Tonsillitis is an inflammatory condition in which pratisarana a para surgical procedure told by Acharya susrutha.

1. Effect of Trikatukadi
Pratisarana in Tundikeri
(Tonsillitis)-A case study
Presented By
Dr.Panchajanya kumar Deevi,
Final year PG Scholar.
Under the Guidance of
Dr.Ch.Ramadevi, M.D, PhD, Asso.Prof.
Dept. Of. Shalakya, DR BRKR GAC,
S.R Nagar, Hyderabad.

2. Contents
Introduction
Tundikeri
Tonsillitis
Pratisarana
Case study
Conclusion

3. Introduction
• The (palatine) tonsils are a pair
of soft tissue masses located at
the rear of the throat (pharynx).
• The tonsils are part of the
lymphatic system, which helps
to fight infections.
• According to Acharya Susruta
Tonsillitis can be compared
with Tundikeri.

4. Tundikeri
Nidana:
“Anupa pisitah Ksheera dadhi matsya ati sevanath”
(Ma.Ni.56/1) -by taking in excess of meat of marshy
animals, curd and fish.
• “Sothah sthalustodadaha prapaki praguktabhyam
tundikeri mata tu” (Su.Ni.16/42,1/2)
• “Hanu sandhyasritah kante karpasi phala sannibhah
pichilo manda ruk sophah kantinah tundikerika”.
(AH.Ut.21/47).
• Acharya Susruta and Madhavakara consider it as
talu gata roga.
• Acharya Vagbhata considered it as kantha roga.

5. Contd...
• Tundikeri means the tonsilar mass look like karpasi
phala.
Dosha:
Kapha, Rakta, Vata and Pitta.
Lakshana:
• Patient suffers with tonsilar inflammation, mild
pricking pain, sliminess and fever.

6. Contd...
Treatment:
“Tundikeri adhrusha kurme sanghate talupupputake
esha eva vidhih karyo viseshah sastrakarmani”
(Su.chi.22/57)
The Tundikeri etc. “4” diseases can be treated like
Galasundika, i.e. pratisarana, kavala graha, dhooma
varti, kshara sidha mudga yusha sevana etc. they
differ only in type of surgery.

7. Tonsillitis
Tonsillitis is inflammation of (palatine)tonsils ,
caused by staphylococci or streptococci.
 It may be acute or chronic.
 Acute tonsillitis is characterised by enlargement,
redness and inflammation.
 Chronic tonsillitis is caused by repeated attacks of
acute tonsillitis, in which the tonsils are small and
fibrosed.

8. Contd….
Symptoms:
• Discomfort in throat
• Difficulty in swallowing
• Generalised body ache
• Fever, Ear ache and Thick speech
Signs:
• Swollen congested tonsils with exudates
• Enlarged tender Jugulo-diagastric lymph nodes

9. Treatment:
Antibiotics, Anti inflammatory, Antipyretics
according to the condition of the patient.
 If the tonsillitis is sever, altering the speech,
swallowing of food and difficult in breathing is
opted for surgery -Tonsillectomy.

10. Pratisarana
Pratisarana is of “4”types
“Kalka, Rasakriya, Kshaudra, Churna” forms can
be used according to place and condition of the
disease.
• Pratisarana has to be done with the tip of the finger –
Angulyagra pranitamtu.
• Doshaghna and Anabhishyandi diet should be taken
after pratisarana. (Su.chi.40/62-63)

11. Trikatukadi – “Trikatu+vacha+saindhava+kshaudra”
I) Trikatu
1.Maricha- Vata Kapha samaka, raktothklesaka,
lekhana and sroto sodhana.
2. Pippali- Kapha Vata samaka, raktotklesaka and
jantughna.
3. Sunti- Kapha Vata samaka, sheeta prasamana,
shotha hara, vedana sthapana.
Contd….

12. II) Vacha
Kapha Vata samaka, pitta vardhaka,
shotha hara, vedana sthapana, lekhana.
III) Saindhava
Tridosha samaka, sukshma sroto sodhana.
IV) Kshaudra
Rakta pitta hara, Kapha samaka,
Vata vardhaka, chedana, sandhaniya.
Contd….

13. Case study
 Patient: ‘x’ aged 15yrs Female ,selected from OPD of
Shalakya ENT unit GAH Erragadda-Hyderabad.
 Chief complaint: complaining of on-off fever along
with difficult in swallowing since 15 days.
 On examination with the help of torchlight, she has
enlargement of (palatine) tonsils with congestion of
pharynx and uvula and slight raise temperature.

14.  Investigations: Advised for Hb,TC,DC,ESR- Report-
Hb-10g/dl,TC-8500 cells/cu.mm, D C
Neutrophils 60% Lymphocytes 30 % Eosinophils2 %
Monocytes2% Basophils 0 % ESR-10 1st hr 20 2nd hr.
 After all investigations patient was explained about
the procedure (pratisarana).
 Primarily she was kept under medication for 5 days
for the control of fever and congestion.
1.Kanchanaraguggulu 2 tab BD, 2. Tribhuvana
keerthi ras 1 tab BD, 3. Lavangadi vati 2tab TID,
4. Subhra bhasma for gandusha.
Contd….

15.  After getting relived from the fever and congestion
patient was given pratisarana with Trikatukadi.
 Patient was advised not to take any diet before
pratisarana.
 Patient was approached with the tip of index finger
by the sides of the mouth after wearing gloves.
 Pratisarana was done for each tonsil “5” applications
one time/day.
 After that patient was given 15 minutes gap and
advised to do gargling with luke warm water mixed
with Saindhava lavana.
Contd….

16.  Patient was given the same treatment for 15 days.
 During this 15 days patient doesn’t use any internal
medicine.
 Result: patient doesn’t get any fever since last 15
days after the treatment, difficulty in swallowing was
relived and the size of the tonsils was decreased.
Contd….

17. Conclusion
Pratisarana is one of the Para surgical
procedure before going for surgical
management.
This particular case study was done
with Trikatukadi, which is formulated
according to condition of the patient .
The result what we get from this
clinical study was encouraging by avoiding
surgery.

18. References
 Susrutha Nidana and chikitsa by kaviraj kunjan lal
bhishag ratna.
 Madhava Nidana with madhukosa vyakya by sri
yadunandan upadhyaya.
 Ashtanga hridaya uttara tantra by sri brahmanand
tripati.
 Text book of Pathology by Harsha mohan .

19. Aknowledgement
I express my deep sense of gratitude to mentors
Prof.& HOD PG Dept.of.S.S.P: Dr. M.Guru murthy.
M.D ,Professor: Dr. T. Praveen kumar.M.D, Associate
professor Dr. CH.Rama Devi . M.D,Ph.D., Assistant
professor: Dr. B.Badrinath Benarji.M.D, for
encouraging me. And I'm thankful to whole Faculty
and Scholars of Dept.of.S.S.P.