2ND YR BAMS

2. BY:
Dr Prashanth Jain MD(Ayu)
HOD Dept of Roganidana
Alvas Ayurveda Medical College
Moodbidiri

3. INTRODUCTION
Stones are an age old suffering of the human body
and occur at several sites in particularly kidney, urinary bladder,
prostate gland, gall bladder and salivary gland .among all, urinary
calculus is very common clinical condition in day today practice.
It is a mootravaha sroto vikara.one among the asta mahagada.
Though it is a tridoshaja vyadhi,kapha dosha takes important part in
hardening of stone.

4. FORMATION OF ASHMARI
AmxÉÑ xucNûÉxuÉÌmÉ rÉjÉÉ
ÌlÉÌwÉ£üÉxÉÑ lÉuÉã bÉOãû|
MüÉsÉÉliÉUãhÉ mÉÇMü:
xrÉÉSvqÉUÏxÉÇpÉuÉxiÉjÉÉ||
xÉÇWûlirÉÉmÉÉã rÉjÉÉ ÌSurÉÉ qÉÉÂiÉÉã
AÎalÉ¶É uÉæ±ÑiÉ: |
iɲ¯sÉÉxÉÇ oÉÎxiÉxjÉqÉÔwqÉÉ xÉÇWûÎliÉ
xÉÉÌlÉsÉ: ||
(xÉÑ.ÌlÉ-3/25-26)

5. Sushruta narrates that .the manner in which even clean
water collected in pot precipitates in bottom after
some time so also the process of hardening of ashmari
occurs with crystals of kapha present in urinary
system.
In the external environment how the condensation
of water takes place by the effect of light,air and
heat, in the same manner kapha which is present
in basti condensed by vata and pitta in body
producing ashmari.

6. ETIMOLOGICAL DIRIVATION
“AvqÉUÏ AvqÉlÉÉqÉç UÉÌiÉ SSÉÌiÉ rÉÉ’’||
( vÉoSMüsmÉSìÓqÉ)
The disease that involves the formation of stone is called
ashmari.
Ashma-Ashman means stones.
The meaning of Ashmari’ is a stone or gravel or rock.

7. DEFNITION
“UÉãaÉqÉÉaÉï xÉëÉãiÉÉÇÍxÉ uÉÉ
ÌuÉvÉãwÉiÉÉã qÉÔ§ÉqÉÉaÉï xÉÇpÉÔiÉ
mÉÉwÉÉhÉ ÌuÉvÉãwÉ:|”
vÉoSMüsmÉSìÓqÉ)
AvqÉUÏ is a stone formed in the xÉëÉãiÉxÉç
especially in
the mutramarga.

8. NIDANA
“iɧÉÉxÉÇvÉÉåkÉlÉvÉÏsÉxrÉÉmÉjrÉMüÉËUhÉÈ
mÉëMÑüÌmÉiÉÈ vsÉãwqÉÉ
qÉÔ§ÉxÉÇmÉ×£üÉãüAlÉÑmÉëÌuÉvrÉ oÉÎxiÉÇ
AvqÉUÏqÉç eÉlÉrÉÌiÉ|”
(xÉÑ.ÌlÉ-3/4)
1 )AxÉÇvÉÉåkÉlÉvÉÏsÉxrÉ
2) AmÉjrÉMüÉËUhÉ:
 According to Charaka
 urÉÉrÉÉqÉiÉϤhÉÉæwÉkɤÉqɱmÉëxÉÇa
ÉÌlÉirÉSìÓiÉmÉ×¹rÉÉlÉÉiÉç |


9. 1.AÉWûÉUeÉ ÌlÉSÉlÉ- AkrÉvÉlÉ ,AÉlÉÔmÉqÉixrÉ
xÉãuÉlÉ ,AeÉÏhÉï ,¤Éç qɱ
2.ÌuÉWûÉUeÉ ÌlÉSÉlÉ-mÉëxÉXçaÉ, urÉrÉÉqÉ,
ÌlÉirÉ SìÓiÉmÉëѸrÉÉlÉ.
3.AÉæwÉkÉ ÌlÉSÉlÉ_ iÉϤhÉÉæwÉkÉ.
cÉ.ÍcÉ.26
 Apathyakarina : following regimen which precipitates
ashmari.i.e dietory factors such as food rich in calcium like
tomato,spinach ,milk causes calcium oxalate stones.
 Asamshodhana sheelasya :infection of kidney with
pseudomonas oraganism .,causes stasis of urine and causes
stone formation.

10.  Vyayama,ushna gamana:
walking in hot sun ,physical exertion,and one who
perspire a lot may generally cause concentrated urine
and ashmari is formed.
 Gharma gamana:
hot climatic condition causes increase in conc of solutes
in urine which results in precipitation of calcium
forming calcium oxalte stones.

11. SAMPRRAPTI
“iɧÉÉxÉÇvÉÉåkÉlÉvÉÏsÉxrÉÉmÉjrÉMüÉËUhÉÈ
mÉëMÑüÌmÉiÉÈ vsÉãwqÉÉ
qÉÔ§ÉxÉÇmÉ×£üÉãüAlÉÑmÉëÌuÉvrÉ oÉÎxiÉÇ
AvqÉUÏqÉç eÉlÉrÉÌiÉ|”
(xÉÑ.ÌlÉ 3/4)
 ‘ÌuÉvÉÉãwÉrÉã²ÎxiÉaÉiÉÇ xÉvÉÑ¢üÇ
qÉÔ§ÉÇ xÉÌmɨÉÇ mÉuÉlÉÈ MüTüÇ uÉÉ |
 rÉSÉ iÉSÉÅvqÉrÉÑïmÉeÉÉrÉiÉã iÉÑ
¢üqÉãhÉ ÌmɨÉãÎwuÉuÉ UÉãcÉlÉÉ aÉÉã ||’
( qÉÉ.ÌlÉ

12.  When prakupita vayu enters basti mukha and causes
obstruction ,dries up mootra,pitta,kapha and
shukra.when these are combined there will b formation
of ashmari which looks like gorochana{bile stone}

13. PURVAROOPA
iÉÉxÉÉÇ mÉÔuÉïÃmÉÉÍhÉ euÉUÉã
oÉÎxiÉmÉÏQûÉUÉãcÉMüÉæ qÉÔ§ÉM×ücNíûqÉç
oÉÎxiÉÍvÉUÉãqÉÑwMüvÉãTüxÉÉÇ uÉãSlÉÉ
M×ücNíûÉuÉxÉÉSÉã oÉxiÉaÉlkÉiuÉÇ
qÉÔ§ÉxrÉãÌiÉ ||
rÉjÉÉxuÉuÉãSlÉÉuÉhÉïÇ SÒ¹qÉç
xÉÉlSìqÉjÉÉÌuÉsÉqÉç|
mÉÔuÉïÃmÉã AvqÉlÉ: M×ücNíûÉlqÉÔ§ÉqÉç
xÉ×eÉÌiÉ qÉÉlÉuÉ:||
(xÉÑ.ÌlÉ 3/5-6)

14.  Basthyaadhmaana: distended bladder
 Aasanna deshe ruja: severe pain in the site of
ashmari
 Basti shiro vedana: supra pubic pain
 shepha ,mushka vedana:
 Basta gandha mootra: urine will have odour of
sheep.
 Mootrakrichra: dysuria
 Jwara,aruchi: fever.

16. SAMANYA LAKSHANA
AjÉ eÉÉiÉÉxÉÑ-
lÉÉÍpÉoÉÎxiÉxÉãuÉlÉÏqÉãWûlÉãwuÉlrÉiÉqÉÎxqÉlÉç
qÉãWûiÉÉã uÉãSlÉÉ
çqÉÔ§ÉkÉÉUÉxÉXçaÉ: xÉÂÍkÉUqÉÔ§ÉiÉÉ
qÉÔ§ÉÌuÉÌMüUhÉÇ
aÉÉãqÉãSMümÉëMüÉvÉqÉirÉÌuÉsÉÇ
xÉÍxÉMüiÉÇ ÌuÉxÉ×eÉÌiÉ
kÉÉuÉlÉsÉXçaÉlÉmsuÉlÉmÉ׸rÉÉlÉÉãwhÉÉkuÉaÉ
qÉlÉåxcÉÉxrÉ uÉãSlÉÉ
pÉuÉÎliÉ||
(xÉÑ.ÌlÉ-3/7)
According to Charaka ;
Obstruction to the mutramarga causing extensive pain in
basti, sevani and mehana

17. TYPES
cÉiÉxÉëÉã AvqÉrÉÉãï pÉuÉÎliÉ: vsÉãwqÉÉÍkɸÉlÉÉ:
iɱjÉÉ-
vsÉãwqÉhÉÉ, uÉÉiÉãlÉ, ÌmɨÉãlÉ, vÉÑ¢ãühÉ cÉãÌiÉ
||
(xÉÑ.ÌlÉ-3/3)
According to Sushruta four types of Ashmari are-
1.Shleshmaja.
2.Vataja.
3.Pittaja.
4.Shukraja.
According to charaka, he considered Ashmari under A¹ÌuÉkÉ
qÉÔ§ÉM×ücNíé.
Chakrapani says
Due to vatadosha – MüSqoÉmÉÑwmÉÉM×üÌiÉ, ̧ÉmÉÑÌOû stones are
formed.
Due to pittadosha - AvqÉiÉÑsrÉ, vsɤhÉ stones are formed
Due kapha and shukra qÉ×²Ï stones are formed.

18. SLESHMAJA ASHMARI LAKSHANA
 Basti nistoda
 Sheetata and guruta in basti pradesha.
 Ashamari: shwetavarna ,kukkutanda pratikasha,
shlakshna, mahath
 Comapared to steruvite stones{calcium
phosphate} ,whitish,large and smooth to touch.

20. Pittaja ashmari:
 Basti daha
 Osha,chosha,daha{dysuria}
 Ashmari:
 bhallataka asthi sadrushya,rakta peeta varna.
 Compared with urate calculi,yellowish red colour

22. PITTAJA ASHMARI SAMPRAPTI AND LAKSHANA
cÉÔwrÉiÉã S½iÉã mÉcrÉiÉ CuÉ
oÉÎxiÉÂwhÉuÉÉiÉ¶É pÉuÉÌiÉ; AvqÉUÏ
cÉÉ§É xÉU£üÉ mÉÏiÉÉuÉpÉÉxÉÉ
M×üwhÉÉ pÉssÉÉiÉMüÉÎxjÉ mÉëÌiÉqÉÉ
qÉkÉÑuÉhÉÉï uÉÉ pÉuÉÌiÉ,
mÉãͨÉMüÐÍqÉÌiÉ ÌuɱÉiÉç||”
(xÉÑ.ÌlÉ-3/9)

23. VATAJA ASHMARI SAMPRAPTI AND
LAKSHANA
“uÉÉiÉrÉÑiÉxiÉÑ vsÉãwqÉÉ
xÉÇbÉÉiÉqÉÑmÉaÉqrÉ rÉjÉÉã£üÉÇ è
mÉËUuÉ×Ì²Ç mÉëÉmrÉ
oÉÎxiÉqÉÑZÉqÉÍkɸÉrÉ xÉëÉãiÉÉã
ÌlÉÂhÉÌ® ,iÉxrÉ
qÉÔ§ÉmÉëiÉÏbÉÉiÉɨÉÏuÉëÉ uÉãSlÉÉ
pÉuÉÌiÉ, iÉSÉirÉjÉïqÉç
mÉÏQèrÉqÉÉlÉÉã SliÉÉlÉç ZÉÉSÌiÉ
,lÉÉÍpÉÇ mÉÏQûrÉÌiÉ,qÉãRíûÇ
mÉqÉתÉÌiÉ ,mÉÉrÉÑÇ xmÉ×vÉÌiÉ
ÌuÉvÉkÉïiÉã ,ÌuÉSWûÌiÉ,
uÉÉiÉqÉÔ§ÉmÉÑUÏwÉÉÍhÉ

25.  Clinical presentation of vataja ashmari
 Brusha arti
 Dantaan khadati{biting of teeth}
 Vepathu{shivering}
 Naabhi peedayati
 Bindu pramana mootra muhu muhu pravrutti.
Nature of calculi : shyava , parusha,khara ,vishama, kadamba
pushpavath,kantakaachita {oxalate stones}

26. SHUKRASHMARI SAMPRAPTI AND
LAKSHANA
“qÉæjÉÑlÉÌuÉbÉÉiÉÉSÌiÉqÉæjÉÑlÉÉ²É vÉÑ¢üÇ
cÉÍsÉiÉqÉÌlÉaÉïcNû̲qÉÉaÉïaÉqÉlÉÉiÉç
AÌlÉsÉÉãÍpÉiÉ: xÉÇlaÉ×½
qÉãRíéuÉ×wÉhÉrÉÉãUliÉUã xÉÇWûUÌiÉ,
xÉÇWØûirÉ cÉÉãmÉvÉÉãwÉrÉÌiÉ;xÉÉ
qÉÔ§ÉqÉÉaÉïqÉÉuÉ×hÉÉãÌiÉ,qÉÔ§ÉM×ücNíûÇ
oÉÎxiÉuÉãSlÉÉÇ
uÉ×wÉhÉrÉÉã¶É
µÉrÉjÉÑqÉÉmÉÉSrÉÌiÉ,mÉÏÌQûiÉqÉɧÉã cÉ
iÉÎxqɳÉãuÉ mÉëSãvÉã
mÉëÌuÉsÉrÉqÉÉmɱiÉã; iÉÉÇ vÉÑ

27.  Shukra vegadharana ,ati maithuna
shukra sthana chyuti
accumulation b/w medra and vrushana
shoshana of drava shukra by vaata dosha
leading to
shukrashmari{mootrakrichra,bastivedana,mushka
shotha}

28. SADHYASADHYATA OF ASHMARI
“uÉÉiÉurÉÉÍkÉ: mÉëqÉãWû¶É
MÑü¸qÉvÉÉãï pÉaÉlSUqÉç
AvqÉUÏ qÉÔRûaÉpÉï¶É
iÉjÉæuÉÉãSUqɹqÉqÉç
A¹ÉuÉãiÉã mÉM×üirÉæuÉ
SÒͶÉÌMüixrÉÉ qÉWûÉaÉSÉ:||”
(xÉÑ.xÉÔ-33/4)
AvqÉUÏ SÉÂhÉÉå
urÉÉÍkÉUliÉMümÉëÌiÉqÉÉã qÉiÉ:
AÉæwÉkÉæxiÉÂhÉ: xÉÉkrÉ:
mÉëuÉ׬¶ÉãSqÉWïûÌiÉ ||

29. CONCLUSION
Sushruta explained four types of stones. Vataja ashmari is
said to be, shyava, parusha, vishama, khara,
kadambapushpavat kantakachita; it appears to be
synonymous with calcium oxalate calculus. Pittaja
ashmari is said to be sarakta, pitavabhasa, krishna,
bhallatakasthipratima; this seems to be synonymous with
uric acid calculus. Kaphaja ashmari is described as,
shweta, snigdha, mahati, kukkutandapratikasha; and
appears to be similar to phosphate calculus. A fourth
variety of the calculus is said to be formed by the
stagnation of sukra in the mutrapraseka, which probably
can be spermolith.

30. Clinical feature of Renal calculi
Pain – renal pain is located over renal angle
hypochondrium and lumbar region . Often severe
radiating to groin and testis in male, pain worsens
on movement.
 The same pain may sometime be felt anterioly in the
costal margin hence it is described as costovertebral
pain.
• Haematuria
• Pyuria
• Fever with chills and rigors
• Burning micturition

31. Ureteric Calculi
• Pain- is of colicky type & radiates from loin to
groin often to the tip of genitalia testis in
males,labia majus in females.It is severe in
intensity, increase with exercise.
• Nausea,vomiting,sweating due to pain
• Haematuria,dysuria,
• Strangury {severe pain in urethra refered from base of bladder
and associated with intense desire to pass urine.}

32. Vesical Calculi
 Common in males,often occurs in childrens
 Frequency is more during day than night
 Pain- More during day which is referred to the tip of
 penis or labia ,also increases during jolting
movements
 suprapubic pain & tenderness may be present.
• Haematuria often terminal
• Interruption of urinary stream & often acute urinary
 retention.
• Burning Micturition
• Fever