Amala pitta management


अम्लपित्त चिकित्सा
(Management of Hyperacidity / APD)
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अम्लपित्त रोग की चिकित्सा करते समय सबसे पहले यह जानना ज़रूरी होता है कि यह किन कारणों से पैदा हुआ है। कारणों का पता चलने पर यह जानने का प्रयास करना चाहिए कि - रोगी की देह (विशेषकर आमाशय) में विकृति क्या है, कहाँ है, व कितनी है ? और, इसके बाद प्रयास किया जाना चाहिए, सम्प्राप्ति बनाने का ।

निदान
• अक्सर देखा जाता है कि अम्लपित्त का रोगी लम्बे समय तक, तथा/अथवा, अधिक मात्रा में ऐसे भोजन करने का आदी होता है, जो कि तीक्ष्ण, उष्ण, व क्षोभकारक हों;
• या फिर, रोगी लम्बे समय तक, तथा/अथवा, अधिक मात्रा में तीक्ष्ण, उष्ण, व क्षोभकारक (ऐलोपैथिक) दवाओं का सेवन करता होता है;
• कभी-कभी अम्लपित्त का हेतु दूषित / बासी भोजन, असमय भोजन, उचित रूप से न चबाया गया भोजन, ज़ल्दी-ज़ल्दी किया गया भोजन भी हो सकते हैं; तथा
• और, कभी आमाशय में होने वाला संक्रमण (H. pylori) भी अम्लपित्त व उससे होने वाले आमाशयिक व्रण (Peptic ulcer) का हेतु बनता है।

सम्प्राप्ति:
ऊपर बताए कारणों का कुल प्रभाव निम्न में से एक अथवा अधिक प्रकार से पड़ता है -

I. आमाशय में  बनने वाले पाचक-पित्त में अम्ल-घटक (Hcl) अधिक बनने लगता है;
II. आमाशयगत श्लेषम-कला (Gastric mucosa) व उसे आच्छादित करने वाली श्लेष्मा (Mucosal barrier) में क्षीणता व दौर्बल्य हो सकता है, जिससे कि आमाशयगत श्लेषम-कला-शोथ (Gastritis) व आम-पच्यमानाशय व्रण (Peptic ulcer) हो सकता है;
III. आमाशय की अनुलोम-गति (Peristaltic movement) में कुछ धीमापन भी हो सकता है, जिससे कि सेवित आहार व पाचक-रस आमाशय में आवश्यकता से अधिक देर तक पडे रहने से आहार-रस में अम्लता (Hyperacidity) व शुक्तता (Fermentation) पैदा होती है; व
IV. आमाशय में आवश्यकता से अधिक अम्ल (Hyperacidity) की विद्यमानता हो सकती है।

चिकित्सा
अब समय आता है, ऊपर बताए कारणों व सम्प्राप्ति के आधार पर चिकित्सा करने का। इसके लिए निम्न रीति से आगे बढ़ा जा सकता है- 

I. पाचक-पित्त में अम्ल-घटक (Hcl) की उत्पत्ति कम करने वाली औषधियों का प्रयोग:

सबसे पहला व महत्वपूर्ण कदम होता है, पाचक-पित्त में अम्ल-घटक (Hcl) की उत्पत्ति कम करने वाली उचित औषधियों का चुनाव (Selection of right drugs) व उनका प्रभावी मात्रा (Therapeutic dose) में प्रयोग। इस वर्ग में हालांकि अनेकों औषधियाँ हैं - शटी, पटोल, धत्तूर्, वासा, गुडूची, यवानी इत्यादि; तो भी सर्वाधिक प्रभावशाली औषधी है - शटी (Hedychium spicatum) । 

शटी के तिक्त (Antagonistic to acid) व कषाय रस (Astringent), तथा ग्राही (Anti-secretory) कर्म इसे आमाशयिक पाचक-पित्तगत अत्यधिक अम्लता (Excessive gastric Hcl) की उत्पत्ति को कम करने वाली एक प्रभावशाली औषधी बनाते हैं ।  इसकी तीक्ष्णता, लघुता, अनुष्णता, व ईषत् कटुता इसके उपरोक्त कर्मों में अतिरिक्त बल प्रदान करते हैं। अपने इन्हीं गुण-कर्मों के आधार पर शटी का भरपूर चिकित्स्कीय उपयोग न केवल अम्लपित्त (Hyperacidity) व परिणामशूल (APD), बल्कि छर्दि (Vomiting) व हिक्का (Hiccup) में भी किया जाता है। इसके व्रणरोपण (Ulcer healing) व शोथहर (Anti-inflammatory) कर्मों के आधार पर इसका आमाशय-शोथ (Gastritis) व परिणामशूल (APD), व आम-पच्यमानाशयगत व्रण (Peptic ulcer) की चिकित्सा में विशेष महत्व है।

II. आमाशयगत श्लेषम-कला (Gastric mucosal barrier) को बल देने वाली औषधियों का प्रयोग:

अम्लपित्त की चिकित्सा में दूसरा महत्वपूर्ण कदम होता है, ऐसी औषधियों का उपयोग जो आमाशयगत श्लेषम-कला (Gastric mucosal barrier) को बल देने वाली हों।  इस वर्ग में हालांकि अनेकों औषधियाँ हैं - मधुयष्टी, आमलकी, शतावरी, गुडूची, अभ्रक, ज़हरमोहरा इत्यादि; तो भी इनमें सर्वाधिक प्रभावशाली औषधी है - मधुयष्टी (Glycyrrhiza glabra) । 

मधुयष्टी के शीत (Anti-enzymatic) व मधुर रस (Antacid) इसे आमाशयगत श्लेषम-कला (Gastric mucosal barrier) को बल देने वाली विशेष औषधी बनाते हैं ।  दूसरी ओर, इसकी गुरुता (Anabolic action) व स्निग्धता (Promotes mucous secretion)  इसे एक श्रेष्ठ रसायन बनाने के साथ-साथ एक प्रभावशाली व्रणरोपक औषधी भी बनाते हैं ।  यही कारण है कि जहाँ एक ओर सर्वांग धातुक्षय (General debility / tissue degeneration) की अवस्था में मधुयष्टी का रसायन के रूप में भूरिशः उपयोग किया जाता है, वहीं व्रण (Wound / ulcer) में एकदेशीय (Local) धातुक्षय (Tissue death / necrosis) की अवस्था में भी मधुयष्टी का व्रणरोपक औषधी के रूप में बहुतायत से उपयोग होता है। अपने इन्हीं गुण-कर्मों के आधार पर मधुयष्टी का उपयोग न केवल अम्लपित्त (Hyperacidity) व परिणामशूल (APD), बल्कि छर्दि (Vomiting),  आमाशय-शोथ (Gastritis), व आम-पच्यमानाशयगत व्रण (Peptic ulcer) की चिकित्सा में भरपूर उपयोग किया जाता है ।

III. आमाशय की अनुलोम-गति (Peristaltic movement) बढ़ाने वाली औषधियों का उपयोगः

इस विकृति के निराकरण के लिए ऐसी औषधियों के उपयोग की आवश्यकता होती है जो कि आमाशय की अनुलोम-गति को तीव्र करते (Stimulate peristalsis) हुए उसमें मौजूद पच्यमान-आहार व आहार-रस (Gastric contents) को शीघ्रता से पच्यमानाशय ( Duodenum) में प्रविष्ट कराएँ (Expedite gastric emptying)। इस वर्ग में यद्यपि अनेकों औषधियाँ हैं - भृंगराज, शटी, मयूरपिच्छ, हरीतकी, निशोथ, पौदीनक, शुण्ठी इत्यादि; तो भी भृंगराज (Eclipta alba) इन सब में अपना विशेष महत्व रखती है ।  

भृंगराज के कटु (Stimulant) व  तिक्त (Acid antagonistic) रस इसे आमाशय की अनुलोमगति बढ़ाने वाली (Peristaltic stimulant) वाली विशेष औषधी बनाते हैं ।  दूसरी ओर, इसकी लघुता व उष्णता (Metabolic stimulant action) तथा रूक्षता (Anti-secretory) इसके उपरोक्त कर्मों में विशेष सहायता (Synergistic action) प्रदान करते हैं।  यही कारण है कि भृंगराज का उपयोग अम्लपित्त (APD) के साथ-साथ छर्दि (Vomiting) में भी किया जाता है। यही नहीं, भृंगराज अग्न्याशयगत पाचक-तत्व (Pacreatic trypsin) का अवरोध करते हुए अग्न्याशय-शोथ (Pancretitis) में भी लाभकारी सिद्ध होता है।

IV. आमाशयगत अत्यधिक अम्ल का निराकरण करने वाली (Acid neutralizing) औषधियों का उपयोगः

इस विकृति के निवारण के लिए ऐसी औषधियों के उपयोग की आवश्यकता होती है जो कि आमाशयगत अत्यधिक अम्ल का निराकरण (Neutralize excessive gastric Hcl) करें। इस वर्ग में मुख्य औषधियाँ हैं - मुक्ताशुक्ति, मुक्ता, प्रवाल, गुडूची, स्वर्जिकाक्षार, निम्बुक, अभ्रक इत्यादि । फिर भी, मुक्ताशुक्ति (Mother of pearl) कई कारणों से इस वर्ग की एक आदर्श औषधी है ।  

मुक्ताशुक्ति का अम्लता-निरोधक (Acid-neutralizing) कर्म इसे आमाशय में मौजूद अत्यधिक अम्लता-निवारण (Acid antagonism) करने के लिए एक आदर्श औषधी बनाता है। यही कारण है कि मुक्ताशुक्ति का उपयोग अम्लपित्त (APD) के साथ-साथ छर्दि (Vomiting), पित्त-प्रधान अरुचि (Dyspepsia), व पित्तज-परिणामशूल (Peptic ulcer) में भी किया जाता है।

अम्लपित्त होने की स्थिति में, प्रत्येक रोगी में सम्प्राप्ति के आधार पर, उपरोक्त चारों वर्गों में से किसी एक अथवा अनेक औषधियों का युक्तपूर्वक प्रयोग अपेक्षित लाभ देता है।

अनुभव बताता है कि, क्योंकि अम्लपित्त के प्रत्येक रोगी में, सम्प्राप्ति के लगभग सभी घटक, कमोबेश रहते ही हैं, अतः उपरोक्त चारों वर्गों में से एक-एक मुख्य औषधी का चुनाव करके, उनका युक्तिसंगत मात्रा व कल्पना में उपयोग, इस रोग की चिकित्सा में आशातीत लाभ देता है। 

इसी आधार पर हमने, प्रत्येक वर्ग में से एक-एक मुख्य औषधी का चुनाव करके, चार मुख्य औषधियों का औषध-योग तैयार किया, तथा इसका अम्लपित्त (Hyperacidity), परिणामशूल (Acid Peptic Diseases), आम-पच्यमानाशयगत व्रण (Peptic ulcer), अजीर्ण (Dyspepsia), छर्दि (Vomiting), आमाशय-कला-शोथ (Gastritis) इत्यादि में, असंख्य रोगियों में, लगभग तीन दशक तक सफलतापूर्वक प्रयोग किया, व इससे आशातीत लाभ पाया।

इस औषध-योग को हमने लोसिड टैबलेट (LOCID Tablet) नाम दिया।

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LOCID Tablet
(लोसिड) टैबलेट

घटकः
• शटी इक्स्ट्रैक्ट 250 mg (2.5 ग्राम शटी चूर्ण के बराबर)
• मधुयष्टी इक्स्ट्रैक्ट 225 mg (2.25 ग्राम मधुयष्टी चूर्ण के बराबर)
• भृंगराज इक्स्ट्रैक्ट 175 mg (1.75 ग्राम भृंगराज चूर्ण के बराबर)
• मुक्ताशुक्ति भस्म  150 mg

मात्रा: 1-2 टैबलेट, भोजन के तत्काल बाद, दिन में तीन बार
निर्देश: अम्लपित्त (Hyperacidity), परिणामशूल (Acid Peptic Diseases), आम-पच्यमानाशयगत व्रण (Peptic ulcer), अजीर्ण (Dyspepsia), छर्दि (Vomiting), आमाशय-कला-शोथ

Dr.vasishth md kayachikitsa

irregular menstrual cycles treatment

Payal K:
Dear Vaidyas...one case of 28 yr old married female, k/c/o bil pcod has irregular menstruation , pittapradhan kaphanubandha prakruti, has history of parikartika ( fissures) on and off, stress .initially was on allopathic HRT for menstruation. When she started taking Ayurveda meds she felt better and had one cycle after 40 days..
   Now again the same problem..more than 50 days have passed no period yet

Can anyone suggest treatment experiences?
  In fairly many patients they get periods regularly for some months and then it gets delayed.

Chetan:
Dear madam

PcOs:
Vaat is blocked by kafa specifically apan Vaayu

Nityaanuloman
Kafavaatshamak Bastis
RAS dhatu gat Aampachan
Is a general sutra

But your patient seems to have Kafa and pitta both blocking Vaata
So Start with shadangodak for pachan
Hingwastak for anuloman 7 days atleast
And then jump on Bastis

Vinaya Ballakur:
Have positive results with Rasa Shala preparation kuberaksha yoga.
Just one or two pills with hot water in the evening is sufficient to regularise periods. Only thing is bleeding must be monitored. If heavy it can be discontinued during periods and then started after complete cessation for the next period to appear on time.

The other drug that really works is Chandraprabhavati in one gm dosage BD. It is a complete medicine that is vatalomaka, shothahara, rasayana and tridoshamaka. Works better with a guggulu preparation that is Lekhan, shothahara and abhyantara vranashodhaka like Triphala guggulu, kanchanar guggulu etc.

Another important lekhan and abhyantara vranashodhaka is varunadi kwatha. Sukumara kwatha restores hormonal balance.

I usually combine combine two or three of the above mentioned medicines.

Boiled water consumption should be advised.

Some counseling may be required. If facing personal problems those needed to be sorted out with family.

Her symptoms are those of pitta aggravation.
Pitta shamaka  chikitsa will help her.
Praval bhasma, Mukta bhasma can be given. Kamdudha ras is a great combination.
Sukumara ghritha, shatavari churna are other medicines that can be combined.
Himsagar thaila application over head can be recommended.

Stop rajasika and tamasika items and advice saatvika diet and lifestyle.

Home remedie for menstrual pain

Remedy for mensuration pain or cramps: Needed: 100ml of water 1 table spoon of Fennel Seeds also called Saunf in hindi and Sombu in tamil. 1/2 spoon of sugar or 1 spoon of palm jaggery or brown sugar. What to do: Take this 100ml of water and allow it to boil. During light heat, add this 1 table spoon of this fennel seed. allow it to boil still the water cosisitancy becomes half of the qty and color changes. Then add either palm jaggery sugar 1 spoon or 1/2 white sugar. filter it.. and drink this Kashayam during your mensuration time. By drinking regularly you will not have cramps or severe pain.

Menopausal complaints and treatment

Vinaya Ballakur:
I  request all Vaidyas for discussion on the complaints of women in  premenopausal and menopausal women please.

Our texts do not describe the dosha aggravation and rogas occuring as a result of hormonal changes  during this phase.
But we commonly find hot flushes, obesity, mood swings, depression , fatigue and other such symptoms .

How to understand from dosha dushya perspective  and how we can best manage the transition smoothly for women.

Kindly discuss.

Applicative theory will let us know why and how certain medicines like Arogya Vardhani and Chandraprabhavati vati that Vd.Gopiji suggested work.

My guru late Shripathi Rao Garu used to say , you can successfully practice if you know how to use Arogyavardhani and Chandraprabhavati even in the absence of other medicines.
Such great potential these two drugs have.

Dr.ravndr:
Ritu aagamanam (rajo darshanam) and Ritu antam (Rajah kshayam) are two rise and fall in physiology related to 'aartava dhaatu'. It never impresses either it's absence or production at an ouset. Nevertheless, it exhibits it's functional replication in the form of monthly vaginal bleedy secretions called 'menses' or menstruation. Along with this, there are other features all over the body in general and related to genital tract in particular.

An absence of menses indicates alterations in the state of aartava dhaatu and it's influence on the body. These only are climacteric changes and the word 'menopause' is considered as a misnomer.

As said in the beginning Stanza, madhya vayah is influenced Pitta and menopause is only a 'ritu sandhi' as we read for 'kaala Vaayu

Here, recollect please on-
"Chaya prakopa prashamaa vaayo greeshmaadishu thrishu, varshaadishu su pittasya, shleshmanah shishiraadishu"

Sanchita vaayu during madhyama vayah  becomes vitiated when vaardhakya begins and carries away the swasthaana Sanchita pitta all over the body only to show the clinical picture as we see or read.

Therefore, vaata-pitta shaamaka  chikits, not pitta shaamaka chikits alone is not satisfied.

Vinaya Ballakur:
Rajonivruthi is not pathological unless premature or abrupt with hysterectomy.
Otherwise it's svabhavika.

This is the samprapti that Ravinder sir derived.

"Sanchita vaayu during madhyama vayah  becomes vitiated when vaardhakya begins and carries away the swasthaana Sanchita pitta all over the body only to show the clinical picture as we see or read."

This explains excessive sweating, hot flushes, vaginal dryness, mood swings, insomnia , fatigue.

What about weight gain?
Vardhakya is the period of vata , so weight loss must be observed. 
🙏🙏

Vd. Uday Patil:
Menopausal Weight gain is vikrut med sanchiti, not sarva dhatu vruddi.
It's vikrut vaat lakshan only.

Dr Kaveti Rajyalakshmi:
As the upadhatu of Rasa dhatu formation is stopped/ reduced (delayed cycles) causes rasa dhatu vriddhi and uttaradhatu vriddhi. Which results in agninasa, vyanga

Vinaya Ballakur:
Very much observed with another upadhatu stanya too.
When Stana pana for baby is practised by mother she loses weight.
Those who do not or cannot are observed to gain unhealthy weight.

Dr.ravndr:
This case is not a routine in all the women. 'Ritu vaiparitya' during 'sandhi vayo kaala' when a woman exposed to V-P kara 'mithya-ahaara vihaara'.

In a case of such 'vaishamya', association of  'aamatva' to the said doshaas is also possible. There need not be involved Kapha in the beginning which sebsequently may be effected or may not be.

That's why every woman of MS is not an obese.

Woman is a more responsible person then a man do. Socio-economic conditions influences her a lot. Therefore, effect of rajo guna influences her a lot.

Rajo guna is duo status of both Vaayu and Agni therefore the said clinical picture.

For management, in gist I can say that Saatvikaahaara and Satvaavajaya are the two major components and Medhya rasaayana is a complimentary to it.

Rishi Vashishth:
Vayu has primary role in weight gain,  which is why  in charaka samhita sutra sthana,  where chikitsa of sthoulya is mentioned,  the first word of the chikitsa sutra is vataghna

Dr.ravndr:
There is no relationship to upadhaatu roopa aartava and Uttara dhaatu vriddha-avastha as per my conceptual study as it has no 'kaarmukata' of 'prasaadana' to Uttara dhaatu Similarly, loss of weight during stanapaana is only because of less supply to meet the demand.

Home remedies

*Remedies*

*Vomiting*
1. take 2 cardamoms and roast on a dry pan. Powder it and add a tsp of honey. Take this frequently
2. Sip a glass of chilled limejuice slowly
3. Ginger tea
4. Add honey into a glass of water and drink sip by sip

*Urine infection*
1. In 8 ounce water put 1 tsp bicarbonate of soda andand drink it
2. Plenty of water
3. Cranberry juice
4. Barley water

*Warts*
1. Rub castor oil and continue doing so for a couple of months
2. Rub raw potato on affected area several times daily (continue for at least 2 weeks)
3. Rub cut onions on the warts
4. Apply papaya or pineapple juice

*Piles*
1. Drink radish juice twice a day (start at 1 cup then increase to 2)
2. Soak 3 or 4 figs in a glass of water and soak overnight. Drink in the morning on a empty stomach

*Indigestion*
1. Have 1 tsp turmeric powder in a glass of warm milk every day

*Arthritis*
1. Make a paste from turmeric and apply to area
2. Drink milk with turmeric

*Headache*
1. Take 5 almonds along with hot milk in your daily diet
2. Drink grape juice
3. Mix a gram of black pepper with honey and milk and take 2 or 3 times daily
4. Apply almond paste of the forehead
5. Eat an Apple with a little salt on an empty stomach (great for migraines)
6. Drink turmeric milk with black pepper

*Backache*
1. Apply ginger paste on affected area

*Sore throat*
1. Add a tsp of cumin seeds and a few pieces of dry ginger to a glass of boiling water. Simmer and drink when cool

*Asthma remedy*
1. Boil ajmo in water and inhale the steam

*Blocked nose*
1. Take a tbsp of crushed ajmo and tie in a cloth and inhale

*Dry cough*
1. Add a gram of turmeric to a tsp of honey
2. Keep chewing cardamom
3. Grate the zest and take the juice of 2 lemons and an inch of grated ginger in a pan. Simmer and drink with a spoonful of honey

*Cold*
1. Mix a gram or cardamom powder with a tsp of honey
2. In a cup of tea add ginger, clove, bay leaf and black pepper. Take twice daily. (Reduce as cold disappears)

A case of Splenomegaly with cirrhosis of liver

Dr Sridevi C:
A case to ponder.
Female-21years.
Came with H/o hair fall. Then said she has some reports and said her abdomen is always HARD. So asked her to come with her previous reports. She is the receptionist so was sure that she will get her reports.

Summary of her reports. Will post a few pics of reports too
2001 - 3 year old-had intestinal obstruction due to Ascariasis
2005 - Portal vein HTN-Ascitis-Splenic calcification-cirrhotic liver changes wth multiple calcific foci
2006-Same above findings with oesophageal varices
2007-Extra hepatic portal vein HTN and h/o haematemesis
2009 to 2013 suffered with complaint of 2007 and so on and off treatment
2016-Splenomegaly with Siderofic nodules and minimal ascites

O/E gross splenomegaly and liver too just palpable. Couldn't elicit fluid thrill. Earlier couldn't eat much. But 2 years back took homoeopathic medicine and from then on appetite is good.
BP, temperature etc normal.

Advised
AVR
Bhunimbadi kashaya

Please go through the investigation report- sending herewith.

Vinaya Ballakur:
Very challenging case Vd. Sridevi ji.
Godugdha is pathya in such cases.
I think all the pathya apathya of yakritodara are a must.

Vd. Surendra Sharmaji prepares yakrid pippali . You may consult him. 
Gomutra hareetaki and bhumyamalaki, punarnavadi kwatham , rohitakarishtam are some preparation you might consider , as you have seen the patient and have an idea what might be helpful for her.

Age is on her side and liver is one organ that successfully regenerates.

Symptomatically, yashti ksheer paka, shatavari churna with milk will help.

Venkatacharya PBA:
I think it’s Asdhya at the most we can make it as yapya
Only plus point is her jathragni is good and food intake is there
If fluid is more tha 3lts you can find fluid thrill
My Advise is
Nirocil tab three times a day it is Ghana of Bhumyamalaki
Nirocil syrup
Yakrit plihari louha
Three times a day
Jalodarari one tab twice it contains Danti beeja dose should as per rigid Bala otherwise you can Punarnava mandoora
Gomutra fresh or arka also helpful
Laghu Aahara
Go dugdha is also good

I thought in this case purely herbal for liver so advised Norocil  ie bhumyamalaki ghana

And jalodara pt needs theeshna Sodhana

Arogya vardhani is also very good its name itself indicates it improves genaral health
Combination of in addition of rasa Gandhka guggulu shilajat Tamra Bhasma  and more quantity of kutuki because of shilajat Rasayana Tamra in liver guggulu as medohara and kutuki as Rechana no doubt it is drug of choice but because of pt condition I thought Nirocil that all

Dr Sridevi C:
Thanks a lot for your valuable time and suggestions🙏 Venkatacharya Sir.

Dr Manik Dixit:
1)Ardhavilwam kashayam ( Kottakkal)
2) Patolakaturohinyadi kashayam

3) Tab. Laghu sut Sekhar

4) Avipathi churnam

Dr,Dilkhush (DK) Tamboli:
What about LFT

Dr Manik Dixit:
May get blood counts done with emphasis on abnormal cells

A Case of kshudra kushta

Vinaya Ballakur:
42 year old woman complains of such rashes since 20 to 25 years.
Sometimes aggravate, sometimes reduce , severe itching , hard small thorn like to touch, no particular reason why they appear.
Has undergone krimi chikitsa, virechana karma three times and taken many medicines , but no relief.
Asked about the names of medicines but gave out two names which are from local pharmacy I believe. Not the classical kind.

Patient not diabetic , good appetite and proper mala mutra visarjan, no other complaints.

Guggulu thikta ghritha
one tsf with warm water  before breakfast and dinner.
Manjishthadi kwatham
10 ml with 40 times water at 6am and 6 pm.
Haridra Khand
1 tsf with warm milk at bedtime for 15 days.
For extn. Appln. Nalpamaradi ker thailam 1 hour before bath.
Nalpamaradi or vibha soap from kotakkal for bath.

I gave the above prescription and advised diet.
Any suggestions ?

When a Vaidya gave  Khadirarishta the severity increased a lot it seems.

Suresh Kumar:
Chopchinyadi choornam 120gms+shadguna sindooram5gms=1tsf daily twice daily after food along with

Anupana Luke worm water.

Vinaya Ballakur:
Saptamrita is really very good dhatu poshaka not just good for vision as we normally use.

Also very good for balancing pitta functions

It contains yashtimadhu but still yashtimadhu ksheer paka anupana will be very useful in such cases.

Excess pyridoxine manifestation is similar to pitta vikruta lakshanas

Dr.pradp Noori:
I think arogyavardhini with sarida choorna for long duration will help

Dr,Dilkhush (DK) Tamboli:
Add...
अविपत्तिकर चूर्ण
In your priscription

Dr.kamal:
Good evening madam...

Kaishora guggulu
Arogyavardhini vati
Manjistadhi kashayam

External..
Pinda tailam and yastimadhu taila mix application

Vinaya Ballakur:
Khadirarishta is vatakaphahara whereas my understanding of this condition is it is pitta kapha Pradhana.
So it was not the best thing to give ??

Or giving an  arishta aggravated pitta so much that severity increased.

Dr.kamal:
Yes madam...Many cases with Arista preparation..if u give khadhiraristam along with saribadyasavam or usheerasavam...no aggravation..

Only khadhiraristam...some times it shows aggravation...

It can be taken as Kshudra kusta..
Sthula ruksha(susrutha)

Actually khadhiraristam having more ushna dravyas...best kapha hara

Dr.pradp Noori:
Sugandhipala

B complex and calcium tablets side effects

Excessive intake of vitamins such as b complex and vitamin C is harmful  to your body

Dr Nikhil Jain:
Need suggestions...

A 62 year old male retired from police department presented with complaints of gastric discomfort ,no other
complaints .
and he underwent health checkup he found significant low platelet count around 45000 then he admitted...
history of hypertension on regular treatment,
no history of diabetes or asthma ,or any anti platelet treatment..
Investigation carried out,, bone marrow aspiration suggestive of no evidence of malignancy,... bone marrow biopsy carried out but failed due to presence of blood clot... patient is totally asymptomatic ...
patient past history of low platelet count in 2012  is  1. 05 Lakh ,in 2014- 95,000...
modern people diagnosed  it is as  ITP idiopathic thrombocytopenia perpura ...during hospitalization patient treated with IV antibiotics IV steroids but there is gradual decreasing the platelet count UPto 00.. hematologist advise him for splenectomy ... patient  return to home.. started Ayurvedic treatment there is a gradual  increasing in platelet count UPto 60000.. fortunately it may be due to steroid effect or effect of Ayurvedic treatment ..but there is  once again decreasing and platelet count.. current status of the patient platelet count is 15000...
Than patient came to me...

I am planning to go ahead with this...
Please suggest

Dr.pradp Noori:
Add Swarnamalani vasant 65mg twice daily with your prescription

Dr Nikhil Jain:
Thank you sir..

Confused with
Laksha
And
Nagkesar

Is it useful....

Dr.pradp Noori:
That is a good thought. But the problem here is asymptomatic presentation . I go for rasayanas where there are no symptoms.

This is a prasara stage of 6 kriyakala .as there is no khavaigunya there are no symptoms so need to do a doshaveparitachikitsa and rasayana .sheeta(pitta ) rasayana (vata)

Vd. Uday Patil:
As d patient is retired police officer, the habit of taking stress / disciplinary nature should be considered for the effect on rakt dhatu (blood cells).

It may be - Tej, Vayu, Aakash mahabhut vruddi leading to decrease in Parthiv cells of Rakta dhatu.

Hypertension is another sign.

Dr Rashmi Patil:
Good evening vaidya gurus, a male patient with age 38 yrs developed this boil over scalp due to pricking of bamboo thorn 1 month history. One day himself cleaned by squeezing. At that time discharge was pushed and blood. Again he developed same. No pain non tender. Only complaint is slow enlargement of the mass. On examination soft non tender. Not movable. Habbit- betel nut chewing.
Need suggestion to approach the case.🙏

Dr.suresh Jakotia:
I think its Haematoma better consult a surgeon.

Dr.kamal:
Yes ...

Otherwise start..
Kuberakshavati
Manjistadhi kashayam
Bilwadi gulika

Try for 15 days..

Vinaya Ballakur:
Dear Vaidyas, please have a look at this report of a 59 year old female patient .

She complains of dyspepsia, headache, all dhatu kshaya lakshanas and is unable to eat anything due to constant mukhapaka.

Has been taking b complex everyday for many years now and neglecting food.

Asked her to stop b complex immediately.

Why I posted this, is a good chunk of our patients does not have any problem except irrational drug intake.
They think  vit supplements and calcium supplements are harmless and are needed on a constant basis to the body.
So history taking must include questions about what suplements patients are taking and from how long.

I gave her yashti ksheer paka and kamdudha ras .
Any suggestions ?

Pyridoxine is POSSIBLY SAFE when taken by mouth in amounts greater than the recommended dietary allowance. In some people, pyridoxine might cause nausea, vomiting, stomach pain, loss of appetite, headache, tingling, sleepiness, and other side effects. Long-term use of high doses is POSSIBLY UNSAFE.

My patient was having all of the above symptoms and more and not responding to treatment.

Suresh Kumar:
Madam any previous history of gastritis, Apd..mukhapaka since how many days.

Vinaya Ballakur:
Yes there is previous history of gastritis, anxiety and weight loss. Also repeated throat infections.
Basically very weak constitution.
Mukhapaka since 15 days.
Patient is habituated to OTC drugs.
Takes paracetamol and combiflam and ranitidine etc. as self medication. I stopped all those and counselled her.
Gave her Amrit Bindu from Shanker pharmacy initially.
And Shankha vati.

The symptoms of gastritis were not relieved.
She had not revealed about b complex thinking it to be of benefit to her.
Now when probed further for intake of medicines came to know about this.
Any way still to see how she will fare. I have a feeling that continuous intake of b complex over a long time is one of the factors for her ill health.
That is why I said I will keep you all posted.

I am thankful to you for responding. 🙏

Continuous intake of calcium tabs is the reason for 30 percent of coronary artery blockages , I read recently.
And we find women over the age of 40 taking calcium tabs daily to prevent osteoporosis.

We are generally led to believe that the water soluble vitamins are safe as the excess will excrete through urine. It's only the fat soluble vitamin excess , we need to worry about.

But excess of b complex can also circulate in blood and create many side effects if not excreted in urine. It can cause neuropathy too.

The irony is the first line of treatment of neuropathies in allopathy is a course of b complex.

Many times our patients ask us if they can take Allopathic medicines along with our prescription.  They even tell us, it's just vitamins.. it's only  nutritional supplements.. only calcium etc....
We cannot allow everything.
We need to monitor everything they consume for our medicines to work.

In short , withdrawing certain medicines will work as nidana parivarjanam in a good many cases.
Samprapti vighatana also must be planned simultaneously and carefully.

Many of my gurus and seniors and  peers are doing it. This message is only for my juniors who are fresh into practice.

Dr,Dilkhush (DK) Tamboli:
Add these..Medicines to your prescription....
1.तालिसादि वटक
               Omit...शुंठी from it
                 Add.. हरितकी
For first week
2.इरिमेदस तेल

After first week...
       Give her
शतपत्र्यादी चूर्ण

Vinaya Ballakur:
Thinking of adding a ghritha.
Sukumara ? Or dadimadi or indukanta. Will it work out ?

Kashaiah Vasam:
1.Yashti madhu ghanvati
2.Giloy ghan vati
3.samshamani vati or sudharshan ghanvati
4.is to R/O HbsAg and HIV test.

Vinaya Ballakur:
Thank you Vd. Kashaiah Garu.
I preferred to give yashti in ksheer paka form as it is easily absorbable, pitta and rakta shamaka and rasayan .
I do not think patient is in a position to metabolize Ghana vatis as of now.
About the tests, HIV , I do not suspect. Not in the risk group.
But will advise Hbs Ag if no response is observed.
Thank you...

Dr Kaveti Rajyalakshmi:
🙏 Mam.Saptamrita Loha  anupana yastimadhu ksheerapaka.

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