Sampraapti:

Due to causative aggravating factors, Kapha and Pitta gets aggravated. It generates different types of Krimi. These Krimi reside at various places in the body. e.g.Aamaas`haya, Pakvaas`haya, Dhamanee, Rakta etc.

 

Types:

There are 20 types of Krimi, which can be also divided as

1. Baahya
2. Aabhyantara

There are also numerous types of Krimi, which can not be counted. According to origin, Krimi are of three types, which could be again classified as visible and invisible.

1. Dris`hya (visible): Pureeshaja (7) and Kaphaja (6) = 13
2. Adris`hya (invisible): Raktaja (7)

 

Kaphaja – Aamaas`haya, Pakvaas`haya ()

Pureeshaja -Aamaas`haya, Pakvaas`haya

Raktaja -Dhamanee

Sanjaata Krimi Lakshan`a:

1. Jvara
2. Vivarn`ataa
3. S`hoola
4. Hridroga
5. Sadana
6. Bhrama
7. Bhaktadvesha
8. Atisaara

 

 

Krimi Chikitsaa

References:

C.Vi.7, S.U.54, A.H.Chi.20, N.R. Krimi

Saamaanya Chikitsaa:

The basic line of treatment for Krimi (Intestinal and other parasites) can be classified into:

1. Apakarshan`a (Extraction measures)
2. Prakriti Vighaata (Antagonastic measures)
3. Nidaana Parivarjana (Avoidance of causative factors)

 

1. Apakarshan`a

Extraction of the parasites should be done

 

With appropriate therapies:

2. Prakriti Vighaata:

Drugs and diet which are pungent, bitter, etc to avoid development of Krimi.

 

3. Nidaana Parivarjana:

Factors which produce the parasites and similar substances should be avoided.

 

The patient should be given oleation and sudation therapies for a period of 6 / 7 days. Following day he should be fed with foods such as milk, sugar candy, curds, etc. to bring about Udeeran`a i.e. propel the parasites to move to the alimentary canal; then if the food consumed previous day is properly digested, should be givenAasthaapana Basti (enema), Vamana (emesis) and Virechana (purgation) therapies on the same day if the patient is Arha (fit) for the therapies.

 

In order to get rid of the worms, the patient should be oleated and should be given emesis followed by purgation with drastic formulations.

 

When the non – unctuous enema comes back, the patient should be bathed with warm water and fed with anti – helminthic food without delay, followed by unctuous enema.

Avasthika Chikitsaa:

The worms / parasites situated in head, heart, nose, ear, and eye should be managed particularly with collyrium and various kinds of Snuffs.

 

Drug of choice:

In all the types Surasaadi Gan`a drugs should be used as the drug of choice. (S.U.54/38)

 

Pathya:

• Rasa – Tikta, Kashaaya, Kat`u
• Gun`a – Rooksha, Ushn`a, Teekshan`a
• Dhaanya – Puraan`a Dhaanya, Rakta S`haalee
• S`haaka – Pat`ola, Vetraagra, Rasona, Vaastuka, Chitraka, Mandaara Patra, Sarshapa, Vid`anga, Nimba, Ajamodaa, Khaira, Kut`aja, Kaaravellaka, Hingu, Devadaara, Agaroo,
• S`himbee – Maasha, Kulattha
• Dugdha – Ghrita, Dugdha
• Drava – Tila Taila, Kaanjika, Tushodaka, Gomootra, Suraa, Ausht`ra Mootra, Sauveeraka
• Phala – Apakva Kadalee, Kant`akaaree, Pakva Taalaphala, Nimbuka Rasa
• Kritaanna – Madhu, Taambula, Kasturee, Kshaara, Aasthaapana Basti, S`hodhana, Dhoopa, Abhyanaga, Kaphaghna Upachaara, S`hirovirechana

Apathya:

• Rasa – Amla, Madhura
• Gun`a – Drava
• S`haaka – Patra S`haaka
• S`himbee – Maasha
• Maamsa – Maamsa
• Dugdha – Dugdha, Dadhi, Ghrita (Ausht`ra Dugdha, Dadhi, Ghrita Varjita)
• Drava – Viruddha Peya, S`heeta Jala
• Phala – Badara
• Kritaanna – Paisht`ika Bhakshya, Ajeern`aas`hana, Viruddhaas`hana, Lavan`a, Chhardi Vega Dhaaran`a, Divaasvapna

 

Introduction:

The disease is related to the loss of S`hukra Dhaatu

Types:

By Charaka

1. Beejopaghaataja
2. Dhvajopaghaataja
3. Jaraaja
4. S`hukrakshayaja

By Sus`hruta

1. Maanasa
2. Dhaatu Kshayaja
3. Dhvajabhangaja
4. Pumstvopaghaataja
5. Sahaja
6. Khara S`hukra Nimittaja

 

Saamanya Chikitsaa

Treatment Kshataksheena also Vaajikaran`a should be followed for Klaibya. Also considering Sampraapti of patients, following treatment modalities should be suggested.

• Shodhana Chikitsaa
• Snehana and Svedana
• Snehayukta Virechana
• Aasthaapana Basti
• Anuvaasana Basti
• Hitakarara Anna Sevana (Anuvaasana, Aasthaapana Basti in Vyatyaatsa)

 

Vishesha Chikitsaa

• Vaajikaran`okta Chikitsaa Bijopaghaata Klaibya (Vaajikarana Yoga)
• Daivavyaapaashraya Abhichaaraja Klaibya
• Dhvajabhangaja Klaibya

• Pradeha
• Parisheka
• Raktamokshana
• Snehapaana
• Snehayukta Virechana
• Anuvaasana Basti
• Aasthaapana Basti

• Dhvajabhangaja Klaibya Vran`a Vran`a Chikitsaa should also be done.

o Jaraaja Klaibya and Dhaatukshayaja Klaibya

• Basti
• Ksheera
• Ghrita
• Snehana
• Snehayukta S`hodhana
• Rasaayana Prayoga
• Ksheerasarpi
• Vrishya Yoga
• Yaapanaa Basti

Asaadhya Klaibya: Klaibya is incurable in following conditions:

Sahaja Klaibya

Sannipaatika Klaibya

Dhvajabhangaja Klaibya

Kshayaja Klaibya

If the site of Marma related is affected.

Introduction:

Kaars`hya is emaciation of the body. It is one of the conditions in Asht`a Nindita Vyaadhi (eight reproached / defamed diseases), which provide the base for a number of diseases to manifest in the body. Contrary to Sthaulya this condition necessitates substantively increasing the body constituents, which is comparatively easy hence it is considered to be better than Sthaulya.

 

Saamaanya Chikitsaa

Brimhan`a is the key treatment for Kaars`hya.

The substance should be Laghu (easy to digest) and Santarpan`a (refreshing, increasing the body constituents Dhaatu).

Maamsa is the most effective Brimhan`a Dravya to be used for treating Kaars`hya.

Pathya

Santarpan`a- Madhura Snigdha Sauhitya

Svapna

(Nidraa, Sleep)

Achintaa

(Non thinking)

Harshan`a

(To be cheerful)

 

Apathya

Vyaayaama

(heavy exercise)

Vyavaaya

(Sexual gratification)

Prajaagara

(Wakefulness)

Chintana

(Preoccupation, worry)

Pathya:

Aahaara:

Sanskrita (processed) Maamsa, Dadhi, Ghrita, Paya

Vihaara:

o Nidraa Sevana

o Harshan`a (to be cheerful)

o Achintana (to take things easy, not to worry)

o Mano Nivritti (cessation of mental activities)

o Snaana (bath)

o Gandha, Maalya Nishevan`a (putting on scent and garlands)

Apathya:

Vihaara:

o Chintaa (worry, preoccupation)

o Vyavaaya (Sexual activity)

o Vyaayaama (Physical exercise)

Introduction:

If the person suffering from Paan`d`uroga indulges in diet and life style which vitiates Pitta, it results in Kaamalaa. This disease can manifest directly even without manifestation of Paan`d`uroga.

It is of two types:

1. S`haakhaas`hrita Kaamalaa also known as Ruddhapatha Kaamalaa
2. Kosht` has`haakhaas`hrita Kaamalaa also known as Bahupitta Kaamalaa.

 

If not specified, Kaamalaa Chikitsaa is generally considered as treatment of Bahupitta Kaamalaa.

 

It is generally said that S`haakhaas`hrita Bahupittaa Kaamalaa is manifested after Kaamalaa while S`haakhaas`hrita Alpapittaa Kaamalaa manifests without prerequisite of Kaamalaa.

 

Saamanya Chikitsaa:

o As there is vitiated Pitta in large amounts, Virechana is the purification modality of choice. The drugs used for Virechana should have Tikta Rasa and Mridu Virechakaeffect.

o Generally Kaamalaa is the sequel of Paan`d`uroga, hence its medication should not be contradictory to Paan`d`uroga.

o In both the types after S`hodhana treatment S`hamana is done. S`hamana Dravyaa should be –

Pittaghna (drugs which annihilate Pitta)

Paan`d`uroga Avirodhi (drugs non conflicting with Paan`d`uroga)

o Draakshaa Rasa (grape juice) and Aamalakee Rasa (juice of embelic myrobalans) should be used for preparing food as well as for drinking.

 

 

Introduction:

Jvara affect body, senses, and mind also diminishes the intelligence, strength, complexion and enthusiasm of the sufferer and produces exhaustion, exertion and aversion to food. It should be treated considering its type, Avasthaa, causative factors and involved Dosha.

 

Contraindications:

Aahaara: Guru Anna, Kashaaya Rasa

Vihaara: Divaasvaapa, Snaana, Abhyanga, Maithuna, Krodha, Pravaata, Vyaayaama.

Kashaaya Rasa, Guru, Ushn`a should be avoided.

 

Saamanya Chikitsaa:

Nava Jvara :

Following treatment modalities should be suggested according to Avasthaa, Rugn`a Bala.

1. Langhana
2. Svedana
3. Kaala
4. Yavaagoo
5. Tikta Rasa
6. Kashaayapaana

1. Langhana

Langhana is the first treatment in Nava Jvara, however Langhana should be advised considering Rugn`a Bala. Depleted Agni is not even capable to digest the medicine, hence, first Langhana should be advised.

 

Langhana types:

o Upavaasa or Anas`hana type of Langhana is expected generally.

o Vamana for Kaphapradhaana Avasthaa.

o Charaka has described 10 types of Langhana.

1. Vamana
2. Virechana
3. Basti
4. Nasya
5. Paachana
6. Annavarjana
7. Udakavarjana
8. Vyaayaama
9. Aatapasevana
10. Maarutasevana

o Hemaadri has added Raktamokshan`a and Deepana thus mentioned 12 types.

o Langhana is indicated for seven days. While Haarita suggests one, three or seven days Langhana according to Dosha.

Effect of Langhana

Jvara is characterized by Aamas`hayastha Dosha, Agnidaurbalya, Saamataa and Srotovibandha. Langhana is best treatment in this condition. Effects of Langhana are as follows:

• Doshakshaya
• Agnivardhana
• Laghutva
• Kshudhaa Vardhana
• Jvaranaas`ha
• Ruchi
• Aamapaachana
• Bala (Utsaaha) Vardhana
• Ojovriddhi

 

Contraindications of Langhana:

Though Langhana is primary treatment of Jvara, it is contraindicated in following Jvara types.

• Kshayaja Jvara

Dhaatukshayaja Jvara

Raajyakshmaajanya Jvara

• Vaataja Jvara
• Bhayaja Jvara
• Krodhaja Jvara
• Kaamaja Jvara
• S`hramaja Jvara

Vamana in Nava Jvara

Indications:

• Kaphapraadhaanya
• Utklisht`a Dosha
• Aamaas`hayasthita Dosha
• Vaamya Rugn`a

2. Svedana

Svedana is indicated in Vaata Kaphaja Avasthaa. Effects of Svedana are:

• Srotos`hodhaka
• Laaghavakara
• Svedakara

 

Indications of Svedana:

• Vaata Kaphaja Jvara
• Kaphaja Jvara
• Vaataja Jvara
• S`heetapoorvaka Jvara

3. Kaala

For Doshapaachana and Agnivardhana, period of 8 days is required. This period should be decided as per signs and symptoms of Agni, Saamataa, Dosha Vriddhi etc. Diet or any other drug is indicated after this period.

4. Yavaagoo

After Vamana (Langhita Rugn`a) Paacahna Dravya siddha Yavaagoo should be given as diet. E.g. Pippalee Naagara Siddha Yavaagoo.

Aahaara of Jvara Rugn`a should be started with Man`d`a, Peyaa and then Yavaagoo. This should be given for Six days or up to Doshapaaka (Jvaramaardava).

 

Effects of Yavaagoo:

Yavaagoo is Laghu, Drava, Sara, Ushn`a. it is indicated for following reasons.

o Agnivardhana

o Vaatanulomaka

o Mootraanulomaka

o Pureeshanulomala

o Doshaanulomaka

o Svedana

o Aamapaachana

o Praan`a Dhaaran`a (Bala)

 

Contraindications of Yavagoo

Due to Ushn`a Gun`a Yavagoo is contraindicated in following diseases.

o Madyaja Jvara

o Madaatyayajanya Jvara

o Madyanitya Rugn`a

o Gresshma Ritu

o Pitta Kaphaja Jvara

o Oordhvaga Raktapitta

 

Indication of Tarpan`a:

In above conditions or Vyaadhi, Tarpan`a is indicated. This Tarpan`a should be made up of Jvaraghna Phalarasa (fruit juices) with Laajaa, Saktu, Madhu, S`harkaraa.

 

5. Tikta Rasa:

For Aamapaachana, Agnideepana Tikta Rasa should be used. Kvaatha etc. formulations should be prepared from Tikta Rasa drugs.

6. Kashaayapaana:

Though Kashaayapaana is indicated after Langhana, (6 – 8 days) Doshaavasthaa should be assessed first.

Aamaavasthaa Paachana Kashaaya

Pakvaavasthaa S`hamana Kashaaya

Kashaaya Rasa formulations are contraindicated in Nava Jvara. Kashaaya Rasa formulations can cause Doshastambhana and may lead to Vishamajvara. Along withKashaaya Rasa, Guru, Ushn`a, Snigdha, Madhura formulations should also avoided.

General flow of Nava Jvara Chikitsaa is as follows:

Jeern`a Jvara Chikitsaa:

Considering status of Dhaatu; Snehana, Ghritapaana, Balya, Brimhan`a Aahaara is indicated in Jeern`a Jvara. Snehana should be administered inform of Anuvaasana Basti, Nasya, Ghritapaana.

 

Indications of Ghritapaana:

o Niraama Dosha

o Jeern`a Jvara

o Ksheen`a (Manda) Kapha

o Vaata Pitta Vriddhi

 

Contraindications of Ghritapaana:

Though Ghritapaana is indicated in Jeern`a Jvara, Kaphaja Jvara and Alanghita Rugn`a are contraindicated.

 

Ghritapaana: Mode of action.

o Nirdrava (Rooksha) Pittas`hamana

o Vaatas`hamana

o Ksheen`a Kaphavardhana

Indications of Ksheerapaana:

o Daaha + Trishn`aa

o Baddha Dosha: Gavya Ksheera (Cow milk): Acts as Pravartaka i.e. Promoting elimination of Mala.

o Chyuta Dosha

o Chhaaga Ksheera (Goat milk): Acts as Samgraahaka

Indications of Anuvaasana:

o Pakvas`hayagata Dosha

o Ksheen`a Kapha Pitta

o Rooksha Rugn`a

o Baddha Purisha

o Niraama Jvara

 

Indications of Nasya:

o Jeern`a Jvara

o S`hirogaurava

o S`hirahs`hoola

o Indriya Jaad`ya

 

Raktadusht`ee Nidaana and Chikitsaa:

Jvara, which does not respond to S`heeta Ushn`a, Snigdha Rooksha Chikitsaa, should be considered as S`haakhaanusaari Jvara. It indicates that Dosha are situated inRaktadhaatu. Raktamokshan`a is indicated in this stage.

Sannipaata Jvara Chikitsaa

Though Sannipaata Jvara has Tridoshavriddhi, Considering individual Dosha levels (tara – tamatva) Chikitsaa to be planned.

Basic aim of Sannipaata Jvara Chikitsaa is to maintain balance of Dosha. In this case two possibilities exist:

1. Samaana Vriddhi (Vaatavriddhatama, Pittavriddhatama, Kaphavriddhatama)

Kaphasthaana S`huddhi (Vamana etc.) is indicated first.

2. Vishama Vriddhi(13 combinations of Sannipaata)

Alleviate (Kshapan`a) Vriddha Dosha.

Aggravate (Vardhana) Ksheen`a Dosha.

 

Vishamajvara Chikitsaa:

o Yuktivyapaas`hraya:

Vaatapradhaana: Snehabasti, Snigdha, Ushn`a Anna Paana

Pittapradhaana: Virechana, Siddha Ghrita, Tikta, S`heeta Anna Paana.

Kaphapradhaana: Vamana, Paachana, Rooksha, Kashaaya Anna Paana

o Daivavyapaas`hraya:

Man`idhaaran`a, Agadadhaaran`a Mangala, Somapoojana, Purushasookta Pat`han`a, Brahmaa Ashvinau -Indra -Himaachala -Gangaa -Marutgan`a poojana.

o Satvaavajaya:

Maanasavikaara Chikitsaa

Karun`aa, Dayaa, and Maana shuddhikara bhaava are effective in all types of Jvara.

Aagantuja Jvara Chikitsaa:

• Abhis`haapaja Jvara
• Abhichaaraja Jvara Daivavyapaas`hraya Chikitsaa
• Bhootaabhishangaja Jvara
• Abhighaataja Jvara: Abhyanga, Ghritapaana, Raktamokshan`a, Madya, Maamsarasa
• Kshataja Jvara, Vran`aja Jvara: Vran`a Chikitsaa.
• Kaamaja, S`hokaja, Bhayaja Jvara: Aas`hvaasana, Harshan`a, Pittaghna Chikitsaa
• Krodhaja Jvara: Sadvaakya, Kaama
• Kaamaja Jvara: Krodha

 

Diet in Jvara:

After Yavaagoopaana, Yoosha or Maamsarasa should be given for 10 days. This diet can be specified as:

• Kaphapraadhaanya, Balavaana Agni Yoosha
• Vaatapraadhaanya, Durbala Agni Maamsarasa.
• Mandaagni, Alasaatmya Rugn`a Use of Amla Rasa.

 

 

Pathya:

Rasa – Tikta

Gun`a – Laghu

S`hooka – Puraan`a Tan`d`ula, Godhuma, Raktas`h`aalee, Shas`hti`ka S`haalee

S`haaka – Tan`d`ulakeeya, Vaastuka, Baala Moolaka, Parpat`ka, Gud`oochee, Kaalas`haaka, Nimba, Maat`ha, Kaaravellaka, Chukra, Vaartaaka, Peelu, Punarnavaa, Paat`haa, Marisha, Jeevantee, Ambasht`hakee, Vandhyaa Karkot`ee

S`himbee – Mudga, Kulattha, Chan`aka, Makusht`a

Maamsa – Laavaa, Kapinjala, Harin`a, Prishat, Kaalapuchchha, S`harabha, S`has`ha, Kuranga, Mriga, Kukkut`a

Dugdha – Godugdha, Ghrita

Phala – Daad`ima, Aamalakee, Parushaka, Mridvikaa

Kritaanna – Mudga, Masoora, Chan`aka, Kulattha, Yava Krit Yoosha, Rakta S`haalee Peyaa, Laajaa Man`d`a, Madhura Takra Yukta Khad`a Yoosha, Jvara Naashaka Aushadha Kvaatha Siddha Bhakta, Peyaa, Nisneha S`haaka

Other – Gud`a, Suraa, Khan`d`a S`harkaraa, S`hun`t`hee, Jeeraka, Saindhava, Pippalee

Apathya:

Rasa – Amla, Kashaaya

Gun`a/ Karma –Vidaahee, Guru, Abhishyandi, Rooksha

S`haaka – Patra S`haaka

Maamsa – Tod`ee Matsya

Phala – Kshudra Panasa, Kalingad`am

Other – Asaatmya Bhojana, Viruddhaanna, Kshaara, Nava Dhaanya, Paisht`ika Padaartha, Taambula, Pin`yaaka, Vegadhaaran`a, Danta Kaasht`ha, Shrama, Vaata Sevana

 

 

 

Introduction:

Indriya are five sense organs responsible for perception of senses. Ayurveda considers Chakshu, S`hrotra, Ghraan`a, Rasana and Sparshana as five Indriya. They are situated at Eyes, Ears, Nose, Tounge and Skin respectively. These organs are considered as Indriya Adhisht`haana means seat of Indriya.

 

Indriya Dusht`ee and its management:

Vitiated Dosha when situate in Indriya they cause either Upaghaata (complete damage) or Upataapai (weakness). Indriya Upaghaata is incurable, but the physician should treat any disease related to Indriya with following guidelines.

Saamanya Chikitsaa:

Diagnosis to assess status of Indriya and related organ (Indriya Adhisht`haana) is very important. If related organ has disease, that should be treated accordingly.

o e.g. If Baadheerya is symptom due to Karn`aars`ha, main disease should be treated.

Differential diagnosis should be thought prior to treatment considering Indriya related signs and symptoms.

o e.g. Indriya Daurbalya appears as symptom of Paan`d`u and Kaamalaa

If Indriya Dusht`ee is complication (Upadrava) of some other disease, that disease should be managed with Indriya specific treatment.

o e.g. Indriyoparodha is Upadrava of Gara Visha. Treatment should be Vishaghna and Indriya Bala Vardhaka

Indriya Naas`ha (complete damage) should be considered as Arisht`a (sign of grave prognosis).

Panchakarma treatment has key role in Indriya related disorders. As its effects are Indriya Balavardhana (strengthening Indriya).

Treatment for head (e.g. Nasya, S`hirobasti, S`hirodhara etc) should be suggested as it is seat of all Indriya.

Treatment should have effects Indriya Prasaadana, Indriya Balavardhaka etc.

Avoid Heena Mithyaa Atiyoga and follow proper code of conduct as per principles mentioned in Dinacharya Ritucharya and Sadvritta.

 

 

Vis`hesha Chikitsaa

Following treatment type can help respective Indriya.

1. Chakshurendriya:

o Chikitsaa Karma: Nasya, Anjana, Tarpan`a, Put`apaaka, As`hchotana, Lepa, Bid`aalaka

o Properties of medicines: Chakshushya, Drisht`i Prasaadana

 

2. S`hrotrendriya

o Chikitsaa Karma: Karn`apooran`a, Ghritapaana

o Properties of medicines: Rasaayana, S`hravan`a S`hakti Vardhaka

3. Ghraanendriya

o Chikitsaa Karma: Nasya

o Properties of medicines: Rasaayana, Kaphagha

4. Rasanendriya

o Chikitsaa Karma: Kavala, Gan`d`oosha, Nasya

o Properties of medicines: Madhura, Amla, Sheeta

5. Spars`hanendriya

o Chikitsaa Karma: Abhyanga, Snehana, Svedana, Udvartana

o Properties of medicines: Snigdha, Varn`ya, Tvachya, Tvak Prasaadana

 

 

Karma

Chakshushya, Jeevana, Kan`t`hya, Medhya, Rasaayana, Snehana, Tvachya, Preen`ana etc.