About Ayurveda

Content

History

Why Ayurveda Originated ?

Eight Branches In Ayurveda

Basic Principles of Ayurveda

Tridosha

Pancha Maha-bootha concept

Ayurvedic Approach to Health and Wellness

About Ayurveda Treatments (Upakrama)

Panchakarma

Ayurvedic Text Books- Tantra

Types Of Medicine In Ayurveda

                   The word Ayurveda is a Sanskrit word (आयुर्वेद) that evolves from combination of two words, "Ayush" (आयुस्) meaning life and "veda" (वेदः) meaning knowledge. Ayurveda means "Knowledge about Life" Ayurveda is a 3000 year old science that originated in India. Present region of North Indian, Pakistan, Nepal, Barma, Tibet and East-Northern places of Bangladesh. The components and concept of Ayurveda is rooted in Vedas. Ayurveda considered as the one of the Upveda of ‘Adharva veda’.

  History

                           Ayurveda is an ancient medical science which was developed in India thousands of years ago. Believed to have been passed on to humans from the Gods themselves.God ‘Dhwanathiri’ considered as the god who gives ayurveda to mankind for his health. In ayurveda literature it says that ayurveda not created, it sates ‘BRAMHA SMRITHWA AYURVEDA ‘. ie God Brahma recollected or compiled ayurveda science. It is believed that early a samhita named ‘Bramha Samhita’ was present. All other samhita’s used content Bramha samhita to write new samhita for easy understanding and usage.

         Ayurvedic Medicine is the world's oldest comprehensive health care system and is indigenous to India where it is widely practiced. "This ancient art of healing asserts that the science, philosophy and spirituality are all necessary aspects of healthy living." Thus Ayurveda is not only a comprehensive medical system but also a way of living and the very concept of "mind, body and spirit" originates from Ayurveda.

              Ayurveda originated in vedic time, ancient universities like was ‘Nalantha’ and ‘Takshashila’ was the main hub off education in ‘Hindustan’. They promoted ayurveda. Due to ‘Buddhism’ and ‘Jainism’  ayurveda spred all over the world, ‘Buddhist’  saints spread the ayurveda to South India, Srilanka, Indonesia etc. But I want to mention one thing that due to principle in ‘Ahimsa’ in ‘Buddhism’, surgical information in the Ayurveda almost lost they give more impotents to herbal and treatment procedure. Still we can see the influence of Buddhism in ayurveda classical text book.

 Why Ayurveda Originated ?

                In vedic time people are preferred ‘yaga’ or ‘Homa’ for a purpose like to get blessing from god, nature etc. To get cure from a disease, ‘Yaga’ is prescribed. Sir, you can simply guess what will be the cost  for a ‘yaga’ like procedure, naturally that will not affordable by people, many families became poor due to this. Also more important thing is there, in ancient time ‘Chatur Varnya’ based community life style is adapted. All are not rich to involve in Yaga and all are not allowed. This situation lead a necessary situation to design a treatment protocol like ayurveda which is effective also cost effective system, even ordinary people can use.

             Our ‘Acharya’ are considered as ‘Apta’, which simply means they free from all the negative energy from the earth, no intention to cheat others, not want to get any profit from anyone. They saw all the people as one, not based on community system. I believe that due to this Ayurveda is still exists, due to their kindness and truthfulness in heart, not me and any of other ayurveda doctors.

 Eight Branches In Ayurveda

   The Branches in Ayurveda are derived from classical Sanskrit literature, in which Ayurveda was called "the science of eight branches" (Sanskritaṣṭāṅga अष्टांग). The components are:

 1.Kayachikitsa (general medicine): "cure of diseases affecting the body".

 2.Kaumāra-bhṛtya and Bala Roga: deals with the treatment of children.

 3.Shalya tantra deals with surgical techniques.

 4.Śālākya-tantra - deals with diseases of the teeth, eye, nose, ear etc.

 5.Bhuta-vidya deals with the causes, which are not directly visible and not directly  explained by tridosha ^,pertaining to micro-organisms or spirits.

 6.Agada-tantra deals with antidotes to poison.

 7.Rasayana-tantra (Geriatrics)/(Anti Agings) : deals with rejuvenation.

 8.Vajikarana tantra (aphrodisiacs) deals with healthy and desired progeny.

 Basic Principles of Ayurveda

Tridosha, Pancha Maha-bootha , Saptha dathu , Agni, concept of  Srothos

Tridosha

·         Vata pertains to air and ether elements. This energy is generally seen as the force, which directs nerve impulses, circulation, respiration, and elimination.

·         Kapha pertains to water and earth elements. Kapha is responsible for growth and protection. The mucousal lining of the stomach, and the cerebral-spinal fluid that protects the brain and spinal column are examples of kapha.

·         Pitta pertains to fire and water elements. This dosha governs metabolism, e.g., the transformation of foods into nutrients. Pitta is also responsible for metabolism in the organ and tissue systems.

Tridosha - Vata, Pitta and kapha

vāyu: pittaṃ kaphaśceti trayo doṣā: samāsata: || vikṛtā’vikṛtā dehaṃ ghnanti te varttayanti ca | (A.H)

Vayu – Vata, Pitta and kapha are the three Doshas of the body. Perfect balance of three Doshas

leads to health, imbalance in Tridosha leads to diseases.

te vyāpino’pi hṛnnābhyoradhomadhyordhva saṃśrayā: ||

vayo’horātribhuktānāṃ te’ntamadhyādigā: kramāt | (A.H.)

The Tridosha are present all over the body, but their presence is especially seen in particular

parts. If you divide the body into three parts, the top part upto chest is dominated by Kapha

Dosha, between chest and umbilicus is dominated by Pitta, below umbilicus part is dominated by

Vata.

Similarly, in a person’s life, day and in night (separately), the first part is dominated by Kapha,

second part is dominated by Pitta and third part is dominated by Vata. While eating and during

digestion, the first, second and third part are dominated by Kapha, Pitta and Vata respectively.

Qualities of Vata

tatra rūkṣo laghu: śīta: khara: sūkṣmaścalo’nila: || (A.H.)

Rooksha – dryness, Laghu – Lightness, Sheeta – coldness, Khara – roughness, Sookshma –

minuteness, Chala – movement These are the qualities of Vata.

Qualities of Pitta

pittaṃ sasneha tīkṣṇoṣṇaṃ laghu visraṃ saraṃ dravam |(A.H.)

Sasneha – slightly oily, unctuous, Teekshna – piercing, entering into deep tissues, Ushna –

hotness, Laghu – lightness, Visram – bad smell, sara – having fluidity, movement, drava –

liquidity are the qualities of Pitta.

Qualities of Kapha

snigdha: śīto gururmanda: ślakṣṇo mṛtsna: sthira: kapha: || (A.H)

Snigdhna – oily, unctuous, Sheeta – cold, Guru – heavy, Manda – mild, viscous, shlakshna –

smooth, clear, Mrutsna – slimy, jely, sthira – stability, immobility are the qualities of Kapha.

The increase, decrease of individual Doshas, or imbalance of couple of these Doshas is called as

Samsarga. And imbalance of all the three Doshas together is called as Sannipata.

Pancha Maha-bootha concept

 Ayurveda is based on the premise that the universe is made up of five elements:

1.Pradvi – earth

2.Aap – water

3.Tejus – Fire

4.Vayu – Air

5.Akash – Space  

            These elements are represented in humans by three "doshas", or energies: Vata, Pitta and Kapha. When any of the doshas accumulate in the body beyond the desirable limit, the body loses its balance. Every individual has a distinct balance, and our health and well-being depend on getting a right balance of the three doshas ("tridoshas"). Ayurveda suggests specific lifestyle and nutritional guidelines to help individuals reduce the excess dosha.

Ayurvedic Approach to Health and Wellness

To maintain the health of a healthy person  (swastha vritha) and cure the disease of a diseased.

Preventive Medicine – Creates and maintains health and longevity of an individual by maintaining balance of a person's prakturi (or constitution) by creating daily and periodic regimens. These health routines focus on diet and exercise, herbals, massage, meditation, and social behavior and positive relationships.

Curative Medicine – Treatments to cure the disease by one or combination of the following approaches:

     · Internal measures, including shodhana (detoxification) and shamana (methods used to improve quality of life via palliative care).

     · External measures, including snehana (oil treatments), svedana (steam therapy using herbal steam), and use of herbal pastes.

     · Surgical methods, including removal of tissues, organs, and harmful growths.

     · Mental and spiritual therapies or daivya chikitsa.

     · Herbal therapy, including astute pharmacology.

 About Ayurveda Treatments (Upakrama)

Two types of  Treatments (Upakrama)

1.Langhana

2. Brimhna

Langhana Therapy further divided in two

1.Sodhana

2.Samana

Saman therapy further divided in to

1.pachana

2.Dipana

3.khuth

4. Vyayama

5. Thritt

6.Athapha

7.Maarutha

 Sothana Therapy (Pancha Karma ) Divided in to –

According to susrutha

1.Vaman (Therapeutic vomiting or emesis)

2.Virechan (Purgation)

3.Basti (Enema using medicine)

4.Nasya ( Application of medicine in Nose)

5.Rakta moksha (Bloodletting or detoxification of the blood)

According To Charaka

1.Vaman (Therapeutic vomiting or emesis)

2.Virechan (Purgation)

3.Nasya ( Application of medicine in Nose)

4.Matra Vasthi (Enema Using tail / Gritam)

5.Kashaya Vasthi (Enema using Kashaya / decotion)

More about Pancha Karma

Panchakarma

            Ayurveda recognizes that all living and non-living things are composed of panchamahabhut or five basic elements of the entire creation. One branch of Indian philosophy—Sankhya, states that there are 24 elements in all, of which five are the foundation of the gross world: earth, water, fire, air and ether. According to ayurveda these five elements in different combinations constitute the three body types/doshas—vata (air and space), pitta (fire) and kapha (earth and water). These two theories are the guiding factors of ayurveda as a therapeutic science.

Ayurveda advises undergoing panchakarma at the seasonal changes to both keep the metabolism strong and keep toxins from accumulating in the body as well as the mind. The process finds the way to the root cause of the problem and corrects the essential balance of mind, body, and emotions. It is considered extremely effective to go through the process of panchakarma prior to any rejuvenation treatment (rasayana/herbal medicines), for it cleanses the body, improves the digestion, the metabolic processes of the body and cleanse the thought process as well.
Basically, panchakarma is meant to make an individual most receptive to the curative process of ayurveda by removing accumulated waste in body and mind.

Vamana (Emesis)

It is a process of therapeutic vomiting (induced), which helps eliminate the toxic or waste matters from the stomach and thoracic cavity. Kapha dominant diseases like severe skin diseases (psoriasis, urticaria); bronchial asthma, mental disorders etc. are selected for this treatment procedure. This process is not suggested for expecting mothers. Normally eight bouts of emesis are followed. The vomiting is stopped when yellow coloration is seen. Then, dhoomapana—inhalation of medicated fumes—is done through a special process. Finally, certain rules have to be followed called paschatkarma that basically implies strict diet regimen.

The entire treatment takes 15 days, and requires good attention as well as skilled assistance.

Virechana (Purgation)

This eliminates the toxic or waste matters from the intestine. It also cures pitta or pitta-dominated diseases. Poorvakarma or initial process of cleansing like vamana is suggested here. About 20 purges may be seen in this process depending on the patient's health.
A mild form of virechana without the poorvakarma, is an integral part of ayurvedic therapy. It is also used for prevention of diseases.

Basti (Enema using medicine)

The process of vasti or therapeutic enema is resorted to eliminate toxins from colon, and strengthens the tissues. Two kinds of vastis are followed in ayurveda. Snehavasti is the vasti where medicated oils are used. This is not advised in patients suffering from diabetes, anemia, diarrhea, and obesity. Poorvakarma is required here.For kashaya vasti, honey, rock salt, sneham (oils), paste of medicines are required and mixed one by one in the above order. This concoction is taken in an empty stomach. After the process the patient is allowed to take a bath.

Diseases like hemiplegia, and disease due to vata are treated by this process. Medicines are selected as per disease and stage.

Nasya (Nasal Application of Herbal Medicines)

Nasya is instillation of medicine through nose. It is an important procedure of ayurveda for the treatment of sirorogas or diseases affecting head area. Nasya helps cleanse the head and sinuses. The process is contraindicated in various psychological diseases, asthma and cough.
Here, the patient is to inhale lightly warmed oil. Warmed oil is massaged in the patient's neck, shoulder, palm, face and sole before and after the process of nasya. Different timings are indicated for different dosha types. Morning time is prescribed for kapha diseases, noon in pitta diseases and evening in vata diseases.

Raktamoksha (Blood-Letting)

Susruta gave stress to Raktamoksha (blood-letting) as one of the panchakarma, taking two of the vastis as a single karma (here, procedure). The process of letting out the vitiated blood is termed raktamoksha. In this procedure localized impurity or poison from the blood is removed through various methods. Often leech is used to suck out the impure blood from the affected area. Blood-letting is also done to eliminate toxins from the blood stream causing various chronic skin disorders like urticaria, eczema, scabies and leucoderma etc. The method was also effectively used to cure enlarged liver and spleen.

            The sodhana treatment / chikitsa known as pancha karma therapy. Most of the Ayurveda therapy centre give imports only for pancha karma therapy, But according to ayurveda sodhana and samana both have equal important.  So I  never say pancha karma is a superior treatment. I think most of time that is not good, because according to literature in ayurveda so many people and disease condition not recommend for pancha treatments. Unfortunately treatment centers want to promote it because it is more profitable business. For preparing a person for pancha karma, a lot of other procedure are need to be do. Like  application of oil in different ways like massage , Dhara etc. You must remembered that our Acharyas I mentioned who is considered as ‘Apta’ not prescribed any oil massage therapy. I always feel bad thiking about that.  One of the intentions to write this article that now a day’s most of people thought that it is only an ‘Oil Massage’ therapy not a science.

Major Ayurvedic Text Books- Tantra (Brhattrayi)

Charak Samhita

Charak Samhita, which dates back to approximately 800 BC, is a major compendium of Ayurvedic medical theory and practice that Charaka, an internist at the University of Taxila, compiled in Sanskrit. Presented as poetry, Samhita contains more than 8,400 verses in its 120 chapters.

Actual content in the Charaka samhita wrote by Acharya Agnivesha. But Acharya Charaka modified it. Some missing chapters are added by Acharya ‘ Dridabala’.

Sushruta Samhita by Sushruta 

This surgical text, which dates back to approximately 700 BC, contains seminal content such as the Ayurvedic definition of health, information on blood, and the description of five sub-doshas of Pitta and the marma points. This volume also includes pioneering techniques in skin grafting and reconstructive surgery.

Ashtanga Sangraha and Ashtanga Hridaya by Vagbhata

Ashtanga Sangraha and Ashtanga Hridayam, dating back to approximately 400 BC, were written by an Ayurvedic physician from the Sindh region of India. The Sangraha is primarily written in prose, while The Hridayam is presented as poetry. These texts define the five subdoshas of Kapha and emphasize the material value of life. The Hridaya is still highly regarded as a primary Ayurvedic medical text book.

Minor Ayurvedic Classics (Lghutrayi)

Sarangadhar Samhita by Sharngadhara 

This text was written in the 13th century AD, and is valued for its explanation of the Ayurvedic concept of materia medica, as well as for its pharmacological formulations. It is also considered the foremost text on pulse diagnosis.

Bhav Prakash Nighantu by Bhavamisra

This 16th century text contains approximately 10,278 verses of varying meters and focuses on herbal descriptions, food, the therapeutic use of trace metals, and rejuvenation therapies. Information on sexually transmitted diseases, particularly syphilis, is also included.

Madhava Nidan by Madhava Kara

This text was written between 700 AD and 1100 AD, and is valued for its precise classification of diseases and disease etiology, particularly in the fields of pediatrics and toxicology. Madhava Nidan is considered the Bible for Ayurvedic clinical diagnosis.

Types Of Medicine In Ayurveda

According to origin

1.  Herbal Medicine – Medicine prepared using medicinal Plants

2.  Mineral Medicine– Medicine prepared using heavy metals like mercury, arsenic, sulphur, siver,gold etc.

3.  Herbo-mineral combined medicine

According to Preparation

1.  Kashaya

2.  Arishta

3.  Asava

4.  Churna

5.  Lehya

6.  Gritha

7.  Gulika

8.  Arka

9.  Basma / kshara

10.            Malahara – Lepana

AyurvedicTreatment of Rheumatoid Arthrtitis (Amavata)

DISEASES OF THE JOINTS

Diseases like arthritis have been known to exist since times immemorial. Charaka Samhita, the Ayurvedic treatise on medicine, deals more effectively with the reason, symptoms, clinical-diagnosis and the possible treatment of arthritis. Prognosis of arthritis, as described by the Ayurvedic physicians, remains unaltered largely.According to Ayurveda, in order to treat various types of arthritis, we need to need to stimulateagni and suppress the ama.Ayurveda distinguishes three categories of arthritis (depending upon the predominance of the biological humour), vataja, paittaka and kaphaja.

Diseases of the joints are better known as rheumatic diseases. Rheumatoid arthritis, osteoarthritis, and gouty-arthritis are common varieties of arthritis encountered in clinical practice. Rheumatism is widely used for inflammation or injury to the soft tissues.Cervical-spondylosis, lumbar-spondylosis, and sciatica are other significant diseases included in this segment.

Rheumatoid arthritis is an autoimmune disorder in which rheumatoid factor is found to be positive. Gout is characterisedby high levels of uric acid in the serum...hyperuricemia. Psoriasis, a skin disorder, is associated with arthritis (psoriatic arthritis).

Pain, inflammation-swelling, fever, morning stiffness and loss of function, are major clinical features of arthritis. Depending on the involvement of the joint, character of the pain and laboratory investigations, the final diagnosis is done. Some form of arthritis like rheumatic-arthritis, involves other organs,including heart and muscles.

AYURVEDIC MANAGEMENT OFRHEUMATIC DISEASES

Inflammatory diseases, including arthritis and rheumatism are a major group of prevalent diseases.Most of the available pain-killers drugs are effective in inflammatory conditions of the joints, but have a major side-effect of gastric irritation and even, ulceration.Active-principleshaving potent anti-inflammatory effect has been isolated from medicinal plants used in Ayurvedic system of medicine.

The management of a joint disease requires a rational approach. In patients suffering from obesity, weight management hasgreatimpact. Ayurvedic system of medicineconsiders malfunctioning of the digestive system responsible for diseases like arthritis and rheumatism. Effective herbs are available for treating arthritis but at the same time side effects caused by the synthetic drugs are alarming.

AMAVATA (RHEUMATOID ARTHRITIS)

Cause: Ama (substance produced by malfunctioning of the digestive system) is considered to be the root cause of Amavata (rheumatoid arthritis) in Ayurveda.Ama circulates in the blood and finally accumulateswithin the joint cavity,resultingin pain and loss of function. Rheumatoid arthritis accounts for fifteen% of the total rheumatic disorders. The incidence is more common in women as compared to men. Further, rheumatoid arthritis is more prevalent in damp and cold conditions.

Signs and Symptoms: Rheumatoid arthritis is a chronic form of arthritis characterized by pain and inflammation of many joints. Rheumatoid arthritis commonly affectsthe small joints of the hands.Rheumatoid arthritis has symmetrical pattern which is not found in osteoarthritis. Rheumatoid arthritis affects finger joints adversely. Z-shaped deformity of the thumb and deviation of the hand are features characteristic to rheumatoid arthritis.

Rheumatoid factor is found to be positive in 80 per cent of the patients. Erythrocytic sedimentation rate is on the higher side in acute cases. Total leukocyte count and differential leukocyte count are also high. In rare cases,anaemia is found. The effect of rheumatoid arthritis is not only confined to joints, but it has extra-articular effects also (as it attacks heart, muscle and eye).

Remedies:Practitioners of Ayurveda use formulations for anti-inflammatory, analgesic and anti-arthritic action with considerable success

Ø Mahayograjaguggul is a traditional remedy for treating rheumatoid arthritis.Two tablets of Mahayograjaguggul, twice a day, are recommended with lukewarm-water.

Ø Triphala Guggul and Yograja Guggul have immunomodulator and cartilage-protective activities.

Ø Maharasnadiquatha, six teaspoonfuls, with water should be consumed twice a day, for better effects.

Ø aDashmoola (combination of roots of ten plants) is standard Ayurvedic remedy for inflammatory diseases like arthritis.

Ø Trikatu powder is recommended for improving digestion. This drug is very effective in detoxifying amain rheumatoid arthritis patients. One teaspoonful, with warm water not only corrects digestion, but stimulates appetite also.

Ø Commiphora mukul, traditionally known as guggul, has figured high in the treatment of arthritis. Animal models have demonstrated anti-inflammatory activity of crude drug and standardized extract containing guggulsterones. Clinical studies have reported utility of the drug in the treatment of rheumatoid arthritis and osteoarthritis

Ø Vishagarbhataila is used for local application twice a day. Hot fomentation after light massage is helpful in reducing the stiffness of the joints.

PRECAUTIONS AND DIET

Ø The patient should ensure consumption of fresh vegetables, garlic and black pepper.

Ø Exposure to cold and damp conditions should be avoided.

Ø Use of the curd should be avoided at night.

Ø Soybean, potato, white grams, pea, potato, and bathing with cold water should be avoided.

Ø Wheat, ginger, ghee, garlic, punarnava, mango, grape, pomegranate, are beneficial in rheumatoid arthritis.

CONCLUSION

Rheumatoid arthritis can be kept under control by a blend of regular exercise, strict diet-regimen and proper medication.

AUTHOR BIO:

Dr.Vikram Chauhan (MD-AYURVEDA) is an Ayurvedic practitioner based in Mohali, India. He is spreading the knowledge of ancient healing treatment of Ayurveda not only in India but also abroad. He has researched age old formulas from ancient Ayurvedic text books to restore health and save human beings from the worst side-effects of chemical based treatments. Dr.Vikram Chauhan is also the author of 'Ayurveda- God's Manual For Healing', an informative book for people interested in learning basics of Ayurveda, diet and principles of healing according to Ayurveda system of medicine. He is CEO and Founder of Planet Ayurveda Products, Planet Ayurveda Clinic and Krishna Herbal Company.

Website – www.planetayurveda.com

Contact:

DR.VIKAS DUBEY, B.A.M.S(M.D)AYU B.V.D.U COLLEGE OF AYURVED                    MOB-9479427096 ,8237250287    E-MAIL ; This email address is being protected from spambots. You need JavaScript enabled to view it.,

  “ROLE OF TILNILOTPAL GANDUSHA IN  MANAGEMENT OF MUKHAPAKA”

Dr. Dubey Vikas

M.D. _(Scholar)

Bharti Vidyapeeth AyurvedaCollege,

Dhankawadi, pune 411043

E-mailAddress-This email address is being protected from spambots. You need JavaScript enabled to view it.,

Phone no. – 08237250287, 09479427096

Second Author-

 Dr.PATWARDHAN. R.P

M.D. (AYU)

PROFESSOR SWASTHAVRITTA

Bharti Vidyapeeth AyurvedaCollege, Dhankawadi, pune 411043

Phone no.- 09422522723

ABSTRACT:-

Now a day lifestyle is drastically changed. Due to increased pollution,Fast life style, junk food habit and addictions  problems of oral health are arising progressively. Therefore there are increased problems regarding bad oral hygiene.Among various Mukharogas, Mukhapaka is Pittaja Nanatmaja and Rakta Pradoshaja Vikara, characterized by VedanayuktaVrana in the Mukhaguha. The lakshanas of Mukhapaka can be co-related with apthous ulcer (recurrent ulcerative stomatitis) explained in modern medical science.

In Ayurveda,  non-practice of  gandusha etc. are  said to be major cause for mukhapaka.Indirectly  it infers  the  importance of  gandusha  because the  physical,  thermal and  chemical causes  of injury  to  oral cavity  (due to  exposure  to various  risk factors)  can  be  better  counteracted  by  practicing  gandusha  daily.  Clinical trial on a single group of 60 patients having mukhapaka,was carried out.

Patients was given Tilnilotpaladi  kwatha Gandusha for period of 7 days in every morning empty stomach.

60 patients studied, maximum number of patients(51.66) belonged to the age group of 20-30 years,Male sex (65%), and upper middle socio economics status (41.6%),mixed diet (61.66),addicted to smoking(38.33%),occupation (20% ) IT professionals.

32% individuals have shown good response,53% sown moderate Response,and 15% shown mild response.

KEYWORDS:Mukhapak, Tilnilotpaladi Yoga, Apthous ulcer.

INTRODUCTION-:

-: Mukha Swasthya (oral hygiene) has gained importance now a day, because mukha is such anga, which is exposed to many risk factors in day-to-day life.

ØDue to increased pollution, junk food habits and addictions like tobacco-guthaka chewing, smoking, soft drinks; problems are arising progressively.

ØTherefore, problems regarding bad oral hygiene are progressively increased.

ØIn Ayurvedic text, Aphthous ulcer is denoted as ‘Sarvasar rog’ or ‘Mukhapaka’ due to its spread in the complete oral cavity (mukha) [2, 3, 4].

ØMukhapaka is Pittaja Nanatmaja & rakta Pradoshaja Vikara, characterized by Vedanayukta Vrana in the Mukha guha.

ØThe lakshanas of Mukhapaka can be co-related with Apthous ulcer; explained in modern medical science

AIM:-

— Management of Mukhapaka by Tilnilotpaladi Gandusha.

 OBJECTIVES :-

— To study the role of Gandusha as an Upakrama of Dinacharya.

— To assess the role of Tilnelotpaladi Gandusha in the prevention of recurrent Mukhapaka.

— To study in detail about Mukhapaka. (Apthous ulcer).

This section includes following headings.

1. Ayurvedic review

a.  Mukha Shareera

b. Mukhapaka

c.  Gandusha

2. Modern review

a.  Anatomy of oral cavity

b. Pathology related to Apthous ulcer.

MUKHAPAKA

Ø Mukhapaka is a condition characterized by vedana & shopha yukta vrana in the mukha guha pratyangas.

ØMukhapaka can be correlated with a disease entity ulcerative stomatitis, in which apthous ulcers are very common with recurrent episodes.

Types –Acc. to Charak, Sushrut & Madhav nidan

1. Vataja Mukhapaka

2. Pittaja Mukhapaka

3. Kaphaja Mukhapaka

Vaghbata - Raktaja and Sannipataja mukhapaka.

 GANDUSHA

ØThe word Gandusha is formed by Gadi + Gandescha which mean mukha purnam i.e. filling the mouth.

Gandusha is the procedure of holding any liquid in the mouth to its full capacity without any movement inside. It is usually done with drava (liquid

TYPES

Based on doshagnata and karmukata Gandusha is classified mainly into four types. They are - 

• Snaihika (lubricating) – indicated in diseases of vata

• Shamana (matigating) – indicated in diseases of pitta

• Shodhana (purificatory) - indicated in diseases of kapha

• Ropana (healing) – indicated in ulcerations of mukha

Anatomy of Mouth

ØA mucosa lined cavity is also called the oral cavity or Buccal (bucca-cheeks) cavity.

ØIt is formed by cheeks laterally, soft and hard palate superiorly.

ØAnterior opening is oral orifice & posteriorly it is continuous with the oropharynx.

REVIEW OF STOMATITIS :

Definition:General term for diffuse inflammation of the mouth.

Apthous ulcer (recurrent ulcerative stomatitis) :

ØThis is a commonest recurrent condition of unknown etiology characterized by painful superficial ulcers in movable mucosa of the mouth.

ØGenerally these ulcers are seen in buccal mucosa, lips, tongue, floor of the mouth, soft palate & oro-pharynx.

ETIOLOGY :-

ØThe cause is obscure.

ØSome probable causative factors are emotional stress, viral infections, endocrine disorders psycho-somatic factors, habitual constipation, auto-immune reaction.

TYPES :-

There are three main clinical types

1. Minor apthae

2. Major apthae

3. Herpetiform apthae

MATERIALS AND METHODS:

Title of study:-

        “Role of Tilnilotpaladi Gandusha in Management of Mukhapaka”

Place of study:-

        OPD and IPD of  B.V.D.U. Ayurved Hospital, Pune ,Maharashtra (India).

Sample Size:- Clinical trial on a single group of 60 persons having mukhapaka, was carriedout.

Drug & Duration of Therapy:-

Selection of Upakram :-

Upakrama  :- Gandusha

Time          :- In Morning (After Dantadhavana)

Form         :- Kashaya (Decoction)

Quantity     :-80-120 ml (As per oral liquid  holding capacity  of the patients)

Drug Ingredients-

 Tilnilotpaladi yoga:- 

 1.Tila (Sesamum Indicum)

2.Nilotpal (Nymphaea stella)

3.Ghee       

4.Sugar,

5.Milk

6.Honey. (5,10)

Procedure  :-

ØThe patient asked to sit in erect posture.

ØThe neck, cheeks and the forehead of the patient to be treated with Gandusha, massaged and fomented.

ØGandush has been so long held in the mouth by the patient till the aggravated dosha accumulated in regions of the cheeks or secreted through the nostrils & the eyes.

Inclusion Criteria :-

ØPatient complaining of recurrent Mukhapaka.

ØPatients between age group of 20-50 years.

ØPatients of both sex included in the study.

Exclusion Criteria :-

As per Bhavaprakasha Purvakhanda, patient contraindicated for Gandusha excluded –

ØGandusha is contraindicated in unconscious, poisoned, weak, krisha person, patient suffering from bleeding disorders and conjunctivitis.

ØPatient having chronic or carcinogenic ulcers in oral cavity.

ØMukhapaka due to any other disorders e.g. Syphilis, AIDS, Dengue Haemorrhagic Fever etc.

ØPatients suffering from any other systemic disorders.

ASSESMENT CRITERIA

Efficacy of  the therapy  was assessed in  the signs  and symptoms before  and after the course of Gandusha.

It was assessed on the basis of self-formulated scoring scale to signs and symptoms of Mukhapaka as follows.

Assessment of parameters for Mukhapaka:

1. Ruja (pain)– using VAS scale for pain Assessment

2.  Daha (burning sensation)

3.   Raktavarnata (Reddness)

4.  Size of the vrana

5.  No of Vrana

Assessment of Parameter for mukhaswasthya

1.  Frequency of attack:-

FOLLOW UP

Follow up will be done periodically for total duration of 21 days.

— 1^st follow up :-  3^th day

— 2^nd follow up:- 7^th day

— 3^rd follow up :- 14^st day (Post Treatment)

— 4^th  follow up:- 21^th day (Post Treatment) 

Observation and results

1.Age wise distribution :-There were maximum no. of patients i.e.51.67 % in age group 20-30 and 38.33% in age group 30-40 also minimum no. of patients i.e.10% in age group 40-50.

2.Sex wise distribution

There were Maximum no. of patients i.e. 65 % were males and 35% were females.This indicated its more incidence rate in males.

3.Dietary Habitat wise distribution

There were Maximum no. of patients i.e. 61.67% were mixed and minimum i.e.38.33% were vegetarian. The ancient Ayurvedic physicians were aware of the ‘Apathyakara Ahara and Vihara' (unsalutary life style and food habits) as the most important causative agent [6, 7, 8].

4.Marital status wise distribution

It was found that maximum number of patients i.e. 65% were married, While 35 % Patients were unmarried.

5.Occupation wise distribution

On considering the nature of occupation, it was found that maximum i.e.20% no. of patients were IT professionals while minimum i.e.3.33% no of patients having government job.

6.Vyasanawise distribution:-

This showed that maximum i.e. 38% patients were having smoking vyasan and mimimum no. of patients  i.e.5% having alcohol tobacco vyasan .

7. vihara  wise distribution:-

Patients  with  history  of ratrijagrana  were 60% and  16.67% had history  of Diwaswapa.

8.Socio economic condition wise distribution

The classification of patients based on their economic status indicates that people of high socio economic status were more susceptible (41.67%) to mukhapaka.

9.Family History wise distribution

Here, it was found that maximum numbers of patients i.e. 58.33% were having family history while 41.67% were not having family history.

10.Prakriti  Family History

It was found that  maximum no. of patients i.e. 46 .67% were belonged to pitta- kaphaPrakriti,, and minimum no. of patients i.e. 1.67% kapha –vataPrakriti.

RESULTS:-

1.Effect of Tilnilotpaladi Yogaon Rujain the management of Mukhapaka

Ruja (Pain) :-

Here P value was >0.05 hence accept H₀ i.e.

On associated symptoms of Mukhapaka, the improvement observed on Ruja (66.97%) was statistically significant.

2.Effect of Tilnilotpaladi YogaonDaha in the management of Mukhapaka

Daha (Burning Sensation) :-

Here P value was <0.05 hence reject H₀ i.e.

On associated symptoms of Mukhapaka, the improvement observed (82%)on Daha was statistically significant.

3.Effect ofTilnilotpaladi Yogaon RaktaVarnata of vranain the management of Mukhapaka

Rakta Varnata of vrana[ Redness] :-

Here P value was <0.05 hence reject H₀ i.e.

On associated symptoms of Mukhapaka, the improvement observed (91%)on RaktaVarnata of vrana was ethically significant.

4.Effect of Tilnilotpaladi  YogaonNo. Of  Vrana in the management of Mukhapaka

Before treatment the mean score of No.Of Vrana was 1.116 which was reduced to 0.433 after treatment with 61.20% relief also p value is <0.05 hence it is statistically significant .

5.Effect of Tilnilotpaladi YogaonSize of Vrana in the management of Mukhapaka

Before treatment the mean score of Size of Vrana was 0.726 which was reduced to 0.266 after treatment with 63.36 % relief  but p value is <0.05 hence it is statistically significant.

6.Effect ofTilnilotpaladi Yogaonfrequency of attack in the management of Mukhapaka:-

Before treatment the mean score of Freq attack was 0.867which was reduced to 0.3 after treatment with 65.39% relief also p value is <0.05 hence it is statistically significant .

7.OVERALL IMPROVEMENT

The above graph showed  that  there were 32 % patients  have  shown  good  response,  53%  shown  moderate while only 15% patients have shown mild response

8.Study of Recurrence:-

-88.33% Patient had no. recurrence after 21 days follow up study.

-6.66% patients had recurrence of mild intencity.

-5% patients had moderate degree of recurrence.

 Conclusion

       The conclusions drawn on the basis of this study are as follows.

1. Among various mukharogas ,mukhapaka is considered as pittaja Nanatmaja and raktapradoshaja vikara ,characterized by vedana Yuktavrana inside the mukhakuhara.Nearly 60% of the population is suffering with this problem.

2. The lakshanas of mukhapaka can be correlated to a clinical entity“Apthous ulcer” (recurrent ulcerative stomatities) explained in the contemporary medical science,which is also characterized by painful Superficial ulcers in the movable mucosa of the mouth with recurrent  episodes.

3. Gandusha upakrama of dinacharya on of the important methods Mentioned in Ayurveda for maintenance of oral hygiene.

4. Out of 60 patients studied, maximum number of patients (51.666%)  belonged to the age group of 20-30 years, Male sex (65%), and upper middle socio economic status (41.66%), mixed diet (61.66%), addicted to smokinge (38.33%).occupation ( 20%  ) IT professionals.

5. Most of the patients were of pitta kaphaprakriti (46.33%), with positive history of ratrijagarana (60%).

6. 32% individuals have shown good response,53% shown moderate Response, and 15% shown mild response.

7. As Tilnilotpaladi Gandusha having madhur,kashyarasa,shetavirya and kaphahe-pittaghnaproperties,It removes aggravated kaph and pitta Guna from oral cavity.

8. Hence from the study it is concluded that,Tilnilotpaladi Gandusha is an important upakrama of Dincharya mentioned in Samhitas which should befolled regularly,in order to prevent Mukharogas and  maintain  oral  hygine.

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