Case-presentation: Pittaja-twak-dushti by Vaidya Subhash Sharma

[10/24, 1:15 AM] Vd. Subhash Sharma Ji Delhi: 

*case presentation - 

नानात्मज पित्त विकार*

*.....त्वगदाहश्च त्वगदरणं च चर्मदलनं च रक्तकोष्ठश्च रक्तविस्फोटश्च .. रक्तमंडलानि...। 

च सू/20 

*वर्तमान में fast food culture, synthetic food, frozen food, preserved food, अम्ल, तीक्ष्ण और उष्णादि गुणों से युक्त भोजन इसका प्रधान कारण है। वैसे तो सभी रोग त्रिदोषज ही होते हैं पर दोष बाहुल्य के कारण उन्हे नाम दे दिया जाता है।*

*इस 12 वर्षीया female patient में चरकोक्त अनेक लक्षण मिले और हेतु आम दोष एवं पित्तकारक आहार ही मिला।*

*सम्प्राप्ति घटक बनाये गये...*

*दोष- पित्त,वात एवं कफानुबंध*

*दूष्य- रस (ज्वर प्रतीति, अंगमर्द,गौरवं, अश्रद्धा आदि) रक्त (रक्त मंडल, त्वग दाह , तृष्णाधिक्य, त्वागवदरण, रक्तकोठ, रक्त विस्फोट, तिक्तास्यता,चर्मदलन) मांस (त्वग्दुष्टि)।*

*स्रोतस - रस-रक्त वाही*

*स्रोतो दुष्टि- अति प्रवृत्ति, संग और विमार्ग गमन*

*उद्भव स्थान - आमाश्य*

*अधिष्ठान - यकृत प्लीहा*

*व्यक्त स्थान- त्वक*

*चिकित्सा सूत्र - सर्व प्रथम आम पाचन, सौम्य विरेचन (क्योंकि रूग्णा बालिका है) मधुर तिक्त शीत एवं ह्रद्य आहार एवं औषध*

*प्रात: कूष्मांड स्वरस 15 ml खाली पेट*

*गुडूची स्वरस 10 ml सांय काल भोजन से 1  घंटा पूर्व*

*नारिकेल जल*

*हरिद्रा खंड 3-3 gm दिन में 2 बार भोजन से 1 घंटा पूर्व*

*शिवक्षार पाचन चूर्ण 3-3 gm दो बार after meals*

*फलत्रिकादि घन वटी 2-2 गोली*

*पंचतिक्त घृत गूगल वटी 1-1 गोली*

*आरोग्य वर्धिनी वटी 1-1 गोली*

*बाह्य अभ्यंगार्थ महामरिच्यादि तैल 2 बार *

*पथ्य का कठोरता से पालन*

*देखें images 24 july, 29 july की, लगभग 6 सप्ताह चिकित्सा करने के बाद औषधि बंद कर मात्र सप्ताह में 2 बार हरिद्रा खंड प्रात: 3 gm खाली पेट दिया गया और सांयकाल महामरिच्यादि तेल अभ्यंग कर 2 घंटे बाद स्नान।*

*सितंबर के अंतिम सप्ताह में बिना औषधि की image भी देखें*

[10/24, 1:15 AM] Vd. Subhash Sharma Ji Delhi: 

*24th july* 👇🏿

[10/24, 1:16 AM] Vd. Subhash Sharma Ji Delhi: 

*29th july* 👇🏿

[10/24, 1:17 AM] Vd. Subhash Sharma Ji Delhi: 

*last week of sep* 👇🏿

[10/24, 6:53 AM] Dr Pankaj Chhayani: 

🙏पितज विकार में मरिच्यादि तैल? मरिच्यादि उष्ण, तिक्ष्ण नहीं पड़ता ?

[10/24, 7:30 AM] Prof Satyendra N Ojha: 

yes, here, dosha assessment looks erratic..

[10/24, 7:30 AM] Prof Prakash Kabbra, Nagpur: 

प्रथित यश वैद्य वर तथा विद्वत मित्रवर्य क्या हम महामरीच्यादी तैल के पर्याय सोच सकते हैं ? पित्त शामक जो त्वचा पर कार्य करे ?

[10/24, 7:32 AM] Prof Satyendra N Ojha: 

jaatyaadi ghria, or tail, or chandanaadi tail.. For pitta ghrita is always first choice

[10/24, 7:45 AM] Prof Satyendra N Ojha: 

*High histamine level in  foods*:

Alcohol.

Pickled or canned foods – sauerkrauts.

Matured cheeses.

Smoked meat products – salami, ham, sausages….

Shellfish.

Beans and pulses – chickpeas, soy beans, peanuts.

Nuts – walnuts, cashew nuts.

Chocolates and other cocoa based products.

[10/24, 7:47 AM] Prof Satyendra N Ojha: 

please, take care of such  foods while dealing with sheetapitta.. *Sankshepatah kriyaayoge nidaana parivarjanam*..

[10/24, 7:53 AM] Dr Dilip Kumar Vyas:💐👌

[10/24, 7:56 AM] Prof Satyendra N Ojha: 

Here , one more concept is after using katu tail (*vriddhyaa*) dosh brings out from shaakhaa to koshtha and thereafter sanshodhan chikitsa is applicable..

[10/24, 8:01 AM] Prof Prakash Kabbra, Nagpur: मान्यवर, संशोधन करताना हो तो

[10/24, 8:05 AM] pawan madan Dr: 🙏🙏🙏

*I think....Vishghan prabhaav of Mahamarichyaafi acts more here.....than its pittavardhak character.*

*There are many such yogas which act like this. They act by the synergistic acts of their ingredients.*

*And even if there is a little pittavardhak actiin.....that is being nullified by alk other medicines which are pittashaamak and pitta anulomak. Mridu virechan also inhibits the pittavardhak action of mahamarichyaadi.*

[10/24, 8:14 AM] Dr Priy-ranjan Tiwari, Haridwar: 👌

[10/24, 8:40 AM] Vd. Subhash Sharma Ji Delhi: 

*सही कहा आपने और यहां केवल लाक्षणिक चिकित्सा ही नही दी गई है आभ्यन्तर प्रयोग के लिये पित्त रेचक और शामक दोनो है।*

[10/24, 8:48 AM] Dr Rameshwar Rao Rane: 

When there is raktadushti swarngairik helps. But if kaph vaataj awasta is there laghusutshekhar is good choice. Overall swarnagairik as basic is good drug in shitpitta uddard koth.

[10/24, 8:50 AM] Dr Shashi Jindal, Chandigarh: 

I have seen pts. specially kids having urticaria due to intestinal worms and chronic, subclinical  throat infections.

[10/24, 8:59 AM] Dr Pankaj Chhayani: 

Marich, vacha both are effective.

[10/24, 9:01 AM] Dr Pankaj Chhayani: 

Yoga having Marich, vacha(both are pramathi) can be given along with Virechaka dravyas.

[10/24, 9:02 AM] Prof. Deep Narayan Pandey: 

पित्त से जुड़े मसलों की चिकित्सा में मरिच का योगदान अनेक रूप और योगों में है।

कहीं प्रधान (गुणांतराधान के कारण) कहीं योगवाही योगदान।

[10/24, 9:32 AM] Dr Surendra A Soni: 

हेतुविपरितार्थकारिचिकित्सा । डॉ पंकज ।

[10/24, 9:32 AM] Dr Surendra A Soni: 🙏🌹 ओझा सर ।

[10/24, 9:33 AM] Prof Satyendra N Ojha: 

please, explain how vishghan prabhaava is achievable ? डॉ पवन मदान जी ।

[10/24, 9:34 AM] Prof Satyendra N Ojha: 

purpose of specific dravya administration.. if we refer yogratnaakar, scenario is very clear..

[10/24, 10:46 AM] Dr Sanjay khedekar: 

महामरीच्यादी तैल

Is prepared by local irritants and mostly toxic metals and herbs. It is drug of choice in the chronic status of skin diseases rather than acute stage. Probable mode of action is firstly local irritant which may increase blood circulation underlying skin layer. Due to increased blood circulation may gives rise to fast healing and increase rate of formation of skin layer (vrana Shodhana and vrana ropana action) .... Same principle is found in charaka  and Sushruta  samhita for dushta vrana and kushta....

[10/24, 11:02 AM] pawan madan Dr: 

🙏🙏🙏

Thanks.

[10/24, 12:10 PM] Prof Satyendra N Ojha: 

Direct exposure of toxic metals with vrana may transform it into dushtavrana or kotha.. is  Toxic metals or Shudha Bhasma  in maha marichyaadi tail ?

[10/24, 12:18 PM] Dr Manu Vats, Patiala: 

Sir Thanks ..again Sir its your USP.... putting a complex clinical case in simple authenticity manner ..It's just like a chapter reading along live example....🙏🙏💐💐

[10/24, 12:22 PM] Dr Surendra A Soni: 

Agree Dr Sanjay !

Presence of Gomay ras, haridra, devdaru, daruhaldi, jatamansi, kushtha, vidanga, shirish,  nimba, guduchi, Amalatas etc makes this vishaghna and antibacterial.

[10/24, 12:59 PM] Dr Sanjay khedekar: 

Ji sir.... arsenic metalloids are used as a ingredients....

[10/24, 1:02 PM] Dr Sanjay khedekar: 

No shuddha bhasma are used for preparation...raw or shuddha hartala and manashila are used for preparation.

[10/24, 1:09 PM] Prof Satyendra N Ojha: 

ok. thank you..🌷💐🌹👍🌷💐🌹

[10/24, 1:11 PM] Dr Sanjay khedekar: 

Thanks Sir !

[10/24, 1:19 PM] Dr Sanjay khedekar: 

Mahamarichyadi tail was first mentioned by Chakradutta in kushta chikitsa... But the basic principles behind this preparation is found in Dushta vrana chikitsa of suhsruta. Where he listed some dravyas for dushta vrana chikitsa .... And advocated for the preparation of oil for external use. Sushrutacharya also mentioned that dushta vrana chikitsa upakrama should be applied in the Kushtha and Prameha Vrana. Also more or less same prescription of oil preparation are found in Charaka samhita Kushta chikitsa like Kanakshiri tail etc. .... In next Chakradutta, vangasen, gadnigraha... Mentioned many other formulations which are based on the same principles.... Some contents are exchanged or replaced with different therapeutic efficacy....

[10/24, 1:22 PM] Prof Satyendra N Ojha: 👍🌷💐🌹👍

[10/24, 1:24 PM] Dr Manu Vats, Patiala: 

Yes I think its much more  krimihar ..u may say antimicrobial or antibacterial.

[10/24, 1:24 PM] Prof Satyendra N Ojha: 

its action is as vrana shodhaka and vrana ropaka..

[10/24, 1:28 PM] Dr Sanjay khedekar: 

Yes sir....you may add antifungal, antihistamine...etc etc....all actions related with skin.

[10/24, 1:31 PM] Prof Satyendra N Ojha: 

Its first choice in vrana ( all types) & krimi.. 2nd choice in vicharchikaadi.. but not convinced with its use in sheetapitta..

[10/24, 1:40 PM] Dr Surendra A Soni: 👌👏👍🙏

[10/24, 1:41 PM] Dr Sanjay khedekar: 🙏🏻🙏🏻

[10/24, 3:00 PM] Dr Manu Vats, Patiala: 

Sir with due regards to your seniority ..We have experienced do many times in Ayurveda where choice of drug has wide area  because of Dosha...So that's why I endorse the clinical use explained by Respected Dr Subhash Sir.....🙏🙏

If one has not experienced then he or she should must put this in respective dictionary or pocket or kit of dispensary.....🙏🙏

[10/24, 3:28 PM] Prof Satyendra N Ojha: 

yes, you are right, i never use it in sheetapitta, i use it in vicharchika, for sheetapitta my choice is jaatyaadi ghrita ..

[10/24, 4:22 PM] Prof. D. S. Mishra Sir: Why jaatyaadi ghrit ?

[10/24, 4:58 PM] Prof. Deep Narayan Pandey: 

आचार्य श्रेष्ठ,

यदि मैं वैद्य होता तो इसका उत्तर यह देता कि राजस्थान की धरती के महान आचार्य शार्ङ्गंधर ने आयुर्वेदाचार्यों को चिकित्सार्थ असीमित और अपरिमित अधिकार दिये हैं। केवल मच्छिका स्थाने मच्छिका रखने की उम्मीद नहीं किया। अंधानुकरण की तो कतई उम्मीद नहीं किया है। 

*व्याधेरयुक्तं यद् द्रव्यं गणोक्तमपि तत्त्यजेत्।*

*अनुक्तमपि यद्युक्तं योजयेत्तत्र तद् बुधः।।*

---शार्ङ्गं., पूर्व. 1.60 (कुछ संस्करणों में 1.54)

🙏💐🙏

आप सभी साथियों के ध्यान में हैं ये मूल सिद्धांत, या यों कहिये साधारण बातें हैं ये सब आपके लिये, पर कभी-कभार याद दिला देता हूँ। 😊

[10/24, 5:48 PM] Prof Satyendra N Ojha: 

in chakradatta, dravya either with ghrit or with tail is indicated in sheetapitta considering vaata pitta and vaatakapha respectively.. either sheeta or ushna annapaanaani are mentioned, further dosha vishesha is kept in center.. for chikitsaka, standard of protocols is there , need to follow it..

[10/24, 11:16 PM] Dr B K Mishra Ji: Why jaatyaadi ghrit ?

Sir, please elaborate with Yukti...

[10/24, 11:24 PM] Prof Satyendra N Ojha: 

Jaatyaadi ghrita ? 

First, its ghrit, so, effective in vaata pradhaana sheetapitta, *Doshapratyanika*.. Second, it contains jaatipallava shankhapushpi khadir kushtha haridra daruharidra kamala yashtimadhu *svarna- gairikaadi*:  almost all dravya are *vyaadhipratyanika*..

finally, my choice, since its *ubhaya pratyanika*..

************************************************************

Above case presentation & discussion held in 'Kaysampraday" a Famous WhatsApp group  of  well known Vaidyas from all over the India. 

                                                      

  Presented by

Vaidyaraj Subhash Sharma

MD (Kaya-chikitsa)

New Delhi, India

email- vaidyaraja@yahoo.co.in