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EVALUATION OF THE EFFICACY OF NIMBARAGWADDHI YOGA AND ...

EVALUATION OF THE EFFICACY OF NIMBARAGWADDHI YOGA AND
JATHIPHALADHI LEPA IN YUVANA PIDAKA, BY V A N I T H A R, Department of Kayachikitsa, Post graduate studies and research center D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, Gadag - 582 103

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    Yavanopidika kc025 gdg Yavanopidika kc025 gdg Document Transcript

    • EVALUATION OF THE EFFICACY OF NIMBARAGWADDHI YOGA AND JATHIPHALADHI LEPA IN YUVANA PIDAKA BY VANITHA R As partial fulfillment of post graduation Degree M.D. (Ayurveda Vachaspati) Under Rajiv Gandhi University of Health Sciences, Bangalore, Karnata. Guide Prof. Dr. Vageepuram Varadhachryalu M.D (Ayu) Professor and head of the department Post graduation and research center Kayachikits. D.G Melmalagi Ayurvedic Medical College Gadag – 582 103 Post Graduation and research center Kayachikitsa 2004
    • J.S.V.V. SAMSTHE’S SHREE AYURVEDIC MECIAL COLLEGE & POSTGRADUVATION AND RESEARCH CENTRE GADAG, 582 103 Certificate This is to certify that R. Vanitha has worked for her thesis on the topic entitled“Evaluation of the efficacy of Nimbaragwadadhi Yoga and jathiphalathi Lepa in YuvanaPidaka. She has successfully done the work under the guidance of Dr.V. VaradacharyuluM.D(Ayu). I here with forward this thesis for the evaluation and adjudication.(Dr. V. Varada Charyulu) (Dr. G.B. Patil) Principal
    • Certificate This is to certify that the thesis entitled “Evaluation of the efficacy ofnimbragwadadhiyoga and Jathi phaladhi lepa in Yuvana Pidaka” is a record ofresearch work conducated by R. Vanitha, under my direct supervision and guidance. The candidate has put is sincere effort after making an intense study coupled withtheoretical and clinical observations. This title has not formed title of degree, associate ship, fellowship and similarother studies in this University. I recommend and same for being submitted for evaluation to the adjudicators. Guide Dr. Varadacharyulu Vangeepuram M.D (Ayu), Gold medallist,Date: Professor and Head of department,Place: Postgraduate studies and research center, Kayachikitsa, D.G. Melmalagi Ayurvedic Medical College, Gadag – 582 103.
    • ACKNOWLEDGEMENT I express my deep sense of gratitude to my respected guide prof. Dr.V.Varadhacharyulu M.D. (Ayu) Head of Department of Kayachikitsa, D.G.M. AyurvedicMedical College and Post Graduate Studies and Research Center, Gadag. He has beenvery kind to guide me in the preparation of thesis and for whose extraordinary efforts,tremendous encouragement and valuable thought provoking advise me to complete thisthesis. I am extremely thankful to Dr. G.B. Patil principal D.G.M. Ayurvedic MedicalCollege and Post Graduate Studies and Research Center, Gadag, for providing allnecessary facilities for this research work. I am very much grateful to Dr.S.H. Doddamani D.D (Ayu) Lecturer P.G.Department, D.G.M Ayurvedic Medical College, Gadag, for his valuable suggestions onthe important subjects. I am ever thankful to Dr. R.Y. Shettar M.D (Ayu) Lecturer P.G. Department,D.G.M. Aurvedic Medical College, Gadag, for his valuable suggestions and moralsupport throughout my career. I wish to convey thanks to my all Under Graduate professors, Assistant professorsand Lecturers of D.G.M. Ayurvedic Medical College, Gadag, for their help andsuggestions during my post graduate studies.
    • ________________________The Effect of Eladi Churna in Amlapita‘Hyperchlorhydiria” I sincerely thanks to my beloved seniors Dr. Anil Kumar Bacha,Dr. B.M. Mukkipatil, Dr. S. Hombal, Dr. yashoda. M, Dr. S.S Hiremath, Dr.A.S. Patil,Dr. Irranna.K, Dr. C.V. Rajeshekar, Dr. J.I.Hiremath, Dr. Shyal, Dr.R.D. Suresh, Dr.S.K.Tiwar, Dr. yashmin, ApP, Dr G.S. hadimani, Dr. Srinivas Reddy, Dr. BG. Swamy, Dr. Seetaram Prasad and Dr. G.S. Hiremeath, for their deep co-operation andinvolvement in the P.G. study. I am also thankful to all my post graduate colleagues Dr, shyju.O, Dr.Shankargouda, Dr.C. hanmantagouda, Dr. V.V. Purad, for their constant co-operation andhelp in the P.G study. I am ever thankful Dr. m.S. Daniganda m.s. for their encouragement and helpthroughout my career. I wish to convey my thanks to beloved librarian Shri.V.M.Mundinamani andMr.S.B.Sureban for supplying me essential references in the study. I am thankful to Mr.Basawaraj. S. Tippanagoundar, Lab. Technician, who extended his co-operation ininvestigations. I thanks to Mr.P.M. Nada kumar for his help in the statistical evaluate. I am highly indebated to my beloved parents Sri Narayan Kulkarni, Smt.Sindhumati, Brothers, Sister, Sisters-in-Law, Brother-in-Law and my all other familymembers for their love and affection rendered throughout my career. Thanks to all physicians, house-surgeons, hospital staff, nurses and non teachingstaff for their timely assistance in completion of this work. Let me express my thanks to all patients, those are on the trial for their consent forenrolling in this clinical study and obedience to advices. Vivekanad.N.Kalkarni
    • _________________________The Effect of Eladi churna in Amlapitta“Hyperchlorhydria” CONTENTSPART – I INTRODUCTIONPART – II LITERARY REVIEW HISTORICAL DERIVATIO AND DEFINITION MODERN VIEW SHREERA NIDANA CHIKITSAPART – III DRUG REVIEW MATERIAL AND METHODS MASTER CHARTS OBSERVATION AND RESULTPART – IV DISCUSSION PROPOSALS FOR FUTURE STUDY CONCLUSION SUMMARY REFERENCES BIBLIOGRAPHY APPENDIX
    • List of PhotographsPhoto – 1 Strucure of Gastric mucosaPhoto – 2 Ela (Elettaria cardomomum)Photo – 3 Vamshalochana (Bambusa arundinacca)Photo - 4 Twak (Cinnamomum Zeylenicum)Photo - 5 Amalaki (Embica officinalis)Photo - 6 Haritaki (Taminalia chebula)Photo - 7 Pippali moola (piper longum)Photo - 8 Seta chandana (Santalum album)Photo - 9 Teja patra (Cinnamomum tamala)Photo - 10 Akarakara (Anacyclus pyrethrum)Photo - 11 Sharkar (Sugar cady)Photo - 12 Instrument used in F.T.MPhoto - 13 Gastric juice collection (Supine position)Photo - 14Gastric juice collection(Sitting position)
    • List of Master chartsChart No. – 1 Demographic data of “Evaluation of the efficacy of Eladi Chuma in Amlapitta (Hyperchlorhdria)”Chart No. – 2 Chief complaints of “Evaluation of the efficacy of Eladi Chuma in Amlapitta (Hyperchiorhydria)”Chart No. – 3 Adhoga Amlapitta lakshanas of “Evaluation of the efficacy of Eladi Chuma in Amlapitta (Hyperchiorhydria)”Chart No. – 4 Uradwaga Amlapitta lakshanas of “Evaluatio of the efficacy of Eladi Chuma in Amlapitta (Hyperchiorhydria)”Chart No. – 5 Vataja, Pittaja Amlapitta lakshanas of “ Evaluatio of the efficacy of Eladi Chuma in Amlapitta(Hyperchlorhydria)”Chart No. – 6 Kaphaja Amlapitta lakshanas of “Evaluation of efficacy of Eladi Chuma in Amlapitta(hyperchlorhydria)”Chart No. – 7 Vata kaphaja and Kapha pittaja Amlapitta lakshanas of “Evaluatio of the efficacy of Eladi churna in Amlapitta (Hyperchlorthydria)”Chart No. – 8 Nidhana of of “Evaluation of the efficacy of Eladi churna in Amlapitta (Hyperchlorhydria)”Chart No. – 9 Subjective parameters of “Evaluatio of the efficacy of Eladi Chuma in Amlapitta (Hyperchlorthydria)”Chart No. – 10 Objective parameters of “Evaluation of the efficacy of Eladi Chuma in Amlapitta (hyperchlorhydria)”Chart No. – 11 Assessment of subjective parameter of “Evaluation of the efficacy of Eladi Chuma in Amlapitta (Hyperchlorhydria)’Chart No. – 12 Statical Assessment of Objective parameters of “Evaluation of the efficacy of Eladi Chuma in Amlapitta (Hyperchlorhydria)”
    • List of TablesTable No – 1 - Samanya lakshna of the Amlapitta according to various Acharysas.Table No – 2 - Vishista Lakshana of the Amlapitta according to Various Acharyas.Table No – 3 - Table Showing types of AmlapittaTable No – 4 - Table Showing Vikalpa samprapti of Amlapitta.Table No – 5 - Table Showing Vikalpa samprapti in relation to samanya laxanas.Table No – 6 - Table Showing Upashaya of the AmlapittaTable No – 7 - Table Showing Differential diagnosis of Pittaja shoola and AmlapittaTable No – 8 - Table Showing Differential diagnosis Parinama shoola and AmlapittaTable No – 9 - Table Showing Differential diagnosis of Annadrava shoola and AmlapittaTable No – 10 - Table Showing Age and sex incidenceTable No – 11 - Table Showing Religion incidenceTable No – 12 - Table Showing Occupational incidenceTable No – 13 - Table Showing Economical status incidenceTable No – 14 - Table Showing Diet habitsTable No – 15 -Table Showing Chief ComplaintsTable No – 16 -Table Showing Associated complaintsTable No – 17 Table Showing Crocity of diseaseTable No – 18 Table Showing Incidence of different types of AmlapittaTable No – 19 Table Showing The over all assessment of therapeutic responses.
    • List of Graphs (Figures)Fig No – 1 - Schematic representation of Amlapitta according to Kriyakala.Fig No – 2 - Schematic representation of Samprapati of Amlapitta.Fig No – 3 - Graph shows the Age and sex incidence.Fig No – 4 - Graph shows the religion incidence.Fig No – 5 - Graph shows the occupational incidence.Fig No – 6 - Graph shows the Economical incidence.Fig No – 7 - Graph shows the diet habits incidence.Fig No – 8 - Graph shows the chief complaint incidence.Fig No – 9 - Graph shows the associated complaintsFig No – 10 - Graph shows the cronicity incidence.Fig No – 11 - Graph shows the incidence of different types of Amlapitta.Fig No – 12 - Graph shows the over all assessment of therapeutic responses.
    • LITERARY REVIEWThe term yuvana pidaka comprises of two words. 1. Yuvana 2. PidakaYuvana:The word is pulliga in gender.The word ‘yuvana’ is derived form the root YU-KANIL-KHAL.Ref: Sabda kalpa druma.The word indicates the age factor of a person. The age factor that is stipulated to say theperson as yuva is between seventeen and thirty years.Ref: Su. Sam. Sutrasthana 35/35According to sir Monier Monier Williams yuvana means young, youthful adult.Taruna, Yuvavastha are the synonyms given to the word.Ref: Sabda Kalpa Druma.Pidaka: The work pidaka is derived form the root PEED-KHAL-TAP dhatus. The work is defined as “PEEDAYATEETI PIDAKA” ‘SPOTAKA VISHESHAHA PIDAKA’ Ref: Sabda kalpa druma by Raja Radha Kanta Deva.According to sir monier Monier Williams Saskrit – English dictionary pidaka menassmall boil, pimple or pustule. Pitaka, pidika, pitika are the synonyms for pidaka. By keeping the above two words in view the yuvana pidaka is defined as follows.SHALAMALI KANTAKA PRAKYAHAKAPHA MARUTA SHONITAIHIJAYANTE PIDAKA YUNAM VAKTREYA MKHA DOOSHIKA Meaning of which conveys as follows.The pidaka in the shape of shalmali kantaka (Spine of Indian red silk tree) produced dueto the vitiation of kapha, vata and Rakta in youth age on the face causing disfiguration iscalled as yuvana pidaka.Ref: su: Sam. Nidana Sthna 13/36 Tarunya pidaka, Mukha Dooshika are the synonyms for yuvana pidaka.
    • The equivalent terminology for yuvana pidaka is Acne. The derivation of the term Acneis obscure and it has been imaginatively attributed to a copist’s error for the error for thegrrek word AKME.Ref: Mackenna R.M.B (1957) Lancet I. 169.The Greek work AKME means peak or prime of life. It also means the period of greatintensity of any symptom, sign or process.Ref: Stedman’s medical dictionary.The work Acne has been applied, with a variety of qualifying adjectives, to manyeruptions on the basis of an assumed aetiological relationship or a rough physical ormorophological similarity to the acne.Here, in this context, yuvana pidaka which is natural occurs in the adolescent perod in theshape of comedones (Shalmali kantakas (or) Dark horny follicular plugs) can be exactlycompared with Acne vulgaris.Acne vulgaris is simple acne which is uncomplicated. The Acne vulgaris is of two typeson the basis of its scar formation. 1. Acne atrophica in which lesions leave a slight amount of scarring, and 2. Acne hypertrophica which leaves on healing conspicuous scars.Acne vulgaris is also of two types according to the eruption of pidaka. 1. Acne papulosa: It is a type of acne vulgaris is in which papule lesions are predominate. 2. Acne pustulosa: In which the pustular lesions are predominate.Ref: 1. Text book of Dermatology by sir Arthur Rook 2. Stedman’s Medical dictionary.Some of the varieties of Acne of qualifying adjectives are listed here for information. 1. Acne agminata: an eruption of small dusty, reddish papule on the face, becaming pustular and followed by slight scarring. The term suggested by crocker for tuberculosis cutes follicularis disseminata. 2. Ace albida : milium 3. Acne artificialis: This acne is produced by external irritants, such as tar or drugs internally administred, such as Lodine. 4. Acne Cachecticorum: Simple acne occurring in the subjects of Anemia; characterized by large, soft, purulent, ulcerative, cystic and scared lesions. 5. Acne Ciliaris: Follicular popules and pustules on the face edges of the eye lids. 6. Acne Conglobata: Severe cystic acne; characterized by cystic lesions, crusts, sinuses and scars. 7. Acne Cornea: Acne Keratosa
    • 8. Acne decalvans: A rare type of pustular folliculitis of the scalp productive of scars of and subsequent alopecia.9. Acne erythematosa: Acne rosacea: Acne of cheeks and more associated with papules, pustules, dilated blood vessels in the nasolabial folds and dilated follicles.10. Acne exulcerans serpigino’sa na’si : It is granulosis rubra nasi.11. Acne frontalis: Acne of the fore head.12. Acne generalis: lesions involving the face, chest and back.13. Acne indurate: Deeply seated acne with large papules and pustules, large scars and hypertraophic scars.14. Acne Keloid: dermatitis papillaris capillitii; Folliculities keloidalis; A chronic eruption of fibruous papules which develop at the site of follicular lesions usually on the back of the neck at the hair line.15. Acne Keratosa: It is an eruption of papules consisting of horny plugs projecting from the hair follicle accompanied by inflammation.16. Acne neonatorum: Acne of infants (of rare condition ) on the fore head and cheeks.17. Acne punctata: It is a condition resubling choleracne where black central comedones present in all the lesions.18. Acne simplex: It is the name given to simple acne. It is also includes Acne vulgris.19. Acne Syphilitica: Pustular syphilis.20. Acne tarsi: Follicular eruptions involving Sabaceous glands of eye lids.21. Acne telangiectodes: An acneiform eruption associated with tuberculosis.22. Acne urticata: An acneiform lesions beginning as small urticarial wheals and followed by slight scarring.
    • 23. Acne Varioloformis: A phogenic infection involving follicles occurring chiefly on the forehead and temples leaving scarring after involution. 24. Bromide acne: Follicular eruption of face or chest due to Bromide ingestion. 25. Halogen acne: This acne occurs due to the halogens viz., florine, Bromine, Iodine Chlorine and Astatine. 26. Cystic acne: Cysts containing pus and sebum produced due to folluculties. And etc.Regional Names: 1. Assam : Salamana 2. Bengal : Bahija phora 3. Dogr. : Muhasika 4. Gujarathi : Khila 5. Hindi : Muhasa 6. Kannada : Modave 7. Malayalam : Mukhakkuru 8. Mra. : Murum, Tarunya pidika 9. Oriya : Vayas vrana 10. Panjabi : kila 11. Tamil : Mugapparu 12. Telugu : motimalu 13. English : pimples 14. Greek : Akme 15. Medical term : Acne 16. Sanskrit : Yuvana pidaka Mukhadooshika Tarunya Pidaka
    • INTRODUCTIONRecent trends of researches in various fields of science and technology have covereddifferent areas of studies for human welfare and scientific advancements which alsoinvolve multi dimensional approaches in medical sciences with basic support ofbiological and pharmacological investigations. In the series of efforts for achievement insolving medical and health problems, cosmetology is newer field of research andscientific interest which is gaining importance. Therefore, the present study has beenundertaken to examine the potentials in Ayurveda in the field of cosmetology and specialattention has been paid to indicate phytodrugs possessing utility in cosmetic field.Yuvuna pidaka is a common complex, fascinating malady of either sex in the teenagers,It is an extremely common complaint with 70% of the population and cilinically evidentat some point during adolescenece or early adult life.The advent of new and potent therapeutic agents for yuvana pidka has provedinsignificant and our inability to treat yuvana pidaka with tropical therapy alone. Thiscommon problem turns into cosmetic problem and results in emotional upset. Patientswith yuvana pidaka are often depressed and may need counseling and family support.Yuvana Pidaka is one of the diseases mentioned under kshudra Rogas. An equivalentterminology in modern medicine in Acne vulgaris. It is also mentioned as Mukhadooshika in ayurvedic classics as it decreases the complexion and smoothness of the face.So a person affected with yuvana pidaka feels like looking ugly, prone to inferiortycomplex and loses the degree of confidence. This disease is viewed as a burningcosmetic problem than a medical one.Even though beauty is skin deep, yet its significance in modern present society. The vastturnover of the beauty aid products is itself a quite example for this serious issue.Therefore Yuvana pidaka requires special attention in the above view and the presentstudy is designed with both internal and external administration of selection of the topic‘EVALUATION OF THE EFFICAACY OF NIMBARAGWADADHI YOGA ANDHATHIPHALADHI LEPA IN YUVANA PIDAKA.The observations on contribution of indigenous medical science provides valuablematerial for multi-disciplinary studies and bio-chemical, biological and pharmacologicalinvestigations on phytoagents. Clinical assessment and detailed screening of drugs mayyield vital results for finding out promising remedies for problems of gerontological fieldattracting scientific world-wide attention.
    • SHAREERA VIVECHANA (ANATOMY AND PHYSIOLOGY)Yuvana pidaka (Acne vulgaris) is the disease of the skin involving the pilosebaceousglands of the integument.It is necessary to go through the pre-requisite knowledge of the disease before proceedinginto study of the disease. Shareera is the base on which the subject of medicine stands.The detailed knowledge of Anatomy and physiology is always important to know thepathogenesis of the disease without which the treatment is not successful. Here, in this context the primary knowledge of shareera of the skin is dealt.According to Ayurvedic doctrines the twak is a matruja bhava and is the upadhatu ofmamsa dhatu. Twak is one of the seats of gnanendriyas. Akasha and vayu areindriyadravyas and Sparsha is the indriyartha. Bhrajaka pitta is located in Twak.According to charaka and vagbhata the twak consists of six layers. But according toSushruta twak is of seven layers. Here Charaka and Vagbhata didn’t mention the seventhlayer-Mamsadhara layer.Vagbhata says Twak is a derivative of Raktha, during its course of paka by dhatooshma.According to sushruta, during the process of parinama of sukrashonita for the formationof garbha, twak etc., are formed just like the cream of milk is formed during boiling.Table showing the layers of the twak mentioned by different authors is shown here. Sl. Sushruta Charaka Vagbhata modern no1. Avabhasini Udakadhara Udakadhara * Stratum Corneum2. Lohitha Asrugdhara Asrugdhara * Stratum lucidum3. Swetha * * * Stratum granulosum4. Tamra * * * Stratum Malphighii5. Vedini * * + Papillary layer6. Rohini * Pranadhara + Reticular layer7. Mamsadhara + Subcutaneous - - Tissue & muscles * : Indicates that acharyas mentioned the layer but not with special - name
    • - : Indicates not mentioned . : Indicates the part of Enpidermis + : Indicates the part of Dermis According to modern, the skin is an anatomically and physiologically specializedboundary lamina which is of major importance in the life of an individual. The skin is adopted to serve many different roles since it is the major interfacebetween the body and its environment. It minimizes, within limits, the potentiallyinjurious effects of mechanical, osmotic, chemical, thermal and photic environmentalstress: it provides a barrier to invasion by micro organisms and it limits and regulates theexchange of heat with the environment by special neurovascular mechanisms. The skinis a major sensory surface. And it provides a sureface for the conversion of precursorcompounds into vitamin D by the action of ultraviolet light. Like this there are so manyfunctions are being done by the skin.The Structure of the skin: The skin is composed of two layers of distinctive structure,properties and embryological origin. The dermis or corium, a connective tissue layer of mesenchymal origin, which iscovered by the epidermis, and epithelial layer derived from embryonic ectoderm. Deepto the dermis lies a superficial fascia, hypodermis or subcutaneous layer which inturn isbound to the underlaying tissues by a dense fibrous deep fascia corresponding to theepimysium of muscle blocks or periosteum or perichondrium of the bony or cartilaginoussurface. The primary barrier to mechanical damage, desiccation and microbial invasion isthe epidermis, particularly the outer horny layers which are highly impermeable to waterand chemicals rather inert. The epidermis, moreover, has a high capacity of regenerationafter damage. The epidermis also generates the appendages of the skin, that is hairs,nails, sudorific (sweat) and sebaceous glands.
    • The dermis, in contrast gives the skin considerable mechanical strength by virtueof the high proportion of collagen fibers intermingled with fibres of elastin and in thevarious cellular components, provides a reservoir of defensive and regenerative elementscapable of combating infection and repairing deep wounds. The vascular supply of the epidermis is limited entirely to the dermis, andtherefore the epidermis relies for its supply of nutrients and metabolic exchange generallyon diffusion to and from the capillaries of the most superficial regions of the dermis. Deep to the dermis lie the subcutaneous tissue layers of the superficial fascia. The disease, yuvana pidaka is a disease of Roma Koopas. So it is worth to studythe structure of hairs which are the appendages of the skin. The appendages also includenails and glands. The hair are found on nearly every part of the surface of the body, but are absentfrom the palms of the hands, the soles of the feet, the dossal surface of the distalphalanges, the umbilicus the glans penis, the innersurface of the prepuce, Labia majoraand minora. They vary much in length, thickness & colour in different parts of the bodyand in different races of mankind. A hair consists of a root (Roma Koopa), the part of implanted in the skin and ashaft (Scapus), the portion projecting from the surface. The root (Radix) of the hair has a proximal enlargement, the bulb, which is set inan invagination of the epidermis and superficial portion of the corium, called the hairfollicle. The hair follicle commences on the surface of the skin with a funner – shapedopening, and passes inwards in an oblique or curved dilated at its deep extremity, whereit corresponds with the hair bulb. The ducts of one or more sebaceous glands open intothe follicle near the skin surface. At the bottom of the each hair follicle ther is a small
    • conical vascular eminence or papilla, similar in every respect to those found upon thesurface of the skin. The hair follicle consists of two coats – an outer dermal and an inner epidermalcoats. The growth of the hair occurs at the hair bulb where the cells capping the papillaproliferate and form the germinal matrix of the hair. The duration of a single hair variesform about four months (eye lashes, axillary hair) to about four years (scalp hair), afterwhich it is shed and is replaced by the sprouting of new cells from the germinal matrixafter a period of rest. Greying or whitening of hair is due to the collection of minute airbubbles in the cortex (and sometimes in medulla also ) of the shaft and to loss of pigment– melanin formation by cells in the germinal matrix. Minute bundles of nonstriated muscular fibres, called arrectores pilorum areconnected with the hair follicles. These are responsible for Gooseskin when the fibresare contracted due to the exposure to cold or in emotional reactions. The sebaceous gland is situated in the angle which the arrector pili muscle formswith the superficial portion of the hair follicle, and contraction of the muscle tus tends tosqueeze the sebaceous secretion out from the duct of the gland. The arrector pili musclesare supplied by sympathetic nerves. The Sebaceous glands are small, sacculated and lodged in the substance of thedermis. They occur in most parts of the dermis, but are especially abundant in the scalpand face; they are also very numerous around the apertures of the ear, nose, mouth, anus,but are abscent in the palms and soles. Each gland consists of a single duct, relatively capcious, which emerges from acluster of oval or piriform alveoli, usually from two to five, but in some instances as mayas twenty in number. Each alveolus is composed of a basement membrane, enclosing anumber of epithelial cells. The outer or marginal cells are small and polyhedral and
    • continous with the cells lining the duct. The remainder of the alveolus is filled withlarger cells containg fact, but in cavity filled with their debris and mass of fatty matter,which contitute the Sebum cutaneum. As the sebaceous gland produce their secretion bycomplete fatty degeneration of their central cells they are classed as holocrine glands. Asthe central cells disintegrate, they are replaced by proliferation of marginal cells. Theducts open most frequently into the hair follicles. But occasionally upon the generalsurface, as in the labis minora, glands penis and the free margins of the lips. On the noseand face the glands are of large size, distinctly lobulated, and often become muchenlarged from the accumulation of pent-up secretion. Sebum acts as a natural lubricantof the hair and skin, protecting skin form the effects of moisture or desiccation and hairsform becoming brittle; It is also has some bactericidal action. The secretory activity ofthe sebaceous glands doesn’t appear to be under nervous control. It is stimulated byhormonal action, particularly androgens. Sweat glands or Sudoriferous glands occur in almost every part of the skin, andhave been classified into two types eccrine and apocrine glands. Eccrine glands are numerous and almost found in every part of the skin. Eachconsists of a single tube, the deep part of which is coiled into and oval or spherical part orduct, traverses the dermis and epidermis and opens on the surface of the skin by aninfundibular aperture. The size of the sweat glands varies. They are especially large in those regionswhere the amount of perspiration is great, as in axilla & groins. Their number varies. They are very plentiful on the plams of the hands and on thesoles of the feet. Apocrine glands ocfure in the axilla, eyelids, areola and nipple of the breast.They are larger than eccrine glands and produce a thicker secretion.
    • Eccrine sweat glands are concerned in the temperature control mechanism bysurface evaporation of the sweat. These are supplied by sympathetic nerves, though thesefibres are cholenergic in nature, and no sweating occurs in a denervated area of skin.Rarely, sweat glands may be congenitally absent. Apocrine glands are under dual autonomic control, but do not respond markedlyto temparature changes, so that strictly speaking they should not be classified under sweatglands at all.
    • NIDANA (AETIOLOGY)The potentiality of a factor to induce the mechanism of pathogenesis and termination intoa status of disease is called as nidana. The whole process is meticulously managed by thesaid causative factor-Nidana involving all pathological elements.While treating diseases our classics gave the highest importance to nidana. They saidavoiding the aetiological factors is the first and foremost thing to be adopted in themanagement of a disease. The knowledge of nidana (aetiology) helps to the great extentin the prevention of disease.The information regarding the exact nidana of yuvana pidak ais not available in theAyurvedic literature. Every author included yuvana pidaka under kshudra rogas becausethe aetiology, pathogenesis and treatment are of minor importance. An attempt to searchthe setilogical factors of yuvana pidaka and a study of nidana is made here. The information regarding the nidana of yuvana pidaka is indirect and scattered.According to madhukosha commentary on madhava Nidhana, yuvana pidaka occurs dueto swabhava.Ref: Ma. Ni: 55/33.The recent studies in modern medicine also support the statement of Madhava Keera. Itis told, that the importance of genetic factors in determining the susceptibility to acne wassuggested.Ref: Hamilton J.B. et al (1964)J. Clini. Endocr. Metab: 23;267A survey revealed the genetic factors play a role in the production, the clinical pattern,the distribution of the lesions and the duration of susceptibility. The mode of inheritanceis unknown, but is assumed to be multifactorial. The association of very severe acne withthe xyy syndome has been recorded. Ref : Voorhaes J.J. et al (1972) Archs. Derm: 105,913 Sushruta and Vagbhata said yuvana pidaka occurs due to yuvavastha whichindirectly refers to the factors or elements participate in the culmination of yuvavastha. Yuvana pidaka occurs as a result of sukra dhatu mala.Ref: sha. Sam. 1/5/14.It is supported by the deeper studies done in modern science. The androgens areresponsible for the grown of person which are very essential during puberty andadolescence. The endocrine factors have very essential role to play in the production ofacne. The research studies revealed that the acne doesn’t develop in castrates andoverctomy before puberty or in ovarian agenesis. This reveals the factors i.e., androgens,
    • which are responsible for a person, during puberty and adolescence, have prime role toplay. These are natural and essential and hence cann’t be avoided. Ref : Hamilton J.B. 1941 J. clin. Endocr. Metab. I ,570 A study on premenstrual exacerbation of acne is not adequantely explained.There is a steady decrease in sebum excretion during the first half of the menstrual cycle;in luteal phase the excretion rate increases and to fall again premenstrually.Ref : Burton J. C et al (1973) Derm –vener: 53-81. The yuvana pidaka is produced due to the vitiation of kapha and vata.Ref : Su.Sam. Ni: 13/36 Ma.Ni: 55/33.This is to understand that the nidana, is responsible for the vitiation of kapha as well asvata causes yuvana pidaka.Vagbhata says the medas encapsulated eruptions of face in youngsters are called asyuvana pidaka. Hence the medas play an important role in the formatio nof yuvanapidaka.Ref: Ast. Sang. Uttara 36/7It is wise to consider her the nidana responsible for the vitiation of medodhatu.Medodhatu is vitiated by kapha prakopaka nidana. Yuvavastha itself is kapha kala andhence there are chances of vitiation of medas naturally also. Medovaha srotas whichseats in medodhatu also vitiated due to medodusti. It is also necessary to consider thenidana responsible for medovaha srota dusti in the causation of yuvana pidaka. Themodovaha stoats is vitiated by Avyaama, Divaswapana and excessive medya consuption(Fatty diet).Ref: Cha. Vi: 5/16Her the kapha prakopaka ahara which is of Guru, Manda, Snigdha and Seeta in character,is considered along with medya ahara as nidama of yuvana pidaka.The role of dietary factors in acne are convinced of their importance. And believe that insome individuals certain fats-notable chocolates, seets, Nuts, meat and perhaps, cheeseand highly seasoned foods will provoke exacerbations. In a invertigation it has beenshow to increase the sebum production in obese subjects.Ref: Hagerman. G. (1967) Derm. Wschr. 153,13.The participation of vayu in the productionof yuvana pidaka comes next to kapha. Thevayu and kapha are vitiated by Seeta guna of the dravya or climate. The studies inmodern science also say that in temperate climates acne is usually at its worst during thecolder months of the year. The vata also is vitiated by Fret, Anger, etc.
    • Ref: ma. Ni: 21/1These factors come under psychological factors. Critical and objective evaluationsuggests that emotional stress plays a minor role in the pathogenesis of acne in general ,but in many cases exacerbations of existing lesions can be convincingly related tostressful episodes. Ref: Lucas. C. J. (1961) Br. Med. J. ii 354Yuvana pidak occurs as a complication to Nasya Karma also. When the person talksloudly, laughs loudly, goes out in cold climate etc., immediately after the procedure.Probable the Nasya karma induces a change in the circulatory mechanism related to theface. The abrupt change associated with prohitary action may create a pathologicalsequece in the production of yuvana pidaka. Even it could induce a reverse mechanismof beaking down the pathogenesis when followed according to the rules and regulationsof the Nasya procedure.According to Sushruta the disease ocfurs due to the vitiation of Rakta along with kaphaand vayu.Ref: Su. Sam. Ni: 13/36.Her Rakta dhatu is vitiated either by kapha or vata. Sometimes the Rakta dhatu isvitiated by Raktaja krimis alone resulting in the production of yuvana pidaka.This statement is supported in modern science also. Corynebacterium acne andstaphalococcus epidermis are very regularly present in acne lesions. The bacteria play arole in causing inflammation resulting pain and in complicating the lesions. Ref: Marple. R. R et al. ( 1974) J. invest. Derm. 62,326. Sebaceous gland activity also plays a role in the production of acne.By taking the above aetiology into consideration it can be classified under six groups. 1. Swabhava 2. Age factors 3. Dietic factors 4. Extra –dietic factors 5. Psychological factors 6. Complication of Nasya karmaSAMPRAPTI (PATHOGENESIS)Due to the said Nidana the kapha and Vata are vitiated. The vitiated doshas causesagnimandhya and lead to ajeerna at respective leverls of dhatus and bhootagni. As aresult Ama related to dosha and dooshya is producedThe vitiated vata also causes shaithilyata of Roma koopas. Here the climate andpsychological factors cause shaithilyata due to the frequent contraction and relaxation oferector pilorum muscles which attached to the Roma koop. As the Roma Koopas are thefinal ending points of all dhamaness and as they are minute the shaithilyata occurs first atthis level.
    • The increased kapha vitiates medodhatu and Raktadhatu. The medovaha srotas also isvitiated by its own nidana or due to the vitaiated meda.These vitiated doshas enter into the Rasayanees and travel all over the body. Sancharidoshas, in the process of population move towards Shaithilyatwa of twakgata Romakupas and get lodged there. This process is called as Schana samshraya and exhibitspoorva roopas. But in this process the doshas and dooshyas are of low intensity and sothe manifestation of the prodromal symptoms is negligiable and exhibits poorva roopas.But in this process the doshas and dushyas are of low intensity and so the manifestationof the prodromal symptoms is negligible and may not be noticed by the subject also.The lodged doshas at Roma koopas causes pidaka. This stage is called vyakti in whichthe signs and symptoms are exhibited through which it is diagnosed as yuvana pidaka.According to modern science the pathogenesis and histopathology of acne is explained asfollows.The earliest detechable change is keratinization of the duct of the Sebaceous gland. Inthe beard area, where the pilosebaceous canal is divided into two channels, the sebaceouschannel fills with keratin. On the trunk, where the pilosebaceous canal has a singlechannel the keratin appears as a peripilar sheath. An inflammatory infiltrate forms in thedermis at the level of the sebaceous duct, and an abscess may develop within the lumenof the follicle. The neck of the follicle becomes distended and may rupture to the surfaceor into the dermis, where the sebum and keratin produce a severe inflammatory reactionwhich may destroy the lower part of the follicle, leaving a blind sac containing hornymaterial, in which further inflammatory changes are unusual. Bacterial activity plays apart in enhancing the inflammatory Changes.The pilosebaceous follicle is commonly obstructed by inspissated material consisting oflipid and keratin, the degree of obstruction bearing some relationship to the severity ofthe acne. The studies revealed the level of sebum production is higher in acne subjectsthan in controls.The horny plug obstructing the upper follicle projects as a comedo or the obstruction maybe below the visible level. Retention of sebum and inflammatory changes combine toproduce an oedematous paple or pustule. Ref: 1. Text book of Dermatology by Sir Arthur Rook 2. Holmes R.L. et. Al (1972) by br. J. Derm 87,143 3. Pochi. P.E. & strauss J.S. (1967) Archs. Derm. 95,47Samprapti Ghataka Vivechana 1. Doshas : Kapha and vata 2. Dushyas : Twak(Rasa), Raktha and Medas 3. Agni and Ama : Jataragni and dhatwagni Jaya Ama 4. Srotas : Medo vaha srotas 5. Dusti Prakara : Sanga 6. Udbhava sthana : Amashaya
    • 7. Roga marga : Bahya 8. Adhistana : Twak gata Roma Koopas 9. Sanchara Sthana : Throught the body 10. Vyakta sthana : Mukha POORVA ROOPA AND ROOPA (SYMPTOMATOLOGY)Symptomatology of particular disease helps in the diagnosis of the disease.Symptomatology includes objective and subjective features called as signs andsymptoms.Acharya Sushruta explaind the igns of the disease where as Vagbhata explained the signsas well as symptoms of the disease to some extent.Yuvana pidaka is a disease of young people. So the age factor, here, also plays animportant role in the diagnosis of the disease along with signs and symptoms of thedisease.Pidaka of youngsters’ face in the shape of shalmali kantaka (spines of Indian red silktree) is called as yuvana pidaka which disfigures the face and so called Mukha dooshika. Ref : Su.Ni: 13/36Vagbhata explained the same as Sushruta. But he added a little more information apartform Sushruta’s details. The pidaka contains encapsulated medas in it which is explainedas sebum by modern science and these pidaka are solid in nature and gives slight pain. Ref: Ast. Snag. Uttara 36/7. The other authors followed Sushruta’s statements only.Acne vulgaris is a disease of inflammation of pilosebaceous gland. The characteristiclesions of acne are comedo, a dark horny follicular plug; small papules with or withoutthe evident of inflammatory changes; pustules which may surmount papules or developindependently, superficially placed at follicular orifices; and nodules, which may exceed2 cm. In diameter and may slowly resolve or break down and discharge.True acne occurs only on the face and neck, on the upper arms and on the trunk to thelevel of waist. The periorbital skin is never involved. The earliest lesion occurs on theforehead or chin or in the nasolobial furrow. The exact distribution of acne in every person is poorly explained. SYMPTOMATOLOGY OF YUVANA PIDAKA
    • S.no ra samhita Sharngiha Vagbhata Prakasha Sushruta Charaka Madava Nidana Laxanas Bhava1. Shalmalikantaka Sadhrusha - + + + + +2. Medas encapsulated Pidaka - - + - - -3. Sarujah - - + - - -4. Ghanah - - + - - -5. Occurs on the face - + + + + +6. Occurs in Yuvavastha - + + + + +7. Mukhadooshika - + + + + + SAPEKSHA NIDANA (DIFFERENTIAL DIAGNOSIS)Yuvana pidaka is one of the diseases where pidaka is the prominent feature. And hencethe differential diagnosis is necessary in the diagnosis of the disease without which thetreatment becomes aimless. Pidaka, as one of the lakshanas, occurs in the following diseases. 1. Yuvana pidaka 2. Prameha pidakas 3. yava Prakyeya 4. Antralagi 5. aParimandala 6. Katchoo and aPama 7. Valmeeka 8. Visrpa 9. Kaksha 10. Gardhabhika 11. pashana Gardhabha 12. Jala Gardhabha 13. Gandha 14. Kusta 15. Agnirohini 16. Spota.
    • But in the diagnosis of the yuvana pidaka, the shape, contents and place of pidaka takethe prime role. In yuvana pidaka the pidakas are in the shape of shalmali kantaka, whichis an unique feature of the yuvana pidaka. And the another special feature of the yuvanapidaka. And the another special feature of pidaka in yuvana pidaka is containing medasinside. These features of pidaka are not found in other pidakas.Pidakas can occur on any part of the body. But in the case of Yuvana pidaka it occurschiefly on the face and only in Yuvavastha. Ref: Ma. Ni. 55/33 Madhukosha CommentaryThe pidaka of yuvana pidaka causes slight pain and the pidaka are solid in consistency.All the above said features together are absent in all the other pidakas. Apart from thatthere are different features which are typical to the pidakas and also they are associatedwith different conditions of disease. Therefore yuvana pidaka can be differentiated by itstypical presentation only. UPADRAVA AND SADHYASADHYATA (COMPLICAITONS AND PROGNOSIS)Yuvan pidaka is a kshudra roga in which the aetiologyl, pathogenesis and treatment areof minor significance. And hence the complications of yuvana pidaka are not delt inclassics.Yuvana pidaka is also tarmed as Mukha dooshika (which disfigures the face). This is dueto the formation of scars which is a complication of Acne.Acne atrophica and acne hypertraphca are the two stages of acne vulgaris, where theformer leaves no scars and the later leaves scars. Ancne hypertrophica will be thelattercondition of acne atrophica if not treated properly during its course. Acne may become an abscess if secondary infection is associated. The prognosis of yuvana pidaka is indirectly explained.According to Charaka, a disease can be easily curble if it occurs in young sters with lesssymptomatology and naturally. Ref : Cha. Su. 10/11.The Yuvana pidaka occurs neither in balyavastha nor in vrudhavastha. It occurs inyuvavastha only.The signs and symptoms, aetiology are being very less, the yuvana pidaka is includedunder kshudra rogas. Yuvana pidaka occurs naturally during yuvanavastha. All these statements make up to declare that the yuvana pidaka is sukha Sadhya. CHIKITSA VIVECHANA (PRINCIPLES OF MANAGEMENT)According to Charaka, the principles of management is classified under three headings. 1. Daiva Vyapashraya 2. Satvavajaya and 3. Yukti Vyapashraya
    • There are no references regarding Daiva Vyapashraya and Satvavajaya Chiktsasto Yuvana pidaka.The Yojana of Oushadha, adhara and vihara according to disease is called yuktivyapashraya chikitsa. This can be again classified into three groups. 1. Antahparimarjana 2. Bahiparimarjana and 3. ShastrapranidhanaAntahparimarjana includes the administration of internal medication of eliminate themorbid factors. Even panchakarma procedure come under this group.In Ayurvedic literate the shamanoushadis for the treatment of yuvana pidaka arementioned in the form of mukha lepa.Vamana and Nasya Karma are told as the panchakarma procedures in the treatment ofyuvan pidak, which come under Anahparimarjana chikitsa.Bahiparimarjana includes snehana, swedana, abhyanga, parishek, pitau, sirobastic, lepa,anjana etc. In the treatment of yuvana pidaka mukalepas, Abhyanga, are explained. Ref: Y.R. : Kshudra roga chikitsaAmong the bahiparimarjana chikitsas mentioned the mukha lepas takes the importantplace. All the authors mentioned mukha lepas in detail in the treatment of yuvana pidaka.In modern science also the external applications in the treatment of acne vulgaris play aprime role and the internal medication is of minor importance unless it is complicatedwith secondary infection.Shastrapranidhana chikitsa comprises of various surgical measures. In the treatment ofyuvana pidaka siravyadha in lalata pradesha is mentioned which comes under this group.In modern science the removal of contents from the cystic acne is advised which comesunder this group. Some of the much lepas mentioned in our taxts are given here under. 1. Vacha, Lodhra, Dhanyaka in equal quatities with milk. Ref: Su.Sam. Chi : 20/37 B.P. Madhyama khanda: 61/34 Sha. Sam. 11/11 Y.R Kshudra rogadhyaya: Chakradatta 55/42 2. Kustumburu + Vacha + Lodhra + Kusta with milk Ref: Su. Sam. Chi 20/37 3. Vacha + Lodhra + Saidhava Lavana with water or milk. Ref: Su. Sam. Chi.: 20/37 Ast, Hr. Uttara 32/3 BP 61/35 Ast. Sang. Uttara 37/5 Sha. Sam 11/11
    • 4. Vata Patra + Narikela Majjeerasa (milk like extraction prepared by grinding and squeezing the endocarp of fresh coconut) Ref: Ast. Hr. 32/3 Ast. Sang. Uttara: 37/5 5. Vacha + Lodhra + Dhaniya + Gorochana + Mareecha with water ( Anukta paribhasha) Ref: BP Madhyama khand 61/34 Sha. Sam. 11/11 Y.R. Kshudra Rogadhyaya C.D, 55/42 6. Shalmali Kantaka Choorna with mailk Ref: Bp 61/36, Madhyama Khanda. Y.R :ksh. Adhy. 7. Matulunga + Vata Patra + Sarpi + Shilajit with Goshakrut rasa. Ref: Sha. Sam. 11/10 Y.R. : Ksh. Aday 8. Arkaksheera + Haridhra, after mardhana is advised as mukha lepa. Ref: Sha: sam. 11/13 Y.R. : Ksh. Adhy 9. Jateephala + Chandana + Mareecha with water (Anukta paribhasha) Ref: Y.R. Ksh. Adhy.Slno. Of Su.sam Ast.Hr Ast.Sang B.P Sha.sam Y.R C.DMukhaLepa 1. + - - + + + + 2. + - - - - - - 3. + + + + + - - 4. - + + - - - - 5. - - - + + - + 6. - - - + - + - 7. - - - - + + - 8. - - - - + + - 9. - - - - - + -
    • Table Showing the Treatment of yuvana Pidaka mentioned by different Texts Sha.Sam Cha.sam Ast. San Su.sam Ast.Hr Y.R C.D B.R B.P 1. Mukha Lepa - + + + + + + + + 2. Vamana - + + + - - - + - 3. Nasya karma - - + + - - - - - 4. Abhyanga - - - - - - + + - 5. Siravyadha - - + - - - + + - PATHYAPATHYA (DIET AND REGIMEN)Pathyapathya should be followed according to the dosha, dooshya and avastha of thediseases. Ref: R. Kshudra roga Chikitsa.In yuvana pidaka the nidana which is discussed should be avoided, as general rule.In yuvana pidaka kapha prakopaka ahara & vihara is always better to avoid. With allconsiderations of Nidana Samprapti and Chickitsa the following list of pathyapathyas canbe considered.PathyasAhara : Purana shastika shali, Godhuma, Tikta shakas like patola, Nimba etc., Dhanyaka, Mareecha, Hingu, Lasuna, All green vegetables & CarrotsVihara(Extra dietetics): Normal exercises exposure to evening sun-light, washing the face regularly with tepid water.ApathyasAhara(Dietetics) : Madhura Rasa padarthas (Sweats especially chocolates, nuts)Medya padarthas (Fats and fatty acids, meat, oils etc.) Dhadhi, ice creams.Vihara : Divaswapana Avyayama Using greasy cosmetics Squeezing the lesions.
    • DISCUSSIONThe observations made in this study for the sake of discussion are based on: 1. Complete case history of the patient. 2. The incidence of associated signs and symptoms and their response to the management. 3. Improvement in the regression and recurrence of yuvana pidaka recorded by the careful general observation and examination of the patients. 4. Case study made in the previous chapter in the form of tables.Age:Yuvana pidaka, its maximum incidence was found in the age group of 16-20. 20 patientsout of 35 were in this group. 8patients each from the age groups of 21-25 and 7 patientsfrom the age group of 26-30. Yuvana pidaka is considered as a disease of young people.In the observation the patients were seen between the age group of 16-35.As per the “table showing the age of the patients and their first occurrence of Yuvanapidaka”, the statistics reveal the first incidence was observed between the 18-23 years ofage. The total number of cases were 43 out of 54 in the group. 3 cases coming within 18years of age included 1 case at the age of 16 and 2 cases at the age of 17. The remaining8 cases were between 24-30 year of age.This clearly speaks yuvana pidaka occurs more in the early part of yuvavastha.Nindana:“The table showing the incidence of nidana in yuvana pidaka patients” reveal thepresence of yuvavastha in all the cases. Atimedya Bhakshana was divided into twogroups, one for vegitarian food habit patients and two for non-vegitarian food habitpatients. 20 patients out of 35 wre found that they were habituated in eating more sweets.24 more fatty diet. Avyayama was found in 17 patients out 35 and Divaswapana in 15patients. Psychological factor and premenstrual exacerbations in female patients werealso considerable.The combination of all types of Nidana was found in some patients who came withsevere Yuvana pidaka.The incidence of yuvan pidaka was high in Non-vegitarians than, in vegetarians. Thisprobably due to the non-vegitarians who consume moe of fatty food, i.e Medya Ahara.Sex:Considering the “table showing the sex incidence of yuvana pidaka” 22 patients weremales and 13 patients were females.Yuvana pidaka was observed in both the sexes almost in equal percentage i.e., 53.7% ofmales and 46.3% of females. There is no sex difference in the incidence of yuvanapidaka. But during observation of the patients it was found the more severe form ofyuvana pidaka was found in males.
    • Results:There was 35 cases out of which cured were 12 34-28, improved were 20 57-14 and not –improved were 38.57The percentage speaks by itself that the Mukha lepa combined with internal modificationprovides grater cure and appreciable improvement. A prolong use of both internal andexternal medication will be very effective.Considering the duration of illness, cases falling within 3 years of duration could bemanaged easily as such in group- ‘B’. 13 cases had a duration of only 1 year, Even theimprovement in this group in seen in the same duration.Cases which had duration of more than 3 years had a picture of improvement only. Thisis due to the effect of combined therapy, which again speaks of the effectiveness of thetherapy. If the duration is less the therapy will be more effective.
    • MATERIAL AND METHODSCriteria for selection of the patients:For the purpose of study and clinical trials 35 patients diagnosed as yuvana pidaka wereselected from OPD of Sri DGM Ayurveda medical College & P.G center the patents wereselected on random basis irrespective of their age, sex, caste, duration of the complaints,food habits and occupation. All the care fulfilled the diagnostics parameters.Criteria for the diagnosis of the diseasePatients who complained pidaka (eruptions) over face, neck and back in yuvartha werediagnostic as yuvana pidaka.Criteria for the selection to of the drugMost of the Ayurvadic clinics gave muc importance to mukha lepa. The Mukha lepa isprepared by mixing Ththiphzla, Manicha and Rakhaethdna and made into cream bore.Internal medication in prepared by making power of Niba twak, twaksara, Beeja, PrtraPushphs, Tnikatn, triphala, anidra and ayurveda. This chorma is made into copsyle of500mg.Criteria for usage of medicine: Internal medicine : the Dose advisal in 29m I day.External: The parents be applied on the overweight and wasted in the movingDuration of the TreatmentThe Duration of the broatment in 21 days and trelowap of 1 month. The results wereasured of the 1 month no interval was advised during their period.Creteria for the annecment of the treatmentDiagnosis of the disease was made according to symptomatology of the diasese Andhence the same was taken for the asserment of the rg.Doubt 68The results of the treatment, after months were assessed in terms of cured, improved andnot improved.Cured: Complete relief form the signs and symptoms during the treatment and non-recurrence of the diseases is considered as cured.Improved: Complete relief from the signs and symptoms during the treatment andrecurrence after stopping the treatment.Not – improved: Continuation of signs and symptoms or slight improvement withrecurrence as before treatment, is considered as not-improved.General Rules: 1. The dosage of internal medication was altered according to theseverity of the disease and age of the patients.2. The duration available for the study was only tow years and hence recurrence criteriais limited within the period.
    • CASSIA FISTULA, LINN.Sans – Nripadruma Arahbhada; Arakvadam; Rajavraksha; Suvarnaka. Eng. – Indianlaburnum; pudding Pipe tree; Purging Cassia. Hind.- Sonhali; Amulthu. Gwalior & Duk– Amaltas; Girmalah; Kirvali. Ben. – Bundarlati; Sanalu; Soondali; Sondal. Guj. –Garmala. Mah – Bahava. Tel- Kondrakay; Rachlachettu; Aragvadhmu; Koelapenna;Relagujju. Tam.-Konai; Irjviruttam; Konraikkai; Sarakkonnai or Sarokkonnoi. Mal.-Konna. Con.-Kakkaemara. Kon.-Kakkayi. Sinb- Ahalla. Arab.-Kahayar-shambar. Habitat.- common throughout India and Burma.Part Used.- Pulp. Rot-bark, flowers, pods, leaves and root. Constituents.- By steam –distilling the finely powdered fruit, a dark-yellow volatile oil with honey-like odour isobtained. Water which distils over with the oil contains normal butyric acid. Pulpconsists of suga, gum, astringent matter, gltem, colouring matter and water.Action.- Pulp. Root-bark, seeds and leaves posses purgative properties. Root acts aspurgative tonic and febrifuge. Fruit is cathartic.Action & uses in Ayurveda .- Madura rasam, seetha veeryam, pitta, pitta-haram, guru ,mild laxative, in jwaram, diseases of the heart, raktapittam, udhardham, soolam.Uses.-Pulp of pods is an agreeable laxative, safe for children and pregnant women. It isbest used combined with other purgatives as a confection or electuary as by itself itreauires to be taken in dient in the confection of senna. Cassia pulp is also employed inthe essence of coffee. A confection of the pulp in 2 to 4 drachm doses is a mild purgativeproducing I or 2 soft motions; and is given in cases of diabetes, Gulkband of which itforms an ingredient is a cooling laxative especially for delicate women; dose is half anounce with warm milk taken at bed time. Externally the pulp is considered to be a goodapplication for gout, rheumatism, snake bite, etc, The pulp of the ripe pod mixed withtamarind pulp taken at bed time acts on the bowels mildly causing one or two softmotions the following morning. In the flatulent colic of children it is commonly appliedround the pavel to produce motions. Flowers in docoction are given in stomachaffections. Externally the leaves ground into a paste are applied to ringworm; bark andleaves mixed and rubbed with oil are applied to pustules, rigworm, chilblains, insectbites, facial paralysis and rheumatism. From 5 to 7 of the powdered seeds are prescribedas an emetic. Root is useful in fever, hear-diseases. Retained excreations, biliousnessetc. CURCUMA LONGA, LINN.Sans.- Rajani; Gauri; Varnavat; haridna; Nisha. Eng.-Saffron; Turmeric. Hind., Duk. &Punj.- Haldi. Kash.- Lindar. Ben.-halud. Mab. & Kon. – Guj.-Halder; Halada. Panj.-halja. Pers.-Serd Chubah; Zard-chobah; Daraserda. Arab.-Zirsud; Uruk-es-suff; Kurkum.Tel.-Pasupu; haridra. Tam. & mal.-majal. Can.-haldi, Arasina. Sinb.-Haradul; Khaka.Burm.-Tanum, Malaya.- kooneit. Fr.-Curvcuma long.Habitat.- Extensively cultivated all over India. In Bombay presidency there are twovarieties (i) with hard rich-coloured oval rhizomes, chiefly used in dyeing, known as‘lakhandi balad’; and the other with softer, larger, lighter-coloured long rhizomes whichare usually used for eating.
    • Parts Used.-An essential oil I P.c. resin, an alkaloid, cur-cumin-the yellowcolouring matter, turmeric oil or turmerol. Turmeric oil is a thick, yellow, viscid oil.Curry powder owes its aromatic taste and smell to this oil. “Turmeric Oil obtained bydistilling in steam turmeric grown in the Chittoor district of Madras Presidency wasexamine. The yield of the oil obtained was 5.8%. turmeric oil though examined severaltimes since 1868, the constituents recorded in literature were: - d-a phellandrene and analcohol called turmerol of formaula CI3HI80 or CI4H2o0. A Systematic examination ofthe oil the revealed that the oil did not contain any phenols, aldehydes or ketones.Caproic acid C6Hio02 (o.I%) was fond to be present as free acid while valeric C5Hio02(O.I%) as a combined acid. The oil was distilled at 20m.m into various fractions rangingbetween 700 to I800 C. The lower fractions contained d-sabinene CroHI6 (2,o%),d-a-phellandrene CroHI6 (4%), Cineol CroHI8o (3.0%) and d-Borneol CrohI7OH (2.5%).The middle fractions were sesquiterpene hydrocarbons mainly zingibereneCr5H24 (30.5%) while the higher fractions were mixtures of the sesquiterpenehydrocarbon and sesquiterpene alchol CI5H260 (50.5%). Considerable changes inoptical rotations in the fractions of the whole oil were observed form time to time.”Formation of Curcumone form Turmerol:-A sesquiterpene alcohol Cr5H260 has been isolated and purified. The pure alcohol hasthe following constants: Boiling point I63.40/II m.m., d 300 0.9506; and n 300 I 5I5I.Turmerol is a monocyclic tertiary sesquiterpene alcohol of formala CI5H260. The bodyto which the formula CI3HI280 or CI4H200 was assigned might have been a mixture ofthe alcohol CI5H260 and the hydrocarbon CI5H24.Rupe in 1909 found that the fractin 1580.I62/II m.m on treatment with alkali yielded aketone-curcumone CI3HI80 which formula was later modified by him as Cr2Hr60 . Itsstructure as 2-methyl-2-p-toyl-methyl ethyl ketone CH3C6H4 CH(CH3). CH2C0.CH3was finally confirmed by Rupe’s synthesis in 1924.It has been shown that the original oil does not contain the ketone but it is formed by theaction of alkali on the alcoholic constituent”turmerol” CI5H260.Turmerol on dehydrogenation with sulper and selenium gave neither cadalin nor eudalin.During catalytic reduction with platinum black and hydrogen, termerod was convertedinto a saturated alcohol CI5H3o0 showing the presence of two double bonds.The alcohol onoxidatin with dilute nitric acid yielded p-tluic.p-toluic, terephthalic andoxale acids.On oxidation with aqueous KMn04 as well as with powdered KMn04 in acetone solution,turmerol gave an acid of melting point 420-430, equivalent 178 and molecular formulaCIIHI402 perhaps identical with the acid obtained by Rupe by oxidation of curcumone.Curcumic acid CIIHI402 melting at 420-430 has the structural formula as p-methyl-
    • 3methyl-hydrocinnamic acid CH3C6H4CH (CH3). CH2COOH. (N.C. Kelkar, IndianInstitute of Science, Bangalore).Action: - Aromatic, stimulant, tonic and carminative. Internaliy juice is anthelmintic.Action & Uses in Ayurveda :- katu tikta rasam, veeryam, ruksham, varnyam, inprameham, pandu, rakta-dosham, krimi, vranam, pinasam. (Therapeutic Notes). Preparations.-powder, Paste Ointment, Oil Lotion, inhalant and Confection.Uses.- Rbizomas are boiled dried and made into powder, which gives a yhellow colourand which is employed largely as a colouring ‘agent and as condiment entering largelyinto the composition of Indian pickles and curry powders. Juice of the fresh rhizome isapplied to recent wounds, bruises and leech-bites. Internally it is used as an anthelmintic.Root is usefully administered in intermittent fevers. In doses of 15 to 20 grains twice aday it is given for flatulence, dyspepsia and weak state of the stomach; it is used bothexternally and internally in skin diseases due to impurity of the blood. A paste ofturmeric and the leaves of justicia adhatoda with cow’s urine is rubbed on the skin inprurigo (Chakradatta). Several other combinations of the sort are in vogue, such asturmeric and nim leaves, turmeric and the ashes of the plantain tree, etc. Turmeric is alsogiven internally with cow’s urine in prurigo and eczema. Mixed with gingelly oil it isapplied to the body to prevent skin eruptions. Turmeric paste mixed with a little lime andsaltpeter and applied hot is a popular application to sprains, bruises, wounds, andinflammatory troubles of the joints. In small-pox and chken-pox a coating of turmericpowder or thin paste is applied to facilitate he process of scabbing, and decation ofturmeric (I ounce of the bruised noot to 20 ounces of water) is applied as a lotion torelieve the burning in catarrhal and purulent opthalmia popularly known as “country soreeye”, and conjunctivitis. A piece of rag soaked in it, and kept constantly over theaffected eye relieves the burning and moderates the urgency of the symptom. Its powderis sprinkled on ulcers to stimulate them to healthy action. “ Tubers sold in the market fordietary purposes are boiled, and are on no account used for dyeing. Turmeric for dyeingis sold separately and Indian women use it to smear their hands and faces with, and iscalled in Tamil ‘Kappumanjal’ – Manual of jail Industries (1931, Madras). Ghee mixedwith powdered turmeric, is given to relieve cough. A paste of turmuric alone orcombined with the pulp of neem leaves is used in ringworm, obstinate itching, eczemaand other parasitic skin diseases. In piles an ointment made of turmeric, hemp leaves,onions, and warm mustard or linseed oil gives great relief when the piles are painful andprotruding also effective in eczema. Itches, etc. In pemphigus and shingles, the part firstsmeared with a thick coating of mustard oil and then dusted on with turmeric powder iscured with 3 or 4 days. In catarrh and coryza the inbalation of the fumes of the burningturmeric from the nostrils causes a copious mucous discharge and gives instant relief; thefumes are also used to relieve hysterical fits. The inhalation is taken at night and no fluidis allowed for some hours afterwards. Smoke produced by sprinkling powdered turmericover burnt charcoal will relieve scorpion sting when the part affected is exposed to thesmoke for a few minutes. Turmuric and alum powder in the proportion of 1 to 20 isblown into the ear n chronic otorrhoea. With borax as pate it is applied to reduce indolentswellings. It is given in urinary diseases. Milk boiled with turmeric rhizome added to it,and then sweetened with sugar is a popular remedy for cold. Internally turmeric is givenin affections of the liver and in jaundice. Following powder is a good digestive:-Take ofturmeric, long pepper, ginger, Cardamoms, ten grains each in powder and black pepper
    • powder five grins. Mix well and make and compound powder. Following confection ishighly recommended in obstinate skin complaints. – Haridrakbanda.-Take or turmeric 64tolas, clacified butter 48 tolas, milk 16 seers; sugar 12 tolas and boil them together over agentle fire in an earthern pot. Then add black pepper, long pepper, ginger, cinnamon,cardamom, tejapatra, baberang seeds, root of Ipomea, Turpethum, the three myrobalans,flowers of Mesua ferea, tubers of Cyperus rotundas and prepared iron, each 8 tols in finepowder and prepare a confection. Dose:-one tola every morning in praurigo, boilsurticaria and chronic skin eruptions-(Bhaishajyratnavali). A cure is effected in 7 days .Tests-Good turmeric should be of a reddish orange apperarance when broken or cut intwo and should also have a moist feeling.MELIA AZADIRACHTASee Azadirachta Indica.(N.O:- Melianceae)Sans.-Ravipriy; Vembaka; Vranashodhakari; Nimba; Arishta; Pichumanthah. Eng.-Neemor magrosa Tree; Indian Lilac. Fr.-Azadirae d’Inde; Margousier. Ger.-IndischerZedrach.Hind., Duk., Punj.&Ben.-Nim or Nimb; Nimga-chh. Guj.-Libma. Mah.-Kadhunimba.Bom.-Nim; Balnimb; Tel.-vepa. Kahibevu. Kon.-Beva-rooku. Pers.-Neem. Sinh.-Kohumba. Burm.-Tamabin; Kamakha. Malay.-Dawoon Nambu; Baypay. Habitat.-Indigenous to and cultivated nearly all over India and in Burma.Parts used:- Every par of the plant-bark, root-bark, young fruit, nut or seed, flowers,leaves gum and toddy or sap. “Bark and leaves are of particular interest form medicinalpints of view”.Constituents.- “The bark exudes a clean bright ambercoloured gum which is collected insmall tears or fragments. It contains a bitter alkaloid named “margosine” in long whiteneedles, as a double salt of margosine and soda-a neutral, amorphous resin believed toreside in the inner bark or liber. Leaves contain a small quantity of bitter substances ofsimilar character but much more soluble in water. This substances also contained in thebark is a hydrate of the resin which it closely resembles in its properties. Seeds containabout 10 to 31 p.c. of a yellow bitter fixe oil which is extracted by boiling or by pressure.“The oil is deep yellow in colour and has a 0.9235 at 15.50 c ; at about 100 to 70C, ifcongealed without losing its transparency; the oil contained free and volatile fatty acids.After standing for about 36 hours, the freshly expressed oil deposited a white sedimentwhich on microscopical examination was found to be amorphous in character. Thecolour reactions of the margosa oil were not characteristic. The volatile fatty acidsprobably consist of a mixture of stearic and oleic acids with a small amount of lauricacid.Action & Uses in Ayurveda .- Tikta rasam, katu vipakam, seetha veeryam, pitta kaphaharam, lagu, grahi, in srameam, trishna, kasam, jwaram, aruchi, krimi, vranam, chardhi,kushtam, premeham. Leaves: In krimi, pitam, visham, arochakam, kushtam. Fruits:-Bedhanam, snigdam, ushana veeryam, lagu, in kushtam, gumam, arsa, krimi, premeham,and in chronic fevers.- (Therapeutic Notes).
    • EMBLICA OFFICINALIS.See Phyllanthus emblica.(NO.- Euphorbiaceae)sans.-Dhatri-phala; Amraphalam; Amalakam; Sriphalam; Amalaki; Vayastha. Eng.-Embic Myrobalam; Indian gooseberry. Ger.-gebrauchlicher, Amlabaum. Fr.-PhyllantheEmbic, Hind- amla; Aoula; Aura; Amlika; Anvurab. Bom.-Amla; Avalkati. Ben.-Amlaki; Amla. Mab. & Gwalior.-Avla; (Seed) Avalkati. Te,.-Neli; Usrikeyi;Amalakamu; Usiri. Tam.-Toppi; Nellikkai. Mal.& can.-Nellikai. Sinb.-nelli; Nelika.Biirm.-zip. Ambala; Amla. Kash.-Aonla. Arab.-Amlaj. Pers- Amla; Amulh; Amial.Assam. Amluki. Nepal.- amla. U.p.- Amla; asula. Uriya.- Amlaki. Santal.-meral. Habitat.- The deccan, the sea-cot districts and Kashmir.Parts Used.- Dried fruit, the nut or seed, leaves, root, bark and flowers. Ripe fruit usedgenerally fresh, dry also used.Action. – Fresh fruit is refrigerant, diuretic and laxative. Green fruit is exceedingly acid.Fruit is also carminative and stomzchic. Dried fruit is sour and astringent. Flowers arecooling and aperient. Bark is astringent.Action & Uses in Ayurveda .- Resa, all except lavana, kashayam dominate, seethaveeryam, mathura vipakam, tridosha, haram, rasayanam, increases sukram. (TherapeuticNotes).Indications.- Rakta-pittam, pramcham, vata-raktam, giddiness, vertigo. External use:- Inmental disorders as paste and tailam to head. Tara-dravam. (Therapeutic Notes).Preparations.- Decoction and infusion of leaves and seeds; a liquor, a fixed and anessential oil; confection; powder; paste and pickles. An astringent extract equal tocatechu is prepared form the root by decoction and evaporation. TERMINALIA BELERICA. Roxb. (No.:- Coberaceae)Sans. – vibhitaka; vibhitaki; vipitakaha; Anilaghnaka; Aksh; bahira; Karshapalah;kaligrvamah; Bhata-vasah. Eng. – Beleric myrobalas. Hind.-Bhaira; Bahera; Bhera;sagona; Bharla; Buhura. Ben.-bohera; baheri; Bhairah; Buhuru; boyra. Punj.-Bahira;Bahera; Birha; Bayran. Bom.-Behara; Behaira; Behada; Behds; bherdha; Balra; bahuda;Yella; Gting; Yel; Behda; Bherdha; Mah.- bherda; Bacheda; Bahera; Sagwan; Beda;yehcla behada. Guj.-berag. Tam.-Tani; Tani; Kattu-elupay; Tanrk-kay; Tandi-tonda;Chattau-elup; Tamkai; Vallaimurdu; Tanioi; Tankrikkai. Tel.-Tani; Tandi; Tandhikaya;Thandra; Thana; tadi; Kattu-olupoe, Tandrakaya; bahadraha Mal.-Tennikai; Tanni. Cun.-Tankrikai; Tari; Shanti-marakon.- Goting. Arab.- baleela. Hbitat.- A tree common in Indian forests and plins” Parts Used – Fruits.Constituents.-Beleric myrobalans consist of gallo-tannie acid, colouring matter. Resins,and a greenish yellow oil 25p.c Action.-Astringet. Tonic, expectors and laxative.
    • Action & Uses in Ayurveda .- Rasam, kashayam, mathura vipaka, ‘ishna veeruyam, pittakapha haram, good for vision, hair. Internally for kasam, krimi, swarbhan-gam, asmari.Externally antiseptic, lotion, Paste for pitta swellings, eye diseases.- ( Therapeutic Notes).TERMINALIA CHEBULA.Retz., T reticulata.(N.O :- Combretaceae).Sans.-Pathya; suddha; Bhisnak-priya: haritaki; Abhaya; Vayastha; Amritha; haimayathi;Vijaya; Jivanthi. Eng.-Myrobalam. Chebulic Myrobalam; Ink nut; Indian gall-nut;Gallnut. Fr. – Badamier Chebule. Ger.-Respiger Myrobalanenbaum. Hind.-Harara; har;Pile-har; Balhar; Zangihar; kalehas (fruit); hana (dye), Punj.- har; Harrar; Hurch; halela(tree); Har. Arab.- Halilaja; Hallela. Pers.-halila hazards. Sind.-Imachi. Hin.&Dui.-Pile-hara; Harda. Ben.-Hora; Hari-taki. Punj.&kash.-Zard Halela. Guj.- Himaja; Pilo-harde:kabuli-hards. Mah.-Hirada. Bom.-Hirda; Harda: Hirada; Bala-hirade; Harle; Pilo –harle;Hardi. Te.-karakkaya: karaka: karaka: karakai (dye): kadukar; karka (tree); Pinda-karakkay(fruit); Tam.-Kadookai; baduk-kai (mature); Pinchu-kadukkai (immature);Kada-kai; Kaduk-kay(tree); Kaduk-kay-pinji (fruit; kadukkai-pon (thses are gall-likeexcrescenses on the leaves and young branches of T.chebula): Mal.- Kadukkal. Can.-Anilayakayi; Alate-huvru (Poo-flowers): Alale or Hirade (dye) Fruit): Sinh.-Aralu.Malay.- Bush Kaduka.Habitat.-This tree is wild in the forest of northern India, central provinces and Bengal.Common in Madras. Mysore and in the southern parts of the Bombay presidency.In general. Myrobalans are oval in shape and about two laches long, and are of a dullyellow colour. There are 4 varieties: (1) Survari harade, which are large, dense andheavy about 2 inches long. Yellowish-brow; when cut it contains yellowish or darkishbrown, pulp and stone. (2) Rangariharade these are smaller, less wrinkled and lessfurrowed than the above variety; in length about an inch; the epidermis is yellow; whencut it presents a yellow dried pulp and a stone. The pulp is less astringent than that ofSurvari harade. (3) bala harade are smaller than the above two varieties. Their colour isdeep brown or black: highly wrinkled, dark or brown epidermis. Their pulp in dark allhomogenous; there is no stone. (4) Java harade: these are the smallest of all. Othercharacters are similar to those of Bala harade.Parts Used.-Dried fruits: immature fruits; mature fruits myrobalans and galls; mostly theouter skin of the fruits. “Two varieties are used in Unani. Viz-(1) Halilard (Maju): (2)Halila kabli (Surat). Besides Halila Siah (Pinju).”-(Therapeutic Notes)Constituents.- Myrobalans contain astringent principles: tannin (tannic acid) 45 p.c., anda large amount of gallic acid, incilage, a brownish yellow colouring matter, chebulinicacid which when heated in water splits up into tannic and gallic acids.Aciton.-Myrobalans are a safe and effective purgative (gentle laxative), astringent andalternative. Unripe fruits are more purgative and the ripe are astringent Rangari haradeare alternative, stomachie, laxative and tonic. Survari harade is a valuable purgative.Bala harade is a mild and safe aperient and antibilious, though astringent, Ripe fruit isconsidered as purgative removing bile and phlegm, and to adjust bile.Action and Uses Ayurveda and Siddha.-Rasa-all except lavana, ushna veeryam, tridoshaharam, mathura vipaka, medyam, rasayanam, lagu, brahmanam, laxative, ayushyam. Inswasam, kasa, prameham, archas, sopham, kushtam, grahani,udaram, hridrogam.Externally, in veta swelling eye diseases, skin diseases.-(Therapeutic Notes)
    • PIPER CUBEBA,Linn – See Cubeba officinaliesPIPER LONGAUM, LINN.Chavica roxburgii.(N.O:- Piperaceae)Sans.-Pippali; Trikana; Tikshnatandula; Maghadhi; vsai-dehikana; (root):- Pippili-moolam; Granthikam. Eng.-Dried chatkins; long-pepper. Hind.-pimpli; Pipal;Pipli;(root) pipli-mool. Ben.-Pili; Pepul. Guj.-Pipara; Pipli; Pipal. Mah.-Mohi; Pimpli;Pipli. Duk.-Pipaliana. Arab.Darfilfil; (root) Fil-fila-daraz; Fil-fila-moya. Pers.-Maghzpipal; Pipli; Filfildray; Pipal. Tel.-Pippali-katte; Peppelu Pippallu(Berries); Pipili;Modi (root). Tam.-Pipli; Tippali; (berries) Tipplilli; (root) modi mal.- Tippli. Can.-Hippali; Yippali. Kon.-Hipli. Sinh.-Tippili. Bom.-Pipli. Punj.-Pipal; Darfilfil. Malay.-Landa; Mula-gu. Burm.-Peikchin. Sind.-fill; fildray. Santal.-Ralli. Nepal-Pipla-mol.Habitant.-This plant is indigenous to North – Eastern and Southern India and Ceylon,and cultivated in Eastern Bengal.Parts Used.- Immature berries ( i.e dried unripe fruits or fruiting spikes ) dried in the sun,and stems (roots).Constituents.- Resin, volvatile oil, starch, gum, fatty oil, inorganic matter and an alkaloid,piperine 1 to 2 p.c.Action .- Infusion is stimulant, carminative alternative tonic more powerful than blackpepper; also aphrodisiac, diureue, vermifuge and emmenagogue. Externally, rebefacient.Root is stimulat. “First fruits are said to be ‘mathura-paka’, guru, katu rasam, seethaveeryam; melt kapham”.- (Therapeutic Notes)Action & Uses in ayuveda.- katu rasam, mathura vipakam, ushna veeryam, vatha kaphaharam, lagu, snigda, rasayanam, vrishyam, clears ulcers, stimulate agni, in swasam,kasam, gulmam, soolam, etc.,(Berries). Root:-as above, pittakaram, in udaram, krimi,anacham, pleeham, etc. 1929 PIPER NIGRUM. LINN. (N.O:-Piperaceae).Sans.-marcham; Maricha; Hapusha; Krishnam; Ooshnam; Valliyam. Eng.-Black-pepper;Decorticated pepper; Common pepper. Fr.-poivre. Ger.-Schwartze pfeffer. Hind.-Gulmirch; kalimirich. Duk. & Ben.-Kalimirich. Punj.-Gol-mirich; Golmorich; Habus.Afgh.-March. Sind.- Gulmirien. Arab.- Filfiluswud; fil-fila-siah. Pers.-pilpil. Kash.-Martz. Ben.-Vellajun. Bom. & Mah.-Kala-miri. Guj.-kalomirich. Tel.-Miriyalu;Miryala-tige. Tam.-milagu. Mal.-Kuru-mulaka; Kuru-milagu. Can.-Volloy-menasu.Kon.-Miri. Sinh.-Kalu-miris. Burm.-Sa-yo-mai; Navukon. Malay.- ladahitam.Habitat.- This pernnial climbing shrub is indigenous to Malabar and Travancore coasts,i.e., western coast of India. Part Used.- Dried unripe fruit-black pepper.Consituents:- A volatile alkaloid piperine or pipirine 5 to 9 p.c., Piperidine or Piperidin 5p.c a balsamic volatile essential oil 1 to 2 p.c., fat 7.p.c masocarp contains chavichi, abalsamic volatile oil, starch, lignin, gum, fat1 p.c proteids 7 p.c. and ash containingorganic matter 5 p.c Chavicin is a soluble pungent concrete resin; it contains very littlepiperline and no voltile oil. Piperine crystallizes in flat, foursided glassy prisms insolublein water.
    • Action.- Black pepper is acrid, pungent, hot, carminative, also used as antiperiodic,Externally it is rubefacient and stimulant to the skin, and resolvet. On the mucousmembrane of the urethra it acts like cubebs; Piperine is a mild antipyretic andantiperiodic.Action & Uses in Ayurveda.- Katu rasam, katu vipaka, ushna veeryam, vata kaphaharam, pitta-haram, tikshnam, ruksham, lagu dipanam, in swasam, soolam krimi, hicca,in eye diseases white pepper paste.- (Therapeutie Notes) ZINZIBER OFFICINALE (SCITAMINACEAE) sans:srangavera;sringa-beram;(dried)-sunta; Nagara; Nagaram;Visoushada;Maha-oushadam; Mahaushada;(fresh)-Ardhrakam;Katu-patram;Mihijam.Eng:Ginger. Fr.-Gingembre. Ger.-Ingwer. Arab.&Per.-zanjabil. Hnid. Duk., Ben. & Punj. (dried):-Sonth; (fresh) Adrak; Ada; Adi. Ben.-Ada. Kash.-Sonth; (fresh) Adrak; Ada; Adi. Ben.-Ada. Kash.-Sho-out. Bom. & Guj.-Adu. Kon. & Mah.-(dried):-Sunt; (fresh): - Ala;Alem. Tel.-(dried):-Sont; (fresh):- Allam. Tam.-(dried):-Shukhu; chukku. (fresh):-Inji.Mal.-Chukka. Can.-(fresh):-Hashi-shunti; (dried):-Vona-Shunti. Kon.-(dried):- Soonti;(fresh):-alen. Sinth.-Inguru. Burm.-(fresh:-Gin-sin; (dried):- Ginsi-kyaw. Malay.-Hulya-kring. Habitat.- Ginger is cultivated in many part of India; on a large scale in the warm,moist regions chiefly in Madras, Cochin and Travancore, and to a somewhat less extentin Begal and the Punjap. Constituents.- “India ginger contains an aromatic volatile oil, 1 to 5 p.c. of light-yellow colour having a characteristic odour and containing camphene, phellandene,zingiberine, cineol and borneol; gingerol a yellow pungent body; an oleoresin-“Gingerin”the avitve principle , other resings and starch; k-oxalate. The essential oil and resin, towhich ginger owes its pungent flavour, occur just beneath the skin or epidermis. Thepungent priciples of ginger are not vilatile in steam to any appreciable extent and are,therefore not found in the volatile oil. It has, however, been isolated and been named‘gingeroal’, but its true chemical nature has not yet been finally settld”.- (Chopra). Action.- Aromatic, crminative, stimulant to the gastrointestinal tract, andstomachiec, also sialagogue and digestive; Externally, a locl stimulant and rebefacient. Action and Uses in Ayurveda.- Katu rasam, ushna veeryam, vata-kapha-haram,katu vipaka, lagu, snigdam, pachanam, ruchyam, vrishyam, swaryam, vibhanada haram,
    • in grahani, agnimathyam, amavatham, chardhi swasam, soolam,arsas anaham, hrith,udhara rogam, externally in kapha, swellings, headache.-(Therapeutic Notes) PTEROCARPUS SANTALINUS, Linn. P. Lignum (N.O.- Papilionaceae)Sans. Hind. Ben. Mah. & Can.-Rakta-chanda. Eng.-RedSanders or Red Sandalwood.Fr.-Santal Rouge. Ger.-Dunkelrothe Flugal-frucht. Hind.-lalchandana. Pers.-Sandalesurkh. Guj & Bom..-Ratanili. Tel.-Rakta gandhamu; Erra-gandamu. Tam.-Shen-chandanam. Mal.-Chan-chandanam. Kon.-Rachandana.Habitat.- This small tree is generally met with in the forest of Southern India.Parts Used.- WoodConstituents.- Santalin or santalic acid, a cryialline red principle; santal pterocarpin, awhite crystalline insoluble substance; homopterocarphin with the same generalproperties, but more soluble in carbon bisulphide; glucoside and colouring matter.Action .- Mildly astringent, cooling and tonic.Uses.- Wood rubbed on a piece of stone with water forms an excellent coolingapplication and purifier of skin after bating like white sandalwood.
    • MYRISTICA FRAGRANS, Houtt M. officinalis, Linn. & Mart., M. aoschata; M. aromatica. (N.o: Myristicaceae)Sans.-Jati-phalam; malathi-phalam. Eng.-Nutmet. Fr.-Muscadier; Musque. Ger.-Achtermuscatnussbaum. Hind. Duk. & Ben.-Jayphal; jaiphal; Jaepatre. Kash.-Zafal. Bom.Punj. Guj. & Mah.-Jayiphal; javantri. Tel.-Jaajikaya. Tam.- Jadikkay; Jathikai. Mal.-Jatika. Can.-jajikai. Kon.-jaiphal. Sinh.-Jadika. Buram.-zadi-phu. Malay.-Bush-pala.Pers. & Arab. –Sauz-Bawwa; Zanza-bawawa.Sans.-Jatipatiri (arillus). Eng.-Mace. Fr.-Macis. Hind. Can. Tel. Mah. & Guj.-Jaepatri.Ben.-Jotri. Punj.-jauntari. Kash.-Jowwatri. Bom.-jawantri. Tam. 7 mal.-jadi-pattiri.Sindh.-Vasavasi. Burm.- Zadi-phu-apoen. Malay.- Bunga-pala. Arab. & Pers.-Bazabaza.Habitat.- Nutmeg tree is indigenous to the Malay peninsula and Penang. It has beensuccessfully cultivated in Madras and Southern India (Nilgiri Hills and Malabar Coast).Seeds are the nutmegs of commerce, and the arillus surrounding the seed within the outershell constitutes, when dried, the product known as mace.Parts Used.- Dried seed (deprived of testa), nutmeg(B.P.) arillus surrounding the seed,mace and wood.
    • Constituents.- Kernal (nutmeg) contains a volatile oil 2.8 pc., a fixed oil, proteids, fate,starch, mucilage and ash. Mce (arillus)contains a volatile oil 8 to 17 p.c., (identical withthat obtained for the Kernal, a fixed oil, resin, fat, sugar, destrin and muscilge, . Thefixed oil which is called “butter of nutmeg” consists of myristin and myristic acid, and aportion of the essential oil. Essential oil contins myristicene and myristicol. Essantial oilof mace is of a yellowis colour with the odour of mace and consist of macene.Action.-Nutmeg is aromtatic, stimulant and carminative; in large doses, narcotic.Concrete oil is used as a rubefacient; volatile oil is stimulant, aperient and carminative.Mace is carminative and aphrodisiae. Mahomedan writers describe nutmeg asstimulating, intoxicating, digestive, tonic and aph-rodisiac. Wood is astringent. “Dr.Osiander descrbies nutmeg as an antipyretic, and Dr.Paracelsus, Lonicerus and Mathiolusdescribe them as a gastric tonic. The content of an ethereal oil, 6-10%, in combinationwith myristicine gives the nutmeg a tonicising action on the stomach; its effect on themucous membrane of the uninary passages is irritative, which may account for its use asan aphrodisiac and abortifacient.- (Dr. Kober). In large doses, nutmeg oil has a narcoticaction and produces nausea, somnolence and headaches.- 9Dr.Marfori-bachem). Dr,Paracelsus, Lonicerus and mathiolus, used nutmegs with a constipating action; also as adiuretic against gastric catarrh and cardiac fibrillation. Dr. Osiander found nutmentsuseful against the vomiting of pregnancy.”Action & Uses in Ayurveda.- Tikta rasam, ushanam, kapha-vata-haram, lagu, rochanum,dipanam, gradi, swryam, in foul month, krini, kasam, chardhi, swasam, sosham,hridrogam, imorteney. (Therapeutic Notes).Mace:- mathura rasam, kattu rasam, ushna veeryam, kapha haram, lagu, ruchi varnakaram, in kasam, swasam, chridhi, thrishna, krimi, visham.Preparations.- Past, powder, pills, Confections, Expressed oil and Decoction of wood.
    • Graph Showing the Results 40 30 20 10 0 ed ed d re ov ov Cu pr pr Im Im Results 1 2 3 34.2857.14 8.57
    • TABLE SHOWING THE INCIDENCE OF NIDANA IN YUVANA PIDAKA PATIENTS IN THE STUDYSL. Nidana No. of Patients PercentageNo.1. Yuvavastha 35 100%2. Atimedya] Sweets 20 57.15 Bhakshana] Meat 24 68.53. Avyayama 17 48.54. Divaswapna 11 31.425. Psychological factors 16 45.716. Premenstrual exacerbations in Female patients 10 28.577. History of Nasya Karma -- 0%Note : For the assessment of psychological factors like mental stress and strain, thepatients were interrogated with great difficulty and delicacy and recorded for the study. TABLE SHOWING THE REPORTED CASES OF YUVANA PIDAKA IN DIFFERENT AGE GROUPS
    • Sl. Age Group No. of Patients PercentageNo.1. 0 – 15 - -2. 16 – 20 20 57.13. 21 – 35 8 22.84. 26 – 30 7 20.15. 31 – 35 - -6. 36 – 40 - -7. Above 40 - - TABLE SHOWING THE FIRST INCIDENCE OF YUVANA PIDAKA IN DIFFERENT AGE GROUPS OF THE REPORTED CASES
    • Sl. Age Group No. of Patients PercentageNo.1. 0 – 15 -- --2. 16 – 20 20 57.13. 21 – 35 10 28.54. 26 – 30 5 14.45. 31 – 35 -- --6. 36 – 40 -- --7. Above 40 -- --Note: The age of every patient, in this table, is considered in which the first occurrenceof the disease was observed. It was calculated by deducting the duration of sickness fromthe present age of the patient. TABLE SHOWING FOOD HABIT INCIDENCE OF YUVANA PIDAKASl. Food Habit No. of Patients PercentageNo.1. Vegetarian 11 31.4
    • 2. Non-Vegitarian 24 68.6 TABLE SHOWING THE SEX INCIDENCE OF YUVANA PIDAKASl. Sex No. of Patients PercentageNo.1. Male 22 62.9
    • 2. Female 13 37.1Table showing the Results Sl.no Result No. of patients Percentage
    • 1. Cured 12 35.282. Improved 20 57.143. Not – Improved 03 8.57
    • RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE KARNATAKA, BANGALORE PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION1. Name of the candidate and : R. VANITHA address (in block letters) No. 6, New State Bank Colony, West Tambaram, Chennai – 600 045 Tamilnadu2. Name of the institute : Sri D.G. Melmalagi Ayurvedic Medical College, Post graduation & Research Center, Gadag - 5821033. Course of study and subject : Ayurveda Vachaspathi M. D. (KAYACHIKITSA)4. Date of admission : September20015. Title of the topic : Evaluation of the efficacy of Nimbaragwadhadi yoga and Kustumburu lepam with Pratimarsha Nasya in Yuvana pidaka (Acne)6. Brief resume of intended work6.1. Need for the study Yuvana Pidaka i.e. a common Complex, fascinating malady of either sex in theteenagers. It is an extremely common complaint with 70% the population and is clinicallyevident at some point during adolescence or early adult life. Out of only 10-20% requestmedical attention for the problem1. The advent of new and potent therapeutic agents foracne has proved insignificant and in our ability to treat acne with topical therapy alone. Thiscommon problem turns into cosmetic problem and results in emotional upset. Patients withacne are often depressed and may need sympathetic counseling and support2. Therefore,the present study is designed with both internal and external administration of Ayurvedicdrugs to correct this cosmetic disorder 12-13.6.2. Review of Literature: Pidakas resembling the thorns of Shalmali with pain are called as Yavana pidaka3. It canbe correlated with Acne vulgaris explained by modern scholars. Acne vulgaris is a clinicalcondition of open and closed comedones, inflammatory papules, pustules, cyst nodules andoften scars 4.
    • Madhavakara uses the synonym Mukhadushika 5. It is also explained that it is a naturalprocess of adolescence. Madhava and Susruta described this disease is manifested due tovitiation of Kapha Vata Doshas and Rakta dhathu6. Vagbhata trace only Vata and Kapha ascausative factors with out considering Rakta7. Ayurveda classical texts like Yogaratnakara, Bhaisajyaratnavali, Susruta samhita,Sahasrayoga etc. give immense importance to the external applications for this problem."Nimbaragwadhadi yoga"8 internally and "Kustumburu lepam"9 externally with PratimarshaNasya 10 in Yuvana pidaka (Acne) are classical formulations extracted from Susruta samhita.As the main Doshas are Vata, Kapha and Rakta, it is necessary for internal medicine forradical cure. Therefore the internal medicine "Nimbaragwadhadi yoga", which is explained in 11the treatment of Padminikantaka , a similar complaint occurring on the face is selectedfrom Susruta samhita.6.3. Objectives of the study1. To evaluate the efficacy of "Nimbaragwadhadi yoga" internally and "Kustumburu lepam" externally with Pratimarsha Nasya in Yuvana pidaka (Acne).2. To evaluate the efficacy of "Nimbaragwadhadi yoga" internally and "Kustumburu lepam" externally with Pratimarsha Nasya in androgens which cause Acne.7. Material and methods7.1. Source of dataa) Literary: Literary aspects of the study will be collected from standard Ayurvedic texts, Modern books, Magazines and journals.b) Drug: Nimbaragwadha yoga and Kustumburu lepam 14 The ingredients of Nimbaragwadha yoga and Kustumburu lepam are properlyidentified. The Good manufacturing procedures are followed for the preparation. Thecombination and proportion of Nimbaragwadha yoga and Kustumburu lepam is asfollows.
    • Nimbaragwadha yoga and Taila (for Pratimarsha Nasya) Nimba (Melia azadirachta Linn.) 1 Part Aragwadha (Cassia fistula, Linn) 1 Part Kustumburu lepam Kustumburu (Coriandrum sativum, Linn) 1 Part Vacha (Acorus calamus, Linn) 1 Part Lodhra (Symplocos racemosa, Roxb) 1 Part Kusta (Saussurea lappa, Clarke) 1 Partc) Patients: Patients with Yavani Pidika will be selected from O.P.D. of Post Graduation andResearch center of Sri D.G.M. Ayurvedic medical college & Hospital, Gadag by presetinclusion and exclusion criteria.7.2. Method of collection of data a) Study design: Prospective open clinical trial b) Sample size: A minimum of 30 patients c) Exclusion criteria: 1. Patients below the age of 10 years and above the age of 30 years, pregnant and lactating women will be excluded from the study. 2. The patients having diabetes mellitus and other systemic diseases will be excluded. 3. The patients with concomitant therapy will be excluded. 4. Patients using Glucocarticoids and anti-epileptic drugs are excluded. d) Inclusion criteria 1. The patients are selected with pidaka between the age groups of 10 to 30 years 2. The patients are selected irrespective of Sex and race based on the clinical signs & symptoms other than that of exclusive criteria, e) Posology: 2 gm/24 hours in divided dose or 33mg/Kg-body weight in divided dose orally f) Study duration: 21 days
    • g) Assessment of result The results will be assessed by subjective as well as objective parameters.7.3. Investigation 1. Hb% 2. Differential count 3. Androgens i.e. Testosterone7.4. Ethical clearance : Obtained8. List of references1. Manual of Dermatology by Philadehphia W. D. Samdos 19912. The look you like by Schoent and Lazar, pp 253-2723. Astanga Sangraha, Uttarasthana 36/5, translated by, Prof. K. R. Srikanta Murthy pp 3164. Manual of Skin disease by Gordon C. Saucer John C. Hall, pp126-1355. Madhava Nidana, Kshudraroga Nidana, 55 chapter.6. Susruta Samhita Nidana 13th chapter.7. Astanga Sangraha uttara sthana, 36/ 58. Susruta samhita Chikitsa 20/379. Susruta samhita Chikitsa 20/3910. Astanga Hridaya uttara 32/411. Susruta samhita Chikitsa 20/3812. B. V. Parmar – Study of Yuvanapidika with special reference to the concept of pathopysiology and its principles of management – Gujarat Ayurveda University, Jamnagar.13. D. P. Singh – Role of certain Indigenous drugs on Yuvana pidaka – Gujarat Ayurveda University, Jamnagar.14. Indian Materia Medica by A. K. Nadkarni, 3rd revised edition, published by Popular Prakashan, Bombay, 1976,
    • EVALUATION OF THE EFFICACY OFNIMBARAGWADADHI YOGAAND JATHIPHALADHI LEPA IN YAUVANPIDAKA - By - Dr. Vanitha. R.
    • Guide Dr. Vangipuram Varadacharyulu M. D. (Ayu), (Osm) Professor and Head of the department, Kayachikitsa. Post graduation studies and research.D.G.Melmalagi Ayurvedic Medical College Gadag- 582103.
    • Introduction01. Recent trends of researches in various fieldswere carried for human welfare.02. This involve multi-dimensional approaches inmedical sciences with basic support of biologicaland pharmacological investigations.03. In the series cosmetology is newer field ofresearch and scientific interest which is gainingimportance.04. Therefore, the present study has been undertakento examine the potentials in Ayurveda in the field ofcosmetology.
    • 05. Yuvana pidaka is a common complex,fascinating malady of either sex in the teenagers.06. It is an extremely common complaint with 70%of the population and clinically evident at somepoint during adolescence or early adult life.07. Yuvana Pidaka is one of the diseases mentionedunder kshudra Rogas and mentioned as Mukhadooshika as it decreases the complexion andsmoothness of the face.08. This disease is viewed as a burning cosmeticproblem than a medical one.09. An equivalent terminology in modern medicinein Acne vulgaris.
    • Historical reviewSushruta Samhita Nidanasthana 1336.Sushruta Samhita Chikitsasthana 2037.Ashtanga Sangraha Uttarasthana 367.Ashtanga HridayaUttarasthana31/5 & 32/3.Madhava Nidana 55/33.Bhavaprakasha Madhyama khanda 31/32-35.Yoga RatnakaraBasava Rajeeyam 22nd Chapter.Sharangadhara Samhita Uttarakhanda 11/11 & 15.Chakradatta Chikitsa prakaranam 55/41-43.Ananga Ranga 8/91-93.
    • Literary meaning The term yuvana pidaka comprises of two words. 01. Yuvana 02. PidakaYuvana The word indicates the age factor of a person. The age factor that is stipulated to say the person as yuvana is betweenseventeen and thirty years2. According to sir Monier Monier Williams yuvana means young, youthfuladult. Taruna, Yuvavastha are the synonyms given to the word3.Pidaka The word is defined as “PEEDAYATEETI PIDAKA” ‘SPOTAKA VISHESHAHA PIDAKA4’ Pidaka menas small boil, pimple or pustule5. Pitaka, pidika, pitika are the synonyms for pidaka.
    • By keeping the above two words in view the yuvanapidaka is defined as follows. SHALAMALI KANTAKA PRAKYAHA KAPHA MARUTA SHONITAIHI JAYANTE PIDAKA YUNAM VAKTRE YA MKHA DOOSHIKA The pidaka in the shape of shalmali kantaka (Spine ofIndian red silk tree) produced due to the vitiation of kapha,vata and Rakta in youth age on the face causing disfigurationis called as yuvana pidaka6. Tarunya pidaka, Mukha Dooshika are the synonymsfor yuvana pidaka.
    • Regional namesAssam : SalamanaBengal : Bahija phoraDogr. : MuhasikaGujarathi : KhilaHindi : MuhasaKannada : ModaveMalayalam : MukhakkuruMarathi : Murum, Tarunya pidikaOriya : Vayas vranaPunjabi : KilaTamil : MugapparuTelugu : MotimaluEnglish : PimplesGreek : AkmeMedical term : AcneSanskrit : Yuvana pidaka, Mukhadooshika, Tarunya , Pidaka
    • Table Showing the layers of twakSl. Sushruta Charaka Vagbhat Modern Udakadhara Udakadhar # Stratum1 Avabhasini Corneum a Asrugdhara Asrugdhar # Stratum2 Lohitha lucidum a * * # Stratum3 Swetha granulosum * * # Stratum4 Tamra Malphighii * * + Papillary5 Vedini layer * Pranadhara + Reticular6 Rohini layer - - +7 Mamsadhara Subcutaneous
    • Description of Twak staraName of the Pradhama Dwithiya Tritiya Chaturtha Panchami Shashti SapatiniAuthor Charaka Pradhama Dwithiya Tritiya Chaturthi Panchami Shashti - Udakadhara Ashrgdhara sidhama Dadru kushta Alagi, Arumshika Kilasa Vidhradhi Vriddha Pradhama Dwithiya Tritiya Chaturthi Panchami , Shashti - Vagbhat Udaka Ashruk sidhma Sarva kushta Alagi, Praana Kilasa VidhradhiPaarishadilya Avabhasini Lohita Sweta Taamra Vedini Rohini Mamsa dhatuNomenclatur Udakadhara Ashrugdhara e Modern Stratum Stratum Stratum Malphigian Stratum Stratum SuperficialNomenclatur corneum lucidum granulosum layer papillae reticulum deep fasci e Sushruta Avabhasni Lohita, Seta, Taamra, Vedini, Rohini, Mamsadhara, siddha Tilakaalakam Charmadala, Kilasa, Kushta, Grandhi, Bhagandara, , Nyachha, Ajagallika, kushta, 1/18th Visarpa 1/5th Apachi, Arshas, Vyanga, Masaka, Arbuda, Vidhradhi 2 1/16th 1/12th Shleepada, yava Gandamala 1 yava As per Dr. Horney layer Stratum Stratum Malphigian Papillary Reticular Subcutaneous Chunekar lucidum granulosum layer layer layer tissue & muscle
    • Changes in the skin Yuvana Pidaka is the disease of Romakoopa.(a) An increase in sebum secretion(b) Thickening of the keratin lining of the sebaceousduct, to produce black heads or comedones. Thecolour of the black heads is due to melanin, not dirt.(c) An increase in fatty acids(d) Inflammation around the sebaceous glands;probably as a result of the release of bacterialenzymes.
    • Nidana All types of Nidanas can be divided into6 types –SwabhavaAge factorDietic factorsExtra-dietic factorsPsychological factorsComplication of Nasya karma
    • Samprapti Nidana sevana Kapaha & Vata dosha pradhana vikriti Agnimandya Ama Dosha-Dushya SammoorchhanaDevelopment of pidakas at Twakghata roma kupas Yuvana pidaka.
    • Samprapti Ghatakas۵ Doshas : Kapha and vata۵ Dushyas : Twak(Rasa), Raktha and Medas۵ Agni and Ama : Jataragni and dhatwagni janya Ama۵ Srotas : Medo vaha srotas۵ Dusti Prakara : Sanga۵ Udbhava sthana : Amashaya۵ Roga marga : Bahya۵ Adhistana : Twak gata Roma Koopas۵ Sanchara Sthana : Through out the body۵ Vyakta sthana : Mukha
    • RoopaS Laxana C.S. S.S. Vag. Bhask. Bhavpr Sharan akasha gadharal. Shalmalikantaka1 Sadhrusha - + + + + + Medas2 encapsulated - - + - - - Pidaka Sarujah3 - - + - - - Ghanah4 - - + - - - Occurs on the5 face - + + + + + Occurs in6 Yuvavastha - + + + + + Mukhadooshika7 - + + + + +
    • Sapeksha NidanaYuvana pidaka KakshaPrameha pidakas GardhabhikaYava Prakyaya Pashana GardhabhaAntralagi Jala GardhabhaParimandala GandhaKatchoo and Pama KustaValmeeka AgnirohiniVisarpa Spota.
    • Sadhyasadhyatwam Yuvana pidaka which appears in certainconditions is said to be sukha sadhya, viz. Yuvana avastha Less symptoms No longer duration
    • Upadrava The Yuvana pidakas causes fomation of scarwhich is complication in cosmicological aspect. Apart from these patient is not developingany severe forms of systemic disorders.
    • Chikitsa vivechana According to Ayurvedic line ofmanagement is of three types –Daiva VyapashrayaSatwavajayaYukti Vyapashraya
    • Yukti Vyapashraya chikitsa This is of three types –@ Antaparimarjana@ Bahiparimarjana@ Shastrapranidhana
    • Treatment of Yuvana Pidaka by Different authorsS Treatment C SS AHr AS BP ShS YR C BRl. S D1 Mukha - + + + + + + + + lepa2 Vamana - + + + - - - + -3 Nasya - - + + - - - - - karma4 Abhyanga - - - - - - + + -5 Siravyadha - - + - - - + + -
    • MUKHA LEPAS : -I. Vacha, Lodhra, Dhanyaka in equal quantitieswith milk.II. Kustumburu + Vacha + Lodhra + Kusta withmilk.III. Vacha + Lodhra + Saidhava Lavana with wateror milk.IV. Vata Patra + Narikela Majjeerasa (milk likeextraction prepared by grinding and squeezing theendocarp of fresh coconut).
    • Mukha Lepas : -V. Vacha + Lodhra + Dhaniya + Gorochana +Mareecha with water ( Anukta paribhasha)6Shalmali Kantaka Choorna with mailk.VI. Matulunga + Vata Patra + Sarpi + Shilajit withGoshakrut rasa.VII. Arkaksheera + Haridhra, after mardhana isadvised as mukha lepa.VIII. Jateephala + Chandana + Mareecha withwater (Anukta paribhasha).
    • PathyapathyaPathya can be prescribed into 2 parts – Ahara : Purana shastika shali, Godhuma, Tikta shakas like patola, Nimba etc., Dhanyaka, Mareecha, Hingu, Lasuna, All green vegetables & Carrots. Vihara : Normal exercises Exposure to evening sun-light Washing the face regularly with tepid water.
    • PathyapathyaApathya can be prescribed into 2 parts – Ahara : Madhura rasa padarthas (Sweets especially chocolates, nuts, etc). Medya padarthas (Fats and Fatty acids, Meat, Oils, etc.). Dadhi. Ice creams. Vihara : Divaswapnas Avyayama. Using greasy cosmetics. Squeezing the lesions.
    • Criteria for Selection of the Patients : - 35 patients diagnosed as yuvana pidaka wereselected from OPD of Sri DGM Ayurveda medicalCollege & P.G center for present clinical trail. The patients were selected on random basisirrespective of their age, sex, caste, duration of thecomplaints, food habits and occupation.
    • Criteria for diagnosis of the Disease : - Patients who complained pidaka (eruptions)over face, neck and back in yuvavastha werediagnosed as yuvana pidaka.Disease assessment gradings –Gr. I – ComedoneGr. II – Comedone & PapulesGr. III – Comedone, Papules, Pustules and cystGr. IV – Wide spread involvement of face and upper half of the body.
    • Trail DrugsFOR INTERNAL FOR EXTERNAL MEDICATION APPLICATIONNimbaragwadadhi yoga Jathiphaladhi Lepa• Nimba (Panchanga) • Jathiphala• Aragwadha • Maricha• Triphala • Raktachandana• Haridra Ref. Sahastrayoga Ref. Yogaratnakara (kushta Prakaranam)
    • Criteria for selection of Drugs : - All the drugs were selected rationally on thebasis of their properties. The formulation of Nimbaragwadadhi yogawas prepared as per the sentence of Sahastra Yoga. The formulation of Jathiphaladi Lepa wasprepared as per the sentence of Yogaratnakara.Posology –Internal Medicines – (Nimbaragwadadhi Yoga) 2gms / day. [Each capsule was of 500 mg.]External Application – (Jathiphaladi Lepa) Appliedon face overnight & washed in the morning.
    • Treatment Protocol –Study duration – 21 days.Follow-up – 1 month.General Rules – 1. The dosage of internal medication wasaltered according to the severity of the disease andage of the patients. 2. The duration available for the study wasonly two years and hence recurrence criteria islimited within the period.
    • Result Assessment Criterias : - The results were assessed after a month in terms ofcured, improved and not improved.Cured : Complete relief form the signs and symptomsduring the treatment and non-recurrence of the disease isconsidered as cured.Improved : Complete relief from the signs andsymptoms during the treatment and recurrence afterstopping the treatment.Not – improved : Continuation of signs and symptomsor slight improvement with recurrence as beforetreatment, is considered as not-improved.
    • Incidence of Nidana SevanaSl Nidana No. of Pts. %1 Yuvavastha 35 100%2 Atimedya Sweets 20 57.15% Bhakshana] Meat 24 68.5%3 Avyayama 17 48.5%4 Divaswapna 11 31.42%5 Psychological factors 16 45.71%6 Premenstrual 10 28.57% exacerbations in Female patients7 History of Nasya karma - 48.5%
    • Graph Showing the incidence of nidana 40 35No. of Pt.s 30 24 20 17 16 20 11 10 10 0 a b c d e f g Nidanas Series1
    • Distribution of Patients by Age Sl. Age group No. of Pt.’s % 1 0 – 15 - - 2 16 – 20 20 57.1% 3 21 – 35 8 22.8% 4 26 – 30 7 20.1% 5 31 – 35 - - 6 36 – 40 - - 7 Above 40 - -
    • Distribution of patients by Age incidence 20 20No. 15 10 of 10 5Pt.s 5 0 0 0 0 0 0 – 15 16 – 20 21 – 35 26 – 30 31 – 35 36 – 40 Above 40 Age groups No. of Pt.s
    • Distribution of Pt.’s showing the first incidence of Yuvana PidakaSl. Age group No. of Pt.’s %1 0 – 15 - -2 16 – 20 20 57.1%3 21 – 35 10 28.5%4 26 – 30 5 14.4%5 31 – 35 - -6 36 – 40 - -7 Above 40 - -
    • Distribution of Pt.’s showing food habitSl. Food habit No. of Pt.’s %1 Vegetarian 11 31.4%2 Non-vegetarian 24 68.6%
    • Distribution of Pt.’s by sex incidenceSl. Sex No. of Pt.’s %1 Male 22 62.9%2 Female 13 37.1%
    • Overall ResultSl. Result No. of Pt.’s %1 Cured 12 35.29%2 Improved 20 57.14%3 Not-improved 03 8.57%
    • Overall result of the therapy Not – Improved 9% Cured 34%Improved 57% Cured Improved Not – Improved
    • DISCUSSION ON DEMOGRAPHIC DATAS –01. Age – As per the “table showing the age of the patients andtheir first occurrence of Yuvana pidaka”, the statisticsreveal the first incidence was observed between the 18-23years of age. This clearly speaks yuvana pidaka occurs more in theearly part of yuvavastha.02. Sex – Yuvana pidaka was observed in both the sexes almostin equal percentage i.e., 53.7% of males and 46.3% offemales. There is no sex difference in the incidence ofyuvana pidaka. But during observation of the patients it was foundthe more severe form of yuvana pidaka was found in males.
    • DISCUSSION ON DEMOGRAPHIC DATAS –03. Food habits – The incidence of yuvan pidaka was high in Non-vegetarians than, in vegetarians. This is probably due to the non-vegetarians whoconsume more of fatty food, i.e Medhya Ahara.04. Nidana – The combination of all types of Nidana was found insome patients who came with severe Yuvana pidaka.
    • DISCUSSION ON RESULTS – There was 35 cases out of which cured were12(34.28%), improved were 20(57.14%) and not improvedwere 3(8.57%). The percentage speaks by itself that the Mukha lepacombined with internal modification provides grater cureand appreciable improvement. A prolonge use of bothinternal and external medication will be very effective. Considering the duration, if the duration is less thetherapy will be more effective.
    • LIMITATION OF STUDYSample size is small to generalize the result.Long standing use of the medications should bestudied on large sample size to find out the statistical& potentiality of the drug.Drug being a compound formation is difficult to drawits mode of action regarding rationality.Samples were selected incidentally.
    • Conclusion Based on literature & observations ofpresent clinical study we can draw followingconclusions –The Yuvana pidaka is common skin problemtroubling predominantly in the teenage.In our classical it is considered as Kshudraroga, but even though 70% of the population iscomplaining of Yuvana Pidaka.
    • This disease is appearing as a cosmeticproblem rather than a systemic disease.This will not produce any severe systemiccomplications but, due to ugly look apatient gets discouraged.Application of both internal & externalmedicaments gives better results thanindividual one.