Nerium Indicum / Karaveeram

 

Nerium Indicum is a plant used in ayurveda as an external applicant in wounds and skin diseases, according to Susrutha samhitha. It is included in Sapthopavisha.

Seen allover India. Now a days, the plant widely cultivated as a garden plant. It can survive in all climates.

Grows in a Hight of 3 meters. Skin is brownish in texture. Leaves are lean, sharpened both ends.

Chemical constituants:

The whole plant contained poisonous Glicosides.

APABAHUKAM

(Clinical Notes on Shoulder Pathologies)


APABAHUKAM



1.FROZEN SHOULDER

Observations:
•Amsa sandhi gata vata
•Chala guna kshaya
•Manda,sthabdha guna vridhi

Vital diagnostic points

•Pain and stiffness.
•Decreased range of  movements.
•Cannot raise arm beyond certain point due to stiffness and pain.
•Physical evaluation of joint and scapula(~winging) helps in primary diagnosis.
•Usually non-edematous.
•Usually presenting age group will be young adults/mostly male.

Underlying causes:-

1.Cervical disc diseases of neck.(directs =>to cervical pathologies)
2.Shoulder injury.
3.Diabetes mellitus.

Suggestive investigations
Blood RE
X-Ray
MRI (not essential in preliminary evaluation)

Line of Rx

Consider jadaragni,ama at dhatu level and other kaphanubandha lakshana.
Snigdha/Ushna chikitsa.

Rx Choices:-

Internal medicines:
1.Vaishwanara ch./Hingu vachadi tab(bipha)
2.Ashtavarga ksm
3.Mustharishtam
4.Dhanwantharam ksm/tab.
5.Snehana.
6.Prasaranyadi ksm


(Guggulu/Sallaki preperations not a must and can be safely avoided.Panion tab/Painoff not a good choice here.)
Stifain tab may be reserved for a later suggestion.

External treatment.

1.Exercise suggestions is a must.[Physio suggestions]Stretching over a wall,step wise raising on window rods.Abduction.Try to improve the comfort zone movement rather than trying for increasing range of movement.

2.Nasyam Karpasasthadi.(5-8drops max.)
3.Rooksha sweda followed by Abhyangam+Ushma Swedam.(Prasaranyadi thaila/ Karpasasthyadi thaila)
4.Jambeerapinda sweda/Patrapotala sweda.

A moderately build young male/29y presented with rt shoulder stiffness was managed in this treatment line.With 7days E/Rx. symptoms subsided with 90% improvement in r.o.m.
_________________________

2.GLENOHUMERAL ARTHRITIS

Observations:
•Vata vridhi in kapha sthana(sandhi)

Vital diagnostic points:

•Progressive shoulder pain.
•Stiffness and loss of motion.
•night pain,mostly postural.

Underlying causes
•O.A ; R.A
•Post trauma.

Suggested investigations:
•Blood routine
•X-Ray
•MRI

Line of treatment:
Vatakapha hara.
Ushna pradhana.
Abhayanthara Snehana.

Rx suggestions

Consider agni/dhatu gata ama before Rx

Internal medicines
1.Rasna saptakam ksm
2.Maharasnadi ksm
3.Aaba guggulu.
4.Gandha tailam Cap.
5.Ksheerabala.
6.Rasonadi ksm.

Ext Rx.
1.Nasyam -Karpasathyadi.
2.Dhanyamla dhara local.
3.Abhyanga with vathahara thailas like Dhanwantharam/Ksheerabala etc.

PINDA TAILAM IS PREPARED IN 3 WAYS

"Sa madhoochishta sa Manjishta Sa sarjarasa Sariba

Pindatailam tadabhyangad Vatharaktha ruchapaham"

The major ingredients of this oil are Rubia cordifolia, sesame oil, bee wax, Hemidesmus indicus, and Rhododendron lepidotum.

It is prepared from the Indian plants Manjishta and Shariba, and is highly therapeutic, as it contains pitta reducing herbs. While Manjistha is known to possess anti-rheumatic properties, Shariba is a perfect body relaxant.

HOW PREPARE PINDA THAILAM

Do you know the preparation of pindathailam?........Yes.

Take tila thailam in a pan and add four times of water (as drava) and a quarter of Manjishta & Sariba (as Kalka). Then boil till 'Khara paaka'. When the paaka attains, sieve it through a net to a vessel. Add Sarjarasa (as powder form) & Bee wax (as pieces) as 'paathra paaka'.

Pinda Thailam (also known as Pinda oil) is a cooling massage oil, and mostly used by Pitta individuals, who particularly suffer from skin problems like rashes and eruptions.

OTHER PREPARATORY METHODS

1

According to some ayurveda classical texts like 'Sahasra Yoga', a kashaya should prepare by Sariba as drava, Manjishta is used as kalka, Sarjarasa and Bee wax are used as paathra paaka.

This method was followed by some ancient Vaidyas in Kerala.

2

Another method as follows is used by some manufacturing units of ayurveda medicines in Kerala. And is available in some Government Dispensaries in Kerala. The method is shown below

Taila:  Tila thailam (3/4 th part) + Eranda thailam (1/4 th part)

Drava:  Dhanyamlam + Water

Kalkam: Manjistha + Sariba + Bee wax + Sarjarasam

No one know the reference of this preparation method. I asked this to the Charge doctor in Quality Control department of the firm, then she replied me that; "Every firm have its own formulary, and in this firm this method used".

Here Sarjarasa and bee wax is added to the pan when the thailam get its khara paakam.

LBA in Ayurveda

LUMBAR SPONDYLOSIS

DEFINITION- IT’S A DEGENERATIVE JOINT DISEASE AFFECTING LUMBAR VERTEBRAE AND INTERVERTEBRAL DISCS, CAUSING PAIN, STIFFNESS , SOMETIMES WITH SCIATIC RADIATION DUE TO NERVE ROOT PRESSURE BY ASSOCIATED PROTRUDING DISCS OR OSTEOPHYTES- DORLAND’S DICTIONARY

CLINICAL FEATURES OF LUMBAR SPONDYLOSIS

1. LOW BACK ACHE
2. PAIN RADIATING TO BACK OF THIGH, BUTTOCKS.
MAY BE SUPER IMPOSED WITH SCIATICA BECAUSE OF ROOT COMPRESSION.
3. NUMBNESS OF LIMBS.
4. LOSS OF TOUCH SENSATION.
5. CONSTIPATION
6. SOMETIMES HEADACHE
7. MUSCLE WEAKNESS, TINGLING
8. MORNING STIFFNESS MAY BE PRESENT
9. PAIN INCREASES BY CHANGING POSTURES AND MOVEMENTS LIKE BENDING ETC

INVESTIGATIONS & DIAGNOSTIC MEASURES

1. RADIOLOGICAL- X-RAY
2. MRI, CT IMAGING
3. DISCOGRAPHY

AYURVEDIC CONCEPT

KATI OR LUMBAR REGION IS VATA SITE ACC TO AYURVEDA’
AT THE SAME TIME JOINTS ARE SITE OF SLESHAKA SLESHMA(KAPHA).
BECAUSE OF NIDANAS( CAUSES) VATHA AGGRAVATION OCURS IN KAPHA STHANAM AND BECAUSE OF THE INCREASE IN RUKSHA GUNA(QUALITY OF DRYNESS) , THE DEHYDRATION OF THE DISC BEGINS, INITIATING THE SCLEROSIS AND WHEN UNINTERVENED THE CONDITION PROGRESSES TO OTHER LEVELS, SUCH AS BULGING, HERNIATION, PROLAPSE AND OSTEOPHYTE FORMATION ETC.

TREATMENT PRINCIPLE

THE AIM OF THE TREATMENT IS TO REDUCE THE DRYNESS AND BRING BACK THE SNEHA GUNA, ELASTICITY AND TO REHYDRATE THE DISC , REMOVING THE OSTEOPHYTES, OR THE MALA ROOPA KAPHA.
IN SIMPLE TERMS , VATA HARAM AND KAPHA HARAM IN INITIAL STAGES AND BRMHANAM IN LATER STAGES TO NOURISH THE DISC.
ITS IMPORTANT TO MAINTAIN AGNI, IN THE PROCESS OF VATA HARAM , KAPHAM SHOULD NOT BE VITIATED. PROPER VATHA ANULOMANAM HAS TO BE ENSURED FOR EFFECTIVE RESULT.

MANAGEMENT

AUSHADAM- MEDICINAL MANAGEMENT
STHANIKA CHIKITSA- LOCAL MEASURES
1.ABHYANGAM-MASSAGE
2.KATI VASTHI- SNEHANAM
3. PATRA POTALI- SWEDANAM

PANCHA KARMA PROCEDURES

1.SNEHA VASTI
2.KASHAYA VASTHI
DIET AND YOGA ASANAS, PHYSICAL THERAPY, LIFE STYLE MODIFICATIONS.

AUSHADHAM- MEDICINES

MAHAYOGA RAJA GUGGULU
LAKSHADI GUGGULU
ABHA GUGGULU
YOGA RAJA GUGGULU
TRAYODASANGA GUGGULU
MAHA RASNADHI KASHAYAM
RASNA SAPTHAKAM KASHAYAM
RASNA ERANDADI KASHAYAM
RASNADI KASHAYAM
DHANWANTHARAM KASHAYAM
ASHTA VARGAM KASHAYAM
VIDARYADI KASHAYAM
BALA ARISHTAM
ASHWA GANDHARISHTAM
VATA GAJANKUSA RASA
VAYU GULIKA
LASHUNA KSHEERA
PRAVALA PISHTI
KSHEERABALA 101
DHANWANTHARAM 101
GANDHA THAILAM 

STHANIKA CHIKITSA

ABHYANGA
USUALLY CARRIED OUT AFTER KATI VASTI PROCEDURE, CAN ALSO BE DONE SEPARATELY TOO.
SPECIAL TYPE OF SPINAL MASSAGE HAS TO BE DONE WITH SPECIAL EMPHASIS ON THE LOWER BACK.
ZIG ZAG STROKES, PARALLEL STROKES AND OTHER SPECIAL SPINAL STROKES WITH PROPER PRESSURE( TOO MUCH OF PRESSURE IS HARMFUL!) FOR A PERIOD OF 25 TO 30 MINUTES 

OILS USED

SAHACHARADI THAILAM
KARPASA ASTHYADI
BALA THAILAM
DHANWANTHARAM
NARAYANA
MAHA MASHA THAILAM
KOTTANCHUKKADI
KSHEERA BALA
KARPURADI
GANDHA THAILAM
KATI VASTHI 

REQUIREMENTS

MASHA PISHTA ( BLACK GRAM FLOUR)
MEDICATED THAILA
COTTON, VESSELS, AND OIL HEATING ACCESSORIES
DHARA TABLE.
PROCEDURE

PATIENT IS MADE TO LIE IN PRONE POSITION.
PISHTA OF MASHA IS MADE IN TO PASTE AND BUILT LIKE A WALL AROUND LUMBO SACRAL AREA.
OIL IS HEATED AND POURED SLOWLY INSIDE THE BOUNDARY WITH THE HELP OF COTTON.
WHEN OIL BECOMES COOL IT IS REPLACED WITH WARM OIL.
CONTINUED FOR A PERIOD OF TIME. APPROX- 30 TO 50 MINS, FOR 7 DAYS OR 14 DAYS.
AFTER THE DURATION , THE OIL IS DRAINED AND FLOUR IS REMOVED
ABHYANGAM OF THE BACK IS GIVEN USING SAME OIL.
ALWAYS SNEHANA MUST BE FOLLOWED WITH SWEDANA PROCEDURE

PATRA POTALI OR ELA KIZHI

A TYPE OF PINDA SWEDAM. WHICH COMES UNDER USHMA SWEDA.

MATERIALS REQUIRED

LEAVES OF VATA HARA LIKE ERANDA ,ARKA , CHINCHA,NIRGUNDI, SHIGRU, KARANJA DHATURA VATHAGNI SINDUVARA -500 gm
CHOORNA OF SATAHVA AND METHIKA-25gm EACH
SAINDHAVA-15gm
LEMON -4 NOS
NIMBA OR SAINDHAVA THAILA OR ERANDA THAILA (REQD QTY)
CLOTH
TWINE TOWEL. VESSEL, FRYING PAN, SPOON, STOVE
RASNADI CHOORNAM
MEDICATED OIL 

PATARA KIZHI PROCEDURE

ALL THE LEAVES ARE CUT IN TO SMALL PIECES, AND SLICES OF LEMON, CHURNAS, SAINDHAVA ARE ADDED AND FRIED IN THE CASTOR OR NEEM OR COCONUT OIL , TILL IT BECOMES ROASTED RED.
THEN THEY ARE MADE IN TO POTALI(USUALLY 4 IN NO)
AFTER ABHYANGA, THE POTALI IS APPLIED OVER THE BODY BY DIPPING IT IN TO THE HEATED OIL.
CIRCULAR MOVEMENTS ARE DONE.
PROCEDURE DONE FOR A PERIOD OF 25-45 MINS

VASTI PRAYOGAM

SNEHA VASTI
MATRA VASTI- MINIMUM DOSE OF SNEHA VASTI ( APP 60-75 ML)
ANUVASANA VASTI.(APP 150 ML)
SNEHA VASTI(250-300 ML)
KSHEERA VASTI CAN BE ADVOCATED.
KARMA VASTI, KALA VASTI, YOGA VASTI- 30, 15 , 8 DAYS OF VASTI ALTERNATELY KASHAYA AND SNEHA VASTHI. KALA VASTI IS IN PRACTICE. 

OIL USED FOR SNEHA VASTI

TILA TAILAM
GUGGULU TIKTAKA GHRTHAM
MAHANARAYANA TAILAM
MAHAMASHADI TAILAM
SUDDHA BALATAILAM
KSHEERABALA
SATAHVADI TAILAM
SUKUMARA GHRTAM
LAKSHADI TAILAM
SAHACHARADI TAILAM
DHANWANTHARAM
GANDHARVA HASTADI
KASHAYA VASTI
DHANWANTHARAM
GANDHARVA HASTADI
SAHACHARADI
ERANDA MOOLA
ASTHAPANA GANA
DASAMOOLA
SATAHVADI

AASYAPAAKAM and its Treatment

Stomatitis is an inflammation of the mucous lining of any of the parts of the mouth, including the cheeks, gums, tongue, lips, and roof or floor of the mouth. The word "stomatitis" literally means "inflammation of the mouth." This inflammation can be caused by conditions in the mouth itself, such as poor oral hygiene, poorly fitted dentures, mouth burns from hot food or drinks, or by conditions that affect the entire body, such as medications, allergic reactions, or infections.

Stomatitis is usually a painful condition, with redness, swelling, bleeding,or bad breath. Stomatitis affects all age groups, from the infant to the elderly.

A number of factors can cause stomatitis. Poorly fitted oral appliances, cheek biting, or jagged teeth can irritate the mouth. Chronic breathing through the mouth becuase of clogged nasal passages can dry the mouth, which can leadto irritation. 

Diseases such as cold sores, gonorrhea, measles, AIDS, and lack of vitamin C can cause stomatitis.

Canker sores are a specific type of stomatitis that causes shallow, painful ulcers usually located on the lips, cheeks, gums, or roof or floor of the mouth. These ulcers can range from pinpoint size to up to an inch or more. Though the cause of canker sores is unknown, nutritional deficiencies (especially vitamin B₁₂, folate, or iron) is suspected.

Generalized stomatitis can be caused by too much alcohol, spices, hot food, or tobacco products. Sensitivity to mouthwashes, toothpastes, and lipstick canirritate the lining of the mouth. Exposure to heavy metals, such as mercury,lead, or bismuth can cause stomatitis. 

Thrush (a type of fungal infection) is also a type of stomatitis.

It can be hard to diagnose stomatitis. A doctor will conduct a physical examination to evaluate the oral lesions and other skin problems. Blood tests or scrapings of the lining of the mouth may be evaluated in a culture or under amicroscope to identify any infections.

Treatments of AASYAPAAKAM

1) Triphala Choorna- for Gargling (Act as disinfectant)

2) Arimedadi tailam- for mouth wash (Will regain the strength if the gum)

3) Anuthailam- for nasya

4) Laxation or Purgation-to remove the indigested bowel (AMAM)

5) Appetizers like Ashtachoornam, Vaiswanara choornam, etc
6) Kashaya like Gandharva Hasthadi, Punarnavadi, Manjishtadi, etc(Ama pachana +Vathanulomana)

Pancha maha bhoota theory

These five elements are:

or Akasha 
Air or Vayu 
Fire or Tejas 
Water or Apa 
Earth or Prithvi

Likewise other elements too were intended by the ancient vaidyas (physicians) to communicate the essential universal principle inherent in a particular element. By fire we mean the universal force in nature that produces heat and radiates light; it is our passion to pursue despite obstacles and delays; it is what burns away the cloak of ignorance (avidya) and allows the Truth to shine with brilliance. Fire removes doubt from the mother-substance of human heart and replaces it with joy. Air is that transparent, rarefied, kinetic force which sets the universe in motion; it moves the blood through the vessels, wastes from the body, thoughts through the mind; it moves the birds to warmer climates in winter, it moves the planets around their suns. Space is the subtlest of all elements which is everywhere and touches everything; in the mind it is the vessel which receives all impressions, in the heart space accepts love; space is receptivity and non-resistance to what is true.

Within a single living cell the earth element predominates by giving structure to the cell. The water element is present in the cytoplasm or the liquid within the cell membrane. The fire element regulates the metabolic processes regulating the cell. While the air element predominates the gases therein. The space occupied by the cell denoting the last of the elements.

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PANCHA VATHA

Vatha

Gunas:
According to Vagbhata the similar features (Samana gunas) of vatha are Rooksha, Lakhu, Seetha, Khara, Sookshma and Chala.

Sthaanam of vatha:
· Pakwasaya( visesha sthaanam)
· Kadee
· Sakthi
· Srotram
· AsthiSprsanendriyam

Samavastha
Utsaha
Uchvasa
Niswasa
Cheshta
Vega pravarthanam
Dhadunam samyak gatya

Increased
Karsya
Karshnya
Ushnakamitwa
Kampa
Anaha
Sakrut graham
Bala bramsa
Nidra bramsa
Indriya bramsa
Pralapa
Bhrama
Deenatha

Decreased
Anga sadam
Alpa bhashitham
Hitham
Samjna moham
Agni sadanam
Prasekam
Alasyam
Gauravam
Swaitya
Saitya
Sladhangatwam
Swasa
Kasa
Athi nidratha

Vitiates in normal:
*At old age
*Late night
*At the end of food

Seasonal changes:
Chayam - Greeshmam
Prakopam - Varsham
Samam - Sarath

Types of vatha and its functions(According to Vagbhata):

1 Name of vatha Prana vatha
Sthanam Moordha
Place of moving

. Uras

. Kanda
Function

· Budhi, hridaya, indriya, chitha-drik
· Steevanam
· Kshavadhu
· Udgara
· NiswasamAnna pravesakrit

2 Name of vatha Udana vatha
Sthanam Uras
Places of moving

· Nasa
· Nabhi
· Galan

Functions
· Vak
· Pravruthi
· Praytnam
· Urjam
· Bala
· Varna
· Smruthi kriya

3 Name of vatha Vyana vatha
Place of vatha Hridayam
Place of moving

· Kritsna dehachari

Functions
· Maha java:
· Gathi
· Avkshepana
· Ulkshepana
· Nimesha
· Unmesha
· Sareearja kriya

4 Name of vatha Samana vatha
place of vatha Agni sameepastha
Place of moving

· Koshte charanam

Functions
· Anna gruhanam
· Anna pachanam
· Anna vivechana

5 Name of vatha Apana vatha
Place of vatha Upanam
Places of moving

· Sroni
· Vasthi
· Medra
· Uru

Functions
· Sukra nishkramanam
· Arthava nishkramanam
· Sakrut nishkramanam
· Mootra nishkramanam
· garbha nishkramanam

· “Pitham pangu kapham pangu pangavo mala dhathavaha
vayuna yatra neeyanthe tatra gachanthi meghavat”

· “Tatra rooksho laghu seethe khara sookshma chalo anila:”
· “tam chala: ulsahochwasa nisawasa cheshta vega pravarthanai:
samyak gatya cha dhadoonam akshanam padavena cha
anugrahanathi
· “………vridhasthu kuruthe∫nila:
karsya karshnya ushnakamitwa kampa∫∫naha sakrut graham
bala nidrendriyabramsa pralapa bhrama dheenatha
· “lingam ksheenenile∫ngasya sado∫lpam bhashide hitham
samjna mohasthada sleshma vridhyukthamaya sambhava:
· “Vayo: ratri bhukthanam te antha madyadika: smrutha”
· “Chaya prakopa prasama vayorgreeshmadishu trishu
varshadishu cha pithasya sleshmana sisiradishu”