Lecture Note: Rationality of Ayurvedic Prescriptions & Hridroga (Part-3)

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Rationality of Ayurvedic Prescriptions & Hridroga
Part-3

Dr. Muralidhara Sharma

based on the lecture available at- Rationality of Ayurvedic Prescriptions & Hridroga

Kaishor Guggulu:
This is another very common prescription.I would prescribe this whenever there is Vata and Pitta involvement and particularly in Rakttavrutta Vata.

Lakshnas of Rakttavrutta Vata

रक्तावृते सदाहाऽर्तिस्त्वङ्मांसान्तरजा भृशम्||a
भवेच्च रागी श्वयथुर्जायन्ते मण्डलानि च| A.H Ni 16/33

The symptoms of Rakttavrutta Vata cover a broad range irrespective of contemporary diagnosis. Contemporary diagnosis for Raktavritta Vata condition could be quite different. However, whenever there is ‘Sadah arati or ‘Mansa Anatargat Shotha,’ extra synovial edema seen in any of the joints, then my prescription is Kaishor Guggulu. It is prescribed even in the case of gouty arthritis or in the case of rheumatoid arthritis in the presence of local inflammatory signs like raised local temperature and tender swelling. When the swelling becomes less tender, and the local signs of inflammation are reduced, but there is intra-synovial effusion, an accumulation of fluid in the joint, then my prescription would be Gokshuradi and Mritunjay. This way, according to the status of the disease, medicine can be prescribed. I don’t mean that Kaishor Guggulu and Mrutunjay Rasa should be prescribed in each and every patient with Rheumatoid arthritis. It is based on the Dosha Lakshna.

Varicose veins or vascular pathologies where there is vascular stasis, Kaishor Guggulu has to be prescribed. Vata Rakta, which involves all the vessels, doesn’t differentiate between arterial disorders and venous disorders. In contemporary science, there are two categories, arterial and venous, but for me, Vata Rakta is one. Kaishor Guggulu can be prescribed in both arterial and venous disorders. In the case of peripheral ischemia when amputation is advised, I have saved a few limbs by prescribing Kaishor Guggulu. Manjishthadi Kshar basti is based on the same perception, like when there is involvement of Vata Rakta. In the case of all peripheral vascular disorders, Kaishor Guggulu is a common prescription. You may combine Kaishor Guggulu with Gandhak Rasayan if there is a wound and discharge. When there is emaciation of limbs, it could be Kaishor Guggulu and Arogyavardhini. If it is about local inflammatory signs, the combination could be based on other clinical presentations, but then there is the involvement of Kaishor Guggulu and Mrutunjay Rasa. The combination could be based on other clinical presentations, but in the case of vascular involvement, Kaishor Guggulu would be a common prescription.

Triphala Guggulu:

It is tridoshahar, with my arbitrary weightage for pitta dosha at 2, for Kapha dosha at 2, and for Vata dosha at 1. In any condition where there is an involvement of Mamsa or Medas and in any condition where there is involvement of Mamsa along with a sign of inflammation, the choice would be Triphala Guggulu. This is the basic difference between the indication of Triphala Guggulu and Kanchanar Guggulu. Kanchanar Guggulu is indicated when there is not much sign of inflammation. When there is a swelling present along with a sign of inflammation, my prescription would be Triphala Guggulu.

  Also, when there is Shofa (swelling) along with Pipilika eva Sanchar, i.e., a tingling sensation, my prescription would be Triphala Guggulu. In Vata vyadhi with a symptom of Pipilika eva Sanchar, the choice of drug would be based on other presentations. In the case of a symptom of ‘Pipilika eva Sanchar’ (tingling) without localized swelling, Ekanveer Rasa is indicated, while when the symptom of ‘Pipilika eva Sanchar’ is present with localized swelling, Triphala Guggulu is indicated. General indications could be for all types of wounds, ulcers, tonsillitis, pharyngitis, and fistulae.

Kakayani Vati:

Kakayani Vati is a Pitta Kaphahar, suitable for any condition involving Rakta Pitta Dushti, characterized by bleeding from the nose, rectum, or anywhere in the body, including bleeding hemorrhoids with Pittaja Arsha Lakshana. In cases of menstrual irregularities marked by irregular bleeding and mild to moderate bleeding, such as spots, Kakayani Vati is a better choice. For severe menstrual bleeding, Chandrakala is the indicated remedy. Additionally, it can be used for conditions like hypertension and cardiomyopathy due to the involvement of Rakta Pitta Dushti. It’s important to note that a common side effect is loose stools, which, although not harmful, serves to sensitize the patient about this possibility.

Makardhwaja

Here I am explaining about Suvarn Ghatita Makardhwaja. In the case of Dhatukshyajanya Vyadhi, particularly Shukrakshya Lakshana, I would prescribe Makardhwaja. Especially in conditions of emaciation, Makardhwaja is indicated, as well as in Kaphaj and Kapha Vataj Vyadhi. Chronic conditions such as bronchiectasis, non-healing ulcers, and abnormalities related to spermatogenesis are common indications for Makardhwaja

Abhayarishta:

I use Abhayarishta very commonly in my practice. I consider it as a Tridoshahar, especially when there is an involvement of Rasa Rakta. It is also indicated in cases of Vibandha, Ajeerna, Agnimandya lakshana, or Grahani lakshana. Additionally, it is suitable for conditions with Saam Kapha or Saam Pitta lakshanas. Abhayarishta is also recommended in cases of irregular bowel movements, particularly occasional constipation and diarrhea without a specific disease diagnosis. While these clinical signs may be related to sprue and similar conditions, they don’t necessarily indicate sprue. Many individuals may present with this type of gastrointestinal issue that is not regular constipation. In such cases, my prescription choice would be Abhayarishta rather than Avipattikar. Avipattikar is better suited for regular constipation conditions. However, when there are altered bowel movements, such as occasional diarrhea and occasional constipation or in diagnosed cases of Grahani, Abhayarishta becomes the preferred choice.

General clinical conditions: Haemorrhoids, Habitual constipation, Malabsorption pathologies

Occasionally, Abhayarishta may cause gripping pain. When a patient experiences a phase of constipation and starts taking Abhayarishta, initial bowel movements may lead to some gripping pain, though it is not constant. There’s no need for excessive caution, but it’s better to sensitize the patient so that they can easily accept this discomfort

Amritarishta:

 It is a very common prescription of mine, and the indications encompass all Kapha Vataja Lakshanas, Rasa Pradoshaja, and Saam Vata conditions. Mrutunjay Rasa has the same indications as Amritarishta. Irrespective of the diagnosis, I would prescribe Amritarishta for all febrile conditions.

Ashvagandharishta:

In the case of Kaphavritta Vata lakshna and Mamsa Medoja Lakshnas, when a patient experiences pain, particularly in the limbs after exercise, or feels less energetic after a reduction in food intake, exhibits exercise intolerance in terms of pain or muscular spasms, and prefers warmth, Ashwagandha is indicated. In the case of neuritis, Ashwagandharishta is recommended. Most patients in middle age may have this condition, often referred to as calcium deficiency. So, I replace contemporary calcium prescriptions with Ashwagandharishta. I prescribe Ashwagandharishta not as a replacement for calcium but as a supplement that improves the total metabolic capacity of tissues and provides relief. In the case of all degenerative disorders, Ashwagandha is indicated.

Usheerasava:

  Usheerasava is indicated in cases of Urdhwaga Raktapitta when there is bleeding from the nose, eyes, or ears. In collagen tissue disorders where there is capillary fragility, and the patient presents with rashes and erythema lesions seen over the body, Usheerasava is another specific indication. It’s not limited to menstrual disorders or urinary tract disorders, although menstrual disorders are my first choice for this medicine. I do not prescribe Ashokarishta at all, which is different from the general trend in practices where Ashokarishta with the bottle itself often features a female face. However, based on my experience, in all conditions where there is a normality of menstrual irregularities, particularly Raktapradar with excessive discharge, Usheerasava is indicated. It is also prescribed in cases of urinary tract infections and bleeding disorders. Occasionally, adverse reactions may include constipation. This is not very critical but could be one of the common complications

 Kumariasav

It is another very frequently prescribed drug. In any case of Dhatwagnimandya, Kumari Asava and Arogyavardhini are indicated. I prefer that it would depend on the other possible issues in a patient. At times, they could be used together, but it also depends on the other issues. These variables may be somewhat subtle, and it’s challenging to objectively define them. It depends on what you observe in the patient. When you see a predominant Dhatwagnimandya, we may combine both drugs. Kumariasava is prescribed when there is moderate Dhatwagnimandya, such as in a child who presents with irregular appetite. Particularly in cases of children addicted to fast food like Kurkure or Lay’s, and they have an irregular appetite, and the mother says the child doesn’t eat, then Kumari Asava is indicated. These differences can be somewhat subtle, and it’s challenging to define them precisely. But in any case, where vague gastrointestinal tract symptoms present with Dhatvagnimandya features and malabsorption conditions, Kumari Asava is prescribed. Dysmenorrhea is another condition where Kumari Asava is often prescribed, as indicated in the texts.

Khadirarishta

 It is prescribed where there is Raktavritta Vata and particularly involving Rasa Rakta Dhatu. In that condition, particularly when there is Shotha and Mandala where you will have circumscribed lesions. Again, I would not say ringworm and taeniasis, and so on. So, it’s not about that, but one of those features which will remind about that, what Mandala will be suggested. It could be any of erythematous rashes, Khadirarishta is indicated.

In septic foci, particularly in children where a pyoderma-like condition occurs, and the child would have multiple spots of infective lesions, and none of the diagnoses is possible. It could be streptococcal infection, and antibiotics have not really solved the problem. In that condition, Khadirarishta is one of the sure-shot remedies. So, this is one of the common groups of children who are brought to Ayurveda clinics, having that nonspecific condition. Again, it is not any specific disease condition like pyoderma, having repeated reddish rashes along with pus formation and so on, very common these days. These days it has become quite common. Earlier it was believed to be an unhygienic condition. But what I would say is, it’s because of the overcautious or wrong perception of hygiene. Often hygiene now is perceived as an application of some smelling agents, powders, and so on. Often, this produces a break in the skin and that produces the damage. My advice to such patients is not to use any of it and use only soap and water. It is one of our strong areas, one of the areas where our treatment can produce a very significant change in the outcome and the patient’s perception also. Rarely, in the case of severe anemia patients who have very severe anemia and don’t respond to the usual standard protocol of the treatment for anemia like Draksharishta or Bruhuna are not helping, and where there is a tendency for bone marrow depression, then my preference would be Khadirarishta. Because it is mentioned as one of the medicines for Kushtha, and Gambhira Dhatugat Kushstha would always have Pandu. And whenever it is accompanied with the manifestation on the skin, Khadirarishta would be a better preferable choice. Very often seen in the case of very chronic Psoriasis conditions, anemia is often seen, and in that condition, it would be a better choice.

Mustakrishta:

It is another drug that is very commonly prescribed by me, particularly in Kapha Vataja Vyadhi, Agnimandya, and Grahani. When a patient has Agnimandya and Grahani, either Mustakarishta or Anandbhairavi would be the choice. Sometimes both of these drugs are prescribed together.

The majority of the time, Anand Bhairavi and Mustakarishta are prescribed together, which would be convenient for the patient. It is not necessary to prescribe them together, but almost the indications are the same as that of Anand Bhairavi.

Saraswatarishta :

I consider Saraswatarishta as Tridoshahar. Again, the ability to consider the ratio is arbitrary. When I have mentioned any of the ratios, these ratios are arbitrary based upon what I have perceived. In the conditions of Ojokshaya and whenever there is a need for Medhya Rasayana, it is indicated. Ojokshaya Lakshanas are exactly similar to the features of Anxiety neurosis. So, when the patient feels that he has a fear and feels weak, these are very frequent issues. Most of the time, most people would have this kind of anxiety neurosis issues, and it is one of the specific prescriptions that I prescribe

Clinical conditions– Hypertension, Psychiatric disorders, degenerative pathologies.

Jeerakadyarishta:

Its action is Pachana, and it is indicated in the case of Pittavritta vyadhi where the patient would have Ushna, Katu, Vidahi ahar as a precipitating factor. For example, if a patient complains of abdominal pain and a history of consuming Katu, Vidahi ahar like Cabbage Manchurian. In such cases, it gives you very gratifying results. A patient having gastrointestinal abnormality due to ice cream and coming to me the next day, I would prescribe Kumari Asava. In all colic where the patient could have a vague condition, pain in the abdomen, and causes are not very specific, I would prescribe Jeerakdyarishta. Nowadays intestinal nonspecific colic is identified in ICD 10 diagnosis.

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