TYPES-(7)

Vatika, pittik,

Kaphaja,

Vata-pittaja,

Vata-kaphaja,

Pitta-kaphaja,

Sannipataja

1

INTRODUCTION

Parinamashoola term is a selfexplanatory i.e. Shoola or abdominal colic that experienced during the digestion of food i.e. 3-4 hours after intake of food when food had reached the intestines. Parinamashoola is an “AVARANA JANYA, TRIDOSHAJA VYADHI”

2

NIDANA

1. Ruksha-sheeta-ushna-tikshna-amla-kshar-lavana-katu-aahar sevana

2. Asatmaya,viruddha ahara

3. Atilanghan,samshana,vegadharana,ratri jagaran,ati maithna

4. Atyaagni tapa,atibharavahan,,ati gaman,

5. Bhaya,krodha,soka,mana,udvega manshik karana

6. Varsha ritu, sheeta ritu, sarad ritu,madya ratri, suryodaya kala,ratri arambha kala

3

LAKSHANA

1. Pain in abdomen after meals or during digestion or any time

2. Snigdha & ushna bhojana sevan se shanti(vatik parinama shoola)

3. Katu-lavana-(spycy) bhojana se shoola vriddhi & sheeta seven se shanti(pittaja parinama shoola)

4. Katu-tikta(bitter) sevena se shanti & prolong mild pain(kaphaja parinama shoola

5. Bhuktejeeryatiyatshoolam – pain occurs during digestion of food

6. Kukshishoola – pain in the abdomen (tummy, belly)

7. Jataraparshwashoola – pain in the abdominal sides

8. Nabhishoola – navel pain

9. Vastishoola – pain in the region of urinary bladder

10. Stanantarashoola – pain in the sternal region (between the breasts)

11. Prishtamulashoola – pain in the sacral region

RELIEVING FACTORS:

Bhuktamatre – after intake of the food

Vantamatre – afer vomiting

Jeerne cha anne – after complete digestion of food

AGGRAVATING FACTORS:

Shashtikashali – food cooked with rice grown in 60 days

Vrihidhanya – barley etc

Shaliodana – cooked rice

4

SAMPRAPTI

Nidana sevana-> agni dusthi-> ajjerna-> amlapitta-> amashya & grahani sotha ->amashaya & grahani sleshma kala me varna -> annadrava/parinama shoola

Intake of Ruksha anna (Yava, Sushka Saka, Jangala Mamsa), Vishamasana and Langhana directly aggravate vayu followed by involvement of pitta and Kapha. Among Tridosha, Vayu is the most power and it encompasses kapha and pitta. Aggravated vata (by the virtue of Shoshna property) decreases pitta and Kapha. ‘Kapha pitte samavritya Shoolakari Bhaved Bali’

It shows that the cause of shoola is Bali –viz Vayu. According to Vijaya Rakshita, Pitta is the most powerful and predominant Dosa in the pathogenesis of Parinama Shoola. Hence pain is experienced during the period of digestion,

i.e when pitta remains in provoked stage. In physiological state Kapha protects Amashaya from the eroding effects of Pachaka pitta. When the equilibrium between secretion of protective Kapha (mucosal gel layer containing glycoprotein, phospholipids, bicarbonate ions) and Pitta (HCL) is breached, causes Vrana in the Gastro-antral mucosa of the Stomach. “Balasah Pracyutah Sthanata Pitten Saha Murcchitah” when Kapha has shifted down from its original place and is subdued, aggravated Vayu overtakes Pitta and Kapha and produces pain during the digestion of food.

5

SAMPRAPTI GHATAKA

DOSHA- tridosha

DUSHYA- anna rasa

ADHISTHANA- amashaya & grahani

SHROTAS- annavaha

SVABHAVA-ashukari

SADHYAASADHYATA- sadhya

6

DOSHA SPECIFIC SYMPTOMS OF PARINAMA SHULA:

VATAJAPARINAMA SHULA (PARINAMA SHULA CAUSED BY VITIATED VAYU):

• Adhmana – abdominal distension

• Atopa – gurgling sounds (in the tummy)

• Vin-mutravibandha – constipation and urinary obstruction

• Arati – non-specific pains

• Vepana – tremors

• Snigdhaushnaprashamana – gets pacified by medicated ghee and oils (application and intake) and hot comforts (like steaming, hot foods, etc)

PAITTIKAPARINAMA SHULA (PARINAMASHULA CAUSED BY VITIATED PITTA) –

• Trishna – thirst

• Daha – burning sensation

• Aruchi – tastelessness

• Sweda – excessive sweating

• Katu-amla-lavanottaram – symptoms worsen when foods predominant with pungent, sour and salt tastes are consumed

• Sheetashamanam – pain reduces on consuming cold foods and comforts

SHLAISHMIKAPARINAMA SHULA (PARINAMASHOOLA CAUSED BY VITIATED KAPHA) –

• Chardi – vomiting

• Hrullasa – nausea

• Moha – indecisiveness

• Manda shoola – mild pain

• Deerghasantati – long standing pain

• Katutiktaupashamana – symptoms are relieved by consumption of pungent and bitter foods

DWIDOSHAJAPARINAMASHOOLA (PARINAMA SHULA CAUSED DUE TO VITIATION OF DOSHAS IN DUALS) –

• VATAPITTAJA PARINAMASHOOLA – symptoms of vataja and pittajaparinamashoola manifested together

• VATAKAPHAJAPARINAMASHOOLA – symptoms of vataja and kaphajaparinamashoola manifested together

• PITTA KAPHAJAPARINAMASHOOLA – symptoms of pittaja and kaphajaparinamashula manifested together

SANNIPATAJAPARINAMASHOOLA (PARINAMASHOOLA CAUSED DUE TO VITIATION OF ALL THE 3 DOSHAS) –

Symptoms of vitiation of all the 3 doshas will be present in sannipataja or tridoshajaparinamashula.

7

PROGNOSIS AND COMPLICATION

PROGNOSIS OF PARINAMA SHULA (INCURABLE PARINAMASHOOLAM) –

Below said types of Parinamashoolas are said to be incurable:

Tridoshaja type of Parinamashula – when all the three Doshas are involved Parinamashula in which there is diminution / deterioration of bala (strength), mamsa (muscles) and agni (digestion capacity or metabolism)

Parinamashoola associated with upadravas (complications)

COMPLICATIONS OF PARINAMASHULA:

• Anaha – flatulence

• Guruta – heaviness of the abdomen

• Chardi – vomiting

• Bhrama – giddiness

• Trishna – thirst

• Jwara – fever

• Aruchi – anorexia

• Krushatwam – emaciation

• Balahani – loss of strength

Tridoshaja type of Parinamashula and parinama Shula associated with deterioration of strength, muscle bulk and digestion capacity is also incurable.

8

CHIKITSA SUTRA

• Langhana – fasting (treatments or measures which induce lightness in the body)

• Vamana – therapeutic emesis

• Virechana – therapeutic purgation

• Vasti – medicated enemas

Treatment principles of individual ParinamaShoola

• VatajaParinamashula – Sneha (external and internal administration of medicated ghee and oil) is an ideal remedy

• PittajaParinama Shula – Virechana or therapeutic purgation

• KaphajaParinamaShoola – Vamana or therapeutic emesis

• DwandwajaParinamashula – Sneha should be administered as in VatajaParinama Shula

• TridoshajaParinama Shula – should be skillfully managed as per the situation and presentation of the disease

1. PACHA/DEEPAN-Sunthi curna 5gm bid before meal

2.abhyanter snehpana- Panchtikta ghrita

3. Svedana-1 din

4. vamana kalp:-

mulethi-30gm + satavari-30gm-->100ml kada + madanphala pippali 15gm->next day add 20ml madhu + 2.5 gm saindhav--> vaman

5. virechana kalp-

(9-10-11 din snehpana, 12-13-14 din rest, 15 day virechana)

amlatas guda 20gh + munakka-20gm + Nisoth-20gm-->100 kada + 40ml castor oil--> 1-20 motion

6.Kal basti (16)

A.anuvasana-Satavari ghrita/Panch tikta ghrita30ml + 1gm saindhav + badi sounf 2gm--> basti

B.niruha basti-

Satavari 30gm + Mulethi 30gm + manjistha 30gm + rakt chandana 30gm + khash 30gm--> 300ml kada + satavari ghrita 50ml + madhu 50 ml--> basti

agar kal basti na do to ksheer basti de

KSHEER BASTI:-

Satavari 50gm + Mulethi 50gm + Rakt chandana 25gm + Khash 25gm-->400ml kada(chankar) + 200ml dugdha--> pakaye--> 200 ml bach jaye then add Satavari ghrita/panchtikta ghrita 50ml + madhu 50ml--> 11-21 din kheer basti

(isme anuvasan dene ki avsyakta nhi h lekin 1st & last & dusti me anuvasan de sakte h)

Treatment of peptic ulcer as per Ayurveda:

Emesis ending with the pitta and purgation ending with kapha should be applied in Annadravashoola which subsides after Amashya and Pakvasaya are evacuated and the measures prescribed in Amalapitta should be adopted.

Role of Ayurvedic drugs and yoga practices

YASHTIMADHU (Glycyrrhiza glabra)

Description of Yashtimadhu in different treatise:

Charaka Samhita: Jeevaneeya, Sandhaneeya, Varnya, Kanthya, Kandughna, Chardinigraha, Shonitasthapana, Snehana etc.

Sushruta Samhita: Kakolayadi, Sarivadi, Anjanadi gana.

Vagbhata: Sarivadi and Anjanadi gana.

Main Active Constituents of Glycrrhiza glabra

Effect of yoga practices on peptic ulcers disease:

Intra organ massage: Improving blood flow and allowing better healing.

By better glandular secretion of mucus Acid reduction by specific poses

Control of mind and calm.

The quality of massage is such that in specific Asana like Suptveerasana, Parvatasana, Suryanamaskar etc.

Asana:

Vajrasana: 5 min.

Pawanamuktasana : 10 min.

Shavasana: 10 min.

Pranayama:

Anuloma-Viloma: 5 min.

Kapalabhati: 5min.

Vajrasana can be done immediate after meals.

All above yogic procedures should be done in morning hours at least 1 hour before breakfast.

DIET AND LIFESTYLE

Pathya(DO):

Laghu aahara,purana shali chavala,sauva,kondo, java sattu, matar dala yush, dhana lava, godugdha, anupa-jangam mamsa, nariyal pani

Vaman,virechana,basti,khali pet na rehna

Apathya(DON’T):

Guru,vidahi,vistambhi,kanji,lavan, mircha, masala,sheetal peya, pizza, samosa,,aalu,baingan, chaval, besan, maida,fish

Ratri jagaran,dhupa sevana, langhana, upavasa

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

- Loha mandur bhasma-(loha)

- Shoolgajakesari rasa-(parad,svarna,tamra,hingu,sunthi,jeera)

- Tripurbhairav rasa-(parad,svarna,tamra,ghritakumari)

- Triphala loham-(triphala,loha,)

- Saptamritta loha-(triphala,mulethi,loha bhasma)

- Dhatri loham-(amla,mulethi,loha)

- Shatavari mandur-(mandur,shatavari)

VATI-(250-500MG WITH USHNA JALA)

- Shambhukadi vati-(sambhk bhasma,saindhav lavan)

- Shankh vati-(chinchakshar,pacha lavan,sankh bhasma,hing)

- Shoolavajrani Vati-(Kuchala,Pushkermula,Trikatu)

- Shankhrasa gutika-(chinchakshar,sankhbhasma,hinga, ajmoda,panchlavan)

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

- Hingvadi curna-(hing,trikatu,patha,haubera,harad,ajmoda)

- Patoladi curna-(patol,chirayata)

- Sankh curna-(shankh,saindhav,yavkshar,tankan)

- Narikela lavana-(nariyal,saindhav)

- Shamundradhya curna-(samundri lavana,saindhav lavana,loha bhasma, trivrit)

- Shatavari curna

- Yastimadhu curna

- Amlaki rasayana

GHRITA/TAILA-(15-20ML WITH USNA JALA/MILK)

- Guda.pippali ghrita

- Pippli ghritam

AVLEHA/PAKA(20GM WITH DUGHDHA)

- Haritaki khanda-(harad,trivrit,loha,abhrak,chaturjata)

- Narikela khanda-(nariyal,mishri)

- Khandamlaki-(kushmanda,amlaki,mishri)