E-ISSN:2456-3110

Case Report

Pratishyaya Among Children

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 8 August
Publisherwww.maharshicharaka.in

Therapeutic Application of Viddhkarma in Pratishyaya Among Children: A Case Report

Rawat K1*, Prakash A2, Verma K3
DOI:10.21760/jaims.10.8.53

1* Kanchan Rawat, Post Graduate Scholar, Department of Kaumarbhritya, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.

2 Anand Prakash, Post Graduate Scholar, Department of Kaumarbhritya, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.

3 Keerti Verma, Professor, Department of Kaumarbhritya, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.

As Nose is sensory organ performs olfactory & respiratory functions. Due to direct contact of nose with external environment, it is exposed to many micro-organisms & pollutants present in the environment. Because of increased environmental pollution & crowdy life, rhinitis is common disease in this present era. In Ayurveda, the condition can be corelated with Pratishyaya. Ayurveda described Pratishyaya as Vata-Kaphaj Roga with characteristic features like; Nasashrava, Ghranauparodha, Shirashoola, Shirogauravam, Jwara, Kasa, Kaphotklesh, Aruchi, Swarbheda. Ayurveda recommends both Shodhan and Shaman Chikitsa for managing Pratishyaya. In this case Viddha Karma, a form of Shodhana Chikitsa, was selected as the main line of treatment. This therapeutic procedure aids in clearing obstructions in blood vessels, thereby improving circulation and stimulating nerve endings. Consequently, it helps reduce the transmission of pain signals from the affected area. This integrative approach not only addresses the symptoms of the disease but also offers safe, gentle, and effective relief. It exemplifies the enduring relevance of Ayurveda in providing comprehensive and holistic healthcare solutions.

Keywords: Pratishyaya, Nasashrava, Ghranauparodha, Shirashoola, Shirogauravam, Jwara, Kasa, Kaphotklesh, Aruchi, Swarbheda

Corresponding Author How to Cite this Article To Browse
Kanchan Rawat, Post Graduate Scholar, Department of Kaumarbhritya, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.
Email: 		Rawat K, Prakash A, Verma K, Therapeutic Application of Viddhkarma in Pratishyaya Among Children: A Case Report. J Ayu Int Med Sci. 2025;10(8):316-320.
Available From
https://jaims.in/jaims/article/view/4582/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-06-18 2025-06-28 2025-07-09 2025-07-19 2025-07-29
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 13.36

© 2025 by Rawat K, Prakash A, Verma K 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].

J Ayu Int Med Sci 2025;10(8)316
Download PDFBack To ArticleIntroductionCase ReportResultDiscussionConclusionReferences
Kanchan R et al. Therapeutic Application of Viddhkarma in Pratishyaya

Introduction

Pratishyaya, the word itself indicates that is recurrent in nature and can be precipitated even due to trivial of etiological factors.[1] Pratishyaya is one among the Nasagata Roga (disease related to nose). It happens due to the vitiation of three Dosha i.e., Vata, Pitta, Kapha.

वातं प्रतत अतिमुखंश्यायो गमनं कफादीनां यत्र स प्रततश्याय । (डल्हण)

Disease defined as the secretion produced by the vitiation of Vata, Kapha flow through the nose.[2] Pratishyaya is the causative condition for all the other disease of nasal cavity and hence it is explained with priority of Nasa Rogas. Acharya Sushruta, Vagbhatta, Madhavakar, Bhava Mishra, and Sharangadhara described the five different types of Pratishyaya. Vataja, Pittaja, Kaphaja, Sannipataja, and Raktaja. Raktaja Pratishyaya has yet to be described by Acharya Charaka and Kashyapa. Symptoms of Pratishyaya resemble those of Rhinitis. Rhinitis is characterized by inflammation of the nasal mucosa, leading to symptoms such as nasal congestion, runny nose, sneezing, and itching. There are two main types: allergic and non-allergic rhinitis. It is a most common chronic disease in children. An Indian study reported that prevalence of allergic rhinitis was 11·3% in children aged 6-7 years, and 24·4% in children aged 13-14 years.[3] In rhinitis, the nasal mucosa becomes inflamed as a result of infection, allergy, or physical irritation. This mucosal lining is richly supplied with blood vessels. When the sympathetic nervous system is activated, it causes vasoconstriction, leading to the shrinkage of the nasal mucosa. On the other side, stimulation of the parasympathetic system is responsible for excessive secretion from the nasal mucosa and local vessel dilatation. Additionally emotional disturbance also plays a significant role as the hypothalamus controls the autonomic nervous system supply of nasal mucosa. Pathophysiology of Pratishyaya: impaired Agni is the root cause of many diseases. The manifestation of Pratishyaya begins from Agnimandhya due to the multiple etiological factors like Vegadharana, Vishmashna, Atijalpana after food, ultimately leads to Mandagni and results in formation of Ama. This produces vitiation of Rasavaha, Raktavaha, and Pranavaha Srotodushti, which in turn causes vitiation of Udanvayu, Tarpaka Kapha, and Bhrajaka Pitta.

Results in Sthanasamsrya of Tridosha in head & expel from nostril cause Pratishyaya. Pooravroop of Pratishyaya like Angamarda (body ache), Shirogurutava (Heavinesss of head), Lomaharsha (Horripilation) clearly show this association of Ama with Pratishyaya.[4]

Pratishyaya is the only disease explained in Shalakya Tantra which develops complication even before the sign and symptoms occur, hence if treated when the Pooravaroops are seen, the further pathology can be stopped.[5] The Roopa of Pratishyaya as per Acharya Charak are: Ghranartitoda (Pricking pain in the nose), Kshavathu (Sneezing), Jalabhsrava (Watery discharge), Swarabheda (Hoarseness of voice), Shirashoola (Headache).

Acharya Kashyap mentioned many co-morbidites about Pratishyaya, which are, Mukha Roga, Karna Roga, as Vata gets stuck in the head region, nose, and oral cavity, which causes a change in the sensation of smell. It may cause loss of smell. Kapha aggravation causes unclear passages, and Pitta aggravation causes putrefaction and a bad smell.

In this case Viddha Karma, a form of Shodhana Chikitsa, was selected as the main line of treatment. In this a dry hollow needle for puncturing is used. This case report highlighted the effect of Viddha Karma in treating a Rhinitis patient.

Case Report

A Nine-year-old male child with chronic episodes of continuous sneezing (8-9 times/day) with rhinorrhea (watery discharge from nose) in the early morning, associated with heaviness in the head region, has been presented in the outdoor department of Kaumarbhritya, Rishikul Campus (Haridwar). These symptoms get aggravated by seasonal variation. He was suffering from these complaints over a period of 4–4½ years. He took contemporary treatment for the same condition and used to get symptomatic relief temporarily. So, the patient came to the hospital for further betterment.

Family history: Not any

Clinical finding

On general examination, the patient was fit and well oriented. Patient has good appetite and has habit of eating packed food 4 times/week.


J Ayu Int Med Sci 2025;10(8)317
Kanchan R et al. Therapeutic Application of Viddhkarma in Pratishyaya

Period of sleep is regular. Anthropometry measure are as follows-

ParametersFindings
Weight28.5 kg (Expected Wt.:29 kg)
Height134cm (Expected Ht:131cm)
Head Circumference52cm
Chest Circumference55cm
Mid Upper arm Circumference19cm (Rt), 19cm (Lt)

The growth and development are proper as per his age.

Systemic examination

The patient was aware of the date, time, and location. His gastrointestinal system and cardiovascular system were also normal.

At rest, the respiratory rate was 24 breaths per minute and other vitals are in normal range.

Local Examination

Examination of Nose:

1. Inspection - Swelling of the nasal mucosa, both nostrils had clear, watery thin secretions.
2. Anterior Rhinoscopy - Lower and anterior part of septum & middle turbinate appears red, floor of the nose becomes red, mucosa is red and nasal septum is normal.
3. No other severe anatomical structural deformities found.

On examining the patient with the help of Ashtvidha Pariksha, the finding are-

Ashtvidha Pariksha

Nadi: Vata Pradhan Pittanubandhi

Mala: Nirama

Mutra: Samanya Pravrti, Peetabh Varn

Jivha: Lipta

Shabda: Spastha

Sparsha: Ruksha, Samsheetoshana

Drikka: Samanya

Aakriti: Samanya

Samprapti Ghataka of Pratishyaya

Dosha: Udanvayu, Tarpaka Kapha, and Bhrajaka Pitta

Dushya: Rasa, Rakta

Agni: Mandagni

Srotas: Rasavaha, Raktavaha, Pranavaha

Srotodushti: Sanga, Attipravrti

Samuthana: Shira

Adhisthana: Nasa, Shiras

Treatment Plan

By keeping the Dosha- Dushya Samurrchana in mind, the patient was advised to use Viddhkarma along with the adjuvant Ayurvedic medicines to pacify Doshas.

Intervention

The patient was treated with 7 sittings of Viddha Karma regularly for 7 days. Viddhakarma was performed in three stages i.e., Purvakarma, Pradhanakarma, and Paschatkarma.

1. Purva Karma:

The patient gave informed written consent, and all the equipment required for and Viddha Karma was kept ready.

jaims_4582_01.JPG
Figure 1: Equipment required for Viddha Karma (26 no. needle, Cotton, Surgical spirit)

2. Pardhana Karma:

The patient was advised to sit in a comfortable position and points were marked on Upnasika (lateral aspect of ala) of the child for the Viddha Karma with the help of a marker by locating the appropriate site for the procedure.

Anatomy of Upanasika

  • Nerve: Infraorbital branch of Trigeminal nerve.
  • Vascular: Lateral nasal branch of facial artery.
  • For Viddha Karma, we use Needle No. - 26 1 &1/2, Pierce it 2-4 mm for Skin.

J Ayu Int Med Sci 2025;10(8)318
Kanchan R et al. Therapeutic Application of Viddhkarma in Pratishyaya

jaims_4582_02.JPG

jaims_4582_03.JPG

jaims_4582_04.JPG
Figure 2: Viddha Karma

3. Pashachaat Karma: Pathya and Apathya (avoid junk/packed food, spicy and salty food) were advised to the patient as per the disease and Dosha Pradhanata. Additionally, daily Yoga practice for 20 minutes was recommended.

Result

Regression of patient’s symptoms was observed from the third day of treatment and complete remission of the condition was observed by 7th day of treatment During the treatment no minor or major complication was observed in the patient.

Days1234567
Episodes of sneezing
Rhinorrhoea
Heaviness in head region		PresentPresentPresentNoneNoneNoneNone

Discussion

Rhinitis diminishes the quality of life for many patients, disrupting their sleep quality and cognitive function and inducing irritability and fatigue. Moreover, it is associated with reduced school and work performance. Due to excessive intake of junk food items (Virudhahara), unawareness regarding health and hygiene, and exposure to the environment and infectious agents, school-going children are more prone to recurrent upper respiratory tract infections. Frequent and improper sleeping can cause vitiation of Vata and Kapha, which may cause Pratishyaya. Nidana Parivarjana should be done initially in the Pediatric population.

Probable mode of action of Viddha Karma

Viddha Karma is among the Shastra Karma as explained in Brihatrayee, Laghutrayee, and other classics. It involves the therapeutic puncturing or piercing of specific anatomical points using a fine, hollow needle. In conditions such as Pratishyaya (rhinitis), where there is a predominance of Vata and Kapha Doshas, the insertion of the needle at the Upanasika (nasal region) brings about a sensation of lightness, primarily due to the regulation and alleviation of Vata (Vatanulomana). In this process there is Sukshma or Avyakta Rakta Srava is always attained, which aids in clearing the obstructed channels (Srotasas), restoring proper blood flow, and promoting detoxification. Additionally, the stimulation of peripheral sensory fibres reduces the transmission of irritating stimuli from the affected area, representing a key mechanism in the therapeutic action of Viddha Karma. This stimulation further activates the immune response, leading to the release of endorphins, which contribute to pain relief and reduction of inflammation.


J Ayu Int Med Sci 2025;10(8)319
Kanchan R et al. Therapeutic Application of Viddhkarma in Pratishyaya

Conclusion

Pratishyaya is a condition primarily affecting the Nasa (nose) and Shiras (head). In the current era of increasing environmental pollution, the incidence of allergic rhinitis (Pratishyaya) is steadily rising.

Management of Pratishyaya involves Shaman Chikitsa, Shodhana Chikitsa, and strict adherence to Pathya-Apathya. Viddhkarma therapy used in treatment are known for balancing Doshas, detoxification, relief in symptoms, nerve stimulation. This holistic approach effectively providing safe, gentle, and reliable relief to the patient.

References

1. Vagbhata. Sharirasthana, Marmavibhagasharira Adhyaya 4/28. In: Garde GK, editor. Ashtanga Hrudya. Reprint ed. Varanasi: Chaukhamba Surbharti Prakashana; 2011. p. 143 [Crossref][PubMed][Google Scholar]

2. Shastri AD. Sushruta Samhita. Reprint ed. Varanasi: Chaukhambha Sanskrit Sansthan; 2017. Uttara Tantra 24 [Crossref][PubMed][Google Scholar]

3. Singh S, Sharma BB, Salvi S, et al. Allergic rhinitis, rhinoconjunctivitis, and eczema: prevalence and associated factors in children. Clin Respir J. 2018;12:547–556. [Crossref][PubMed][Google Scholar]

4. Shastri AD. Sushruta Samhita. Reprint ed. Varanasi: Chaukhambha Sanskrit Sansthan; 2017. Uttara Tantra 24/26 [Crossref][PubMed][Google Scholar]

5. Kumari N. A Textbook for Roga Nidana and Vikruthi Vijnana. Vol. 1. Varanasi: Chaukhambha Orientalia; p. 235 [Crossref][PubMed][Google Scholar]

Disclaimer / Publisher's Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of Journals and/or the editor(s). Journals and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.


J Ayu Int Med Sci 2025;10(8)320