E-ISSN:2456-3110

Case Report

Bhedana Karma

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 1 January
Publisherwww.maharshicharaka.in

Bhedana Karma in the management of Chalazion: A Case Study

Varun TV1*, Chaitra TM2, Akshitha P3
DOI:10.21760/jaims.9.1.53

1* Varun TV, Assistant Professor, Dept of Shalakya Tantra, Rajeev Institute of Ayurvedic Medical Science and Research Centre, Hassan, Karnataka, India.

2 Chaitra TM, Assistant Professor, Dept of Kriya Sharira, Rajeev Institute of Ayurvedic Medical Science and Research Centre, Hassan, Karnataka, India.

3 Akshitha P, Post Graduate Scholar, Dept of Rachana Sharira, SDM College of Ayurveda, Hassan, Karnataka, India.

A chalazion, the most common inflammatory lesions of the eyelid. They are typically slowly enlarging, non-tender eyelid nodules, benign and self-limiting, though they can develop as a bump on eyelid. In Ayurveda it can be correlated with Utsangini, Tridoshaja Vartmagata Roga. In this study a 20 year old female patient approached to the Shalakya Tantra OPD of Rajeev Institute of Ayurvedic Medical Science and Research Centre, Hassan with a history of swelling on upper eyelid of right eye since 2 months. The growth was large in size and the inner part of eyelid is red in colour and painless. On examination the patient was diagnosed with chalazion. The patient was treated with Bhedana Karma followed Pratisarana Karma and systemically administered Shamana Chikitsa. Remarkable result was observed in all the aspects of the disease. Hence, Bhedana and Pratisarana Karma are proofed to be effective in the management of chalazion.

Keywords: Chalazion, Utsangini, Bhedana Karma, Pratisarana Karma

Corresponding Author How to Cite this Article To Browse
Varun TV, Assistant Professor, Dept of Shalakya Tantra, Rajeev Institute of Ayurvedic Medical Science and Research Centre, Hassan, Karnataka, India.
Email: 		Varun TV, Chaitra TM, Akshitha P, Bhedana Karma in the management of Chalazion: A Case Study. J Ayu Int Med Sci. 2024;9(1):329-332.
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https://jaims.in/jaims/article/view/2923

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-11-14 2023-11-24 2023-12-04 2023-12-14 2023-12-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 20.33

© 2024by Varun TV, Chaitra TM, Akshitha Pand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Varun TV et al. Bhedana Karma in the management of Chalazion: A Case Study

Introduction

A chalazion is a chronic sterile lipo-granuloma. They are typically slowly enlarging, non-tender eyelid nodules. Chalazion are typically benign and self-limiting, though they can develop is a red bump on eyelid and also they can develop chronic complications. It is sometimes called an eyelid cyst or a meibomian cyst. A chalazion is caused by inflammation of a meibomian gland.[1] Recurrent chalazia should be evaluated for malignancy.

It is a common condition, though the exact incidence in worldwide is not documented. It appears to affect males and females equally, but exact numbers are not available. [2]

It is more common in children and young adults and the patients having eye strain due to refractive errors. The main predisposing factors of chalazion are habitual rubbing of eyes or fingering of the lids and nose, excessive intake of carbohydrate or alcohol.[3]

Chalazion can be correlated with Utsangini. Abhyanthara Mukhi, Bahya Utsanga, Pitaka on Varthma, Raktha Varna, Kandu and Kukkudanadavat Srava[4] are the symptoms of Utsangini which are similar to that of chalazion. Utsangini is one of the Vartmagata Roga and according to Acharya Sushruta Utsangini is Tridhoshaja Vyadi. According to Acharya Vagbhata Utsangini is Rakta Doshaj Vyadi. Which is characterised by Abyantaramukhi (Opening in the inner side), Bahya Utsanga (Nodular swelling in the external surface of the eye lid), Adho Vrtmana (In lower lid) Tadrupa Pidika (similar blisters around the main Utsanga)[5], Tamra (A copper coloured Pidika), Kandu (Itching), Rakta (Red colour), Sthula[6], Bahyaat Api Drushyate (Visible from external surface), Katina (Hard), Manda Vedna (Dull pain), Prabhinna Sravet Sravaa Kukutanda Rasopamam (if busting discharge thick pus resembling egg yolk).[7]

Aims and Objectives

To evaluate the effect of Bhedana Karma and Pratisarana Karma in the management of chalazion.

Materials and Methods

Case history

A 20 year old female patient came to out-patient department of Shalakya Tantra, Rajeev Institute of Ayurvedic Medical Science and Research Centre, Hassan in September 2023. She had swelling on upper eyelid of right eye since 2 months. The growth was large in size and the inner part of eyelid is red in colour and painless. On examination sclera, cornea, iris, pupil and lens were found to be normal. Visual acuity of both the eyes was 6/6. On the basis of clinical signs and symptoms the patient was diagnosed with chalazion.

Past history: Nothing significant.

Family history: No one in her family is having similar complaints.

Personal history:

Bowel : Regular

Appetite : Good

Micturition : 2 to 3 times/day

Sleep : Sound

Hypertension : No

Diabetes : No

Smoking : No

Alcohol : No

General Examination

Pallor : Negative

Oedema : None

Cyanosis : None

Tenderness : None

Pulse : 72/min

BP : 122/84 mm of Hg

Systemic Examination

Respiration    : Chest clear &Throat red

CVS : S1, S2

Bowel sounds   : Positive

CNS : Well oriented


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Varun TV et al. Bhedana Karma in the management of Chalazion: A Case Study

Abdomen : Soft

Treatment History

In this study we selected the treatment of Bhedana Karma, Pratisarana Karma with the mixture of Saindhava Lavana, Madhu and Ghrita. And as a Shamana Chikitsa, 2 tablets of Kancahanara Guggulu for internal administration twice in a day for 5 days.

Discussion

Chalazion is non-infective lipo-granulomatous inflammation of Meibomian gland. It’s also called Meibomian cyst. It is correlated to Utsangini in Ayurveda. Utsangini is explained under Vartmagatha Rogas by both Sushrutha and Vagbhata. It is a Tridoshaja Sadhya Vyadhi according to Acharya Sushrutha. But whereas according to Acharya Vagbhata it is a Raktaja Sadhya Vyadhi. Both Shastra and Ashastra Chikitsa are mentioned in the treatment of Utsangini.

Bhedhana Karma

Bhedyam Bhedaneeyam, Vidradyadi

It means incision taken for opening a cavity or taping of cavity to drain out pus, Rakta, removing calculus etc. features of ideal Incision Aayata (Deergha - adequate length), Vishala (Vistheerna - extensibility), Sama (uniform cut edges), Suvibhakta (Heena and Atidosha Mukta), Nirashraya (Away from Jihwa, Danti, Asthi, Marma), Should have knowledge of Aama and Pakvaavastha (Asama Paako Pakva).

Acharya Sushrutha has indicated Bhedana Karma (Bhedana Sadhya Vyadhi) in the following diseases - All Vidradhi except Sannipatika, Vataja Granthi, Pittaja Granthi, Kaphaja Granthi, three types of Visarpa, Vridhi Roga, Vidarika, Prameha Pidika, Vrana Shopha, Stana Vidradhi, Avamanthaka, Utsangini, Kumbhika, Anusayi, Nadi Vrana, Vrinda Roga, Pushkarika, Alaji, Kshudraroga, Talupupputa, Danta Pupputa, Tundikeri, Gilayu, Ashmari And Medaja Roga etc.[8]

In conditions which having pus inside, but not having an opening, even having sinuses inside or pus pocket are ideal to Bhedana or splitting and draining the accumulated pus.[9] Shastra's and Anushastra's used for Bhedana Karma are Vriddhi Patra, Nakha Sastra, Mudrika, Utpala Patra and Ardha Dhara

. Anushastra's are Twak Sara, Sphatika, Kaca (glass pieces), Kuruvinda, Nakha.

Pratisarana or rubbing has been explained as Sthanika Chikitsa. Pratisarana is done, where Shastra Karma has a limitation to be used because of the sensitive surgical sight and for proper healing process of surgical sight.

Hastameva Pradhana Yantra

Hasta (hand) has been used to carry out the procedure with various Lekhana Dravyas on such a delicate and sensitive structure with the expectation to cease the deep rooted / recurring / stubborn conditions. The importance of Pratisarana in Netra Roga as local ocular therapeutic/ surgery and its measures is immense into the present day in any chronic conditions as acute management due to its vast advantages, cost effect, availability of the drugs and procedure.

Ghee can helpmoisturize the delicate skin around your eyes, cleansing and wound healing properties, reduce dark circles and wrinkles, and promote relaxation and restful sleep. But that's not all. Ghee can also be used to make Netra Tarpana an Ayurvedic eye treatment. This treatment is a powerful ally for your health and beauty, especially for eyes

In addition to its use as a natural sweetener, honey is used as ananti-inflammatory, antioxidant and antibacterial agent. People commonly use honey orally to treat coughs and topically to treat burns and promote wound healing.

Saindhava Lavana: Light, Unctuous, effect on Tridosha - We have already know that salt taste usually increases Pitta, but Saindhava Lavana, being cold in potency helps to balance Pitta. And it also helps to relieves Kapha.

Kanchanara Guggulu consist bark of Kachanara, Triphala, Trikatu, bark of Varuna, Ela, Tvaka, Dalachini and Guggulu.[10] All the contents have Lekhana property and Kanchanara has specially Granthi Nashaka property.[11] Anupana is Kanchanara Kashaya which enhanced the activity of Kanchanara Guggulu. On the basis of these properties, it helped in the healing of the site where Shastra Karma performed, as well as relieving the symptoms of chalazion.


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Varun TV et al. Bhedana Karma in the management of Chalazion: A Case Study

Result

After performing Bhedana Karma and Pratisarana Karma for three days, there was a marked relief in the complaints, like swelling of the lid and foreign body sensation in eyes. No complications are observed during the procedure and after the procedure. No complaints from patient were not there during the procedure of Bhedana and after the completion of the treatment.

Conclusion

This case study reveals the patient with large single chalazion can get significant result through Bhedana Karma followed by Pratisarana Karma and Ayurveda management.

References

1. Jin KW, Shin YJ, Hyon JY. Effects of chalazia on corneal astigmatism: Large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism. BMC Ophthalmology. 2017 Mar 31;17(1):36.

2. National Centre for Biotechnology Information. Chalazion [Internet]. Bethesda (MD): National Library of Medicine (US); 2017.

3. Cleveland Clinic. Chalazion (Meibomian Gland Cyst) [Internet]. Cleveland Clinic; [updated 2022 May 6; cited 2023 Dec 21].

4. Narayan JV. Netra roga Vidyana. Shalakya-1. Pune: Vimal Vision Publication; 2018; 2:76.

5. Ambikadatta Shastri. Sushrut Samhita. 12th ed. New Delhi: Chaukhamba Publication; 2001; 26: shu.utt. 3/9.

6. Nidan, 59/76.

7. Dalhan Tika - Sushrut Samhita. 12th ed. New Delhi: Chaukhamba Publication; 2001; 26: shu.utt. 3/9.

8. Dutt A. Sushruta Samitha. Sutra Sthan 25/5-8. Delhi: Chowkhamba Orientalis; 2008.

9. Murthy KRS. Sushruta Samitha. Chikitsa Sthan 1/34. Varanasi: Chowkhamba Orientalia; 2016.

10. Sharangdhar Acharya. Sharangdhar Samhita, uttar khanda 13/13. In: Anjanaidana of Maharshi Agnivesha annotated with Deepika

Hindi commentary by Dr. Brahmanand Tripathi. Varanasi: Chaukhambha Surbharti Prakashan; 2013; 137.

11. V. Sharma. Dravya Guna Vigyana, vol. II. Varanasi: Chaukhambhan Bharti Academy; 2007; 236.


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