Ashmaree

 

Introduction:

As`hmaree means calculus. Though As`hmaree have Kapha dominance. They are formed due to all the three Dosha.Sus`hruta has mentioned Kapha dominance in all the types of the As`hmaree as Kapha itself is converted into As`hmaree.

 

Nirukti:

 

Tulyataam As`hmanaa Yaanti Tasmaat Taam As`hamri Viduh |

Sampraapti:

1. In a person who consumes unwholesome diet, aggravated Kaphasaturates the urine causing As`hmaree.
2. Urine is dried along with the S`hukra, Pitta, Vaayuor Kapha, causing As`hmaree like the drying of the Pitta in the cow forming Gorochana.
3. Doshaget saturated with the Mootra causing As`hmaree according to Upasnehana Nyaaya.

 

Types:

1. Vaataja
2. Pittaja
3. Kaphaja
4. S`hukraja

 

As`hmaree resembles Kadamba Pushpa. It is S`hlakshn`a. It may be tri-folded and soft. When it obstructs the path of urine, it causes pain in the Basti. There is pain in Sevanee, Mehana, Basti. Urination gets distorted. There is pain in the Med`hra (Mridgaati Med`hram). Also the person passes urine frequently. Due to irritation if there is wound in the urinary tract, then there is heamaturia.

 

When the As`hmaree gets broken, the gravel passes through the urine. This is Mootra S`harkaraa.

Vaataja As`hmaree

Aggravated Kapha enters into the Basti Mukha causing its obstruction.

Signs and Symptoms:

Daalana, Bhedana, Toda. Basti becomes heavy and cold. As`hmaree is S`hyaava, Rooksha in colour, having sharp edges.

Pittaja As`hmaree

Pitta along with the Kapha get saturated and enter into the Basti Mukha causing obstruction.

Signs and Symptoms:

Chosha, Daaha, Paaka. Basti resembles the Ushn`a Vaata. As`hmaree resemble the Bhallaatakaasthi. It is Red or yellow or black.

 

Kaphaja As`hmaree

Kapha along with the Vaayu get saturated causing obstruction by residing into the Basti Mukha.

Signs and Symptoms:

Vedanaa, As`hmaree is large in size, S`hlakshn`a in appearance. It is white in colour.

All these three types of As`hmaree are seen in the children. In the older person S`hukraja type is seen.

 

S`hukraja As`hmaree

Due to Maithuna Vighaata or AtiMaithuna, S`hukra does not get ejaculated properly and gets saturated along with the Vaayu. It gets situated into the joining of Med`hra and Vrishan`a. After residing there it gets dried there. It obstructs the urinary tract.

Signs and Symptoms:

Mootra Krichchhra, Basti Vedanaa, Vrishan`a S`hotha. If As`hmaree is newly formed, then after Peed`ana it gets dissolved, but if it old, it does not get dissolved.

 

When As`hmaree enters into the urinary tract, it causes Daurbalya, Sadana, Kaars`hya, Kukshi S`hoola, Arochaka,Paan`d`utva, Ush`naVaata, Trishn`aa, Hritpeed`ana, Chhardi .

 

Saadhyasaadhyatva: Generally, As`hmaree is S`hastrasaadhya Vyaadhi.

Saadhya As`hmaree – Nava, Baala Rugn`a

Krichchhrasadhya Chirotthita

Asadhya – Sikataa S`harkaraanvita As`hmaree

Comparative study of As`hmaree types

	As`hmaree	Vaataja	Pittaja	Kaphaja	S`hukraja
Rogamaarga
Vyaadhi classification		Baala Vis`hishtaVyaadhi	Baala Vis`hishta Vyaadhi	Baala Vis`hishtaVyaadhi
Svabhaava	Ghora
Avayava	Bastimukha, Basti, Mehana			Basti, Basti Mukha, Mehana	Vrishan`aMed`hrayh Antare
Upas`haya					Peed`ana UtpannamaatreEva
Dosha	Kapha Prakopa	Vaata Prakopa	Pitta Prakopa	Kapha Prakopa
Dhaatu					S`hukra Dusht`i
Mala	Mootra
Srotas	MootravahaSrotasRodha	MootravahaSrotasRodha	MootravahaSrotasRodha	MootravahaSrotasRodha	MootravahaSrotas Rodha S`hukravahaSrotas Dusht`i

 

 

As`hmaree Chikitsaa

Reference:

C.Chi.26, S.Chi.7, A.H.Chi.11, N.R. As`hmaree

Introduction:

The stone like structure formed in the Mootraas`haya and which obstructs the free flow of urine is termed as As`hmaree. Its a very serious disease which has a grave prognosis.

Vaataja, Pittaja, Kaphaja & S`hukraja these are the four types of As`hmaree.

 

Saamaanya Chikitsaa:

As`hmaree should be treated with drugs in its early stages but it should be removed by surgery in advanced stages (when it becomes too big).

 

 

Avasthikaa Chikitsaa:

 

As`hmaree should be treated by Siddha Ghrita, Kshaara, Kashaaya, Ksheera, Yavaagoo, Yoosha and Uttara Basti. The medicines and diet should be Vaataalleviating.

Charaka has suggested the following method for As`hmaree Nirharan`a The patient should consume Nigada, a type of Madya and then should travel on a very fast moving vehicle.

 

If all the above measures fail to expel the As`hmaree out of the body spontaneously then it should be extracted by surgery.

o As`hmaree Nirharan`a S`hastrakarma:

o For surgery perianal approach should be adopted.

o Basti should be incised at Niraavaran`a area.

o Basti should not be incised at two places if gets cut then it becomes Sadhyo Praan`ahara (life threatening).

o The surgeon should take precaution not to injure the following eight vital parts during surgery. Sevanee (perineal raphe), S`hukraharan`ee Srotas (seminal vesicles), Phala (testes), Guda (rectum and anal sphincter), Mootraseka (urethra), Mootravaha (ureter), Yoni (uterus), Basti (bladder).

 

Pathya –

Dhaanya – Godhooma, Jeern`a S`haalee, Yava

S`haaka – Tan`d`uleeyaka, Aardraka, Gokshura, Varun`a, Paashaan`abheda,

S`himbee – Kulattha, Mudga

Maamsa – Jaangala Pas`hu Maamsa

Phala – Kushmaan`d`a,

Other – Madya, Yavakshaara, Basti, Virechana, Vamana, Langhana, Svedana, Avagaaha, Vaarisechana

Apathya –

Rasa – Kashaaya

Gun`a/ Karma – Rooksha, Guru, Avasht`hambaka, Viruddhaanna

Other – S`hushka, Paisht`ika Anna, Kharjoora, S`haaka, Kapittha, Jamboo, Mootra S`hukra Avarodha