1. Engorgement of veins over abdomen,

2. Fluid thrill, Everted umbilicus, Shifting dullness

3. Abdominal distension,palpation

4. Serous discharge from rectum.

Types-(2)

Swatantra,partantra

1

LAKSHANA

The following are the signs and symptoms of Udakodara (Ascites):

1. Loss of appetite, morbid thirst, discharge from the anus, colic pain, Dyspnoea, cough and general debility

2. Appearance of net-work of veins having different colours over abdomen and

3. In percussion and Palpation, the physician feels as if the abdomen is like a leather bag filled with water.

This is called Udakodara (Ascites). [47]

2

NIDANA

ETIOLOGY AND PATHOGENESIS OF UDAKODARA (ASCITES):

Agni (digestion strength) loses its power because of excessive intake of water after administration of Snehana treatment (oleation) or by a person suffering from Mandagni (suppressed power of digestion) or by an individual who is suffering from Rajayakshma or excessively emaciated.

As a result of this, Vayu located in Kloman (viscera located adjacent to the heart, i.e right lung) gets interrupted with Kapha and UdakaDhatu (a liquid element of the body) increases the quantity of that water in the obstructed channels of circulations. The vitiated Kapha and Vayu from their own locations assist in increasing this water as a result of which Udakodara (ascites) is caused. [45-46]

3

PURVARUPA

- Shudhanash-mukh ka meetha rehna

- Anna k jeerna & ajjerna ka gyan na hona

- Pet ka atyadhik bharna-fulana

- Pairo me shotha

- Bala hansha

- Parishram se svasha kasta

- Adhyamana

- Udar pe rekhao ka dikhna & juuriyo (bali) ka nash

4

SAMPRAPTI

Nidana sevana-> tridosha(kapha,pitta-> agnimandhya, vata-> rasa,rakta,udak dusti) udak ka tvak & mamsa dhatu k madhya sanchaya-> jalodara

5

SAMPRAPTI GHATAKA

DOSHA- vata pradhana tridosha

DUSHYA- anna, rasa,purisha

ADHISTHANA- amashaya,pakvashaya

SHROTAS- rasa,rakta, udakvaha

SVABHAVA- chirkari

6

PROGNOSIS

The physician should immediately treat this condition before the appearance of complications and before water accumulates in the abdomen.

If the treatment is neglected, then the vitiated Doshas get displaced and become liquefied as a result of Paripaka (maturation), causes stiffness in the joints and channels of circulation and divert sweat from the external channels. The water element moves sideways (Tiryak). It collects in the abdominal cavity. This zigzag- moving sweat adds to the quantity of water already accumulated in the abdomen.

The appearance of this sticky liquid makes the abdomen dull in percussion and soft to touch. The abdomen becomes dull in percussion and soft to touch. Thereafter, the net-work of veins disappears.

During this period, the umbilical region is primarily afflicted, and from there the disease spreads in the remaining parts of the abdomen. Thereafter, states accumulating in the abdomen.

THE SIGNS AND SYMPTOMS OF THIS CONDITION ARE AS FOLLOWS:

1. Excessive enlargement of the sides of the abdomen

2. Disappearance of the network of the veins and

3.On palpation and percussion, the physician feels as if the abdomen is like a leather sack filled with water. [48]

UPADRAVA – COMPLICATIONS

Thereafter, the patient gets afflicted with complications, like

Chardi -vomiting, Atisara – diarrhoea,

Tamaka type of Asthma, Trushna – Morbid thirst, shwasa – dyspnoea, Kasa – cough, Hikka- hiccup, Daurbalya- debility, Parshvashoola – pain in the sides of the chest, Aruchi -anorexia, Svarabheda -hoarseness of voice and Mutrasanga—anuria (suppression of urine). A patient with these complications is incurable. [49]

Thus, it is said: of the 6 types of Udara, Viz

Vatodara ,Pitodara ,Kaphodara ,Plihodara ,Sannipatodara and Udakodara, the subsequent ones are more and more difficult for treatment than the previous ones.

After a fortnight, Baddhagudodara (abdominal swelling caused by the obstruction in the intestine) becomes incurable.

Udakodara (ascites) in its JataUdaka stage (when water accumulates in the abdomen) and Chidrodara (acute abdominal swelling caused by intestinal perforation) are generally incurable right from the beginning [50-51]

BAD PROGNOSIS

Shoonakshi – Swollen eyes,

KutilaUpastha – curved pudendum, sticky and thin skin and diminished strength, blood, muscle tissue as well as Agni (Power of digestion and metabolism) – appearance of these signs and symptoms indicate the incurability of the condition [even if the patient is otherwise curable].

Occurrence of complications, like swelling in all the vital organs, dyspnoea, hiccup, anorexia, morbid thirst, fainting, vomiting and diarrhoea lead to the death of the patient suffering from Udara (obstinate abdominal disease).

All varieties of Udara, right from the time of their manifestation, are generally considered difficult to cure; however it can be cured with adequate care soon after its appearance. If the patient is otherwise strong and if water has not started accumulating in the abdomen [52-54]

7

AJATODAKA STAGE

SIGNS AND SYMPTOMS OF AJATODAKA STAGE OF UDARA – ASCITES

Ajata means not yet appeared, Udaka means water.

SIGNS AND SYMPTOMS INDICATING AJATODAKA (NON-APPEARANCE OF WATER) STAGE OF UDARAROGA

1. There will be either no swelling or less Swelling in the abdomen and legs

2. The colour of the abdomen will be reddish

3. There will be tympanic sound on percussion

4. The abdomen is not very heavy

5. Always having gurgling sound in the abdomen

6. The abdomen will be covered with the network of veins

7. There will be movement of wind from rectum to the umbilicus and distension of the umbilical region; it will be suppressed after the elimination of stool and flatus

8. There will be colic pain in each of the heart region, umbilicus, inguinal region, lumber region and anus

9. Flatus will be eliminated with force

10. The power of the digestion of the patient will not be very weak

11. Because of excessive salivation, there will be imperceptibility of taste in the mouth and

12. There will be scanty urine and hard stool

The above mentioned signs and symptoms indicate Ajatodaka (non-appearance of water in the abdomen) stage of UdaraRoga.

Having ascertained it with care, the physician well acquainted and the time of the treatment, should initiate remedial measures for the patient. [55-58]

8

CHIKITSA SUTRA

In Udakodara (Ascites), the patient is given therapies to correct the defects of the liquid elements (ApamDoshaharani) in the beginning.

The patient is given therapies containing cow’s urine, drugs having Tiksna (sharp) attributes and different types of Alkalies. He is given food which is digestive stimulant and which alleviates Kapha. Gradually, the patient is prohibited to take water and other liquids [93 ½ – ½ 95]

BUTTERMILK OF UDARAROGA

Buttermilk, which is not very thick, which is sweet (not sour) and which is free from fat is useful for the patient suffering from UdaraRoga.

If the patient is suffering from SannipatikaUdaraRoga, then he should take buttermilk along with Tryusana (ginger, pepper, long pepper) Alkalies and Rock salt

The patient of Vatika type of UdaraRoga should take

• Buttermilk along with Pippali – Piper longum and Rock- salt.

In Paittika type of UdaraRoga, the patient should take

• Buttermilk which is freshly churned and sweet and added with sugar and the powder of Madhuka (licorice).

For the patient suffering from Kaphaja type of UdaraRoga, buttermilk added with Yavani, Rock salt, cumin seeds and Trikatu (ginger, pepper and long pepper) and it should not contain much of fat.

The patient of Plihodara (abdominal swelling caused by the enlargement of spleen) should take

• Butter milk along with honey, oil and the powder of Vata, Sunthi, Shatahva (dill), Kustha and rock salt.

The patient suffering from Udakodara (Ascites) should take

• Buttermilk prepared of well formed curd along with the powder of Trikatu (ginger, pepper and long pepper).

For the patient suffering from Baddhodara (enlargement of abdomen because of intestinal strangulation), butter- milk added with Hapusha, Yavani, cumin seeds and rock salt is useful.

The patient suffering from Chidrodara (abdominal swelling caused by intestinal perforation) should take

• butter milk along with Pippali and honey

Butter milk is like nectar for people suffering from heaviness, anorexia, suppression of the power of digestion, diarrhoea and diseases caused by aggravated Vata and Kapha. [101 ½ – ½ 107]

USE OF MILK

If the patient of Udara is suffering from oedema, Anaha (bloating, abdominal distension because of wind), pain, thirst and fainting, then camel milk is useful. After administration of Panchakarma treatment, when it has become emaciated, cow milk, goats milk and buffalo milk are useful [ 107 ½ – ½ 108]

RECIPES FOR EXTERNAL USE

The paste of Devadaru – Cedrusdeodara, Palasa – Butea monosperma, Arka – Calotropisprocera, GajaPippali, Shigru—Moringaoliefera and Ashwagandha- Withaniasomnifera taken in equal quantities, prepared by triturating with cow’s urine is applied over the abdomen of the patient suffering from UdaraRoga.

Vrushchikali, Vacha – Acoruscalamus, Kustha – Sausserealappa, Panchamula (Bilva – Aegle marmelos, Syonaka – Oroxylumindicum, Gambhari – Gmelinaarborea, Patali, and Ganikarika), Punarnava – Boerhaviadiffusa, Bhutika, Nagara – Zingiberofficinale and Dhanyaka is boiled in water and this decoction is used for sprinkling over the abdomen of the patient suffering from UdaraRoga.

Similarly the decoction of Palasa – Butea monosperma, Kattrna and Rasna is used for sprinkling [108 ½ -110]

USE OF URINE

8 type of urine [described in Sutra 1/92-104] is used in sprinkling (over the abdomen) and drinking by the patient suffering from UdaraRoga. [½ 111]

USE OF MEDICATED GHEE

If the patient of UdaraRoga has Ruksha-dryness and Bahuvata- excess of Vayu in his body, and if he needs elimination therapy, then medicated ghee which is stimulant of digestion and which cures UdaraRoga is administered. These recipes will be described hereafter. [111 ½ – ½ 112]

PANCHAKOLA GHIRTA

NAGARA GHRUTA

CHITRAKA GHRTA

YAVADI GHRUTA

VIRECHANA – PURGATION THERAPY

By the administration of the above mentioned recipes of medicated ghee, the patient becomes oleated; he regains strength; aggravated Vayu in his body gets alleviated and the adhesiveness of the Doshas in various Ashayas (visceras) is diminished. Thereafter, the patient of UdaraRoga is given purgation therapy described in Kalpa section. [118 ½ – ½ 119]

PATOLADICHURNA

NARAYANA CHURNA

HAPUSHADYA CHURNA

NILINYADYACURNA

TREATMENT SEDULE 1 YEAR

1. DEEPAN/PACHANA-trikatu curna

2.NITYA VIRECHANA-

- Erand bhrast haritaki or

- Erand tail 20ml every night

3.(Virechana yogya na to go mutra yukt tikshna basti)

TIKSHNA NIRUHA BASTI KALP:-

Nisoth-30gm +

Choti harad-30gm +

Kutki-30gm-------->300 ml kada

---> 2nd day add 50ml gomutra + 5gm yavakshar-->basti

DIET AND REGIMEN

Since the abdomen is filled with vitiated Doshas, the power of digestion gets diminished. Therefore, the patient should take such food which is light to digest. (Laghuahara)

He should take Rakhtashali – red rice, Barley, moong dal – green gram, meat of animals and birds inhabiting arid zone (Jangalamamsa), milk, cow’s urine, Asava (alcoholic preparation in which drugs are generally added without boiling), Arista (alcoholic preparation), honey, Seedhu (a type of alcohol) and Sura (another type of alcohol).

He may also take Yavagu (thick gruel) and boiled rice prepared by boiling with the decoction of Panchamula (roots of Bilva, Syonaka, Gambhari, Patali and Ganikarika) and added with slightly sour ingredients, unctuous substances, like ghee and oil, and pungent drugs along with vegetable soup or meat soup.

He should avoid aquatic meat and animals inhabiting marshy land; leafy vegetables; pastries, preparations of sesame seeds, exercise, walking long distance, and sleep during day time and travelling by fast moving vehicles.

He should also avoid hot, saline and sour things, ingredients which cause burning sensation (Vidahi) and heavy food. This type of patient should strictly avoid taking water. [96 ½ – ½ 101]

OTHERS TREATMENT

After the vitiated Doshas are gradually eliminated, the patient is given the meat of animals inhabiting arid zone. For the elimination of the residual Doshas, following recipes is administered to the patient:

1. The paste of Devadaru – Cedrusdeodara along with milk is taken for 1 month

2. The powder of Gajapippali and Sunthi along with milk

3. Milk boiled with 1 Kola each of Vidanga – Embeliaribes, Chitraka – Plumbagozeylanica, Danti, Chavya – Piper retrofractum and Trikatu (Sunthi – zingiberoffcinale, Pippali – Piper longum and Marica – Piper nigrum); intake of this medicated milk cures an acute form of Udara (obstinate abdominal disorders including Ascites) for the preparation of this recipe, the powder of above mentioned drugs is boiled by adding 8 Palas of milk and 32 Palas of water)

4. Decoction of Triphala (Haritaki – Terminalia chebula, Bibhitaka – Terminalia bellerica and Amalaki—Phyllanthusemblica), Danti and Rohitaka along with Trikatu(Sunthi – Zingiberoffcinale , Pippali – Piper longum, and Marica -Piper nigrum) and Yavaksara take food along with the soup of meat of animals inhabiting arid zone

5. Meat along with the recipes of SudhaksiraGhrta or SnuhiksiraGhrta- vde verses 138- 145 above;

6. Harithaki along with cow’s urine followed by milk as post prandial drink; the patient should not take any cereal while taking this recipe.

7. Buffalo – urine; this should be taken for one week; during this period the patient should not take any cereal

8. Buffalo milk, to be taken for 1 week; during this period the patient should not eat any cereal.

9. Camel- milk along with the powder of Trikatu (Sunthi – Zingiberoffcinale, Pippali – Piper longum and Marica – Piper nigrum) to be taken for 1 month.

10. Goat- milk along with the powder of trikatu (sunthi, Pippali and Marica) to be taken for 3 months.

11. 1000 fruits of haritaki (to be taken according to the procedure prescribed for PippaliVardhamanaRasayana- (vide Cikitsa 1: 3: 36-40).

12. Shilajitu along with milk

13. Guggulu according to the procedure prescribed above for Silajatu, i.e along with milk

14. Juice of green ginger along with milk

15. Til oil cooked with ten times of ginger- juice

16. Oil of the fruits of Danti and Dravanti ; this is useful in Dusodara(sannipatikaUdara); if there is Colic Pain, abdominal distension and constipation, then this oil should be taken along with Mastu (thin butter- milk) vegetable soup, meat soup etc

17. Oils collected from the seeds of Sarala, Madhusigru and Mulaka; these are useful for massage as well as for taking internally; these oils cure colic pain in the patient suffering from Vatodara;

18. Arishtas ( alcoholic preparations) these recipes are useful if there is Staimitya (a feeling as if a person is covered with a wet cloth or leather), anorexia and nausea; if there is suppression of the power of digestion,

and if the patient is accustomed to alcoholic drinks

19. Ksharas (Alkaline preparations); these recipes are useful if kapha become thick and sticky in the patient suffering from UdaraRoga it liquefies the Kapha;

20. [PippalyadiKsara] Pippali – Piper longum, Tilvaka, Hingu, Sunthi – Zingiberofficinale, Gajapippali, Bhallataka – Randiadumetrum, fruit of Sigru – Moringaoliefera, Triphala (Haritaki – Terminalia chebula , Bibhitaki – Terminalia bellerica and Amalaki – Phyllanthusemblica), katurohini, Devadaru – Cedrusdeodara, Haridra, Daruharidra — Berberisaristata, Sarala, Ativisa, Dhava, Vida, Audbhida and samudra) – all these drugs are mixed with curd, ghee, muscle fat, bone marrow and oil and burnt over the fire[ the quantity of curd, etc. Should be such that the powders of drugs are enable to take the shape of bolus; this bolus is kept in an earthen vessel and covered with an earthen plate; the joint between the earthen vessel and earthen plate is sealed with the help of mud smeared cloth; this is placed over fire for reducing the ingredients into ashes. 1 Karsa of this powder is taken after food along with Madira (alcoholic drink), Dadhimanda (water squeezed out of curd), hot water, Arishta (a type of alcoholic preparation), Sura (alcohol) and Asava (another type of alcoholic preparation). It cures heart disease, oedema, Gulma, (Phantom tumour), enlargement of spleen, piles, various types of UdaraRogas, Visucika (choleric diarrhoea), Udavarta upward movement of wind) and Vatasthila (stone like growth in the abdomen caused by vayu).

21. KsharaVatika- Stool of the goat is burnt, reduced to ashes, diluted with 6 times cow’s urine and strained through a cloth for twenty one times to prepare Kshara (Alkaline preparation). This Alkaline preparation is cooked till it becomes thick in consistency. To this , Pippali – Mula, pancalavana (Sauvarcala, Saindhava, Vida, Audbhida and Samudra), Pippali, Chitraka –Plumbagozeylanica, Sunthi, Triphala(Haritaki, Bibhitaka and Amalaki), Trivrt, Avca, Yavaksara, Svarjiksara, Satala, Danti, Svarnaksiri and Visanika – 1 Karsha each is added and cooked (the quantity of liquid Kshara should be eight times of the powder). From out of this paste, pills of 1 Kola each are prepared. Intake of this pill along with Sauvira ( a type of vinegar) cures oedema, indigestion and acute form of jalodara oedema, indigestion and acute form of Jalodara ( Ascites)

22. Shastika type of rice is impregnated with cow’s urine. This rice is cooked with milk and given to the patient as much as he could take. Thereafter, he is given sugar- cane juice which cures UdaraRogas. By the administration of this recipe, the aggravated Vayu, Kapha and Pitta get restored to their own locations

23. To the patient having costive bowels, vegetables preparation of the leaves of Sankhini, Snuhi, Trivrt, DantiCirabilva etc. is given before food. By the administration of this recipe, the stool becomes soft and the physician well versed in medical texts should administered milk along with cow’s urine for the elimination of the residual Doshas

24. If the patient suffer from Sula (pain in the sides of the chest) Hrdgraha (stiffness and pain in the cardiac region) because of aggravate Vayu, then he is given oil cooked with BilvaKsara( fruits of Bilva should be burnt for the preparation of kshara or Alkali preparation and the oil is cooked with this Kshara preparation

25. Similarly, oil cooked with the Kshara( Alkali preparation) of either agnimantha, Syonaka, Palasa, Stems of Tila, Bala, Kadali or Apamarga should be given to the patient for the cure of UdaraRogas( obstinate abdominal disorders) by the administration of this medicated oil, Hrdgaha) stiffness and pain in the cardiac region caused by vayu in the patient suffering from UdaraRoga gets subsided

26. If Kapha gets occluded (Avrtta) either by Vayu or by Pitta and if Vayu gets afflicted (Avrtta) by Kapha and Pitta, then castor oil added with Drugs appropriate for the alleviation of the respective Doshas is administered.

27. If the patient gets flatulence even after proper purgation, then he is given Niruhabasti( a type of enema prepared of Unctuous, sour and saline drugs) and

28. If the patient suffers from flatulence and there is occlusion of Vayu, then he is given medicated enema therapy prepared of Tiksna (having sharp attributes) drugs, alkalies and cow’s urine. [ 145 ½- ½ 175]

Administration of Snake- venom

If the UdaraRoga caused by the simultaneous vitiation of all the 3 Doshas does not yield to the above mentioned treatment, then the physician should call for patient’s relatives, friends, wife ,Brahmanas, the kin(authorities of the state) and preceptors, and inform them of his doubts about the curability of the disease in normal course they should also be informed that patient will certainly die if the risk of toxic therapy is not permit, after this statement, if the friends, etc, of the patient permit, then he is given snake- venom mixed with his food and drinks.

A (Cobra) snake should be enraged and made to bite a fruit to ejaculate its venom the physician after due consideration, should ask the patient to eat that fruit.

The snake- venom is Pramathi [ the drug which by its own potency drains out the accumulated Doshas from the channels of circulation is called Pramathi) because of this, the compact Doshas which are stabilized and completely submerged in the tissues and which have gone astray to channels other than their own, get instantaneously separated from tissues and come out .

When the aggravated Doshas are eliminated, then the patient is sprinkled with cold water and the physician should give him either milk or Yavagu (thick gruel) inadequate quantity depending upon his strength.

Then for 1 month, the patient should not take any cereal and depend upon the leaves of Trivrit – Operculinaturpethum, Mandukaparni – , Barley, Vastuka and Kalasaka. These leafy vegetables can be either boiled or taken in unboiled form.

No sour drug, salt or fat is added to these vegetables. These are to be prepared along with the own juice or by adding water.

If during this 1 month, the patient feels thirsty , then he is given the juice of above mentioned plants, specially or Kalasaka to drink.

Intake of these leafy vegetables will eliminate the accumulative Doshas, and after 1 month, the patient who has already become weak is given camel- milk to restore his vitality. [175 ½ – 183 ½]

Surgical Measures

The following surgical measures are performed by the physician having practical experience for the removal/ correction of Shalya (foreign bodies including perforation etc).

An expert surgeon should do an incision in the left pelvic region below the umbilicus leaving 4 fingers breadth of space (from the level of the umbilicus) with the help of an appropriate surgical instrument.

After opening the abdomen, the physician should carefully examine the intestines for strangulation and perforation. The afflicted part is anointed with ghee and foreign bodies, like hair etc, is removed from the intestine. Thereafter, the afflicted are put in its appropriate place.

If there is morbidity in the intestine,then it is made to be Biten by big- black- ants (Pipilikas). Having ascertained the cut off then these intestines is placed back into their appropriate place and the incised abdominal skin is sutured with the help of a needle. [184 ½- 188]

Abdominal Tapping

If liquid is already accumulated in the abdomen(Jatodaka stage) in all types of Udara – Ascites Rogas, the physician should tap in the left side of the abdomen below the umbilicus (with the help of torchar and canula), later, with the help of the canula all the fluid by applying pressure, the abdomen is tied tightly with the help of a cloth- bandage, the retraced abdomen is required to be similarly tied with the help of a cloth- bandaged after the administration of enema or purgation therapy and after similar other measures. [189- 190]

Diet

After the fluid from the abdomen is drained out, the patient is made to fast and thereafter, he is given (thin gruel) which is prepared without adding fat and salt. Thereafter, for 6 months, the patient should live only on milk.

Thereafter, for 3 months, the patient should take Peya (thin Gruel) prepared of milk. For 3 months, thereafter, he is given cereals like Syamaka or Koradusa along with milk. These are light for digestion and no salt is given to the patient during this period.

Thus, the patient having reached the Jatodaka stage of ascites should overcome the ailment in 1 year. [191- ½ 193]

Utility of Milk

After the administration of all therapies, the patient should invariably be given milk to take for maintaining the harmony of Doshas and for promoting strength as well as stability in the body.

By the administration of different therapies, the body of the patient becomes emaciated and all the tissue elements in his body get diminished.

For such patient, milk is very useful. It is as good as the ambrosia for the gods. [193 ½- 194]

Thus it is said:-

In this chapter dealing with the treatment of UdaraRogas the Sage Atreya has described in brief as well as in detail the following topics.

1. Causative factors

2. Premonitory signs and symptoms

3. Signs and symptoms of eight varieties of UdaraRoga ( obstinate abdominal diseases including ascities) in detail as well as in brief;

4. Complications and their seriousness

5. Curability and incurability

6. Signs and symptoms of Jatodaka( where fluid has started accumulating in the abdomen) and Ajatodaka abdomen) stages of this disease and

7. Treatment [195- 196]

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Jalodaradi rasa-(jayphala,tamra,snehusheera)

- Icchabhedi rasa-(kajjli,jayphala,sunthi)

- Varishoshana rasa-(kajjali vanga,abhraka)

- Narach rasa-(kajjali,trikatu,tankana)

- Hridyarnava rasa-(kajjali,tamra,triphala,makoy)

- Yakrutpalihari loha-(kajjali,loha,abhrak)

- Loknath rasa-(kajjali,abhrak,loha,tamra)

- Punarnava madura-(danti,punarnava,nisoth,madura)

- Tala sindura-(kajjali,hartal,kumari)

- Tamra bhasma

VATI-(250-500MG WITH USHNA JALA)

- Katuki Vati-(Katuki)

- Abhaya vati-(snuhiksheer,tankan,haritakai)

- Arogyavardhani vati-(tamra,kutaki,abhrak)

- Kshar vatika-(danti,nisoth,triphala)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Narayan curna-(giloy kutaj,bilwa)

- Havukshadya curna-(triphala,svarnsheeni,kutaki)

- Punarnavadi curna-(punarnava,devdaru,haritaki)

KAVATH/ASAV/ARISHTA-(20-40ML WITH SAMABHAG WATER)

- Punarnavadi kwatah-(punarnava,devdaru,kutaki)

- Dashamuladi kvatah-(dasamula,sunthi,punarnava)

- Punarnava asthak kvatha-(punarnava,bilwa,patol)

- Kumaryasava-(kumari,haritaki,loha,tamra)

- Arjunarista-(arjuna,draksha,madhuk)

- Abhayarista-(haritaki,vidang,draksha)

- Punarnavasava-(trikatu,triphala,gokshura,punarnava)

GHRITA-(10-20ML WITH KOSHNA DUGDHA)

- Narach ghrita-(triphala,nisoth,snihiksheer,dantimula)

- Bindughrita-(arkaksheer,snihu ksheer,haritaki)

RASAYANA-

- Haritaki rasayana-( morning 1harad)

- Sheelajatu rasayana-(40-20-10 gm)

- Guggalu rasayana-(3-6gm)