ejpmr, 2020,7(8), 374-377 SJIF Impact Factor 6.222 Review Article Hemalata. EUROPEAN JOURNAL European OF PHARMACEUTICAL Journal of Pharmaceutical and Medical Research AND MEDICAL RESEARCH ISSN 2394-3211

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REVIEW ON LOCAL TREATMENT IN GYNAECOLOGY

Dr. Hemalata R. Jalgaonkar*

M.S. PhD (Presutitantra and Strirog), H.O.D. (Prasutitantra and Strirog Dept.), Ashtang Ayurved Mahavidyalaya, Pune.

*Corresponding Author: Dr. Hemalata R. Jalgaonkar M.S. PhD (Presutitantra and Strirog), H.O.D. (Prasutitantra and Strirog Dept.), Ashtang Ayurved Mahavidyalaya, Pune.

Article Received on 13/06/2020 Article Revised on 03/07/2020 Article Accepted on 24/07/2020

ABSTRACT Healthy state of women is very much needed for the society, it growth and prosperity. one of the world‟s oldest system of health, gives a detail description of stree roga vyadhies. Womens always face very common gynecological problems like white discharge, itching at , foul smelling vaginal discharge, burning micturition

etc. In such problems Sthanik Chikitsa have given excellent results and these local therapies should be practiced for admirable results in the above mentioned gynecological problems. Here an attempt is made for the conceptual stu dy and analyzing the sthanikchikitsa in different diseases of Stree roga. All the classical references regarding chikitsa of the same were collected and analyzed.

KEYWORDS: Ayurveda, Stri Roga, Sthanikchikitsa.

INTRODUCTION Ganana Adhyaya of PurvaKhanda. Description available A woman undergoes various physical and physiological in Yogaratnakara Yonirogadhikara Adhyaya. In changes during her reproductive period i.e. from Bhaishajya Ratnavali mentioned about Hingawastaka menarche (onset of menstruation) to menopause Choorna in Agnimandhya Chikitsa prakarana Adhyaya. (Cessation of menstruation). Awareness and There are some Sthanik Chikitsa (Local Therapies) in management of these changes are necessary for a woman Ayurveda described by Ancient Acharyas that possess

to remain healthy. outstanding and satisfactory outcomes in the management of Yonivyapada. Sthanik Chikitsa includes Women perpetuate the human race by creating and Yonidhawanaor YoniParisheka (vaginal Douche), Yoni- mothering children. The health of the family, society and Pichu (tampoon soaked in medicated oil or liquid is culture that revolves around women depends to a large placed into the ), Uttar -Basti (Medicated oil or decoction is pushed into the uterine cavity through degree on women health. Ayurveda has explained Woman health and discussed different gynecological vagina), Yoni Dhupana (Fumigation of vagina with disorders under the common heading of Yonivyapada. medicated smoke), Yoni-Varti (Insertion of medicated pessary into the vagina), YoniPurana (vaginal The word yoni is derived from the root „Yu‟ with „Nit‟ packing),Yoni-Lepana (vaginal painting), etc. pratyaya. Yoni means the womb, , vulva, vagina, female organs of generation. The word „vyapad‟ derived OBJECTIVES from the root word „vi + vyap‟ with „lyut‟ pratyaya. 1. To study the litrerary view of Sthanik Chikitsa from Vyapad‟ means injure or make worse or destroy. various Ayurvedic texts. 2. To study the probable mode of action of Sthanik describes Nidana, Lakshana, Samprapti, Chikitsa. and Chikitsa of twenty Yonivyapad in Yonivyapad Chikistitama Adhyaya of Chikitsa Sthana. Description is MATERIALS AND METHODS found in in Yonivyapad Pratishedha Sthanikchikitsa in various stree roga in classical texts Adhyaya of Uttaratantra. Astanga Hridaya and Astanga described as follows:- Sangraha describes Nidana, Purvaroopa, Lakshana, Samprapti of twenty Yonivyapad in Guhyaroga A) YONI PICHU (Tampoons) Vignaneeya Adhyaya of Uttaratantra. Description is 1. Tampoon soaked with oil prepared with juice of rat available in Madhava Nidana Yonivyapad meat. ( Yonikanda) Nidanamadhyaya. Description is also found in 2. Tampoon soaked with Guduchyadi tail. (Vataja Bhavaprakasha Madyamkhanda Yoni rogadhikara yonivyapada) Adhyaya of Chikitsa Sthana. Sharangadhara Samhita has 3. Tampoon soaked with kwath of dasangri and mentions number of Yonivyapad as twenty in Roga srimada. (Sannipataja yonivyapada)

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4. Tampoon soaked with Tila tail. (Vataja yonivyapada) Yoni Varti helps to clear the vagina and also provides the 5. Tampoon soaked with oil medicated with decoction opportunity to re-create the optimum vaginal health. of sallaki, jingini, jambu, dhava and panchvalkal. (Acharna, Paripluta, upapluta , Vamini and vipluta C) YONI DHAWANA OR YONI PARISHEKA yonivyapada) (Vaginal Douche) 6. Tampoon soaked with Dhatkyadi Tail. (vipluta and 1. With decoction of Aragvadhadi group of drug. (Yoni upapluta yonivyapada) daurgndhya, yoni kleda) 7. Tampoon soaked with Dashmoolkwath or ghrita. 2. With decoction of karira, dhava, arka, venu, nimbi, (Vataja yonivyapada) jambu, jingini, and sukta. (Yoni shtrava) 8. Tampoon soaked with Ghrita. (Pittaja yonivyapada) 3. With decoction of triphala. (Yoni shtrava) 9. Tampoon soaked with chandanakwath. (Pittaja 4. With decoction of guduchi, triphala, and danti. yonivyapada, Yonidaha) (Yoni kandu) 10. Tampoon soaked with oil prepared with Ushira. 5. with decoction of Rajavraksadi group of drugs. (Pittaja yonivyapada) (Yoni paichhilya) 11. Tampoon soaked with suramanda. 6. With decoction of Tuvaraka. (Yoni daurgndhya) (Kaphajayoniroga , Yoni kandu) 7. With decoction of sarala and mudgaparni. 12. Tampoon soaked with Udambar or Triphalakwath. (Vatajaartvadushti) (Kaphajayoniroga) 8. With decoction of Gairika and nimbi. 13. Tampoon soaked with Udambaradi Tail. (Vivrita (Pittjaartvadushti) yoni) 9. With decoction of lodhra and trikatu. 14. Tampoon soaked with Phalaghrita or (Kaphajaartavadushti) changeryadighrita. (Prasansini yoni) 10. With decoction of (Kunapgandhiartavadushti) 15. Tampoon soaked with oil prepared with MadhurvargaAushadha (in 9th month of pregnancy) MODE OF ACTION OF YONI YONI DHAWANA 16. Tampoon soaked with JatyadiTaila or ghrita. The Yoni Dhavan (Prakshalana) is exceptionally unique (Mahayoni) and it's a solution for gynecology grumblings. It's procedure of cleaning to vaginal zone and siddha tailas MODE OF ACTION OF YONI PICHU:- Pichu helps are utilizing for such a movement. This method is the medicine to remain at the site for a longer period for recommended for gynecological disarranges, aggravation, better action. The mode of action depends on the disintegrations, barrenness. It gives quality to vaginal medicine used, as different medicines have different muscles. This is a general purifying measure of genital mode of action. The sesame oil base is most commonly organs to maintain a strategic distance from parasitic or used and it has high antiseptic and antibacterial property. yeast diseases. It's a sanitization procedure which has The pichu used during pregnancy and labour helps to many advantages to women. Genital organs of women soften the vaginal canal enaqbling easy delivery and easy get spotless and crisp after Yoni dhawan and it forestalls expulsion of placenta. parasitic and yeast diseases.

B) YONI VARTI (Pessary) D) YONI DHUPANA (Fumigation of vagina with 1. Pessary prepared with bile of hog. (Kaphaja medicatedsmoke) yonivyapada) 1. Fumigation with Haridra and Brahti. (yoni kadu) 2. Pessary prepared with powdered yava (barley) and 2. Fumigation with Sarala, guggalu, yava mixed with Masa (a type of bean). (Kaphaja yonivyapada) ghrita (Swetapradara) 3. Pessary prepared with pippali, maricha, masa, 3. Fumigation with sarpanirmok and katualabu. shatahwa, kusttha, and rock salt. (Kaphaja (Garbhsanga) yonivyapada) 4. Fumigation with bhojapatra, kakamachi, katualabu, 4. Pessary prepared with bile of cow or fish or kinva kritavedhana, sarshpa. (Aparasanga) mixed with honey. (vipluta yonivyapada) 5. Fumigation with kustha, guggalu, agara mixed with 5. Pessary prepared with kustha, pippali, tip of twig of ghrita. (Sutikaparicharya) arka, rock salt and urine of goat. (Karnini yonivyapada) MODE OF ACTION OF YONI DHUPANA 6. Pessary prepared with Kasis, triphala, sphatika, Medicines which are used in the form of smoke by samnga, lajjalu, amrasthi, dhatakipushpa. (Yoni burning of it is called as Dhupana. Fumigation is done on paichhilya) wounds, a part of the body or on the whole body 7. Pessary prepared with Ikshvaku, danti, madanphala, depending on the need. Fumigation is the exposure till kinva, yavashooka, and snuhiksheera. (Anartava) the action of smoke or of fumes of any kind as a means of disinfection or eradication. It is derived from the Latin MODE OF ACTION OF YONI YONI VARTI term “Fumus” which means smoke and “ago” means to Varti is prolonged and long lasting. Varti can be used drive away. The fumigation carried out using fine effectively in infections and delaying there recurrences. powder of selected dry drugs with the intention of nirjatukarana (disinfection) is called as Dhupana.

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Dhupana is a process explained from time immemorial MODE OF ACTION OF YONI UTTAR BASTI from the period of Samhitas. It is widely used not just in Uttar Basti removes the srotosangha and corrects the Ayurveda Pharmaceutics for disinfecting the artavagni which regulates the menstrual cycle, thus Bheshajagara (Drug store) to prevent degradation of raw resulting in ovulation. Ovaries contain receptors which drugs, but also as preprocessing in Ayaskruti, various receive hormones secreted by hypothalamus and kalpanas like Sandhana, etc. Different Dhupakalpas are pituitary gland. The drug stimulates these receptors, so explained in treatises that are used in various ailments for that proper ovulation occurs in each cycle. UttarBastiis curative purpose and also Dhupas are employed for an ideal local treatment in tubal block and can be prevention of diseases. Yoni dhupana is also used for adopted for all sorts of problems of infertility as well as local disinfection of genital organs. reproductive tract disorder. In tubal blockage the drug is reaching in bulk to the site of pathology. Hence Uttar E) YONI LEPANA (vaginal painting) Basti relieves tubal block by lysis of adhesions and 1. With powder of palashbeeja and udambarphala relieves obstruction. In cervical factor, drug administered mixed with tilataila and honey. (Vivrita yoni) locally in the cervix and absorbed by cervical epithelium 2. With powder of makandaphala mixed with honey due to sukshma property of drug. The lipid soluble drug and kapura. (Vivrita yoni) is passively diffused across the membrane in the 3. With powder of tuttha, gairika, lodhra, ela, rasanjana, direction of its concentration gradient. The rate of harenu, pushpakasis, salt mixed with honey. (Yoni transport is proportional to lipid: water partition Arsha) coefficient of the drug. The more lipid soluble, higher is 4. With powder of burnt broken earthan pots and the concentration and quicker diffusion. In this way triphala mixed with ghrita. (Yoni Arsha) altered cervical pH can be corrected by Uttar Basti Uttar Basti helps in endometrial conditions by improving MODE OF ACTION OF YONI LEPANA thickness of endometrium, improves the quality of endo- In lepana the drug penetration is higher on the vagina, metrium, helps in curing endometriosis, absorption is the efficacy of lepana relates to both its inherent potency very fast gives quicker result. and the ability of the drug to penetrate the skin, muscles and mucosa. DISCUSSION The vagina is a potential space that connects the lower F) YONI PURANA (vaginal packing) portion of the uterus (cervix) to the outside environment. 1. With fat of bear, crab or cock medicated with It has been explained under Bahirkarmendriya and is one Madhura group of drugs. (Mahayoni) of the BahyaSrotas in women. Drug transport across the 2. With Vesawara (minced meat or oleo mixed with vaginal membrane may occur by a number of different drug). (Prasansini yoni) mechanisms: 3. With khadir, pathya, jatiphala, nimba, puga, mixed a) Diffusion through the cell due to a concentration with soup of mudga gradient (transcellular route), b) Vesicular or receptor-mediated transport mechanism, MODE OF ACTION OF YONI PURANA or Yonipuran involves filling of vaginal cavity using c) Diffusion between cells through the tight junctions powders, pastes & medicated oils. It offers local (intercellular route) therapeutic action. This therapy employed when large amount of drug needs for longer duration of time to In some cases, drugs given by the intra vaginal route achieve expected results. have a higher bioavailability compared to the oral route as it bypasses the liver. The vaginal wall is very well G) YONI UTTAR BASTI (Medicated oil or decoction suited for the absorption of drugs for systemic use, since is pushed into the uterine cavity through vagina) it contains a vast network of blood vessels. Moreover the 1. Guduchyadi Tail basti yonivyapada) anatomically backward position of the vagina may help 2. Madhukksheersidhhabasti. (Vataja (Pittaja in self containing of the drug thereby holding it in situ yonivyapada) for a longer duration. 3. Basti with the oil medicated with jivaniya group of drugs. (Kaphavataja yonivyapada) CONCLUSION 4. Traivratasnehabasti. (Udavarta yonivyapada) Thus we conclude that the holistic approach (sthanik 5. Basti with the oil medicated with decoction of chikitsa) of ayurvedic system of medicine gives dashmool and trivrta. (Udavarta yonivyapada) completely relief to the patients from yoni rogas. Sthanik 6. Basti with oil medicated with jivaniya group of drug. chikitsa in stree rog and prasutitantra are very (Shushka yoni, Acharanayoni, Aticharana, karnini encouraging. Medicines used in the above case are yonivyapada) affordable, effective and easily available. Each Sthanik 7. Basti with the ghrita medicated with decoction of Chikitsa holds its own importance and shows marvelous kasmari and kutaja. (Raktayoni) results when applied with proper indications, strict 8. Basti with shirishtaila or balataila. (Yonishoola) aseptic precautions and extreme carefulness.

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