E-ISSN:2456-3110

Review Article

Ashmari Chikitsa

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 8 AUGUST
Publisherwww.maharshicharaka.in

Ekala Dravya Prayoga mentioned in classics for Ashmari Chikitsa - A Review

George S1*, MS Veena2
DOI:10.21760/jaims.9.8.17

1* Sunona George, Post Graduate Scholar, Department of Dravyaguna, Government Ayurveda Medical College, Bengaluru, Karnataka, India.

2 MS Veena, Professor and HOD, Dept of PG and PhD Studies in Dravyaguna, Government Ayurveda Medical College, Bengaluru, Karnataka, India.

Acharyas have described various disorders related to Mutravaha Srotas, with Ashmari being one such condition that can be correlated with urolithiasis based on its clinical features. It affects approximately 12 million people worldwide, with 1 in 10 individuals experiencing it at least once in their life-time, and 2% of cases being recurrent. Prevalence of renal calculi is more in males than in females about 11% in males and 9% in females. Though different treatment modalities are there for Ashmari, Ekala Dravya Prayogas are common, convenient, economical and effective method of treatment. Acharyas have described drugs such as Sigru (Moringa oleifera), Tumburu (Zanthoxylum alatum), Gokshura (Tribulus terrestris), Varuna (Crataeva nurvala) etc. for Ekamoolika Prayoga in Ashmari. Most of drugs are of Kashaya-Tikta Rasa, Laghu - Ruksha Guna and Tridosha-Hara which is administered with different Anupanas, found to be effective in Ashmari Chikitsa.

Keywords: Ashmari, Ekamoolika Prayoga, Urolithiasis, Ekala Dravya

Corresponding Author How to Cite this Article To Browse
Sunona George, Post Graduate Scholar, Department of Dravyaguna, Government Ayurveda Medical College, Bengaluru, Karnataka, India.
Email: 		George S, MS Veena, Ekala Dravya Prayoga mentioned in classics for Ashmari Chikitsa - A Review. J Ayu Int Med Sci. 2024;9(8):117-121.
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https://jaims.in/jaims/article/view/3735

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-07-15 2024-07-25 2024-08-05 2024-08-15 2024-08-26
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© 2024by George S, MS Veenaand 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

Ashmaanaam Raati Dhadhati Ya which means the formation of hard stony structure is Ashmari. Vedana at Nabhi, Basti, Sevini and Medra (pain in umbilical and inguinal region), Mutradhara Sangam (impaired urinary flow), Gomedaka Prakasha Mutram (discolored urine), Sa Rudhira Mutrata (Blood in the urine), Sasiktham (along with gravel) and Mutra Vikiranam are the features of Ashmari, clinical features of the same can be correlated to urolithiasis. Sushruta mentioned Ashmari under Ashtomahagada due to its recurrence and bad prognosis.[1]

Urolithiasis, also known as renal calculi, is a condition where crystals in urine aggregate and form stones in urinary tract. The incidence and prevalence of urolithiasis have increased significantly over the past few decades due to factors such as changes in lifestyle, dietary habits and due to certain medications. Global warming will further increase the frequency of urolithiasis by 7-10%.[2] With different treatment modalities, Acharya’s had mentioned different Ekamoolika Prayogas for curing Ashmari. In this article Ekamoolika Prayoga of different drugs along with its method of administration is mentioned.

Aim and Objectives

To analyze various Ekala Dravya Prayoga quoted in classics for Ashmari Chikitsa with method of administration

Materials and Methods

Ashmari

According to Acharya Sushruta, Divaswapna (Day sleep) Samashana (Combining both compatible and non-compatible foods), Adhyashana (Eating food too frequently), Viruddha Ahara (Non compatible foods), over indulgence in Vyayama (physical exercise), excessive intake of Ruksha Madya (Consuming alcoholic beverages), Anupa Mamsa (Eating flesh of animals of marshy places) and Ajeerna (Indigestion) are considered to be causative factors of Ashmari.[3] Ashmari is a Tridoshaja Vyadhi where Vata cause Avarana to Basti and Parishoshana of Mutra, Mutra along with Pitta, Kapha and Sukra results in formation of Ashmari like the formation of Gorochana.[4]

Mainly are of 4 types

Vataja, Pittaja, Kaphaja and Sukrashmari.

Table 1: Single drugs used in Ashmari Chikitsa according to Ayurvedic classical texts

SNDrugBotanical NameFamily NamePart used
1.ShigruMoringa oleiferaMoringaceaeMoola
2.TumburuZanthoxylum alatumRutaceaeBeeja
3.HaritakiTerminalia chebulaCombretaceaeBeeja
4.KutajaHolarrhena antidysentricaApocynaceaeTwak
5.TrapusaCucumis sativusCucurbitaceaeBeeja
6.NarikelaCocos nuciferaAraeceaePushpa
7.GokshuraTribulus terrestrisZygophyllaceaePhala
8.PrunarnavaBoerhaavia diffusaNyctaginaceaeBeeja
9.MayurashikhaAdiantum lunulatumPolypodiacaeWhole plant
10.VarunaCrataeva nurvalaCapparidaceaeMula, twak
11.HaridraCurcuma longaZingiberaceaeKanda
12.BhringarajaEclipta albaAsteraceaeWhole plant
13.VibhitakiTerminalia bellericaCombretaceaeBeeja
14.BrahmiBacopa monnieriScrophuliaraceaeMoola
15.PatalaStereospermum suaveolensBignonaceaeWhole plant
16.Karavira Nerium oleanderApocynaceaeMoola
17.Kushmanda Benincasa hispidaCucurbitaceaePhala, Pushpa
18.PashanabhedaSaxifraga ligulataSaxifragaceaeMoola
19.TalamulaCurculigo orchioidesAmaryllidaceaeKanda
20.Yava Kshara, Shilajathu, Madya

Method of Administration of Single Herbs

  • Moola Kalka (paste of root) of Sigru along with cold water will cure Ashmari and Sarkara.[5]
  • Yavakshara mixed with equal quantity of Sitopala (Sugar candy).
  • Choorna (powder) of Tumburu Beeja (seeds) mixed with honey and cow’s milk for seven days.
  • Kalka (paste) of Vibhitaki Beeja (seeds) with Sura (wine).
  • Shigru Moola Kashaya (decoction of root) with lukewarm water.[6]
  • Seeds of Haritaki or Punarnava bolied in milk.
  • Root of Mayurashikha along with
  • Kapotavanga Moola (root) along with Sura(wine) or along with milk.
  • After drinking Madya taken for ride on chariot or horse ride will expels Ashmari.[5]

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  • Kutaja Twak Kalka (paste of bark) mixed with curd will cure Ashmari.[7]
  • Trapusa Beeja (seed) / Narikela Pushpa (flower) along with milk will expel
  • Gokshura Choorna (powder)along with honey and sheep’s milk will cure Ashmari in seven days.
  • Varuna Moola Kashaya (decoction of root) with Varuna Moola Kalka (paste of root) will cure Ashmari or Varuna Twak Kashaya (decoction of bark) along with Guda (jaggery).[6]
  • Rajani Choorna (powder) along with Guda (jaggery) and Thushodaka (rice water).
  • Shilajathu powder along with honey.[8]
  • Bhringaraja powder along with sheep’s urine.
  • Kshara (alkali) of Patala or Karavira along with sheep’s urine.
  • Phala (fruit) and Pushpa (flower) Swarasa of Kushmanda along with Yavakshara and Guda.[9]
  • Ghrita (ghee) cooked with Pashanabheda and cow’s urine[10]
  • Talamula Choorna along with water kept in Tamra Patra (copper vessel) for one Ahoratram (24hrs).[11]

Discussion

Among them 6 drugs are Tridoshahara, 3 drugs are of Kapha-Pitta Hara, 3 drugs are Kapha-Vatahara, 2 drugs are Vata-Kaphahara,2 drugs of Vata-Pitta Hara and 1 drug of Raktha-Pitta Hara. Method of administration of all Dravyas is oral. Ashmari is a Tridoshaja Vyadhi among drugs mentioned most of are Tridoshahara, some are of Kashaya, Tikta, Madhura Rasa which is Kapha - Vata Shamaka. Most of drugs mentioned are of Laghu, Ruksha Guna thus it act as Sleshmahara where Sleshma is considered as Asraya of Ashmari. Drugs like Yavakshara and Shilajathu have Lekhana and Chedana actions. Ekamoolika Prayogas that can be advised in Kaphaja Ashmari - Bhringaraja powder along with sheep’s urine as both drugs have Laghu, Ruksha and Ushna Guna. Shilajathu along with honey, as Shilajathu is Laghu, Ruksha and Chedana, also honey is Agrya in Sleshmahara Karma. Kshara of Patala or Karavira along with sheep’s urine as all these drugs have Kapha Hara action.

Table 2: Rasa-Panchaka and Doshaghnata of Dravyas.[12-14]

SNDrugRasaGunaViryaVipakaDoshaghanata
1.ShigruKatuRuksha, TikshnaUshnaKatuVata-Kaphahara
2.Tumburu Tikta-KatuLaghu RukshaUshnaKatuVata-Kaphahara
3.Haritaki Lavana varjitha-Pancha RasaRukshaUshnaMadhuraTridoshahara
4.KutajaKatu-KashayaRukshaSheetaKatuPitha-Kapha Shamaka
5.Trapusa MadhuraLaghuSheetaMadhuraRaktha-Pitta Hara
6.Gokshura MadhuraGuru, SnigdhaSheetaMadhuraTridoshahara
7.Prunarnava TiktaLaghuSheetaKatuKapha-Pitta Shamaka
8.Varuna Kashaya, Madhura, Tikta,Laghu, RukshaUshnaKatuKapha-Vatahara
9.Haridra Tikta- KatuRuksha, LaghuUshnaKatuKapha- Pittahara
10.Mayurashikha (Hamsapadi) Madhura, Tikta, KashayaLaghu, RukshaSheetaKatuPitta- Kapha Hara
11.BhringarajaKatu- TiktaLaghu, RukshaUshnaKatuKapha-Vatahara
12.VibhitakaKashayaLaghu, RukshaUshnaMadhuraTidoshahara
13.Patala Tikta, KashayaLaghu, RukshaUshnaKatuTridoshahara
14.KaraviraKatu, TiktaLaghu, RukshaUshnaKatuKapha-Pitta Hara
15.KushmandaMadhuraLaghu, SnigdhaSheetaMadhuraVata-Pitta Hara
16.YavaksharaKatuRuksha, LaghuUshnaKatuKapha-Vata Hara
17.BhramiTikta, Kashaya, MadhuraLaghu, SaraSheetaMadhuraTridoshahara
18.PashanabhedaTikta, KashayaTikshna, SnigdhaSheetaKatuTridoshahara
19.ShilajathuTikta, KatuLaghuUshnaKatuKapha-Vata Hara, Chedana,
20.TalamulaMadhura, TiktaGuru, SnigdhaUshnaMadhuraVata-Pitta Hara

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Haridra Choorna along with Thushodaka as both drugs is Laghu, Ruksha and Ushna. Ekamoolika Prayogas that can be advised in Pittaja Ashmari - Phala and Pushpa Swarasa of Kushmanda along with Yavakshara and Guda, as Kushmanda and Guda are Madhura Rasa and Sheeta Virya. Pashanabheda Kwatha along with Shilajathu and Sharkara, Pashanabheda & Sharkara are Pittahara.

Ekamoolika Prayogas that can be advised in Vataja Ashmari - Gokshura Choorna along with honey and sheep’s urine as Gokshura is Madhura Rasa, Guru and Snigdha also sheep’s urine is Ushna.

Ekamoolika Prayogas that can be advised in Shukra Ashmari - According to Yogaratnakara Shatavari Mula Rasa along with milk is indicted in Shukra Ashmari.

The drugs like Varuna, Shigru, Gokshura, Haridra, Shilajathu and Yavarkshara are proven for their anti-urolithiatic activity. Lupeol extracted from Varuna not only prevented the formation of calculi but also reduced the size of renal stones.[15] In Gokshura presence of quercetin, diosgenin, and tannic acid in the extract has a protective capacity rather than curing urolithiasis.[16] Curcumin extracted from Haridra proven to have significant effect in both preventive as well as curative property in urolithiasis of rats.[17] Presence of catechin, gallic acid, quercetin, and tannic acid in Pashanabheda are proven for its anti-urolithiatic activity.[18]

Pathya-Apathya in Ashmari

According to Bhaishajya Ratnavali Vaari Sevana (more fluid intake), Yava (barley), Kulattha (horse gram), Purana Sali (rice kept more than 1 year), Kushmanda (ash guard), Mudga (green gram) and ginger are advised for Ashmari Rogi.[19] Caffeinated drinks, beer and foods that high in oxalates like chocolates, nuts, beans (including soybeans), rhubarb, spinach, beets, green leafy vegetables, excess salt and black tea should be avoided. Additionally, a high intake of sodium, calcium and protein rich foods can contribute to renal stones.[20]

Conclusion

Most of the drugs mentioned by Acharya’s are now proved experimentally for their anti urolithiatic activity.

They are simple, easily available and economical with successful utility. Most of drugs are Laghu, Ruksha Guna and Tridoshahara which will be helpful in curing Ashmari. Proper administration of these Ekala Dravya along with Anupana is highly recommended in Ashmari Chikitsa.

References

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2. Carsten A Wagner, Etiopathogenic factors of urolithiasis Arch Esp Urol 2021 Jan;74(1):16-23
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11. Bhavamishra, Bhavaprakasha, edited by Pandit Sri Brahma Sankara Misra, Chikitsa prakaran, vol-2, Ashmari roga adhikara, Chaukhambha Sanskrit Bhawan Varanasi, Edition Reprint 2018, page- 210.
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16. Sharma, I., Khan, W., & Ahmad, S., (2017). In vitro and ex vivo approach for anti-urolithiatic potential of bioactive fractions of gokhru with simultaneous HPLC analysis of six major metabolites and their exploration in rat plasma. Pharmaceut. Biol., 55(1), 701–711.
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