E-ISSN:2456-3110

Case Report

Dhoompana and Karnapichu

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 3 MARCH
Publisherwww.maharshicharaka.in

Chronic Suppurative Otitis Media correlated with Karnasrava - Ayurvedic Interventions Using Dhoompana and Karnapichu

Chaudhari S1*, Sharma A2
DOI:10.21760/jaims.10.3.64

1* Shital Chaudhari, Post Graduate Scholar, Department of Shalakya, National Institute of Ayurveda, Deemed to Be University (De Novo), Jaipur, Rajasthan, India.

2 Aparna Sharma, Professor, Department of Shalakya, National Institute of Ayurveda, Deemed to Be University (De Novo), Jaipur, Rajasthan, India.

Introduction: Ear pus discharge with central small perforation and hearing loss are common complaints that can significantly affect quality of life. Karnapichu and Karnadhoopana therapy, an Ayurvedic treatment, has been suggested as a potential symptomatic treatment. This case study reports a 48-year-old male, who presented with bilateral ear pus discharge with small central perforation and decreased hearing in the last 7 months. The disease chronic suppurative otitis media can co-related to Karnasrava in Ayurvedic science. Acharya Sushruta explains that Karnasrava is an ailment marked by ear discharge, primarily triggered by the Aavarana of the Vata Dosha.

Materials and Methods: a fully conscious male patient, presented to the Shalakya Tantra OPD, National Institute of Ayurveda, Jaipur with complaints of pus discharge from both ears, decreased hearing, and numbness in bilateral ear for the past 7 months. Clinical examination and investigations revealed bilateral ear small perforation with active discharge with hearing loss. Karna Dhoopana and Karna Pichu therapy was administered as a symptomatic treatment and other oral treatment also given for 4 months.

Results: Following Karna Dhoopan and Karna Pichu therapy, the patient experienced significant improvement in both ear with reduction pus discharge and Tympanic membrane healing with hearing. The therapy was well-tolerated, and no adverse effects were reported significant subjective improvement was observed with oral medications.

Discussion: This case study highlights the potential benefits of Karna Dhoopana and Karna Pichu therapy in managing ear discharge associated with hearing loss.

Keywords: Chronic Suppurative Otitis Media, Hearing Loss, Karna Pichu, Karna Dhoopana, Karnasrava

Corresponding Author How to Cite this Article To Browse
Shital Chaudhari, Post Graduate Scholar, Department of Shalakya, National Institute of Ayurveda, Deemed to Be University (De Novo), Jaipur, Rajasthan, India.
Email: 		Chaudhari S, Sharma A, Chronic Suppurative Otitis Media correlated with Karnasrava - Ayurvedic Interventions Using Dhoompana and Karnapichu. J Ayu Int Med Sci. 2025;10(3):412-416.
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https://jaims.in/jaims/article/view/4185/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-02-13 2025-02-25 2025-03-05 2025-03-15 2025-03-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 11.82

© 2025 by Chaudhari S, Sharma A and 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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Download PDFBack To ArticleIntroductionAim and ObjectivesCase ReportDiscussionConclusionReferences
Shital C et al. Chronic Suppurative Otitis Media correlated with Karnasrava

Introduction

This case study examines chronic suppurative otitis media (CSOM) from both modern medical and Ayurvedic perspectives. Chronic Suppurative Otitis Media (CSOM) is an inflammatory disease impacting mucous membrane of middle ear cleft, marked by pus-filled ear discharge, swelling, pain, and perforation of eardrum. This condition affects individuals of all ages and both genders in India, and it stands as leading cause of hearing loss among rural population. Karnasrava is a condition described by Acharya Sushruta in chapter titled Karnaroga Vigyaniya, where it is listed among twenty-eight Karnarogas. Acharya Charaka identified Karnasrava as a symptom occurring in four types of Karnarogas caused by imbalance of different Doshas. Acharya Vagbhata also highlighted Karnasrava as a significant symptom within five types of Karnshoola. Both Ayurveda and modern science concur that Rhinitis and nasopharynx play a crucial role in development of Karna Srava (CSOM). Pratishyaya (chronic rhinitis) is identified as primary underlying cause of this condition.

Pathogenesis of Karnasrava

Nidan Sevana → Vata-Kapha Sanchaya → Common aggravating factors like Shiroabhighata, Nimajjato Jale, Prapak or Vidhradhi → Vata-Kapha Prakopa → Prasara in different organs → Sthan Samshraya in Karna → Further Nidan Sevana → Karnasrava

According to Acharya Sushruta, the treatment for Karnasrava includes procedures such as Shirovirechana (nasal purgation), Dhoopan (medicated fumigation), Purana (filling with medicated substances), Pramargana (cleaning) and Dhavana (washing).

Based on this background, current study aims to assess combined effectiveness of Karnadhoopana with Kaishor Guggulu + Nimba Churna + Haridra Churna + Sarshapa Taila Karnapichu with Jatyadi Taila following Pramarjana, and an internal Ayurvedic regimen (including Sitopaladi Churna,

Tankana Bhashma, Godanti Bhashma, Guduchi Satva, Yastimadhu, and Kaishore Guggulu and Sarivadi Vati and Gandhak Rasayana and Chitrak Haritaki Avleha) in the management of Karnasrava.

Aim and Objectives

To evaluate the effectiveness of Karnadhoopana, Karnapichu, and internal medicines in the management of “Karnasrava” with special reference to CSOM through a single case study.

Case Report

A 48-year-old male patient presented to the Shalakya Tantra OPD on September 2, 2024, with primary complaints of numbness and purulent discharge from both ear for over six months. The patient also reported reduced hearing, ringing, and itching in the ear for the past 4 months. Despite receiving oral antibiotics and analgesic medications for six months, there was no relief.

Table 1: Sign and symptoms

SNSign and symptomsDuration
1.Ear numbnessMore than 4 months
2.Purulent dischargeMore than 6 months
3.Reduced hearingMore than 4 months
4.PerforationMore than 6 months

Examination

A small central perforation was observed in the anteroinferior quadrant of the left tympanic membrane, accompanied by on/off discharge in the external acoustic meatus. There was no family history of similar illness. The Rinne test yielded negative results, the Weber test showed lateralization to the affected (left) side, and the Air-Bone Conduction was normal in both ear.

General Examination

The patient's Sharirik Prakriti was identified as Pitta-Vataj. He had a Madhyam Kostha, indicating average bowel habits, Madhyam Bala, signifying moderate physical strength, and Madhyam Satva, representing balanced psychological strength.

Plan of Treatment

Table 2: Prepared a plan on Ayurvedic mixtures as given below.

SNDrugsAyurvedic mixtureDoseAnupana
1.Complex medicineSitopaladi Churna - 3gm
Yashti Churna - 1 gm
Godanti Bhasma - 500mg
Kapardika Bhasma - 125mg
Tankan Bhasma - 250 mg		5 gm two time a day after mealHoney

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Shital C et al. Chronic Suppurative Otitis Media correlated with Karnasrava

SNDrugsAyurvedic mixtureDoseAnupana
2.Single medications1. Kaishor Guggulu 500mg
2. Gandhak Rasayana 500mg		500 gm two time a day after mealLike warm water
3.Complex drug for Karna DhoopanaKaishor Guggulu 250mg + Nimba Churna + Haridra Churna + Sarshapa TailaTake mixer with oil put it on fire flameFor fumigation
4.Karna PichuJatyadi Taila15- 20 mins 2 time a dayAs required for local application
5.Rasayana1) Sarivadi Vati 500mg
2) Chitrak Haritaki Rasayana 12gm		1) 500mg Vati 2 time a day
2) 12gm in divided dose 2 time a day		1) milk
2) milk

Follow-Up

The patient returned for regular follow-up every fifteen days for a period of three months, with no episodes of relapse. Upon assessment three months after the completion of treatment, there were no signs of recurrence. The patient experienced symptomatic relief consistently every fifteen days, as detailed in the table below.

Table 3: Assessment of classical sign and symptoms in each follow up:

SNSymptomsBT
(Before time)		AT
(After time)		Follow-up after 15 daysFollow-up after one monthFollow-up after two monthsFollow-up after three months
Subjective parameters
1.Numbness of ear211100
2.itching001000
3.Impaired hearing111110
Objective parameters
1.Discharge101000
2.Perforation101100
3.Pure tone audiometry111111

Table 4: Grading suggests.

SNCharacteristics featuresGrade
1.Numbness of ear
No numbness of ear0
Continuous but not incapacitating normal activity1
Persistent and significantly disrupting daily activities2
2.Itching
No itching0
Occasional itching1
Continuous mild itching2
Continuous severe itching3
3.Impaired hearing
Absent0
Unable to hear the whispering voice1
Unable to hear normal voice2
Unable to hear a loud voice3
4.Discharge
Absent0
Mild scanty discharge1
Moderate within canal2
Severe secretion coming out from ear canal3
5.Perforation
No perforation0
Small central perforation (<2mm)1
Moderate – large central perforation (2 to 3)2
Severe subtotal perforation (>3mm)3
6.Pure tone audiometry
Up to 25 dB0
26 to 45 dB1
45 to 65 dB2
More than 65 dB3

Discussion

According to Ayurvedic texts, Vata Dosha is primarily respon. for Karnasrava, with Srava being main symptom.


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Ruksha Sweda's key property is its drying effect, which is why Karnadhoopan is effective; it not only dries the Srava but also inhibits microbial growth. The Dhoopan fumes may also provide a sedative effect and dry up the Srava. Additionally, the heat from the Dhoopan helps with vasodilation and increases blood circulation, enhancing drug absorption and promoting healing.

Jatyadi Taila primarily functions on Vrana (wounds) through Shodhana (cleansing) and Ropana (healing), aiding in proper wound healing. For local application, Jatyadi Taila was used as Karna Pichu. The local action of Pichu relies on the cellular absorption of the medicine, performing functions such as Snehana (oleation), Sodhana (cleansing), and Ropana (healing). The detailed pharmacological activities of the herbo-mineral drugs used are outlined below:

Table 5: reported pharmacological activities of drugs.

SNDrugsReported activity
1.Sitopaladi ChurnaThe ability to balance Vata and Kapha Doshas and offer revitalization
2.Yastimadhu ChurnaAnti-inflammatory and antioxidant activity
3.Godanti BhasmaAnti-pyretic, anti-inflammatory and analgesic effect
4.Tankana BhasmaAntiseptic and anti-inflammatory effects
5.Kaishor GugguluAnti-allergic, anti-bacterial, antioxidant, and blood purifying property, wound healing property
6.Gandhaka RasayanaAntibacterial, anti-inflammatory
7.Sarivadi VatiRasayana property
8.Kaishor Guggulu + Nimba Churna + Haridra Churna + Sarshap Taila = KarnadhoopanaAntibacterial and wound healing property
9.Chitrak Haritaki AvalehaRasayana

Conclusion

Considering the various aspects of treating Karnasrava, it is evident that Karnapichu, Karnadhoopana, and herbo-mineral formulations are effective in managing this ear condition. In the mentioned case study, there was a significant reduction in ear discharge, perforation, and impaired hearing. Therefore, it can be concluded that Ayurvedic medicines and procedures are beneficial in managing Karnasrava.

Overall, these findings suggest that Ayurveda offers a valuable approach to the alternative management of CSOM, utilizing oral and topical medications, along with cleaning procedure.

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