Case presentation: 'Uterine-fibroid' by Vaidya Pawan Madaan

This is a case that proves that components/basic consideration of Samprapti & Principles of management described by Acharya Charak are applicable in every branch of Ashtanga-ayurveda whether it is Shalya, Shalakya or Stri-roga-prasuti-tanatra etc.

Vaidya Pawan Madaanji cured this case effectively with regulating the Apan-vayu & concerned srotasas in broader perspective by applying the classical consideration of basic samprapti and its 'Vighatana'.

Dr. Surendra A. Soni 

CLINICAL CASE PRESENTATION –

UTERINE FIBROID

A CASE OF

-52 year female

-presented with USG report showing uterine fibroid of the size of 15 x 12 mm in the anterior uterine wall

with

-complaints of headache on and off

-generalized pain in lower limbs

-pain in the knees - on and off

-generalized weakness in the body

-complaint of breathlessness sometimes or feeling of difficulty taking breath

PAST HISTORY –

-in the last 10-15 years she was having increased frequency of headache which was non-specific, not associated with nausea or vomiting, usually due to anxiety

-she is a known hypertensive and taking allopathic medicines amlodipine + atenolol for this daily  x  10-12 years

-also taking some multivitamins on and off

-no any other specific history of any other illness or treatment being taken in the last 15-20 years

MENSTRUAL HISTORY –

-during the reproductive years no any menstrual disturbance regarding the regularity, flow or pain during menstrual cycles

ROGI PAREEKSHAA –

ANNAVAHA SROTAS –

-KSHUDHAA – sometimes ok sometimes less

-KANTHADAAHA, URODAAHA – on and off

-HRILAAS / VAMI – no

-UDARA SHOOL – no

-distended but lax abdomen, bowel sounds heard clearly, no organomegaly, no any scar, no spider naevi, no caput medullaris, no any tenderness abdominal either on superficial or deep palpation

PUREESHAVAHA SROTAS –

-VIBANDHA - ++

-MALA PRAVRITTI – usually daily but hard stools, sometimes missed for one day

SHUKRAVAHA SROTAS –

-menstrual periods are still coming but irregular with irregular bleeding, sometimes with clots, sometimes little increased bleeding, sometimes normal bleeding

-no any tenderness in the pelvic area either with superficial or with deep palpation

PRANAVAHA SROTAS –

-no DNS, no any increased secretions in the nose

-throat – normal looking, no any increase in tonsils

-trachea in normal position on palpation

-chest – normal vesicular breathing, no any wheezing, ronchi, crepiitations, rub or stridor

-normal shaped chest, normal respiratory rate

-difficulty in breathing on and off was found to be associated with stress and anxiety

ASTHI SANDHI VAHA SROTAS –

-tenderness on tibial shaft and wrist joints with mild pressure

-knee joints – mild genu varum - thus disturbed gait, mild swelling around knees, good crepitations heard in the knee joints

-generally joints looking week and KRISHA

-can`t stand for long periods, feels pain in lower legs after standing for about 10 – 15 minutes

-can walk only for about 500 metres to1 km at a stretch

ASHTAVIDHA PAREEKSHAA –

JIHWAA – AAMYUKTA

NAKHA – ROOKSHA

MALA – SHUSHKA

MUTRA – normal, TAIL BINDU PAREEKSHA not done

NETRA – sunken eyes without luster, no pallor, no ictrous, no KF rings

NAADI – MANDA AND VEGAWATI

SHABDA – sharp voice

SPARSHA and AAKRITI – KHARA SPARSHA, medium built body

GENERAL PARAMETERS –

WEIGHT – 79 KG

BP – 110/70

PULSE – 80 per min

SAMPRAAPTI –

DOSHA – VAATA PRADHAANA TRIDHOSHA

DUSHYA – RAKTA, ASTHI, MAANSA

ADHISHTHAANA – SHUKRAVAHA SROTAS, uterus

SROTAS – RASAVAHA SROTAS, SHUKRAVAHA SROTAS

SROTODUSHTI – SANGA

AGNI – VISHAMA

KOSHTHA - KRURA

NIDAANA –

RASA DUSHTI / AARTAVA VAHASROTO DUSHTI / ASTHIKSHYA

CHIKITSA TATVA – (LINE OF TREATMENT)

-RASA RAKTA PRASAADAKA

-ASTHI PAACHAKA / ASTHI POSHAKA

CHIKITSA VICHAAR –

The uterus, ovaries, fallopian tubes, breasts, their contents, secretions and connective tissues all belong to ARTAVA VAHA SROTAS, the channels carrying out female reproductive functions and the functions of ARTVA VAHA SROTAS are dependent on correctly functioning RASA DHAATU as well as RASA VAHA SROTAS.

The uterus has three main linings: innermost mucosal layer, middle muscular layer and a thicker outer wall.

When there is KAPHA DUSHTI as a result of RASA DUSHTI and other reasons, there could be manifestation of ARBUDA like fibroids in the uterus.

As ARTAVA VAHA SROTAS acts as one system, its components are all subject to fibrotic cellular changes, so if the uterus is removed and KAPHA accumulation remains unchecked, these KAPHA deposits tend to migrate to the remaining ARTAVA sites.

This KAPHA here is the DUSHTA MALA ROOPA KAPHA which basically takes its origin from the DOOSHITA RASA DHAATU so by focusing on the treatments of DOOSHITA RASA DHAATU, the treatment of uterine fibroids is achievable.

Within ARTAVA VAHA SROTAS, VAATA(Apaan) governs the functions of timing, communication and coordination with other psycho-biological cycles. PITTA governs the circulatory functions, and their functional interface with ARTAVA VAHA SROTAS. Each lunar cycle between menarche and menopause, rich deposits of blood and mucous accumulate along the inner surface of the uterus in preparation for possible conception. KAPHA governs the mucosal properties of thickness, viscosity and adherence affecting these three linings when uterine fibroid form.

PITTA when causes the DOOSHANA of the RAKTA which is a factor in the normal menstrual functions and when it is associated with the DOOSHITA RASA DHAATU, can lead to formation of abnormal growths in the uterus.

CHIKITSAA GIVEN --

28-5-2015

HARAD PAAKA

5 GM at night

Tab NITYANAND RASA

2-2

Tab KAANCHANAARA GUGGULU

2-2

Tab TAPAYAADI LOH

1-1

ASTHIMAJJA POSHAKA COMPOUND – (SELF MADE)

(A combination of powders of LAJJAWANTI, SAFED MOOSLI AND BEEJDANA)

1-2 GM BD twice a day

This treatment continued for almost 3 months with other medicines whenever needed for minor problems.

23-9-2015

USG – size of the fibroids 10 x 10 mm

-       Bilateral renal calculi around 3 mm size

The HARAD PAAKA was omitted now and the other same treatment was given for 3 more months till January 2016, after this patient discontinued the treatment

20-4-2016

She again presented with added complaints of generalized pains in lower limbs.

Again started with the following treatment –

Tab Nityanand Rasa

2-2

Tab Kanchnaar Guggulu

2-2

ASTHIPOSHAKA COMPOUND as described above.

With added

Tab Shigru

1-1

This treatment was continued for 3 more months and then she stopped the treatment.

27-9-16

She came with the USG report showing NO FIBROIDS in the uterus.

The relevant PATHYA APATHYA was suggested time to time as per the requirement and was followed by the patient.

She was a bit anxious patient so time to time counseling sessions were given as per the need.

VAIDYA PAWAN MADAAN

CONSULTANT AYURVEDA PHYSICIAN

AMRIT AYURVEDA CLINIC

ADARSH NAGAR

JALANDHAR CITY, PUNJAB

CURRENTLY

Senior Ayurveda Physician

Jiva Ayurveda Clinic

Sector 21-B

Faridabad.

drmadaan@gmail.com

www.ayurvedhelpline.com