Ayurvedic Therapeutic Utilisation Of Tikshan Kshara

Abstract

There are many things in Ayurvedic science which are not fully known to the world. For them it is just as a magic or miracle but things are different with the Ayurvedic science. Ayurveda is the science which is considered as fifth veda according to some references and on the other hand some references suggest that it is the part of the atharva veda. As mentioned before, many things in Ayurveda are not fully known, for example Rasaushadhi, Which are still misunderstood as toxic for the body but their intake gives impressive results in many chronic conditions and even acts as immunomodulatory in cases of cancer and some viral infections. Like Rasaushadhi there is one more thing mentioned in Ayurvedic texts whose benefits are not known much but is of great therapeutic use. This thing is called kshara and in this article we will discuss Tikshana Kshara along with its therapeutic importance in detail.

Introduction

Starting with the introduction of the topic, we must understand that

What is Kshara?

Kshara or ksharas are the alkaline substance that is obtained from the water soluble ashes of the herbal plants. In Ayurvedic texts there are a variety of kshara which are mentioned. Discussing specifically about Tikshan Kshara, it is a highly alkaline and caustic concentrated solution which contains non metallic elements like potassium and sodium. The hydroxides of these elements are used to destroy the growths like warts etc. The concentrated solution of alkali has the capacity to destroy the superficial skin and deeper tissues. A Crust of dead tissues is formed, which separates shortly leaving a deep ulcer. This is a strong caustic penetrates and liquifies the deeper issues.

Though such destructive action is unwanted. Weak caustics like silver nitrate, copper sulphate, phenol etc are used for treatment of warts, ulcers, dental caries, follicular conjunctivitis and dog or snake bites.

Similarly Acharya Sushruta has mentioned manufacturing techniques and therapeutic use of Tikshna kshar in various types of surgical disorders. It is used in the treatment of haemorrhoids, fistula in ano, anal fissure, non healing and unhealthy wounds, sinuses, moles and warts. It is specially for external use and is contraindicated in internal administration.

Kshara Preparation

The preparation of Kshara is only done in sharad kala or Autumn season. Autumn season is considered between October and november. The preparation should be done near a hilly area.

Before the preparation of kshara, mangacharna is guided. Manglacharna is holistic and devotional rituals which are to be conducted. After this a healthy mushkaka plant or Elaeodendron glaucum should be taken along with its roots. The plant is made into small parts and subjected to boiling till it is covered into total ash. After the separation of burned lime stones from the ashes it is collected in a sterile jar. It is to be noted that ash must not have any type of contamination or it should not be exposed to moisture. The kshara collected from this method is called prathamika kshara or primary Kshara.

This is one of the examples given by Sushruta, later he had mentioned some set of herbs from which kshara or alkali can be extracted and further can be used for medicinal purposes.

After the collection of ashes in a sterile container it is to be prepared as kshara. For that it is to be mixed in 4 times water and stirred well and then left for three hours. The solution should be filtered through three layered cloth. The obtained material is then taken in an iron vessel. Now heat the material till the water is completely evaporated. Once it becomes free from water content then it should be powdered and stored in the airtight glass jar.

List of Plants for Kshara Preparation

Following are the Plants that can be used for preparing kshara:

• Kutaja (Holarrhena antidysenterica)
• Palasha (Butea monosperma)
• Gunja (Abrus precatorius)
• Ashwakarna (Dipterocarpus turbinatus)
• Agnimantha (Premna integrifolia)
• Paaribhadraka (Erythrina variegata)
• Saptachanda (Alstonia scholaris)
• Bibhitaki (Terminalia bellerica)
• Ashwamarka (Nerium indicum)
• Aaragwadha – (Cassia fistula)
• Asphota – (Hemidesmus indicus)
• Tilwaka – (Symplocos racemosa)
• Putika – (Holoptelea integrifolia)
• Arka – (Calotropis procera)
• Snuhi – (Euphorbia neriifolia)
• Chitraka – (Plumbago zeylanica)
• Apamarga – (Achyranthes aspera)
• Kadail – (Musa sapientum)
• Paatala – (Stereospermum suaveolens)
• Vrusha – (Adhatoda vasica)
• Naktamaala – (Pongamia Pinnata)

Selection of herbs for Kshara Preparation according to dosha dominance

The herbs for kshara preparation are also selected on the basis of dosha dominance. Some of the examples are as follows:

• Kadali – Vata Alleviating Property
• Aragwadha, Krutavedana, Kutaja etc – Pittaghna property or pitta alleviating property
• Palasha, Karanja, Tilwaka, vasa, Agnimantha, snuhi, apamarga, putika, Nimab, ashwakarna, karavira, bibhitaki, Arka, Krishnamushkaka, Saptachchada – Kapha alleviation property or kapha ghana
• Patala, sariva, Gunja – Tridosha pacification property

Types Of Kshara

Ayurveda mentions two types of Kshara. The types are as following:

1. Paneeya Kshara
2. Pratisarana Kshara

1. Paneeya Kshara

The paneeya kshara are the alkalis which can be consumed through the mouth. This type of kshara are to be used in conditions like Arsha (haemorrhoids), Agnisada (indigestion causing dyspepsia), Ashma (Urinary stones), Gulma (Abdominal tumours) & Udara (Enlarged abdomen, abdominal disorders and ascites).

2. Pratisarana Kshara

Pratisarana kshara are the alkalis which are to be applied externally. This type of kshara is used in management of mashaka (Moles), Shwitra (leucoderma), Bahya arsha (External piles), Kushta (Skin diseases), Supti (Anaesthetic patches), bhagandara (fistula in ano), Arbuda (tumours or cancer), granthi (tumours or fibroids) and dushta nadi vrana (Contaminated or foul sinus ulcers).

Pratisarnnaya kshara is further subdivided into three categories. These three are as follows:

• Mridu kshar (Mild)
• Madhyam (Moderate)
• Tikshana (Intense)

Type on the basis of season of preparation

1. Uttamn (best) – Prepared in Greeshma (Summer season)
2. Madhyam (better) – Prepared in sharad (Autum season)
3. Adhama (Bad) – Prepared in Varsha ritu (Rainy season)

Classification of Kshara on the basis of their numbers

Sr. No.	Classification of Kshara on the basis of number	Number of Kshara	Name of Kshara	Reference
1.	Ksharadwya	02	Kshara of Swarji (Caroxylon griffithii) and Yava (Hordeum vulgare)	Rasa tarangini
2.	Kshara traya	03	Kshara of Swarji (Caroxylon griffithii), Yava (Hordeum vulgare) and Tankana (Borax)	Rasa tarangini
3.	Kshara panchaka	05	Kshara of Musaka (Schrebera swietenioides), Yava (Hordeum vulgare), Palash (Butea monosperma), Swarji (Caroxylon griffithii) and Tila (Sesamum indicum)	Rasa tarangini
4.	Kshara Shastaka	06	Kshara of Tila (Sesamum indicum), Palash (Butea monosperma), Vacha (Acorus calamus), Apamarga, Kutaja (Holarrhena antidysenterica), and Mustaka (Cyperus royundus)	Dhanvantari nighantu
5.	Kshara Saptaka	07	Kshara of Swarji (Caroxylon griffithii), Yava (Hordeum vulgare), Tankana (Borax), Suvarchika, Palash (Butea monosperma), Gaurya, Mutsaka (Cyperus royundus)	Ayurvedic pharmacopia
6.	Ksharashtaka	08	Kshara of Snuhi (Euphorbia nerifolia), Palash (Butea monosperma), Apamarga (Achyranthes aspera), Chinca (Tamarind), Arka (Calotropis gigantea), Tila (Sesamum indicum), Swarji (Caroxylon griffithii) and Yava (Hordeum vulgare)	Rasa Tarangini
7.	Ksharadasaka	10	Kshara of Shigru (Moringa oleifera), Mulaka (Raphanus sativus), Palash (Butea monosperma), Chukrika (Tamarind fruit), Chitraka (Plumbago zeylanica), Adraka (Zinziber officinalia), Nimba (Azardicha indica), Ikshu (Saccharum officinarum), Apamarga (Achyranthes aspera) and Mochak (Musa sapientum)	Raj nighantu

After knowing and gaining so much knowledge about kshara, we already know that kshara has therapeutic value. Moving further in the article we will discuss the therapeutic utilisation of kshara.

Qualities of Kshara

• Tridohsa ghana – pacifies tridosha
• Soumaya – Pleasant and mild nature
• Dahana – Burns, Corrodes
• Pachana – Ripens the Wound
• Darana – bursts open wounds
• Katuka – Pungent
• Ushna – Hot potency
• Teekshna – Intense action
• Vilayana – Liquifies
• Shodhana – Cleansing Property
• Ropana – Has healing effect/Improving granulation
• Shoshana – Drying or absorbing property
• Stambhana – Arrests or stops oozing
• Lekhana – Scraping nature
• Krimighana – Kills microbes
• Shukra ghana – Causes sterility

Standard properties of Kshara (Ashtanga Hridaya Sutrasthana 30)

• Na aati Teekshana – Not too strong
• Na aati Mridu – Not too mild
• Shalkshna – Smooth
• Pichchila – Slimy or smooth
• Sheeghraga – Spreads Quickly
• Sita – White in Colour
• Shikari – Remaining Like a mountain peak at the site of application
• Sukha nirvapya – Easy removable
• Na vishyandi – Don’t produce much moistness
• Na ati ruk – Doesn’t cause much pain

Therapeutic Utilisation Of Kshara

If we look into the above mentioned types of kshara then it's already understood that kshara has various categories. After going through basic details of kshara now let's discuss the therapeutic application of tikshna kshara.

Kshar karma was very popular in Ancient India for the treatment of various surgical disorders and physicians who are having speciality in kshara therapy were known as kshara vaidya. The surgical value of kshara due to its therapeutic utility in various diseases is excellent. Acharya Sushruta has mentioned this para surgical tool for the various surgical ailments.

Because of its action of chedya (excision of the tissues), Bhedya (Penetration into deeper tissues), lekhya (Scraping of tissues), it is used in many conditions in which major surgical procedure is not possible. Although agni karma (Thermal cauterization) which is mentioned by Sushruta, is superior to kshara karma as the disease managed by agni karma do not relapse. In Addition scope of mridu kshar in internal Administration orally for the treatment of various types of abdominal disorders, which proves its superiority than other forms of para surgical procedures.

Indications of Kshara

As mentioned before kshara is used in various type of conditions the major indications of kshara are as following:

• Mridu kshara is indicated for internal use like in abdominal disorders or gastrointestinal disorders. Mostly works for indigestion, dyspepsia, constipation, worms and hyperacidity
• Tikshana kshara is used externally for the treatment of various types of ailments like ringworm, leucoderma, piles, fistula, sinus, tumour, small warty growths, unhealthy or infected wounds, Abscess along with various types of skin diseases, oral and dental diseases, ear, nasal and ocular diseases.

Method of kshara application

The Application of kshara is done after Purva karma (Pre operative procedure), its application of kshara is Pradahan karma (operative procedure) and After its application patient has to follow Pashchat Karma (Post operative procedure).

Purva Karma (Pre- operative Procedure)

• Patient should visit his/her doctor with a free mind and should not have fear, anxiety, tension or doubts in mind.
• Patients are also advised to take light meals before kshara karma.
• The area where procedure is to be done should be properly ventilated.

Pradhan karma (Operative procedure)

• The patient is placed on the operation table.
• The diseased part is exposed, cleaned and examined carefully.
• Before the application of kshara Lekhan, visravan or scraping, scrapping of the diseased part is to be done till the blood oozes out.
• In case of raised lesion, its excision is to be done.
• Now the kshara is applied on the affected area with a probe mounted with a cotton swab.
• The lekhan, visravan and excision is only done in the lesions which have hard tissues. This results in penetration of kshara into deeper tissues.
• The kshara is applied on the skin till the counting of 100 but can vary according to the type of the kshara, soft or hard tissues, mucosal or cutaneous tissues. In addition one can wait till the time symptoms of proper cauterization appear on the skin.

Paschat Karma (Post operative procedure)

• As soon as the signs of samyak dagdha appear that are signs of proper cauterization, the kshara is immediately or rapidly neutralised by acidic fluid like kanji mastu.
• Later on the cauterised part is completely washed out with distilled water  and application of Jatyadi or Yasti Ghrita is done on the  cauterised lesion.
• Finally dressing is done.
• Techniques may vary according to site and kshara karma in case of ear, eye, nose and oral diseases is to be done very carefully.
• In case of haemorrhoids, the kshara application is done by visualising the lesions by Proctoscope.

As mentioned above samyak dagdha lakshan or appearance of proper cauterization are to be watched. So, following are the symptoms of proper, improper or extensive cauterization.

Smyak Dagdha (Proper Cauterization)

After 30-60 seconds of kshar application the tissues of the disease part becomes purple or dark black in colour and cauterised lesions is shrinked, pain and discharge relieved. Patients also feel easiness with relief of prominent symptoms.

Heena Dagdha (Improper Cauterization)

The colour of the Treated area looks reddish with aggravated pain and itching.

Ati Dagdha (Extensive Cauterization)

It is followed by burning and severe pain, along with burning of the cauterised area, ulcerations with purulent discharge and fever. Along with these symptoms it also has generalised pain in the body, intense thirst and shock and even death may occur.

Above mentioned points are to be kept in mind whenever you are doing kshar karma. Kshar karma especially with tikshan kshara is really helpful in various types of diseases and other types of kshara are also really beneficial in many types of diseases. Kshara karma is also done in Pilonidal sinus, Chronic dacryocystitis, chronic trachoma and warts.

Conclusion

The kshara Karma is one of the best gems of Ayurveda which can be used successfully in the conditions where major surgical procedures are not possible. As mentioned above Ayurveda has many hidden secrets, such secrets can be enlightened for the benefit of mankind and other kinds as well. The above article has entire information about the kshara, Its definition, preparation, herbs which are used for kshara preparation, various types of kshara and how it can be utilised. Moreover, it also has information regarding the entire procedure of kshara karma and also about its therapeutic utilities. In case of any queries kindly visit www.PlanetAyurveda.com

Diagnosis of Twak Roga (Skin Diseases) & Treatment Protocol in Ayurveda

Abstract

Twak roga or skin disorders are the most recurrent and common human health affiliation. Skin conditions are affecting around 900 million people world wide at any time. In India, the percentage of people with skin disease varies according to geographical areas. It is in between 7.9% to 60%. Skin and subcutaneous diseases are responsible for significant morbidity worldwide but they don't get due importance in national health planning and policies in several countries. As the diseases related to skin or twaka are becoming common and allopathic science does not have a handful of drugs to get rid of them, many of the population is searching and getting relief from Ayurvedic preparations. In this article we will be discussing how Ayurveda understands skin disorders and what are the ways through which skin conditions are diagnosed in Ayurveda.

Introduction

Before jumping on to the diagnostic ways Ayurveda suggests for Twak roga, one should understand what is skin according to Ayurveda. Skin or twak is one among the five gyane indriya (Sensory faculties) of the body. This is also considered as updhatu of mansa dhatu and has a function to analyse sensation of touch. The skin is also the ashrey sthana or location of sweat channels. These sweat channels are named as swedo vahi srotas in Ayurveda. Ayurveda acharaya had mentioned that twak has seven layers and every layer has its different thickness. There are some diseases in Ayurveda which are mentioned to be specific in certain layers of skin.

Now moving forward let's dig deeper into the concept of Twak roga according to Ayurveda.

Common Skin Problems explained in Modern vs. Ayurveda

Skin diseases as mentioned above are becoming common world wide. Whether children or adults, all age groups are suffering. Modern science explains skin disease as in the form of rashes, viral infections, bacterial infections, fungal infections, parasitic conditions, pigmentation disorders, wrinkles, spider veins, varicose veins and many others.

But Ayurveda has mentioned all skin conditions under a single category that is kushtha. Kushtha has two subtypes maha kushtha and shudra kushtha. Maha kushtha has seven types and shudra kushtha has 18 types. It is even mentioned that kushtha can be of innumerable types. All of the modern explained skin conditions may not have clear cut correlation with kushtha types but according to dosha vitiation and dhatu involvement a very good management of skin conditions can be done in Ayurveda.

Ayurveda suggests a wide range of causes for dermatological diseases as well. Mainly the Nidana or causative factors include the following:

• Aharaja Nidana: Food related causes
• Viharaja Nidana: Regimen related causes
• Manasika Nidana: Specific psychological causes
• Vishesha Nidana: Some etiological factors that are specific to this condition and do not exist in other conditions
• Sahaja Nidana: The factors that cause disease due to beeja bhaga avyava dushti or genetic cause

Most of the skin diseases or dermatological conditions are the results of wrong food habits, not so good lifestyle, unhygienic habits and certain psychological factors.

The most important in all of the mentioned causes is Faulty diet. But how is the diet responsible? That's the question. The answer of this question is as following:

Taking of heavy meals, taking of meals before the previous meal is being digested or consumption of unwholesome foods, taking milk along with meat or fish, bathing while feeling hot like after being exposed to sunlight, suppression of urges of vomiting etc. All these factors vitiate pitta and kapha dosha which gets mixed up with vata dosha. Thus the spread of these tridosha over the body tissue happens resulting in patches, itching, inflammation wherever doshas get stagnant.

As we know the basics of Twak roga as per Ayurveda, now let's discuss the most important part of this article and that is diagnostic indices of twak roga.

Diagnostic Indices of Twak Roga (Skin Diseases)

The diagnosis of the skin diseases depends on the sign and symptoms the patient usually presents with.

The usual symptoms associated with twak roga are itching, pain and disturbed sensations in the nature of crawling, sense of heat, stinging, no sensation or hyperaesthesia that is excessive sensitivity.

On the other hand the patient also presents with some signs which are called as Vrana or primary lesion. The primary lesions which are usually noticed are as follows:

1. Macules (Vaivarnya)

Macule is a small sized, not so raised circumscribed lesion with alteration in colour. The macules are generally of two types: Erythematous like in dermatitis, psoriasis, leprosy etc

Pigmentary macules are further divided into three types:

1. Hyperpigmentary: Chloasma, freckles
2. Hypopigmentary: Leprosy, tinea versicolor
3. Depigmented: Vitiligo, leucoderma

2. Papule (Pidika)

It is a solid , raised lesion about the size of a split pea or smaller. A papule can be static or can be transient as well. An endemic papule is usually superficial, dry, solid and flesh coloured. The dermic papule is deeper, elastic and radish. The common causes of papules are warts, eczema, psoriasis, lichen, acne, chicken pox, syphilis, drug eruption etc. The examples of nodules are neurofibromatosis, leprosy, skin cancer, syphilis etc.

3. Vesicle (Sphota)

This is a circumscribed serum or plasma containing elevation of the integument. When ruptured, the contains ooze out. The size of the vesicle varies from the size of a pin head to that of a small pea. A similar lesion but larger in size is called a bulla. Usually, vesicles are transitory and of short duration. They either rupture or ooze, or their contents usually coagulate to form crusts, or enlarge to form bullae, or transform to pustules. Their roof can also get rubbed off to leave behind a moist and raw surface. On the palm of the hands they are situated rather deeply, hence their content is discharged with difficulty. On the mucous membrane their roofs get rubbed off very easily producing erosion. The common causes of vesicles are - eczema, scabies, chicken pox, herpes zoster, insect bites etc. The common causes of bullae are: impetigo, pemphigus, dermatitis and herpetiformis etc.

4. Wheal (Mandala)

It is flat, evanescent swelling on the skin which is due to the local dilatation of blood vessels. The increased permeability results in localised edema. Wheal disappears without leaving any trace of tain, scars or atrophy. A wheal is usually pale in the centre and red at the periphery, but it may be uniformly whitish or reddish. Occasionally, it may be surmounted by vesicles. The common examples of wheals are: urticaria, drug rashes, insect bites etc.

5. Pustule (Puya pidaka)

This differs from a vesicle or a bulla in the nature of its content. The pustules are fluid containing elevation. This may arise as such or may be a transformation from a papule. Pustules terminate by rupture or desiccate to form irregular yellow crusts. Common examples are furunculosis, scabies, acne, chickenpox, carbuncle, impetigo etc.

In some other cases there are presence of secondary lesions as well. Secondary lesions are the result of modification of the primary lesion either by the individual with the lesion or through the natural evolution of the lesion in the environment.

Secondary lesions which are generally present in skin conditions are as follows:

1. Scales or Squama

It is a dry exfoliation of the skin. This is due to the increased or abnormal formation of stratum corneum (hyper or parakeratosis). This results from the erythema or inflammation of the skin or increase in dryness. The conditions which result in formation of scales are: psoriasis, tinea corporis, pityriasis versicolor, seborrheic dermatitis, eczema, exfoliative dermatitis, tinea capitis, pityriasis rosea, lupus erythematosus etc.

2. Crust or Scab

This represents a dried up mass of oozing and other products of inflammatory tissue which is particularly epithelial debris. Scabs from on vesicles, pustules, bullae or ulcers erosions and excoriations. The crusts are common in herpes zoster, eczema, dermatitis, impetigo, ulcer, seborrhoeic dermatitis.

3. Excoriations

They are superficial, linear lesions which are characterised by the removal of the epidermis by scratching or by abrasion. An excoriation may be superficial or deep. This gets covered by a crust. The crust is simple, with blood or impeti. Excoriations is an evidence of pruritus.

4. Fissure

It is a linear crack in the integrity of the skin reaching down to the papillary layer of the dermis or deeper. It has length but has no breath. A fissure is usually accompanied by pain which interferes with the movement of a particular part. Common examples of fissure are fissure-in-ano, chronic eczema in the palms and soles, angular stomatitis, chapping of hands as in extreme dryness, syphilitic fissure.

5. Ulcer

Ulcer is the circumscribed lesion starting from a break in the skin, reaching up to the level of dermis. It has a definite length as well as breath. The ulcers are commonly caused due to traumatic, pyogenic, varicose ulcer, peripheral vascular disorders, metabolic disorders etc.

6. Scar

Scar represents a healed destructive lesion of the dermis and deeper parts. Whenever any inflammatory or traumatic lesion destroys the basal layer of the epidermis and the underlying corium, a scar is formed. Superficial epidermal lesions heal without scarring. The most common causes of scarring are traumatic burns, chickenpox, herpes, varicose ulcer, neoplasm, leprosy etc.

These are the general signs which are observed in a patient by the doctor to diagnose the condition. But there is also significance of dosha predominance in the skin conditions.

Following chart shows predominant clinical features of the skin conditions according to dosha dominance.

Vataj Pradhanta	Pittaj Pradhanta	Kaphaj Pradhanta
Roukshyata (roughness)	Daha (Burning sensation)	Shweta (white in colour)
Parushya (Hardness)	Raga (redness)	Saityata (cold in touch)
Toda (Pricking pain)	Srava (Suppuration)	Kandu (itching)
Sankocha (Constriction)	Visra gandha (Smell like raw meat)	Gaurava (Heaviness)
Shyava varna (Blackish in color)	Anga patna (Sloughing of limbs)	Jantubhi abhibhakshana (Maggot formation)
Arjunvarna (Reddish in color)		Kleda (Stickiness)

So, that's all about the diagnosis of tawk roga. Once you have analysed the type of lesion and the dosha involved, then only after that you will be able to give the treatment.

Ayurveda is no doubt a very deep science and yes according to dosha dushya and appearance a skin disorder can be easily diagnosed. But you must be very accurate because this will decide what type of treatment you are going to advise.

The following chart is based on the assessment of the dosha and how various stages are decided according to that.

Dosha	Stage	Treatment
Vata - Pitta	Acute	Ghrita
Pitta - Kapha	Sub Acute	Churna/Kashaya
Kapha - Vata	Chronic	Aasav, arishta, lavana or kshara

This is basically an overview of how various formulations in Ayurveda are used in skin conditions.

But obviously, internal and external both types of treatment are necessary for severe conditions.

So what is the treatment protocol in ayurveda for Twak vikara or skin disorders?

The line of treatment in this Twak vikara starts from:

• Diagnosing: The diagnosis must be accurate and quick to get complete results.
• Secondly, if the condition seems chronic then shodhana must be done. Shodana is detoxification of human body using various panchakarma procedures.
• If the condition is acute then using herbal preparations according to dosha predominance can help. One can also use rasayan aashadi along with sanshaman aushadhi (Internal medication) as well.
• In most of the skin disorders virechana is preferred. The reason is, it expels out excessive pitta dosha in the body. Rakata and pitta dosha are in an inseparable relation as pitta is the mala od rakata dhatu. As excessive pitta gets out of the body the purification of blood takes place. That's how the subsiding of the conditions takes place.
• Raktamokshana is also done as a pradhan karma in skin conditions.
• After rakat mokshana and virechana, ghritpana (internal intake of medicated ghrit) is advised to avoid prakopa or aggravation of vata dosha.
• Lepa is also applied after shodhana or rakta mokshana.

After diagnosis and treatment one should also follow some pathya and apathya. These are basically the changes one should introduce in diet and lifestyle. Pathya are the things which are to be consumed or followed. On the other hand apathya are the things which can be abstained from diet and lifestyle as well.

Pathya for Diet and Lifestyle in Twak Roga

So, here the question arises what exact role diet plays in all of these?

Diet is really important to follow as we are what we eat. Salty, spicy foods along with incompatible food combinations like meat with milk or fish with milk, fast foods, junkfood, cold drinks etc generally aggravates the symptoms. Also non veg, tea or coffee, amla and guru dravya (Heavy to digest food) along with navin anna (freshly harvested grains), masha (black lentils), mulaka (radish), curd and dairy products also plays an important role in aggravation of symptoms.

Now what should be eaten? To answer this question following are some tips that are to be followed by a twak roga patient very strictly:

• The diet should be balanced and wholesome
• Sattwik diet is very essential in twak roga. Satwik here means a diet which is having only natural food articles like vegetables, fruits, legumes, sprouts and dairy only when the cow is fed and milked properly.
• Light diet, not too oily and not too dry.
• Periodic fasting is also to be done.
• Maintain adequate hydration by drinking enough amounts of water.
• Tikta dravya, old shali, yava, godhuma (wheat), mudga, adhaki, old ghee, mustard oil, tila oil, go mutra etc can be consumed.

Pathya Lifestyle

• One should wake up early in the morning and should go to bed early as well.
• Try to meditate for 15 minutes in a day. This will helps in getting rid of stress.
• Do yoga or exercise in fresh cool air as it stimulates natural skin restoration, Mild sun light is also good for skin.
• Clothing should be proper as well.
• Bathing should be done regularly.
• Digestion should be observed on regular basis.

Apathya Diet and Lifestyle in Twak Roga

• Avoid food articles which are Salty, pungent and spicy.
• The concept of virudha should be understood and must be followed.
• Only freshly prepared vegetables and legumes must be eaten.
• Sprouts and plant based protein must be preferred.
• Excessive stress is dangerous as it can aggravate symptoms.
• Anger, greed, excessive sexual activities must be abstained.
• Exposure to excessive cold and excessive heat can aggravate symptoms.
• Sedentary lifestyle is to be Avoided.
• Late night sleeping is to be avoided.
• Diet cheat is not to be done.

So these are the pathya and apathya which are to be followed in the Twak roga.

Twak roga in ayurveda is a very vast topic and needs a deep understanding of dosha and dushya. The management in some cases also becomes tough as patient cooperation with diet and lifestyle is needed highly.

Conclusion

As mentioned before twak roga, if to be managed with Ayurveda needs high patient corporations and will power as well. The patient is asked to abstain from things for his or her own benefits. Obviously disease management comes with a price and that price is paid by the patient by following the rules of abstinence. Twak roga can be very difficult to manage sometimes when there is involvement of all three dosha and the condition is chirkaliya which means from a long time. No doubt herbs and herbal formulation help a lot but the contribution from the side of the patient is must. In case of any queries kindly visit www.PlanetAyurveda.com

Alternative Treatment for Somatoform Disorders With Herbal Remedies

Abstract

There are many situations and conditions in life that have an impact on our day to day activity as well. Some people are affected by these situations so much that they develop various types of physiological conditions as well. In some other cases the person who is suffering from a certain diseased condition can also suffer from certain psychological suffering. But there is another aspect and that is when a person is suffering from a psychological condition and has unexplained physiological suffering. This condition is called Somatoform Disorder. The article has detailed information regarding somatoform disorders and also about its Ayurvedic management.

Introduction

The somatoform Disorder is a group of psychiatric conditions in which patients present with a myriad of clinically significant but also unexplained physical symptoms. The patient generally focuses on pain or fatigue which is followed by major emotional distress and problems functioning. The patient may or may not be diagnosed with a medical condition which has association with symptoms but the reactions to the symptoms are not normal. Patients with somatoform disorder are not faking their symptoms, the distress they have due to pain and other problems is real regardless of whether or not a physical explanation can be found. Due to this distress and symptoms their day to day life and activity is hampered. This is also responsible for stress and frustration in many patients.

Key notes for Somatoform Disorder

• Somatoform Disorder: Group of psychiatric conditions with physical symptoms which are not having any physical basis.
• In most of the cases a psychiatric assessment will show that the physical symptoms bear a close relationship with stressful life events or emotional conflicts.
• The degree of psychological understanding which the patient achieves is minimal and the efforts of the physician to discuss the possibility of psychological causation are firmly resisted
• By the time patient is referred to a psychiatrist there is multitude of negative investigations and unhelpful operations, particularly hysterectomy, cholecystectomy.
• The cardinal feature is severe, persistent pain which cannot be explained by a physical illness or physiological disturbance.
• Patients with this condition demand great emotional support from their families.
• In Ayurveda the condition can be very well related to Unmada. Unmada is termed as insanity but it is more than that.
• Unmada patient’s generally have symptoms like masked intelligence or diversion of intellect, deviation of mind, lack of courage & irrelevant speech.
• Aforementioned symptoms can result in the manifestation of symptoms similar to Somatoform disorders.

Causes of Somatoform Disorders

It is not precisely clear what causes Somatoform disorders. But it is believed that there are several contributing factors. Such factors can be genetic or hereditary. Such things can include hypersensitivity to pain sensations. Family influence can be one more countable factor as well.

An individual who possesses a negative personality trait which can influence illness and physical symptoms as well. Even when an individual gives more attention to the bodily symptoms or sensations, such cases can also be involved.

So the causes according to modern science in somatoform disorders can be summed up as following three:

• Family influences
• Genetic factors
• Hypersensitivity

Now if discussed According to the Ayurvedic aspect then Somatoform disorders are somehow related to Unmada explained in Ayurveda. The causes of Unmada explains:

विरुद्धदुष्टाशुचिभोजनानि प्रधर्षणं देवगुरुद्विजानाम्|
उन्मादहेतुर्भयहर्षपूर्वो मनोऽभिघातो विषमाश्च चेष्टा||

Reference - Chikitsa sthana 9/4

The above verse means incompatibility of food, unclean or contaminated food, possession of spirits, gods, teachers along with mental trauma due to recurrent fear, exposure to fear and adopting difficult posture are the most general causes of Unmada occurrence.

The above mentioned causative factors then results in

तैरल्पसत्त्वस्य मलाः प्रदुष्टा बुद्धेर्निवासं हृदयं प्रदूष्य|
स्रोतांस्यधिष्ठाय मनोवहानि प्रमोहयन्त्याशु नरस्य चेत||

Reference - Chikitsa sthana 9/5

The verse suggests causative factors result in the dosha aggravation in the person who is having low level of sattva guna (Heena sattva). Low levels of sattva guna means weak minded people (In the simplest language). Then in aforementioned people vitiation of hridya (Seat of intellect) takes place. Thus the manovaha srotas (Channels carrying mental factors) delude a person's mind quickly.

Types of Somatoform Disorders

Somatoform disorders are distinguished by thoughts, emotions or actions which are related to somatic symptoms. Following are the types of somatoform disorders:

1. Somatization Disorder: This occurs when a person continuously complains of physical symptoms irrespective of any physical condition. The diagnostic criteria includes experienced inexplicable physical symptoms that starts before the age of 30, persistence of symptoms for several years. Symptoms can include pain, stomach problems, sexual or neurological issues.
2. Conversion Disorder: The condition is diagnosed when physical symptoms mimic symptoms of a neurological disorder when there is no neurological disorder present.
3. Pain Disorder: Somatoform disorder characterised by pain in one or more parts of the body without any known cause.
4. Hypochondriasis: This occurs when the person believes that his/her minor signs or symptoms are the result of a major disease.

Symptoms related to Somatoform Disorders

Modern science suggests that somatoform disorders have symptoms as following:

• Persistent worrying about possible illness.
• Interpretation normal bodily sensations as an indication of a severe disease.
• Fear that the symptoms are life threatening or dire, even when there is no medical confirmation for the same.
• Excessive visits to a physician or hospital.

Ayurveda suggests following as Somatoform Disorder Symptoms

धीविभ्रमः सत्त्वपरिप्लवश्च पर्याकुला दृष्टिरधीरता च|
अबद्धवाक्त्वं हृदयं च शून्यं सामान्यमुन्मादगदस्य लिङ्गम्||

Reference - Chikitsa sthana 9/6

The above verse suggests Abnormal intellect, Psychic agitation, eyes restlessness, impatience, confused speech, feeling of emptiness in mind are the most general symptoms explained in ayurveda regarding somatoform disorders.

Diagnosis of Somatoform Disorder

The somatoform disease is only diagnosed if the patient is displaying at least one somatic symptom like presence of pain or sleepiness that causes distress or negatively impacts daily routine.

The patient will have extreme and unrelenting thoughts along with severity of their symptoms, experience high levels of anxiety regarding their health and also spend too much time on symptoms or health.

Such symptoms must be present at least for six months or more, so that the patient can be diagnosed with somatoform disorder.

Treatment of Somatoform Disorder

Various therapies are recommended for somatoform disorder. The therapies include the following:

• CBT (Cognitive Behavior Therapy)
• Mindfulness-based interventions
• Acceptance and commitment therapy
• Relaxation therapy

According to Ayurvedic view point, the treatment in somatoform disorder or unmada is as following:

• The patient is administered with various types of ghrita formulations like hingvadi ghrit, kalyanak ghrita, mahakalyanaka ghrita, mahapaishachika ghrita and lashunadya ghrita.
• The isolation of the patient is also done so that any type of violent action or self harming activity can be avoided.
• Some therapies like psychotherapy & spiritual therapy are done in this case so that the sattva guna can be established and maintained.
• Some herbs like brahmi, ashwagandha, vacha, yashtimadhu, giloy, haridra, bibhitaki, haritaki, amalaki etc can be used well in this condition.

Herbal Remedies for Somatoform Disorder by Planet Ayurveda

Planet Ayurveda is a leading herbal manufacturing unit which has its distributorships almost all over the globe. The Planet Ayurveda was established approximately 20 years back and now is helping a huge sum of the Global population with Ayurvedic herbs and Herbal formulations. The Formulations prepared by Planet Ayurveda are both Classical as well as patent. These formulations are manufactured under the strict guidance and surveillance of MD Ayurveda Doctors. All of the Herbal formulations undergo proper Quality check and hence contain no dyes, additives, adulterants, colours, favouring agents etc. In case of Somatoform disorders Planet Ayurveda offers following Formulations:

1. NEUROGENIE CAPSULES
2. BOSWELLIA CURCUMIN
3. PHYLLANTHUS NIRURI
4. KALYANAKA GHRIT
5. SARASWATARISHT

Products Description

1. Neurogenie Capsules

The Neurogenie capsule is a very impressive patent Formulation by Planet Ayurveda. The capsules are the fantastic combination of two herbs Ashwagandha (Withania Somnifera) and Brahmi (Bacopa Monnieri). The herbs have an impressive effect in Anuloman of Vata dosha and also give really good results in stabilising the thought process of a person. Generally the recurrent stress and anxiety can cause occurrence or aggravation of pain but with this formulation both the stress along with anxiety can be handled well. Also the capsules are manufactured with the standardised extract of both herbs and do not have any side effects. As the name of the formulation suggests, it is a genie formulation in conditions like somatoform disorders.

Doasge: Two Capsules twice daily after meals with lukewarm water.

2. Boswellia Curcumin

Boswellia curcumin is also a patent formulation by Planet Ayurveda which has a lot of benefits due to its amazing ingredients. The formulation has two ingredients that are shallaki (Boswellia serrata) and haldi (Curcumin longa). The constituents of these herbs are very well known to tackle any type of pain and also help in Anuloman of the vata dosha in the body. The formulation has great results in relieving many types of pain and also helps in proper digestion as well. Boswellia curcumin is prepared from the standardised extract of herbs and gives very impressive results not only in this condition but also in many other disorders as well.

Dosage: One Capsule twice daily after meals with lukewarm water.

3. Phyllanthus Niruri

Phyllanthus niruri is a single herbal capsule which is manufactured using bhumi amla (Phyllanthus Niruri). Bhumiamla is a very popular herb in Ayurvedic texts and Capsule Phyllanthus niruri, which is prepared from its standardised extract, is also having amazing benefits. The formulation has an anti-inflammatory effect and due to its effect on the liver, it aids better digestion. The formulation helps in the pacification of kapha and pitta. In addition, it helps in the elimination of ama dosha that is endotoxins from the digestive tract due to its purgative effect. The formulation has an impressive result in somatoform disorders as well.

Dosage: One Capsule twice daily after meals with lukewarm water.

4. Kalyanaka Ghrit

Kalyanaka ghrit is an impressive Classical formulation manufactured by Planet Ayurveda. Kalyanak ghrit has ingredients like haritaki (Terminalia chebula), Bhibhitaki (Terminalia bellirica), Amalaki (Emblica officinalis), Badi elachi (Amomum subulatum), Devadaru (Cedrus deodara), Shweta Sariva (Hemidesmus indicus) and many others. The ghrita has its effect in anulomana of vata dosha and is mainly used in the management of unmada (understood as insanity). The ingredients of kalyanaka ghrit help in clearing bowels as well and improves the status of digestive fire too. The classical formulation also gives good results in improving the memory and brain functioning as well.

Dosage: One tsp twice daily after meals with lukewarm water.

5. Saraswatarisht

Saraswatarisht is a classical preparation manufactured by Planet Ayurveda. This formulation has ingredients like Brahmi (Bacopa monnieri), Shatavari (Asparagus racemosus), Vidarikand (Pueraria tuberosa), Harad (Terminalia chebula), Khas (Vetiveria zizanioides), Adrak (Zingiber officinale) and many others. The saraswatarisht is known to reduce anxiety and fatigue as well. The arishta preparation is really good and impressive and shows results much quicker because of its liquid preparation because liquids tend to absorb more quickly than any other form of formulation. Saraswatarisht is a very impressive channel opener and also helps in the anuloman of Vata dosha as well. All over the formulation has a great impact in boosting central nervous system functioning.

Dosage: Two tsp twice daily after meals with lukewarm water.

Contact Planet Ayurveda Support Team to provide you the costing/ordering and delivery information at – costing.planetayurveda@gmail.com or Call at 0172-521-4040 (India), +91-172-521-4040 (Outside India) or Whatsapp at (+91) 842-749-4030.

Conclusion

The somatoform disorder are the type of conditions which are not fully understood and the patient is misguided with various medications and many types of procedures like Dilatation and curettage, hysterectomy, cholecystectomy, endoscopy, colonoscopy and what is the result? Nothing.. Patient has no improvement, the pain still persists and then after so much damage the patient is finally referred to psychiatric care. But what's done is done. The irreversible procedures which are being done are done. So, it is really important to rule out what exactly is the problem from which a person is suffering and how it can be ruled out whether it's psychological or physiological. For such conditions it is better to opt for Ayurveda because with Ayurvedic herbs and formulations, there is no side effect and they help in gradual recovery quite well. In case of any queries kindly visit www.PlanetAyurveda.com

Ayurvedic Treatment For Reactive Arthritis / Reiter's Syndrome With Herbal Remedies

Abstract

There are a lot of things that are affecting our life, or You can say disturbing our smooth going life. Apart from situations, the most disturbing thing is the diseased state. When the person is not feeling well that is the most disturbing thing in his/her life. Emotions or our mental status we can hide, humans are expert in that but the body's diseased state cannot be hidden. When you are not feeling well, it's like a gesture written on your face. In this article we will be discussing a condition that can potentially disturb your smooth going daily activities and it is called Reiter's syndrome or Reactive arthritis. The condition is better manageable with Ayurvedic formulations. Now let's discuss Reiter's syndrome or Reactive arthritis in detail along with its Ayurvedic management.

Introduction

Reiter's Syndrome or Reactive Arthritis is a condition in which swelling of joints takes place. This swelling is associated with pain as well and swelling is triggered by an infection which is present in other parts of the body. Reactive arthritis is also described as the classical triad of arthritis, urethritis and conjunctivitis. However, the majority of patients do not present with the classical triad. Reiter's syndrome is named after Hans Reiter, who was the first person to describe this syndrome. According to present study the condition is an deviant autoimmune response or condition which is because of the long standing salmonella, shigella, campylobacter, or chlamydia infections in the gastrointestinal system. Though the condition is rare and its occurrence in population based studies is to be between 0.6 - 27% per one lakh. About 1-3% of patients with urethritis usually develop Reactive Arthritis. Now, let's get into the details of the topic that is Reter's Syndrome or Reactive Arthritis.

Key Notes for Reiter's Syndrome or Reactive Arthritis

• Reiter's Syndrome or Reactive Arthritis: A seronegative Spondyloarthropathy
• Causes: Underlying infection of urethra, Conjunctiva, Uvea, Intestines
• Epidemiology: Rare
• Predominance: Common in Young man below the age of 40 years, Rare in Children
• Anatomical Location: Unilateral/ Bilateral
• Diagnosis: Clinical triad, History, Symptoms and Ophthalmologic Examination
• Along with prevalence of HLA-B27 is estimated to be 30%-50% with wide variations in the range values
• Ayurvedic perspective: Reactive arthritis or Reiter's syndrome is a Form of Amavata. Amavata is a condition in which vitiation of Vata dosha (Kinetic energy) along with accumulation of ama (Endotoxins) takes place in Body.

Causes Of Reiter's Syndrome / Reactive Arthritis

The Reiter's Syndrome or Reactive Arthritis is caused by an underlying infection of some other system. Most common infections include the following:

• Infection by microorganism Chlamydia
• It can also be acquired through Sexually transmitted diseases
• Other organisms like Salmonella, Shigella, Yersinia and Campylobacter can cause Gastrointestinal infections resulting in Reactive arthritis or Reiter's Syndrome
• As aforementioned infection of Uvea and Urethra can also cause this Condition

When discussed in Ayurveda, Reactive arthritis or Reiter's syndrome is the result of Vata Aggravation (Excess of Kinetic Energy) along with deposition or accumulation of Ama Dosha (Endotoxins) in the body. This happens due to the out of order or without disciplined diet and lifestyle we are following.

Symptoms Of Reiter's Syndrome / Reactive Arthritis

The symptoms of Reiter's Syndrome or Reactive Arthritis includes a large variety but the most commonest are the following:

Clinical Triad

Uvea Inflammation, Conjunctiva Inflammation, Urethra Inflammation

• Pain in joints along with stiffness
• Inflammation of Tendons & ligaments attached to bones
• Swollen toes along with fingers
• Skin problems in few cases
• Back in lower back

On the other hand, As per Ayurveda Ama Vata has symptoms as following:

Ama and Vata vitiation involves Koshtha (Gastrointestinal tract), Trika (Lumbar sacral spine), and Sandhis (Joints). It also involves Pan in joints, low appetite, Indigestion, stiffness along with swelling in Joints, Weakness and heaviness in chest as well.

Common Causative Agents

The commonest causative agents for Reiter's Syndrome or Reactive Arthritis are as follows:

• Salmonella enteritidis
• Shigella flexneri
• S. dysenteriae
• Yersinia enterocolitica
• Campylobacter jejuni
• Clostridium difficile

Diagnosis Of Reiter's Syndrome / Reactive Arthritis

The symptoms manifest several days to weeks after the initial infection. Diarrhoea or other symptoms which are the result of the offending agents are usually resolved by the time a patient develops arthritis. So, for diagnosis following procedure is the best to follow:

• History of past illness: This plays an important role before declaring a patient to have reactive arthritis or Reiter's Syndrome. History of long standing infection gives a detailed idea about the situation.
• Physical examination: It will reveal presence of sausage shaped fingers, toes, Pain in heel which will be bilateral (mostly), Asymmetric oligoarthritis limited to lower extremities, conjunctivitis, iritis, Acute diarrhoea or onset of cervicitis within 4 weeks of onset of arthritis.
• Blood Tests like C reactive Protein (whose levels are elevated in body due to presence of infections) and HLA- B27 (which comes out positive in this case).

Treatment of Reiter's Syndrome or Reactive Arthritis

The treatment is done in various steps. After going through a patient's detailed symptoms, antimicrobial therapy is generally preferred. The duration of these antimicrobial medications is for 3 to 6 months.

Treatment of underlying infection is to be done at the earliest

In certain patients, for relieving pain and stiffness painkillers in a combination of muscle relaxants are also given.

When nothing works, neither NSAIDS nor antiinflammatory drugs than steroids are the Choice of Drugs in this case. At a tapering dose, these steroids are introduced in the treatment.

Ayurvedic Perspective of Reiter's Syndrome or Reactive Arthritis

As aforementioned, Reiter's Syndrome or Reactive Arthritis is a form of Ama Vata. Ama are the toxins that are accumulated in the body and Vata is the kinetic energy which gets disturbed due to certain food and lifestyle habits. In this case the Ama is produced by the bacterias or antimicrobial agents in the form of Cytotoxins. Due to Aagantuj karna (or external factors responsible for infections inside the body), dhatu kshaya (Tissue deterioration) is there along with vitiation of agni (Digestive fire) and this results in the aggravation of Vata dosha.

Vata dosha, due to its chal guna (Mobile property) carry ama (Cytotoxins) from the Srotas (microchannels) and with a huge strength it carries it to the joints and then lakshana (symptoms) like shotha (swelling), ruja (pain), stambhan (stiffness) and other symptoms appear.

That's the Ayurvedic perspective for the occurrence of Reiter's Syndrome or Reactive Arthritis.

In this condition Ayurveda suggests a very particular type of treatment. The treatment protocol according to ayurveda includes the following:

• Langhan (Intermittent fasting): For digestion enhancement
• Sweden (Dry Sudation): Reduces pain and Swelling
• Deepan and Pachan (Digestive and Carminative): Enhances Appetite
• Virechan (Purgation): Eliminates Toxins
• Snehapana (Oleation Therapy): For reducing Stiffness
• Basti (Medicated Enema): Expels toxins from colon and pacify Vata dosha

Herbs like Haridra, Shallaki, Guggul, Amla, Ashwagnadha, Brahmi etc. have a very impressive result in this condition. They help in expulsion of Ama from the body and also help in pacification of Vata dosha.

The formulations which are giving impressive results in Amavata are Simhanad guggul, Yograj guggul, Brahmi vati etc. are having very impressive results in Reactive Arthritis. Oil of castor also plays a very important role in elimination of ama dosha and pacifying vata as well.

Herbal Remedies for Reiter's Syndrome or Reactive Arthritis by Planet Ayurveda

Planet Ayurveda is a leading herbal formulations manufacturing company. The formulations which are prepared by Planet Ayurveda are completely herbal and do not have any type of side effects. The products are manufactured under the Guidance of MD Ayurveda experts. Planet Ayurveda has outlets all over the world and its products are Approved by FDA, US as well. Planet Ayurveda also has various oyster certifications like Kosher, HALAL and many others. The Ayurvedic formulations are advised in a combination, in many types of conditions and have very fruitful impact. The formulations which are given in Reiter's syndrome or Reactive Arthritis are as follows:

1. Boswellia Curcumin
2. Amalaki Rasayan
3. Yograj Guggul
4. Aamvatantak Churna
5. Ashwagandhaghan Vati
6. Orthovita Oil

Products Description

1. Boswellia Curumin

Boswellia curcumin is Planet Ayurveda's Patent formulation and has impressive results in conditions like Reiter's Syndrome. The formulation has ingredients like Shallaki (Boswellia serrata) & Haridra (Curcumin longa). Boswellia curcumin is in capsule form and helps in the pacification of ama dosha. These capsules have their impact on digestion as well. They help in the cleansing of micro channels so that easy passage for Vata movements can be made. Boswellia curcumin is a fantastic combination which also helps with pain due to its Vata pacification property and reduces swelling as well. The formulation has no side effects and gives impressive results in this condition.

Doasge: One capsule twice a day after meals with lukewarm water.

2. Amalaki Rasayan

Amalaki Rasayan is one another formulation by Planet Ayurveda which has only amalaki (Emblica officinalis) as its ingredient. The Amalaki rasayan has a rejuvenating effect and has the capacity to balance all the doshas in the body that is Vata, pitta and Kapha as well. Moreover, it is also having antioxidant effects and supports healthy digestion. The formulation has an impressive effect in balancing the metabolic working and thus stabilises the body really well. It also acts as an immunomodulator and prevents attacks of any further infections. Amalaki rasayan capsules are prepared with the best and standardised extract of amla.

Dosage: One capsule twice a day after meals with lukewarm water.

3. Yograj Guggul

Yograj guggul is an impressive Ayurvedic classical preparation which has potent ingredients like guggul (Commiphora guggul) along with other ingredients like pippali (Piper longum), ajwain (Carum copticum), vidang (Embelia ribes) and others. Yograj guggul is classically mentioned especially under amavatrogadhikara, which means it is used specifically in the management of ama vata and its forms. In conditions like Reiter's Syndrome or Reactive Arthritis the formulation has marvellous impact by pacification of Vata dosha and also in elimination of endotoxins from the body. Due to the presence of guggul it is having a healing effect as well. In addition, it reduces swelling and relieves pain in Reiter's Syndrome or Reactive Arthritis.

Dosage: Two tablets twice a day after melas with lukewarm water.

4. Aamvatantak Churna

Aamvatantak churna is a peculiar formulation for amavata and also for various forms of amavata. The churna is having ingredients like shunthi (Zingiber officinalis), pippali (Piper longum), amalaki (Emblica officnalis), haritaki (Terminalia chebula), Vibhitaki (Terminalia bellirica) and many others. Here aam stands for endotoxins, Vata stands for excess of kinetic energy in the body and antak means the ones who end both. That is how the formulation works, it eliminates the ama dosha, pacifies the Vata dosha, improves the digestion and refines the entire system. Once elimination and pacification is done the symptoms subsides gradually thus improving the entire situation.

Dosage: One tsp twice a day after melas with lukewarm water.

5. Ashwagandhaghan Vati

Ashwagandhaghan vati has ashwagandha (Withania somnifera) as its only ingredient. The formulation has an impact on deeper dhatus and helps in subsiding the swelling and pain in the joints. The ashwagandha is an excellent immunomodulator as well thus making the condition good and the situation improves impressively. This formulation also helps in the elimination of ama and pacify Vata and Kapha dosha that are potential and kinetic energies in the body. The symptoms like pain and difficulty in movement are very well handled by using this formulation. Ashwagndhaghan vati works to strengthen the entire body framework.

Dosage: Two tablets twice a day after meals with lukewarm water.

6. Orthovita Oil

The orthovita oil is one of the patent products of Planet Ayurveda which has ingredients like tail tarpon, shul gajendra, gandhapura, turpentine, saindhavadi taila, prasarini oil and few others.its application should be done gently and thus help in anulomana of Vata dosha as well. The orthovita oil helps in supporting normal movement of joints and also maintains the strength of joints.

How To Use Oil: Mix both the oil and warm it through the water bath method before application. Never warm the hot through direct heating. Apply it on the affected area and massage gently.

Contact Planet Ayurveda Support Team to provide you the costing/ordering and delivery information at – costing.planetayurveda@gmail.com or Call at 0172-521-4040 (India), +91-172-521-4040 (Outside India) or Whatsapp at (+91) 842-749-4030.

Conclusion

The Reiter's Syndrome or Reactive Arthritis is a very rare condition which can develop in even children, if the case is the rarest. But without modern medication this condition is quite manageable with Planet Ayurveda's formulations. They help in elimination of accumulated cytotoxins and pacify the Vata dosha which is responsible for various types of deformities, pains and selling in this case. But with Ayurveda the things can be much better and the patient gets relief along with the disciplined lifestyle and diet habits. In case of any queries kindly visit www.PlanetAyurveda.com

Steven Johnson Syndrome & Its Ayurvedic Treatment With Herbal Remedies

Abstract

Steven Johnson syndrome is a rare, acute and fatal skin reaction involving mucus membrane. The most common causative factor among 80% of the population is allergic reaction to medications. It is also known as a "minor form of toxic epidermal necrolysis", in which skin cells die and epidermis gets separated from dermis. The skin usually regrows over weeks and full recovery takes months. This syndrome is a medical emergency condition which needs hospitalization. It has significant morbidity and mortality. In this article we will know the detailed information regarding Steve Johnson syndrome and its management according to Ayurveda.

Introduction

Steven Johnson syndrome (SJS) is a serious skin disorder that causes rashes, blisters on skin and skin starts peeling off. These rashes are painful which spread and form blisters, the top layer of affected skin dies and heals after several days. With skin, mucus membrane is also involved which includes eyes, genitals, lower respiratory tract, nasal and mouth mucosa. Complications may occur in eyes like conjunctivitis and keratitis. SJS is an immune mediated complex disorder. Initially in the early stage, patients have fever and flu like symptoms and in later stage rashes and blisters occur. It is a hypersensitive skin reaction. SJS involves 10% of body surface area. Treatment focuses on removing the cause, managing pain and caring for wounds done. The more severe form of Steven Johnson Syndrome is Toxic Epidermal Necrolysis (TEN) as it involves 30% 0f body surface area. The mortality of this disease is 5-7%.

Symptoms Of Steven Johnson Syndrome

The typical prodromal symptoms of Steve Johnson Syndrome are as follows-

• Productive cough or thick purulent sputum
• Fever
• Sore throat and mouth
• Headache
• Malaise
• Arthralgia and fatigue
• Skin painful and burning sensation
• Skin lesions appear on oral mucosa, esophagus, pharynx, anus vagina and urethra.
• Ocular symptoms - Red eye, watering, dry eye, pain and itching, decreased vision, foreign body sensation, diplopia, and photophobia.
• Reduced ability to eat and drink.

Clinical Representation

The clinical presentation of Steve Johnson syndrome is as follows-

• The rashes began as macules which may later turn into pustules, vesicles or bullae
• Typical lesion of multiform
• The lesions become bullous and later ruptured
• Rashes can form anywhere on palms, soles or dorsum of hand (extensor surfaces are commonly affected)
• Sloughing of skin
• Tachycardia
• Hypotension
• Seizures and mental illness

Causes Of Steven Johnson Syndrome

There are various etiological factors of SJS, whereas drugs are most common cause-

• Infections (viral diseases, influenza, herpes, mumps, typhoid, fungal diseases)
• Drug induced (antibiotics, analgesics, NSAIDS, cold and cough medications, penicillin's, anticonvulsant drugs)
• Genetics
• Idiopathic cause 25 - 50%

Risk Factors

The risk factors regarding SJS are as follows-

• Family history
• Weak immune system
• Genetics
• HIV infections
• H/O having medications

Diagnosis

The diagnoses of Steve Johnson syndrome are as follows-

• Darshan, prashan and sparshan (physical examination and medical history)
• Skin biopsy
• Culture
• Imaging
• Blood tests

Ayurvedic View Of Steven Johnson Syndrome

It is a misconception that natural herbs cause no risk but some drugs cause adverse reactions such as guggul, swarna bhasma, rasa aushdhis, etc. If drugs are taken without proper knowledge, over dosage and their principles. Reactions can also be caused by having the wrong species of medicinal plants. According to Ayurveda. Balancing doshas (vata, pitta and kapha) are done and detoxifies the body helps in recovery of Steve Johnson syndrome. Diet based on raw and healthy foods including fresh fruits, juices and vegetables added with plenty of water is recommended during treatment.

Management

Primarily, as we know SJS is an emergency condition, the patient should be hospitalized and stop the medications which the patient is taking to rule out the cause, then manage accordingly.

• Stopping non-essential medications
• Antibiotics to control infection
• Pain medication to reduce discomfort
• Anti- inflammatory drugs or ointments. Corticosteroids and immunoglobulins
• Supportive care - Fluid replacement, nutrition, wound care, etc

Herbal Treatment By Planet Ayurveda For Steven Johnson Syndrome

Planet Ayurveda is a widespread company which is known for its natural and raw products and it is also GMP certified. Planet Ayurveda has various combinations of medicines for different disorders. All the products are natural without any artificial preservative. The best herbal combination for Steven Johnson Syndrome by Planet Ayurveda are as follows are as follows are as follows-

1. Kaishore Guggul
2. Gandhak Rasayan
3. Manjishtha Capsules
4. Gleaming Skin, Hair, Nails Formula
5. Chopchini Churna

Products Description

1. Kaishore Guggul

Kaishore Guggul is a vati preparation mentioned in Ayurveda classical texts. It mainly contains two ingredients triphala - Amalaki (Phyllanthus emblica), haritaki (Terminalia chebula) and bibhitaki (Terminalia billerica) and guggul (Comiphora mukul). These tablets help in blood circulation and act as a defense mechanism. It has anti- inflammatory, anti – bacterial properties and is used in metabolic disorders. It reduces pain and swelling.

Doasge: Two tablets twice a day after meals.

2. Gandhak Rasayan

The gandhak rasayan is standardized tablet preparation which contains gandhak (sulfur), it has a wide range of therapeutic and rejuvenating properties. It increases immunity and protects against many infectious diseases. It has antibacterial properties and cures various skin disorders.

Dosage: Two tablets are given twice daily with lukewarm water after meals.

3. Manjistha Capsules

Manjistha Capsules are standardized preparations which mainly contain manjistha known as Rubia cordifolia. It acts as blood purifier (Rakta shodhak) and is useful in skin rashes, acne, itching, irritation, scales and patches. The anthraquinones present in manjistha possess its anti microbial, anti fungal, antioxidant property and act as immuno- modulator.

Dosage: One is given twice daily with lukewarm water after meals.

4. Gleaming Skin, Hair, Nails Formula

It is a capsule preparation which contains manjistha (Rubia cordifolia), pit papda (Fumaria officinalis), sariva (Hemidesmus indicus). Manjistha acts as a good blood purifier and helpful in skin disorders. Fumaria is useful in treatment of different dermatological conditions, eruptive skin diseases such as eczema, multiple sclerosis, psoriasis because it contains alkaloids, tannins. Hemidesmus is widely used for skin diseases and helps in detoxifying the body.

Dosage: 1-2 capsules twice daily with plane water after meals.

5. Chopchini Churna

Chopchini churna is a powder preparation in classical Ayurveda. It mainly contains chopchini (Smilax china). It has analgesic, anti-inflammatory and stimulant effects. It is a very beneficial herb for various skin disorders. Chopchini balances all tridosha (vata, pitta, kapha).

Dosage: ½ tablespoon twice daily with lukewarm water after meals.

Contact Planet Ayurveda Support Team to provide you the costing/ordering and delivery information at – costing.planetayurveda@gmail.com or Call at 0172-521-4040 (India), +91-172-521-4040 (Outside India) or Whatsapp at (+91) 842-749-4030.

Conclusion

Steven Johnson Syndrome is a life threatening mucocutaneous disease triggered by medications mostly and some viral diseases. All the information mentioned above can be helpful if somebody is suffering Steven Johnson Syndrome but for medicinal advice you must concern the physician. The team of Planet Ayurveda is experienced to help you in recovering from diseases.

Subacute Sclerosing Panencephalitis Treatment in Ayurveda with Herbal Remedies

ABSTRACT

Subacute Sclerosing Panencephalitis (SSPE) is a progressive neurological disorder of children and young adults which commonly affects the central nervous system. Neurological disorders are diseases of the central and peripheral nervous systems. The brain and Spinal Cord are surrounded by tough membranes which are further enclosed in the skull and spinal vertebrae. It is a highly complex part of the body which coordinates the actions and sensory information and transmits its signals from one part to another part of the body. The nerves which transmit signals from the brain are known as Efferent nerves, which transfer the nerves to CNS (Central nervous system) are afferent nerves. There are two types of cells in the nervous system- Neurons and Glial cells. CNS (Central nervous system) is enclosed and protected by the meninges which is a three-layered system of membranes and the tough outer layer is Dura Mater. Nervous system is the main command centre which controls the movements, thoughts and automatic response. In this article, we are going to discuss its causes, symptoms and its ayurvedic aspect in detail.

INTRODUCTION

Subacute Sclerosing Panencephalitis (SSPE) is a rare complication due to an infection of Measles (Rubeola). It is a progressive Neurological disorder characterized by the inflammation of the brain (Encephalitis). It is commonly known as Dawson Disease which primarily affects children and it is estimated about 2 in 10,000 people with measles develop SSPE. It appears months or years later which causes mental deterioration, seizures and jerks of muscles. It usually develops 2-10 years after the initial viral attack. Measles remain endemic in many countries due to poor access to vaccinations. Subacute Sclerosing Panencephalitis is a single-stranded RNA virus of the Paramyxoviridae family which can be transmitted through aerosols and develops various complications, is a slow and persistent viral infection which are related mainly to measles.

PATHOPHYSIOLOGY

• The person who directly gets infected with measles causes SSPE, which has the strains of the tri-residue motif and has increased motility to spread.
• Measles has a tropism for lymphocytes in the lower respiratory tract and in epithelial cells of the upper respiratory tract.
• The virus infects the immune system cells within the respiratory tract which carry the infection to lymph nodes.
• The lymphatic system, various organs and tissue when infected through the fusion of cells causes the formation of Syncytium which is known as Warthin-Finkeldey Cells.  
• When the epithelial cells get destroyed via infections so the cells get sloughed off via cough and sneezing leading to allowing airborne transmission of the virus to another host.
• The typical immune response to infection usually starts with T-Helper 1 cells which release interferon alpha and IL-2.
• These Cytokines are helpful in eliminating viral infections from cells.
• It is due to the poor cellular response of immunity.
• The actual Mechanism is the Infection of CNS, where CD46 and Protein F play an important role in the entry of neurons.

HISTOPATHOLOGY

• Between 1933-1934 Dawson Investigated various cerebral lesions with several cellular inclusions.
• In 1960, electron microscopy the paramyxovirus was found within the lesions of SSPE patients.
• This disease includes the inflammation of both meninges and cerebral tissue with scattered demyelination neurons and support cells which contain various inclusion bodies and loss of neurons.
• The early stage shows the infection of the Central Nervous System which causes cellular swelling and damage to the genetic material
• Lipid Peroxidation causes demyelination in the early course which has an inflammatory phase in oligodendrocytes and neurons.
• Neurofibrillary Tangles have been found in the cases of SSPE (Subacute-Sclerosing panencephalitis).
• RNA from measles is isolated in various parts such as in Brain, Eyes, and spinal cord in patients with SSPE.

STAGES

• Stage 1- It includes personality/behavioral changes such as dementia, irritability and regression of speech. This stage lasts for 6 months. 
• Stage 2- It is made up of declination in motor functions which include symptoms- Dyskinesia, Dystonia and Myoclonus.
• Stage 3- It includes the progression to extrapyramidal symptoms which have symptoms of spasticity and Posturing. In this stage the complication starts which results in blindness or death.
• Stage 4- It develops due to a persistent vegetative state, akinetic mutism and autonomic failure. Occurs in the final stage during which breathing, heart rate and blood pressure are usually affected.

CAUSES

• Generally, the measles virus does not cause any damage to the brain.
• But due to the abnormal response of the immune system to the virus, it forms various mutant variations which further cause inflammation of the brain (irritation/ swelling) which usually lasts for many years.
• Single-stranded RNA Virus which is highly contagious is transmitted from one infected individual.

CLINICAL PRESENTATION

It is present with progressive Neuropsychological deterioration which consists of various personality changes such as Ataxia, myoclonus, seizures and coma.

• Early symptoms include- Poor performance in School, temper outbursts, Hallucinations and poor sleep.
• Various Unexpected Muscular jerks of the arms, head and body which finally cause Seizures together with Uncontrollable muscle movements. The speech and eyesight continue to deteriorate.
• When muscles become rigid and swallowing becomes difficult and further results in Pneumonia.
• In the final phases, the body temperature rises and there is abnormal pulse pressure.

DIAGNOSIS

• Brain Biopsy
• CSF Finding
• MRI (Magnetic resonance imaging)- shows decreased grey matter volume and Atrophy with ventriculomegaly.
• Magnetic Resonance Spectroscopy
• Spinal Tap
• Serum antibody titer
• EEG (Electroencephalogram)
• CT SCAN (Computed tomography)

TREATMENT

• Treatment factors include in reduction of symptoms, if the diagnosis is made during phase 1 it is possible to treat with Oral Isoprinosine (Inosiplex) and Intraventricular Interferon Alfa.
• Ribavirin (a nucleotide analogue)
• Antiepileptics used for controlling seizures

VACCINATIONS FOR MEASLES

1. It prevents SSPE from developing and the vaccination for measles is very safe and effective to prevent initial infections.
2. It should be separated into 2 doses, one dose at the age of 12-15 months and the second dose between 3-5 years of age.
3. It should not be immunosuppressed.

DIFFERENTIAL DIAGNOSIS

• Viral Encephalitis
• Autoimmune Encephalitis
• NMDA receptor encephalitis
• Atypical Multiple Sclerosis
• Neoplasms
• Paraneoplastic Syndrome

AYURVEDIC ASPECT

Ayurveda is one of the oldest forms of Holistic medicine which is used widely all over the world. Ayurveda focuses on the healing of the body which further states that it is a ‘Science of  Life’. In ayurveda, imbalances in the tridoshas are responsible for emotional, Mental and Physiological health. Mainly in SSPE (Subacute sclerosing Panencephalitis) mainly Vata doshas are affecting the various movements in the body and nervous system activities. Whenever there is an imbalance in Vata doshas, it results in various diseases. These doshas move in all the minute channels of the body and due to their nature gets aggravated along with Pitta and Kapha doshas which get displaced from their normal pathway and throw them at the abnormal path of the body and causes diseases. Mainly Avarana is a unique concept which is mainly seen in Vata disorders, as it encloses the doshas. This causes obstruction in Vata and disorders are known as Avaran Janya Vyadhi. In Vata-related disorders, Prana Vata is associated with the Head (brain).

HERBS USEFUL IN SSPE (SUBACUTE SCLEROSING PANENCEPHALITIS)

1. Ashwagandha

Ashwagandha (Withania somnifera) is a most potent ayurvedic herb which is helpful in the healing system. It is helpful in strengthening the immune system. Balances tridoshas of the body especially Kapha and Vata doshas. Improves the mass of the body and provides proper nourishment. Has anti-inflammatory properties and is well known for its nervine tonic which pacifies the nervous system and manages sleep disorders in many people.

2. Tagar

Tagar (Valeriana wallichii) is helpful in providing strength and promoting overall immunity. Is a great Vata, Kapha pacifier and is a great appetizer which is helpful in relaxing the muscles and calms the overall nervous system of the body. Reduces stress and anxiety which maintains overall neurological disorders. It is a good diuretic and improves various infertility conditions.

3. Brahmi

Brahmi (Bacopa monnieri) is helpful in balancing Vata and Kapha doshas. It is helpful in improving strength and immunity which are helpful in neurological disorders. It is used to influence the cells of the brain by promoting the regeneration of cells in the brain. Rejuvenates the mind and enhances memory. Is helpful in the digestive system which promotes proper digestion and prevents gastric ulceration.

4. Gandhak

Gandhak (Sulphur) is helpful in balancing tridoshas of the body and has various properties such as Anti-bacterial, Anti-viral. Has blood-purifying properties which reduce itching and improve the complexion of the skin. Possess the property of enhancing the immunity of the body and is beneficial in urinary tract disorders. Cures malabsorption syndrome and is an efficient wound healer and pain reliever.

HERBAL REMEDIES FOR SSPE (SUBACUTE SCLEROSING PANENCEPHALITIS) BY PLANET AYURVEDA

Planet Ayurveda is a trustworthy herbal pharmaceutical brand whose products are used by people in various parts of the world and not only in India. The products which are prepared and formulated here are pure, herbal and vegetarian which are free from any preservatives, chemicals, dyes and fillers. The products which are manufactured are under the Supervision of M.D Ayurvedic doctors which are as formulated as per Ayurvedic Principles. Numerous Acute and Chronic diseases are treated by herbal remedies of Planet ayurveda which are prescribed by our Ayurvedic Doctors. For Subacute Sclerosing Panencephalitis, Planet Ayurveda provides a combination of medicines which helps the natural management of the disease and prevents its further progression.

PRODUCTS LIST

1. Tab. Gandhak Rasayan
2. Neurogenie Capsules
3. Cap. Boswellia Curcumin
4. Cap. Gotu Kola
5. Cap. Indian Valeriana

Herbal Remedies For SSPE (Subacute Sclerosing Panencephalitis)

PRODUCTS DESCRIPTION

1. Gandhak Rasayan

Gandhak Rasayan are herbal tablets which are made by planet ayurveda using Shuddh Gandhak (Sulphur). It acts as a natural blood purifier and manages skin disorders. Has antibacterial properties which prevent burning sensation and skin redness. Improves the overall health of the body and supports various kidney and stomach issues. Increase the immunity of the body and is helpful in fighting against infections.

Dosage- 2 tablets twice daily after meals with plain water.

2. NeuroGenie

NeuroGenie are polyherbal Capsules which are formulated by planet Ayurveda using Brahmi (Bacopa monnieri) and Ashwagandha (Withania Somnifera). It is helpful in the treatment of Insomnia and improves memory and mental power. Has anti-diarrheal properties which aid digestion and improve absorption. Controls the Vata doshas which nourishes the neurons and organs to function properly.

Dosage- 2 capsules twice daily after meals with plain water.

3. Boswellia-Curcumin

Boswellia curcumin are polyherbal Capsules which are made by planet ayurveda using Shallaki (Boswellia serrata) and Curcumin (Curcuma longa). It is helpful in maintaining overall health and well-being. Supports healthy joints and relieves morning stiffness. Rich in antioxidants and has Neuroprotective activity which supports the movement of joints.

Dosage- 1 capsule twice daily after meals with plain water.

4. Gotu Kola Capsules

Gotu Kola is a single herbal Capsule which is manufactured by planet Ayurveda using a Standardized extract of Gotu Kola (Centella Asiatica). It is helpful in the treatment of all neurological disorders which calms the mind and has bacterial and Viral Infections. Helpful in the healing of wounds and burns. Supports healthy mental functioning and acts as an anti-anxiety agent.

Dosage- 2 Capsules twice daily after meals with plain water.

5. Indian Valeriana

Indian Valeriana is a single herbal Capsule which is made by planet ayurveda using a standardized extract of Tagar (Valeriana Wallichii). It is helpful in calming the mind and body which provides relief from stress and anxiety. Manages the blood pressure and relaxes the central nervous system. Manages muscle pain and has antispasmodic and analgesic properties.

Dosage- 1 capsule twice daily after meals with plain water.

Contact Planet Ayurveda Support Team to provide you the costing/ordering and delivery information at – costing.planetayurveda@gmail.com or Call at 0172-521-4040 (India), +91-172-521-4040 (Outside India) or Whatsapp at (+91) 842-749-4030.

CONCLUSION

Subacute Sclerosing Panencephalitis (SSPE) is a progressive neurological disorder of children and young adults which commonly affects the central nervous system. The nerves which transmit signals from the brain are known as Efferent nerves, which transfer the nerves to CNS (Central nervous system) are afferent nerves. Subacute Sclerosing Panencephalitis (SSPE) is a rare complication due to an infection of Measles (Rubeola). It is a progressive Neurological disorder characterised by the inflammation of the brain (Encephalitis). Mainly in SSPE (Subacute sclerosing Panencephalitis) mainly Vata doshas are affecting the various movements in the body and nervous system activities. Prana Vata is associated with the Head (brain). This causes obstruction in Vata and disorders are known as Avaran Janya Vyadhi. Further, we will discuss herbal supplements from Planet Ayurveda for SSPE (Subacute sclerosing panencephalitis) which are helpful in this without causing any side effects.