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Pandhare et. al. : The Healer Journal January 2021; 2(1)

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Ayurveda Management of Urdhwaga Amlapitta With - A Case Report Amarjit Pandhare1, Anjali Deshpande

1PG scholar 2 Head of Department, Department of ayachikitsa, BSDT’S Ayurved Mahavidyalaya , Wagholi, Pune. ABSTRACT:

Background: The Amlapitta is one of the common disease of Annavaha Srotaswhich bears the direct impact of the dietic errors that a person indulges. Amlapitta Vyadhi is complex of symptoms correlated with acid peptic disease/gastritis/hyperacidity described in modern medicine science.Many new drugs are available like antacids, proton pump inhibiters,H2 blockers, in modern medicine system but all they provides symptomatic relief instead of complete cure of disease and they also have Amlapitta was treated withVamana Karma(Therapeutic emesis), as indicated in Kashyap . A 53 years old female patient presented with complaints of Chardi(Vomiting), Hritkanthadaha(burning sensation in chest and throat), Tikta-Amlodgara(Acid eruction with bitter and sour taste and Hrullas( Nausea) since 1 year. Dadimashtak Churna for Deepan, Pachana.Panchatikta ghrit for internal oleation was used .External oleation and sudation was done with Nirgundi oil. Vamana dravyamadanphal phant while Yashtimadhu Kwatha was used for Aakanthapan as Vamanopaga dravya. On the follow up day it was seen that patient got complete relief from Chardi, Hritkanthadaha Hrullas and Tikta -Amlodgara. Thus Vamana Karma Urdhwaga Amlapitta.

Keywords: Urdhwaga Amlapitta, Vamana karma, Hyperacidity.

INTRODUCTION: Amlapitta is a disease of Annavaha Srotas(Gastrointestinal ,eating junk food and stressful behavioural pattern of people tract disorder).It is caused due to improper digestion which in current era.In present population it is very common disease occurred due to changing lifestyle, irregular meals timing with or without severity.The word Amlapitta is comprises of

Access the article online Dr. Amarjit Pandhare Quick Responde Code PG scholar Department Of Kayachikitsa, BSDT’S Ayurved www.thehealerjournal.org Mahavidyalaya , Wagholi, Pune.

Submitted: 18.11.2020 Received: 20.01.2021 DOI: 10.51649/healer.41 Revised: 21.01.2021 Accepted: 26.01.2021

www.thehealerjournal.org l The healer l Volume 02 l Issue 01 l January 2021141 Pandhare et. al. : The Healer Journal January 2021; 2(1) two words,Amla (Sour)and Pitta (Gastric juice) The disease Investigations: Aacharya Kashyap.It has also been 1.Hemogram--Hb-15gm/dl;WBC-7700/cmm;RBC- mentioned in Yogratnakara,Chakradatta,Bhavprakash 4.94mil/cmm;plt-2,29000 2.ESR-10mm; 3.BSL(f)-70mg/dl and Madhavnidan.In Madhavnidan Special entity ; 4.Urine(R)-pus cells-1-2 4.H-pylori test- not performed for is mentioned for Amlapitta ,but was not described this patient. separately in Charaka, Vagbhataand Sushruta but has been referred at certain places.Agnimandya (loss of apetite) is Materials: Table No.1-constituent for Vamana Karma. caused due to Viruddha Aahar (Incompatible diet),Aam Sr.No. Drug Name Treatment (to consume food even though the previous food is not digested),Adhyashana(Food after meals),Snigdha Panchatikta Ghrit Snehapana (oily), (Heavy meal) according to 2. Nirgundi taila Sarvanga Snehan Kashyap3.According to Madhavkara increased Pitta(Gastric 3. Nirgundi Kwath Sarwanga Swedan juice)causes Amlapitta4. Agnimandya(loss of apetite) is 4. Madanphal Phant Vamankalpa root cause of all diseases according to Ayurveda5 .Two 5. Yashtimadhu Kwatha Vamanopaga types of the Amlapitta are described in Ayurvedic texts,i.e. 6. Yashtimadhu Kwatha Aakanthapan Urdhwaga and Adhoga Amlapitta. In Urdhwaga Amlapitta Shodhan chikitsa: Poorva Karma: vitiated Pitta and Kapha are the key factors causes whole 7 Pathological process.In Bhavprakash Deepan, Pachana-DadimashtakChurna 2gm twice a day suggested for Urdhwaga Amlapitta is Vamana6.In Allopathy it with warm water for 3days.Internal snehapana- Panchatikta 8 is correlated with acid peptic disorder/gastritis/hyperacidity. ghrita in increasing dosei.e.30,60,90ml for 3 days, early in The stomach normally secretes acid that is essential in the the morning at empty stomach daily was followed. Snehapana digestive process .Hyperacidity refers to a set of symptoms was stopped on third day as Samyak snighdha lakshnas were which is caused due to an imbalance between the acid seen. During this time period patient was advised secreting mechanism of stomach and proximal intestine and special code & conduct : 1. Aahara(diet)-drava,ushna, the protective mechanisms that ensure their safety .When anabhishyandi,warm water and avoid Snigdha(oily) there is excess production of acid in the stomach ,it results Heavy() (routine in the condition known as Hyperacidity. activity): ,avoid day sleep(diwaswapa),not suppress natural urges,avoiding AIMS AND OBJECTIVES: To evaluate the role of heavy exercise ,speaking loud,anger,depression,too much Vamana karma in the management Of Urdhwaga Amlapitta. cold,hot and direct exposure to air. Kaphotkleshaka MATERIALS AND METHODS: A 53 years old female Aahar(curd,curd rice,banana with milk)was Advised to the patient approaching the Kayachikitsa OPD of BSDT’S patient on Vishramdin(when internal oleation not done) ayurved hospital and research centre, wagholi, pune, Sarvanga Snehana with Nirgundi oil, Sarvanga Swedana on 11/12/2018(opd no-2018/c-547) with signs with Nirgundi kwathwas performed. and symptomsof UrdhwagaAmlapitta as Chardi(vomiting) Pradhan Karma: after every meal daily,since one year. Persistent Hrit- Kanthadaha(Burning sensation in chest and throat) On the day of Vamana Patient was asked to pass natural throughout the day,Tikta amlodgara(Acid eruction with urges.Sarvanga snehan,swedan were done.Before Vamana bitter and sour taste,Hrullas(Nausea).Since one year she procedurepatient was examinedi.e.B.P., Pulse, R.R. etc. had history of all above symptoms. She had no any present Vamana -Madanphal Phanta,Vamanopagadravya illness. h/o-alcohol consumption since 15 years taking for Aakanthpan-Yashtimadhu Kwatha.Whole procedure spicy food and stressful work. Patient was admitted(ipd was examined as per said in ancient texts:Vaigiki- 0. no-2018/2855) in the same hospital for Vamana Karma. 05,Antiki-Pittanta ,Laingiki-Udarlaghavta,Prasanna On examination: Pulse: 80/min, B.P.: 124/78mmhg, Temp: atmendriya,Maniki:Total sevit(intake) dravya-5650ml,total 98.6F,RS,CVS,CNS:NAD,Jivha-sama. expelled was

142www.thehealerjournal.org l The healer l Volume 02 l Issue 01 l January 2021 Pandhare et. al. : The Healer Journal January 2021; 2(1) containing thick mucus along with much quantity of froth +++ 3 Severe hrullas with impact all and it was slimy and sticky.-Madhyam . Activity Assessment was done before treatment i.e. After Paschat Karma: Snehapana and before VamanaKarma(B.T.)After 3 hrs After Samyak Vamana Patient was kept on paschat karma of Vamana Karma(A.T.)and Finally on the 15th day of i.e. for 2-2 Vamana Karma(F.U.) Annakala(Peya,Vilepi) with complete rest. Observations and Results: The present case was managed After Patient was asked not to take with Vamana Karma and patient was asked for follow- up Amla, katu,lavana rasatmak Aahar ,spicy,oily,heavy food after 15days.On the 15th day after Vamana Chardi and Hrit- in diet.also advised to take regular time to time meal.Asked kanthadaha not to take Diwaswapa(Day sleep), Jagarana etc. was seen in the other symptoms-Hrullas andTiktaamlodgar.

Assessment Criteria: Signs and Symptoms B.T. A.T. F.U. Chardi 03 0 0 Subjective Parameters:Chardi,Hrit-Kanthadaha, Tikta- Hrit-Kanthadaha 03 0 0 Amlodgara, Hrullas. For all these symptoms following Tikta-Amlodgara 02 01 01 grades were applied: Hrulllas 02 01 01 1.Chardi: DISCUSSION: Grade Score Feature Urdhwaga Amlapitta is caused due to vitiation of Kapha 0 0 Absent and Pitta,This is an and in Vamana + 1 Frequency: 1-2times per week ++ 2 Frequency: 3-5 times per week karma,amashyayastha doshas are expelled out.As said by Yogratnakara “Poorvam tu vamanam karyam …”.Vamana +++ 3 Frequency: Daily Chardi shodhana karma for 2.Hrit-Kanthadaha: Urdhwaga Amlapitta.

Grade Score Feature To digest the Ama,to makes the Dosha Nirama and thereby 0 0 Absent to increase Deepana, Pachana is useful.Abhyantar + 1 Occassional Snehapana make the lina Dosha free from their Adherence.By ++ 2 Related to meals only the Snehana,Swedana Dosha gets liquify.To bring Dosha from +++ 3 Persistent throughout the day Shakha to Koshtha all these preparatory measures are necessary. 3.Tikta-Amlodgara: Vyavayi,Vikasi properties having Vamana Dravyas by virtue of

Grade Score Feature Veerya(Potency)circulate quickly into large and small capillaries 0 0 Absent of the body.Due to Ushnaguna Dosha started liquify in body.Malas + 1 Occassional symptoms gets detaches from Dhatus because of Vikasi Guna of dravya.Due ++ 2 Only at time of meals to Sukshma guna and Anupravana properties Malas or Doshas +++ 3 Persistent throughout day pass through smallest capillaries and Malrupi Kapha reaches toKoshtha( Stomach.)Pathology is corrected by eliminating 4.Hrullas: disease causing factor Kapha from its main site of accumulation Grade Score Feature by Vamana Therapy.Vamana cleanse the toxic material from body 0 0 Absent and restores the Agni (impaired metabolism)by acting at cellular + 1 Occaissionally interfering with level,thereby correcting acid secretion and Vamana Action12. In some social activity this case Before Vamana patient was having Chardi,Hrit-kanth ++ 2 Prolonged and troublesome hrullas adaha,Tiktaamlodgara,Hrullas as presenting complaints.After Vamana karma patient receieved .On follow up day.i.e.on 15th day after Vamana KarmaChardi and Hrit-

www.thehealerjournal.org l The healer l Volume 02 l Issue 01 l January 2021143 Pandhare et. al. : The Healer Journal January 2021; 2(1) kanthadaha 7. Bhaisajyaratnavali of Shri Govind Das edited by seen in other symptoms. Bhisagratna Shri Brahmashankar Mishra,Vidyotini commentary .The Kashi series 2nd CONCLUSION: Vamana Karma has substantial role edition ,;Chaukhambha Sanskrit Prakashana in treating Urdhwaga Amlapitta symptomatically and Chapter 08;2018,244p.

Urdhwaga Amlapitta in such a short time period . 8. Bhaisajyaratnavali of Shri Govind Das edited by Bhisagratna Shri Brahmashankar Mishra,Vidyotini ACKNOWLEDGEMENTS: Not Applicable Hindi commentary .The Kashi Sanskrit series 2nd CONFLICT OF INTEREST: Author declares that there is edition ,Varanasi;Chaukhambha Sanskrit Prakashana Chapter 54;2018,906p.

SOURCE OF SUPPORT: None 9. Shivprasad Sharma,editor. Ashtangsangraha of Vruddha Vagbhata,Sutrasthana , Snehavidhi ,2nd REFERENCES: edition , Chapter 25, Verse 36.Varanasi; Chaukhambha 1. Madhavkara Madhavnidana-Part2 Madhukosha Sanskrit comm By Shri VijayRakshit and Shri Kantha 10. Ganesh Krushna Garde,Sartha Vagbhata Ashtanga Dutta Amlapitta Adhyaya 21st edition.Published by Hridaya with the commentaries reprint edition 2011. Chaukhamba Sanskrit sansthana,Varanasi1993. sthana, Vamanavirechanavidhim,Chapter 2. Madhavkara Madhavnidana –Vidhyotini hindi comm. 18,verse 32. Varanasi;Chaukhambha Surbharati By Shri SudarshanShastri,AmlapittaAdhyaya21st Prakashan :2011,77p. edition Published by Chaukhambha ,Sanskrit 11. Ganesh Krushna Garde,Sartha Vagbhata Ashtanga sansthana,Varanasi 1993,page No.170-172 Hridaya with the commentaries reprint edition 2011. 3. Samhita revised by Vatsya withSanskrit Sutra sthana, Vamanavirechanavidhim, Chapter Introduction by Nepal Rajguru Pandit Hemraja Sharma 18,verse 30 Varanasi;Chaukhambha Surbharati with Vidhyotini Hindi commentary,Chaukhamba Prakashan :2011,77p.

12. Ganesh Krushna Garde,Sartha Vagbhata Ashtanga Edi.Reprint,2008; 335. Hridaya with the commentaries reprint edition 2011. 4. Madhavnidana with commentaries The Madhukosa Sutra sthana, Vamanavirechanavidhim, Chapter of Srivijayarakshita and srikanthadatta with 18,verse 60 Varanasi; Chaukhambha Surbharati The Vidhyotini Hindi Commentary edited by Prakashan :2011,79p. Prof.Yadunandana Upadhyaya,Chaukhambha How to cite this article: Prakashan ,Varanasi,Chapter 51 verse2-12,Edi. Reprint,2007:171-2. Pandhare A , Deshpande A, Management Of Urdhwaga Amlapitta With Vamana Karma - A Case 5. Ganesh Krushna Garde,Sartha Vagbhata Report, The Healer Journal, 2021;2(1):141-144. Ashtanga Hridaya with the commentaries reprint edition 2011.Nidana sthana Chapter 12,verse 1. Varanasi:Chaukhambha Surbharati Prakashan :2011,page 197

6. Bhavmishra Bhavprakasha.Edited by Bhisagratna Shri Brahmashankar Mishra Vidyotini Hindi commentary .The Kashi Sanskrit series 5th edition. Varanasi; Chaukhambha Sanskrit Prakashana Madhya Khanda ,Chapter 10,verse 13 ;1988,133p.

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