Contraindications of Virechana- Relevance in present scenario.pptx
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Contraindications of Virechana- Relevance in present scenario.pptx
- 1. CONTRAINDICATIONS OF VIRECHANA – RELEVANCE IN PRESENT SCENARIO
- 2. NEED OF THE TOPIC • Aware about conditions where virechana should not be done • Possibilities of doing virechana in contraindicated cases
- 3. Why ayogyata is told? “विरेचनैर्यान्ति नरय विनयशमज्ञप्रर्ुक्तैरविरेचनयर्य ॥” (सु/वच/३३/३१)
- 4. VIRECHANA • तत्र दोषहरणं अधोभयगं विरेचनसंज्ञकम् ; उभर्ं िय शरयरमलविरेचनयविरेचनसज्ञञां लभते ॥ (Cha/Ka/1/4) • विरेचनं वित्तहरयणयं ... | (Cha/Su/25/40) • ..... अनयमर्त्वम् | (Cha/Si/1/17)
- 5. CONTRAINDICATIONS THROUGH DIFFERENT SAMHITAS • अविरेच्यस्तु सुभग क्षतगुदमुक्तनयलयधोभयगरक्तवित्त अवतविलंवित दुर्ालॆन्तिर् अल्पयवि वनरूद कयमयवदव्यग्रयजयणा निज्वरर मदयत्ययवर्त अध्मयत शल्य अवदातयवभहत अवतविग्ध रूक्ष (च/वस/२/९) • ................................. न तु रेच्यय निज्वरय ॥ अल्पयवि अधोगवित्तयस्रक्षतियय्िवतसयररण । सशल्ययस्थयवित क्र ू रकोष्ठयवतविग्ध शोवषण ॥ (अ ह्रु/सू/ १८/१०)
- 7. VITALS DURING VIRECHANA* *Clinical study to evaluate the effect of Virechanakarma on serum electrolytes by Adil Rais and Santoshkumar Bhatted PMID : PMC3968700
- 8. HYPERCALCEMIA CONSTIPATON NAUSEA DECREASED APPETITE CONFUSION ABDOMINAL PAIN FLANK PAIN REPEATED URINATION VIRECHANA AYOGA VITGRAHA CHARDI ARUCHI - - - - VIRECHANA ATIYOGA - - - TAMA DARSANA PAKWASAYA SULA PARSWA KAMPA - COMPARISON OF VIRECHANA AYOGA/ATIYOGA WITH ELECTROLYTE CHANGES
- 9. HYPOCHLOREMIA HYPOVENTILATION RESPIRATORY ACIDOSIS VOMITING DEHYDRATION FLUID LOSS METABOLIC ALKALOSIS VIRECHANA AYOGA HRUDAYAASUDHI - - - - VIRECHANA ATIYOGA HRIDAYASOSHA SWASA CHARDI JALAM SRAVET KAPHA PITTA RAHITA UDAKA NISARANA -
- 10. HYPOKALEMIA ABNORMAL HEART RHYTHM FLACCID PARALYSIS WEAKNESS TREMOR MUSCLE CRAMP CONSTIPATION MYALGIA VIRECHANA AYOGA - URUSADA - - PINDIKODWESTANAM VITGRAHA - VIRECHANA ATIYOGA HRUDAYODWESHTANAM - DOURBALYA KAMPA - - ANGAMARDANA
- 11. HYPONATREMIA NAUSEA MALAISE LETHARGY LOSS OF APPETITE CONFUSION IRRITABILITY MUSCLE WEAKNESS VIRECHANA AYOGA CHARDI - - AGNISADANA - - - VIRECHANA ATIYOGA - DOURBALYA KSHAMATA - SMRITI BHRAMSA - -
- 12. AYOGYATA
- 13. KARMA ASAHA SL NO. CONDITIONS CHARAK SAMHITHA SUSRUTHA SAMHITHA ASHTANGA SANGRAHA ASHTANGA HRIDAYA KASYAPA SAMHITHA 1 LANGHITHA + - + - + 2 DURBALA + - - - - 3 DURBALENDRIA + - - - - 4 UPAVASITA + - - - + 5 SUBHAGA + - - - + 6 ALPAGNI + + + + - 7 ABHIHATA + - - - - 8 KSHATAKSHEENA + + + - + 9 NAVAPRASUTA - + - - -
- 14. SL NO. CONDITIONS CHARAKA SAMHITHA SUSRUTHA SAMHITHA ASHTANGA SANGRAHA ASHTANGA HRIDAYA KASYAPA SAMHITHA 10 SRANTA + + - - - 11 PIPASITA + + - - + 12 KARMABHARAADHWAHATA + + - - - 13 VRIDDHA + - - - - 14 BALA + + + - - 15 ATIKRUSHA + - + - + 16 ATISTHULA + + + + + 17 DARUNA KOSHTA + - + + - 18 KSHAMA + - - - + 19 GARBHINI + + - - - 20 BHUKTABHAKTA + + - - -
- 15. VATAKARA VIHARA SL NO CONDITIONS CHARAKA SAMHITHA SUSRUTA SAMHITHA ASHTANGA SANGRAHAM ASHTANGA HRIDAYAM KASYAPA SAMHITHA 1 RATRI JAGARANA - - + - - 3 ATIRUKSHA + - - - - 4 BHAYOPATAPTA - + - - - 5 CHINTHAPRASAKTHA + - - - - 6 MAITHUNAPRASAKTH A + - - - - 7 ADHYAYANA PRASAKTHA + - - - - 8 VYAYAMA PRASAKTHA + + + + - 9 SALYARDITHA + - + + - 10 KAAMADIVYAGRA + + - - -
- 16. Sl No Conditions Charaka Samhitha Susruta Samhitha Ashtanga Sangraha m Ashtanga Hridayam Kashyapa samhitha 1 Atisnigdha + + - + - 2 Niruda + - - - - RELATED TO KARMA
- 17. SAAMAVASTHA Sl No Conditions Charaka Samhitha Susruta Samhitha Ashtanga Sangraha m Ashtanga Hridayam Kashyapa samhitha 1 Nava pratisyaya - + - - - 2 Nava Jwara + + + + -
- 18. DISEASES OF RECTUM Sl No Conditions Charaka Samhitha Susruta Samhitha Ashtanga Sangraha m Ashtanga Hridayam Kashyapa samhitha 1 Kshataguda (anal injury) + + + - - 2 Muktanala /guda bhramsa + - + - -
- 19. SAMAMARGA VYADHI Sl No Conditions Charaka Samhitha Susruta Samhitha Ashtanga Sangraha m Ashtanga Hridayam Kasypa samhitha 1 Adhoga raktapitta + + + + 2 Atisara - - - +
- 20. OTHER DISEASES Sl No Conditions Charaka Samhitha Susruta Samhitha Ashtanga Sangraha m Ashtanga Hridayam Kasyapa Samhita 1 MADATYAYA + + + - - 2 ADHMANA + + + - - 3 RAJAYAKSHMA - - + - - 4 PAKSHAGHATA - - - - + 5 ARDITA - - - - + 6 URUSTAMBA - - - - + 7 VATIKA HRDROGA - - - - + 8 KSHEENA RETAS GADANIGRAHA 9 HANUGRAHA - - - - + 10 KEVALA VATA - - - - +
- 21. SUBHAGA SUKUMARA DURBALA • Ayogya purusha • औषधिेगं न सहेत् • Parikartika vyapat
- 22. BAALA • Asampurna dhatu • औषधर्ल असह • Virechana is particularly contraindicated • Suggest basti in-place of virechana eg Chaturbhadrika basthi
- 23. VRUDDHA • Sheeryamana dhatu/Ksheena dhatu • औषधर्ल असह - teekshna ushna • Bowel incontinence • Chance of dehydration is high
- 24. ATISNIGDHA • Ayogya purusha • अवतर्ोग भर्यत् • Virechana vega cannot be controlled • Parikarthika vyapat by teekshna oushadha • Sleshmotklishtena ..virechanam urdhwam pravartate… • Peetam snigdhena sasneham …stambhayetchyutan… • Visarpa pidaka sopha kamala pandurogina..naatisnigdhaan virechayet… Cha/Si/6/88
- 25. ATIRUKSHA • Ayogya purusha • ियतकोियत् अङ्गग्रहम् • Produce hrtsula, sandhibheda, anaha, chardi ,murcha, klama, pranahani • Adhmana vyapat by mrdu oushadha • Upadrava vyapat with ruksha oushadha
- 27. KAMADIVYAGRA MANA • Ayogya purusha • अर्ोग भर्यत् • सकष्टिेगप्रिृवत्त • Ayoga may produce vibhramsa, hikka, stambha … • अथैनं िुनरेि िेह स्वेदयभ्ययमुिियद्ययनुिहतमनस....च/सू/१५/१७ • Ekagramanasaa peetam samyak yogaaya kalpate Cha/Si/6/17
- 28. PIPASITA • Ayogya purusha • औषधर्ल असह and may leads to pranahani • Chances of dehydration
- 29. ATISTHULA • Ayogya purusha • Ashta ninditha purusha • औषधर्ल असह • Severe tiredness and profuse sweating • Associated disease make them vulnerable to vyapat
- 30. ATIKRISHA & KSHAMA • Ayogya purusha – ashta ninditha purusha • Atikrisha – under weight in relation to age, sex … • Kshama - may not be underweight in relation to age.. But with excessive catabolic activity • ियत कोि भर्यत् • औषधर्ल असह • Malnourishment & Wasting Syndrome
- 31. SALYARDITHA & ABHIHATA • Ayogya purusha • क्षते ियर्ुरयवितो जयवितं हन्ययत् • Dhatu kshayajanya vatakopa
- 32. GARBHINI • गभाव्ययित्/ गभास्रयिभर् • Snehadikriya…garbhnisishopeeda • Cannot do straining • Dehydration chances are more • Blood flow to foetus
- 33. LANGHITHA & NIRUDA • Ayogya purusha • औषधर्ल असह • Niruha basthi produces mandagni • निरूढस्य च कञयञनिर्मन्दो भवनि देनिि : ।(सु/नच/३९/३) • िरो नवररक्तस्तु निरूिदञिां नववर्मयेि् सप्तनदिञ्यवव्ां ... च/नस/१/२६
- 35. KSHATA GUDA Ayogya roga प्रयणोिरोधकरयं रुजयं जनर्ेत् Produce teevra ruja Anal fissure (both acute and chronic) –severe pain with haematochezia on straining Anal abscess Acute anal fistula Rectal ulcer Rectal trauma
- 36. ATISARA Ayogya roga अवतप्रिृवत्त Vata pradhana dosha kopa अत्र च प्रिृत्तदोषे अवतर्ोगभर्यन्न िुनविारेचनप्रर्ोगमनुजयनयते । Chakrapani (Cha/K/12/65) Inflammatory Bowel diseases – Crohns Dz and Ulcerative colitis – diarrhoea IBS-D Colon cancer Lactose intolerance
- 37. AJIRNA ►Coeliac disease – gluten - diarrhoea ►Zollinger Ellison Syndrome - gastrinomas ►Sodhanas are generally contraindicated अजयणयात् िधाते ग्लयवन विर्न्धश्चयवि प्रिताते। ियतं संशोधनं चैि वििरयतं प्रिताते ॥ (Cha/S/6/14) ►Virechana vegapravrutti occurs after oushdhapaka/pachyamana ►Amadosha yukta avastha ►Cholelithiasis
- 38. ADHOGA RAKTHAPITTA Ayogya roga अवतप्रिृवत्त Rakta dhatu – jeevana Dhatukshayat pranabhayam Dysentery - Diarrhoea with blood and mucus Colonic/colorectal polyp – haematochezia and diarrhoea First to fourth degree haemorrhoids with bleeding – haemorrhage by straining
- 39. Proctitis – haemorrhage and pain Crohn's disease - haemorrhage Diverticulosis - common cause of acute lower gastrointestinal bleeding Ulcerative colitis , Ischemic colitis - haemorrhage Rectal prolapse - haemorrhage Angiodysplasia - haemorrhage Malignant neoplasm of colon (anal or colon Cancer) - develop haemorrhage
- 40. MUKTANALA Ayogya roga अवतप्रिृत्त्यय हन्ययत्। असंिृतगुद । Bowel incontinence - Symptoms due to muscle injury, nerve injury, constipation/diarrhoea Rectal prolapse Rectocele Inflammatory bowel disease
- 41. DARUNA KOSHTA दयरुणकोष्ठस्य विरेचनोद्धतय दोषय हृच्छ ू लििाभेदयनयहयङ्गमदा छवदा मूच्छयाक्लमयन् जनवर्त्व प्रयणयन् हन्यु: || Herniation Volvulus Intussusception – friable bowel wall Bowel ischemia- friable bowel wall Paralytic ileus Hirschsprung’s disease
- 42. ADHMANA • Ayogya roga • मलयशर्सवित ियतकोियत् जयिहयवन • Severe bloating – Cancer of stomach pancreas ovary … • Irritable Bowel Syndrome • Bowel obstruction from scar tissue or tumour
- 43. CARDIOVASCULAR SYSTEM ▲VATIKA HRIDROGA ▲ Ayogya roga ▲Aashukaritwat ▲NIDANA - teekshna virechana and teekshna basthi, atisrama ▲हृदर्कषाणयत् ▲Congestive heart failure – electrolyte imbalance ▲Cardiac arrhythmia
- 44. LOCOMOTORY SYSTEM • URUSTAMBA • Ayogya roga • Panchakarmas are contraindicated • Virechana is not capable of eliminating Uru sthitha Kapha (ama medas & K)dosha • TB of weight bearing bones, Ca bone • HANUGRAHA • Vatapradhana doshakopa • Waterloss –K+ loss - muscle cramp
- 45. IMMUNE SYSTEM ◙NAVA JWARA ◙Ayogya purusha ◙अवििक्वयन् दोषयन् न वनहारेत्, ियतमेि च कोिर्ेत् ◙ Amashayotha vikara ◙NIDANA – panchakarma mithyaati yoga ◙Amayuktha avastha/ Kapha pradhana avastha ◙Fever – dehydration is a cause and hence maintenance of hydration is must eg : cholera
- 46. •RAJAYAKSHMA • Ayogya roga • Vata pradhana Doshakopa • Atisara itself is a lakshana • Sarvadhatu kshayartasya balam tasya hi vitbalam
- 47. • TUBERCULOSIS – • Pulmonary tuberculosis – weight loss and fatigue • Miliary tuberculosis – diarrhoea and hypercalcemia • AIDS - • Ayogya purusha • Ojo kshaya • Immuno compromised condition • Weight loss • Inflammatory process ?? withstand
- 48. CENTRAL NERVOUS SYSTEM • MADATYAYA • Ayogya roga and purusha • मद्यक्षयणे देहे ियर्ु प्रयणोिरोधं क ु र्यात् • Tridoshajam • Kaphasthananupurvya cha kriya karya madatyaye | Pittamaruta paryanta: prayena hi madatyaya: || (Cha/Chi/24/107) • Alcoholic neuropathy – nerve damage, diarrohea
- 49. • Ayogya roga • Vataja nanatmaja vyadhi • Kaphasthana gata vyadhi- hence VK pradhana • Pitta involvement is very rare • Bells Palsy or Facial Nerve Palsy ARDITA
- 50. PAKSHAGHATA • Ayogya roga • Vataja nanatmaja vyadhi • Pakwasaya kshobhajanitha vata • Dhatu kshayajanya vatakopa – sodhana ? • Practical difficulties • Cerebro Vascular Accident due to lack of blood flow/ haemorrhage at the brain
- 51. KEVALA VATA oAyogya roga oPunaha vata kopa bhayat oRikta koshta produces further vata kopa
- 52. Critical notes on virechana karma • Purvahne laghubhojayet….adhaparahne ..prayachet.. • Acharya says purvahna kala …Other time ?? • Virichyate mandakaphastu samyak …Other koshtas ?? • Atimandagni /ati teekshnagni ?? • Naatisnigdha sareeraya …snehavirechanam| Snehotklishta …………ruksham dadyat virechanam| • Indicators of contraindications
- 53. DOSHA & OUSHDHA • Snigdha virechana in kleda pradhana vyadhi eg: udara, visarpa, kushta • Ruksha virechana in vata pradhana diseases • Eg : gomutraadi yoga in condition with oesophageal varices • Paittika avastha – teekshna oushadhi like gomutra • Kapha avastha – mrdu oushadha like avipathy choorna • Vatika avastha – ruksha virechana like icchabhedi rasa
- 54. PUBLISHED WORKS !!! • Ksheena retas – Contraindicated by Gadanigraha • ASSESMENT OF THE EFFICACY OF VIRECHANA KARMA IN THE MANAGEMENT OF KSHINA SHUKRA W.S.R. TO OLIGOZOOSPERMIA Pramod S. Mandalkar, Nitin A. Pandav • Outcome – Double arm study/ 10 pt each group/ • Group B -apatyakara ghrita Samana -20g & Group A – virechana and then samana ghritha • Semenogram was done • Found better result in Group A
- 55. CONCLUSION • र्ेभ्यो र्न्न वहतं र्स्मयत् कमा र्ेभ्यश्च र्न्तद्धतम् । न चैकिेन वनवदाष्टे अप्यथे अवभवनविशेद् र्ुध ॥ स्वर्मप्यत्र िैद्येन तर्क्यं र्ुन्तद्धमतय भिेत् । च/वस/२/२४ • Better to avoid – excess bleeding, severe pain, severe electrolyte imbalance, weak persons …
- 56. Exceptions in contraindicated case • In amaatisara/pakwatisara associated with soola,adhmana etc sneha virechana is advised वहत:िेहविरेको िय र्स्तर् विन्तच्छलश्च र्े। विन्तच्छलस्वरसे वसद्धं वहतं च िृतमुच्यते ॥ S/U/40/102 • In strictly contraindicated disease rajayakshma also, mild virechana is advisable according to dosha aggravation वदषयवधकयनयं िमनं शस्यते सविरेचनम्। िेहस्वेदोििन्नयनयं सिेहं र्न्न कशानम्। शोषय मुञ्चवत गयत्रयवण िुरयषस्त्रंिदवि । अर्लयिेवक्षणयंमयत्रयं वक ं िुनर्ो विररच्यय्ते॥ Ch/Chi/8/87-88
- 57. • In krimija hrdroga it is indicated क ृ वमहृद्रोवगणयं विग्धं भोजर्ेत् विवशतौदनम्। दध्नय च िललोिेतं त्र्यहं िश्चयविरेचर्ेत् ॥ Su/U/43/20 or भुक्ते अवधक ं जयर्ावत शूलमल्पं जयणे न्तस्थतं चेत् सुरदयरुक ु ष्ठम्। ……………………………………………………………… जयणे अवधक े िेहविरेचनं स्ययत् फलैविारेच्यो र्वद जयर्ावत स्ययत्॥ वत्रष्वेि कलेष्ववधक े तु शूले तयक्ष्णं वहतं मूलविरेचनं स्ययत् ॥ • In pittaja hridroga it is indicated शयतय प्रदेहय: िररषेचनयवन तथय विरेको र्वद वित्तदुष्टे । द्रयक्षयवसतयक्षौद्रिरूषक ै स्ययच्छु द्धे तु वित्त्पिहमन्नियनम्॥
- 58. • Ksheenakshayorakshata balavrudha deeno adha soshi bhaya soka tapta|| sranta trushartaa parijeernabhakta garbhini adhogachati yasya cha asrk|| navapratisyaya madatyayi cha navajwari ya cha navaprasuta| salyarditaschapi avirechaniya: snehadibhirye twanupaskrutascha || (Vangasena) • Raktatisara – adhogaraktapitta and if excess P,udarakrmi,mutrabaddha िथञ पररहृिञनि प्रबलनपत्तसन्तञनपिञिनिक ृ नर्ग्िोदरञिनप च र्ूत्रनवष्टनभिः । • नसिनत्रकटुचूर्मक ै रनिर्वञररर्ञ वञन्वििैन्विवृल्लवर्िञगरै र्ृदुनवरेचिैयोर्येि् ॥ KAlyanakarika
- 59. Continued… • Jayapala yoga ushnodaka is CONTRA-INDICATED • ASUDHAVATOLASSITA apana vata peeta • Naati snigdhaan virechayet/ naati snigdhaan vishodhayet|
- 60. RATIONALE BEHIND CONTRA-INDICATIONS SL NO. CONDITIONS CHA/SI/2/9 A S/ SU/27/10 1 SUBHAGA, SUKUMARA DUE TO HRIDAYAAPKARSHANA SEVERE HAEMORRHAGE MAY TAKE PLACE VIA UPPER AND LOWER ROUTE - 2 KSHATA GUDA SEVERE PAIN SEVERE PAIN WHICH MAY EVEN HAMPER LIFE 3 MUKTANALA (INCONTINENCE OF SPHINCTER) DESTROYS THE BODY DUE TO अवतप्रिृवत्त - 4 AJIRNA AMA DOSHA -
- 61. SL NO. CONDITONS CHA/SI/2/9 A S/ SU/27/10 5 ADHOGA RAKTAPITTA ATISARA CONDITION WORSENS ATISRAVANA OF BOTH LEADS TO MRTYU 6 LANGHITHA, NIRUDA,DURBALENDRIYA, ALPAAGNI RAJAYAKSHMA UNABLE TO WITHSTAND OUSHADHABALA CANT WITHSTAND OUSHADHA VEGA MALA TASYA HI VITBALAM 7 KAAMADIVYAGRA MANA AYOGA OR SAKASHTA VEGAPRAVRUTTI - 8 NAVAJWARA APAKWADOSHA IF TRIED TO ELIMINATE LEADS TO VATAKOPA VATAKOPA DUE TO ELIMIN- ATION OF AVIPAKWADOSHA 9 MADATYAYA AGGRAVATION OF VATA LEADING TO DEATH AGGRAVATION OF VATA LEADING TO DEATH 10 ADHMANA FURTHER INCREASE OF ADHMANA OR DEATH DUE TO VATA VRUDHI MALASAYA SANCHITHA VATAKOPA RESULTING IN DEATH 11 SALYARDITA ABHIHATA VATA GETS SEATED AND CAUSE PRANA HIMSA VATA GETS SEATED AND CAUSE PRANA HIMSA
- 62. SL NO. CONDITIONS CHA/SI/2/9 A S/ SU/27/10 12 ATISNIGDHA ATIYOGA BHAYA ATIYOGA BHAYA 13 RUKSHA KRURA KOSHTA VATAKOPA LEADS TO ANGAGRAHA VITIATED DOSHA WUDNT EXPELS & PRODUCE HRTSULA, SANDHIBHEDA, ANAHA, CHARDI ,MURCHA, KLAMA, PRANAHANI 14 DARUNA KOSHTA DOSHA WHICH ARE DISPLACED BY VIRECHANA CAUSES PAIN INHEART,ANAHA,ANGAMARDA, CHARDI,KLAMA AND THEN DEATH - 15 KSHATAKSHEENA PROFUSE HAEMORRHAGE DUE TO FURTHER STRAIN AND INJURY DURING AND AFTER VIRECHANA - 16 GARBHINI GRABHAVYAPAD , GARBHASRAVAM, AND OCCURENCE OF SEVERE DISEASES SAME AS VAMANA AYOGYA VYAPAD 17 ATIKRISHA, ATISTHULA, BAALA, VRUDHA, ATIKSHEENA, SRAMA, ATITRUT, ATIKSHUT CONDITION BECOMES FATAL DUE TO INABILITY TO TOLERATE THE OUSHADHA BALA, MRUTYU - 18 KATINA VYAYAMA , BHARA VAHANA, ADYADHWA, UPAVASITA, ATIVYAVAYA,ADHYANA, ATICHINTA KSHEENA DUE TO RUKSHATA ,VATA KOPA OCCURS- HAEMORRHAGE OR ULCERATION -
- 63. INDICATIONS “ विरेकसयध्यय गुल्मयशोविस्फोटव्यङगकयमलय:। जयणाज्वरोदरगरच्छवदाप्लयहहलयमकय ॥ विद्रवधन्तस्तवमरं कयच: स्यन्द: िक्वयशर्व्यथय । र्ोवनशुक्रयिर्य रोगय: कोष्ठगय: क ृ मर्ो व्रणय: ॥ ” (A H/Su/27/8-9)
- 64. RENAL SYSTEM ♣ Chronic Kidney disease with diarrhoea/vomiting ♣Acute Renal Failure – electrolyte imbalance ♣Dehydration ♣Constriction alkalosis
- 65. Excitation of sensory nerve ending leads enteral hypermobility Eg Small bowel irritant – castor oil, Large bowel irritant – anthraquinone DOUBTS: SAMVRTA KOSTA = VAYUNA ALPIKRTA KOSHTA MUKTHANALA = ASAMVRTA GUDA SUBHAGA GUDA = SUKHA SAMVARDHITHAM AAHU DARUNA KOSHTA = VRECHANAT HATAT DOSHA HRTSULA PARVABHEDA ANAHA ANGAMARDA CHARDI MURCHA KLAMA Y ONLY ATISARA NOT GRAHANI/PRAVAHIKA …? MODERN TRATMMENT LAXATIVE FOR FISSURE BUT WEE CONTADICT?
- 66. THANK YOU
Editor's Notes
- Vircan s a praticly msusd a lot.. .But it s not so..bahuiti..thus knlde regrdng dos and donts fr dng a karma is ver much essential..and hence..
- Panchakarmiya sidhi charak adhyaya discuss CI before idicatn emphasis importance of virechana Panchakarmiya sidhi – 1st contra
- More indict with less CI hence
- Sodhna4 elimnn dosha thru ano rectal route…mainly Phara…phalasruti says aimed at brnging anamaytwam
- Classical versus..brht laghu trayi same op
- Modrn ife style..many GI dis.. Lead to blunted …
- Case study -changes ..virechna..so hypoTN weakpulse more care
- Study in virechna Ca Inc , Na K Cl dec ..Same in aty/ayo = vyapat/-
- Cl compnds r essntl in mantng gud health.. Hcl
- Nerve fn…BODY GROWTH
- Na in on transfer..nerve fn
- NW INTO DETALINGS OF AYOGYTA
- Categorize ths aogya into …exertn during karma
- Most r physiolgcal cndtns
- Which wil provke V
- Reltn with our therapeutic karmas
- Amapradhna avastha of dzs
- Anatomcal abnormal or abhighta
- Pravartana via same evacuatve route
- Diff dz condtn where rehn s CI…interestingly pakshghta
- Cant control their bowel habit
- Manda kapha condition …is for virechana..Sneha virech in snigdhleads Vgraha gudastambha sula.
- After snehan – still ruksha….doshamarga nirodhanat
- Irratnal Da2da practis..wt lifting..strain,,,stress,,work load,,xams..excercises.. After havng vire med HRUD-ANGAGRAHA vyapat…Saahasika
- Psychological factors
- Jaleeyamsa is less agan ushna teekshn agneya oushadhi of virchna
- Agni more ..med paka occurs
- Krisha – physio..Kshama – patho…undernursmnt- dehydrtn lethargy Cachexia –wt loss atigue
- V @ kshta site get irritated by rchn pranahani…blood and fluid loss
- Sus..garbhavakranit sareeram..Chance of premature delivery,,
- Hisyat shunya sareeram
- Attempt to classify C system wise fr ractical utility
- PROCTALGIA FISSURE – TEAR --------trtmnt is laxative bt virechna is ABSCESS – PUS FILLED CAVITY FISTULA – OPENED UP
- Crohns dz- inflamtn of whole git UC – inflamtn of LI Y not CI grahani or pravahika,amatisara Lactose intolerance – redcd ability to digest lactose – lactase in SI undgst pass to colon where t produce symps
- Coeliac – auto immune-SI- villi atrophy…. ZES – gastrinomas – neuroendocrine tumor – Stomach and duodenam – more acid- apakwa pitha in K sthana vamna- + Diarrhoa…cholelthiasis- gall stone – surgically managed….disease is occurring n ayogya purusha like obese, hormone therapy,,practical difficulty………severe indigestion – avipaka bahudoshavastha---pt is unfit due to less energy ---by less absorption
- Polyp- colonic figer lke growth
- Proctitis – inflammatory rectum Diverticulosis – outpouching of colonic sub/mucosa Angio – vascular malformations -vessel walls are thin, with little or no smooth muscle
- cant control bowel movemet prolapse to anus rectocele- rectm to vagina SAMVRTA KOSTA = VAYUNA ALPIKRTA KOSHTA
- Dfficulty to pass motn Hirschsprung's disease (HD or HSCR) is a birth defect in which nerves are missing from parts of the intestine. The most prominent symptom is constipation
- Mitral stenosis – calcficatn of leaflet
- *“URUSTAMBHA” – AORTOILIAC OCCLUSION WITH METABOLIC SYNDROME? Dr. Prasad Mamidi IJGP Vol II No I 2017
- Samprapti norole Rajayakshma inidcatd sramsana – Cha/Chi/8/87
- Millet like small pulmonary tb shows wide hematogenous transmission - fatal
- Alcoholic neuropath – diarrhoea may be a symptom..no other need fr rechn in pathology
- Bells palsy pathology have nt an relatn with virechana Antiinflammatory in modern ??
- Pitta anubandha can do rechna,.. Pakwashaya kshobhajanitha vata is getting expelled n virechana
- Vatasyopakrame sneha seda samsodhanm mrdu.. Virechana – pakwasaya kshobhajanita vata nirharana
- Vasantha rtu in vigata sleshmanam afternoon|| virechanam vrudhakaphe tadhordham
- Intrstn work -less than 20 million spermatozoa per milliliter of ejaculation
- Though I may indcte sme dzs or Ci some others…its u ho decide whch s gud fr the pt and which s nt …ur yukti is the final judge
- Different opinon regarding indicated cases
- Even from classics we can indcn of contr cases
- Cha/K/8/46 Abhayad modakam seeta jala Danti ASUDHAVATOLASSITA – anonya avarana of vata anulomana is preferred over vrechna
- Mrduvirechana/laxatives – eg anjira, badama, eluvaa, gandhaka, madhu,guda, harraa, bilva, palasabeeja, amala , imali Vrechana – purgative- eranda thaila, sanaya, nisotha, revacini Tivravirechna/drastic purgative- snuhiksheera, jamalagota, indravaruni satva Jalavata virechna/hydrogogue- indravaruni, jamalogota with ushtraksheera, kaladana Lavanika rechana/saline purgative – thuhara kshara, yavakshara, apamargakshara, sarjakshara Pittansaraka rechana/ cholagogues – tamrabhasma, alua, nisodha, revacini
- We can c a lot mny indcatn fr rechana i a few num of contra .. Present scenario more are life style disorder with more affinity towards git disturbance…may be due to impaired pitta..Hence the wse and judicious selectn of vrchna is helpful in correcting that pitta ..Now a days contempry allopaths also focus on Colon detox liver detox progrms as a trartmnt option
- To reduce kidney load we cn gve virechana …constrn alkalo – incrse in blood ph due to less fluid loss