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Evaluation of Efficacy of Plaksha Twak Churna in the Management of Shweta Pradara A Comparative Clinical Study - Dr. Kalavati. D. Petlur, Department of Dravya Guna, Post Graduate Studies & Research Centre, D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE,GADAG

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Shweta pradara#dg16 gdg

  1. 1. Evaluation of Efficacy of Plaksha Twak Churna in the Management of Shweta Pradara A Comparative Clinical Study By Dr. Kalavati. D. Petlur Dissertation submitted to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore In partial fulfillment of the degree of Ayurveda Vachaspati M.D. In Dravya Guna Under the Guidance of Dr. Kuber Sankh M.D. (Ayu) and Co-guidance of Dr. Shashikant Nidagundi M.D. (Ayu) Department of Dravya Guna Post Graduate Studies & Research Centre D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG 2006-2009
  2. 2. D.G.M.AYURVEDIC MEDICAL COLLEGE POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG - 582 103 This is to certify that the dissertation entitled “Evaluation of Efficacy of PlakshaTwak Churna in the Management of Shweta Pradara A Comparative Clinical Study” is abonafide research work done by Dr. Kalavati. D. Petlur in partial fulfillment of therequirement for the post graduation degree of “Ayurveda Vachaspati M.D. (Dravya Guna)”Under Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka.Dr. Shashikanth Nidagundi Dr. Kuber Sankh M.D. (Ayu) M.D. (Ayu)Co- Guide GuideLecturer in Dravya Guna Asst.ProfessorDGMAMC, PGS&RC, GADAG Dept. of Dravya Guna DGMAMC, PGS&RC, GADAGDate: Date:Place: Gadag Place: Gadag
  3. 3. J.S.V.V. SAMSTHE’S D.G.M.AYURVEDIC MEDICAL COLLEGE POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG, 582 103 Endorsement by the H.O.D, Principal/ head of the institution This is to certify that the dissertation entitled “Evaluation of Efficacy of PlakshaTwak Churna in the Management of Shweta Pradara A Comparative ClinicalStudy” is a bonafide research work done by Dr. Kalavati. D. Petlur under the guidanceof Dr. Kuber Sankh , M.D. (Ayu), Asst. Professor and Dr. Shashikanth Nidagundi,M.D. (Ayu), in partial fulfillment of the requirement for the post graduation degree of“Ayurveda Vachaspati M.D. (Dravya Guna)” Under Rajiv Gandhi University ofHealth Sciences, Bangalore, Karnataka.. (Dr. G. V. Mulagund) (Dr. G. B. Patil) Professor & HOD Principal, Dept. of Dravya Guna DGM Ayurvedic Medical College, PGS&RC Gadag Date: Date: Place: Gadag Place: Gadag
  4. 4. Declaration by the candidate I here by declare that this dissertation / thesis entitled “Evaluationof Efficacy of Plaksha Twak Churna in the Management of ShwetaPradara A Comparative Clinical Study” is a bonafide and genuineresearch work carried out by me under the guidance of Dr. Kuber SankhM.D.(Ayu) Professor and Dr. Shashikanth Nidagundi M.D.(Ayu),Lecturer in Dravya Guna, DGMAMC, PGS&RC, Gadag.Date :Place : Gadag (DR. KALAVATI. D. PETLUR)
  5. 5. © Copy right Declaration by the candidate I here by declare that the Rajiv Gandhi University of HealthSciences, Karnataka shall have the rights to preserve, use and disseminatethis dissertation/ thesis in print or electronic format for the academic /research purpose.Date :Place : Gadag (DR. KALAVATI. D. PETLUR)© Rajiv Gandhi University of Health Sciences, Karnataka
  6. 6. ACKNOWLEDGEMENT This is a moment of great pleasure and Contentment for me as writingAcknowledgment is the last phase in completion of this research work. At the onset my devotional pranamas to Shri Sainath, Shiradi Math and HolinessSri. Jagadguru Abhinava Shivanada Swamiji, Shivananda math, Gadag. I take this glorious opportunity to acknowledge with deep sense of gratitude to Dr.G.V. Mulagund, professor, Head of the Dept, Department of post graduate studiesresearch (Dravyaguna) D.G.M.A.M.C,Gadag for his valuable guidance and closesupervision during the entire phase of the study. I take this opportunity to acknowledge with the deep sense and gratitude to myguide Dr. Kuber Sankh. Asst. Professor, Department of post graduate studies andResearch (Dravyaguna) D.G.M.A.M.C,.Gadag for their valuable guidance and closesupervision during the entire phase of the study. My profound gratitude to my co- guide Dr. Shashikanth Nidagundi, lecturer,Department of Post graduate studies and Research (Dravyaguna) D.G.M.A.M.C, Gadagfor their good and valuable guidance through out this dissertation work. With profound sense A gratitude I express my sincere thanks to Dr. G.B. Patil,beloved Principal , D.G.M.A.M.C. Gadag, I thank Sri. S.B. Saunshi, Chairman and all thecommittee members for their constant encouragement, facilities provided and moralsupport during my post graduate study. I wish to add my warmest thanks to my PG teaching faculty, Dr. K.S. Paraddi, Dr.G.S. Hiremath, Dr. M.C. Patil, Dr. K. Shivaram Prasad, Dr. Shashidhar Doddamani, Dr.Santosh Belavadi, Dr. Jagadish Mitti, Dr. Raghavendra Shettar, Dr. GirishDanappagoudar, Dr. Veena Kori, Dr. Ashok Patil for their valuable suggestions andtimely help made me to complete this dissertation work successfully, I thank Dr. G.B. Mulugund, Prof and H.O.D, Department of P.G studies inDravyaguna GAMC, Bangalore. For their constructive suggestions and encouragement inpreparing this dissertation. I sincerely thank P.M. Nandakumar statistician, Sri. V.M. Mundinamani,Librarian, Sri. Lakkundi, Photographer, Sadguru Computers for their timely help duringmy study. I
  7. 7. I express my sincere thanks to Dr. Chandrakant. S. Hiremath, Principal ShriRaghavendra Ayurvedic Medical College, Malladahalli for their kind support. I extend my greatfulness to my colleague Dr. G.S. Kulkarni who helped meduring my dissertation work. I extend my gratefulness and sincere heart felt gratitude tomy colleagues Dr.Kavita Mittalkod, Dr. R.A. Malwad, Dr. Jaya Malgoudar, Smt. P.K.Belavadi and other office staff for their timely support and encouragement got during thecourse. I am very thankful to my friends Dr. Mukta, Dr. Savita, Dr. Jaya, Dr.Sarvamangala, Dr. Veena, for their help and co-operation during the study. I wish to thank Principals of Rajeev Gandhi D.Ed. College, Anglo Urdu D.Ed.College of Gadag R.M.O and all the physicians and other staff of the hospital and all mypatients and their assistants for their co-operation during my clinical study. And I expressmy deepest gratitude to my beloved Parents Devendrappa, Smt. Laxamavva and mybeloved Husband Rachappa and my lovely daughter Sunanda, my brother Mr & Mrs.Mahantesh, Udayavani, and family members, my aunty Shanta who have inspired me tocontinue my PG study with their constant moral support. I wish to thank G.B. Mamdapur, Chairman and all the committee members ofS.VP.R.A.M.C. Badami for their economical support.Place: GadagDate: (K. D. Petlur) II
  8. 8. ABBREVIATIONA.H. Astanga HridayaA.P.I. Ayurvedic Pharmacopoeia of IndiaA.S. Astanga sangrahaB.P. BhavaprakashaB.R. Bhaishajya RatnavaliBP.N. Bhavaprakasha NighantuC.Chi Charaka Samhita Chikitsa SthanaC.S. Charaka samhitaD.N. Dhanwantari NighantuPVS Dravyaguna Vijnana By Priyavrat SharmaVMG Dravyaguna vijnana By V.M. GogteD.G Dravyaguan vijnana.I.M.M. Indian Materia MedicaI.M.P. Indian Medicinal PlantsK.N. Kaiyadeva NighantuM.D. Madhava DravyagunaM.N. Madanapala NighantuN.A. Nighantu AdarshaR.N. Raja NighantuR.R.S Rasa Ratna SamucchayaR.S.S Rasendra Sara SangrahaS.S Sushruta SamhitaS.N Shaligrama NighantuSha.Sam Sharangadhara SamhitaY.R. Yoga Ratnakar III
  9. 9. ABSTRACT Shweta pradara is one of the commonest problems of women. Women suffer fromleucorrhoea at least once in a while during their lifetime. Recurrence also is a commonphenomenon and it occurs mainly due to infections by bacteri, fungi and protozoa.Usually it occurs in unhygienic conditions, but can also occur after some surgicalprocedures and at the time of delivery. This condition is described in ayurvedic classicsby the term shwetapradara as a symptom in various vaginal related diseases (yonivyapat).Though there are different modes of treatment for yonivyapat, the significant one is localtherapy. Hence this study was conducted to find out some suitable drug for this procedureand Plaksh (Ficus lcaor) was selected. Here study is aimed to evaluate the effect ofPlaksha twak churna in Shweta pradara.OBJECTIVES 1. Pharmacognoistical evaluation of Plaksha, Preliminary phyto chemical study, Macroscopical evaluation, Standardization and validation. 2. To Evaluate the efficacy of Plaksha twak churna in the management of Shewta pradara. 3. To evaluate the Plaksha twak kashaya as a trans vaginal douche in the management of Shweta pradara. 4. To evaluate the comparative effect of Plaksha twak churna orally and kashaya as trans vaginal douche in the management of Shweta pradara.METHOD In this prospective comparative clinical study, 30 patients randomly selected andGrouped as A and B receiving Plaksha twak churna with Madhu and Plaksha twak churna IV
  10. 10. kashaya as trans vaginal douche respectively for the study duration of 21 days from theday of initiation of medication with dose of 4 gms with honey BD. The patients are askedfor the reporting every 7th, 14th and 21st days efficacy was assessed by the difference ofbefore and after the treatment from the subjective and objective parameters.RESULTS Individually all the 2 groups showed highly significant in subjective as well asobjective parameters comparatively group A shows more significant then the group B.INTERPRETATION & CONCLUSION The statistical analysis is done by using student’s paired t-test, by assuming thatthe drug is not responsible for changes in the readings before and after treatment. Fromthe analysis all parameters shows highly significant (as p<0.05). The parametersExcessive Vaginal Discharge, Vaginal ph, Vaginal Smear and Extensive prurtis showsmore highly significant than the other parameters ( as p<0.001). and the parametersPersistent vulval moistness and General weakness shows less highly significant (asp>0.001). The percentage of improvement in the parameters is Excessive Vaginal Dischargewith 96.66667, Persistent vulval moistness with 91.42857 %, Extensive pruritis with91.11111%, General weakness with 93.47826%, Pain in lumbar region with 87.5%,Vaginal ph with 26.89394 % and Vaginal Smear with 100% from the study.KEY WORDS Plaksha (Ficus lacor), Madhu (Honey) Leucorrhoea; Methods; Clinical study; Results; V
  11. 11. CONTENTS Page No.1. Introduction 1-22. Objectives 3-33. Review of literature 4-60 a) Drug Review 4-32 b) Disease Review 33-60 4. Methodology 61-74 5. Results 75-105 6. Discussion 106-118 7. Conclusion 119-120 8. Summary 121-121 9.Bibliography 122-13110.Annexure VI
  12. 12. LIST OF TABLES DRUG REVIEW TABLE 1 PLAKSHA Page No.Table 1.1 – Showing Gana and Varga according to different 7 classicsTable 1.2 – Showing Prayaya according to different authors. 8-10Table 1.3 – Showing Guna according to different authors 20Table 1.4 – Showing Karma according to different authors 21Table 1.5 – Showing Prayojya anga according to different authors 22Table 1.6 – Showing Prayoga according to different authors. 23Table 1.7 – Showing the Matra according to different authors. 24Table 1.8 – Showing the use of Plaksha in different yogas. 25Table 1.9 – Showing Pharmacological action of Madhu 30 TABLE. 2. DISEASE REVIEW Page No.Table 2.1 – Showing the Swaroopa of Shuddha Artava 40Table 2.2 – Showing the Nidana of Shweta pradara. 40Table 2.3 – Showing the Yoni rogas in which Shwetasrava is 42 considered as a symptomTable 2.4 – Showing the Sthanika lakshanas of Shweta pradara 43Table 2.5 – Showing the Pathyapathya in Shweta pradara. 46Table 2.6 – Showing the Incidence of cause of Leucorrhoea 55 TABLE. 3. OBSERVATIONS AND RESULTS Page No. Table 3 a) Showing the Physical constants & found values of Bark 74 powder of Plaksha. Table 3 b) Showing the Thin layer Chromatography analysis of 74 Aqueous extract. Table 3 c) Showing the Phytochemical components and found 75 values of bark powder of Plaksha. Table 3.1 Showing the incidence of Menstrual history 77 Table 3.2 Showing the incidence of Age 78
  13. 13. Table 3.3 Showing the incidence of Socio-economic status 79Table 3.4 Showing the classification of Patients based on their 80 PrakrutiTable 3.5 Showing the incidence of Dietic pattern 80Table 3.6 Showing the incidence of Nidhana 81Table 3.7 Showing the result by religion in Shweta pradara with 82 Plaksh twak churna.Table 3.8 Showing the result by occupation in Shweta pradara 83 with Plaksh twak churna.Table 3.9 Showing the Economic status in Shweta pradara with 83 Plaksh twak churna.Table 4.0 Showing the result by Diet in Shweta pradara with 84 Plaksh twak churna.Table 4.1 Showing the percentage by presenting complaints. 84Table 4.2 Showing the percentage of distribution of patients by 84 Associated complaints.Table 4.3 Showing the percentage of Ahara Nidana observed in 84 the studyTable 4.4 Showing the percentage of Vihara Nidana observed in 84 the studyTable 4.5 Showing the percentage of Manasika Nidana observed 85 in the studyTable 4.6 Showing the Chronisity of Leucorrhoea observed in the 85 studyTable 4.7 Results of Plaksha twak churna in Swetapradara 85Table 4.8 Showing the grades of Excessive vaginal discharge 85 Before treatment in Group A & B.Table 4.9 Showing the grades of Excessive vaginal discharge 86 After treatment in Group A & B.Table 5.0 Showing grades of Persistent vulval moistness Before 86 treatment in Group A & B.Table 5.1 Showing grades of Persistent vulval moistness After 86 treatment in Group A & B
  14. 14. Table 5.2 Showing grades of Extensive pruritis before treatment 87 in Group A & BTable 5.3 Showing grades of Extensive purities after treatment in 87 Group A & BTable 5.4 Showing grades of General weakness before treatment 87 in Group A & BTable 5.5 Showing grades of General weakness after treatment in 87 group A & B.Table 5.6 Showing grades of pain in lumbar region before 88 treatment in Group A&BTable 5.7 Showing grades of pain in lumbar region after 88 treatment in Group A&BTable 5.8 Showing the grades of Draging sensation before 89 treatment in Group A & B.Table 5.9 Showing grades of Draging sensation after treatment in 89 Group A & B.Table 6.0 Showing the distribution of Patient by Degree of 89 vaginal pH before and after treatmentTable 6.1 Showing the distribution of Patient by Degree of 89 vaginal smear before and after treatmentTable 6.2 Showing the Statistical Analysis of both the groups, 90 Before and after treatment and Percentage of improvement with respect to excessive vaginal discharge.Table 6.3 Showing the Statistical Analysis of both the groups, 91 Before and after treatment and Percentage of improvement with respect to Vulval moistrness.Table 6.4 Showing the Statistical Analysis of both the groups, 91 Before and after treatment and Percentage of improvement with respect to Extensive Pruritis.Table 6.5 Showing the Statistical Analysis of both the groups, 92 Before and after treatment and Percentage of improvement with respect to General weakness.
  15. 15. Table 6.6 Showing the Statistical Analysis of both the groups, 93 Before and after treatment and Percentage of improvement with respect to Pain in Lumbar region.Table 6.7 Showing the Statistical Analysis of both the groups, 93 Before and after treatment and Percentage of improvement with respect to Vaginal pH.Table 6.8 Showing the Statistical Analysis of both the groups, 94 Before and after treatment and Percentage of improvement with respect to Vaginal Smear.Table 6.9 Analysis table by using student t- test 95Graph No. LIST OF GRAPHS Page No. 1 Showing the incidence of Menstrual history 77 2. Showing the incidence of Age 78 3. Showing the incidence of Socio-economic status 79 4. Showing the classification of Patients based on their 80 Prakruti. 5. Showing the incidence of Dietic pattern 80 6. Showing the incidence of Nidhana 82 7. Showing the incidence of Religion 82 8. Showing the distribution of patient by occupation 83
  16. 16. LIST OF PHOTOGRAPHS Plate No 1 Plant Plaksha (Ficus lacor) Fig. 1 Plaksha twak (Ficus lacor) Fig. 2 Plaksha twak churna (fine) Fig. 3 Madhu Fig. 4 Plaksha twak churna (course) Fig. 5 Plaksha twak kashaya Fig. 6 Vaginal douche Plate No 2 T.S. of Bark stem Fig.10 Microscopic view of Powder (Plaksha) Plate No 3 TLC of Plaksha twak churna Fig. 11 Dragendroff Fig. 12 UV LIST OF MASTER CHARTS Page NoMaster Chart 1 Assessment of subjective parameters in Group –A 96 98Master Chart 2 Assessment of objective parameters in Group –A 99Master Chart 3 Assessment of subjective parameters in Group –B 100Master Chart 4 Assessment of objective parameters in Group –B
  17. 17. Introduction INTRODUCTION In present era abnormal vaginal discharge is quite frequent complaint of womenin gynaecologic clinic1. Shweta pradara troubles more than 75% of women during theirlife. Most of the women are working, due to change in life style, food, habit, work load,faces lots of stress and strain. Women are subject to large number of complaints andconnected with genital organs. Gender differences play a role in manifestation of diseaseand health out comes. The disease Shweta pradara based on theoretical and clinical symptoms can becompared to Leucorrhoea. The pathogens like Trichomonas vaginalis 94.5%), Ngenorrhoeae (2.7%) and C albicans (6.7%) were exclusively present in leucorrhoea2.Gynaecological complaints includes leucorrhoea, disfunction uterine bleeding, pelvicinflammatory disease etc, among them leucorrhoea is more prevalent. The externalgenitalia with long tubular content is susceptible to the infectious conditions from pubertytill menopause, either because of unhygienic conditions or coital and evenphysiologically. Wide variety of reasons are encountered in its causation, commonly fungal,parasitic, bacterial and sexually transmitted diseases. Most secretions are regarding lifecycle physiological and warrant no medical interventions. But it is significant if it isblood stained, profuse, foul smelling or changes in its colour. If not treated infection maycontinue for months even years and may spread to other areas of genital tract3. Though there is an established line of treatment for leucorrhoea in the allopathicsystem of medicine, most of the drugs fail to cure the disease completely and recurrence 1Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  18. 18. Introductionis common. Many ayurvedic formulations have been evaluated clinically, and Plaksha isone of the new drug taken up for the trial in this study. Ayurveda is the safest curative system. There are many drugs described inayurvedic literature for Shweta pradara among them plaksha4 (Ficus lacor) is one of themost potent drug for Shweta pradara. On the basis of authentic classical references theeasy availability of a drug and cost effectiveness developed interest in selecting this drugfor Shweta pradara. An effective remedy for shweta pradara is Plaksha twak. (Ficus lacor) comesunder the kashaya skandha and is one among panchavalkala. Due to its kashaya rasa itacts as rakta stambhaka and grahi. Due to its sheeta veerya and laghu ruksha qualities actsas vranashodhana and vrana ropana5-9, so these actions are extremely beneficial in curingshweta pradara. A warm vaginal douche of plaksha twak churna kashaya is beneficial togeneral cleansing and elimination of purulent discharge. Plaksha twak churna have manymeans to kill fungus, bacteria, parasite as its acts as krimighna. In present study is aimed to evaluate the efficacy of Plaksha twak churna in themanagement of Shweta pradara with the view to find out therapeutically efficacious,safer, cost effective and easily available drug. 2Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  19. 19. ObjectivesOBJECTIVES 1. Pharmacognoistical evaluation of Plaksha. a. Macroscopical evaluation b. Microscopical evaluation c. Standardization and Validation. 2. Preliminary phyto chemical analysis of Plaksha. 3. TLC of Plaksha. 4. To Evaluate the efficacy of Plaksha twak churna in the management of Shewta pradara. 5. To evaluate the Plaksha twak kashaya as a trans vaginal douche in the management of Shweta pradara. 6. To evaluate the comparative effect of Plaksha twak churna orally and kashaya as trans vaginal douche in the management of Shweta pradara. 3Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  20. 20. Drug Review DRUG REVIEWHistorical aspect of the Drug Plaksa is one of the ficus species and is member of group vanaspatya chatustayaalong with aswattha, udumbara, nyagrodha. The plant is mentioned in vedic samhitas.Brahmanas and kalpa sutras10. Plaksha is used in the Indian system of medicine since antiquity and it has beenmentioned in Yajurveda, Charaka samhita, sushruta samhita, Astanga hridayam, Bhav-Prakasha and in various Nighantus like Dhanwantari Madanapala and texts of Ayurvedaand Yunani, Panini, the great grammarian of Sanskrit refers the principal tree of NorthIndia including Plaksha in his Astadhyas of Panini “(Agarwal, 1952)11. Madanapal described described the drug Plaksha as visarpajit i.e it cureserysepalas. Plaksha is extensiovely used ion the treatment of ulcers along with the fouringredients in the groups panchavalkala. The four drugs are the root barks of ficusglomerata, Ficus religiosa, Ficus bengalensis and Azardirachta indica. The healing takesplace properly when oils and ointments containing Plaksha are used. It’s fruits have been described in charaka samhita (su 27, 164) and shushrutasamhita (su. 46,165) along with other ficus fruits. It is also mentioned in visnu (1,22,9) and Bhagawata (5,20,2) puranas andraghuvamsha (8,93).Charaka: described it as mutra sangrahaniya while susruta and vagbhata have mentionedit under Nyagrodhadi gana. It is considered as one of the ksiri vrksas or pancha valkalasby Bhavamisra. 4Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  21. 21. Drug ReviewShatapathabrahmanha: gives reference pertaining to plaksha. One among vanaspatisand beneficial in the Yajna (Homage) Plaksha, Kashmarya, Ashvattha, Udumbara,Pitudaru, bilwa are shrestha, vetasa is Nikrastha.Etareya brahmanha: We come across the reference about these vanaspatis. Pranou vaivanaspati (E.Br. 2/4,20) 5/23, 7/32) Chatusta vanaspatis are Plaksha, Nyagrodha,Udumbara, Asvattha. (E.Br. 6/16)Kalpasutra: Gives the reference about the usage explained like Plakshodumbara.Panini: Mentioning of the vanaspatyadi gana (6/2/140) Plakshodumbara.Vattikakar: Description regarding vanaspatis (1/4/12)Bhattoji: Give the reference with an examples as “Plakshanyagrodhou”Taittiriya samhita: The references as Plakshanyayagrodhakhadirpalasha (6/3/20/2)Usage of “Praksha” word. One among Kshirivruksha In the unmada roga havan byplaksha is told. Fruits of this tree are edible. In the yajna usage of plakshakha explained.Darila: We come across the reference of Plakshodumbar “Pipariti” is supreme.In Yajurveda: Reference as Plaksha is one among vanaspatis.Patanjala: Reference as that “Plakshodumbara”Sushruta Samhita: Reference regarding Kshirivruksha such as plaksha, Nygrodha,Udumbara, Ashwattha these four vanspatis included in the “Vishnu sahasranam” even petnames of God Vishnu. Specific references are available regarding ‘plaksha’ cÉiÉÑhÉÉï ¤ÉÏUÏuÉפÉÉhÉÉqÉç (xÉÑ. 1/4) ¤ÉÏUÏuÉפÉMüwÉÉrÉ (zÉÑ.ÍcÉ. 16/13; 46/433) iÉcÉÈ ÌmɹuÉ ¤ÉÏËUhÉÉqÉç (xÉÑ.ÍcÉ. 20/34) Told ÌuÉSìÍkÉ ÍcÉÌMüixÉÉ WåûiÉÑ (ÍcÉ.16, /13) 5Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  22. 22. Drug Review ¤ÉÏUÏuÉÑ¤É MüwÉÉrÉ Told. In the context of “Nyagrodhaadi gana” explaination regarding plaksha, kapitana,Nyagrodha, Udumbara, Ashwatha. Shushruta clearly mentioned Panchakashayaprayojana in detail12. uÉÉiÉeÉ MühÉïzÉÔsÉ – MühÉïmÉë¤ÉÉsÉlÉ and MühÉïmÉÔUhÉ by mÉlcÉMüwÉÉrÉ YuÉÉjÉ, cÉÑhÉï. (xÉÑ.E. 11/42) SÒaÉÉïÎlSiÉ ÌmÉÎcNûiÉ rÉÉåÌlÉ – mÉlcÉMüwÉÉrÉ cÉÔhÉï – mÉÔUhÉ, mÉlcÉMüwÉÉrÉ YuÉjÉ – kÉÉuÉlÉ (xÉÑ.E. 36/25)Charaka Samhita: In Charaka samhita specification of Panchavalkala (Ch. 22/14),Panchakshirivruksha (Chi. 11/44) Nyygrodhadhaischturbi (Si. 10/37) toldmÉlcÉuÉsMüsÉ, mÉlcÉMüwÉÉrÉ – irÉaÉëÉåkÉ, AμÉijÉ, ESÒqoÉU, msɤÉ, uÉåiÉxÉ explained. (Ch. 15/41)Astanga Hradaya: In the context of chikitsa Shofanirvanartha, nygrodhadipanchavalkala explained. (Ch. 15/41)Vagbhat: Vagbhat attributed the same opinion as that of charaka, Shofa nirvapana hetu(chi. 15/16) Nayagrodhadi four drugs with vetasa valkala told chandanadi ghrita (chi10/42)Brahatrayi: Especially the manifold actions of the drugs mentioned are highlighted bythe synonyms, Kshiri vruksha kashaya, valkala, specifically Nyagrodha, Udumbara,Ashvattha, Plaksha known as Panchavalkala and panchakshiri. Different opinionsregarding these five drugs.Chakrapani: Reference regarding “Panchavalkala kashaya” In this context vetasa told.In the chapter on “dviruniya” Shofanirpanha hetu (Chi. 25/46) these 4 drugs vetasavalkala ghruta mishrita pralepa told. Visarpa chikitsa hetu (Chi. 12/84) 4 drugs with 6Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  23. 23. Drug Reviewvetasa, pallava, valkala kalka gruta mishrita- pralepa In panchaksheeravruksha prasangawith 4 drugs + kapitana told.Dalhana: In this (Vi.Chi) references regarding Nyagrodha, Udumbar, ashvatta, plakshagardabhanda told. Anupana vivechana (Su. 46/433) and vranashodhana hetu prayukta‘kashayanam’ hetu (chi. 20/16) (Chi. 2/66) ‘Kshiri’ i.e kshudraroga chikitsa. Dalhana toldtwachaha pishtava kshireenam and vatadi pancha kshirini vruksha twacha told.Utpatti13: msɤÉÉå qÉåkÉålÉ – iÉæ 7/4/12/1 iÉxrÉ (SæuÉæUÉsÉprÉqÉÉlÉxrÉ mÉzÉÉåÈ) AuÉÉQÒû qÉåkÉÈ mÉmÉÉiÉ | xÉ LuÉ uÉlÉxmÉÌiÉUeÉÉrÉiÉ | iÉÇ SåuÉÉÈ mÉëÉmÉzrÉlÉç | iÉxqÉÉiÉçç mÉëZrÉÈ| mÉëZÄrÉÉå Wû uÉæ lÉÉqÉæiÉSè, rÉiÉç msÉ¤É CÌiÉ’- zÉ0 3/8/12)Table No-1.1 Ganas and vargas according to different classicsCharaka samhita Mutra sangrahniya kasaya skandhaSushruta samhita Nyagrodhadi Phala vargaAstanga hridaya NyagrodhadiBhavaprakasha Nighantu (Kshirivriksha) vatadi varga panchavalkalaNighantu Adarsha Vatadi vargaKaiyadev Nighantu Oushadhi vargaRaj Nighantu Amradi vargaDhanvantari Nighantu Amaradi vargaMadanapala Nighantu Vatadi vargaShaligram Nighantu Vatadi varga 7Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  24. 24. Drug Review Abhidana Ratnamal Kashaya dravya skandha Madhav dravya guna Vividoushadi varga Amara kosha Vanoushadi varga Table No-1.2 Paryayas according to different authorsSynonyms CS14 SS15 AH16 BN17 KN18 RN19 MN20 NA21 Ab AK23 SN24 SKD25 R22Plaksha + + + + + + + + + + + +Jathi + + + + + +Parkari + +Parkati + + + + + +Pippari +Shrungika +Vathi + + + +Pugamunda +Gardabhanda + + + + + +Kamandalu + + + +Plava + + +Gandhamunda +Charudaru +Suparshva + + + + + +Charudarshana + + +Mundika + 8 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  25. 25. Drug ReviewAshwath patra + +Kapitana + +Ksiri + + + + +Shrangi + +Varohashakhi + +Kapitaka +Drada praroha + + +Plavaka + +Plavanga + +Mahabala + +Hrsva plaksha + +Sushita +Shitaviryaka +Pundra + +Mahavaroha + +Hrsva parna + +Pimpari + +Bhidura + +Mangalacchaya +Charuvrksha +Garbha +bhandaka 9 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  26. 26. Drug ReviewPippari + +Yupa +Pippalapadapa + +Kapotana +Pitana +Ashwatthi +Karpari +Plavaksha +Shungi +Avarohashakha +Ploksha +Sukshma +Sushouta +Shoutavarnyak +Bhitura + Paryayas and its meanings26 1) msÉ¤É - mÉë¤ÉUÌiÉ CÌiÉ msɤÉÈ | Spreading much more 2) msɤÉÌiÉ: AkÉÉå aÉcNûÌiÉ msÉ¤É = mÉëÌiÉ AkÉÉå aÉcNûÌiÉ qÉÔsÉÉæ CÌiÉ | By its Jatha rupa root facing towards down. 3) eÉPûÏ : eÉOûÉ xÉÉÎliÉ AxrÉ CÌiÉ eÉOûÏ | (N.A) 10 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  27. 27. Drug Review Here Jata found 4) eÉOûÌiÉ – xÉÇbÉÉiÉÏ pÉuÉiÉÏÌiÉ | ‘eÉOû xÉÇbÉÉiÉå’ (N.A) It founds as Jata all at one 5) mÉMïüOûÏ : mÉMïüOûÉZrÉÇ TüsÉqÉxrÉ mÉMïüOûÏ | rÉSè uÉÉcÉxmÉÉÌiÉ: = TüsÉÇ iuÉålÉxrÉmÉMïüOûqÉç | mÉ×crÉiÉå xÉqrÉMçü xÉÇoÉkrÉiÉå uÉëhÉÉÌSwÉÑ CÌiÉ | (N.A) Best remedy in Ulcers 6) ÌmÉmmÉsÉmÉÉSmÉ: A synonym told by ¤ÉÏUxuÉÉqÉÏ 7) Suparshwa – Few branches and many adventitious roots growing down word 8) Kamadalu – Probably indicates the habitat near fresh water or it may also refer to shape of fruit. MODERN REVIEW OF THE DRUG PLAKSHABotanical Name27: Ficus lacor Ficus = From an original Arabic word meaning fig Lacor = or thespasia populuca = divine.VERNACULAR NAMES28Latin Name : Ficus lacorSanskrit : Ashvatthi, charudarshani, Dradapraroha, Gardabhanda, Jati, KamandalrohataruHindi : Kahimal, Kaim, Pakar, Pakri, KhabarMarathi : Bassari, Lendwa, PakariGujarati : Pepri 11Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  28. 28. Drug ReviewTelgu : Badijuwi, Jati, JuvviKannada : Basarigida, Juvvi, Hasuri, Karibasari, Kadubasari, Jeevibasari, BasaBengal : Pakar, PakurEnglish : Wave leaved fig treeTamil : Jovi, Kallal, Kurugatti, KuruguMalayalam : Bakri, Chakkila, Chela, Itti, JathiBengal : Pakar, PakurBombay : Bassari, kaim, pakri, pipliKolami : BaswesaKonkani : KillahKurku : Pepere, pepreLambadi : KatipipriNepal : Safed kabraNorth-west provinces: PakurPunjab : Batbar, Jangli pipliSindhalese : Kalha, KiripellaTulu : Basari goliThana : KelUrdu : PakhariUriya : Pakodo, RushorchonaCan : Juvi, kari 12Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  29. 29. Drug ReviewCLASSIFICATION OF PLAKSHA Plaksha has been mentioned in various Ganas due to its manifold actions bydifferent authors. They have been listed below.Botanical Classification29Kingdom – PlantaeDivision – MagnoliophytaClass – MagnoliopsidaSub class – RosidaeOrder – RosalesFamily – MoraceaeGenus – FicusSpecies – FicusDiagnostic features of Family Moraceae Plant usually trees and shrubs with stipulate leaves; latex present, Inflorescencecymes of small male and female flowers, perianth usually 4 gamo-or polyphyllous,persistent, stamens 4 opposite to tepals; gynoecium bicarpellary, synacarpous, superior,unilocular, fruit nut or drupe.Distribution30 It is commonly called Mulberry family and consists of 53 genera and 1400species. It is distributed in warm temperate, tropical and substropical countries of theworld. In India the family represented by about 104 species belonging to 15 genera. 13Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  30. 30. Drug ReviewVegetative characters:Habit – Mostly trees (Morus, Ficus), shrubs or climbers rarely herbs (Dorstenia), mostlywith lates.Root – Tap root, branched, produce adventitious aerial roots (Ficus sp)Stem – Aerial, erect or climbing, cylindrical solid, branched, woody, gum may be exudedfrom the surface.Leaf – Alternate usually simple, cauline, ramal, in some, stipulate stipules large andleafy, caduceus, entire or deeply lobed, or serrate, glabrous or glaucous, reticulate-unicostate or multicostate.Floral CharactersInflorescence – catkin (Morus) or hypathodium (Ficus) or globose heads(Plecospermum).Flower – Small, inconspicuous, bacteate, or ebracteate, incomplete usually unisexual,monoecious (Ficus, Morus) or dioecious, actinomorphic, hypogynous, clclic. In Ficusfive types of Flowers viz.1. Male with pistillode, 2. Female flower, 3. Male without pistillode, 4. Female with shortstyle, 5. Sterile flowers.2. Perianth – 2 to 6, two in Ficus carica, four in Morus, six in other Ficus spp. Free orunited, inferiou, usually green, persistent, valvate or imbricate in bud; sometimes absent.Male flowersPerianth – As above.Androecium – 1 to 6 in various specied of Ficus, 4 in Morus, bent or straight opposite toperianth leaves, introrse, bithecous, basifixed or dorsifixed. 14Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  31. 31. Drug ReviewGynoecium – Represented by pistillode.Female FlowerPerianth – As aboveAndroecium – AbsentGynoecium – Bicarpellary, syncarpous, superior, unilocular, ovule solitary or two, erector pendulous, style simple or bifid, stigma 1 or 2, linear of filiform.Fruit – Sorosis (Morus), syconus (Ficus) etaerio of achenes or drupes (Maclura), berry(Cudrania).Seed – Endosperimic or non-endospermic.Pollination – Entomophilous or anemophilousFicus exhibits extraordinary way of pollination. The insects enter the hypanthodiumthrough apical opening to lay eggs in the ovaries of sterile flowers (or gall flowers). Theinsects cannot lay eggs in the ovaries of fertile female flowers as they are covered byhairs. The bodies of insects get dusted with pollen from the male flowers, then they enteranother hypanthodium and so come in contact with the papillose long styles of the fertilefemale flowers, in this way cross pollination is ensured.Flower formulae:Male flower –  0 P2-6 or (4) A1-6 or 3-8 G0 or pistillode.Female flower –  0 P2-6 or (4) or zero A0 G(2).Botanical DescriptionFicus lacor - A large spreading deciduous fast growing tree, all parts glabrous; barkgrey, smooth, scaly. 15Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  32. 32. Drug ReviewLeaves – membranous, 9-12.5 by 5-6.3cm. ovate or ovate-oblong, shortly and ratherabruptly acuminate, with entire, subundulate margins.Base – Usually rounded, slightly cordate, or sometimes narrowed or acute, 3-nerved;lateral main nerves 5-7 not very prominent.Petioles – 3.8 – 5.7 cm. long, some times indistinctly jointed with the blade;Stipules – about 13mm long, broadly ovate, acute, pubescent.Receptacles – axillary in pairs, sessile, globose, 6mm diam, whitish, flushed with red anddotted, when ripe; basal bracts, ovate- round, minute.Male flowers - few, bracte sessile near the mouth of the receptacles.Stamen1; another broadly ovate; Filament short. Sepals 4 or 5, Gall and fertile flowers;perianth as in the Male. Style of fertile female flowers long, of the gall folwers short;stigma elongate.Distribution: Plains and lower hills of India, Ceylon- Malaya.Pharmacognosy of Plaksha (Stem Bark)31 a) Macroscopic – Bark rough, occurring in flat to curved, quilled pieces, measuring 0.4-0.7 cm in thickness; external surface ash or whitish-grey; numerous transversely arranged lenticels; ranging from 0.1 cm – 1.3 cm in length, lip- shaped and exfoliating; internal surface rough, fibrous, longitudinally striated, reddish-brown; fracture, fibrous. b) Microscopic – Shows 5-8 layered cork consisting of thin-walled, rectangular cells, a few external layers exfoliating; secondary cortex very wide consisting of compactly arranged, rectangular, thick-walled, pitted cells, patches of circular to elongated, lignified, elliptical stone cells with radiating canals, a few with 16Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  33. 33. Drug Review concentric striations; a few prismatic crystals of calcium oxalate and reddish- brown contents found scattered throughout the secondary cortex; secondary phloem very wide consisting of mostly stratified layers of collapsed cells forming ceratenchyma, groups of fibres, phloem parenchyma, laticiferous cells, traversed by 2-5 seriate phloem rays; phloem fibres lingnified with wide lumen and pointed tips; thin-walled, rectangular, a few phloem parenchyma containing prismatic crystals of calcium oxalate. c) Powder – Reddish-brown; shows thick-walled parenchyma with simple pits; stone cells in groups and singles, prismatic crystals of calcium oxalate, elongated phloem fibres with wide lumen and pointed tips.Identity, Purity and StrengthForeign matter - Not more than 1 percentTotal ash - Not more than 10 percentAcid-insoluble ash - Not more than 1.5 percentAlcohol-soluble extractive- Not more than 5 percentWater-soluble extractive - Not more than 6 percentPharmacognosy of Plaksa (Fruit)32 a) Macroscopic: Fruit is a syconus, 0.5 to 1.0 in dia, attached with pedicel; sub- globose, wrinkled, glabrous, having three basal bracts; grayish- borown to yellowish-brown; taste, astringent. b) Microscopic: Fruits shows single layered, thin-walled epidermis followed by a narrow zone of 2 to 5 layers, of round, oval, rectangular, lignified stone cells with wide lumen; rest of mesocarp very wide consisting of oval to polygonal, 17Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  34. 34. Drug Review collenchymatous cells containing brownish contents; a few vascular traces found scattered in this zone; inner zone consisting of stone cells similar in shape and size to these found scattered in outer zone; male and female flower attached to inner of mesocarp. c) Powder – Dark grayish-brown; shows fragments of epidermal cells; single, or groups of lignified stone cells; collenchymatous cells; a few debris of male and female flowers present.Identity Purity and StrengthForeign matter - Not more than 2 percentTotal ash - Not more than 9 percentAcid-insoluble ash - Not more than 1 percentAlcohol-soluble extractive - Not more than 5 percentWater-soluble extractive - Not more than 15 percentTLC TLC of alcoholic extract on Silica Gel ‘G’ using n-Butanol: Acetic Acid: Water(4:1:5) shows in visible light three spots at Rf. 0.27, 0.63 (both grey) and 0.97 (yellowishgreen). Under UV (366 nm) six fluorescent zones are visible at Rf. 0.53, 0.63, 0.84, 0.91,(all blue) and 0.97 (pink). On exposure to Iodine vapour twelve spots appear at Rf. 0.12,0.16, 0.22, 0.27, 0.50, 0.63, 0.73, 0.84, 0.91, 0.94 and 0.97 (all yellow). On spraying withNinhydrin reagent a single spot appears at Rf. 0.97 (brick red).Constituents – Amino Acids 18Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  35. 35. Drug ReviewVARIETIES OF PLAKSHA:According to Bhavaprakasha Nighantu331. Jangala2. GramyaAccording to P.V. Sharma34Three varieties – 1) Var, infectoria 2) Var, lambertiana 3) Var, weightiana 4) Ficus lacor,Other species35 - 1) Ficus arnottiana 2) Ficus rumphii, Blume 3) Ficus talboti. G 4) Ficus retusa, Ficus microcrapa syn, Firetusa acuct 5) Ficus tsiela Roxb 6) Ficus tsjakela Burm f.Table No. 1.3 GUNAS (PROPERTIES) ACCORDING TO DIFFERENTAUTHORS.Properties BN36 DN37 MN38 RN39 KN40 NA41 SN42 P.V. Sharma43RasaKashaya + + + + + + +Katu - + + - + + -GunaSheeta + + + + + + + -Guru - - - - - - - +Ruksha - - - - - - - +VeeryaSheeta + + + + + + +Vipaka 19Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  36. 36. Drug ReviewKatu + + + + + + +DoshaghnataKaphahara + - + - + + - +Pittahara + + + + + + + +Phytochemistry: Stem bark44 – contains methyl ricinolate, caffeic acid, bergenin,lanosteral and B- sita sterol, sterols, sugar, Tannin, Alkaloid and saponin.(Carbohydrates, glycosides, Proteins, amino acids)Leaves – contain the flavonoids, scrbifolin -6-0- (arabinopyranosy 1- (1-2) – B-Dglucopyranoside) [(C27 H30O15, mp 340-420) and scutellarein 6-0B-glucoside.Fruit – Amino AcidsTannins45 – They have been known as astringents substances, having capacity tocombine with tissue proteins and precipitate them. They are used as antiseptics, in thetreatment of diarrhea, to check small haemorrhages. Tannin detoxifies the fungal infections, acts as tonic. They are agents whichcontract muscular fibers and control the abnormal secretions of mucous membranes.Tannins are soluable in water.Table No. 1.4 KARMAS ACCORDING TO DIFFERENT AUTHORSKarmas CS46 SS47 AH48 BP49 DN50 RN51 KN52 NA53 DG. 54 M P.V.56 HMK N55 SharmaVrana ropaka + + + + + + +Yonigata roga + + + + + + +Rakta vikara + + + + + + +Grahi + + +Shotahara + + + + +Vrana + + +prakshalana 20Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  37. 37. Drug ReviewMedahara +Visarpa + +Murcha + +Bhrma + +Pralapa + +Shamaka +Sthambhana + + +Mutrasangrah + + +aniyaSangrahaka + +Vistambakara +kaKaphapitta + + + + +NashakaDahaPrashananaRaktashodhanaStanya +Shonita +stapanaVarnya +Garbhashaya +shothaharaMukha +rogahara 21Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  38. 38. Drug ReviewTable No. 1.5 PRAYOJYA ANGAParts used P.V.57 RN58 BN59 NA60 Indian D.G.V Sharma material61 M.G62Bark + + + + + +Leaves - - - + + -Fruit - + - - - -Table No. 1.6 PRAYOGA ACCORDING TO DIFFERENT AUTHORSPrayoga CS63 SS64 AH65 B K R M D N D.G D.G. D.G74 P N67 N68 N69 N70 A71 P.V.S72 J.L. V.M.G 73 N 66 NShotha + + - + + + +Vrana + + + + + + +Rakta vikara + + + + +Visarpa + + + + +Raktapitta + + + + + +Raktapradara + + +Shwetapradara + +Prameha + +Atisara blood + + + +Pravahika + +Yonisrava + +Yoniroga + + +Daha + + + + + +Astanya +Stomatitis +Jvara + +Vidradi 22Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  39. 39. Drug ReviewPrayoga75: All parts are acrid, pungent, cooling; useful in diseases of the blood and thevagina, ulcers, burning sensations, biliousness, “kapha” inflammations, leprosy,hallucinations, loss of consciousness. The fruit is sour; the seeds are useful in bronchitis, biliousness, scabies, boils,inflammation. The bark of this, along with the barks of other four species of ficus and of meliaazadirachta, pass by the name of panchavalkala. They are used in combination. Adecoction is much employed as a gargle in salivation, as a wash for ulcers, and as aninjection in leucorrhoea. Nighantu describes this tree as cooling, pungent astringent and curative of Raktadosha, moorcha srama and pralapa. Bark enters the composition of Panchavalkala decoction of the bark is used asgargle in salivation; as a wash for ulcers and also as an injection in leucorrhoea. This alsocures yonidosha charaka prescribes a varti or suppository made with the pulversised barkto be inserted into the vagina in case of yoni-srava. As a vegetable, the leaves can beeaten as they are, by those who suffers from Raktapitta.Table No. 1.7 Matra (Posology) D.G. D.G. D.G. Indian Charak80 P.V.S76 HMK77 V.M. Gogte78 material79Powder - 3-5 gm -Decoction 50-100 ml 40-50 ml 50-100 ml 23Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  40. 40. Drug ReviewTherapeutic uses81Charaka – Erysipelas – cold paste of the tender leaves and bark mixed with profuse gheeshould be applied (cs.ci. 21.85)Charaka – Meno metrorrhagia – Lump of powdered bark of plaksha mixed with honeyshould be kept in lubricated vagina. (cs.chi. 30,119)Charaka – Inflammation – paste of bark of above drugs mixed with ghee form anexcellent anti-inflammatory agent (cs.ci. 25, 46)Sushrut – Diarrhoea with blood – Barks of plash sallaki and tinisa are pounded withmilk, mixed with honey and then taken (ss.u. 40.119)Bhavaprakasha – Intrinsic haemorrhage tender leaves of Plaksha vetasa etc andtanduliya etc are wholesome as vegetable (B.P. Ci. 9,18)Uses in othersystem of medicine In Chinese medicine bark diaphoreticTable No.1.8. USE OF PLAKSHA IN DIFFERENT YOGASS.L.No Yoga Indication Reference1 Changeri ghrita Raktarsha Bhel,sa 16/39/4012 Vranashodhana kashaya Vrana Bhel, sa 27/10/467-4683 Nyagrodhadhya ghrita Pradara, shweta, rakta, Bhai. R 93/2036-2037 Krishna, shrava, yonishrava4 Vatadi lepa Shotha C.S.Chi. 25/46/7055 Nyagrodhadi lepa Vrana C.S. Chi 25/63/7076 Panchavalkala churna Vrana C.S. Chi. 25/67/7057 Vrana shodhaka kashaya Vrana prakshalana C.S. Chi. 25/84/710 24Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  41. 41. Drug Review8 Nyagrodhadi ropanha kwatha Vrana ropanartha C.S.Chi 25/87/7209 Nyagrodhadi kashaya Vrana C.S. Chi. 30/84/85110 Nygrodhadi pralepa Vrana C.S.Chi. 30/46/811 Panchavalkalamr lepa Abhighataja Y.R.U 6/163/164 mutrakricchra, vataja mutrakrucchra12 Shatadhouta ghrita Raktaja vrana shotha Y.R. Chi 6/163/164 lepartha13 Nyagrodhadi kwatha Vrana shotha Y.R. Chi. 8/17614 Panchavalkaladi yoga Puya vrana Y.R. 10/17615 Gouradhya ghrita Vrana, sahaja, purana Y.R Chi. 1-4/183 nadi, vishama vrana16 Baladi taila Sadhya vrana ropana S.S. Chi 2/53/1917 Decoction of plaksha bark Stomatitis, Ulcer I.M.M. P 55118 Inj of Plakshatwak kashaya Leucorrhoea yonidosha I.M.M. P55119 Varti of pulversed plaksha Yoni srava I.M.M 551 bark20 Vaginal suppository of Menorrhagia A.Ph. logy P.659 plaksha bark powder leucorrhoea21 Vaginal douche of plaksha Menorrhagia A.Phology P 659 kashaya leucorrhoea22 Plaksha twak churna Yonisrava C. S. Chi 36/11623 Plaksha twak kwatha Vranaropanartha C. S. Chi. 13/85 25Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  42. 42. Drug Review24 Nyagrodhadi lepa Shotha Vr. Ma IInd vol 44/7 P- 57325 Preprn of ile & aintment Ulcers A.D. plant sources P- 37726 Usirasava Ulcers A.D. plant sources P- 37727 Gandhatailam Ulcers A.D. plant sources P- 37728 Nalpamaradi tailm Ulcers A.D. plant sources P- 37729 Dinesavalyadi Kulambu Ulcers A.D. plant sources P- 37730 Parantyadi taila Ulcers A.D. plant sources P- 37731 Valiya marma gulika Ulcers A.D. plant sources P- 377Research Profile821) Plaksha as anti inflammatory- Ficus lacor was studied experimentally for anti-inflammatory activity in caraginin induced paw edema. This showed a good result.However, in the classics it used or external application alone. Only two formulationshave reference for this drug to be one of the ingredients keeping this in mind anotherstudy was carried out though topical application of Plaksha kashaya in ear edema in rats 26Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  43. 43. Drug Reviewinduced by croton seed oil. This method of application of this was 5 minutes parisheka(pouring in thin a stream of kashaya) in 1 hour and repetition of the same in every hourfor four hours. This was sufficient to produce significant anti-inflammatory effect. Thisstudy proved the drug to be having highly significant effect both as internal and topicalapplication.2) The caloric values and ash content in the leaves at different growth stages of five Ficusspecies (Ficus religiosa, F elastica, F. lacor, F. Microcarpa cv Golden-leaves, Fmicrocarpa) were studied. The results showed that the ash content increased with thegrowth of the leaves, the relatively high ash contents of old leaves were not the lowest,which indicates that the leaves have a mechanism to maintain the balance of nutritiouselements. The young leaves have relatively higher gross caloric value than mature andold leaves, gross caloric value in the leaves at different development stages vary withspecies. The gross caloric values in the leaves at different development stages havedistinct liner correlation with ash contents. The ash-free caloric values in the leaves at thedifferent development stages also vary with species.3) Tanin stimulates the uterus. In prolonged and frequent uterine bleeding is suggested inall cases of uterine bleeding. It is reported to have stimulant effects on the endometriumand ovarian tissue, and useful in menorrhagia.4) Reported as even infected with trichomanas vaginalis were also cured. Cervicalerosion cases showed healing of erosions. 27Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  44. 44. Drug Review ANUPANAMadhu83,84 UeÉlÉÏcÉÔhÉïqÉkÉÑMüqÉç kÉȨ́ÉTüsÉUxÉlÉiÉÑ cÉiÉÑmÉëMüÉU mÉëSUqÉç lÉzÉrÉåiÉ lÉ xÉÇzÉrÉÈ | Harudra powder, madhu (honey), amalaki, swarasa are supposed to be bestvehicles or anupanas for pradara roga.The role of Mahdu: MüwÉÉrÉlÉÑUxÉÇ Ã¤É zÉÏiÉsÉÇ qÉkÉÑU qÉkÉÑ | SÏmÉlÉÇ sÉåZÉlÉÇ oÉsrÉ uÉëzÉÉåkÉlÉUÉåmÉhÉqÉç | xÉÇkÉÉlÉÇ sÉbÉÑ cɤÉÑwrÉ xuÉjÉïqÉç ¾û±Ç ̧ÉSÉåwÉlÉÑiÉç || Madhu is astringent in anurasa, unctuous cooling, sweet, digestive stimulant,lekhana and strength promoting. It cleans and heals ulcers and helps in joining offractured bones, It is light promoter of eye sight and good voice, cardiac tonic andalleviant of all the doshas.Synonyms: Madhu Makshika, Madhvika, Kshaudra, Saragh, Makshikavanta,Varativanta, Bringa vanta, Pushpa, Rasobhava.Vernacular Name:Kannada : Jenu tuppaEnglish : HoneyHindi : ShahadMarathi : MadhuTamil : TeniBangali : Madhu 28Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  45. 45. Drug ReviewGujarathi : MadhuPharmacological Properties:Rasa : Madhura, KashayaGuna : Guru, RukshaVeerya : SheetaVipaka : MadhuraPrabhava : YogavahiDoshagnata : TridoshaPhysical Properties: Honey is thick, Semitranslucent liquid of yellowish brown clour of aromaticodour. After some times it becomes opaque and crystalline.Chemical Composition : The sugars in honey, fructose, glucose and maltose followed by lowerconcentration of sucrose and maltose. The average composition of honey is as follows.Moisture - 17.1% Calcium - 5mgProtein - 0.2% Phosphorous - 16mgMinerals - 0.2% Iron - 0.9mgCarbohydrates - 74% Vitamin C - 4mgNava Madhu: Navamadhu i.e freshly collected madhu is nourishing. It does not alleviate kaphain excess. 29Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  46. 46. Drug ReviewPurana Madhu: Bhava mishra says, purana means after one year (Samvastra) Madhu becomespurana i.e old. Purana Madhu in general, cures meda and sthaulya. It is grahi, Ruksha andexceedingly depleting one.Table No.1.9. SHOWING PHARMACOLOGICAL ACTION OF MADHUS.L.No Pharmacological Ch.s Sus. V. B.P R.N D.N P.N action1. Balya - + - - + + +2 Chedana + - + - - - -3 Chakshyashya - + + + - + +4 Deepana - - - + - + +5 Hridya - - - + - + -6 Lekhana - - - + - + +7 Medo hara - + - - + - +8 Ropona - + + + - + +9 Sandhana - + + - + + -10 Swarya - - - + + + -11 Srotashodhaka - + - + - - -12 Sangrahi - + - + - + -13 Varnya - + - + - - -14 Vajeekar - - - + - - -15 Medhya - - - + - - - 30Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  47. 47. Drug Review MODERN PHARMACOGNOSY OF HONEY85Synonyms – Madhu, honey, purified, melBiological surce – Honey is a sugar secretion deposited in honey comb by the bees, Apismellifera, Apis dorsata, belonging to family Apidae, order Hymenoptera.Geographical source – Honey is produced in Africa, Australia, New zeland, Californiaand India.Preparation for market – Honey is extracted from the comb by centrifugation. It must befree from foreign bodies Honey is liable to fermentation, unless it is suitable processed.Honey is heated to 800C before it sent to the market cooled rapidly. Filtered throughflannel.Description – Colour – Pale yellow to yellowish brown Odour – Characteristic, pleasant Taste – Sweet and faintly acid.Standards – Weight per ml – 1.35 to 1.35g Specific rotation - +300 to - 100 Total ash – 0.1 to 0.8% It is syrupy thick liquid, translucent when fresh onkeeping it becomes opadue and glanular due to the crystallization of glucose.Chemical constituents – Gulcose 35% ( 3%) Fructose 45% ( 5%) Sucrose 25% Uther constituent maltose, gum, traces of succinic acid, acetic acid, dextrin,formic acid, enzymes, vitamins Adulteration – Artificial invert sugar, an adulterant ofhoney contains furfural – detected by fiechel’s test gives instant red colour withresorcinol in hydrocholoric acid.Uses – 1) Used as demulcent and sweeting agent 2) Good nutrient to patients. 31Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  48. 48. Drug Review 3) It is antiseptic and applied to wounds.Exploration – 1) India is only exploited 10% of its honey potential. 2) India is producing 11000 tones of honey per annum 3) Per capital consumption of honey in India only 8.0gms while in Germany is 1800gms. 32Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  49. 49. Disease Review DISEASE REVIEWHistorical Review This Indian system of medicine has got a vast history based on veda, upaveda,purana etc which are dealt as under. Veda kala (2500 BC – 100 BC) Samhita kala (1000BC – 100AD) Sangraha kala (800AD – 1600AD) Adhunika kala (1600AD –onward) Atharva veda is regarded to be the authentic source of Ayurveda, given fewreferences pertaining to pradara but no reference available regarding shvetapradara. Inveda there is a mentioning of krimis, which cause the injury to uterus through vagina.The word “Asrava” has been mentioned which mean to flow, to flow, to move, in vedathere is a mentioning of Krimis, which (A.V. 44.3) cause the injury to uterus throughvagina.SAMHITA PERIOD Samhita period is said to be the scientific era of medicine in India.  CHARAKA SAMHITA (400BC-500BC): Indetail description of yoni vyapat is described in chikitsasthana 30th chapter. In the context of chikitsa he mentioned about pandure-asragdare (C.Ci. 30/119)86  SUSHRUTA SAMHITA (800BC-700BC): He explained the yoni rogas in chapter yonivyapatpratishedhadhyaya. No specific reference are available regarding shevetapradara (SU.U. 38 chapter)87  ASTANGA SANGRAHA (400AD): He explained the yonirogas in chapter guhyarogavignaniyadhyaya specific reference of shwetapradara is mentioned but 33Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  50. 50. Disease Review in chikitsa he mentioned about “site shukle asrakdhare” is shwetapradara (A.S.U. 39/123)88  ASTANGA HURDAYA (500AD): He explained yonirogas in Guhyaroga vignaniya adhyaya. No specific reference of shwetapradara available, but he mentioned pandu srava for yoni in kaphaja yoni Lakshana. (A.H.U. 33/44)89  MADHAVA NIDANA (800AD): He mentioned the Pandu srava in kaphaja asragdara lakshana, no specific reference is available regarding shweta pradara. (M.N. II 61/3)90  CHAKRAPANI (1100AD); Chakrapani clearly mentioned the Lakshana and chikitsa of shwetapradara. He mentioned pandusrava from yoni is shwetapradara and in chikitsa kashaya dravyas are used. (Chakrapani coments on C.Ci. 30/119)91  SHARANGADHARA SAMHITA (1300AD): Specific reference are not available but he mentioned the yoni rogas and shwetapradara chikitsa. (Sr.S.P.K. 7/177 and M.K. 2/110&114)92  BHAVAPRAKASHA (500AD): There is a detail explanation of pradara under streerogaadhikara and pandu srava is mentioned in kaphaja pradara and chikitsa of shweta pradara along with all types of pradara is also explained. (B.P.M.K.streerogadhikara)93  YOGARATNAKARA (1600 AD): Detail explaination of pradar, in that pandu srava is mentoned in kaphaja pradara. In chikitsa also he indicated shweta pradara chikitsa while explaining all types of pradara chikitsa. (Y.R.Streerogadhikara)94 34Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  51. 51. Disease Review  BHAISHAJYARATNAVALI (1600 AD): The author explained the shweta pradara chikitsa in detail. (B.R.Pradararoga chikitsa prakarana)95.  NIRUKTHI AND PRATHIBHASHA: The term “SHWETA PRADARA” is formed by union of two words, shweta and pradara. They can be derived in following way.  Shwitt+Acch The word shweta is formed by ‘shwit’ dhatu.  Shwetate iti / Rupyaml Shweta is the varna resembles to Roupya  Shwetate its / shwita shouklo + pachadach/shukla Shweta is varna which resembles shukla varna and also kshira, Dadhi, Roupya are different substances which resembles the shweta varna. (S.K.D)96  Shweta-white (San-eng dictionary)PRADARA  Pra + Dru Vidarane + Rudaram (S.K.D)97 This term pradara is formed by “pradhatu and indicates vidarana.  Vidarana (Samskrit-kan-dictionary) The term vidara means srava  Tannamaka srouraktadisravaroge | Rajaha pradeeryate yasmat Pradarastena sa smratana. | Pradara is a roga in which raktadi srava is occur and depending upon the srava the name comes along with pradara. Narou Rugbhedah iti medinou || It is a rogabeda of nari (women) 35Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  52. 52. Disease Review Asya Namantaram asragadara || Tattu phalitayonya Raktadidhatu ksharanam || The raktadi dhatu ksharana from yoni is pradara (S.K.D)98 Pradara: Rending, Tearing, A kind of disease of women | (San-eng dictionary) Rajah pradeeryate yasmat pradarastena sa smrutah || (C.Chi. 30/209)99 Due to Pradirana (excessive excretion of raja, it is named as pradara.SHWETA PRADARA: The word shwetapradara is not mentioned as an independent disease in greatyonirogas, specially kaphaja yoni rogas as “yonigata shweta picchila srava”.………….. MüTüÉåÅÍpÉwrÉÇÌSÍpÉuÉ×kkÉÈ………….. xÉÑMÑüjÉïiÉç ÌmÉΊsÉ zÉÏiÉsÉÉ MühQÒûaÉëxiÉÅsmÉuÉåSlÉÉqÉç………….. mÉÉÇQÒûuÉhÉï iÉjÉÉ mÉÉhQÒûÌmÉÎcNûsÉÉiÉïuÉuÉÉÌWûlÉÏqÉç || (cÉ.ÍcÉ. 30/13)100 Commenting on this chakrapani quotes that mÉëSU ÌuÉÍzɹ AjÉÉåï pÉuÉÌiÉ mÉÉÇhQÒûUå mÉëSUÍqÉÌiÉ μÉåiÉmÉëSU | cÉ.ÍcÉ. 30/223101 Here pradara referes to both asrugdhara and kaphajasrava. But chakrapani in his commentary has used the term shwetapradara for pandura ashrugdhara. In the same chapter at 116 shloka charaka quotes UÉåÌWûiÉMüÉiqÉÔsÉMüsMÇü mÉÉÇhQÒûUåÅxÉ×akÉUå ÌmÉoÉåiÉç || (cÉ.ÍcÉ. 30/116)102 Where pandura ashrugdhara refers to shweta pradara Sharangadhara, bhavaprakasha,Yogaratnakara have used the word shwetapradara for white vaginal discharge. 36Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  53. 53. Disease Review Like this shwetapradara is described as cordinal symptom in so many yonirogas.Some times this symptom is so severe that it over shadows the symptom of actual diseaseand woman come for the treatment of only this shwetapradara. Probably due to thisreasons charaka, vagbhata etc have not mentioned shweta pradara as disease but haveprescribed only symptomatic treatment. Hence a consolidated aspect of other yonirogasshould be taken into consideration to study the Nidana roopa, samprapti etc. Among the yonirogas slesmala yonivyapat sannipataja yonivyapat, vipluta yoniyapadaticharana yonivyapad and acharana yonivyapad represents shwetapradara with theirspecific features. Other reasons to consider the shwetapradara under yonirogas is, CjjÉæiÉæsÉï¤hÉæÈ mÉëÉå£üÉ ÌuÉÇzÉÉÌiÉjÉæÌlÉeÉÉaÉSÉÈ iÉzÉÑ¢ükÉÉUcÉirÉÉåÍpÉSÉæwÉærÉÉåÌlÉÃmÉSìuÉiÉÉ | aÉÑsqÉ AÉzÉï mÉëSUÉSÉïYcÉ uÉÉiÉÉkÉæYcÉÉÌiÉmÉÏQûlÉqÉç || 103 While explaining the upadrvas of yonirogas pradara is one among them. Another reason is in the same chapter at the end of the yonivyapath rogas, UÉåÌWûiÉMüÉiqÉÔsÉYsÉMÇü mÉÉhQÒûUåÅxÉ×akÉUå ÌmÉoÉåiÉç || 104 Shwetapradara is related to arthavaha srothas, susrutha quotes that, AÉiÉïuÉhWåû ²å iÉrÉÉåqÉÔïsÉÇ aÉpÉÉïzÉrÉ AÉiÉïuÉuÉÉÌWûlrÉ Arthava vahini is two in number having roots in garbhashaya and arthavavahasrothas. Injury to these srotas leads to vandhyathva,maithuna asahishnutha andarthavanasha. This reveals anatomical stucters and physiological importance ofarthavaha srotas. The main root of arthavavahaa srotas is garbhashaya which refers to 37Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  54. 54. Disease Reviewuterine cavity, and atrthavavahini refers to to yoni,fallopian tubes and ovarian gland.Hence detail knowledge about these structures is necessary to know the diseaseshwetapradara.YONIDerivation: The word yoni is derived from the Sanskrit root YU (Amarakosh) YU means joinor unite, which is suffixed with NI to form the word yoni. Thus the literal meaning of theword yoni is a place of contact or union.Synonyms of Yoni Bhagam, Varangam, Upasthah, samara mandiram, madanalayah, rati kuharum,rati graham, rati, mandiram, janma vartanum, adharam, prakritih, apatham, samara kupah,ratyanga, pushpa pathah. Utpatti sthana, pushpin, samsarmargaka, samsar, marga, guhyam, adhah. The dictionary meaning of yoni is wombs, uterus, vulva, the female organs ofgeneration any place of birth or origin, generating cause, spring. Vagbhata while describing the specific muscles of woman used the word yoni todenotes the entire reproductive system. Maharshi sushruta and vagbhat while giving thereasons for conception occurring only during rtu kala have used the word yoni to donoteuterus and cervical canal. ûrÉÉåÌlÉxiÉÑ zÉUuÉlÉÉprÉÉM×üÌiÉUrÉÉxiÉÉuÉiÉÉï | iÉxrÉ iÉ×iÉÏrÉ AÉuÉiÉåï ÌmɨÉmÉYuÉzÉÉrÉÉ UÉåÌWûiÉqÉixrÉqÉÑZÉMüÉUÉ aÉpÉÉïzÉÉrÉrÉÉ iÉxrÉ zÉÑ¢üÉiÉïuÉmÉëuÉåzÉÏlrÉÉx§ÉÏx§É mÉåzÉrÉ || A.xÉÇ.AÉ 5/116105 38Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  55. 55. Disease Review The shape of yoni resembles shankha nabhi is hallow portion of conch shell andhas three avruthas. The garbhashaya is attached to third avrutha. In yoni, there are threnadis- samirana, chandramasi and gowri. At clitoris is mainly samirana shukra falling onit becomes fertile. The woman having mainly chandramasi is easily satisfied with clitorisand delivers female children sexual satisfaction to women possessing gowri nadi inupasthagrabha (deepen part of vaginal cannel is attached with difficulty and she deliversusually male children. The word yoni in ayurveda classics refers to whole reproductivesystem of woman starting from the valva to the ovaries as well as supporting strugtures.2. Garbhashaya: Garbhashaya as the word is combination of two words. Garbha+Ashaya, Garbha resides in this ashaya so it is called as Garbhashayawomen possess one extra ashaya known as Garbhashaya. Which is situated in the thirdavarta of the yoni, in between pittasaya and pakwashaya, behind the bladder.x§ÉÏhÉÉÇ aÉpÉïzÉrÉÉåŹÍqÉÌiÉ ÌmɨÉmÉMüuÉÉzÉrÉÉåqÉïkcÉå aÉpÉïzÉrrÉÉ rÉ§É aÉpÉÉïÎxiɹÌiÉ || xÉÑ.zÉÉ. 5/32106rÉjÉÉ UÉåÌWûiÉqÉxirÉ qÉÑZÉÇ pÉuÉÌiÉ ÃmÉiÉÈ || xÉÑ.zÉÉ. 5/44107 In shape it resembles the mouth of rohita fish. Acharya kashayapa has described it is in between the vipula kundala of srotas(multiple coils of intestine) covered with jarayu (peritoneum) It resembles to the mouthof the rohita a fish Acharya Dalhana explains that the resembalance to the mouth ofRohita fish is to denote the internal structures of the uterus. Acharya Bhava mishraexplains identically to that of sushruta. 39Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  56. 56. Disease Review3. Artava:Derivation: Artavam is derived from the root word Rutu.“Rutuhu asya prapthah”Who has got rutu i.e period, suffixed with Ann. Artava is formed, means stree beeja orpushpa.Defination: The rakta gets collected inside the Garbhashaya and flows out for three daysevery month, this is known as artava. Artava, which is agneya, has characterstics of rakta, forms garbha and is essentialfor life. The dominant mahabhoota is tejas. Its pramana is 4 anjalis. The period of about12 days from the commencement of menstruation which is most suitable period forconception is termed as rutukala. Artava is slightly black. Is also called as Rajah, which is produced from theRasadhatu itself.Table No-2.1. Swaroopa of Shudha Artava108Swaroopa Cha.Sam Su. Sam As. S As. Hri Bha. PraGunja phala varna + - - - -Padma lakta + - - - -Indra gopa + - - - -Shasa asrak - + + + +Laksha rasa - + + + -Nishpicchila + - - - +Na daha + - - - +Na arthi + - - - +Dautam cha - + + + -Virajyayate + - - - -Na ati bahu + - - - -Na ati alpa + - - - - 40Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  57. 57. Disease ReviewVRIDHI, KSHAYA, LAKSHAN OF ARTAVA: 1) Vridhi: Anga marda (Body ache) Artava ati pravriti (increased flow of artava) Daurgandhya (Bad smell) 2) Kshaya: Yathochita kala adarshana (Tringular menstruation) Alpata (Scanty flow) yonivedana (Pain in the vagina)Table No-2.2. Showing the Nidana of Shweta pradaraNidana Cha.S Su. S As. S As. Hri Bha. Pra MN Yog.rMithyachara + + + + + + +a) Mithyaharab) Mithy viharaArtava Dusthi + + + + + + +Beeja Dosha + + + + + + +Daiva + + + + + + +Pravridha - + + + - - -linga purushaatisevanaRuksha - + + + - - -Durbala BalaApadravya - - + + - - -PrayogaManasika - - + + - - -Garavisha - - + + - - -Specific shvetapradara nidana is not mentioned in classical literature. General pradaranidana is mentioned as follows. Lavana, Amla, Katurasa, Vidahi, Guru, Snigda Mamsa of gramya, Oudaka, Medya Krashara, Payasa, Dadhi, shukta, mastu, sura Virudhahara, adhayashana, madhyapana Garbhapata, Atimithuna, Yana, Ajirna, Adwa 41Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
  58. 58. Disease Review Bharavahana, Abhigata, Divashayana Among the above nidana the aharajanya nidana will vitiates rakta, it’s amount willincreased and reach shleshmadhara kala of artavavaha srotas, vitiates stanika kapha andvata, result in shvetapradara. The viharajanya causes are vitiates vata and increases amount of rakta and resultin shvetapradara Apadravya will vitiates sthanika vata & kapha result in shveta pradara.Some other causative factors of shvetapradara are as follows:Yoni adhavana Ativyavaya AbhigataUnhygenic condition Chills Guru aharaRaktalpata Oily substances Ati katu rasa sevanaDurbalata Ati ushna ahara ShalyaKrimi Malabaddhata Ati nidraGarbhapata Nagnayoni ChintaAti prasava Malnutrition Krodha Constant cold water bath specially during rutukala constant working in water orwearing wet under garments, unsatisfied married life, contraceptives.Table No. 2.3. The yoni rogas in which the shweta srava is considered as a symptomS.No Name of Yoni vyapata Predominarncy of dosha1. Shleshmala yoni vyapata Kaphaja2. Tridoshaja yoni vyapata Tridoshaja3. Acharana Yoni vyapata Vataja (Cha) Kaphaja (Su)4. Atichurna Yoni vyapata Vataja (Cha) Kaphaja (Su)5. Upapluta Yoni vyapata Vata, kapha (cha)6. Vipluta Yoni vyapata Vataja (Su)Purva Roopa In Ayurvedic classics it is observed that purva roopa is explained as samanya i.ewhich predicts the on coming disease but also specifies the doshic sub type of particularon coming disease. 42Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.

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