Introduction

In Ayurveda, Acharya Yogratnakara says that “Strinam Pumsam Cha Jayante Upadamsha Daruna” which means that Upadamsha condition can be present in both male and female.^[1] Upastha means genitals and Damsha means more painfull and difficult to manage.^[2] It is caused by Athi Maithuna, Aprakshaliya Yoniyadi Nidanas.^[3] Mainly in this case Pitta-Kapha Pradhana Raktha Dusti is noted. It further leads to Jwara, Shwayathu, Daha, Kandu, Pakvaudumbara Sadrusha like features.^[4] The treatment principles explained by Astanga Sangrahakara as “Vata Doshamcha Alepa Sekadinavistam Vidyath, Evam Sadya Eva Rukthodashopharagasamramba Nivartanthe ”.^[5] Which clearly declares that in case of acute condition the Sthanika Chikitsa work so effectively than any other Shodana Chikitsa. So, for this reason the genital herpes condition treated with Yoni Prakshalana, Yoni Pichu and few Shamanaoushadis.

Case Report

A 27-year-old female married patient presented with a itching and rashes in vagina since 20 days. Associated with white discharge in last 4 days. She consulted a local doctor and was treated for same but no improvement noticed. There was no history of diabetes mellitus, hypertension, and any other major disorder. History of constipation in last 4 months. Her husband also had a similar condition 2 months prior of spreading and it was cured. She had a history of genital herpes during her 1^st pregnancy. Now again it reoccurred so came to our hospital for further management.

Rajo Vruthanta

Age of Menarche - 14 Years
No of days Bleeding - 4 to 5 Days
Length of cycles = 28 - 30 Days

Garbhini Vruthanta: P₁ A₀ L₁ D₀

L1 = 2.5 years female LSCS (Due to non-progression of labour)

Vaivahika Vrittanta: Married life - 4 Years (Non consanguineous marriage)

Vyavaya Vrittantha:

Coitus - 1-2 times / week
Dyspareunia - Absent

• Mobility = Normal
• Movement = Normal
• Bleed on touch = Absent
• Lateral fornices = Free
• Posterior fornice = Free

Investigations

VDRL: Negative
HIV 1&2: Negative
Urine Routine: Pus cells: 4-5 /hpf
Epithelial cells: 5-6 /hpf
Bacteria: Absent

Samprapti^[6]

अतिमैथुनादि निदान सेवन
↓
पित्त कफ प्रधान रक्त दृष्टि
↓
स्थान संशय in जननाङ्ग त्वचा
↓
Leads to क्षते अक्षते श्वयथुमुपजनयन्ति
↓
उपदंश

Samprapti Ghataka

दोष : पित्त कफ प्रधान रक्त दुष्टि
दूष्य : रक्त, लसिक
अधिष्ठान : जननेन्दिय
स्रोतस् : मूत्रवह, आर्तववह स्रोतस
स्रोतो दुष्टि प्रकार :अतिप्रवृति
अग्नि : मन्दाग्नि
साध्य / असाध्यता : सुखसाध्या

Treatment

Result

Shamanaushadhis

Discussion

The genital herpes is the condition which can be considered as Kshudra Roga i.e, Upadamsha. In ayurveda, the concept of Sthanika Chikitsa has been well researched.^[7] The results shows that it was not just a topical application, but a method of medications that clear and restore the vaginal flora. Among them Prakshalana can prove to be effective and easy mode of treatment.^[8] The Prakshalana using the Kwatha of Haridra, Guduchi and Manjista was found to be much effective. Haridra (Curcuma longa) as a action like Raksthashodana, Shothahara, Vranapaha, Twakdoshahara, Kaphapittaghna.^[9] Guduchi (Tinospora cordifolia) it is Tridoshagna, Daha Prashamana, Jwarahara, Krimighna, Kandughna, Yoni Shodhana, Shothahara, Vrana Shodhana and Ropana.^[10] Manjista (Rubia cordifolia) has action like Shothahara, Kushtaghna, best in case of Yoni Vikaras and Vrana.^[11] Thus the target specific action was achieved by using these drugs Kwatha. Yoni Pichu is also one among the Sthanika chikitsa. According to Sushruta, Pichu helps in Lekhana Karma and thus removes slough. Pichu done using Jatyadi Taila which is Tiktha and Kashaya Rasa Pradhana. Both of which are Pitta Kaphahara and have properties of Vrana Shodhana, Ropana, Poothihara and Vedanasthapana. Jati contains salicylic acid which is anti-inflammatory in action.^[12] Pichu helps the medicine to remain at that site for a longer period for better action. It improves the musculature tone of vaginal canal.^[13] Arogyavardini Vati which is Malashuddhikara, Sarvaroga Prashamani, Kushtaghna.^[14] Chandraprabha Vati is Tridoshaghna, indicated in Yoni Rogas, Vrana, Muthravaha Sroto Vikaras and having anti-inflammatory action.^[15] Syp. Ural SF which contains Gokshura, Pashanabheda and other Mutra Virechaneeya Gana Dravyas. They further help in clearing the urinary track.^[16] Tab Vasulax where it does Vibandahara.

Thus, all drugs used for Prakshalana are having Tik-tha, Kashaya Rasa, Laghu Rooksha Guna. so their action are Vrana Shodhana, Ropana, Shothahara, Vedanasthapana, Kandughna, Krimighna.