E-ISSN:2456-3110

Review Article

Artavavaha Srotas

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 7 JULY
Publisherwww.maharshicharaka.in

A critical study of Artavavaha Srotas w.s.r. to Vandhyatva (infertility)

Anjini M1*, Jaiswal RT2, Ram M3, Saxena A4
DOI:10.21760/jaims.9.7.13

1* Anjini M, Post Graduate Scholar, Department of Samhita Evum Siddhant, Government Ayurvedic Pg College and Hospital, Varanasi, Uttar Pradesh, India.

2 Ramnihor Tapsi Jaiswal, Reader, Department of Samhita Evum Siddhant, Government Ayurvedic Pg College and Hospital, Varanasi, Uttar Pradesh, India.

3 Manohar Ram, Reader, Department of Samhita Evum Siddhant, Government Ayurvedic Pg College and Hospital, Varanasi, Uttar Pradesh, India.

4 Anjana Saxena, Reader, Department of Samhita Evum Siddhant, Government Ayurvedic Pg College and Hospital, Varanasi, Uttar Pradesh, India.

The Moola of Artavavaha Srotas are Artavavahi Dhamani and Garbhashaya as per Sushruta. Artavavaha Srotas shows quite similarities with female reproductive system explained in modern medical science. The health of a female starts in the foetal stage itself, which describes the measures to yield a healthy child. Just as the river is cleansed by its flow the women are purified by the menstrual flow. That is the reason for the non-susceptibility of women to many diseases. The regimens to be followed during menstrual and post-menstrual periods are well advocated in Ayurveda. Disregard to these regimens is the leading cause for many of the gynecological and systemic diseases in women. Anatomical defects of the reproductive system could be one of the commonest causes of bad obstetric history. As per ayurveda, important factors for conception are considered as Ritu (fertile period), Kshetra (uterus and reproductive organs), Ambu (Proper nutrient fluid) and Bija and also normalcy of Hrdaya (Psychology). From the time immemorial the phenomenon of infertility was prevalent throughout the world and this may persist till the human race exists. Failure to achieve conception by a couple within one year is termed as infertility. The historical importance of Stri Vandhyatva and a comparative study of Nidan, Samprapti, Lakshana, Chikitsa etc. compiled from various Granthas like Harita Samhita etc. are being presented in this study. One in every four couples in developing countries had been found to be affected by infertility. In India alone many women are suffering from infertility. The major causes are including male factor such as azoospermia, hypospadias, female factors such as such as peritoneal factor, tubal factor, ovarian factor, cervical factor. Sometimes unexplained causes are also explained. So, this article contents about the importance of Artavavaha Srotas in causing Vandhyatava, general awareness and clinically used various treatment modalities as per Ayurveda for female infertility has been explained.

Keywords: Srotas, Aartavavahasrotas, Vandhyatva, Infertility

Corresponding Author How to Cite this Article To Browse
Anjini M, Post Graduate Scholar, Department of Samhita Evum Siddhant, Government Ayurvedic Pg College and Hospital, Varanasi, Uttar Pradesh, India.
Email: 		Anjini M, Jaiswal RT, Ram M, Saxena A, A critical study of Artavavaha Srotas w.s.r. to Vandhyatva (infertility). J Ayu Int Med Sci. 2024;9(7):100-108.
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https://jaims.in/jaims/article/view/3599

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-05-14 2024-05-24 2024-05-31 2024-06-08 2024-06-21
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© 2024by Anjini M, Jaiswal RT, Ram M, Saxena Aand 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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Introduction

The anatomical and physiological description in Ayurvedic literature is different from modern science, these are described based on the principles more than the structures present. Modern science is based on Pratyaksha only, while Ayurveda does consider the Anumana, Aaptopadesha along with Pratyaksha. In Ayurveda, the anatomical description is gross based on various principles like Srotas, Dhatu, Marma and so on. The channels of circulation, carrying the Dhatu (tissue elements or their constituents), undergoing transformation, to their destination are called as Srotas.

As many are the structural entities in the human body, in correspondence to these, as many are the types of Srotases. The specific varieties of the Srotas in the human body are the same in number as the structural entities in it. In absence of their respective Srotas, no entity of the human body undergoes manifestation or diminution. When the flow of appropriate nutrients and energies through these channels are unimpeded, health of the individual is maintained; when there is excess, deficiency, or blockage in these channels, disease occur.

According to Chakrapani, the commentator of Charaka Samhita, the channels which transport the Poshaka Dhatus (the part of the Rasa etc. tissues which flow to provide nutrition to the successive tissues) are called Srotas. These Srotases are Atisukshma, Athibahu, Aparisankhya according to their anatomy. The word Ayanamukhani is used as adjective of Srotamsi. Along with Vahana of different Dhatu, Upadhata and Mala through Ayanamukha, Sravana Kriya always takes place in Srotas.

Srotas:

Holistic biology of Ayurveda is based on Triguna, Tridosha, Sapthadhatu, Oja, Agni, Ama and Srotas. Srotas are the inner transport system of the body which provide platform for activities of other important bio-factors. Ayurvedic classics proclaim "Srotomayam Hi Shariram” means that living body is a channel system and is comprised of innumerable channels which are designed as inner transport system for diverse function, gross and subtle, biological and energetic.

According to Charaka, in Vimana Sthana chapter 5.[1]

यावन्तः पुरुषे मूर्तिमन्तो भावविशेषास्तावन्त एवास्मिन् स्त्रोतसां प्रकारविशेषाः ।

स्त्रोतांसि खलु परिणाममापद्यमानानां धातूनामभिवाहीनि भवन्त्य यनार्थेन ||

Generally, the word Srotas indicates all the macro and micro channels and pathways operating in the living organism, and also used as pathway for Dhatu transformation.

Charak has defined it as "Sravanat Srotamsi" means the structure through which Sravanam takes place. He has described that Srotamsi are channels which transport the Dhatus (Asthayi or Poshya Dhatu) which are subjected to transformation.

Chakrapani has explained that Sravanat means Sravanam of Rasadi Poshya Dhatu. Acharya Sushruta and Vagbhata both have compared Srotas to the extremely fine passages and pores present in the lotus stem, through which Rasadi Poshya Dhatu circulate all over the body and provide nutrition to body.

Artavavaha Srotas:

Artavavaha Srotas are the channels of transformation and transportation of female reproductive constituents and menstrual blood originating from uterus (Garbhashaya) and its vessels (Artavavahi Dhamani).

According to Sushruta,

आर्तववहे द्वे, तयोर्मूलं गर्भाशय आर्तववाहिन्यश्च धमन्यः |

तत्र विद्धाया वन्ध्यात्वं मैथुनासहिष्णुत्वमार्तवनाशश्च ||

Roots of Artavavaha Srotas:

The Channels which carry the menstrual blood out of the body during monthly cycles in women are 2 in number. Their roots are located in;

  • Garbhashaya: Uterus
  • Artava Vaahini Dhamani: The Arteries which carry the menstrual blood

Symptoms of damage or injury to Artavavaha Srotas:

  • Vandhyatva: Infertility
  • Maithuna Asahishnuta: Intolerance to sex

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  • Aartava Naasha: Amenorrhoea
  • Dyspareunia: Difficulty in sex or painful sex

Vandhyatva:

Vandhya refers to absolute inability to conceive due to series of innate problems like Bijopaghata (congenital or acquired abnormalities) resulting in sterility. It is a Universal Phenomenon occurring both in developing and under developing countries. Charaka and Vagbhata have referred Vandhya as the result of Pradusta Garbhasaya Bija Bhaga of Sonita. The incidence of Primary infertility is about 50% among females, while it is 25% among males, male and female factors together account for another 25%. Besides genetic factors, changed life style, increased stress, strain and environmental pollution are identified as factors contributing to the rising rate of infertility. Charaka and Vagbhata have referred Vandhya as the result of Pradusta Garbhasaya Bija Bhaga of Sonita.[1]

यस्य यस्य ह्यवयवस्य बीजे बीजभागे वा दोषाः प्रकोपमापद्यन्ते, तं तमवयवं विकृतिराविशति । यदा ह्यस्याः शोणिते गर्भाशयबीजभागः प्रदोषमापद्यते, तदा बन्ध्यां जनयति । (Ca.Sa.4/30)

Vedas:

The Vedas are considered as the most earliest of the literature available, In Rigveda, there is a clear description about the Krimis like Durnama, which destroys Garbhasaya (Uterus) leading to infertility in woman.

Charaka:

Classifies Vandhya into 3 types:

  • Vandhya
  • Apraja
  • Sapraja.

Vandhya: it is due to congenital absence of uterus or Artava, Chakrapani explains "Vandhya refers to incurable congenital or acquired abnormalities, resulting into absolute sterility" (Ca.Sa.2/5, Chakrapani Commentary).

Apraja: infertility in which woman conceive after treatment or primary infertility.

Sapraja: It is a condition in which a woman in her active reproductive age does not conceive after giving birth to one or more children or it refers to secondary infertility.

Suśruta Samhita:

Susruta has quoted Vandhya in Vimsati Yoni Vyapats.

  • Infertility has been included in the clinical features of injury to Artavavaha Srotas (Su.Sa.9/12).
  • Susruta while describing Bija Bijabhaga Dushti states that vitiated Sukra and Artava by Vatadi dosas, causes infertility.[2] (Su.Sa.2/5)
  • He also included Vandhya under Vataja Yoni Vyapats of which the characteristic feature is

वन्ध्यां नष्टार्तवां विद्याद् |

The word Artava, means Stri Bija (ovum) or Rajasräva (Menstrual Blood). So, the word Nastartava may represent the absence of either ovum or menstrual blood.

Astanga Sangraha:

  • Vägbhata has referred Vandhyatwa, due to abnormality of [3] (A.S.Sar.2/48)
  • Abnormalities of Kshetra, woman suffering from Yoni Vyapats, never conceive and untreated Yoni Vyapats ultimately results in [4] (A.S.Ut.38/53)
  • Putragni & Jatagni Yoni Vyapats cause

Astanga Hridaya:

Acharya Vagbhata has given more importance to psychological, emotional factors and mental health for Garbhadharana (conception).

Normal functioning of,

  • Vatodosha,
  • Ojobala (immunity),
  • Shadbhavas like Matruja (mother), Pitruja (father), Atma (soul).
  • Satmya (Wholesome/Compatible), Rasa (nutrition), Satva (mind) also plays an important role in fertility.[5] (A.H. Sar. 1/8-9). Derangement in these factors may results in

Madhava Nidana:

Madhavakara included the Vandhya in Vimsati Yoni Vyapat.[6] (Ma.Ni.62/3)

वन्ध्यामाह - नष्टमार्तवं रजो यस्यां सा तथा |

Vandhya: loss of Artava without pregnancy


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Bhavamisra:

Bhavamisra denotes the cause of Vandhyatva is semen falling on the Samirana Nadi.[7]

समीरणा चन्द्रमुखी च गौरी विशेषमासामुपवर्णयामि ।।

प्रधानभूता मदनातपत्रे समीरणा नाम विशेषनाडी ।

तस्या मुखे यत् पतितं तु वीर्यं तन्निष्फलं स्यादिति | (Bh.Pr.Pu.Garb.3/18)


Kasyapa Samhita:

  • Kasyapa mentions Vandhyatva as one of the eighty disorders of [8] (Ka.Sam.Su.28/6)
  • He says that, the couple having number of children with proper growth and development due to effect of nature or their own deeds are fortunate, otherwise (having failed to achieve pregnancy) should be treated under the description of [9] (Ka.Sam.Sar.5/3)
  • Kasyapa has mentioned one Puspagni having abnormal Puspa or menstruation (no conception) and certain other characterized with repeated expulsions of fetus of different gestational periods, since in these condition also the woman fails to get a child, thus it can also be included under infertility.[10] (Ka.Sam.Khi.6/33)
  • He mentions abnormality in Sadbhavas will cause the infertility.[11] (Ka.Sam.Sa.5/5)
  • Excessive Medication for Vamana, Virecana to a person of Mrdu Koshta, even after proper Snehana and Svedana causes bleeding, resulting in the vitiation of Vayu, this aggravated Vayu causes destruction of Bija and Puspa. in such conditions infertility always develops.[12] (Ka.Sa.Si.3)


Harita Samhita:

As per Harita Samhita Vandhya is described as a separate entity.

While discussing abnormalities of Kshetra, he says that, constriction of uterus and vulva due to the coitus done with the girl before menarche also causes infertility.[13] (Ha.Sam.3, 5-48/1,2)

In abnormalities of Ambu, Harita mentioned Dhatu Kṣhaya (Ha.Sam.48/1) is one of the causes for infertility.

Classification of Vandhya as per Harita Samhitä.

  • Käka Vandhya
  • Anapatya
  • Garbha Srava
  • Mrtavastha
  • Dhatukṣaya
  • Garbha Kosa Bhanga

Except Kaka Vandhya all are curable


Bhela Samhita:

  • Bhela says that, Vandhyatva occurs due to abnormalities of Bija of female and male.
  • Non consumption of congenial
  • Suppression of natural urges and disorders of Yoni

The woman either delivers abnormal child or become infertile is known as Vandhya. He further mentions that, causes of failure to become pregnant are only two i.e.

  • Affected with various diseases of Vata
  • Abnormalities of Yoni (reproductive organs).[14] (Bhe.Sam.Sa.2),


Rasa Ratna Samuchaya:

Vandhya has been classified into 9 groups as follows: [15] (RRS. 22/1-4)

    1. Vandhya (infertility due to influence of misdeeds done by couple in their previous or present life),
    2. Rakta Vikära Janya
    3. Vata Dosa Janya
    4. Pitta Dosa Janya
    5. Kapha Dosa Janya
    6. Tridosaja
    7. Bhūta Janya
    8. Deva Janya
    9. Abhicara Janya.


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Vandhya has been again classified as

1. Garbha Sravi (repeated abortion).
2. Mrtastha (Still born),
3. Stri Prasuti (Who delivered female baby)
4. Kaka Vandhya (Who delivered one child) (R.R.S. 22/4)

Yogaratnakara:

He has included Vandhya in Vimsati Yoni Vyapat

Yogaratnakara has followed Susruta as

Vandhya Nastartava Ghneya i.e., loss of Artava or Rakta due to Vayu is known as Vandhya.[16]

Chikitsa:

Management of Vandhyatva w.s.r. to Abijotsarga can be broadly classified into:[17]

(A) Shodhanam:

  • Snehanam
  • Svedanam
  • Vamanam
  • Virechanam
  • Niruha Vasti
  • Anuvasana Vasti
  • Uttara Vasti

(B) Samana Chikitsa:

  • The line of treatment described for Sukra Doşa, Artavadoşa, Stanya Roga, Klaibya, Mudha Garbha, Garbhiniroga, Apraja Roga, can be adopted for Artava Duşţi Chikitsa (Su.U.38/37,32).
  • Rasayana and Väjikaraņa drugs are also useful (Su.Sa.2/12)
  • Sukradoşahara Ouşada may also be useful (Su.Sa.2/12)
  • Kşhīra only or medicated with Jivanīya Drugs is useful for treatment (K.S.Si.)

Treatment for anovulatory cycle:

  • Kapha Vata Haram, Usnam, Anulomanam type of drugs should be selected.
  • Gulma Nāsanam, Artava Visesatvam, Kațu Rasam, Lekhanam, Sophagnam, Artava Pravartanam type of drugs should be selected.

Virecanam:

Dose: Fixed based on the Kosta of the patient.

  • Sukumara Erandam - 20 ml at 9.30 am on empty stomach.
  • Kalyānakam Gudam - 25 gm at 9.30 am on empty stomach
  • Kumāri Ennai (Siddha) - 20 ml at 9.30 am on empty stomach
  • Vizhuthi Ennai (Siddha) - 20 ml at 9.30 am on empty stomach

Kaşhaya Kalpana:

Dose: 60 ml b.d. half an hour before food

  • Saptasāram Kaşāyam
  • Kulatthādi Kaşayam
  • Kaņā Satāhvādi Kasāyam
  • Mahā Rāsnādi Kasayam

Vați Kalpana:

Dose: 2 b.d after food

  • Rajapravartini Vați
  • Candraprabha Vați
  • Siva Gulika

Arista/Asava kalpana:

Dose: 25 ml b.d after food

  • Lakşmaņāriştam
  • Kumāryāsavam
  • Lohāsavam
  • Jirakāriştam

Rasa Ousadis:

  • Ayakänta Chendūram - 250 mg b.d with honey after food
  • Känta Sindūram - 250 mg b.d with after food

Reduced thickening of endometrium:

  • Here Kapha Kşaya and Vāta Vṛddhi in Väta Sthana takes place.
  • Madhura Rasam and Brmhaņa Ouşadam helps when given after appropriate

For Virecanam:

Dose: 25 gm on empty stomach at 9.30 am. Kosta of the patient should be assessed before fixing the dosage.


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  • Trivrt Lehyam
  • Kalyānaka Gudam

Pratimarşa Nasyam:

Dose: 2 drops each nostril/day

  • Dhanvantaram Tailam
  • Kşhirabalā Tailam

Yapana Vasti is effective.

Lehya Kalpana:

Dose: 10 gm b.d after food.

  • Kumāri Lehyam
  • Küşmanda Rasāyanam
  • Satāvari Lehyam
  • Gokşūrādi Sarpir Gudam

Taila Kalpana (internal):

  • Maşa Tailam - 10 ml b.d with milk after food
  • Kşīra Balā 7 Avarti Tailam - 10 drops b.d with milk after food
  • Sahacaradi Pasti Pakam- 10 ml b.d with milk after food.

Ghrta Kalpana:

Dose: 10 ml b.d with milk after food.

  • Kalyāņakam Ghrtam
  • Mahā Kalyāņakam Ghrtam
  • Phalasarpis
  • Vidāryādi Ghrtam
  • Ajamāmsa Ghrtam:
  • Brhat Cāgalādya Ghrtam
  • Mahā Paisācika Ghrtam

Arista Kalpana:

Dose: 25 ml b.d after food.

  • Asvagandhāriştam
  • Balāriştam

Ksīra Kaşāyam:

Dose: 60 ml at 6 pm after food.

  • Ratna Puruşh, Lākşa, Satāvari, Balā, Ardrakam
  • Vatānkuram
  • Lakmsana

  • Satāvari

Pathya:

  • Coitus during Rtukāla is beneficial.
  • Milk is beneficial use of this help in achievement of pregnancy.
  • Meat increases Artava, gives nourishment and helps in getting pregnancy.
  • Lasuna is also Pathya for infertile woman.[17]

Infertility:

Definition: Infertility is defined as a case of not able to conceive after 1 year of regular sexual intercourse without the use of contraceptives.

  • It is when a female cannot conceive due to a problem with the reproductive system of either partner.
  • Infertility can be primary or secondary.
  • Primary infertility is when someone is not able to conceive at all.
  • Secondary infertility is when someone has previously conceived but is no longer able to get pregnant or carry a baby to term.[18]

Causes in females:

Infertility in females can also have a range of causes.

Problems with ovulation:

  • Ovulation disorders make up about 25% of infertility cases in females.
  • Ovulation is the monthly release of an egg.
  • The eggs may never be released, or they may only be released in some cycles.

Ovulation disorders can occur due to:

Hyperprolactinemia:

If prolactin levels are high and the female is not pregnant or breastfeeding, it may affect ovulation and fertility.

Thyroid problems:

An overactive or underactive thyroid gland can lead to a hormonal imbalance that interferes with ovulation.


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Polycystic ovary syndrome (PCOS):

This is a hormonal condition that can cause frequent or prolonged menstruation and can interfere with ovulation. Problems in the uterus or fallopian tubes can also prevent the egg from traveling from the ovary to the uterus, or womb. If the egg does not travel, it can be harder to conceive naturally.

Other causes:

  • Chronic conditions: These include AIDS or cancer.
  • Primary ovarian insufficiency (POI): The ovaries stop working normally before the age of 40 years.
  • Poor egg quality: The quality of the eggs may interfere with conception. As a female ages, the number and quality of the egg’s declines. Eggs that are damaged or develop genetic abnormalities may also not be able to sustain a pregnancy. The older a female is, the higher the risk.

  • Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix.
  • Submucosal fibroids: Benign or noncancerous tumors occur in the muscular wall of the uterus. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg.
  • Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.
  • Tubal ligation: In females who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high.[19]

How common is infertility?

Worldwide, 8-12% of couples experience fertility problems. At least 20% of infertility cases happen solely due to a problem with the male reproductive system. In addition, 19% of American females ages 15-49 years’ experience primary infertility after 1 year of trying. About 6% of married females ages 15 49 years’ experience secondary infertility.

Complication of infertility

  • If conception does not occur, it can lead to stress and possibly depression.
  • Some physical effects may also result from treatment for infertility. For example, a female could get ovarian hyperstimulation syndrome (OHSS) from taking medications to stimulate the ovaries.
  • There can be an ectopic pregnancy.
  • Multiple pregnancies may also result from fertility treatment. If there are too many embryos, carrying all of them to term may cause health problems during the pregnancy.[19]

Points to remember:

  • If the function of Artavavaha Srotas are deranged due to causes like malnutrition, Psychological, behavioral factors, Injuries and iatrogenic factors will affect the Beeja, Beejabhaga Avayava and produce diseases like Vandhya, Klaibya
  • Life style of present day's women is very stressful, unhealthy and unhygienic due to unawareness, hectic and fast running schedule. So, infertility is emerging as one of the major disorder affecting the social and psychological aspect of the life of the masses. hence causing mental instability of the male as well as female partner
  • Infertility currently affects about 10 to 14 percent of the Indian population, with higher rates in urban areas where one out of six couples is impacted. Nearly 27.5 million couples actively trying to conceive suffer from infertility in India.
  • Every human being has a right to the enjoyment of the highest attainable standard of physical and mental health. Individuals and couples have the right to decide the number, timing and spacing of their children. Infertility can negate the realization of these essential human rights.
  • Infertility has significant negative social impacts on the lives of infertile couples and particularly women, who frequently experience violence, divorce, social stigma, emotional, stress, depression, anxiety and low self-esteem.

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    In such situations, education and awareness raising interventions to address understanding of the prevalence and determinants of fertility and infertility is essential.
  • The infertility literature can also serve to remind us that it is not only women who reproduce, who undergo medicalization and who experience stigma, and that men need to be a part of research on gender and health
  • The most important goal of the fertility investigation is to identify the cause(s) of infertility and to prescribe adequate therapy. This is not the only task of the physician, however, as she/he should also provide accurate information to the couples and often correct misinformation gained from friends or family.

Conclusion

Infertility affects millions of peoples worldwide and has an impact on their family and communities. Ayurveda helps in regulating menstrual cycles, enhancing general health and wellness, reducing stress, enhancing sleep, controlling anxiety and increasing energy level, balancing the endocrine system and improving blood flow in pelvic cavity, thereby promoting fertility.

By this study, what is Artavavaha Srotas as per text and what are its afflictions and how its affliction leads to Vandhya, the relation of Artavavaha Srotas and Vandhyata will be established and will prove that the Ayurvedic principles are effective with systematic approach in managing unexplained infertility in a holistic and cost-effective method.

References

1. Charaka samhita Vidyotini Tika by Pt. Kashinath Pandey and Dr. Gorakhnath Chaturvedi, Charaka Sarira 4/30 , Charaka Vimana Sthana chpt 5.

2. Sushruta Samhita By Ambika Dutta Shastri Part 1 & 2, Chaukhambha Sanskrit Sansthan, Varanasi, su.sa 2/5 .

3. Astanga Sangraha Sarira sthana -2/48, Saroj Hindi commentary by Ravidatt Tripathi Chowkhamba Prakashana Varanasi, 2006; 192.

4. Astanga Sangraha uttaram 38/53, Saroj Hindi commentary by Ravidatt Tripathi Chowkhamba Prakashana Varanasi, 2006; 192.

5. Astanga Hridaya Sarira Sthana chapter 1/8-9, Vidhyotini Hindi commentary by Kaviraj Atrideva gupta revised by Vaidhya Yadunandana Upadhyaya published by Chaukhambha Sanskrit series, 2012; 132.

6. D 1995 Madhava Nidanam(62/3), Published by Prachi Publications, Hyderabad .

7. Bhava Prakasha (part 1&2) Bhavamishra with Vidhyotini Hindi commentary by Shri Brahma Shankar Mishra, 9th edition 1999, Purvakhanda 3/17; 2

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J Ayu Int Med Sci 2024;9(7)107