Kshata ksheena

Ayurveda approach for chronic emaciation due to injury-kshata ksheena. By Dr.Shruthi Panambur

Transcript

1. PRAYOGIKA SIDDHANTA PRESENTER DR. SHRUTHI PANAMBUR FINAL YEAR PG SCHOLAR DEPT OF PG STUDIES IN AYURVEDA SAMHITA AND SIDDHANTA SRI SRI COLLEGE OF AYURVEDIC SCIENCE & RESEARCH HOSPITAL GUIDED BY DR. SRI NAGESH K.A PROFESSOR & HOD DEPT OF PG STUDIES IN AYURVEDA SAMHITA AND SIDDHANTA SRI SRI COLLEGE OF AYURVEDIC SCIENCE & RESEARCH HOSPITAL CRITICAL ANALYSIS OF SAMPRAPTI AND CHIKITSA OF KSHATA KSHEENA
2. CONTENT 1. INTRODUCTION 2. REVIEW OF LITERATURE 3. DISCUSSION 4. CONCLUSION 2
3. INTRODUCTION •Kshataksheena is a condition with kshaya due to injury or trauma. •Kshataksheena is explained in 11th chapter of charaka samhita •The disease shows close resemblance with rajayakshma as both involves kshaya but due to specific nidana in kshataksheena and due to chikitsa pradhanyata it is explained as separate chapter in chikitsa stana of charaka samhita •So here critical analysis of samprapthi and chikitsa is done. 3
4. REVIEW OF LITERATURE REFERENCES निरुक्ति निदाि रूप पूर्वरूप संप्राक्ति साध्यासाध्यता निनित्सा पथ्य 4
5. REFERENCES संहिता स्थान अध्याय िरि संनिता निनित्सा स्थाि 11 5 हनरुक्ति क्षत • क्षणु निंसायाम् क्षीण • नक्ष क्षये
6. निदाि नर्क्षते र्क्षनस व्यानिर्वलर्ाि् समुदीयवते| स्त्रीषु िानतप्रसिस्य रूक्षा्पपप्रनमताननि ||(ch.chi.11/8) NIDANA NIDANA ििुषाऽऽयस्यतोऽत्यथं अिीयािस्य, उच्च भारमुद्वितो गुरुम् दू रं र्ा व्रजतो द्रुतम् पततो नर्षमोच्ेभ्यो मिािदीं र्ा तरतो र्नलनभ सि युध्यत ियचर्ाव सि िार्त र्ृषं ियं र्ा िार्न्तं दम्यं र्ाऽ न्यं निगृह्णत सिसोत्पततो दू रं ननलािाष्ठाश्मनिर्ावताि् नक्षप तो निघ्नत पराि् तूणं िानतप्रिृत्यत तथाऽन्यच िमवनभ क्र ू रचभृवनम भ्याितस्य स्त्रीषु िानतप्रसिस्य रूक्षा आिार अ्पप आिार प्रनमताननि 6
7. संप्राक्ति •उरो नर्रुज्यते तस्य नभद्यतेऽथ नर्भज्यते| प्रपीड्येते तत पार्श्वे नुष्यत्यग ं प्रर्ेपते||(CH.CHI.11/9) Nidana उरो नर्रुज्यते, नभद्यते, नर्भज्यते, प्रपीड्येते पार्श्वे नुष्यत्यग ं प्रर्ेपते, lakshana 7
8. रूप •क्रमाद्वीयं र्लं र्णो रुनिरनिश्च िीयते| ज्वरो व्यथा मिोदचन्यं नर्ड्भेदोऽनिर्िादनप|| दुष्ट श्यार् सुदुगवन्ध पीतो नर्ग्रनथतो र्ह | िासमािस्य ि श्लेष्मा सरि सम्प्रर्तवते| स क्षत क्षीयतेऽत्यथं तथा नुक्रौजसो क्षयात्|(CH.CHI.11/10-11) •क्रमात् – िीयते - वीयय, बलं, वर्य, रुहि अहि •ज्वर, व्यथा, मनोदैन्यं, हवड्भेदो, अहि वध •कासमानस्य ि श्लेष्मा – दुष्टः, श्यावः, सुदुर्यन्धः, पीतो, हवग्रहथतो, बहः, सरिः •शुक्रौजसोः क्षयात् 8
9. पूर्वरूप •अव्यिं लक्षणं तस्य पूर्वरूपनमनत स्मृतम्|| उरोरुक्शोनणतच्छनदव िासो र्चनेनषि क्षते| क्षीणे सरिमूत्रत्वं पार्श्ववपृष्ठिनिग्रि ||(CH.CHI.10/12-13) •अव्यिं लक्षणं •क्षते- उरोरुि ् नोनणतच्छनदव िासो •क्षीणे- सरिमूत्रत्वं पार्श्ववपृष्ठिनिग्रि 9
10. साध्यासाध्यता • अ्पपनलगस्य दीिािे साध्यो र्लर्तो िर् | पररसंर्त्सरो याप्य सर्वनलग ं तु र्जवयेत्||(CH.CHI.11/14) सर्वनलग ं असाध्य पररसंर्त्सरो याप्य अ्पपनलगस्य दीिािे र्लर्तो िर् साध्य 10
11. निनित्सा • लाक्षा प्रयोर् • एलाहद र्ुहिक • रि अहतप्रवृहि हिहकत्सा • आवक्तिक हिहकत्सा • अमृतप्राश घृत • श्वदंष्टराहद घृत • समसिु घृत • प्रथम सहपयर्ुयड 11 • हितीय सहपयर्ुयड • तृतीय सहपयर्ुयड • ितुथय सहपयर्ुयड • पञ्चम सहपयर्ुयड • क्षीर् योर्ा • सैन्धव िूर्य • षाडव • नार्बल कल्प
12. लाक्षा प्रयोग AVASTHA PRAYOGA NAVA URA KSHATA Laksha, madhu. Ksheera- after it is digested anna with ksheera and sharkara is given PAARSHVA & BASTHI VEDANA, ALPA PITTA AND AGNI Laksha with sura is given ATISARA Laksha with musta, ativisha, pata, vatsaka churna DIPTANALA Laksha sarpi, madhuchishta, jivaniya gana aushada, sita, tvaksheera with ksheera 12
13. AVASTHA PRAYOGA IN KSHATA FOR SANDANARTHA Ksheera, ikshu mula, bisa granti,Padma kesara, chandana with madhu JWARA AND DAHA Yava churna with ksheera, gritha or sita, kshaudra, yava saktu or with ksheera KAASA, ASTI SHULA, PAARSHVA SHULA Maduka, maduuka, draksha, tvaksheera, pippali, bala churna licked with gritha and madhu. 13
14. एलानद गुनिि INGRIDIENTS INDICATION Twak, ela, patra- ½ aksha Pippali- ½ pala Sita- 1pala Madhuka- 1 pala Karjura - 1 pala Mrudvika – 1pala With madhu 1 karsha gutika is prepared Kala – daily prata and sayam 1 each Kasa Shwasa Jwara Hikka chardi Murcha Mada Brahmana Rakta shtivana Trushna Paarshava shula Arochaka Shosha Pliha Adyavata Swara beda Ksata Kshaya raktapitta 14
15. रि अनतप्रर्ृनि निनित्सा 1. Daksha Anda With Yusha Or Jala 2. Chataka Anda Rasa Yusha Or Jala 3. Chaga Or Jangala Mamsa Rakta Yusha Or With Jala 4. Punarnava Churna With Rakta Shali Sharkara Draksha Gritha Ksheera 15
16. आर्क्तिि निनित्सा AVASTHA PRAYOGA Rakta shtivana Madooka, maduka, ksheera sidda tandula Muuda vata Aja meda cooked in sura, saindava is added to it. Kshama, ksheena, ura kshata, anidrata, vata vrudha Aja meda cooked in ksheera sara added with gritha kshaudra and sharkara Ksheena, kshata, krusha For mamsa raktha vardana Yava, godhuma, sharkara, jeevaka, rushabaka, madhu. With anupana ksheera or mamsa bhakshi prani mamsa with gritha , pipali, madhu Ura kshata, shukra ksheena Nyagroda, udumbara, ashwata, plaksha, shala, pushpa priyangu, tala mastaka, jambu twak, priyala, ashwa karna with ksheera it is made ksheera paka and gritha is extracted and it is taken with shali 16
17. AVASTHA PRAYOGA Ura kshata Yashti madhu, naga bala kwatha is made, equal quantity ksheera and gritha are added. Kalka- payasya, pippali, vamshalochana Gritha is made Kshata rogi laksha rasa – 4bhaga Ksheera- 8bhaga Gritha- 1 bhaga Kalka- katvanga, darvi twak, vatsaka twak, indrayava sama pramana(1/4 bhaga) 17
18. अमृतप्रान र्ृत INGRIDIENTS INDICATION Jeevaniya gana dravya Punarnava Bala Bharangi Atmagupta Shati Tamalaki Kana Shringataka Payasya Shalaparni Prishnaparni Brihati Gritha is prepared, taken with mamsa rasa Nashta shukra Kshata ksheena Durbala Vyadi karshita Stree prasakta Krusha Varna swara heena Brumhana Kasa Shwasa Jwara Hikka Daha Trushna Rakta pitta Putra prada Kantakari Gokshura Draksha Akshoda Sarpi Ksheera Dhatri rasa Vidari rasa Ikshurasa Changa mamsa Madhu Sharkara Maricha Twak Ela Patra keshara Vamana Murcha Hridaya roga Yoni roga Mutra vikara 18
19. र्श्वदंष्टर ानद र्ृत INGRIDIENTS INDICATION Kwatha- gokshura, usheera, manjishta, bala, kashmarya, katuna, darba mula, pruthak parni, palasha, rushabaka, stira each 1 pala Kalka – swagupta, jeevanti, meda, rushabaka, jeevaka, shatavari, vriddi, mrudvika, sharkara, sravani, bisa, sama pramana Gritha- 1 prasta Ksheera – 4 prasta Vata pitta hridrava Shula Mutra kruchra Prameha Arsha Kaasa Shosha Kshaya Who does ati maituna, danus prayoga, madya, bhara, adva, 19
20. समसिु र्ृत INGRIDIENTS INDICATION Kwatha- yashti madhu- 8 pala, draksha- 1 prashta, jala Kalka – pippali- 8 pala, Gritha- 1 prasta Madhu- 8 pala Sharkara- 8 pala Saktu- 1 prasta Kshata ksheena Rakta gulma 20
21. प्रथम सनपवगुवड INGRIDIENTS INDICATION Gritha – 2prastha 2 prastha of each amalaki, vidari, ikshu. Kashaya of jeevaniya dravya Go Ksheera Aja ksheera After cooling 1 prastha sita 2 prastha of madhu is added. Disease more of pitta- lehana is done vata- pana, should drink with tvak ksheera, sharkara, laja Anupana- ksheera Yakshma Apasmaara Raktapitta Prameha Kshaya And also it is vayastapana, ayushya, maamsa prada, shukra prada, bala prada. 21
22. नद्वतीय सनपवगुवड INGRIDIENTS INDICATION 1 pala of bala, vidari, hrusva panchamula, punarnava, shrunga of pancha ksheeri vriksha 2 parts ksheera 1 part vidari swarasa 1 part of aja maamsa rasa 1 adaka gritha 1 aksha of jeevaniya dravya added and cooked 32 pala sita is added 1 kudava of godhuma, pippali, vamsha lochana, sringataka added Madhu 1 pala matra is taken and tied in bhurja patra. Anupana – ksheera or madhya Kapha Shosha Kaasa Kshataksheena Shrama Stree karshita Bhara karshita Rakta shtivana Taapa Pinasa Parshva shula Shira shula Svara bheda Varna nashi 22
23. तृतीय सनपवगुवड INGRIDIENTS INDICATION 1 pala tavaksheeri, sravani, draksha, murva, jivaka, vira kanda, ksheerakoli, brihati, kapikacchu, karjura, Meda triturated with ksheera 2 prastha of dhatri swaras, Vidari swarasa, ikshu rasa Gritha After cooling ½ tula sita, 1 prastha madhu Kasa Hikka Jwara Yakshma Shwasa Rakta pitta Halimaka Shukra kshaya Nidranasha Trushna Karshya Kamala 23
24. ितुथव सनपवगुवड INGRIDIENTS INDICATION 10pala dried amalaki, draksha, atmagupta, punarnava, shatavari, vidari,samanga, pippali, 8pala nagara 1 pala madhuyashti 1 pala sauvarchala 2 pala maricha 2 adhaka ksheera Tila taila Gritha 100 pala sita Kshata ksheena Shushka For pushtyartha 24
25. पञ्चम सनपवगुवड INGRIDIENTS INDICATION 1 adaka go ksheera 2 prastha gritha 2 adaka ikshu rasa 2 prastha vidari swarasa 2 prastha mamsa rasa of tithira 1 kudava madhuka pushpa Priyala ½ kudava tugakshiri 20 fruits karjura 20 vibhithaki 1 pala pippali 30 pala sita 1 karsha madhuka ½ pala jeevaniya dravya Triturated with ikshu rasa Modaka is prepared out of it. Vataraktha Pitta roga Kshata kasa Kshayaja kasa Ksheena shukra Ura raktha Krusha Durbala Vrudha varna., bala pushti Yoni dosha who suffer from miscarriages or death of featus in womb 25
26. क्षीण योगा INGRIDIENTS INDICATION Sharkara Pippali Madhu Gritha Ksheera Due to ati maituna the prakupita vayu goes to bashti pradesha and causes different diseases. For brumhanartha Vata nashaka Vrushya Kasa jwara Vidari kanda swarasa, ikshu rasa sadita mudga yusha added with gritha and amla phala Good for the person who have kshaya because of ati maithuna Jeevaniya brumhaniya Yava saktu, madhu, gritha Kshataksheena person who has good jataragni Jeevaniya gana dravya sidda jangala pashu pakshi mamsa rasa added with gritha and sharkara Ura kshata Go, mahisha, ashwa, aja ksheera or mamsa rasa or yusha with amla rasa , gritha When kshata ksheena patient good jataragni, If person is suffering from atisara he has give grahi medicine as mentioned in rajayakshma 26
27. सचन्धर् िूणव INGRIDIENTS INDICATION Saindava lavana- 1 pala Shunti – 2 pala Sauvarchala – 1 pala Vrikshamla – 1 kudava Amla dadima- 1 kudava Arjaka patra- 1 kudava Maricha- 1 pala Jeera – 1 pala Dhanyaka- 2 pala Sharkara – 12 pala Taken with food Rochana Deeepana Balya Parshva arthi Shwasa Kasa 27
28. षाडर् INGRIDIENTS INDICATION Dhanyaka – 1 shodashika Ajaji – 2 pala Ajamoda – 2 pala Amla dadima- 4 pala Vrikshamla – 4 pala Sauvarchala lavana – 1 pala Shunti – 1 karsha Daditta madya bhaga- 5 pala churna of all above dravyas Sharkara – sixteen pala It is given as ahara only. Atisara Mandagni In yakshma also it is given 28
29. िागर्ल ि्पप INGRIDIENTS INDICATION Kwatha- nagabala twak – ½ karsha with ksheera increased till 1 pala and decreased to ½ karsha Kala – 1 month Ahara – ksheera Pushti Ayu bala Arogya kara Mandukaparni, shunti, yashtimadhu also can be taken like nagabala kalpa 29
30. पथ्या • यद्यत् सन्तपवणं नीतमनर्दानि नितं लर्ु| अन्नपािं निषेव्यं तत्क्षतक्षीणच सुखानथवनभ || यच्ोिं यक्तिणां पथ्यं िानसिां रिनपनििाम्| तच् ि ु यावदर्ेक्ष्यानिं व्यानिं सात्म्यं र्लं तथा||(CH.CHI.11/93-94) •Santarpana, sheeta, avidahi, hitam, laghu annapaana 30
31. DISCUSSION •WHY KSHATAKSHEENAIS EXPLAINED IN DIFFERENT CHAPTER •Kshata Ksheena Has Different Nidana That Is Majorly External injury And Has Different Chikitsa 31
32. DISCUSSION •WHY NOT KSHEENA KSHATA •If So Then Hetu Will Be Ksheena For Kshata Where As There Will Be Kshata First Then Ksheena 32
33. DISCUSSION •NIDANA IN PRESENT DAYS- OCCUPATINAL HAZARD •Labor Workers who carries heavy things •Athletes •Weight lifters •Swimmers •Announcers •Construction workers •Wrestlers etc.. 33
34. DISCUSSION •WHAT IS URAS? WHY URAS? •HRUDAYOPARIKANTAAT ADHO BHAGA 34
35. DISCUSSION •FIRST RUPA IS EXPLAINED BEFORE PURVA RUPA •TVARITA CHIKITSA •PURVA RUPA WILL BE ISHAT VYAKTA 35
36. DISCUSSION •DOSHA & DHATU INVOLVED IN KSHATA KSHEENA •PRANA VATA •UDANA VATA •AVALAMBAKA KAPHA •SADAKA PITTA •MARMA STANA •RAKTHA 36 क्रमाद्वीयं र्लं र्णो रुनिरनिश्च िीयते| ज्वरो व्यथा मिोदचन्यं नर्ड्भेदोऽनिर्िादनप|| दुष्ट श्यार् सुदुगवन्ध पीतो नर्ग्रनथतो र्ह | िासमािस्य ि श्लेष्मा सरि सम्प्रर्तवते| स क्षत क्षीयतेऽत्यथं तथा नुक्रौजसो क्षयात्|(ch.chi.11/10-11)
37. DISCUSSION 37 Kshataksheena Rajayakshma Raktapitta Kshataja Kasa Nidana – abhighataja Nidana – ayatabala arambha, vegadharana, kshaya, vishamashana Lakshana – parakupitha vayu resides in shiras causes shiroruk, in parshva parshav ruk, in uras uro ruk and causes injury then raktha steevana Nidana – pitta prakopa ahara vihara Nidana – abhighata. Lakshana – first there will shushka kasa there after kapha with shonita appears.
38. DISCUSSION •WHY NO SPECIFIC CHIKITSA SUTRA MENTIONED KSHATA KSHEENA? •There is no pattern of occurrence of vyadhi samprathi. Its an emergency condition. 38
39. DISCUSSION •IMPORTANCE OF LAKSHA IN KSHATA KSHEENA •नतिा िषायोष्णा निग्धा नोनणतनपििुत्। ि ृ नमश्लेष्मव्रणान्हक्तन्त भूतज्वरानतविाननिी॥ Dhanvantari Nighantu •लाक्षा र्र्ण्ाव निमा र्ल्या निग्धा ि तुर्रा लर्ु । अिुष्णा िफनपिास्रनिक्कािासज्वरप्रणुत्॥ व्रणोर क्षतर्ीसपवि ृ नमि ु ष्ठगदापिा॥Bhava Prakasha 39
40. DISCUSSION •IMPORTANCE OF ANUPANA IN LAKSHA PRAYOGA •Agni Manda – Sura (Deepana Hrudya) •Atisara – musta (grahi, deepana, sheeta) •Deepthanala – gritha, ksheera (guru, brimhana) •Sandhanartha – madhu (madhura, Kashaya, sandhana, ropana) 40
41. DISCUSSION •IMPORTANCE OF LEHANA IN KSHATA KSHEENA •Pruthvi and jala mahabhuta pradhana which is jeevan, tarpana, sandhana, bhrumhana. •Mainly given in pittavata vridha condition. 41
42. DISCUSSION •IMPORTANCE OF AJA MAMSA IN KSHATA KSHEENA िानतनीतगुरुनिग्धं मांसमाजमदोषलम्|| नरीरिातुसामान्यादिनभष्यक्ति र्ृंिणम्| CH.SU.27/1) 42
43. DISCUSSION •IMPORTANCE OF SATKU IN KSHATA KSHEENA •निर्ो र्ृंिणा र्ृष्यािृष्णानपििफापिा | पीता सद्योर्लिरा भेनदि पर्िापिा || गुर्ी नपण्डी खराऽत्यथं लघ्र्ी सचर् नर्पयवयात् | निूिामानु जीयेत मृदुत्वादर्लेनििा ||(SU.SU.4.411-412) 43
44. DISCUSSION •IMPORTANCE OF KSHEERA AND GRITHA IN KSHATA KSHEENA •भक्ष्या क्षीरि ृ ता र्ल्या र्ृष्या हृद्या सुगक्तन्धि || अदानिि पुनष्टिरा दीपिा नपििानिा |(SU.SU.4.392) •तेषां प्राणिरा हृद्या र्ृतपूरा िफार्िा || र्ातनपििरा र्ृष्या गुरर्ो रिमांसला | (SU.SU.4.393) 44
45. DISCUSSION •IMPORTANCE OF SHADAVA IN KSHATA KSHEENA •लर्र्ो र्ृंिणा र्ृष्या हृद्या रोििदीपिा | तृष्णामूच्छावभ्रमच्छनदवश्रमघ्ना रागषाडर्ा ||(SU.SU.46) 45
46. DISCUSSION •WHY NOT TAILA GUDA PRAYOGA IN KSHATA KSHEENA •Though Taila Is Madhura Rasa •Taila Has Ushna, Tikshna, Pittala, Lekhana. 46
47. DISCUSSION •SARPI GUDA PRAYOGA IN KSHATA KSHEENA •Gritha Has madhura rasa, sheeta, sandhaniya, mrudu. •Sharkara - र्ृष्या क्षीणक्षतनिता सिेिा गुडनि व रा|(CH.SU.27/241) 47
48. DISCUSSION •AUSHADHA SEVANA KALA IMPORTANCE •Sabhaktha is advised which is helpful in ksheena, bala vardaka. •Muhur muhur is advised in prana vata. 48
49. DISCUSSION •PATTERN OF NOMENCLATURE IN SAINDAVADI CHURNA •यक्ति येि प्रिािेि द्रव्यं समुपसृज्यते| तत्सञ्ज्ञि स योगो र्च भर्तीनत नर्निश्चय || फलादीिां प्रिािािां गुणभूता सुरादय | ते नि तान्यिुर्तवन्ते मिुजेन्द्रनमर्ेतरे||(CH.KA.12/43-44) 49
50. DISCUSSION •AUSHADHA GUNA FOR CHIKITSA BY THE END OF REVIEW •रोपणं जीर्िं सन्धािीय र्ृंिणं तपवणं र्ातिर नपििर रिप्रसादि औषि 50
51. CONCLUSION •Kshanta ksheena is a condition where kshaya happened due to kshata. •Kshata ksheena nidana can be seen in few occupational hazard. •Due to tvarita chikitsa, rupa is explained first and then purva rupa. •Though it seems similar to rajayakshma, kshataja kasa, raktapitta due to its difference in the manifestation and chikitsa it is explained in different chapter. •Importance of chikitsa, aushadha yoga, aushadha kala, anupana is understood from the pattern of chikitsa in kshata ksheena. 51