dr. Aditi Gandhi

27. HARITAKI PRAYOGA GUDA + HARITAKI – Daily morning ( Su .) HARITAKI + PIPPALI Churna fried in Ghrita , taken with guda . (Ch.) HARITAKI Churna fried in Ghrita and consumed with Trivrt & Danti Churna . (Ch.) 03-06-2022 27 Dr. Aditi Gandhi

28. Takra stored in pot applied with the Kalka of following : ( Su .) CHITRAKA MOOLA PIPPALI PIPPALI MOOLA CHAVYA VIDANGA SHUNTHI HARITAKI 03-06-2022 28 Dr. Aditi Gandhi

29. In case of Vibandha and shoola in Arsha : PATHA + BILVA Churna PATHA + SHUNTHI Churna PATHA + AJAMODA Churna 03-06-2022 29 Dr. Aditi Gandhi

30. Continued … TRIPHALA Kwatha / Swarasa + TRIVRUT Churna . (Ch.) GOMUTRA + HARITAKI & GUDA soaked overnight. (Ch.) Takra + HARITAKI / TRIPHALA (Ch.) Madya with KAPITHA & BILVA (Ch.) Madya with CHITRAKA Churna (Ch.) BHALLATAKA Churna followed Takra sevana . (Ch.) PANCHAKOLA Churna with Takra (Ch.) 03-06-2022 30 Dr. Aditi Gandhi

31. SHAKA PRAYOGA (Ch.) Yamaka – Trivrt , Danti , Palash, Changeri , Chitraka patra . Yamaka – Upodika , Tanduliya , Vastuka , Suvarchala , Lonika , Yava shaka , Kakamachi , Guduchi patra , Changeri , Jivanti , Shati , Garjara added with Dadhi / Dadima swarasa + Dhanyaka / Shunthi churna . 03-06-2022 31 Dr. Aditi Gandhi

32. भवन्ति चात्र- ( Su .) यथा सर्वाणि कुष्ठानि हतः खदिरबीजकौ | तथैवार्शांसि सर्वाणि वृक्षकारुष्करौ हतः ||१९|| Khadira and Asana – cures Kushtha . Similarly, Vrkshaka ( Kutaja ) and Arushkara ( Bhallataka ) cures ARSHA . 03-06-2022 32 Dr. Aditi Gandhi

33. Yoga Trayushnadi Churna with Manda/ Madya/ Ushna Jala Takra arishta Pippalyadi Ghrita Chavyadi Ghritha Nagaradya Ghritha Abhaya arishta Danti arishta Phala arishta and Dwitiya Phala Arishta Kanaka arishta 03-06-2022 33 Dr. Aditi Gandhi

34. Proprietary Pilex - Tablet & Ointment (Himalaya) Arshopy – Tablet & Ointment ( Revinto ) Pilocid - Tablet & Gel ( Kottakkal ) Pilie – Tablet ( Dr. Vashisht’s ) 03-06-2022 34 Dr. Aditi Gandhi

35. Anupana Shushka arsha , Vata vrddhi, Sharira rukshata , Mandagni – मदिरां शार्करं जातं सीधुं तक्रं तुषोदकम्| अरिष्टं दधिमण्डं वा शृतं वा शिशिरं जलम् ||१२८|| कण्टकार्या शृतं वाऽपि शृतं नागरधान्यकैः| अनुपानं भिषग्दद्या द्वातवर्चोऽनुलोमनम् ||१२९|| (Ch.) Sidhu prepared from Madira and Sharkara Takra Tushodaka Arishta Dadhi manda Ushna jala Shita Jala Kantakari Kwatha Dhanyaka – Shunthi jala 03-06-2022 35 Dr. Aditi Gandhi

36. Pathya Yava Godhuma Rakta Shali Takra Navanita Mrg mamsa Aja dugdha Kanji 03-06-2022 36 Amalaki Kapittha Kulattha Punarnava Surana Vastuka Patola Maricha Vrntaka Dr. Aditi Gandhi

37. Apathya Anupa desha pashu-pakshi mamsa Pinyaka Dadhi Pishtaka Masha Guru ahara Vishtambhi ahara Nishpava Karira Bilva Tumbi Upodika Pakwa amra 03-06-2022 37 Dr. Aditi Gandhi

38. Bibliography Brhatrayi - Ch.S ., Su.S ., A.H., A.S. Bhava Prakasha Samhita Nighantu Adarsh – Bapalal Vaidya Classical Use of IMP – PV Sharma Ayurveda Standard Treatment Guidelines Kayachikitsa – Ajay Kumar Sharma, Anil Kumar Singh SRB’s Manual of Surgery – Sriram Bhat M. Bhaishajya Ratnavali -9 Google - images 03-06-2022 38 Dr. Aditi Gandhi

39. THANK YOU ! 03-06-2022 39 Dr. Aditi Gandhi