shweta pradara#dg16 gdg
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Evaluation of Efficacy of Plaksha Twak Churna in the Management of Shweta Pradara A Comparative Clinical Study - Dr. Kalavati. D. Petlur, Department of Dravya Guna, Post Graduate Studies & Research Centre, D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE,GADAGTRANSCRIPT
Evaluation of Efficacy of Plaksha Twak Churna in the Management of Shweta Pradara
A Comparative Clinical Study
By
Dr. Kalavati. D. Petlur
Dissertation submitted to the
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
In partial fulfillment of the degree of
Ayurveda Vachaspati M.D.
In Dravya Guna
Under the Guidance of Dr. Kuber Sankh
M.D. (Ayu) and Co-guidance of
Dr. Shashikant Nidagundi
M.D. (Ayu)
Department of Dravya Guna Post Graduate Studies & Research Centre
D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG 2006-2009
D.G.M.AYURVEDIC MEDICAL COLLEGE
POST GRADUATE STUDIES AND RESEARCH CENTRE
GADAG - 582 103
This is to certify that the dissertation entitled “Evaluation of Efficacy of Plaksha
Twak Churna in the Management of Shweta Pradara A Comparative Clinical Study” is a
bonafide research work done by Dr. Kalavati. D. Petlur in partial fulfillment of the
requirement for the post graduation degree of “Ayurveda Vachaspati M.D. (Dravya Guna)”
Under Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka.
Dr. Kuber Sankh
M.D. (Ayu) Guide
Asst.Professor
Dept. of Dravya Guna
DGMAMC, PGS&RC, GADAG
Date:
Place: Gadag
Dr. Shashikanth Nidagundi
M.D. (Ayu) Co- Guide
Lecturer in Dravya Guna
DGMAMC, PGS&RC, GADAG
Date:
Place: Gadag
J.S.V.V. SAMSTHE’S
D.G.M.AYURVEDIC MEDICAL COLLEGE
POST GRADUATE STUDIES AND RESEARCH CENTRE
GADAG, 582 103
Endorsement by the H.O.D, Principal/ head of the institution
This is to certify that the dissertation entitled “Evaluation of Efficacy of Plaksha
Twak Churna in the Management of Shweta Pradara A Comparative Clinical
Study” is a bonafide research work done by Dr. Kalavati. D. Petlur under the guidance
of Dr. Kuber Sankh , M.D. (Ayu), Asst. Professor and Dr. Shashikanth Nidagundi,
M.D. (Ayu), in partial fulfillment of the requirement for the post graduation degree of
“Ayurveda Vachaspati M.D. (Dravya Guna)” Under Rajiv Gandhi University of
Health Sciences, Bangalore, Karnataka.
.
(Dr. G. B. Patil) Principal,
DGM Ayurvedic Medical College, Gadag
Date: Place: Gadag
(Dr. G. V. Mulagund) Professor & HOD
Dept. of Dravya Guna PGS&RC
Date: Place: Gadag
Declaration by the candidate
I here by declare that this dissertation / thesis entitled “Evaluation
of Efficacy of Plaksha Twak Churna in the Management of Shweta
Pradara A Comparative Clinical Study” is a bonafide and genuine
research work carried out by me under the guidance of Dr. Kuber Sankh
M.D.(Ayu) Professor and Dr. Shashikanth Nidagundi M.D.(Ayu),
Lecturer in Dravya Guna, DGMAMC, PGS&RC, Gadag.
Date :
Place : Gadag
(DR. KALAVATI. D. PETLUR)
© Copy right
Declaration by the candidate
I here by declare that the Rajiv Gandhi University of Health
Sciences, Karnataka shall have the rights to preserve, use and disseminate
this dissertation/ thesis in print or electronic format for the academic /
research purpose.
Date :
Place : Gadag
(DR. KALAVATI. D. PETLUR) © Rajiv Gandhi University of Health Sciences, Karnataka
I
ACKNOWLEDGEMENT
This is a moment of great pleasure and Contentment for me as writing
Acknowledgment is the last phase in completion of this research work.
At the onset my devotional pranamas to Shri Sainath, Shiradi Math and Holiness
Sri. Jagadguru Abhinava Shivanada Swamiji, Shivananda math, Gadag.
I take this glorious opportunity to acknowledge with deep sense of gratitude to Dr.
G.V. Mulagund, professor, Head of the Dept, Department of post graduate studies
research (Dravyaguna) D.G.M.A.M.C,Gadag for his valuable guidance and close
supervision during the entire phase of the study.
I take this opportunity to acknowledge with the deep sense and gratitude to my
guide Dr. Kuber Sankh. Asst. Professor, Department of post graduate studies and
Research (Dravyaguna) D.G.M.A.M.C,.Gadag for their valuable guidance and close
supervision during the entire phase of the study.
My profound gratitude to my co- guide Dr. Shashikanth Nidagundi, lecturer,
Department of Post graduate studies and Research (Dravyaguna) D.G.M.A.M.C, Gadag
for their good and valuable guidance through out this dissertation work.
With profound sense A gratitude I express my sincere thanks to Dr. G.B. Patil,
beloved Principal , D.G.M.A.M.C. Gadag, I thank Sri. S.B. Saunshi, Chairman and all the
committee members for their constant encouragement, facilities provided and moral
support during my post graduate study.
I wish to add my warmest thanks to my PG teaching faculty, Dr. K.S. Paraddi, Dr.
G.S. Hiremath, Dr. M.C. Patil, Dr. K. Shivaram Prasad, Dr. Shashidhar Doddamani, Dr.
Santosh Belavadi, Dr. Jagadish Mitti, Dr. Raghavendra Shettar, Dr. Girish
Danappagoudar, Dr. Veena Kori, Dr. Ashok Patil for their valuable suggestions and
timely help made me to complete this dissertation work successfully,
I thank Dr. G.B. Mulugund, Prof and H.O.D, Department of P.G studies in
Dravyaguna GAMC, Bangalore. For their constructive suggestions and encouragement in
preparing this dissertation.
I sincerely thank P.M. Nandakumar statistician, Sri. V.M. Mundinamani,
Librarian, Sri. Lakkundi, Photographer, Sadguru Computers for their timely help during
my study.
II
I express my sincere thanks to Dr. Chandrakant. S. Hiremath, Principal Shri
Raghavendra Ayurvedic Medical College, Malladahalli for their kind support.
I extend my greatfulness to my colleague Dr. G.S. Kulkarni who helped me
during my dissertation work. I extend my gratefulness and sincere heart felt gratitude to
my colleagues Dr.Kavita Mittalkod, Dr. R.A. Malwad, Dr. Jaya Malgoudar, Smt. P.K.
Belavadi and other office staff for their timely support and encouragement got during the
course. I am very thankful to my friends Dr. Mukta, Dr. Savita, Dr. Jaya, Dr.
Sarvamangala, Dr. Veena, for their help and co-operation during the study.
I wish to thank Principals of Rajeev Gandhi D.Ed. College, Anglo Urdu D.Ed.
College of Gadag R.M.O and all the physicians and other staff of the hospital and all my
patients and their assistants for their co-operation during my clinical study. And I express
my deepest gratitude to my beloved Parents Devendrappa, Smt. Laxamavva and my
beloved Husband Rachappa and my lovely daughter Sunanda, my brother Mr & Mrs.
Mahantesh, Udayavani, and family members, my aunty Shanta who have inspired me to
continue my PG study with their constant moral support.
I wish to thank G.B. Mamdapur, Chairman and all the committee members of
S.VP.R.A.M.C. Badami for their economical support.
Place: Gadag
Date: (K. D. Petlur)
III
ABBREVIATION
A.H. Astanga Hridaya
A.P.I. Ayurvedic Pharmacopoeia of India
A.S. Astanga sangraha
B.P. Bhavaprakasha
B.R. Bhaishajya Ratnavali
BP.N. Bhavaprakasha Nighantu
C.Chi Charaka Samhita Chikitsa Sthana
C.S. Charaka samhita
D.N. Dhanwantari Nighantu
PVS Dravyaguna Vijnana By Priyavrat Sharma
VMG Dravyaguna vijnana By V.M. Gogte
D.G Dravyaguan vijnana.
I.M.M. Indian Materia Medica
I.M.P. Indian Medicinal Plants
K.N. Kaiyadeva Nighantu
M.D. Madhava Dravyaguna
M.N. Madanapala Nighantu
N.A. Nighantu Adarsha
R.N. Raja Nighantu
R.R.S Rasa Ratna Samucchaya
R.S.S Rasendra Sara Sangraha
S.S Sushruta Samhita
S.N Shaligrama Nighantu
Sha.Sam Sharangadhara Samhita
Y.R. Yoga Ratnakar
IV
ABSTRACT
Shweta pradara is one of the commonest problems of women. Women suffer from
leucorrhoea at least once in a while during their lifetime. Recurrence also is a common
phenomenon and it occurs mainly due to infections by bacteri, fungi and protozoa.
Usually it occurs in unhygienic conditions, but can also occur after some surgical
procedures and at the time of delivery. This condition is described in ayurvedic classics
by the term shwetapradara as a symptom in various vaginal related diseases (yonivyapat).
Though there are different modes of treatment for yonivyapat, the significant one is local
therapy. Hence this study was conducted to find out some suitable drug for this procedure
and Plaksh (Ficus lcaor) was selected. Here study is aimed to evaluate the effect of
Plaksha twak churna in Shweta pradara.
OBJECTIVES
1. Pharmacognoistical evaluation of Plaksha, Preliminary phyto chemical study,
Macroscopical evaluation, Standardization and validation.
2. To Evaluate the efficacy of Plaksha twak churna in the management of Shewta
pradara.
3. To evaluate the Plaksha twak kashaya as a trans vaginal douche in the
management of Shweta pradara.
4. To evaluate the comparative effect of Plaksha twak churna orally and kashaya as
trans vaginal douche in the management of Shweta pradara.
METHOD
In this prospective comparative clinical study, 30 patients randomly selected and
Grouped as A and B receiving Plaksha twak churna with Madhu and Plaksha twak churna
V
kashaya as trans vaginal douche respectively for the study duration of 21 days from the
day of initiation of medication with dose of 4 gms with honey BD. The patients are asked
for the reporting every 7th, 14th and 21st days efficacy was assessed by the difference of
before and after the treatment from the subjective and objective parameters.
RESULTS
Individually all the 2 groups showed highly significant in subjective as well as
objective parameters comparatively group A shows more significant then the group B.
INTERPRETATION & CONCLUSION
The statistical analysis is done by using student’s paired t-test, by assuming that
the drug is not responsible for changes in the readings before and after treatment. From
the analysis all parameters shows highly significant (as p<0.05). The parameters
Excessive Vaginal Discharge, Vaginal ph, Vaginal Smear and Extensive prurtis shows
more highly significant than the other parameters ( as p<0.001). and the parameters
Persistent vulval moistness and General weakness shows less highly significant (as
p>0.001).
The percentage of improvement in the parameters is Excessive Vaginal Discharge
with 96.66667, Persistent vulval moistness with 91.42857 %, Extensive pruritis with
91.11111%, General weakness with 93.47826%, Pain in lumbar region with 87.5%,
Vaginal ph with 26.89394 % and Vaginal Smear with 100% from the study.
KEY WORDS
Plaksha (Ficus lacor), Madhu (Honey)
Leucorrhoea; Methods; Clinical study; Results;
VI
CONTENTS
Page No.
1. Introduction 1-2
2. Objectives 3-3
3. Review of literature 4-60
a) Drug Review 4-32
b) Disease Review 33-60
4. Methodology 61-74
5. Results 75-105
6. Discussion 106-118
7. Conclusion 119-120
8. Summary 121-121
9.Bibliography 122-131
10.Annexure
LIST OF TABLES
DRUG REVIEW
TABLE 1 PLAKSHA
Page No.
Table 1.1 – Showing Gana and Varga according to different
classics
7
Table 1.2 – Showing Prayaya according to different authors. 8-10
Table 1.3 – Showing Guna according to different authors 20
Table 1.4 – Showing Karma according to different authors 21
Table 1.5 – Showing Prayojya anga according to different authors 22
Table 1.6 – Showing Prayoga according to different authors. 23
Table 1.7 – Showing the Matra according to different authors. 24
Table 1.8 – Showing the use of Plaksha in different yogas. 25
Table 1.9 – Showing Pharmacological action of Madhu 30
TABLE. 2. DISEASE REVIEW
Page No.
Table 2.1 – Showing the Swaroopa of Shuddha Artava 40
Table 2.2 – Showing the Nidana of Shweta pradara. 40
Table 2.3 – Showing the Yoni rogas in which Shwetasrava is
considered as a symptom
42
Table 2.4 – Showing the Sthanika lakshanas of Shweta pradara 43
Table 2.5 – Showing the Pathyapathya in Shweta pradara. 46
Table 2.6 – Showing the Incidence of cause of Leucorrhoea 55
TABLE. 3. OBSERVATIONS AND RESULTS Page No.
Table 3 a) Showing the Physical constants & found values of Bark
powder of Plaksha.
74
Table 3 b) Showing the Thin layer Chromatography analysis of
Aqueous extract.
74
Table 3 c) Showing the Phytochemical components and found
values of bark powder of Plaksha.
75
Table 3.1 Showing the incidence of Menstrual history 77
Table 3.2 Showing the incidence of Age 78
Table 3.3 Showing the incidence of Socio-economic status 79
Table 3.4 Showing the classification of Patients based on their
Prakruti
80
Table 3.5 Showing the incidence of Dietic pattern 80
Table 3.6 Showing the incidence of Nidhana 81
Table 3.7 Showing the result by religion in Shweta pradara with
Plaksh twak churna.
82
Table 3.8 Showing the result by occupation in Shweta pradara
with Plaksh twak churna.
83
Table 3.9 Showing the Economic status in Shweta pradara with
Plaksh twak churna.
83
Table 4.0 Showing the result by Diet in Shweta pradara with
Plaksh twak churna.
84
Table 4.1 Showing the percentage by presenting complaints. 84
Table 4.2 Showing the percentage of distribution of patients by
Associated complaints.
84
Table 4.3 Showing the percentage of Ahara Nidana observed in
the study
84
Table 4.4 Showing the percentage of Vihara Nidana observed in
the study
84
Table 4.5 Showing the percentage of Manasika Nidana observed
in the study
85
Table 4.6 Showing the Chronisity of Leucorrhoea observed in the
study
85
Table 4.7 Results of Plaksha twak churna in Swetapradara 85
Table 4.8 Showing the grades of Excessive vaginal discharge
Before treatment in Group A & B.
85
Table 4.9 Showing the grades of Excessive vaginal discharge
After treatment in Group A & B.
86
Table 5.0 Showing grades of Persistent vulval moistness Before
treatment in Group A & B.
86
Table 5.1 Showing grades of Persistent vulval moistness After
treatment in Group A & B
86
Table 5.2 Showing grades of Extensive pruritis before treatment
in Group A & B
87
Table 5.3 Showing grades of Extensive purities after treatment in
Group A & B
87
Table 5.4 Showing grades of General weakness before treatment
in Group A & B
87
Table 5.5 Showing grades of General weakness after treatment in
group A & B.
87
Table 5.6 Showing grades of pain in lumbar region before
treatment in Group A&B
88
Table 5.7 Showing grades of pain in lumbar region after
treatment in Group A&B
88
Table 5.8 Showing the grades of Draging sensation before
treatment in Group A & B.
89
Table 5.9 Showing grades of Draging sensation after treatment in
Group A & B.
89
Table 6.0 Showing the distribution of Patient by Degree of
vaginal pH before and after treatment
89
Table 6.1 Showing the distribution of Patient by Degree of
vaginal smear before and after treatment
89
Table 6.2 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to excessive vaginal
discharge.
90
Table 6.3 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to Vulval moistrness.
91
Table 6.4 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to Extensive Pruritis.
91
Table 6.5 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to General weakness.
92
Table 6.6 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to Pain in Lumbar region.
93
Table 6.7 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to Vaginal pH.
93
Table 6.8 Showing the Statistical Analysis of both the groups,
Before and after treatment and Percentage of
improvement with respect to Vaginal Smear.
94
Table 6.9 Analysis table by using student t- test 95
Graph No.
LIST OF GRAPHS
Page No.
1 Showing the incidence of Menstrual history 77
2. Showing the incidence of Age 78
3. Showing the incidence of Socio-economic status 79
4. Showing the classification of Patients based on their
Prakruti.
80
5. Showing the incidence of Dietic pattern 80
6. Showing the incidence of Nidhana 82
7. Showing the incidence of Religion 82
8. Showing the distribution of patient by occupation 83
LIST OF PHOTOGRAPHS
Plate No 1 Plant Plaksha (Ficus lacor)
Fig. 1 Plaksha twak (Ficus lacor)
Fig. 2 Plaksha twak churna (fine)
Fig. 3 Madhu
Fig. 4 Plaksha twak churna (course)
Fig. 5 Plaksha twak kashaya
Fig. 6 Vaginal douche
Plate No 2 T.S. of Bark stem
Fig.10 Microscopic view of Powder (Plaksha)
Plate No 3 TLC of Plaksha twak churna
Fig. 11 Dragendroff
Fig. 12 UV
LIST OF MASTER CHARTS Page No
Master Chart 1 Assessment of subjective parameters in Group –A 96
Master Chart 2
Assessment of objective parameters in Group –A
98
Master Chart 3
Assessment of subjective parameters in Group –B
99
Master Chart 4
Assessment of objective parameters in Group –B
100
Introduction
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
1
INTRODUCTION
In present era abnormal vaginal discharge is quite frequent complaint of women
in gynaecologic clinic1. Shweta pradara troubles more than 75% of women during their
life. Most of the women are working, due to change in life style, food, habit, work load,
faces lots of stress and strain. Women are subject to large number of complaints and
connected with genital organs. Gender differences play a role in manifestation of disease
and health out comes.
The disease Shweta pradara based on theoretical and clinical symptoms can be
compared to Leucorrhoea. The pathogens like Trichomonas vaginalis 94.5%), N
genorrhoeae (2.7%) and C albicans (6.7%) were exclusively present in leucorrhoea2.
Gynaecological complaints includes leucorrhoea, disfunction uterine bleeding, pelvic
inflammatory disease etc, among them leucorrhoea is more prevalent. The external
genitalia with long tubular content is susceptible to the infectious conditions from puberty
till menopause, either because of unhygienic conditions or coital and even
physiologically.
Wide variety of reasons are encountered in its causation, commonly fungal,
parasitic, bacterial and sexually transmitted diseases. Most secretions are regarding life
cycle physiological and warrant no medical interventions. But it is significant if it is
blood stained, profuse, foul smelling or changes in its colour. If not treated infection may
continue for months even years and may spread to other areas of genital tract3.
Though there is an established line of treatment for leucorrhoea in the allopathic
system of medicine, most of the drugs fail to cure the disease completely and recurrence
Introduction
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
2
is common. Many ayurvedic formulations have been evaluated clinically, and Plaksha is
one of the new drug taken up for the trial in this study.
Ayurveda is the safest curative system. There are many drugs described in
ayurvedic literature for Shweta pradara among them plaksha4 (Ficus lacor) is one of the
most potent drug for Shweta pradara. On the basis of authentic classical references the
easy availability of a drug and cost effectiveness developed interest in selecting this drug
for Shweta pradara.
An effective remedy for shweta pradara is Plaksha twak. (Ficus lacor) comes
under the kashaya skandha and is one among panchavalkala. Due to its kashaya rasa it
acts as rakta stambhaka and grahi. Due to its sheeta veerya and laghu ruksha qualities acts
as vranashodhana and vrana ropana5-9, so these actions are extremely beneficial in curing
shweta pradara. A warm vaginal douche of plaksha twak churna kashaya is beneficial to
general cleansing and elimination of purulent discharge. Plaksha twak churna have many
means to kill fungus, bacteria, parasite as its acts as krimighna.
In present study is aimed to evaluate the efficacy of Plaksha twak churna in the
management of Shweta pradara with the view to find out therapeutically efficacious,
safer, cost effective and easily available drug.
Objectives
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
3
OBJECTIVES
1. Pharmacognoistical evaluation of Plaksha.
a. Macroscopical evaluation
b. Microscopical evaluation
c. Standardization and Validation.
2. Preliminary phyto chemical analysis of Plaksha.
3. TLC of Plaksha.
4. To Evaluate the efficacy of Plaksha twak churna in the management of Shewta
pradara.
5. To evaluate the Plaksha twak kashaya as a trans vaginal douche in the
management of Shweta pradara.
6. To evaluate the comparative effect of Plaksha twak churna orally and kashaya as
trans vaginal douche in the management of Shweta pradara.
Drug Review
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
4
DRUG REVIEW
Historical aspect of the Drug
Plaksa is one of the ficus species and is member of group vanaspatya chatustaya
along with aswattha, udumbara, nyagrodha. The plant is mentioned in vedic samhitas.
Brahmanas and kalpa sutras10.
Plaksha is used in the Indian system of medicine since antiquity and it has been
mentioned in Yajurveda, Charaka samhita, sushruta samhita, Astanga hridayam, Bhav-
Prakasha and in various Nighantus like Dhanwantari Madanapala and texts of Ayurveda
and Yunani, Panini, the great grammarian of Sanskrit refers the principal tree of North
India including Plaksha in his Astadhyas of Panini “(Agarwal, 1952)11.
Madanapal described described the drug Plaksha as visarpajit i.e it cures
erysepalas. Plaksha is extensiovely used ion the treatment of ulcers along with the four
ingredients in the groups panchavalkala. The four drugs are the root barks of ficus
glomerata, Ficus religiosa, Ficus bengalensis and Azardirachta indica. The healing takes
place properly when oils and ointments containing Plaksha are used.
It’s fruits have been described in charaka samhita (su 27, 164) and shushruta
samhita (su. 46,165) along with other ficus fruits.
It is also mentioned in visnu (1,22,9) and Bhagawata (5,20,2) puranas and
raghuvamsha (8,93).
Charaka: described it as mutra sangrahaniya while susruta and vagbhata have mentioned
it under Nyagrodhadi gana. It is considered as one of the ksiri vrksas or pancha valkalas
by Bhavamisra.
Drug Review
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
5
Shatapathabrahmanha: gives reference pertaining to plaksha. One among vanaspatis
and beneficial in the Yajna (Homage) Plaksha, Kashmarya, Ashvattha, Udumbara,
Pitudaru, bilwa are shrestha, vetasa is Nikrastha.
Etareya brahmanha: We come across the reference about these vanaspatis. Pranou vai
vanaspati (E.Br. 2/4,20) 5/23, 7/32) Chatusta vanaspatis are Plaksha, Nyagrodha,
Udumbara, Asvattha. (E.Br. 6/16)
Kalpasutra: Gives the reference about the usage explained like Plakshodumbara.
Panini: Mentioning of the vanaspatyadi gana (6/2/140) Plakshodumbara.
Vattikakar: Description regarding vanaspatis (1/4/12)
Bhattoji: Give the reference with an examples as “Plakshanyagrodhou”
Taittiriya samhita: The references as Plakshanyayagrodhakhadirpalasha (6/3/20/2)
Usage of “Praksha” word. One among Kshirivruksha In the unmada roga havan by
plaksha is told. Fruits of this tree are edible. In the yajna usage of plakshakha explained.
Darila: We come across the reference of Plakshodumbar “Pipariti” is supreme.
In Yajurveda: Reference as Plaksha is one among vanaspatis.
Patanjala: Reference as that “Plakshodumbara”
Sushruta Samhita: Reference regarding Kshirivruksha such as plaksha, Nygrodha,
Udumbara, Ashwattha these four vanspatis included in the “Vishnu sahasranam” even pet
names of God Vishnu. Specific references are available regarding ‘plaksha’
cÉiÉÑhÉÉï ¤ÉÏUÏuÉפÉÉhÉÉqÉç (xÉÑ. 1/4)
¤ÉÏUÏuÉפÉMüwÉÉrÉ (zÉÑ.ÍcÉ. 16/13; 46/433)
iÉcÉÈ ÌmɹuÉ ¤ÉÏËUhÉÉqÉç (xÉÑ.ÍcÉ. 20/34) Told
ÌuÉSìÍkÉ ÍcÉÌMüixÉÉ WåûiÉÑ (ÍcÉ.16, /13)
Drug Review
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
6
¤ÉÏUÏuÉÑ¤É MüwÉÉrÉ Told.
In the context of “Nyagrodhaadi gana” explaination regarding plaksha, kapitana,
Nyagrodha, Udumbara, Ashwatha. Shushruta clearly mentioned Panchakashaya
prayojana in detail12.
uÉÉiÉeÉ MühÉïzÉÔsÉ – MühÉïmÉë¤ÉÉsÉlÉ and MühÉïmÉÔUhÉ by mÉlcÉMüwÉÉrÉ YuÉÉjÉ, cÉÑhÉï. (xÉÑ.E. 11/42)
SÒaÉÉïÎlSiÉ ÌmÉÎcNûiÉ rÉÉåÌlÉ – mÉlcÉMüwÉÉrÉ cÉÔhÉï – mÉÔUhÉ, mÉlcÉMüwÉÉrÉ YuÉjÉ – kÉÉuÉlÉ (xÉÑ.E. 36/25)
Charaka Samhita: In Charaka samhita specification of Panchavalkala (Ch. 22/14),
Panchakshirivruksha (Chi. 11/44) Nyygrodhadhaischturbi (Si. 10/37) told
mÉlcÉuÉsMüsÉ, mÉlcÉMüwÉÉrÉ – irÉaÉëÉåkÉ, AμÉijÉ, ESÒqoÉU, msɤÉ, uÉåiÉxÉ explained. (Ch. 15/41)
Astanga Hradaya: In the context of chikitsa Shofanirvanartha, nygrodhadi
panchavalkala explained. (Ch. 15/41)
Vagbhat: Vagbhat attributed the same opinion as that of charaka, Shofa nirvapana hetu
(chi. 15/16) Nayagrodhadi four drugs with vetasa valkala told chandanadi ghrita (chi
10/42)
Brahatrayi: Especially the manifold actions of the drugs mentioned are highlighted by
the synonyms, Kshiri vruksha kashaya, valkala, specifically Nyagrodha, Udumbara,
Ashvattha, Plaksha known as Panchavalkala and panchakshiri. Different opinions
regarding these five drugs.
Chakrapani: Reference regarding “Panchavalkala kashaya” In this context vetasa told.
In the chapter on “dviruniya” Shofanirpanha hetu (Chi. 25/46) these 4 drugs vetasa
valkala ghruta mishrita pralepa told. Visarpa chikitsa hetu (Chi. 12/84) 4 drugs with
Drug Review
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara-
A Clinical study.
7
vetasa, pallava, valkala kalka gruta mishrita- pralepa In panchaksheeravruksha prasanga
with 4 drugs + kapitana told.
Dalhana: In this (Vi.Chi) references regarding Nyagrodha, Udumbar, ashvatta, plaksha
gardabhanda told. Anupana vivechana (Su. 46/433) and vranashodhana hetu prayukta
‘kashayanam’ hetu (chi. 20/16) (Chi. 2/66) ‘Kshiri’ i.e kshudraroga chikitsa. Dalhana told
twachaha pishtava kshireenam and vatadi pancha kshirini vruksha twacha told.
Utpatti13: msɤÉÉå qÉåkÉålÉ – iÉæ 7/4/12/1
iÉxrÉ (SæuÉæUÉsÉprÉqÉÉlÉxrÉ mÉzÉÉåÈ) AuÉÉQÒû qÉåkÉÈ mÉmÉÉiÉ |
xÉ LuÉ uÉlÉxmÉÌiÉUeÉÉrÉiÉ | iÉÇ SåuÉÉÈ mÉëÉmÉzrÉlÉç |
iÉxqÉÉiÉçç mÉëZrÉÈ| mÉëZÄrÉÉå Wû uÉæ lÉÉqÉæiÉSè, rÉiÉç msÉ¤É CÌiÉ’- zÉ0 3/8/12)
Table No-1.1 Ganas and vargas according to different classics
Charaka samhita Mutra sangrahniya kasaya skandha
Sushruta samhita Nyagrodhadi
Phala varga
Astanga hridaya Nyagrodhadi
Bhavaprakasha Nighantu (Kshirivriksha) vatadi varga panchavalkala
Nighantu Adarsha Vatadi varga
Kaiyadev Nighantu Oushadhi varga
Raj Nighantu Amradi varga
Dhanvantari Nighantu Amaradi varga
Madanapala Nighantu Vatadi varga
Shaligram Nighantu Vatadi varga
Drug Review
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Abhidana Ratnamal Kashaya dravya skandha
Madhav dravya guna Vividoushadi varga
Amara kosha Vanoushadi varga
Table No-1.2 Paryayas according to different authors
Synonyms CS14 SS15 AH16 BN17 KN18 RN19 MN20 NA21 Ab
R22
AK23 SN24 SKD25
Plaksha + + + + + + + + + + + +
Jathi + + + + + +
Parkari + +
Parkati + + + + + +
Pippari +
Shrungika +
Vathi + + + +
Pugamunda +
Gardabhanda + + + + + +
Kamandalu + + + +
Plava + + +
Gandhamunda +
Charudaru +
Suparshva + + + + + +
Charudarshana + + +
Mundika +
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Ashwath patra + +
Kapitana + +
Ksiri + + + + +
Shrangi + +
Varohashakhi + +
Kapitaka +
Drada praroha + + +
Plavaka + +
Plavanga + +
Mahabala + +
Hrsva plaksha + +
Sushita +
Shitaviryaka +
Pundra + +
Mahavaroha + +
Hrsva parna + +
Pimpari + +
Bhidura + +
Mangalacchaya +
Charuvrksha +
Garbha
bhandaka
+
Drug Review
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Pippari + +
Yupa +
Pippalapadapa + +
Kapotana +
Pitana +
Ashwatthi +
Karpari +
Plavaksha +
Shungi +
Avarohashakha +
Ploksha +
Sukshma +
Sushouta +
Shoutavarnyak +
Bhitura +
Paryayas and its meanings26
1) msÉ¤É - mÉë¤ÉUÌiÉ CÌiÉ msɤÉÈ |
Spreading much more
2) msɤÉÌiÉ: AkÉÉå aÉcNûÌiÉ msÉ¤É = mÉëÌiÉ AkÉÉå aÉcNûÌiÉ qÉÔsÉÉæ CÌiÉ |
By its Jatha rupa root facing towards down.
3) eÉPûÏ : eÉOûÉ xÉÉÎliÉ AxrÉ CÌiÉ eÉOûÏ | (N.A)
Drug Review
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Here Jata found
4) eÉOûÌiÉ – xÉÇbÉÉiÉÏ pÉuÉiÉÏÌiÉ | ‘eÉOû xÉÇbÉÉiÉå’ (N.A)
It founds as Jata all at one
5) mÉMïüOûÏ : mÉMïüOûÉZrÉÇ TüsÉqÉxrÉ mÉMïüOûÏ |
rÉSè uÉÉcÉxmÉÉÌiÉ: = TüsÉÇ iuÉålÉxrÉmÉMïüOûqÉç |
mÉ×crÉiÉå xÉqrÉMçü xÉÇoÉkrÉiÉå uÉëhÉÉÌSwÉÑ CÌiÉ | (N.A)
Best remedy in Ulcers
6) ÌmÉmmÉsÉmÉÉSmÉ: A synonym told by ¤ÉÏUxuÉÉqÉÏ
7) Suparshwa – Few branches and many adventitious roots growing down word
8) Kamadalu – Probably indicates the habitat near fresh water or it may also refer to
shape of fruit.
MODERN REVIEW OF THE DRUG PLAKSHA
Botanical Name27: Ficus lacor
Ficus = From an original Arabic word meaning fig
Lacor = or thespasia populuca = divine.
VERNACULAR NAMES28
Latin Name : Ficus lacor
Sanskrit : Ashvatthi, charudarshani, Dradapraroha, Gardabhanda, Jati,
Kamandalrohataru
Hindi : Kahimal, Kaim, Pakar, Pakri, Khabar
Marathi : Bassari, Lendwa, Pakari
Gujarati : Pepri
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Telgu : Badijuwi, Jati, Juvvi
Kannada : Basarigida, Juvvi, Hasuri, Karibasari, Kadubasari, Jeevibasari, Basa
Bengal : Pakar, Pakur
English : Wave leaved fig tree
Tamil : Jovi, Kallal, Kurugatti, Kurugu
Malayalam : Bakri, Chakkila, Chela, Itti, Jathi
Bengal : Pakar, Pakur
Bombay : Bassari, kaim, pakri, pipli
Kolami : Baswesa
Konkani : Killah
Kurku : Pepere, pepre
Lambadi : Katipipri
Nepal : Safed kabra
North-west provinces: Pakur
Punjab : Batbar, Jangli pipli
Sindhalese : Kalha, Kiripella
Tulu : Basari goli
Thana : Kel
Urdu : Pakhari
Uriya : Pakodo, Rushorchona
Can : Juvi, kari
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CLASSIFICATION OF PLAKSHA
Plaksha has been mentioned in various Ganas due to its manifold actions by
different authors. They have been listed below.
Botanical Classification29
Kingdom – Plantae
Division – Magnoliophyta
Class – Magnoliopsida
Sub class – Rosidae
Order – Rosales
Family – Moraceae
Genus – Ficus
Species – Ficus
Diagnostic features of Family Moraceae
Plant usually trees and shrubs with stipulate leaves; latex present, Inflorescence
cymes of small male and female flowers, perianth usually 4 gamo-or polyphyllous,
persistent, stamens 4 opposite to tepals; gynoecium bicarpellary, synacarpous, superior,
unilocular, fruit nut or drupe.
Distribution30
It is commonly called Mulberry family and consists of 53 genera and 1400
species. It is distributed in warm temperate, tropical and substropical countries of the
world. In India the family represented by about 104 species belonging to 15 genera.
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Vegetative characters:
Habit – Mostly trees (Morus, Ficus), shrubs or climbers rarely herbs (Dorstenia), mostly
with lates.
Root – Tap root, branched, produce adventitious aerial roots (Ficus sp)
Stem – Aerial, erect or climbing, cylindrical solid, branched, woody, gum may be exuded
from the surface.
Leaf – Alternate usually simple, cauline, ramal, in some, stipulate stipules large and
leafy, caduceus, entire or deeply lobed, or serrate, glabrous or glaucous, reticulate-
unicostate or multicostate.
Floral Characters
Inflorescence – catkin (Morus) or hypathodium (Ficus) or globose heads
(Plecospermum).
Flower – Small, inconspicuous, bacteate, or ebracteate, incomplete usually unisexual,
monoecious (Ficus, Morus) or dioecious, actinomorphic, hypogynous, clclic. In Ficus
five types of Flowers viz.
1. Male with pistillode, 2. Female flower, 3. Male without pistillode, 4. Female with short
style, 5. Sterile flowers.
2. Perianth – 2 to 6, two in Ficus carica, four in Morus, six in other Ficus spp. Free or
united, inferiou, usually green, persistent, valvate or imbricate in bud; sometimes absent.
Male flowers
Perianth – As above.
Androecium – 1 to 6 in various specied of Ficus, 4 in Morus, bent or straight opposite to
perianth leaves, introrse, bithecous, basifixed or dorsifixed.
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Gynoecium – Represented by pistillode.
Female Flower
Perianth – As above
Androecium – Absent
Gynoecium – Bicarpellary, syncarpous, superior, unilocular, ovule solitary or two, erect
or pendulous, style simple or bifid, stigma 1 or 2, linear of filiform.
Fruit – Sorosis (Morus), syconus (Ficus) etaerio of achenes or drupes (Maclura), berry
(Cudrania).
Seed – Endosperimic or non-endospermic.
Pollination – Entomophilous or anemophilous
Ficus exhibits extraordinary way of pollination. The insects enter the hypanthodium
through apical opening to lay eggs in the ovaries of sterile flowers (or gall flowers). The
insects cannot lay eggs in the ovaries of fertile female flowers as they are covered by
hairs. The bodies of insects get dusted with pollen from the male flowers, then they enter
another hypanthodium and so come in contact with the papillose long styles of the fertile
female flowers, in this way cross pollination is ensured.
Flower formulae:
Male flower – 0 P2-6 or (4) A1-6 or 3-8 G0 or pistillode.
Female flower – 0 P2-6 or (4) or zero A0 G(2).
Botanical Description
Ficus lacor - A large spreading deciduous fast growing tree, all parts glabrous; bark
grey, smooth, scaly.
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Leaves – membranous, 9-12.5 by 5-6.3cm. ovate or ovate-oblong, shortly and rather
abruptly acuminate, with entire, subundulate margins.
Base – Usually rounded, slightly cordate, or sometimes narrowed or acute, 3-nerved;
lateral main nerves 5-7 not very prominent.
Petioles – 3.8 – 5.7 cm. long, some times indistinctly jointed with the blade;
Stipules – about 13mm long, broadly ovate, acute, pubescent.
Receptacles – axillary in pairs, sessile, globose, 6mm diam, whitish, flushed with red and
dotted, when ripe; basal bracts, ovate- round, minute.
Male flowers - few, bracte sessile near the mouth of the receptacles.
Stamen1; another broadly ovate; Filament short. Sepals 4 or 5, Gall and fertile flowers;
perianth as in the Male. Style of fertile female flowers long, of the gall folwers short;
stigma elongate.
Distribution: Plains and lower hills of India, Ceylon- Malaya.
Pharmacognosy of Plaksha (Stem Bark)31
a) Macroscopic – Bark rough, occurring in flat to curved, quilled pieces, measuring
0.4-0.7 cm in thickness; external surface ash or whitish-grey; numerous
transversely arranged lenticels; ranging from 0.1 cm – 1.3 cm in length, lip-
shaped and exfoliating; internal surface rough, fibrous, longitudinally striated,
reddish-brown; fracture, fibrous.
b) Microscopic – Shows 5-8 layered cork consisting of thin-walled, rectangular
cells, a few external layers exfoliating; secondary cortex very wide consisting of
compactly arranged, rectangular, thick-walled, pitted cells, patches of circular to
elongated, lignified, elliptical stone cells with radiating canals, a few with
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concentric striations; a few prismatic crystals of calcium oxalate and reddish-
brown contents found scattered throughout the secondary cortex; secondary
phloem very wide consisting of mostly stratified layers of collapsed cells forming
ceratenchyma, groups of fibres, phloem parenchyma, laticiferous cells, traversed
by 2-5 seriate phloem rays; phloem fibres lingnified with wide lumen and pointed
tips; thin-walled, rectangular, a few phloem parenchyma containing prismatic
crystals of calcium oxalate.
c) Powder – Reddish-brown; shows thick-walled parenchyma with simple pits;
stone cells in groups and singles, prismatic crystals of calcium oxalate, elongated
phloem fibres with wide lumen and pointed tips.
Identity, Purity and Strength
Foreign matter - Not more than 1 percent
Total ash - Not more than 10 percent
Acid-insoluble ash - Not more than 1.5 percent
Alcohol-soluble extractive- Not more than 5 percent
Water-soluble extractive - Not more than 6 percent
Pharmacognosy of Plaksa (Fruit)32
a) Macroscopic: Fruit is a syconus, 0.5 to 1.0 in dia, attached with pedicel; sub-
globose, wrinkled, glabrous, having three basal bracts; grayish- borown to
yellowish-brown; taste, astringent.
b) Microscopic: Fruits shows single layered, thin-walled epidermis followed by a
narrow zone of 2 to 5 layers, of round, oval, rectangular, lignified stone cells with
wide lumen; rest of mesocarp very wide consisting of oval to polygonal,
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collenchymatous cells containing brownish contents; a few vascular traces found
scattered in this zone; inner zone consisting of stone cells similar in shape and
size to these found scattered in outer zone; male and female flower attached to
inner of mesocarp.
c) Powder – Dark grayish-brown; shows fragments of epidermal cells; single, or
groups of lignified stone cells; collenchymatous cells; a few debris of male and
female flowers present.
Identity Purity and Strength
Foreign matter - Not more than 2 percent
Total ash - Not more than 9 percent
Acid-insoluble ash - Not more than 1 percent
Alcohol-soluble extractive - Not more than 5 percent
Water-soluble extractive - Not more than 15 percent
TLC
TLC of alcoholic extract on Silica Gel ‘G’ using n-Butanol: Acetic Acid: Water
(4:1:5) shows in visible light three spots at Rf. 0.27, 0.63 (both grey) and 0.97 (yellowish
green). Under UV (366 nm) six fluorescent zones are visible at Rf. 0.53, 0.63, 0.84, 0.91,
(all blue) and 0.97 (pink). On exposure to Iodine vapour twelve spots appear at Rf. 0.12,
0.16, 0.22, 0.27, 0.50, 0.63, 0.73, 0.84, 0.91, 0.94 and 0.97 (all yellow). On spraying with
Ninhydrin reagent a single spot appears at Rf. 0.97 (brick red).
Constituents – Amino Acids
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VARIETIES OF PLAKSHA:
According to Bhavaprakasha Nighantu33
1. Jangala
2. Gramya
According to P.V. Sharma34
Three varieties – 1) Var, infectoria
2) Var, lambertiana
3) Var, weightiana
4) Ficus lacor,
Other species35 - 1) Ficus arnottiana
2) Ficus rumphii, Blume
3) Ficus talboti. G
4) Ficus retusa, Ficus microcrapa syn, Firetusa acuct
5) Ficus tsiela Roxb
6) Ficus tsjakela Burm f.
Table No. 1.3 GUNAS (PROPERTIES) ACCORDING TO DIFFERENT
AUTHORS.
Properties BN36 DN37 MN38 RN39 KN40 NA41 SN42 P.V. Sharma43
Rasa Kashaya + + + + + + + Katu - + + - + + - Guna Sheeta + + + + + + + - Guru - - - - - - - + Ruksha - - - - - - - + Veerya Sheeta + + + + + + + Vipaka
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Katu + + + + + + + Doshaghnata Kaphahara + - + - + + - + Pittahara + + + + + + + +
Phytochemistry: Stem bark44 – contains methyl ricinolate, caffeic acid, bergenin,
lanosteral and B- sita sterol, sterols, sugar, Tannin, Alkaloid and saponin.
(Carbohydrates, glycosides, Proteins, amino acids)
Leaves – contain the flavonoids, scrbifolin -6-0- (arabinopyranosy 1- (1-2) – B-D
glucopyranoside) [(C27 H30O15, mp 340-420) and scutellarein 6-0B-glucoside.
Fruit – Amino Acids
Tannins45 – They have been known as astringents substances, having capacity to
combine with tissue proteins and precipitate them. They are used as antiseptics, in the
treatment of diarrhea, to check small haemorrhages.
Tannin detoxifies the fungal infections, acts as tonic. They are agents which
contract muscular fibers and control the abnormal secretions of mucous membranes.
Tannins are soluable in water.
Table No. 1.4 KARMAS ACCORDING TO DIFFERENT AUTHORS
Karmas CS46 SS47 AH48 BP49 DN50 RN51 KN52 NA53 DG. 54
HMK
M
N55
P.V.56
Sharma
Vrana ropaka + + + + + + +
Yonigata roga + + + + + + +
Rakta vikara + + + + + + +
Grahi + + +
Shotahara + + + + +
Vrana
prakshalana
+ + +
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Medahara +
Visarpa + +
Murcha + +
Bhrma + +
Pralapa + +
Shamaka +
Sthambhana + + +
Mutrasangrah
aniya
+ + +
Sangrahaka + +
Vistambakara
ka
+
Kaphapitta
Nashaka
+ + + + +
Daha
Prashanana
Rakta
shodhana
Stanya +
Shonita
stapana
+
Varnya +
Garbhashaya
shothahara
+
Mukha
rogahara
+
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Table No. 1.5 PRAYOJYA ANGA
Parts used P.V.57
Sharma
RN58 BN59 NA60 Indian
material61
D.G.V
M.G62
Bark + + + + + +
Leaves - - - + + -
Fruit - + - - - -
Table No. 1.6 PRAYOGA ACCORDING TO DIFFERENT AUTHORS
Prayoga CS63 SS64 AH65 B
P
N66
K
N67
R
N68
M
N69
D
N70
N
A71
D.G
P.V.S72
D.G.
J.L.
N73
D.G74
V.M.G
Shotha + + - + + + +
Vrana + + + + + + +
Rakta vikara + + + + +
Visarpa + + + + +
Raktapitta + + + + + +
Raktapradara + + +
Shwetapradara + +
Prameha + +
Atisara blood + + + +
Pravahika + +
Yonisrava + +
Yoniroga + + +
Daha + + + + + +
Astanya +
Stomatitis +
Jvara
Vidradi
+ +
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Prayoga75: All parts are acrid, pungent, cooling; useful in diseases of the blood and the
vagina, ulcers, burning sensations, biliousness, “kapha” inflammations, leprosy,
hallucinations, loss of consciousness.
The fruit is sour; the seeds are useful in bronchitis, biliousness, scabies, boils,
inflammation.
The bark of this, along with the barks of other four species of ficus and of melia
azadirachta, pass by the name of panchavalkala. They are used in combination. A
decoction is much employed as a gargle in salivation, as a wash for ulcers, and as an
injection in leucorrhoea.
Nighantu describes this tree as cooling, pungent astringent and curative of Rakta
dosha, moorcha srama and pralapa.
Bark enters the composition of Panchavalkala decoction of the bark is used as
gargle in salivation; as a wash for ulcers and also as an injection in leucorrhoea. This also
cures yonidosha charaka prescribes a varti or suppository made with the pulversised bark
to be inserted into the vagina in case of yoni-srava. As a vegetable, the leaves can be
eaten as they are, by those who suffers from Raktapitta.
Table No. 1.7 Matra (Posology)
D.G.
P.V.S76
D.G.
HMK77
D.G.
V.M. Gogte78
Indian
material79
Charak80
Powder - 3-5 gm -
Decoction 50-100 ml 40-50 ml 50-100 ml
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Therapeutic uses81
Charaka – Erysipelas – cold paste of the tender leaves and bark mixed with profuse ghee
should be applied (cs.ci. 21.85)
Charaka – Meno metrorrhagia – Lump of powdered bark of plaksha mixed with honey
should be kept in lubricated vagina. (cs.chi. 30,119)
Charaka – Inflammation – paste of bark of above drugs mixed with ghee form an
excellent anti-inflammatory agent (cs.ci. 25, 46)
Sushrut – Diarrhoea with blood – Barks of plash sallaki and tinisa are pounded with
milk, mixed with honey and then taken (ss.u. 40.119)
Bhavaprakasha – Intrinsic haemorrhage tender leaves of Plaksha vetasa etc and
tanduliya etc are wholesome as vegetable (B.P. Ci. 9,18)
Uses in othersystem of medicine In Chinese medicine bark diaphoretic
Table No.1.8. USE OF PLAKSHA IN DIFFERENT YOGAS
S.L.No Yoga Indication Reference
1 Changeri ghrita Raktarsha Bhel,sa 16/39/401
2 Vranashodhana kashaya Vrana Bhel, sa 27/10/467-468
3 Nyagrodhadhya ghrita Pradara, shweta, rakta,
Krishna, shrava,
yonishrava
Bhai. R 93/2036-2037
4 Vatadi lepa Shotha C.S.Chi. 25/46/705
5 Nyagrodhadi lepa Vrana C.S. Chi 25/63/707
6 Panchavalkala churna Vrana C.S. Chi. 25/67/705
7 Vrana shodhaka kashaya Vrana prakshalana C.S. Chi. 25/84/710
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8 Nyagrodhadi ropanha kwatha Vrana ropanartha C.S.Chi 25/87/720
9 Nyagrodhadi kashaya Vrana C.S. Chi. 30/84/851
10 Nygrodhadi pralepa Vrana C.S.Chi. 30/46/8
11 Panchavalkalamr lepa Abhighataja
mutrakricchra, vataja
mutrakrucchra
Y.R.U 6/163/164
12 Shatadhouta ghrita Raktaja vrana shotha
lepartha
Y.R. Chi 6/163/164
13 Nyagrodhadi kwatha Vrana shotha Y.R. Chi. 8/176
14 Panchavalkaladi yoga Puya vrana Y.R. 10/176
15 Gouradhya ghrita Vrana, sahaja, purana
nadi, vishama vrana
Y.R Chi. 1-4/183
16 Baladi taila Sadhya vrana ropana S.S. Chi 2/53/19
17 Decoction of plaksha bark Stomatitis, Ulcer I.M.M. P 551
18 Inj of Plakshatwak kashaya Leucorrhoea yonidosha I.M.M. P551
19 Varti of pulversed plaksha
bark
Yoni srava I.M.M 551
20 Vaginal suppository of
plaksha bark powder
Menorrhagia
leucorrhoea
A.Ph. logy P.659
21 Vaginal douche of plaksha
kashaya
Menorrhagia
leucorrhoea
A.Phology P 659
22 Plaksha twak churna Yonisrava C. S. Chi 36/116
23 Plaksha twak kwatha Vranaropanartha C. S. Chi. 13/85
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24 Nyagrodhadi lepa Shotha Vr. Ma IInd vol 44/7 P-
573
25 Preprn of ile & aintment Ulcers A.D. plant sources P-
377
26 Usirasava Ulcers A.D. plant sources P-
377
27 Gandhatailam Ulcers A.D. plant sources P-
377
28 Nalpamaradi tailm Ulcers A.D. plant sources P-
377
29 Dinesavalyadi Kulambu Ulcers A.D. plant sources P-
377
30 Parantyadi taila Ulcers A.D. plant sources P-
377
31 Valiya marma gulika Ulcers A.D. plant sources P-
377
Research Profile82
1) Plaksha as anti inflammatory- Ficus lacor was studied experimentally for anti-
inflammatory activity in caraginin induced paw edema. This showed a good result.
However, in the classics it used or external application alone. Only two formulations
have reference for this drug to be one of the ingredients keeping this in mind another
study was carried out though topical application of Plaksha kashaya in ear edema in rats
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induced by croton seed oil. This method of application of this was 5 minutes parisheka
(pouring in thin a stream of kashaya) in 1 hour and repetition of the same in every hour
for four hours. This was sufficient to produce significant anti-inflammatory effect. This
study proved the drug to be having highly significant effect both as internal and topical
application.
2) The caloric values and ash content in the leaves at different growth stages of five Ficus
species (Ficus religiosa, F elastica, F. lacor, F. Microcarpa cv Golden-leaves, F
microcarpa) were studied. The results showed that the ash content increased with the
growth of the leaves, the relatively high ash contents of old leaves were not the lowest,
which indicates that the leaves have a mechanism to maintain the balance of nutritious
elements. The young leaves have relatively higher gross caloric value than mature and
old leaves, gross caloric value in the leaves at different development stages vary with
species. The gross caloric values in the leaves at different development stages have
distinct liner correlation with ash contents. The ash-free caloric values in the leaves at the
different development stages also vary with species.
3) Tanin stimulates the uterus. In prolonged and frequent uterine bleeding is suggested in
all cases of uterine bleeding. It is reported to have stimulant effects on the endometrium
and ovarian tissue, and useful in menorrhagia.
4) Reported as even infected with trichomanas vaginalis were also cured. Cervical
erosion cases showed healing of erosions.
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ANUPANA
Madhu83,84
UeÉlÉÏcÉÔhÉïqÉkÉÑMüqÉç kÉȨ́ÉTüsÉUxÉlÉiÉÑ
cÉiÉÑmÉëMüÉU mÉëSUqÉç lÉzÉrÉåiÉ lÉ xÉÇzÉrÉÈ |
Harudra powder, madhu (honey), amalaki, swarasa are supposed to be best
vehicles or anupanas for pradara roga.
The role of Mahdu:
MüwÉÉrÉlÉÑUxÉÇ Ã¤É zÉÏiÉsÉÇ qÉkÉÑU qÉkÉÑ |
SÏmÉlÉÇ sÉåZÉlÉÇ oÉsrÉ uÉëzÉÉåkÉlÉUÉåmÉhÉqÉç |
xÉÇkÉÉlÉÇ sÉbÉÑ cɤÉÑwrÉ xuÉjÉïqÉç ¾û±Ç ̧ÉSÉåwÉlÉÑiÉç ||
Madhu is astringent in anurasa, unctuous cooling, sweet, digestive stimulant,
lekhana and strength promoting. It cleans and heals ulcers and helps in joining of
fractured bones, It is light promoter of eye sight and good voice, cardiac tonic and
alleviant of all the doshas.
Synonyms: Madhu Makshika, Madhvika, Kshaudra, Saragh, Makshikavanta,
Varativanta, Bringa vanta, Pushpa, Rasobhava.
Vernacular Name:
Kannada : Jenu tuppa
English : Honey
Hindi : Shahad
Marathi : Madhu
Tamil : Teni
Bangali : Madhu
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Gujarathi : Madhu
Pharmacological Properties:
Rasa : Madhura, Kashaya
Guna : Guru, Ruksha
Veerya : Sheeta
Vipaka : Madhura
Prabhava : Yogavahi
Doshagnata : Tridosha
Physical Properties:
Honey is thick, Semitranslucent liquid of yellowish brown clour of aromatic
odour. After some times it becomes opaque and crystalline.
Chemical Composition :
The sugars in honey, fructose, glucose and maltose followed by lower
concentration of sucrose and maltose. The average composition of honey is as follows.
Moisture - 17.1% Calcium - 5mg
Protein - 0.2% Phosphorous - 16mg
Minerals - 0.2% Iron - 0.9mg
Carbohydrates - 74% Vitamin C - 4mg
Nava Madhu:
Navamadhu i.e freshly collected madhu is nourishing. It does not alleviate kapha
in excess.
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Purana Madhu:
Bhava mishra says, purana means after one year (Samvastra) Madhu becomes
purana i.e old.
Purana Madhu in general, cures meda and sthaulya. It is grahi, Ruksha and
exceedingly depleting one.
Table No.1.9. SHOWING PHARMACOLOGICAL ACTION OF MADHU
S.L.No Pharmacological
action
Ch.s Sus. V. B.P R.N D.N P.N
1. Balya - + - - + + +
2 Chedana + - + - - - -
3 Chakshyashya - + + + - + +
4 Deepana - - - + - + +
5 Hridya - - - + - + -
6 Lekhana - - - + - + +
7 Medo hara - + - - + - +
8 Ropona - + + + - + +
9 Sandhana - + + - + + -
10 Swarya - - - + + + -
11 Srotashodhaka - + - + - - -
12 Sangrahi - + - + - + -
13 Varnya - + - + - - -
14 Vajeekar - - - + - - -
15 Medhya - - - + - - -
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MODERN PHARMACOGNOSY OF HONEY85
Synonyms – Madhu, honey, purified, mel
Biological surce – Honey is a sugar secretion deposited in honey comb by the bees, Apis
mellifera, Apis dorsata, belonging to family Apidae, order Hymenoptera.
Geographical source – Honey is produced in Africa, Australia, New zeland, California
and India.
Preparation for market – Honey is extracted from the comb by centrifugation. It must be
free from foreign bodies Honey is liable to fermentation, unless it is suitable processed.
Honey is heated to 800C before it sent to the market cooled rapidly. Filtered through
flannel.
Description – Colour – Pale yellow to yellowish brown
Odour – Characteristic, pleasant
Taste – Sweet and faintly acid.
Standards – Weight per ml – 1.35 to 1.35g
Specific rotation - +300 to - 100
Total ash – 0.1 to 0.8% It is syrupy thick liquid, translucent when fresh on
keeping it becomes opadue and glanular due to the crystallization of glucose.
Chemical constituents –
Gulcose 35% ( 3%)
Fructose 45% ( 5%)
Sucrose 25%
Uther constituent maltose, gum, traces of succinic acid, acetic acid, dextrin,
formic acid, enzymes, vitamins Adulteration – Artificial invert sugar, an adulterant of
honey contains furfural – detected by fiechel’s test gives instant red colour with
resorcinol in hydrocholoric acid.
Uses – 1) Used as demulcent and sweeting agent
2) Good nutrient to patients.
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3) It is antiseptic and applied to wounds.
Exploration – 1) India is only exploited 10% of its honey potential.
2) India is producing 11000 tones of honey per annum
3) Per capital consumption of honey in India only 8.0gms while in
Germany is 1800gms.
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DISEASE REVIEW
Historical Review
This Indian system of medicine has got a vast history based on veda, upaveda,
purana etc which are dealt as under.
Veda kala (2500 BC – 100 BC)
Samhita kala (1000BC – 100AD)
Sangraha kala (800AD – 1600AD)
Adhunika kala (1600AD –onward)
Atharva veda is regarded to be the authentic source of Ayurveda, given few
references pertaining to pradara but no reference available regarding shvetapradara. In
veda there is a mentioning of krimis, which cause the injury to uterus through vagina.
The word “Asrava” has been mentioned which mean to flow, to flow, to move, in veda
there is a mentioning of Krimis, which (A.V. 44.3) cause the injury to uterus through
vagina.
SAMHITA PERIOD
Samhita period is said to be the scientific era of medicine in India.
CHARAKA SAMHITA (400BC-500BC): Indetail description of yoni vyapat is
described in chikitsasthana 30th chapter. In the context of chikitsa he mentioned
about pandure-asragdare (C.Ci. 30/119)86
SUSHRUTA SAMHITA (800BC-700BC): He explained the yoni rogas in chapter
yonivyapatpratishedhadhyaya. No specific reference are available regarding
shevetapradara (SU.U. 38 chapter)87
ASTANGA SANGRAHA (400AD): He explained the yonirogas in chapter
guhyarogavignaniyadhyaya specific reference of shwetapradara is mentioned but
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in chikitsa he mentioned about “site shukle asrakdhare” is shwetapradara (A.S.U.
39/123)88
ASTANGA HURDAYA (500AD): He explained yonirogas in Guhyaroga
vignaniya adhyaya. No specific reference of shwetapradara available, but he
mentioned pandu srava for yoni in kaphaja yoni Lakshana. (A.H.U. 33/44)89
MADHAVA NIDANA (800AD): He mentioned the Pandu srava in kaphaja
asragdara lakshana, no specific reference is available regarding shweta pradara.
(M.N. II 61/3)90
CHAKRAPANI (1100AD); Chakrapani clearly mentioned the Lakshana and
chikitsa of shwetapradara. He mentioned pandusrava from yoni is shwetapradara
and in chikitsa kashaya dravyas are used. (Chakrapani coments on C.Ci. 30/119)91
SHARANGADHARA SAMHITA (1300AD): Specific reference are not available
but he mentioned the yoni rogas and shwetapradara chikitsa. (Sr.S.P.K. 7/177 and
M.K. 2/110&114)92
BHAVAPRAKASHA (500AD): There is a detail explanation of pradara under
streerogaadhikara and pandu srava is mentioned in kaphaja pradara and chikitsa
of shweta pradara along with all types of pradara is also explained.
(B.P.M.K.streerogadhikara)93
YOGARATNAKARA (1600 AD): Detail explaination of pradar, in that pandu
srava is mentoned in kaphaja pradara. In chikitsa also he indicated shweta
pradara chikitsa while explaining all types of pradara chikitsa.
(Y.R.Streerogadhikara)94
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BHAISHAJYARATNAVALI (1600 AD): The author explained the shweta
pradara chikitsa in detail. (B.R.Pradararoga chikitsa prakarana)95.
NIRUKTHI AND PRATHIBHASHA: The term “SHWETA PRADARA” is
formed by union of two words, shweta and pradara. They can be derived in
following way.
Shwitt+Acch
The word shweta is formed by ‘shwit’ dhatu.
Shwetate iti / Rupyaml
Shweta is the varna resembles to Roupya
Shwetate its / shwita shouklo + pachadach/shukla
Shweta is varna which resembles shukla varna and also kshira, Dadhi, Roupya
are different substances which resembles the shweta varna. (S.K.D)96
Shweta-white (San-eng dictionary)
PRADARA
Pra + Dru Vidarane + Rudaram (S.K.D)97
This term pradara is formed by “pradhatu and indicates vidarana.
Vidarana (Samskrit-kan-dictionary)
The term vidara means srava
Tannamaka srouraktadisravaroge |
Rajaha pradeeryate yasmat Pradarastena sa smratana. |
Pradara is a roga in which raktadi srava is occur and depending upon the srava the
name comes along with pradara.
Narou Rugbhedah iti medinou ||
It is a rogabeda of nari (women)
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Asya Namantaram asragadara ||
Tattu phalitayonya Raktadidhatu ksharanam ||
The raktadi dhatu ksharana from yoni is pradara (S.K.D)98
Pradara: Rending, Tearing, A kind of disease of women | (San-eng dictionary)
Rajah pradeeryate yasmat pradarastena sa smrutah || (C.Chi. 30/209)99
Due to Pradirana (excessive excretion of raja, it is named as pradara.
SHWETA PRADARA:
The word shwetapradara is not mentioned as an independent disease in great
yonirogas, specially kaphaja yoni rogas as “yonigata shweta picchila srava”.
………….. MüTüÉåÅÍpÉwrÉÇÌSÍpÉuÉ×kkÉÈ
………….. xÉÑMÑüjÉïiÉç ÌmÉΊsÉ zÉÏiÉsÉÉ MühQÒûaÉëxiÉÅsmÉuÉåSlÉÉqÉç
………….. mÉÉÇQÒûuÉhÉï iÉjÉÉ mÉÉhQÒûÌmÉÎcNûsÉÉiÉïuÉuÉÉÌWûlÉÏqÉç || (cÉ.ÍcÉ. 30/13)100
Commenting on this chakrapani quotes that
mÉëSU ÌuÉÍzɹ AjÉÉåï pÉuÉÌiÉ
mÉÉÇhQÒûUå mÉëSUÍqÉÌiÉ μÉåiÉmÉëSU | cÉ.ÍcÉ. 30/223101
Here pradara referes to both asrugdhara and kaphajasrava. But chakrapani in his
commentary has used the term shwetapradara for pandura ashrugdhara.
In the same chapter at 116 shloka charaka quotes
UÉåÌWûiÉMüÉiqÉÔsÉMüsMÇü mÉÉÇhQÒûUåÅxÉ×akÉUå ÌmÉoÉåiÉç || (cÉ.ÍcÉ. 30/116)102
Where pandura ashrugdhara refers to shweta pradara Sharangadhara, bhavaprakasha,
Yogaratnakara have used the word shwetapradara for white vaginal discharge.
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Like this shwetapradara is described as cordinal symptom in so many yonirogas.
Some times this symptom is so severe that it over shadows the symptom of actual disease
and woman come for the treatment of only this shwetapradara. Probably due to this
reasons charaka, vagbhata etc have not mentioned shweta pradara as disease but have
prescribed only symptomatic treatment. Hence a consolidated aspect of other yonirogas
should be taken into consideration to study the Nidana roopa, samprapti etc.
Among the yonirogas slesmala yonivyapat sannipataja yonivyapat, vipluta yoniyapad
aticharana yonivyapad and acharana yonivyapad represents shwetapradara with their
specific features.
Other reasons to consider the shwetapradara under yonirogas is,
CjjÉæiÉæsÉï¤hÉæÈ mÉëÉå£üÉ ÌuÉÇzÉÉÌiÉjÉæÌlÉeÉÉaÉSÉÈ
iÉzÉÑ¢ükÉÉUcÉirÉÉåÍpÉSÉæwÉærÉÉåÌlÉÃmÉSìuÉiÉÉ |
aÉÑsqÉ AÉzÉï mÉëSUÉSÉïYcÉ uÉÉiÉÉkÉæYcÉÉÌiÉmÉÏQûlÉqÉç || 103
While explaining the upadrvas of yonirogas pradara is one among them.
Another reason is in the same chapter at the end of the yonivyapath rogas,
UÉåÌWûiÉMüÉiqÉÔsÉYsÉMÇü mÉÉhQÒûUåÅxÉ×akÉUå ÌmÉoÉåiÉç || 104
Shwetapradara is related to arthavaha srothas, susrutha quotes that,
AÉiÉïuÉhWåû ²å iÉrÉÉåqÉÔïsÉÇ aÉpÉÉïzÉrÉ AÉiÉïuÉuÉÉÌWûlrÉ
Arthava vahini is two in number having roots in garbhashaya and arthavavaha
srothas. Injury to these srotas leads to vandhyathva,maithuna asahishnutha and
arthavanasha. This reveals anatomical stucters and physiological importance of
arthavaha srotas. The main root of arthavavahaa srotas is garbhashaya which refers to
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uterine cavity, and atrthavavahini refers to to yoni,fallopian tubes and ovarian gland.
Hence detail knowledge about these structures is necessary to know the disease
shwetapradara.
YONI
Derivation:
The word yoni is derived from the Sanskrit root YU (Amarakosh) YU means join
or unite, which is suffixed with NI to form the word yoni. Thus the literal meaning of the
word yoni is a place of contact or union.
Synonyms of Yoni
Bhagam, Varangam, Upasthah, samara mandiram, madanalayah, rati kuharum,
rati graham, rati, mandiram, janma vartanum, adharam, prakritih, apatham, samara kupah,
ratyanga, pushpa pathah.
Utpatti sthana, pushpin, samsarmargaka, samsar, marga, guhyam, adhah.
The dictionary meaning of yoni is wombs, uterus, vulva, the female organs of
generation any place of birth or origin, generating cause, spring.
Vagbhata while describing the specific muscles of woman used the word yoni to
denotes the entire reproductive system. Maharshi sushruta and vagbhat while giving the
reasons for conception occurring only during rtu kala have used the word yoni to donote
uterus and cervical canal.
ûrÉÉåÌlÉxiÉÑ zÉUuÉlÉÉprÉÉM×üÌiÉUrÉÉxiÉÉuÉiÉÉï |
iÉxrÉ iÉ×iÉÏrÉ AÉuÉiÉåï ÌmɨÉmÉYuÉzÉÉrÉÉ UÉåÌWûiÉqÉixrÉqÉÑZÉMüÉUÉ
aÉpÉÉïzÉÉrÉrÉÉ iÉxrÉ zÉÑ¢üÉiÉïuÉmÉëuÉåzÉÏlrÉÉx§ÉÏx§É mÉåzÉrÉ || A.xÉÇ.AÉ 5/116105
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The shape of yoni resembles shankha nabhi is hallow portion of conch shell and
has three avruthas. The garbhashaya is attached to third avrutha. In yoni, there are thre
nadis- samirana, chandramasi and gowri. At clitoris is mainly samirana shukra falling on
it becomes fertile. The woman having mainly chandramasi is easily satisfied with clitoris
and delivers female children sexual satisfaction to women possessing gowri nadi in
upasthagrabha (deepen part of vaginal cannel is attached with difficulty and she delivers
usually male children. The word yoni in ayurveda classics refers to whole reproductive
system of woman starting from the valva to the ovaries as well as supporting strugtures.
2. Garbhashaya:
Garbhashaya as the word is combination of two words.
Garbha+Ashaya, Garbha resides in this ashaya so it is called as Garbhashaya
women possess one extra ashaya known as Garbhashaya. Which is situated in the third
avarta of the yoni, in between pittasaya and pakwashaya, behind the bladder.
x§ÉÏhÉÉÇ aÉpÉïzÉrÉÉåŹÍqÉÌiÉ ÌmɨÉmÉMüuÉÉzÉrÉÉåqÉïkcÉå aÉpÉïzÉrrÉÉ rÉ§É aÉpÉÉïÎxiɹÌiÉ || xÉÑ.zÉÉ. 5/32106
rÉjÉÉ UÉåÌWûiÉqÉxirÉ qÉÑZÉÇ pÉuÉÌiÉ ÃmÉiÉÈ || xÉÑ.zÉÉ. 5/44107
In shape it resembles the mouth of rohita fish.
Acharya kashayapa has described it is in between the vipula kundala of srotas
(multiple coils of intestine) covered with jarayu (peritoneum) It resembles to the mouth
of the rohita a fish Acharya Dalhana explains that the resembalance to the mouth of
Rohita fish is to denote the internal structures of the uterus. Acharya Bhava mishra
explains identically to that of sushruta.
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3. Artava:
Derivation:
Artavam is derived from the root word Rutu.
“Rutuhu asya prapthah”
Who has got rutu i.e period, suffixed with Ann. Artava is formed, means stree beeja or
pushpa.
Defination:
The rakta gets collected inside the Garbhashaya and flows out for three days
every month, this is known as artava.
Artava, which is agneya, has characterstics of rakta, forms garbha and is essential
for life. The dominant mahabhoota is tejas. Its pramana is 4 anjalis. The period of about
12 days from the commencement of menstruation which is most suitable period for
conception is termed as rutukala.
Artava is slightly black. Is also called as Rajah, which is produced from the
Rasadhatu itself.
Table No-2.1. Swaroopa of Shudha Artava108
Swaroopa Cha.Sam Su. Sam As. S As. Hri Bha. Pra
Gunja phala varna + - - - -
Padma lakta + - - - -
Indra gopa + - - - -
Shasa asrak - + + + +
Laksha rasa - + + + -
Nishpicchila + - - - +
Na daha + - - - +
Na arthi + - - - +
Dautam cha - + + + -
Virajyayate + - - - -
Na ati bahu + - - - -
Na ati alpa + - - - -
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VRIDHI, KSHAYA, LAKSHAN OF ARTAVA:
1) Vridhi: Anga marda (Body ache) Artava ati pravriti (increased flow of artava)
Daurgandhya (Bad smell)
2) Kshaya: Yathochita kala adarshana (Tringular menstruation) Alpata (Scanty flow)
yonivedana (Pain in the vagina)
Table No-2.2. Showing the Nidana of Shweta pradara
Nidana Cha.S Su. S As. S As. Hri Bha. Pra MN Yog.r
Mithyachara
a) Mithyahara
b) Mithy vihara
+ + + + + + +
Artava Dusthi + + + + + + +
Beeja Dosha + + + + + + +
Daiva + + + + + + +
Pravridha
linga purusha
atisevana
- + + + - - -
Ruksha
Durbala Bala
- + + + - - -
Apadravya
Prayoga
- - + + - - -
Manasika - - + + - - -
Garavisha - - + + - - -
Specific shvetapradara nidana is not mentioned in classical literature. General pradara
nidana is mentioned as follows.
Lavana, Amla, Katurasa, Vidahi, Guru, Snigda
Mamsa of gramya, Oudaka, Medya
Krashara, Payasa, Dadhi, shukta, mastu, sura
Virudhahara, adhayashana, madhyapana
Garbhapata, Atimithuna, Yana, Ajirna, Adwa
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Bharavahana, Abhigata, Divashayana
Among the above nidana the aharajanya nidana will vitiates rakta, it’s amount will
increased and reach shleshmadhara kala of artavavaha srotas, vitiates stanika kapha and
vata, result in shvetapradara.
The viharajanya causes are vitiates vata and increases amount of rakta and result
in shvetapradara
Apadravya will vitiates sthanika vata & kapha result in shveta pradara.
Some other causative factors of shvetapradara are as follows:
Yoni adhavana Ativyavaya Abhigata
Unhygenic condition Chills Guru ahara
Raktalpata Oily substances Ati katu rasa sevana
Durbalata Ati ushna ahara Shalya
Krimi Malabaddhata Ati nidra
Garbhapata Nagnayoni Chinta
Ati prasava Malnutrition Krodha
Constant cold water bath specially during rutukala constant working in water or
wearing wet under garments, unsatisfied married life, contraceptives.
Table No. 2.3. The yoni rogas in which the shweta srava is considered as a symptom
S.No Name of Yoni vyapata Predominarncy of dosha
1. Shleshmala yoni vyapata Kaphaja
2. Tridoshaja yoni vyapata Tridoshaja
3. Acharana Yoni vyapata Vataja (Cha) Kaphaja (Su)
4. Atichurna Yoni vyapata Vataja (Cha) Kaphaja (Su)
5. Upapluta Yoni vyapata Vata, kapha (cha)
6. Vipluta Yoni vyapata Vataja (Su)
Purva Roopa
In Ayurvedic classics it is observed that purva roopa is explained as samanya i.e
which predicts the on coming disease but also specifies the doshic sub type of particular
on coming disease.
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In case of shweta pradara and yoni vyapata there is no reference regarding the
poorva roopa but according to the vagbhata quotation the avyakta or alpa lakshanaas are
considered under poorva roopa.
Roopa
Yonitach shweta srava
Samanya lakshanas are mentioned in charaka, Yogaratnakara as follows:
1) xÉ MÑürÉÉïiÉç ÌmÉÎcNûsÉÉ zÉÏiÉÉ MühQÕûaÉëxiÉÉsmÉ uÉåSlÉqÉç | cÉ.ÍcÉ. 30
2) zÉsÉåwqÉsÉÉ ÌmÉÎcNûsÉÉÇ rÉÉåÌlÉÈ MühQÒûaÉëxÉÉiÉÅÌiÉzÉÏiÉsÉÉ
---------------- zsÉåwqÉÉ _________ pÉuÉåiÉç || rÉÉå.U.E. 14109-110
excessive srava (shweta)
Angamarda
Vedana
The lakshanas are divided into slanika sarvadaihika lakshana
Table No. 2.4. Stanika lakshana:
Lakshana C.Chi C.D A.S.U A.N.U B.P.U V.R.U M.N.I
Pandu or shveta srava + + + +
Srava is like amarasa
(Apakwarasa)
+ + +
Srava is like sapicchila + + +
Srava is like pulakatoya
(rice or flesh washed
water)
+ + +
Picchila + + + +
Guru + + - -
Snigda + + - -
Shitalata + + + +
Alpavedana + + - -
Kandu + + + +
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SAMPRAPTI
Acharya charaka mentioned pradara samprapti as follows:
The lakshana of kaphaja pradara resembles to shvetapradara. So its samprapti can
be formed like this:
Due to excessive intake of gurvadi ahara and kaphavardhaka vihara (kleda, drava,
shita picchila guna), produce srotodusti in artavaha srotas, vitiates stanik kapha and vata
results in shwetapradara. Due to shweta srava it is named as pandure asragdare and
shweta pradara.
All yoni rogas are caused by vata vikruti (C.Ci 30/115)111 The vata vikriti nidanas
are not observed in aharajanya nidana, here vata vitiates due srotodusti, prarada is one of
symptom of apanavrata pitta (su.ni. 1/37)112 and disorder of rakta (C.Su. 28/11-12)113
Ahitakara Vihara
Saravadaihika (kapha) Sthanika
Vata vikruti (apanavata)
Agnimandya
Ama
Samarasadhatu
Artavaha srotus dushti
Sthana samshraya of dustha dosha in gabhashaya and yoni
Shwetasrava
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Samprapti ghataka:
Dosha : Kapha (Vatanubandhi)
Doshya : Rasa and Rakta
Agni : Jatharagni mandajanya ama
Srotas : Artavaha srotas
Srotodusti prakara: Sanga and atipravrutti are more suggestive, sanga occur due to ama
formation in artavaha srotas. Vitiates the vata and sthanika kapha
produce atipravrutti.
Adhisthana : Gabhashaya, Yoni
Sanchara stana : Artavaha srotas
Vyakta stana : Yoni
Ama : Jatharagni, Vikruti will produce ama. This cause sama rasa and
saamarakta
Vyadhi swabhava: It takes prolong duration from nidana sevana to lakshana
vyaktavasta. After vyaktavasta also the woman hegitate or neglects
to consult the physician. So it again prolongs the duration. Hence it
is chirakari
Sarvadaihika lakshana:
Dourbalya Supra pubic pain
Pulling sensation in jangha Heavyness in jangha
Alasya Aruchi
Ajirna Malabaddata
Shirashoola Shirobrama
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Katishoola Pschycological disturbance – samprapti
VYAVACHHEDAKA NIDANA
The vyava chhedaka nidana are as follows:
Upapluta
Sannipataja yoni vyapat
Upashaya and Anupashaya
Upashaya:
Specific upashaya is not mentioned in texts
Rukshopachara and Ushnopa chara
Japa kusuma
Tandulodak
Coconut water
Yoni prakashalana by kashaya rasa dravya like panchakshiri quatha or kankshi jala.
Anupashaya
Nidana
Constant cold water bath and wearing wet clothes.
SADHYASADHYATA : YAPY
The woman with continuous discharge, suffering from trushna, daha, durbala is
asadhya for chikitsa.
Hrutbhara, vedana, hrutipidana, cause swasakrusta, murchana later leads to
raktapradara
Treated in time is susadhya otherwise dusadhya.
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UPADRAVA
Dourbalya, Brama, Murcha, Tama, Trushna, Daha, Pralapa, Pandutwa, Tandra vata
vikara
Shopha is produced by pradara.
Table No. 2.5. PATHYA APATHYA
S.L.No Pathya Apathya
1. Diet with milk and mamsarasa Excessive katu rasa, shveta shali
2. Diet made with yavana usage of
Abhyarista, sidhu, tail, pippalichurna,
pathya and lohabhasma along with
madhu
Mamsa, Fish, Egg
3. Samashana Fried substance, excessive hot
substance
3. Vegetable fruits Guru ahara, Madhyapana
4. Nutricious food Onion, garlic, potato
5. Good hygiene Excessive srama, cold water bath and
wearing wet clothes chinta, krodha
6. Maintain dinacharya
7. Satvika vichara
Chikitsa sutra:
zÉsÉåwÉçqÉeÉÉxÉÑ cÉ Ã¤ÉÉåwhÉÉÇ MüqÉï MÑürÉÉïSÉÌuÉ cÉsɤÉhÉÈ|| cÉ.ÍcÉ. 30/42114
According to ayurvedic principles the first line of treatment is
“Nidana parivarjana” since it is kaphaja vyadhi, chikitsa should be done by
rooksha, ushna karmas this includes samshamana and samshodhana.
Samshamana: Systemic medication, local medication like pich, varti, kalka dharana with
kaphanashaka dravyas.
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Samshodhana: Uttaravasti, Yoni prakshalana with kwath prepared out of
kashayarasatmaka dravyas.
Abhyantara:
1. Rohitaka moola kalka should be taken with water. cha.chi. 30/116115
2. Juice of amalaki mixed with honey or sugar. A.S.
3. Paste of lohdra mixed with decoction of stem bark of nyagrodha should be taken.
Cha.Chi. 30/116116
4. Prepare the paste of amalaki beejakalka with water and add honey sugar give for
oral administration. Y.R.U 155P
5. Drinking of root of chakramarda pasted with rice water in morning hours cures
shwetapradara. Y.R.U. 156P
6. Use of nagakeshara with butter milk followed by diet on only cooked rice and
butter milk cures shwetapradara. Y.R.U. 156P
7. Badarabeeja choorna with honey and jaggery cures shwetapradara with in 3 days.
Cha.Chi. 30/118117
8. Use of darvyadi decoction cures shweta pradara. Sh.S.M.K. 2/113-116.118
9. Use of kashaya prepared with nyagrodha group of dravya is beneficial due to its
astringent properly.
Rasoushadhis:
Pradarantaka loham I & II
Pradarantaka rasha
Pradarari rasah (III)
Trivanga bhasma
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All these rasoushadhis contain vanga along with parada and gandhaka.
BHAHYA PRAYOGA: (STANIKA)
1. In case of excessive vaginal discharge a kshauma (flexon cloth) –vastra dipped
with decoction of stem-bark of only nyagrodha lodhra with vata should be placed
in vagina. (cha.chi. 30/173)119
2. Vaginal irrigation with kashaya of twak of lodra and vata should be done.
Cha.Chi. 30/72120
3. After snehana of vaginal canal kalka prepared with twak of plaksha mixed honey
should be placed. I.E. 39/73
4. Varti made with powder of lodhra priyangu and madhuka mixed with honey or
else of with kashaya drugs should be placed in snigdha yoni. Sh.S.M.K. 2/112)121
5. After snehana vaginal canal dhupana with sarala, guggulu and yava mixed with
plenty of grita or else katu matsyaka with oil should be done. Sh.S.M.K. 2/112122
6. Watery discharge per vaginum is cured by insufficient fine powders of khadira,
pathya, Jatiphala, nimba and puga triturated with soup of mudga and dried or else
powdered kahdhira, pathya, jatiphala puga and flowers of mudga. Sh.S.M.K. 116.
B.P. Ch. 70/47123,124
Anupana125:
UeÉlÉÏcÉÔhÉïqÉkÉÑMüqÉç kÉȨ́ÉTüsÉUxÉlÉiÉÑ
cÉiÉÑmÉëMüU mÉëSUqÉç iÉzÉcÉåiÉ lÉ xÉÇzÉÉrÉÈ |
Haridara powder, madhu, amalaki swarasa are supposed to be best vehicles or
anupanas for pradararoga.
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The role of madhu:
MüwÉÉrÉlÉÑUxÉÇ Ã¤ÉÇ zÉÏiÉsÉÇ qÉkÉÑU qÉkÉÑ |
SÏmÉlÉÇ sÉåZÉlÉÇ oÉsrÉÇ uÉëhÉzÉÉåkÉlÉUÉåmÉhÉqÉç
xÉÇbÉÉlÉÇ sÉbÉÑ cɤÉÑwrÉ xuÉrÉïqÉç QûkrÉÇ Ì§ÉSÉåwÉlÉÑiÉç ||
Madhu is astringent in anurasa, unctuous, cooling sweet, a digestive stimulant,
lekhana and strength promoting. It cleans and heals ulcers and helps in joining of
fractured bones. It is light promotes of eye sight and good voice, cardiac tonic and
alleviant of all the three doshas.
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MODERN CONCEPT “LEUCORRHOEA”126,127,128
Syn: Vaginal white discharge
The term leucorrhoea is strictly defined as an excessive vaginal discharge more
than normal. The term leucorrhoea should be restricted to those patients in whom the
normal vaginal secretion is increased in amount. In such patients there will be no excess
of leucocytes present when the discharge is examined under the microscope, and the
discharge is macroscopically and microscopically non-purlent. Purulent discharge is due
to specific infections such as gonorrhoea, trichomoniasis and moniliasis, to ulcerated
growths of the cervix and vagina. The symptom of excessive is a subjective one with
individual variation. To decide it to normal and not an infetive one requires clinical and
laboratory investigations. The term leucorehoea should fulfil the following criteria. The
excess secrtion is evident from persistent vulval moistness or staining of undergarments
(brownish yellow on drying) or need to wear a vulval pad. It is non-purulent, non-
offensive and non-irritant never causes prurities.
VAGINA
The Vagina of a healthy audult female is consist of white coagulated material
which contain squamous cells, Doderlein bacilli and coagulated secretion. Doerlein
bacilli are large gram positive organisms which are sugar fermenting. This ability to
convert glycogen in to latic acid is responsible for the high acidity of the normal healthy
audult vagina. The vaginal contents are mostly derived from the squamous cells of
vagina.
In healthy women the cervical secretion is small in amount and there is little
secretion from the endometrium of the body of uterus even during secretory phase of
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menstrual cycle. If the escape of endometrial serection is largely blocked by the plug of
mucous in the endocervix. The pathological conditions as erosions and ectropion of the
cervix are fromed, the mucus secrection is increased, so that patients may complain of a
mucous discharge at vaginal orifice.
The superficial cornified cells of the vaginal mucosa produce glycogen under
estrogen stimulation and are continuosly desquamated. As a result of breaking down of
the cells, glycogen is liberated and is ultimately converted into lactic acid.
In the new born before the appearance of Doderlein’s bacilli, glycogen is broken
down in to lactic acid and there is some evidence that the process is brought about by
enzyme action. After the appearance of Doderlin’s bacilli the production of lactic acid is
augmented by the action of the bacilli on simple sugars.
The amount of normal vaginal seretions varies with age in health and disease.
Pregnancy increase it, and just before the menstruation.
In healthy it is dependent on the vascular state of the genitalia and this itself is
largely oestrogen dependent. Congestive conditions of the genitalia and the adjacent
pelvic organs increase vaginal transudation apart from increased secretion that such
conditions themselves contribute to the vaginal contents.
The normal moistness of the vagina is sufficient to lubricate the vagina and labia
minora without staining the under clothes. Except at certain times when the secretion is
increased. These times are at ovulation, the immediate premenstrual phase, during
pregnancy and under the stimulus of sexual excitation.
A moderate increase in vaginal secretion is one in which the under clothes are wet
and require changing
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Vaginal acidity:
The vaginal acidity is due to lactic acid, which may be present as much as 0.6%.
The PH value is 5.7% in the newborn and reaches 6-7 in children, and falls to 4 at
puberty. During pregnancy the PH value is usually 4. After menopause the PH rises to 7.
the normal PH for healthy women during the child bearing period of life is about 4.5.
The deorlen’s bacillius is almost the only organism which will grow at a PH of 4-
4.5. as the acidiy of vagina falls and the PH rises, non-resident pathogens are able to
thrive.
Natural defence mechanism of the vagina against infection:
The skin of the vagina is a tough stratified squamous epithelium devoid of glands.
It presents a smooth unbroken surface to the attack of pathogenic organisms. The PH is
low and high acidity mitigates against bacterial growth. The thickeness of the squamous
the epithelium and the hostile PH depend upon oestrogen and therefore it is only in
extreme with before puberty. During the era of sexual activity and maxium oestrogen
production there are certain times at which the PH is raised.
During menstruation when the cervical and endometrial discharge which is
alkaline, tends to neutralize the vaginal acidity.
After abortion or labour when the alkaline lochia has a similar effect.
An excess cervical discharge has the same effect.
Apart from these excess cervical discharge has the same effect.
Apart from these exceptions, the vagina is naturally self sterilizing.
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A Clinical study.
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Flora of the female genital tract:
In healthy women the fallopian tubes, the cavity of the uterus and the upper third
of the cervical canal are free of micro-organisms as does the vagina. In healthy vagina the
Doderlei’s bacillus is the only organism found in upper two thirds of the vagina, but in
the neighborhood of the vulva both saprophytic and paracitic organisms can usually be
demastrated.
Doderlein’s bacilli have been found in the vagina of the new born with in nine
hours after delivary, although the usualtime for them to appear is fifteen hours. The
vagina of the new born is probably inoculated during parturition.
During the puerperium the acidity of vagina is reduced and foreign organisms and
other pathogens can grow. During the climacteric and after menopause the number of
Doderein’s bacilli is reduced and sometimes this organism cannot be demonstrated in the
vagina.
The important of doderlein’s bacillis is that its presence is associated with the
production of lactic acid contained in the vagina and these acidy inhibits the growth of
organisms. In the multiparous woman when the vaginal orifies is patulous as a result of
lacerations during child birth, foreign organisms may be found in the lower part of
vagina, which by producing low grade vaginitis give rise to discharge.
AETIOLOGY
Physiological:
The physiological basis involved in normal vaginal secretion is dependent on the
endogenous oestrogen level. With the rising oestrogen level, there is abundant secretory
activity of the endocervical glands and superficial vaginal epithelium becomes rich in
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glycogen. The glycogen loaded epithelium sheds. The glycogen being converted in to
lactic acid by Doderlein bacilli. As a result the vaginal PH becomes acidic. The mucoid
secretion from cervical glands is normally small in amount. The carbohydrate radicle of
the glycoprotein mucin is split off and fermented in to lactic acid. If however the mucus
is secreted in excess, it pours out at the vulva.
Normal secretion from vulva, vagina, cervix show an increase in conditions when
the oestrogen level becomes high. Such conditions are.
1) New born:
Some newborn gets leucorrhoea for a week due to maternal oestrogen.
2) During puberty:
Increased levels of endogenous oestrogen lead to marked over growth of the
endocervical epithelium which may encroach on to the ectocervix producing
congenital erosion leads to increased secretion.
3) During Menstrual cycle:
Around ovulation – Peak rise of oestrogen leads to increase in secretory
activity of cervical glands.
Premenstrual pelvic congestion and increased mucous secretion from the
hypertrophoid endometrial glands.
4) Pregancy:
There is hyperoestrinism with increased vascularity. This leads to increased
vaginal transudate and cervical gland secretion.
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5) During sexual excitement:
When there is abundant secretion from bartholin’s glands. It is of tempaorary
duration and needs no treatment.
Non-Pathogenic leucorrhoea:
It is classified in to two:
1) Cervical leucorrhoea
2) Vaginal leucorrhoea
1) Cervical Leucorrhoea:
Non-infective cervical lesion may produce excessive secretion which pours out at
vulva. Such lesions are cervical erosion, chronic cervicitis mucous polyp and ectropion,
which is caused when the cervix has been badly lacerated during child birth so that the
cervix is partly everted to expose the cervical glands.
2) Vaginal Leucorrhoea:
This form of leucorrhoea is seen when the discharge originates in the vagina itself
asa transudation through the vaginal walls. It is now established that almost all the lactic
acid of the healthy vagina is formed from the glycogen contain in the keratinized cells of
vagina and the vaginal protion of the cervix. The cells are constantly being desquamated,
when that glycogen is liberated to be fermented by Doderlein’ bacilli, a process which
result in the production of lactic acid. This process is under the control of oestrogen, the
level of which determines the PH of the vaginal transudation.
Local congestive states of the pelvic organs such as pregnancy aquired
reroversion, prolapsed congested ovaries, chronic pelvic inflammatory diseases and
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chronic constipation with a sedentary occupation, pills ill health is also one of the
important cause of an excessive discharge.
Pathological:
This can be divided in to two
1. General health causes (One third)
2. Genital causes (Two third)
The important causes are ill health, Aneamia, colitis, vaginitis cervical erosion.
Table No. 2.6. Incidence of cause of Leucorrhoea
a) Ill health and malnutrition 25.4%
b) Dysfunctional 7.0%
General Health factor
c) Psychological 0.6%
Vulval growth and ulcer 1%
Vaginitis 19%
Cervical erosion -20%
Chronic cervicitis -7%
Uterine tumour (Polyptibroid) 1%
Genital prolapse 10%
Contraceptives 2%
Pelvic factors
Pregnancy 3%
Clinical features:
Excessive white discharge per vagina
Non irritant, non offensive, non purulent
No prurities
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DIGNOSIS:
1. HISTORY:
i. Age of the patient
Marriage
ii. Present illness: Character of leucorrhoea
Its duration
Timing with menstruation
Vulval irritation or any other symptoms
Use of contraceptives
iii. Menstrual History and obstetrical history
iv. Pastmedical and drug history
H/o tuberculosis, anaemia, dysentery, diabetes, antibiotic taken.
2. General health Examination: to detect ill health, anaemia etc.,
3. Gynacological examination:
P/v and P/s examination to detect the condition of valva, urethra, Bartholin glands,
vagina, cervix, uterus, foreign body and any growth.
Local Examination
A) Vulval inspection reveals
-The discharge looks white or creamy in colour.
- There is no evidence of Pruritis.
B) Bimanual including a speculum examination reveals
- The nature and amount of the discharge.
- The condition of the vaginal wall and cervix.
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- It reveals either a negative pathology.
- Associated pelvic lesion mentioned earlier causing vaginal
Leucorrhoea.
C) To exclude the infective nature,the discharge is subjected to
microscopic examination for detection of pus cells.
If pus calls are not found,then irrespective of any organism
present,it can be concluded that the discharge is true leucorrhoea and not due to
infection.
If pus cells are found,and unless an obvious cause such as
cancer or a foreign body is revealed,the nature of organisms present must then be
determined by the study of fresh preparations,stained smears and cultures.
4. Investigation:
To exclude infective nature, the discharge is subjected to microscopic
examination for detection of pus cells. If pus cells are not detected, it is considered as a
case of true leucovrhoea. If pus cells are detected further investigation are to be carried
out to identify the organism from the discharge.
Wet mount preparation of vaginal discharge for T.vaginalis and moniliasis.
Vaginal and cervical discharges should be examined by staining and culture for
the causative factor.
Cytological study from vagina and cervical scraping.
Treatment:
This should be conducted according to the determined cause.
Local hygiene should be maintained.
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Improvement of general health
Cervical factors may require surgical treatment
Pelvic lesion producing vaginal leucorrhoea require appropriate therapy Pill users
have to stop it.
Ill health leucorrhoea is treated by deworming,boiled water.
Correction of anemia.s
Pond bathing is prohibited.
Consolation to patient is done.
Vaginal irrigations – Betadine is the best antiseptic douche.
Introduction of pessaries like—
1) Estrogen to promote Keratinization.
2) Antibiotics.
3) Cortisone or Bacteriostatic drugs.
4) Fungicidal drugs.
Bactericidal cream like triple sulpha cream,betadine.
Phisiological leucorrhoea does not need any treatment. It subsides by itself and
the patient is to be repeatedly assured and convinced by making to understand that
it is purely physiological.
Methodology
59 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
METHODOLOGY
MATERIALS
Source of Data
Literary source
T.L.C.
Literary aspect of study is collected from Ayurvedic texts, modern texts, and
updated with recent medical journals and from internet search.
Drug
Plaksha (Ficus lacor) twak
Madhu (Honey) – As (anupana)
Collection of Raw Materials
Source of data:
1. Identification: Botanically identified plaksha twak is selected for the study.
2. Collection: The good quality plaksha twak is collected from the market of
Udupi.
3. Physical properties of plaksha twak:
The bark is rough in appearance, occurring in flat to curved, pieces, external
surface ash or whitish grey in colour.
Method of preparation
Source of the drug
Botanically identified freshly collected bark of plaksha (Ficus lacor) were
procured, cut into small pieces and dried. These dried pieces were powdered with
pulvaliser.
Methodology
60 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
Process of preparation of plaksha twak churna. (Course and fine)
1. The dried pieces weighting 5 kg were made into course powder.
2. The course powder was allowed to dry completely by keeping in drying
chambers.
3. Further among 5 kg course powder 2 kg course powder was made into fine
powder with the help of pulvaliser and sieved through 120 size mesh.
4. 3 kg of course powder and 2 kg of fine powder was collected and preserved in
separate airtight containers.
Place of preparation of medicine
The preparation of medicine was done in post Graduation Research studies
Department of Rasashastra D.G.M. Ayurvedic medical college Gadag.
Form of the medicine
The medicine was administered in the form of
1. Churna – orally
2. Kashaya – As vaginal douche.
Methodology
61 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
METHODS
Material
The preparation of plaksha twak churna (fine) (sample A) and plaksha twak
churna (coarse) (sample B) are taken for study.
Methods
Objectives:
1. Pharmacognoistical evaluation of Plaksha.
a. Macroscopical evaluation
b. Microscopical evaluation
c. Standardization and Validation.
2. Preliminary phyto chemical analysis of Plaksha.
3. TLC of Plaksha.
4. To Evaluate the efficacy of Plaksha twak churna in the management of Shewta
pradara.
5. To evaluate the Plaksha twak kashaya as a trans vaginal douche in the
management of Shweta pradara.
6. To evaluate the comparative effect of Plaksha twak churna orally and kashaya
as trans vaginal douche in the management of Shweta pradara.
Criteria for selection of patients
a. Patients are diagnosed as shweta pradara as per the classics.
b. Respective of sex (only female patients are considered)
c. Patients in between the age group of 20-50 years.
2. Study Design
It is comparative clinical study of both churna and kashaya in
shwetapradara.
Methodology
62 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
3. Source of Data
30 patients are selected from free check up health campus and also from
O.P.D department of Dravyaguna. Post Graduation studies and Research centre,
D.G.M.A.M.C and Hospital by present inclusion and exclusion criterial.
4. Sampling method
The patients are made into two groups Group A consists 15 patients and
Group B consists of 15 patients.
5. Inclusion criteria
1. All patients are between age group 20-50 years with complaint of
a. Shweta srava from Yoni
b. Shitalata
c. Kandu
d. Katishula
e. Dourbalya
f. Dragging sensation in abdomin.
2. The patients of shwetapradara are selected irrespective of their occupation,
socio-economical status, food habits etc.
3. Shweta pradara associated with trichomonas vaginals and candida
albicans.
6. Exclusion criteria
a. Pregnancy and lactation
Methodology
63 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
b. Pelvic inflammatory disease
c. Abnormal papsmear
d. Abnormal uterine bleeding
e. Gynaecological causes like ovarian cyst, prolapse fibro myoma
polyps
f. Systemic diseases including severe anemia and HIV
g. Uses of hormones or intra uterine devices.
h. Classical veneral diseases like gonorrhoea and syphilis.
7. Diagnostic criteria
a. Patients having shweta srava from yoni with or without associated
symptoms are taken for study.
b. Vaginal pH is below 5.7 to 6.0
c. Microscopic study of vaginal smear shows clue cells is selected for
study
8. Intervention
Group A – Patients administered Plaksha twak churna 4 gm B.D with madhu
for 21 days before meals.
Group B – Patients administered Plaksha twak churna kashaya 50 ml as
vaginal douche in the morning before meals for 21 days.
9. Laboratory investigations
Investigations were done to diagnoses the disease, to exclude the patients
and to know the prognosis of the patients.
Haematological - a) Hb% (Haemoglobin%)
b) E.S.R. (Erythrocyte sedimentation rate)
c) T.C (Total count)
d) D.C. (Differential count)
Methodology
64 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
Vaginal smear
Vaginal pH
10. Assessment of clinical trial
a. The assessment of clinical trial is done by observing the severity of
symptomatology as well as Lab investigation.
b. The clinical assessment are done before treatment and after treatment,
observed after 1st week, after 2nd week, after 3rd week of treatment.
c. The Lab investigation is done before and after treatment and the
difference in values assessed and analyzed.
Grades for the subjective Parameters
1. Excessive vaginal discharge
0 – Normal
1 – Persistent moistness of vulva
2 – Need to change the under garments frequently
3 – Severe moistness
2. Persistent vulval moistness
0 – Normal
1 – Mild moistness
2 – Moderate moistness
3 – Severe moistness
3. Extensive pruritis
0 – Normal
Methodology
65 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
1 – Occasionally pruritis
2 – Pruritis through out the day
3 – Increase particular time of day / Night
4. General weakness
0 – Normal
1 – Patient is able to involve in Physical activity
2 – Patient is slow to involve in Physical activity
3 – Patient feels exhausted to involve in physical activity
5. Pain in lumbar region
0 – Normal
1 – Particular time concerned with menstrual cycle
2 – Pain particular time of day relieves after rest
3 – Severe continuous pain more relief even after rest.
6. Dragging sensation in abdomen
0 – Normal
1 – Mild
2 – Moderate
3 – Severe before menstruation
Methodology
66 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
1. Pharmacognostic study of Plaksha
The Plaksha twak was taken for pharmacognostic study both in wet as well as
dry form. Its macroscopical and microscopical structures were studied in detail. Later
characteristics of the powder were also studied.
Materials for T.S. of Stem bark129
1) Napkin 2) Watch glass 3) Test tubes
4) Painting brush 5) Bunsen burner 6) A sharp razor blade
7) Micro slides 8) Cover slips 9) A beaker full of water
10) A dropper 11) filter paper /blotting paper 12) Stains
13) Drug sample 14) Forceps 15) Test tube holder
16) Test tube stand 17) Needle 18) Camel hair brushes
Methodology for T.S. of Stem bark (Micro preparation)
To study the anatomy of stem, a hand section is taken with the razor blade
sections are stained with saffren in and made semipermanent and observed under 10
X and 45 X magnification in light microscope. Photographs are taken through
binocular lens.
Methodology for the Microscopic powder
The powder drug was taken in the watch glass and few ml of chloralhydrate is
added and warmed, then removed chloral hydrate, then equal amount of Phloro
glucinol and HCL acid was added then wait for few minutes and mounted on the slaid
then one drop of glycerin is added, placed a cover slip and observed under microscop.
Photographs are taken through binocular lens.
2. IDENTIFICATION BY T.L.C
Drug: Extraction of sample (Aq & Alc) which is treated with 1:10ml solute; solvent
like ethyl alcohol with dilution method.
Methodology
67 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
Equipment: Silica gel, TLC kit, hot air oven, standard glass, wattaman glass plate,
beakers, sprayer.
Chemicals: Dragendroff’s reagent, Silica gel, ethyl alcohol.
Method: T.L.C. of the ethyl alcohol extract of the sample & Aqueous extract of the
sample was carried out as follows.
The silica gel powder mixed with water and made thin paste, then with the
help of glass slide, the silica gel was spread on glass plates uniformly, After some
times the air dried plate were kept in a hot oven at110-120 degree centigrade heay
was given continuously then the prepared sample is kept on a side of the plate then
immersed in solvents upto 30 minutes then Dragendroff’s solution is sprayed on the
plates.
A parameter called the Rf value is always used in TLC this is determined as
follows.
Rf = Distance traveled by the solute
__________________________
Distance traveled by the solvent
Aq extract = 12.6 Alc extract = 12.5
_____ = 0.96 _____ = 0.86
13 14.5
3. Preliminary Phytochemical analysis of Plaksh twak churna
Preliminary Phytochemical analysis of Plaksh twak churna was carried out at
Dr. Sandesh Kamat, Chief Executive, Bio Genics Research & training Institute in
Biotechnology, Unkal, Hubli.
4. Analysis of Plaksha twak churna for physical constants
Methodology
68 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
Bark powder of Plaksha was analysed for physical constants at Dr. Sandesh
Kamat, Chief Executive, Bio Genics Research & training Institute in Biotechnology,
Unkal, Hubli.
I. Determination of moisture content
Material : Petriplates, physical balance, dessicator oven.
Method : 2 gms of the sample was taken in the previously weighed petriplates.
Petriplates were kept in the oven maintained at 1100c for drying. After 3 hours
petriplates were taken out and weight was noted down. This procedure was repeated
for 4-5 times until the constant weight is reached.
%Moisture = difference in weights X 100/ weights of the sample
II. Determination of ash content
Materials: Silica crusible, physical balance, dessicator, Bunsen burner.
Method : Weight of the empty crucible was noted down. 2 gms of the sample was
taken in the previously weighed crucible and was heated on a Bunsen burner until it
turned into ash. It was then cooled in a dessicator and weighed.
%Ash = difference in weights X 100/ weight of the sample
III. Determination of water insoluble ash
Materials : Silica crucible, hot H2O, ash less filter paper (whatmann No.42),
dessicator.
Method : The ash obtained from the above test was dissolved in H2O and filtered. The
water insoluble as collected on the filter paper was heated again on the Bunsen burner
until it turned into ash. The crucible was cooled in the dessicator and weighed.
%Water insoluble ash = difference in weights X 100 / weight of the sample
IV. Determination of acid insoluble ash
Materials : Silica crucible, 25% Hcl, ashless filter paper (whatmann no.42) dessicator.
Methodology
69 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
Method : The water insoluble ash obtained is dissolved in 15ml of 25% HCL and then
filtered. The acid insoluble ash collected on the filter paper was heated again. The
crucible was cooled in the dessicator and weighed.
%Acid insoluble ash = difference in weights X 100 / weight of the sample
V. Determination of water soluble extractive
Materials : Volumetric flask, distilled water, Chloroform, filter paper, evaporating
dishwater bath, ovan. Dessicator, physical balance.
Method : 5 gms of the powder was taken in the volumetric flask. Few drops of
chloroform were added to avoid the fungal attack. Subsequently 100 ml of distilled
water was added. It was kept for 24 hours, shaking frequently during the first six
hours. The solution was filtered the next day and 25 ml of this filtrate was evaporated
in a previously weighed evaporating dish on a water bath. Later it was dried in the
oven at 1100c to remove the traces of water. Weights were noted.
%Water soluble extractive = difference in weights X 100 / weight of the sample
VI. Determination of alcohol soluble extractive
Materials : 5 gms of the powder was taken in the volumetric flask. 100 ml of alcohol
was added to it, flask was kept for 24 hours, shaking frequently during the first six
hours. The solution was filtered the next day and 25 ml of this filtrate was evaporated
in a previously weighed evaporating dish on a water bath. Later it was dried in the
oven at 1100c to remove the traces of alcohol. Constant weights were noted down.
% Alcohol soluble extractive = difference in weights X 100 / weight of the sample.
Preliminary Phytochemical investigations of extracts130
Qualitative chemical tests were conducted for alcoholic and aqueous extracts of
Plaksh (Ficus lacor) to identify the various phyto constituents. The various tests
and reagent used are given below and observation are recorded.
Methodology
70 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
Material:
Drug: Aqueous & Alcoholic Extractive sample of Plaksh (Ficus lacor)
Equipments: Test tube, holder, stand, spirit lamp, pipette, glass rods, beakere 50 ml
to 250 ml, conical flask, water bath.
I. Test for alkaloids
a) Mayer’s test: The different reagents used are Mayer’s reagent (Potassium
mercuric iodide solution) giving cream coloured precipitate
1.Test solution with Mayer’s reagent
b) Test solution plus concentrated HNO3 plus 3% KOH in ethamol
c) Dragendorff’s reagent (Potassium bismuth iodide solution) giving reddish
brown precipitate
1.Test solution with Dragendorff’s reagent
d) Wagner’s reagent (Iodine, potassium iodide solution) Yielding reddish
brown
precipitate
1.Test solution with Wagner’s reagent
II. Test for Carbohydrates
a) Molish reagent : Ag or alcoholic solution of sub’s plus 10% alcoholic
solution of A Napthol Shake plus concentrated H2SO4 along the side of the tube
b) Benedict’s test : 5 ml of Benedict’s reagent plus 3 ml of sugar solution boil
for 2 minutes then allow to cool
c) Fehling’s test :2 ml of fehling’s solution
A + 2 ml of fehling solution
B + 2 ml of sugar solution then boil.
Methodology
71 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
d) Barfoed’s test :2 ml of test solution plus 2ml of barfoed’s reagent, boil on
water bath.
e) Seliwanoff’s test :3 ml of Seliwanoff’s reagent plus 1 ml of sugar solution,
boil for 2 minutes.
III. Test for Glycosides
a) Keller-kiliani test for digitoxose : The test consists of boiling about 1 gm
finally powdered digitalis with 10 ml 70% alcohol for 2-3 minutes. The extract
is filtered. To the filtrate is added, 5 ml water and 0.5 ml strong solution of lead
acetate. Shake well and separate the filtrate. The clear filtrate is treated with
equal volume of chloroform and evaporated to yield the extractive. The
extractive is dissolved in glacial acetic acid and after cooling, two drops ferric
chloride solution is added to it. These contents are transferred to a test tube
containing 2 ml concentrated sulphuric acid. A reddish brown layer acquiring
bluish-green colour after standing is observed due to the presence of giditoxose.
b) Baljet test : To a section of digitalis, sodium picrate solution is added. It
shows yellow to orange colour.
1. Foreign organic matter - Not more than 2%
2. Loss on drying - Not more than 5% W/W, by drying to
constant weight at 1050 C.
3. Acid – insoluble - Not more than 5%
c) Bornatrager’s test : Anthraquinone derivatives are generally detected by
Bornatrager’s test. In this test, the drug is powdered and further extracted with
ether or any water immiscible organic solvent. The filtered ethereal extract is
made
Methodology
72 Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
alkaline ether with caustic soda or ammonia, by which the aqueous layer shows,
after shaking, pink, red or violet colour. Bornatrager’s test is negative in case of
anthrenols (Reduced forms). Anthrones are detected with their fluorescence test.
IV. Test for Amino Acid
a) Ninhydrin test : 2 ml of Original solution plus 5 ml of Ninihydrin solution
boil for 2 minutes then allow to cool.
V. Test for Steroids
a) Salkowaski’s test : 2 ml of test solution in chloroform plus slowly add 2 ml
of concentrated H2 SO4 wait for 3 minutes.
b) L.B, : Libermann-Burchrdt’s test : 2 ml of test solution in chloroform
plus 10 drops of acetic anhydride plus 2 drops of concentrated H2 SO4.
VI. Test for Proteins
a) Biuret test : 2 ml of Original solution plus 2 ml of 10% NaOH solution plus
2-3 drops of 1 % CUSO4 solution mix.
VII. Test for Tannins
Test solution plus Ferric chloride (Fecl3) gives bluish black or brownish –
green colour
Results
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of
Shweta Pradara- A Clinical study.
73
OBSERVATION AND RESULTS
The observation and result of the present study are presented as under-
Pharmacognoistical and Preliminary Phyto chemical data pertaining to
the values of study, macroscopic evaluation, standardization and
validation of prepared drug.
Thin layer chromatography analysis of Aqueous extract.
Observations of the clinical study for the evaluation of effect of the
drug have been recorded.
Observation pertaining to the pharmacognostic study of Plaksh twak
a) Macroscopic – Bark rough, occurring in flat to curved, quilled pieces,
measuring 0.4-0.7 cm in thickness; external surface ash or whitish-grey;
numerous transversely arranged lenticels; ranging from 0.1 cm – 1.3 cm in
length, lip-shaped and exfoliating; internal surface rough, fibrous,
longitudinally striated, reddish-brown; fracture, fibrous.
b) Microscopic – Shows 5-8 layered cork consisting of thin-walled, rectangular
cells, a few external layers exfoliating; secondary cortex very wide consisting
of compactly arranged, rectangular, thick-walled, pitted cells, patches of
circular to elongated, lignified, elliptical stone cells with radiating canals, a
few with concentric striations; a few prismatic crystals of calcium oxalate and
reddish-brown contents found scattered throughout the secondary cortex;
secondary phloem very wide consisting of mostly stratified layers of collapsed
cells forming ceratenchyma, groups of fibres, phloem parenchyma, laticiferous
cells, traversed by 2-5 seriate phloem rays; phloem fibres lingnified with wide
lumen and pointed tips; thin-walled, rectangular, a few phloem parenchyma
containing prismatic crystals of calcium oxalate.
Results
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Shweta Pradara- A Clinical study.
74
Powder – Reddish-brown; shows thick-walled parenchyma with simple pits; stone
cells in groups and singles, prismatic crystals of calcium oxalate, elongated phloem
fibres with wide lumen and pointed tips.
Phytochemical study
The following observations were made in Plaksha with regard to-
Physical constants
Physico-chemical study
Table No. 3.a. Showing the Physical constants and found values of bark powder of Plaksha
Sl no Method adopted Plaksha (Ficus lacor)
1 Foreighn matter Not more than 1%
2 Total Ash Not more than10%
3 Acid insoluble Ash Not more than 1.5%
4 Water soluble extractive Not more than 6%
5 Alcohol soluble extractive Not more than 5%
Table No. 3.b. Showing the Thin layer Chromatography analysis of Aqueous extract
S.L.no Phyto constituents
TLC Plate
system
Detector Rf values
Spot colour Result
1 Alkaloid Silicagel G
Ultra violet 0.75 0.61
Fluorescent Green Fluorescent Green
Present Present
2. Alkoloid Silicagel G
Drangendroff’s reagent
0.75 0.61
Orange Orange
PresentPresent
Results
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of
Shweta Pradara- A Clinical study.
75
Table No. 3.c. Showing the Phytochemical components and found values of bark powder of Plaksha.
Test and reagents Observation Inference
Test for Carbohydrates (aqeous)
Molis Test: To the 2 ml of sample, aqueous 2 drops of alpha-napthol and mixed carefully rundown the concentrated H2SO4 along the walls of the tubes carefully
Test for Glycosides(aqeous)
To 1ml of test solution add 3 ml of anthrone reagent and mix well
Test for Polysaccharides (alcoholic)
To 1 ml of test solution, 2 drops of iodine solution was added
Test for Proteins (aqeous)
Test for free amino acids (aqueous)
To 1 ml of test sample add 5 drops of ninhydrin and boil for 2 min
Bradford’s test (aqeous)
To 0.5 ml of test sample add 2 ml of Bradford’s reagent
Test for alkaloids (aqeous)
To 1ml of test sample add 3ml of Drangendroff reagent, mix well, boil for 5 min.
Mayer’s test (aqeous)
To the 1 ml of test sample add 1 ml of mayer’s reagent, mix carefully
Test for Steriods
Liberman burchard test
To 2ml of sample (chloroform extract) add 10 drops of acetic acid and 2 drops of conc. H2SO4, mix.
Salkwoski test
2 ml of sample (chloroform
The purple violet ring at the junction of two layers
Green coloured complex formed
Blue coloured solution observed
Purple coloured solution observed
Observe the blue colour
Dark brown orange colour
White pale Yellow observed at the bottom of test tube
Initially red colour appears followed by blue and finally green colour development
Presence of carbohydrates
Presence of glycoside
Absencey of Polysaccharides
Presence of free amino acids
Presence of proteins
Presence of alkaloids
Alkaloids present
Steroids present
Results
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of
Shweta Pradara- A Clinical study.
76
extract) in a dry tube and add 2 ml of Conc. H2SO4, mix vigorously.
Test for Flavonoids(aqueous)
To 1ml of test sample, iodine solution was added drop wise
Test for Lipid(chloroform)
To 2ml of test sample, iodine solution was added drop wise
Test for Oils(chloroform)
The 1 drop of sample was placed on a filter paper and allowed to dry.
Test for saponins
Few drops of sample heated with alcoholic KOH and boiled for 1min and cooled. Acidified with 1 ml of conc. HCl. A portion of it was treated with 10 ml of water and 5% NaOH, added drop wise
Test for Tannins (aqueous)
Test solution plus Ferric chloride (Fecl3)
Steroid and H2SO4 layers separated and sample layer formws cherry red colour and acid layer forms green colour
Yellow colour formation
Original iodine colour disappears
Clear greasy spot observed
Clear soap was observed while shaking
Bluish black or brownish – green colour
Steroids present
Presence of Flavonoids
Lipids are present
Lipids are present
Saponins are absent
Tannins are present
Clinical observations
The present clinical study was meant for evaluation of Plaksha Twak Churna
in the Management of Shweta Pradara. Total 30 patients were taken randomly for the
above-mentioned study. All the patients under study were observed clinically during
the course of treatment and follow up. The patients were selected as per the study
design and evaluated through various subjective and objective parameters.
The demographic data pertained to age, Menstrual history, socio-economic
status, dietic pattern, habits and etiological factors have been tabulated and
percentages are represented through diagrams.
Results
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Shweta Pradara- A Clinical study.
77
The data pertaining to objective parameters like vaginal smear and Vaginal pH
have been recorded before and after treatment.
The data pertaining to subjective response of the patients are shown in
percentage through tables and finally compared between two groups.
Table 3.1 Showing the Incidence of Menstrual History
Menstrual
History
Group
A
Percentage Group
B
Percentage Total Percentage
Excessive 13 86.66% 10 66.66% 23 76.66%
Irregular 5 33.33% 2 13.33% 7 23.33%
Graph No 1 Showing the Incidence of Menstrual History.
0%
20%
40%
60%
80%
Percentage 77% 23%
Excessive Irregular
Results
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Shweta Pradara- A Clinical study.
78
Incidence of Age :
Incidence of age between 20-30 years, 30-40 years and 40-50 years was 80%
(12 patients) 20% (3 patients) respectively in group A. where as in group B the
incidence of age between 20-30 years, 30-40 years and 40-50 years was 66.66% (10
patients), 33.33% (5 patients) and 0% in both groups of (40-50) In total the incidence
of age between 20-30 Years , 30-40 Years, 40-50 Years was 73.33% (22 patients)
26.66% (8 patients) and 0% (40-50) age respectively.
Table 3.2 Showing the incidence of Age
Age Group A Percentage Group B Percentage Total Percentage
20-30 Yrs 12 80% 10 66.66% 22 73.33%
30-40 Yrs 03 20% 05 33.33% 08 26.66%
40-50 Yrs 0 0% 0 0% 0 0%
Total 15 100% 15 100% 30 100%
Graph No 2 Showing the incidence of Age
0%
20%
40%
60%
80%
Percentage 73% 27% 0%
20-30 30-40 40-50
Results
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Shweta Pradara- A Clinical study.
79
Incidence of socio economic status :
Incidence of the socio economic status is 80% (12 patients) 20% (3 patients)
and 0% (patients) belongs to Poor, Middle, Higher middle, Higher class respectively
in group A. where as in group B 13.33% (2 patients) 4.66% (7 patients), 40.6% (6
patients) 0% (patients) belongs to Poor, Middle, Higher middle, Higher class Socio
economic status respectively.
Table 3.3 Showing the incidence of Socio-economic status
Income Group A
Percentage Group B
Percentage Total Percentage
Poor 12 80 % 02 13.33 % 14 46.66 % Middle 03 20 % 07 46.66 % 10 33.33% Higher middle
0 0 % 06 40.66 % 06 20.10 %
Highers 0 0% 0 0% 0 0% Total 15 100 % 15 100 % 30 100 %
Graph No 3 Showing the incidence of Socio-economic status
46.66%
33.33%
20.10%
0%0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
Poor Middle Higher middl Higher
Results
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Shweta Pradara- A Clinical study.
80
Table No. 3.4. Showing the classification of Patients based on their Prakruti
Prakruti Group A Group B Total Percentage
Vata Kapha 03 06 09 30%
Kapha vata 09 06 15 50%
Kapha pitta 03 03 06 20%
Graph No. 4. Showing the classification of Patients based on their Prakruti
30.00%
50.00%
20.00%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
Vata kapha Kapha vata Kapha pitta
Incidence of dietic pattern
In the group A 60% (9 females) belongs to Mixed and 40% (5 females) belong
to vegetarian. Where as in group B 40% (6 females) belongs to mixed and 60% (9
females) belongs to vegetarian. In total the clinical study comprises 50% (15 females)
belongs to mixed and 50% (15 females) belongs to vegetarian food patterns.
Table 3.5 Showing the incidence of dietic pattern
Diet Group A Percentage Group B Percentage Total Percentage
Mixed 09 60% 6 40% 15 50%
Vegetarian 06 40% 09 60% 15 50%
Total 15 100% 15 100% 30 100%
Results
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Shweta Pradara- A Clinical study.
81
Graph No 5 Showing the incidence of dietic pattern
Mixed50%
Vegetarian50%
Mixed
Vegetarian
Incidence of etiological factors
In the group A 13.33% (2 females), 20.00% (3 females), 60.00% (9 females)
86.66% (13 females) 13.33% (2 females) 73.33% (11 females) were affected with
Abhishyandi ahara, Viruddha ahara, Lavana amla, katu, rasa, yoni, yoni aprakshalana,
atimaithuna, chinta, nidanas respectively. Where as in group B 20.00% (3 females)
13.33% (2 females) 40.00% (6 females) 66.66% (10 females), 06.66% (1 females),
73.33% (11 females) nidana’s respectively.
In total 16.66% (5 females), 16.66% (5 females), 50.00% (15 females),
76.66%, (23 females), 10.00% (3 females) affected with nidanas respectively.
Table 3.6. Showing the incidence of Nidana
Aetiological Factors
Group A
Percentage Group B
Percentage Total Percentage
Abhishyandi ahara
2 13.33% 3 20.00% 5 16.66%
Virudha ahara 3 20.00% 2 13.33% 5 16.66% Lavana amla
katu rasa pradhara
9 60.00% 6 40.00% 15 50.00%
Yoni aprakshalana
13 86.66% 10 66.66% 23 76.66%
Ati maithuna 2 13.33% 1 06.66% 03 10.00% Chinta 11 73.33% 11 73.33% 22 73.33%
Results
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Shweta Pradara- A Clinical study.
82
Graph No 6. Showing the incidence of Nidana
Table No. 3.7. Result by religious in shweta pradara with plaksh twak churna.
Religion Good response
Moderate Response
Poor Response
No Response
Total Percentage
Hindu 14 0 0 0 14 46.66% Muslim 9 0 0 0 9 30.00% Christian 0 3 0 0 3 10.00% Others 0 4 0 0 4 13.33% Total 23 7 0 0 30 100% Percentage 76.66% 23.33% 0% 0% 100% -
In the present study, 14 patients (46.66%) are Hindus, 9 patients (30%) are
Muslims, 3 patients (10%) are Christain, 4 patients (13.33%) are others.
Graph No. 7. Showing the incidence of Religion
16.66% 16.66%
50%
76.66%
10.00%
73.33% A B S Ahara
Virudahara
L A K ahara
Yoni aprakshalana
Ati maithuna
Chinta
46.66%
30.00%
10.00%
13.33%
HINDU
MUSLIM
CHRISTIAN
OTHERS
Results
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Shweta Pradara- A Clinical study.
83
Table No. 3.8. Results by occupation in Swetapradara with Plaksha twak churna.
Occupation Good response
Moderate Response
Poor Response
No Response
Total Percentage
Sendentory 8 0 0 0 8 26.66% Active 0 10 0 0 10 33.33% Labour 0 12 0 0 12 40% Total 8 10 12 0 30 100% Percentage 26.66% 33.33% 40.00% 0% 100% -
In the present study 8 patients (26.66%) are of Sedentary type, 10 patients
(33.33%) active, 12 patients (40%) Labour.
Graph No. 8. Showing the distribution of Pt.’s by Occupation.
27%
33%
40% Sedentary
Active
Labour
Table No.3.9. Results by Economic status in Swetapradara with Plaksha twak
churna.
Economic status
Good response
Moderate Response
Poor Response
No Response
Total Percentage
Poor 16 0 0 0 16 53.33% Middle 0 7 0 0 7 23.33% Higher middle
0 0 7 0 7 23.33%
Higher 0 0 0 0 0 0% Total 16 7 7 0 30 100% Percentage 53.33% 23.33% 23.33% 0 100 -
Results
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Shweta Pradara- A Clinical study.
84
Table No. 4.0. Results by Diet in Swetapradara with Plaksha twak churna.
Diet Good response
Moderate Response
Poor Response
No Response
Total Percentage
Vegetarian 12 0 0 0 12 40.0% Mixed diet 0 18 0 0 18 63.0% Total 12 18 0 0 30 100% Percentage 40.0% 63.0% 0% 0% 100% -
Table No. 4.1. Distribution of Patients by presenting complaints.
Presenting Complaints
Patients Percentage
Yoni srava 15 50.00% Kandu 6 20.00% Katishula 9 30.00%
Table No. 4.2 Distribution of Patients by Associated complaints.
Associated Complaints
Patients Percentage
Katishula 3 10.00% Jwara 5 16.66% Angamarda 6 20.00% Udarashoola 5 16.66% Dourbalya 5 16.66% Yonidaha 6 20.00%
Table No. 4.3. Ahara Nidana observed in the study
Ahara Nidana Patients Percentage Abhishyandi Ahara 5 16.66% Lavana amla katu 15 50.00% Viruddha ahara 9 30.00% Adhyashara 1 3.33%
Table No. 4.4. Vihara Nidana observed in the study
Vihara Nidana Patients Percentage Diwa swapna 5 16.66% Ayana 2 6.66% Yonia prakshalana 19 63.33% Atimaithuna 4 13.33%
Results
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85
Table No. 4.5. Manasika Nidana observed in the study
Manasika Nidana Patients Percentage Chinta 25 83.33% Krodha 2 6.66% Anya Vegavarodha 3 10.00%
Table No. 4.6. Chronisity of Leucorrhoea observed in the cases
Chronisity of Swetapradara
Patients Percentage
10-20 days 6 20.00% 20-30 days 6 20.00% . 1 months 12 40.00% > 2 months 6 20.00%
Table No. 4.7. Results of Plaksha twak churna in Swetapradara.
Result No of Patients Percentage Well respond 25 83.33% Moderately 5 16.66% Responded 0 0% Not Responded 0 0% Total 30 100%
Section C - Data Related To Response To The Treatment
Response to treatment w.r.t Excessive Vaginal discharge
Table 4.8 Showing Grades of Vaginal discharge Before Treatment in Group A &
B
Grades No of
Patients
Group
3 % 2 % 1 % 0 %
15 A 4 26.66% 10 66.66% 1 7% 0 -
15 B 1 6% 10 67% 4 26.66% 0 -
Results
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Table 4.9 Showing Grades of Excessive vaginal discharge After Treatment in
Group A & B
Grades No of Patients Group
0 % 1 % 2 % 3 %
15 A 13 87% 2 13.33% - - - -
15 B 15 100% - - - - - -
Gr-O No Discharge, Gr-1 Persistent moistness of Vulva, Gr-2 Need to change the
undergarments frequently, Gr-3 Need to use an extra cloth or pad
Table 5.0 Showing Grades of Persistent vulval moistness Before Treatment in
Group A & B
Grades No of Patients Group
3 % 2 % 1 % 0 %
15 A 1 7% 7 46.6% 7 47% - -
15 B - - 3 20% 5 33% 7 47%
Table 5.1 Showing Grades of Persistent vulval moistness After Treatment in
Group A & B
Grades No of Patients Group
0 % 1 % 2 % 3 %
15 A 12 80% 3 20% - - - -
15 B 15 100% - - - - - -
Gr-O No Moistness, Gr-1 Mild moistness, Gr-2 Moderate moistness ,
Gr-3 Severe moistness
Results
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Table 5.2 Showing Grades of Extensive pruritis Before Treatment in
Group A & B
Grades No of
Patients Group
3 % 2 % 1 % 0 %
15 A 1 7% 8 53.3% 6 40% - -
15 B 3 20% 3 20% 6 40% 3 20%
Table 5.3 Showing Grades of Extensive pruritis After Treatment in
Group A & B
Grades No of Patients
Group 0 % 1 % 2 % 3 %
15 A 13 87% 2 13.3% - - - -
15 B 13 87% 2 13.3% - - - -
Gr-O No Pruritis, Gr-1 Occasionally pruritis, Gr-2 Pruritis through out the day, Gr-
3 Increases particular time of day/night
Table5. 4 Showing Grades of General weakness After Treatment in
Group A & B
Grades No of Patients
Group 3 % 2 % 1 % 0 %
15 A 7 46.6% 6 40% 2 13.3% - -
15 B - - 5 33% 1 7% 9 60%
Table 5.5 Showing Grades of General weakness After Treatment in
Group A & B
Grades No of Patients Group
0 % 1 % 2 % 3 %
15 A 12 80% 3 20% - - - -
15 B 15 100% - - - - - -
Results
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Gr-O No Weakness, Gr-1 Patient is able to involve in routine activity
Gr-2 Patient is slow to involve in routine activity
Gr-3 Patient feels exhausted to involve in routine activity
Table 5.6 Showing Grades of Pain in lumbar region Before Treatment in
Group A & B
Grades No of
Patients Group
3 % 2 % 1 % 0 %
15 A 5 33% 8 53.3% 2 13.3% - -
15 B - - 3 20% 1 7% 11 73%
Table 5.7 Showing Grades of Pain in lumbar region After Treatment in
Group A & B
Grades No of Patients
Group 0 % 1 % 2 % 3 %
15 A 11 73% 4 26.6% - - - -
15 B 14 93.3% 1 7% - - - -
Gr-O No Pain, Gr-1 Mild , Gr-2 Moderate, Gr-3 Severe
Table 5.8 Showing Grades of Dragging sensation in abdomen Before Treatment in
Group A & B
Grades No of
Patients Group
3 % 2 % 1 % 0 %
15 A - - 5 33% 10 66.66% - -
15 B - - - - 2 13.3% 13 87%
Results
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Table 5.9 Showing Grades of Dragging sensation in abdomen After Treatment in
Group A & B
Grades No of Patients
Group 0 % 1 % 2 % 3 %
15 A 14 93.3% 1 7% - - - -
15 B 15 100% 0 - - - - -
Gr-O Normal, Gr-1 Mild , Gr-2 Moderate, Gr-3 Severe
Objective Parameters
Table No.6.0. Showing the distribution of the patients by degree of Vaginal pH
before and after treatment.
SL.No Degree of Vaginal pH BT % AT % 1 3 - 4 0 0% 7 23.33% 2 4 - 5 6 20.00% 20 66.6% 3 5 - 6 11 36.66% 3 10.33% 4 6 - 7 10 33.33% 0 0% 5 7 - 8 3 10.00% 0 0
Vaginal Smear
Table No.6.1. Showing the distribution of the patients by degree of Vaginal
Smear before and after treatment.
SL.No Degree of Vaginal Smear
BT % AT %
1 Grade – 0 0 0% 30 100%2 Grade – 1 19 63.33% 0 0 3 Grade – 2 11 36.6% 0 0%
Results
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90
OVERALL ASSESSMENT OF STATISTICAL DATA
Table No.6.2. Showing the Statistical Analysis of both the groups, Before and
after treatment and Percentage of improvement with respect to excessive vaginal
discharge.
Parameter Treatmen
t Group
Duration Mean±SD Mean±SE DF T-
Value
P-
Value
Rema
rks
BT 2.2 0.560 - - - - -
A AT 0.133 0.351 2.06 0.118 17.457 <0.001 HS
BT 1.8 0.56 - - - -
Excessive
Vaginal
discharge
B
AT 0.0 0.0 1.8 0.144
14
12.5 <0.001 HS
In order to assess the Excessive Vaginal discharge patients of each group
were examined according to the clinical findings and the results were analyses from
the statistical analysis.
The parameter Excessive Vaginal discharge in group A Mean ±SD before
was 2.2 ±0.56 and after the treatment it is reduced to 0.133 ±0.351, with Mean
difference 2.06 and standard of mean 0.118 and test shows more highly significant in
group A as P<0.001.
In group B Mean ±SD before was 1.8 ±0.56 and after the treatment it is
reduced to 0.0 ±0.0 with Mean difference 1.8 and standard of mean 0.144 and test
shows more highly significant in group B as P<0.001.
The parameter Excessive Vaginal discharge is having more effect in group A
than group B ( By Comparing t-values).
Results
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Shweta Pradara- A Clinical study.
91
Table No.6.3. Showing the Statistical Analysis of both the groups, Before and after treatment and Percentage of improvement with respect to Vulval moistrness.
Parameter Treatmet
Group
Duration Mean±SD Mean±SE DF T-
Value
P-
Value
Rem
arks
BT 1.6 0.632 - - - - -
A AT 0.2 0.414 1.466 0.133 11.02 <0.00
1
HS
BT 0.733 0.798 - - - - -
Persistent
Vulval
moistness
B
AT 0.0 0.0 0.733 0.206
14
3.55 <0.01 HS
The parameter Persistent Vulval moistrness in group A Mean ±SD before
was 1.6 ±0.632 and after the treatment it is reduced to 0.2 ±0.414, with Mean
difference 1.466 and standard of mean 0.133 and test shows more highly significant in
group A as P<0.001.
In group B Mean ±SD before was 0.733 ±0.798 and after the treatment it is
reduced to 0.0 ±0.0 with Mean difference 0.73 and standard of mean 0.206 and test
shows more highly significant in group B as P<0.01.
The parameter Persistent Vulval moistrness is having more effect in group A
than group B ( By Comparing t-values).
Table No.6.4. Showing the Statistical Analysis of both the groups, Before and after treatment and Percentage of improvement with respect to Extensive Pruritis.
Para-
meter
Treatment
Group
Duration Mean±SD Mean±SE DF T-
Value
P-
Value
Remar
-ks
BT 1.666 0.617 - - - - -
A AT 0.133 0.09 1.5
33
0.133 11.52 <0.001 HS
BT 1.33 0.975 - - - - -
Exten
sive
Prurit
is
B
AT 0.133 0.351 1.2 0.243
14
4.93 <0.001 HS
Results
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Shweta Pradara- A Clinical study.
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The parameter Extensive Pruritis in group A Mean ±SD before was 1.666
±0.617 and after the treatment it is reduced to 0.133 ±0.09, with Mean difference
1.533 and standard of mean 0.133 and test shows more highly significant in group A
as P<0.001.
In group B Mean ±SD before was 1.33 ±0.975 and after the treatment it is
reduced to 0.133 ±0.351 with Mean difference 1.2 and standard of mean 0.243 and
test shows more highly significant in group B as P<0.001.
The parameter Extensive Pruritis is having more effect in group A than
group B ( By Comparing t-values).
Table No.6.5. Showing the Statistical Analysis of both the groups, Before and after treatment and Percentage of improvement with respect to General weakness.
Parameter Treatment
Group
Duration Mean±SD Mean±SE DF T-
Value
P-
Value
Rem
arks
BT 2.33 0.723 - - - - -
A AT 0.2 0.414 2.2 0.174 12.64 <0.001 HS
BT 0.733 0.961 - - - - -
General
weakness
B
AT 0.0 0.0 0.733 0.248
14
2.955 <0.05 HS
The parameter General weakness in group A Mean ±SD before was 2.33
±0.723 and after the treatment it is reduced to 0.2 ±0.414, with Mean difference 2.2
and standard of mean 0.174 and test shows more highly significant in group A as
P<0.001.
In group B Mean ±SD before was 0.733 ±0.961 and after the treatment it is
reduced to 0.0 ±0.0 with Mean difference 0.733 and standard of mean 0.248 and test
shows more highly significant in group B as P<0.05.
Results
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Shweta Pradara- A Clinical study.
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The parameter General weakness is having more effect in group A than
group B ( By Comparing t-values).
Table No.6.6. Showing the Statistical Analysis of both the groups, Before and after treatment and Percentage of improvement with respect to Pain in Lumbar region.
Parameter Treatment
Group
Duration Mean±SD Mean±SE DF T-
Value
P-
Value
Rem
arks
BT 2.2 0.676 - - - - -
A AT 0.266 0.457 1.93 0.181 10.66 <0.001 HS
BT 0.466 0.833 - - - - -
Pain in
Lumbar
region
B
AT 0.066 0.258 0.4 0.19
14
2.10 >0.05 NS
The parameter Pain Lumba region in group A Mean ±SD before was 2.2
±0.676 and after the treatment it is reduced to 0.266 ±0.457, with Mean difference
1.93 and standard of mean 0.181 and test shows more highly significant in group A
as P<0.001.
In group B Mean ±SD before was 0.466 ±0.833 and after the treatment it is
reduced to 0.066 ±0.258 with Mean difference 0.4 and standard of mean 0.19 and test
shows non significant in group B as P>0.05.
The parameter Pain in Lumba region is having more effect in group A than
group B ( By Comparing t-values).
Table No.6.7. Showing the Statistical Analysis of both the groups, Before and after treatment and Percentage of improvement with respect to Vaginal pH.
Parameter Treatment Group
Duration Mean±SD Mean±SE DF T-Value
P-Value
Remarks
BT 6.1 1.22 - - - - - A AT 4.54 0.65 1.533 0.34 4.508 <0.001 HS
BT 6.22 1.116 - - - -
Vagnial pH
B AT 4.46 0.714 2.12 0.177
14
11.977 <0.001 HS
Results
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of
Shweta Pradara- A Clinical study.
94
The parameter Persistent Vaginal Ph in group A Mean ±SD before was 6.1
±1.22 and after the treatment it is reduced to 4.54 ±0.65, with Mean difference 1.533
and standard of mean 0.34 and test shows more highly significant in group A as
P<0.001.
In group B Mean ±SD before was 6.22 ±1.116 and after the treatment it is
reduced to 4.46 ±0.714 with Mean difference 2.12 and standard of mean 0.177 and
test shows more highly significant in group B as P<0.001.
The parameter vaginal Ph is having more effect in group B than group A ( By
Comparing t-values).
Table No.6.8. Showing the Statistical Analysis of both the groups, Before and after treatment and Percentage of improvement with respect to Vaginal Smear.
The parameter Vaginal smear in group A Mean ±SD before was 1.26
±0.457 and after the treatment it is reduced to 0.0 ±0.0, with Mean difference 1.266
and standard of mean 0.118 and test shows more highly significant in group A as
P<0.001.
In group B Mean ±SD before was 1.466 ±0.516 and after the treatment it is
reduced to 0.0 ±0.0 with Mean difference 1.466 and standard of mean 0.133 and test
shows more highly significant in group B as P<0.001.
The parameter Vaginal Smear is having more effect in group B than group A
( By Comparing t-values).
Overall the drug is having more effective in vaginal smear and Vaginal Ph in
group B and it is more highly significant in all other parameter in group A.
Parameter Treatment
Group
Duration Mean±SD Mean±SE DF T-
Value
P-
Value
Rema
rks
BT 1.266 0.457 - - - - -
A AT 0.0 0.0 1.266 0.118 10.72 <0.001 HS
BT 1.466 0.516 - - - - -
Vaginal
Smear
B
AT 0.0 0.0 1.466 0.133
14
11.022 <0.001 HS
Results
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Table No. 6.9.Analysis table by using student t-test.
Parameter Mean SD SE t-value p-value Remarks Excessive Vaginal Discharge
1.933333
0.52083
0.095091
20.33148
<0.001 HS
Persistent vulval moistness
1.1
0.758856
0.138548
7.93948
<0.01 HS
Extensive pruritis
0.76489
0.13965
0.13965
9.786377
<0.001 HS
General weakness
1.466667
1.105888
0.201908
7.26405
<0.01 HS
Pain lumbar region
1.166667
1.053183
0.192285
6.067382
<0.01 HS
Vaginal ph 1.983333
0.769722
0.140532
14.11304
<0.001 HS
Vaginal Smear
1.366667
0.490133
0.089486
15.27241
<0.001 HS
% of imp 96.66667 91.42857 91.11111 93.47826 87.5 26.89394 100
Conclusion:
The statistical analysis is done by using student’s paired t-test, by assuming
that the drug is not responsible for changes in the readings before and after treatment.
From the analysis all parameters shows highly significant (as p<0.05). The
parameters Excessive Vaginal Discharge, Vaginal ph, Vaginal Smear and Extensive
pruritis shows more highly significant than the other parameters ( as p<0.001). and
the parameters Persistent vulval moistness and General weakness shows less highly
significant (as p>0.001).
The percentage of improvement in the parameters is Excessive Vaginal
Discharge with 96.66667, Persistent vulval moistness with 91.42857 %, Extensive
pruritis with 91.11111%, General weakness with 93.47826%, Pain lumba region with
87.5%, Vaginal ph with 26.89394 % and Vaginal Smear with 100%
from the study.
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta Pradara- A Clinical study.
96
Master chart 1
ASSMENT OF SUBJECTIVE PARAMETERS OF GROUP A
Excessive Vaginal discharge
Persistent Vulval moistness
Extensive Pruritis
General weakness
Pain in Lumba region
Draging sensation in abdomin
SLNo Gr A
OPD. No
BT AT Dif BT AT Dif BT AT Dif BT AT Dif BT AT Dif BT AT Dif1 9 2 0 2 3 1 2 2 0 2 3 1 2 2 0 2 2 1 1 2 10 3 0 3 2 0 2 2 0 2 2 0 2 3 0 3 1 0 1 3 34 2 0 2 2 0 2 1 0 1 3 0 3 3 1 2 1 0 1 4 18 2 0 2 1 0 1 1 0 1 3 0 3 2 0 2 1 0 1 5 35 3 1 2 2 1 1 1 0 1 3 0 3 3 0 3 1 0 1 6 56 3 1 2 2 0 2 2 0 2 2 1 1 2 0 2 2 0 2 7 55 1 0 1 2 0 2 2 1 1 3 1 2 2 0 2 1 0 1 8 37 2 0 2 1 0 1 1 0 1 1 0 1 2 1 1 1 0 1 9 3 2 0 2 1 0 1 1 0 1 2 0 2 1 0 1 1 0 1 10 5 2 0 2 1 0 1 3 1 2 2 0 2 1 0 1 2 0 2 11 61 2 0 2 2 1 2 2 0 2 2 0 2 2 1 1 1 0 1 12 1 2 0 2 1 0 1 2 0 2 3 0 3 2 0 2 2 0 2 13 25 2 0 2 1 0 1 2 0 2 2 0 2 3 1 2 1 0 1 14 29 2 0 2 1 0 1 2 0 2 1 0 2 2 0 2 2 0 2 15 37 3 0 3 2 0 2 1 0 1 3 0 3 3 0 3 1 0 1
BT= Before Treatment AT= After Treatment Dif = Difference
Master Chart
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Pradara- A Clinical study.
97
Excessive vaginal discharge
Gr-O No Discharge, Gr-1 Persistent moistness of Vulva, Gr-2 Need to change the
undergarments frequently , Gr-3 Need to use an extra cloth or pad
Persistent vulval moistness
Gr-O No Moistness, Gr-1 Mild moistness, Gr-2 Moderate moistness , Gr-3 Severe
moistness
Extensive pruritis
Gr-O No Pruritis, Gr-1 Occasionally pruritis, Gr-2 Pruritis through out the day ,
Gr-3 Increases particular time of day/night
General weakness
Gr-O No Weakness, Gr-1 Patient is able to involve in routine activity , Gr-2 Patient is
slow to involve in routine activity, Gr-3 Patient feels exhausted to involve in routine
activity
Pain in lumbar region
Gr-O No Pain, Gr-1 Mild , Gr-2 Moderate, Gr-3 Severe
Dragging sensation in abdomen
Gr-O Normal, Gr-1 Mild , Gr-2 Moderate, Gr-3 Severe
Master Chart
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
98
Master Chart 2
ASSMENT OF OBJECTIVE PARAMETERS OF GROUP A
Vagnial pH Vaginal Smear S.L. No Gr.A
OPD BT AT Dif BT AT Dif
1 9 6.5 4.5 2 1 0 1 2 10 7.0 4.5 2.5 2 0 2 3 34 6.0 4.2 1.8 2 0 2 4 18 4.2 4.5 -0.3 2 0 2 5 35 8 5.0 3 1 0 1 6 56 4.1 6.0 -1.9 1 0 1 7 55 8.0 5.0 3 2 0 2 8 37 5.9 4.5 1.4 1 0 1 9 3 7.0 5.5 2.5 1 0 1 10 5 6.0 4.0 2.0 1 0 1 11 61 6.0 3.5 2.5 1 0 1 12 1 4.5 3.5 1 1 0 1 13 25 6.5 4.5 1 1 0 1 14 29 6.8 4.5 2.3 1 0 1 15 37 5.0 4.5 0.5 1 0 1
BT= Before Treatment AT= After Treatment
Master Chart
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99
Master Chart 3
ASSESSMENT OF SUBJECTIVE PARAMETERS OF GROUP B
BT= Before Treatment AT= After Treatment Dif = Difference
Excessive Vaginal discharge
Persistent Vulval moistness
Extensive Pruritis
General weakness
Pain in Lumba region
Draging sensation in abdomin
Sl NoGrB
OPD No
BT AT Dif BT AT Dif BT AT Dif BT AT Dif BT AT Dif BT AT Dif1 63 2 0 2 2 0 2 2 0 2 0 0 0 0 0 0 0 0 0 2 61 2 0 2 2 0 2 3 0 3 2 0 2 0 0 0 0 0 0 3 60 1 0 1 2 0 2 3 0 3 0 0 0 0 0 0 0 0 0 4 67 1 0 1 1 0 1 0 0 0 2 0 2 0 0 0 0 0 0 5 94 3 0 3 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 6 83 2 0 2 1 0 1 2 0 2 1 0 1 0 0 0 0 0 0 7 69 2 0 2 1 0 1 2 1 1 0 0 0 0 0 0 0 0 0 8 85 2 0 2 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 9 74 1 0 1 0 0 0 0 0 0 2 0 2 1 0 2 0 0 0 10 87 2 0 2 0 0 0 1 0 1 2 0 2 2 0 0 0 0 0 11 75 2 0 2 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 12 76 2 0 2 0 0 0 1 0 1 0 0 0 0 1 1 1 0 1 13 77 2 0 2 0 0 0 1 0 1 0 0 0 2 0 0 0 0 0 14 78 1 0 1 0 0 0 0 0 0 2 0 2 2 0 2 1 0 1 15 79 2 0 2 1 0 1 2 1 1 0 0 0 0 0 0 0 0 0
Master Chart
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
100
Master Chart 4
ASSESSMENT OF OBJECTIVE PARAMETERS OF GROUP B
Vagnial pH Vaginal Smear Sl.NoGr.B
OPD BT AT Dif BT AT Dif
1 63 5.8 4.2 1.6 1 0 1 2 61 6.0 3.5 2.5 2 0 2 3 60 7.0 4.5 2.5 1 0 1 4 67 5.8 3.5 2.3 2 0 2 5 94 6.0 3.5 2.5 1 0 1 6 83 6.5 4.5 2 2 0 2 7 69 7.0 4.5 2.5 1 0 1 8 85 6.0 4.2 1.8 2 0 2 9 74 4.2 4.5 -0.3 2 0 2 10 87 8 5.0 3 2 0 2 11 75 4.1 6.0 -1.9 1 0 1 12 76 8.0 5.0 3 2 0 2 13 77 5.9 4.5 1.4 1 0 1 14 78 7.0 5.5 2.5 1 0 1 15 79 6.0 4.0 2.0 1 0 1
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
101
DISCUSSION
In This study the Evaluation of efficacy of plaksha twak churna in the
management of Shweta pradara, A Clinical study is done.
1) Shweta pradara is a very common and irritating condition in women, Around 30-
40% of the patients attending the Gynecological OPD in routine practice are
suffering from this disease.
2) The disease Shweta pradara based on theoretical and clinical symptoms can be
compared to Leucorrhoea.
3) The pathogens like Trichomonas vaginalis (4.5%) N gonorrhoeae (2.7%) and C
albicans (6.7%) were exclusively present in leucorrhoea.
4) Charaka described plaksha under the Kashayakanda while shushruta and
Vagbhata have mentioned it under Nyagrodhadi gana. It is considered as one of
the ksirivraksas or pancha valkalas by Bhavamisra. Much beneficial in Yonigata
vikaras.
5) Tha plaksha twak, (Ficus lacor) is used in this study. It is having properties like
Kashaya rasa it acts as rakta stambhaka & grahi. Due to its sheeta veerya and
laghu, ruksha qualities acts as Vranashodhana and vrana ropana. So these actions
are extremely beneficial in curing Shweta pradara. A warm vaginal douche of
plaksha twak churna kashaya is beneficial to general cleansing and elimination of
purulent discharge. Plaksha twak churna have many means to kill fungus,
bacteria, parasite as it acts as krimighna. In shwetapradara there is mere
predominance of kapha dosha, here the rasadi dhatu get decreased due to vata
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
102
dosa. So in order to cure the vitiated kapha, plaksha twak churna is implemented
in this clinical study as it is kaphagna.
Importance of madhu as anupana in this study:
Madhu as it is katu, tikta kashaya rasa pradhana and ushna virya ruksha guna
yukta so it does dosha bhedan and effect in kapha vitiated diseases and as shweta pradara
is one among kaphaja vyapat.
Dose – group A 4 gms of plaksha twak churna with madhu per day in divided dose was
advised. And madhu enhances the properties of plaksha twak churna.
Aushadhi sevana kala – Medicine should be taken before meals reason behind this is
the main cause for yoni vyapat especially apana vata vitiation plays an important role.
For the purpose of vata anulomana, agni deepana.
Group B- the patients of group B were treated with Plaksha twak churna kashaya every
day fresh kashaya was prepared as the saveeryata kalavadhi of kashaya is 24 hours.
Dose – 50gms powder to prepare kashaya. Sterilized vaginal douche was placed
approximately till it reaches to cervix carefully. Sterilization was maintained to avoid
infection. Douche was removed to avoid infection. After 5 to 10 minutes.
Pharmacognostic study
In order to standardize the identification of Plaksha, a detail pharmacognostic
study including microscopic and macroscopic characters of the twak and its powder was
carried out. The features observed are furnished in the related chapter and compared with
pharmacognostic study of Ficus lacor done at Ayurvedic Pharmacopia of India. Both the
study seemed similar thus proving the genuinity of the drug collected.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
103
Analytical study
The result of analytical study of Plaksha twak done at Bio Genics research &
training institute in Biotechonology, Unkal, Hubli was matched with analytical study
reports of previous research works and was found to be similar. The result of physical
constant in Plaksha twak churna also matched with the reports of previous works and
have been found to be similar.
Plan of Study:
In this study total 30 patients were taken for clinical trial in which two groups A
& B of each 15 patients were selected for study at D.G.M.A.M.C.P.G.R&S Gadag.
The disease shwetapradara is diagnosed on the basis of subjective parameters i.e
signs and symptoms as mentioned in our classics and objective parameters.
In present study overall 30 patients fall under age group of 20-50 years. Out of
which 73.33% (22 patients) between age between 30-40 years. The incidence is found
more in between age of 20-30 years due to in present study the minimal age criteria for
the study is 20 because the age for marriage for women is 18 and above and trans vaginal
douche can be advised only to married women.
Maximum is 50 years because the menopause stage starts at the age of 40 there is
hormonal changes. So the age is limited.
The incidence of Socio-economic status majorly concerned to shwetapradara. It
was found that 46.66% in poor state. 33.33% middle class families and where less as
20.10% in higher middle class families. Due to poor state malnutrition, unhygienic
condition. Mostly poor woman’s more prone to shweta pradara.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
104
The incidence of disease was found up to 50% Kapha vataja, and 30% vata kapha,
20% kapha pitta in the present study it can be preassumed that kapha vataja prakrati
person get affected more by shweta pradara compared to other prakrati person. Because
shweta pradara is due to vitiation of kapha and vata dosha.
The incidence of yoni aprakshalana 76.66% indicates the negligence towards
health and hygine more prone to words infection. It is a major cause for shweta pradara.
In the present study out of 30 patients 23 (76.67%) patients were having the
excessive menstruation, and 7 (23.33%) patients were having complaint of irregular
menstrual cycle. Which is also cause for artavadusti is also major cause for shweta
pradara.
It was evident from the present study the 40% of the patients were labour. More
prone towards the disease due to the unhygienic living standards.
In the present study out of 30 patients 10 (33.33%) were having the history of
abortions. It is also one of the cause for shweta pradara. It may be due to vitiated vata
dosha.
Subjective parameters like excessive vaginal discharge shows highly significant
in both groups due to control of kapha. Extensive purities was another major parameter
found more in both groups. It was also markedly reduced and shows highly significant. It
may be due to the kandugnata action of drug. And sthambaka action of the drug.
Associated with madhu act as kapha vata shamaka grahi guna present in madhu acts as
amapachaka & sthambak. The lekhana guna helps to destroy the sanga and act as
srotomukh vishodhaka with its yoga vahi guna.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
105
Duration
For all the two groups duration was fixed upto 21 days. As it is comparative study
based on duration of vaginal douche, the duration of plaksha twak churna along with
madhu was fixed up to 21 days.
Data collection
Data from each group was collected before treatment after treatment and at the
end of the follow up. The data was collected properly and documented and statistically
analyzed. To see the effect of plaksha twak churna along with madhu & plaksha twak
kashaya as trans vaginal douche.
Statistical analysis
The data collected was statistically analyzed under the guidance of statician. The
data was computed for mean, standard deviation standard error, t value and p value. P
value was obtained by using students paired ‘t’ test. Significance of the results was based
on the p value. The statistical values from each group were compared and analyzed to see
the significance of the treatment.
Other objective parameters are found to be improved after the treatment in both
groups.
1) Chemical compound tannic acid present in the drug helps to normalize pH value
of vagina.
2) The normal vaginal pH is acidic that is 4.5 alteration in this vaginal pH value
leads to growth of organism which cause white vaginal discharge.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
106
Vaginal secretion consist of tissue fluid, epithelial debris. Electrolytes, proteins
and lactic acid, so excessive vaginal discharge causes imbalance of all essential
component, individual feel general weakness, body ache, back ache.
3) The Objective parameter vaginal smear shows highly significant 100% result by
the study. Here the probable mode of action of the drug due to as it is krimighnna
have many means to kill fungus, bacteria, parasite. As it is of antiseptic destroy
invading organisms like (Trichomonas vaginalis) (Candida albicans) shofagna –
action helpful in the inflammatory conditions of the patients and improvement
shown in the results with highly significant. Astringent nature of kashaya rasa are
locally protein precipitants. They reduce the permeability of cell membranes.
These are used therapeutically reduce inflammation of mucous membranes
promote healing.
4) The laboratory investigations show Hb% more significantly improved observed
findings that 0.1gm – 0.2gm of haemoglobin increases in every individual. The
selected plaksha has the rasayanik sangatan like carbohydrates, amino acids,
polysaccharides, proteins, calcium oxalate, and tannic acid. Madhu has
rasayanaika sangathan phosphorus, barbohydrate and iron vitc, tannic acid, both
together helpful to fulfil deficiency in above criteria.
Probable mode of action of Trailed drugs
Probable mode of action of Plaksha twak churna with madhu.
1) Charaka described Plaksha under mootra sangrahaniya which indicates its action
on mootravaha srotovikara i.e a drug of choice for some uro-genital diseases and
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
107
also been used in sukra vaha sroto vikaras. Shweta pradara is seen in anemia and
in artavaha srotovikaras
The artavaha srotos of female is homologus in function with shukra vaha
srotas of males. Hence the drugs acting on Sukravaha srotas may act as similarly on
artavaha srotas. Again Plaksha twak comes under kashaya sknda, nyagrodhadi gana
and one among panchavalklas so it is considered as much beneficial in yonigata
vikaras.
2) Plaksha twak churna, kapha vata shamaka, agini deepaka, ama pachaka,
sthambaka, sroto mukha vishodhaka, vrana shodhana, vrana roopana, grahi,
shotahara, yoni doshahara.
3) Kashaya rasa act as lekhana and stambhaka due to rooksha guna, sheeta veerya
and laghu paka aggravates vata subsides kapha have absorbing effects
(kledhahara). Hence it checks the ati pravruti of shweta srava as it is sheeta veerya
it helps to check the flow of discharge. Improves the tissues increases the bala
acts as dourbalya nashaka.
4) Katu vipaka act as Jatharagni deepaka, ama pachaka, plaksha twak churna with
madhu as it has been sroto mukha vishodhana due to chedana and lekhana
properties. It destroys the sangha of rasavaha srotas caused due to ama kapha.
Kashaya rasa makes dhatus free from impurities.
5) Presence of rich in alkaloids shows Haemostatic action. Which is beneficial in
shwetapradara including disfunction of uterine bleeding.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
108
Probable mode of action of Plaksha twak kashaya as vaginal douche.
Grahi, kaphagna, vrana ropaka, vedana sthapaka, shothahara, yoni dosha nasha,
kashaya rasa act as kapha shamaka. The grahi guna present in Plaksha twak act as sthanik
dhatwagni janya ama pachaka, and sthambaka which helps to check the yoni gata srava.
Due to vedana sthapaka property helps to cure yonigata vedana, sothahara property
relives yonigata sotha.
By all these properties it acts as yonidosha nashaka which indicates that in all
types of yoni vyapat, it can be advisable.
NIDANA
Avoiding the nidana itself is a first line of treatment so it seems very essential to
understand the nidana of the every vyadhi
1) Mithya achara
Mithya achara includes both mithya ahara and vihara
a) Mithya ahara
Ahara which are kapha vardak, are main etiological factors for shweta pradara
due to excess intake of guru, snigda, picchila, drava, sheeta, madhura, rasayukta ahara
which are predominant in prathivi and apa maha bhuta, due to their chirapaki guna. They
produce agni mandya, then produces ama further does the rasa vaha sroto dushti nad artw
vaha srotas dushti, leads to the shweta pradar.
Abhishendi ahara dravya produces the kleda in the dosha, dhatu, mala and srotas.
Due to this picchila and guru guna present in the abhishendi dravya act as sroto
avarodhak and simultaneously it increases the kapha doshas leads to shweta pradara.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
109
In the present study most of the patients were having the history of intake of
kapha vardaka and abhishendi ahara such as curds, milk, jaggery and chapatti etc.
b) Mithyavihara
It includes the vyavaya karma with the purush who has the pravradha linga,
ativayaya karma, who follows unhygienic procedure, that is yoni adhavana, repeated
grabha pata and D&C and adhik vyayam. These all are included in mithya viahara which
produces the sthanika uttejana in the yoni as well as external genitalia which ultimately
result in the vitiation of sthanika dosha particularly vata and kapha. And also the vega
dharana like mala, mutra leads to vitiation of apana vata, sthana samshraya of apana vata
takes place in artaw vaha srotas cause shweta pradar.
In present study most of the patients were having the history of ativyayama
karma, yoni adhavana, (unhygienic procedure) repeated abortions with Dilation and
Curatage, vega dharana like malavega etc.
c) Apadravya prayoga: Copper T,
d) Manasika
Manasika dosha and shareerika doshas are interlinked, due to the mental anxiety
and depression as well as desiring for sex etc will cause the vitiation of raja and tama
dosha which ultimately vitiate the vata and kapha dosha thus produces the shweta
pradara.
In present study most of the patients were having the history of manasika is
anxiety depression etc.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
110
2) Artava dusti
Here artava vruddhi, artava kshaya are considered and all hormonal imbalance
can be included.
In the present study patients were having the history of artava kshaya and vruddhi.
3) Beeja dosha
Abnormalities of shukra and stree beeja various chromosomal or genetic
abnormalities can be considered i.e kulaja vrattanta.
4) Daiva
Unknown or idiopathic factor come under this category, cause may be super
natural power or poorva janma kruta karma.
ROOPA
The complete vyakta lakshanas are considered as roopa.
In this vyadhi pratyatma lakshana is yoni gata shweta srava.
And in the present study all most all the patients were having the complaint of
yonigata, kandu, vedana, kati, shoola, sarvang marda, daurbalyata, so these can be
considered as anubandi vedana.
1) Yoni gata Shweta srava
Excessive yonitah shweta srava is the main complaint, swaroopa of srava differs
from jaliya, dadhi vata.
2) Yoni gata kandu
It is the main clinical symptom of shweta pradar. Due to excessive srava which is
kaphaia causes the kandu and also it may be due to unhygienic procedure.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
111
3) Yonigata vedana
This may be due to the effects of vata vitiation. Especially apana vata dushti. As
the functions of artaw vaha srotas are under the control of apanavata hence aggravated
apana vata may cause the yoni gata vedana.
4) Kati shoola
Kati shoola may be due to the vitiation of apana vata, particularly pain is at the
sacrum vitiated vata cause pain as vata and asthi dhatu are related with ashraya ashrayi
bhava.
5) Sarvanga marda
Sarvang marda is also due to the vitiation of the vata dosha.
6) Daurbalyata
Prakrat shleshma is considered as bala, in shweta pradara there is excessive
discharge of sama kapha which leads to bala kshaya according to modern the vaginal
discharge consist of electrolyte, proteins, epithelial cells which are essential elements,
when there is excessive discharge that leads to weakness.
7) Adho udara shoola
It indicates the shoth condition of the yoni because of the sthana samshraya of
dosha and dushya at trayavart yoni.
8) Vibanda
Aggravated vata dosha particularly apanavata dosh causes the vibanda
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
112
UPASHAYA
Acharya charaka in nidana explains all the chikitsa as upashaya and it also called
as pathya in different contexts. Hence all the therapies that relieve shweta pradar can be
taken of upashaya.
ANUPASHAYA
All nidana explained for shweta pradar and apathya can be considered as
anupashaya.
CHIKITSA OF SHWETA PRADARA
1) Shamana – abhyantar
2) Sthanika
1) Shamana – By going through all the chikitsa dravya explained shamanaushadhi
we come to know that all dravyas contain kapha shamak, agni Deepak, grahi,
vrana prashamana, shothahar, krimigna, kandugna, amapachak, sroto mukha,
vishodaka, and vatanulomak properties, these all help in the samprapti vighatana.
2) Sthanika – Yoni dhawana, pichu dharana, kalka lepana, varti prayoga and
dhoopana etc sthanika chikitsa are advised.
Dravyas used for sthanika chikitsa are similar to with abhyantar chikitsa
As in shweta pradara vyadhi, kapha dosha is sthanantara gata dosha. Kapha
accumulates in vata Pradesh especially apana vata Pradesh, hence one should give
chikitsa for kapha dosha without harming the vata dosha.
In this clinical study both shamana as plaksha twak churna with madhu
and plaksha twak kashaya as transvaginal dush as a sthanika chikitsa was done.
Discussion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
113
Pathya Apathya
Pathya:
All the pathya ahara explained in classics having Ushna, ruksha, laghu guna act as
agni Deepak, amapachaka, kapha vata shyamaka and vatanulomak.
In the present study Jawar roti, kulath, mudga, patola, lashuna, vrantaka, and
ushnodaka were advised these all help to stimulate agni and mitigate kapha vata dosha. In
vihara to avoid unhygienic procedure, remove copper T and abstinence from intercourse
up to treatment period.
Apathya:
All Nidanas of Shweta pradara are considered as apathya.
In the present study curd, Jaggery abhishyandi ahara, oral contraceptive pill were
advised.
Conclusion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
114
CONCLUSION
After a prompt theory and clinical study on evaluation of efficacy of Plaksha twak
churna in the management of Shwetapradara, A clinical study, following conclusion are
drawn.
1) Shweta pradara correlates with modern disease Leucorrhoea on the basis of
symptomatology.
2) Apart from the one of the symptom in yoni vyapat sweta pradara is considered as
a swatantra vyadhi as differentiated in the aspect of srava, varna and chikitsa.
3) Along with kapha vardaka aharajanya nidana, viharajanya nidanas like ativyavaya
repeated garbhapata and Dilate and Curatage, use of apadravya and yoni
adhawana etc are also major cause for shweta pradara.
4) Plaksha is identified as Ficus lacor and anupana madhu as honey. Have the effect
shwetapradara.
5) With the dose of 4gms/BD with madhu for 21 days to the first group and the 50ml
of the plaksha twak churna kashaya administered before the meals for 21 days, do
not cause any untoward effect in patients between the age group 20-50 yrs.
6) The percentage and result evaluated on the basis of subjective and objective
parameters for group A and B cumulatively and graphically.
7) Plaksha contains nutrients like protein carbohydrates, calcium oxalate, amino
acids and tannin which have specific action over shwetapradara and also anaemia.
8) Clinical study revealed that both groups are effective in the management of
swetapradara.
Conclusion
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
115
9) Plaksha and madhu are economical effective drug in shwetapradara without any
side effects.
10) In the patients who complains of yonigata shweta srava with pain in lumbar
region, General weakness, yonigata kandu and less Hb% alone plaksha twak
churna with madhu is effective.
11) In the patients who complains of yonigata srava along with yonigata kandu, bahya
shotha alone plaksha twak kashaya as vaginal douch is effective.
12) In the result there is zero (0%) patients who does not respond, 25 (83.33%)
patients shown good response and moderately response in the schedule are 5
(16.66%)
Limitations of the Study
The sample size is very small to generalize the result.
Future Prospective
To achieve the aims and objectives of study the maximum work is to be done to
present this clinical study. Even though there is wider scope to study further.
In larger samples the study reveals the good sort of results.
Role of plaksha twak churna on female hormones like oestrogen, progesterone
etc.
Role of plaksha twak kashaya in maintanance of vagnial pH.
Summary
Evaluation of Efficacy of Plaksha Twak (Ficus lacor) in the Management of Shweta
Pradara- A Clinical study.
116
SUMMARY
This study is performed to understand efficacy of plaksha twak churna in the
management of shweta pradara.
The aims and objectives of present study have been discussed.
The drugs plaksha and anupana madhu are reviewed, discussed elaborately and
explained from Ayurvedic and modern pharmacognosy and journals.
The definition history, etiology, samprapti, laxana and treatment of shwetapradara
according to all classics were reviewed in study.
The study was conducted on 30 patients which made into 2 equal groups each 15
patients in group A Plaksha twak churna 4gms BD Madhu. In group B plaksha
twak churna kashaya as Vaginal douche was administered in the dosage of 50ml
early in the morning, Before meals for 21 days duration to each group.
In this study incidence of socio economic status, sex, religion, constitution dietics
were highlighted in the observation.
Good response to symptoms of shweta pradara found in both groups.
Overall the drug is having more effective in vaginal smear and Vaginal Ph in
group B and it is highly significant in all other parameter in group A.
122
BIBILIOGRAPHIC REFERENCES
INTRODUCTION
1) D.C. Datta, Text book by Gynecology & Contraception, 3rd ed. Culcutta, New
central book Agency 2001, P. 503-505.
2) www.google.com, PMID: 9715025 [PubMed-indexed for MEDLINE]
3) www.google.com/ayu/leucorrhoea.htm
4) Pandit Kashinath shastri & Dr. Gorakhnath chaturvedi ed. Charaka samhita,
Chikitsa sthana, Chapter-30, sloka no-118-120, 17th ed. Chaukhambha bharti
academy, 1991 P.858.
5) Dr. Indradeo Tripathi, Raja Nigantu, Amradi varga, Sloka 125, 2nd ed. Krishna
das Academy Varanasi, 1998, P. 365.
6) Prof. Priyavart Sharma, Dhanvantari nigantu, Amradi varga sloka 74 & 15, I ed.
Choukambha orientalia, Varanasi 1982, p. 162.
7) Prof. Priyavart Sharma, kaiyadevanigantu, Amradi varga sloka 435 – 437, I ed.
Choukambha orientalia, Varanasi 1978, P. 80.
8) Dr. G.S. Pandey, Bhavaprakash nigantu, Vatadi varga, sloka 11, 6th ed.
Choukambha bharati Academy Varanasi, 1982 P. 518.
9) Dr. K.M. Nadakarni’s, Indian meteria medica, Vol-I, reprint-1996, Bombay
popular prakshan, Mumbai, 1996, P. 551.
123
DRUG REVIEW
PLAKSHA
10. Prof. P.V. Sharma fruits & Vegetables in Ancient India, I edition, Choukambha
Orientalia, Varanasi, 1979, P-63.
11. K. Raghunatham, Pharmacogonosy of Indigenous drugs 2nd ed, Central council
for research in Ayurveda and siddha, New delhi 2005, P-742.
12. Prof. Priyavarat sharma, Dravyaguna vijnana, IVth Vol, 2nd ed, Choukhambha
Sanskrit sansthan, Varanasi 19997, P-5th.
13. Prof. V.V. Prasad, Plants and other drugs of Shushruta samhita saptadaya,
Nyagrodhadi ganha 1st ed, Rastriya Ayurveda vidyapeeth, New delhi, 2002, P-
58,60.
14. Pfof. Priyavrat Sharma, Dravyaguna vignana, IInd ed, Choukhambha Sanskrit
sansthan, Varanasi, 1977, P-5, 102,203.
15. Pandit Kashinath shastri and Dr. Gorakhnath Chaturvedi ed, Charaka samhita,
Chikitsa sthana, Chapter-30, Sloka No-118-120, 17th ed, Chaukhambha bharati
Academy, 1991, Pg: 858.
16. Shushruta, Susruta samhita sutra sthana chapter 36, sloka no-23-24, Kaviraj
Ambikadatta shastri editor- 5th ed, Varanasi: Chowkhamba Sanskrit samsthana;
Pg: 138-139.
17. Vagbhata, Astanga Hrudaya Chikitsa Vol-I Chapter 15, Sloka -41, K.R.
Shrikantamurthy Vaidya editor, Varanasi: Krishnadas Academy: 1996, Pg-72.
18. Dr. G.S. Pandey, Bhavaprakash nighantu, vatadi varga, sloka 11, 6th ed,
Choukambha bharati Academy Varanasi, 1982, P. 518.
19. Prof. Priyavart sharma, Kaiyadevanighantu, Aoushadhi varga sloka 435-437, Ied,
Choukambha Orientalia Varanasi, 1982 P: 80.
20. Dr. Indradeo Tripathi, Raja Nighantu, Amradi varga, sloka 122-125, 2nd ed,
Krishna das Academy Varanasi, 1998, P:365.
21. Madanapala, Madanapala Nighantu Vatadi varga, Sloka-7, Ramprasad Patiyala
editor, 1st ed, Bombay Khemaraj Shrikrishna das Prakashna; 1966 Pg:110.
22. Bapalal G. Vaidya, Nighantu Adarsha, Sloka – 1-5, 1st ed, Varanasi,
Chowkhamba Bharati Academy; 1968, Pg: 467.
124
23. Prof. P.V. Sharma, Abhinava ratnamala sloka No-45, 1st ed, Varanasi
Choukhambha orientalia; 1977, P-43.
24. Amara simha, Amarakosha, Vanaushadi varga, Pt Haragovinda shastri, Varanasi,
Choukhambha sanskrit Sansthan, reprint 2006, P-177.
25. Lala Saligramaji vaishya, shaligram nighantu Bhushanam varga, Bombay;
Kemaraj Sri Krishnadasa Prakashani 1997, Pg: 494.
26. Raja radha kanta deva, shabda kalpa drum, 3rd ed, choukhambha Sanskrit series
varanasi; 1967, P-375.
27. Bapalal. G. Vaidya, Nighantu Adarsha Vatadi varga, Sloka-1, ist ed, Varanasi:
Choukhamba Bharati Academy: 1968. Pg:467.
28. K.R. Kirtikar, B.D. Basu, Indian medicinal plants Vol-3rd 2nd Ed, Dehra Dun:
International Book Distributors; 1975 pg: 2319.
29. V.M. Gogate, Ayurvedic Pharmacology and Therapeutic uses of medicinal plants
1st ed, Bombay Bharatiya vidhya Bhavan; 2000. Pg: 659.
30. www.google.com/botanjcallassification/Ficuslacor
31. Saxena, N.B, Plant taxanony, 3rd ed, Merrut; Pragati Prakashana; 2001, P-453-
455.
32. The Ayurvedic Pharmacopeia of India Vol 3rd , 1st revised ed, Government of
India; ministry of health and welfare; 1999, pg:135.
33. The Ayurvedic Pharmacopeia of India Vol 4th , 1st ed, Government of India;
ministry of health and welfare; 1999, pg:93-94.
34. Dr. G.S. Pandey, Bhavaprakash Nighantu, Vatadi sloka-11, Varga 6th ed,
Choukambha bharati Academy Varanasi, 1982, Pg: 518.
35. P.V. Sharma, Dravyaguna vijnana Vol-II, 16th ed, Varanasi; Chowkhambha
Bharati Academy; 1994, Pg: 670-671.
36. Dr. S.K. Sharma, Medicinal plants used in Ayurveda, New Delhi, R.A.V.
Publication; 1998, Pg-92-93.
37. Bhavamisra, Bhavaprakasha Nighantu vatadi varga sloka-12. G.S. Pandey editor,
7th ed, Varanasi, Chowkhamba Bharati Academy 1984, Pg: 518.
38. Dhanvantari, Dhanvantari nighantu Amradivarga Sloka-75, P.V. Sharma editor.
1st ed, Varanasi. Chowkhamba orientalia; 1982, Pg: 162.
125
39. Madanapala, Madanapala Nighantu vatadi varga sloka-7, Ramprasad patiyala
editor 1st ed, Bombay: Khemaraj Shrikrishnadas Prakashan; 1988, Pg: 110.
40. Dr. Indradeo Tripathi, Rajanigantu, Amradi varga, Sloka 124, 2nd ed, Krishna das
Academy Varanasi, 1998, Pg:365.
41. Prof. Priyavart Sharma, Kaiyadevanigantu, Aoushadhi varga sloka – 473, 1st ed.
Choukhambha orientalia, Varanasi 1978, Pg: 80.
42. Bapalal G. Vaidya, Nighantu Adarsha Vatavadi varga 1st ed, Varanasi
Choukhamba Bharati Academy; 1968, Pg: 467.
43. Lala saligramaji vaishya, Shaligram Nighantu Bhushanam... varga, Bombay;
Kemraj Sri Krishnadasa Prakashan; 1997, Pg:494.
44. P.V. Sharma, Dravyaguna vijnana vol-II, 16th ed, Varanasi; Chowkhambha
Bharati Academy; 1994, Pg: 670.
45. The Wealth of India, Anonymous Raw materials Vol-IV, Revised ed, New Delhi,
Pub & inf, Directorate CSIR; 1956, Pg:36.
46. C.K. Kokate, Pharmacognosy 18th ed, Pune; Furia Sri D.K. Nirali Prakashan;
2002, Pg: 255.
47. Pandit Kashinath shastri and Dr. Gorakhanath Chaturvedi ed, Charaka samhita
chikitsa sthana chapter-30, Sloka no 118, 17th ed, Choukhambha bharati
Academy, 1991, Pg: 858.
48. Shushruta, Susruta samhita sutra sthana chapter 36, Sloka no- 24, Kaviraj
Ambikadatta shastri editor, 5th ed Varanasi; Chowkhamba Sanskrit samsthana;
Pg: 139.
49. Vagbhata, Astanga hrudaya Chikitsa vol-I, Chapter 15, Sloka-41, K.R.
Shrikantamurthy Vaidya editor, Varanasi, Krishnadas Academy; 1996. Pg:
50. Dr. G.S. Pandey, Bhavaprakash Nighantu, Vatadi varga, Shloka-12, 6th ed.
Choukambha bharati Academy Varanasi, 1982, Pg: 518.
51. Prof. Priyavart sharma, Dhanvantari Nigantu, Amradi varga Sloka-75, 1st ed.
Choukambha orientalia, Varnasi, 1982, Pg:162.
52. Dr. Indradeo Tripathi, Raja nigantu, Amradi varga, Sloka-125, 2nd ed, Krishna das
Academy Varanasi, 1998, Pg: 365.
126
53. Prof. Priyvart Sharma Kaiyadevanigantu, Amradi varga Sloka 437, 1st ed,
Choukambha Orientalia, Varanasi 1978, Pg: 80.
54. Bapalal G. Vaidya, Nighantu Adarsha Vatadi varga, 1st ed, Varanasi;
Choukhamba Bharati Academy; 1968, Pg: 466.
55. Sri Vishwanath dvivedi, Dravya guna Hastamalak vata kula; 3rd ed, Jaipur;
Premalata Nathanhi publication scheme: 1995, Pg: 357-358.
56. Madanapala, madanapala Nighantu Vatadi varga, Sloka-7, Ramprasad Patiyala
editor, 1st ed, Bombay; Khemaraj Shrikrishnadas Prakashan; 1988, Pg: 110.
57. P.V. Sharma, Dravya guna Vijnana Vol-II, 16th ed, Varanasi; Choukhambha
Bharati Academy; 1994, Pg: 670.
58. P.V. Sharma, Dravya guna vijnana, Vol-II, 16th ed, Varanasi; Choukhambha
Bharati Academy; 1994, Pg: 671.
59. Dr. Indradeo Tripathi, Rajanagantu, Amradi varga, Sloka-125, 2nd ed, Krishna das
Academy Varanasi, 1998, Pg: 365,
60. Dr. G.S. Pandey, Bhavaparakash Nighantu, Vatadi varga 6th ed, Choukambha
Bharati Academy Varnasi, 1982, Pg: 518.
61. Bapalal G. Vaidya, Nighantu Adarsha Vatadi varga, 1st ed, varnasi; Choukhambha
Bharati Academy; 1968, Pg: 467.
62. K.M. Nadakarnis, Indian material medical Vol-I, A.K. Nadakarni, 3rd ed,
Bombay; Popular Prakashan; 1982 Ptg: 551.
63. V.M. Gogate, Ayurvedic Pharmacology and Therapeutic uses of medicinal plants
1st ed, Bombay; Bharatiya vidhya Bhavan; 2000, Pg: 659.
64. Pandit Kashinath Shastri and Dr. Gorkhnath Chaturvedi Charaka samhita,
Chikitsa sthana, Chapter-30, Sloka-120. 17th ed, Choukhambha bharati Academy,
1991, P-858.
65. Shushruta, Sushruta samhita sutra sthana chapter 36, Sloka-24 Kaviraj
Ambikadatta shastri editor, 5th ed, Varanasi: Chouwkhamba Sanskrit samsthana;
Pg-139.
66. Vagbhata, Astanga Hrudaya Chikitsa Vol-I Chapter 15, Sloka-41, K.R.
Shrikantamurthy vaidya editor, Varanasi; Krishnadas Academy; 1996 Pg:
127
67. Dr. G.S. Pandey, Bhavaprakash nighantu, Vatadi varga Sloka-12, 6th ed,
Choukhambha bharati Academy Varanasi, 1982, Pg: 518.
68. Prof. Priyavart Sharma, Kaideva nighantu, Amradi varga, Sloka 437, 1st ed,
Choukhambha orientalia, Varanasi 1978, P: 80.
69. Dr. Indradeo Tripathi, Rajanighantu, Amradi Varga Sloka-125, 2nd ed, Krishna
das Academy Varanasi, 1998, Pg:365.
70. Madanapala, Madanapala nighantu vatadi varga Sloka-7, Ramprasad patiyala
editor, 1st ed, Bombay; Khemaraj Shrikrishnadas Prakashana; 1988, Pg: 110.
71. Prof. Priyavart Sharma, Dhanvantari nigantu, Amradi Varga Sloka-75, 1st ed,
Choukambha Orientalia, varanasi 1982, Pg: 162.
72. Bapalal G. Vaidya, Nighantu Adarsha Vatadi varga, 1st ed, Varnasi:
Choukhambha Bharati, Academy; 1968, Pg: 468.
73. P.V. Sharma, Dravya guna vijnana Vol-II, 16th ed, Varanasi; Choukhambha
Bharati Academy; 1994, Pg: 673.
74. J.L.N. Shastri, Dravyaguna, vijnana, 1st ed, Varanasi, Choukhambha orientalia;
2004, P-947.
75. V.M. Gogate, Ayurvedic Pharmacology and therapeutic uses of medicinal plants
1st ed, Bombay; Bharatiya vidhya Bhavan; 2000. Pg: 660.
76. K.M. Nadakarnis, Indian material medical Vol-I, A.K. nadakarni ed, 3rd Bombay;
popular prakashan; 1982, Pg: 551.
77. P.V. Sharma, Dravyaguna vijnana Vol-II, 16th ed, Varanasi, Choukhambha
Bharati Academy; 1994, Pg: 672.
78. Shri Vishwanath divedi, Dravya guna Hastamalak vata kula, 3rd ed, Jaipur;
Premalata Nathani Publicatrion Scheme; 1995, Pg: 358.
79. V.M. Gogate, Ayurvedic Pharmacology and Therapeutic uses of medicinal plants
1st ed, Bombay Bharatiya Vidhya Bhavan; 2000, Pg: 661.
80. K.M. Nadakarnis, Indian material medical Vol- I, A.K. Nadakarni 3rd ed,
Bombay; Popular Prakashan; 1982, Pg: 552.
81. Pandit Kashinath Shastri and Dr. Gorakhnath Chaturvedi ed, Charaka Samhita.
Chikitsa sthana, Chapter-30, Sloka-118-120, 17th ed, Chaukhambha Bharati
Academy 1991.
128
82. www.google.com
83. Dr. G.S. Pandey, Bhavaprakash nighantu, Maduvarga, 6th ed, Choukambha
bharati Academy varanasi 1982, Pg; 759-761.
84. Prof. Priyavart Sharma, kaideva nigantu, Aoushadhi varga, Sloka- 175-178, 1st ed,
Choukhamba orientalia varanasi,1979, Pg; 36.
85. C.K. Kokate, Pharmacognosy 18th ed. Pune: Furia D.K. Nirali Prakashan; 2002,
Pg; 140.
DISEASE REVIEW
86. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 2) 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi.
Chikitsa Sthana,30th Chapter,Shloka-119,pp-767.
87. Sushruta Samhita,By kaviraj Ambika dutta shastri (Part 2) . Choukhamba
Sanskrit Sansthan,Varnasi.Uttara sthana,38th Chapter,pp-156.
88. Ashtanga Samgraha of Vaghbhata,By Prof k.R.Srikantha Murthy,Vol 3 1st
Edition,1997,Choukhamba Orentalia,Varnasi.Uttara Sthana 39th Chapter,pp-
335.
89. Ashtanga Hrudaya,By Prof k.R.Srikantha Murthy,Krishna Das Academy,Vol
2nd Edition,1997.Uttara Sthana 33rd Chapter,Shloka-44,pp-313.
90. Madhava Nidana of Sri Madavakara,By Sri Sudarshana Shastri,(Part-2) 31st
Edition,2002.Choukhambha Sanskrit Samsthan. 61st Chapter,Shloka-3,pp-346.
91. Chakrapani Coments on Charaka Samhita of Agnivesha of Chakrapani
Datta,By Kashinath Shastri(Part 2) 8th Edition 2004. Choukhamba Sanskrit
Sansthan,Varnasi. Chikitsa Sthana,30th Chapter,Shloka-119,pp-767.
92. Sharangadhara Samhita,By Dr Brahmanand Tripati,1st Edition 1990,Pratama
Kanda,Choukhamba Surabharati Prakashana,Varnasi.7th Chapter,Shloka-
177,pp-45.
93. Sharangadhara Samhita,By Dr Brahmanand Tripati,1st Edition
1990,Madhayama Kanda,Choukhamba Surabharati Prakashana,Varnasi.2nd
Chapter,Shloka-110- 114,pp-69.
129
94. Bhavaprakash of Sri Bhava Mishra,By Sri Brahmashankar
Mishra.Chaukhamba Sanskrit Series,Varnasi.Streerogadhikara,68th
Chapter,pp-755.
95. Yoga Ratnakar By Dr Indradev Tripathi,Krishnadas Academy,Varnasi,1st
Edition,1998.Streerogadhikara,pp-802.
96. Baishjya ratnavali,By Sri Ambikadatta Shastri,Ayurvedacharya,Chaukhambha
Sanskrit Sansthan.Pandu Roga Chikitsa Prakarana,pp-266.
97. Shabda Kalpa druma,by Raja Radha Kanta deva (Part 5).The Chaukhambha
Sanskrit Series,Varnasi.pp-181.
98. Shabda Kalpa druma,by Raja Radha Kanta deva (Part 3).The Chaukhambha
Sanskrit Series,Varnasi.pp-274.
99. Ibid.
100. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 2) 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi.
Chikitsa Sthana,30th, Chapter,Shloka-209,pp-777.
101. Ibid,30th Chapter,Shloka-13,pp-752.
102. Ibid,30th Chapter,Shloka-223,pp-779.
103. Ibid,30th Chapter,Shloka-116,pp-769.
104. Ibid,30th Chapter,Shloka-117,pp-767.
105. Ibid,30th Chapter,Shloka-116,pp-767.
106. Ashtanga Samgraha of Vaghbhata,By Prof k.R.Srikantha Murthy,Vol 3 1st
Edition,1997,Choukhamba Orentalia,Varnasi.Uttara Sthana 5th Chapter
Shloka-116.
107. Sushruta Samhita,By kaviraj Ambika dutta shastri (Part 1) . Choukhamba
Sanskrit Sansthan,Varnasi,Sharera Sthana 5th ChapterShloka-32,pp-46
108. Ibid,5th Chapter,Shloka-44,pp-47.
109. Ibid,1st Chapter,Shloka-27,pp-7.
110. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 2), 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi.
Chikitsa Sthana,30th, Chapter,Shloka-12.
130
111. Yoga Ratnakar By Dr Indradev Tripathi,Krishnadas Academy,Varnasi,1st
Edition,1998.utara Sthana,14th Chapter.
112. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 2), 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi.
Chikitsa Sthana,30th , Chapter,Shloka-115,pp-767.
113. Sushruta Samhita,By kaviraj Ambika dutta shastri (Part 1) . Choukhamba
Sanskrit Sansthan,Varnasi,Nidana Sthana 1st ChapterShloka-37,pp-231.
114. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 1), 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi
Sutra Sthana,28th Chapter, Shloka-11-12,pp-571.
115. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 2), 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi.
Chikitsa Sthana,30th, Chapter,Shloka-42.
116. Ibid,Shloka-116,pp-767.
117. Ibid.
118. Ibid.
119. Sharangadhara Samhita,By Dr Brahmanand Tripati,1st Edition
1990,Madhayama, Kanda,Choukhamba Surabharati Prakashana,Varnasi.2nd
Chapter,Shloka-113- 116,pp-149.
120. Charaka Samhita of Agnivesha of Chakrapani Datta,By Kashinath
Shastri(Part 2), 8th Edition 2004. Choukhamba Sanskrit Sansthan,Varnasi.
Chikitsa Sthana,30th, Chapter,Shloka-173,PP-774.
121. Ibid,Shloka-72,pp-761.
122. Sharangadhara Samhita,By Dr Brahmanand Tripati,1st Edition
1990,Madhayama Kanda,Choukhamba Surabharati Prakashana,Varnasi.2nd
Chapter,Shloka-112,pp-149.
123. Ibid.
124. Ibid,Shloka-116,pp-150.
125. Bhavaprakash of Sri Bhava Mishra,By Sri Brahmashankar Mishra.
Chaukhamba, Sanskrit Series,Varnasi,Chikitsa Sthana,70th Chapter,pp-774.
131
126. Jeffcoates Principles of Gynaecology,5th edition 1987,Butterworth,Heinemann
International Editions,Revised by V.R.Tindall .pp 550-552.
127. Shaws Texts book of Gyaenecology,B.I.Churchill living stone Pvt Ltd,New
Delhi.11th edition-1994.pp 130,131,139.
128. C.S Dawn,Text book of Gynaecology,Contraception and Demography.14th
edition-2003,Dawn books,Kolkota.pp 150.
129. Khandelwal, K.R. Practical Pharmacognesy, III ed, Pune, Nirali Prakashana
2000, Pg; 149-160.
130. Khandelwal K.R. Practical pharmacology Technique & experiments, 9th
edition. Pune Nirali Prakashana; 2002. Pg. 149-153.
References
28. msɤÉÉå eÉÌOû mÉMïüUÏ cÉ mÉMïüOûÏ cÉ mÉMïüOûÏ cÉ Îx§ÉrÉÉqÉÌmÉ || 11||
msÉ¤É MüwÉÉrÉÈ ÍzÉÍzÉUÉå uÉëëhÉÉrÉÉåÌlÉaÉSÉmÉWûÈ |
SÉWûÌmɨÉMüTüxÉë klÉÈ zÉÉåjÉWûÉ U£üÌmɨɾÒûiÉç || 12 || (pÉÉ.mÉë.ÌlÉ) (uÉOûÉÌSuÉaÉï)
29. ÌmÉmmÉËU: ´É×ÇÌaÉMüÉ uÉÉOûÏ aÉSïpÉÉhQûÈ MüqÉhQûsÉÑÈ ||435||
msɤÉ: msÉuÉÉå aÉlkÉqÉÑhQûÉå qÉÑÎhQûMüÉåÅxuÉijÉmɧÉMüÈ ||
mÉÔaÉqÉÔhQû¶ÉÉÂSÉÂ È xÉÑmÉÉμÉï¶ÉçÃSzÉïlÉÈ ||436||
ÌmÉmmÉËUxiÉÑuÉUÈ zÉÏiÉÉå uÉëhÉrÉÉåÌlÉÌuÉxÉmÉïlÉÑiÉç |
SÉWûÌmɨÉMüÄTüMüxÉëklÉÉå qÉåSÈ ÌmɨÉÉxÉëzÉÉåÄTüÎeÉiÉç || 437|| (Mæü.Så.ÌlÉ) AÉæwÉÍkÉ uÉaÉï)
30. msɤÉ: MümÉÏiÉlÉÈ ¤ÉÏUÏ xÉÑmÉÉμÉæÅjÉ MüqÉhQûsÉÑÈ |
´ÉÑ…ûÏ uÉUÉåWûzÉÉUuÉÏ cÉ aÉSïpÉhQûÈ MümÉÏiÉMüÈ |
SØûQûmÉëUÉåWûÈ msÉuÉMüÈ msÉuÉQè¶É qÉWûÉoÉsÉÈ || 123||
msɤɶÉåzÉcÉæuÉÉmÉUÉå ¾ûxuÉÈ xÉÑzÉÏiÉÈ zÉÏiÉuÉÏrÉïMüÈ |
mÉÑhQíûÉåû qÉWûÉÅuÉUÉåWû¶É ¾ûxuÉmÉhÉïxiÉÑ ÌmÉqmÉËUÈ |
ÍpÉSÒUÉå qÉ…ûsÉcsÉÉrÉÉå ¥ÉçårÉÉå ²ÉÌuÉzkÉÉÍqÉkÉÈ ||124||
msɤÉÈ MüOÒûMüwÉÉrɶÉç ÍzÉzÉÏUÉå U£üSÉåwÉÎeÉiÉç |
qÉÔcNïûpÉëqÉmÉësÉÉmÉlkÉÉå WûxuÉsmɤÉÉå ÌuÉzÉÉåwÉiÉÈ || 125|| (UÉeÉ.ÌlÉ) (AÉqÉëÌSuÉaÉï)
31. msɤÉ: MümÉÏiÉlÉÈ ´ÉÑ…ûÏ xÉÑmÉÉμÉæ¶ÉÉÂSzÉïlÉÈ |
msÉuÉMüÉå aÉSïpÉhQû¶É MüqÉhQûsÉÑC uÉïOûsmÉuÉÈ || 74||
qÉÔNïû´ÉqÉmÉësÉÉmÉÉ¶É WûUåiÉç msɤÉÉå ÌuÉzÉåwÉiÉÈ || 75|| (kÉ.ÌlÉ) (AÉqÉëÌSuÉaÉï)
32. msÉuɶÉçÃuÉפÉÈ xÉÑmÉÉμÉÉå aÉpÉïpÉÉhQûMüÈ |
uÉOûÏ MüqÉhQûsÉÑrÉÑïmÉÈ ÌmÉmmÉËU¶ÉÉÂSzÉïlÉÈ |
msɤÉÈ zÉÏiÉÉå uÉëhÉzsÉåwqÉÉÌmɨÉzÉÉåjÉÌuÉxÉmÉïÎeÉiÉç ||7|| (qÉSlÉmÉsÉ. ÌlÉ) (uÉOûÉÌSuÉaÉï)
34. msɤÉÉåeÉOûÏmÉMïüUÏcÉMümÉïUÏcÉÃSïzlÉÏ |
´ÉÑ…ûÏuÉUÉåWûzÉÉUÌuÉcɽμÉijÉÏÌmÉÇmÉUÏuÉOûÏ ||
msɤÉÈ MüOÒûÈ MüwÉrɶÉzÉÏzÉÏUÉåU£üSÉåwÉÎeÉiÉç |
qÉÔNïûpÉëqÉmÉësÉÉmÉblÉÉå¾èxuÉmÉiÉÉåÌuÉzÉåwÉiÉÈ | (zÉÍsÉaÉëqÉ ÌlÉ) (uÉiÉÉÌSuÉaÉï)
AlÉÑmÉÉlÉ
84. qÉkÉÑ xuÉÉSÒ ÌWûqÉ Ã¤É MüwÉÉrÉlÉÑUxÉ sÉbÉÑ |
SÏmÉlÉÇ aÉëÉÌWû cɤÉÑwrÉÇ xuÉjÉïÇ uÉhrÉïÇ ÌuÉsÉåmÉlÉqÉç || 205 ||
xÉÉæMÑüqÉÉrÉïMüUÇ uÉ×wrÉÇ ¾Òû±Ç xÉëÉåuÉÉåÌuÉzÉÉåkÉlÉqÉç |
xÉÔ¤ÉqÉÇ qÉåkÉÉMüUÇ NåûÌS uÉëlÉzÉÉåkÉlÉUÉåmÉhÉqÉç ||
ÌuÉUÉSÇ UÉåcÉlÉÇ ¾ûÉÌS mÉëxÉÉSeÉlÉlÉÇ eÉrÉåiÉç |
qÉåSÈ ÌmɨÉMüTüμÉÉxÉ ÌWûkqÉqÉåWûuÉÍqɤÉrÉÉlÉ ||
SÉåwɧÉrÉÉÌiÉxÉÉUxÉëiÉ×wÉhÉÉ SÉWûÌuÉwÉM×üÍqÉlÉç |
MÑü¹ÉzÉÉåïU£üÌmɨÉblÉÇ rÉÉåaÉuÉÉÌWû cÉ uÉÉiÉsÉqÉç ||
uÉÉiÉsÉÇ uÉÉiÉMüÉåmÉåÅÌmÉ uÉwÉïwÉÑ qÉkÉÑ zÉxrÉiÉå | (Mæü.ÌlÉ. AÉæwÉÍkÉ uÉaÉï)
“Management of Shweta Pradara with Plaksha Twak” 1
DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA D.G.M.A.M.C.GADAG
SPECIAL CASE SHEET FOR “MANAGEMENT OF SHWETA PRADARA WITH PLAKSHA TWAK”
Guide: Dr. Kuber Sankh, M.D (Ayu), Schoar: Dr. Kalavati. D. Petlur
Asst. Prof., P.G. Dept of Dravyaguna.
1) Name of the Patient
2)Father’s / Husband’s name
Sl.No
3) Sex Male Female OPD No
4) Age Years IPD No
5) Religion Hindu Muslim Christian Other
6) Occupation Sedentary Active Labour
7) Marital status Married Unmarried Widow
8) Economical status Poor Middle Higher middle Higher class
9) Address
Contact No: Pin
10) Selection Included Excluded
11) Schedule Initiation
Date
Completion
Date
Well responded Moderately responded 12) Result
Responded Not responded Discontinued
13) INFORMED CONSENT I Daughter/Wife of am
exercising my free will, to participate in above study as a subject. I have been informed to my satisfaction,
by the attending physician the purpose of the clinical evaluation and nature of the drug treatment. I am also
aware of my right to opt out of the treatment schedule, at any time during the course of the treatment.
EzÀÄ £Á£ÀÄ ²æ/²æªÀÄw ___________________________________________________ £À£Àß
¸ÀéEZÉѬÄAzÀ PÉÆqÀĪÀ aQvÁì ¸ÀªÀÄäw. ¥Àæ¸ÀÄÛvÀ £ÀqÉ¢gÀĪÀ aQvÁì ¥ÀzÀÞwAiÀÄ §UÉÎ £À£ÀUÉ aQvÀìPÀjAzÀ ¸ÀA¥ÀÇtð
ªÀiÁ»w zÉÆgÉwzÀÄÝ ªÀÄvÀÄÛ AiÀiÁªÁUÁzÀgÀÄ aQvÉì¬ÄAzÀ »AwgÀÄUÀ®Ä ¸ÁévÀAvÀæ÷å«zÉ JAzÀÄ w½¢gÀÄvÉÛ£É.
gÉÆVAiÀÄ gÀÄdÄ/Patient's Signature
“Management of Shweta Pradara with Plaksha Twak” 2
14) Chief Complaints (Pradhana vedana) : Complaints - Lakshana Duration
1 Excessive vaginal discharge (White, Red tinged, Creamy)
2 Persistent vulval moistness 3 Extensive pruritis 4 General weakness 5 Pain in lumbar region 6 Dragging sensation in abdomen 7 Anya Laxanas
15) Associated Complaints (Anubandha vedana) :
Associated Complaints - Lakshana Duration 1 Katishoola (Back Pain) 2 Jwara (Fever) 3 Anga marda (Malaise) 4 Udara shoola (Abdominal pain) 5 Dourbalya (Weakness) 6 Yoni daha (Burning sensation)
16) Occupational History (if any) : 17) Personal History (Vaiktiyaka vrutanta) : Food habits Vegetarian Mixed diet Taste preferred Sweet Sour Salty Pungent Bitter Astringent Agni Sama Vishma Manda Teekshna Kosta Mrudu Mandhyama Krura Nidra Day Night Sound Distrubed Addictions Tobacco Alcohol Drugs Bowel habits Normal Loose Constipated Menstrual History Regular Irregular Amenorrhea Menopause Family history – Specify if any has the same disease
Other system medications Treatment history (if any) Obstetric history (if any)
Gynaecological History (if any)
History of past illness (if any)
“Management of Shweta Pradara with Plaksha Twak” 3
18) Examination of Patients
a) Vitals:
1. Temp F 2. Pulse rate /min 3. Resp. Rate /min 4. B.P Mm of hg 5. Height M 6. Weight Kgs
b) Systemic:
System Findings G.I.T Respiratory system Cardio vascular system Central nervous system Genito urinary system
c) Ayurvedic methods of Examination:
Prakruti V P K VP VK PK VPK
Sara Pravara Avara Madhyama Samhanana Susamhita Asamhita Madhyma samhita Pramana Height in Cms Weight in Kgs Satmya Ekarasa Sarvarasa Ruksha Sneha Satwa Pravara Avara Madhyama Ahara Shakti Abhyavaharana Jarana Vyayam Shakti Pravara Avara Madhyama Vaya Balya Yauvana Vardhakya
Nadi Dosha Pravrutti
Gati Varna
Purnata Gandha
Spandana Kathinya
Mutra
Jihwa Ardra Sushka Sama Nirama Lepa Nirlepa
Mala
Shabda Sparsha Sheeta Ushna
A
stas
than
a
Drik Akruti
“Management of Shweta Pradara with Plaksha Twak” 4
d. Local Examination (Yoni Pareeksha) :
( SzÉïlÉiÉÈ LuÉqÉç xmÉzÉïiÉÈ) 1. External genital organ - vulval (Bahya yoni)
a. Prakrata e. Vaivarnya
b. Vaikruta f. Shotha
c. Vruna g. Utseda
d. Pidaka h. Anya
2. Yoni Mukha
a. Samvruta d. Srava
b. Ragata e. Anya
c. Vivruta
3. Yoni Patha
a. Ragatha
b. Shotha
c. Anya
4. Grabhashaya Greeva (By speculum examination)
a. Tanu e. Vruna
b. Bahula f. Arsha
c. Mrudu g. Mamsankurani
d. Kathina h. Anya
5. Srava a. Pramana - Bahula, Natibahula, Alpa b. Gandha - Visra, Pooti, Knupa, Anya c. Varna - Sweta, Pandu, Raktabha Rakta shyava varna Anya 6. Guna - Picchita, Drava, Ghana, Tanu, Phenila, Pooya, Grathita
“Management of Shweta Pradara with Plaksha Twak” 5
19) Nidana:
Ahara Vihara Anya Nidanarthakara
Vyadhi
Abhishyandi Ahara Diwaswapna Vegavarodha Ajeerna
Lavana amla katu Avyayama Manasika karana Agnimandya
Viruddha ahara Yoni
Aprakshana
Upapluta
Adhyashana Atimiathuna Acharana
Aticharana
Atyananda
20) Samprapti Ghatakas
a. Dosha e. Dooshya
b. Agni f. Ama
c. Srotas
d. Dusti Prakara
21) Investigations (Prayoga shala pareeksha krama)
1) Erythrocyte Sedimentation Rate
2) Hb%
3) Differential count - Lymphocytes
Neutrophils
Eosinophils
Basophils
Monocytes
4) Total count
5) Vaginal smear test
6) Vaginal Ph
“Management of Shweta Pradara with Plaksha Twak” 6
22) Treatment Schedule (Plaksha twak kashaya – 50 ml as vaginal douch for 21 days)
Day Date Investigator’s Note
Day 1
Day 7
Day 14
Follow up
Day 21
23) Assessment
A) Disease Assessment
1) Subjective Parameters Before After Difference
BA
1 Excessive vaginal discharge
(White, Red tinged, Creamy)
2 Persistent vulval moistness
3 Extensive pruritis
4 General weakness
5 Pain in lumbar region
6 Dragging sensation in abdomen
7 Anya Laxanas
1 Vaginal PH 2 Vaginal Smear
“Management of Shweta Pradara with Plaksha Twak” 7
Grades of assessment
1) Excessive vaginal discharge
Gr-O No Discharge
Gr-1 Persistent moistness of Vulva
Gr-2 Need to change the undergarments frequently
Gr-3 Need to use an extra cloth or pad
2) Persistent vulval moistness
Gr-O No Moistness
Gr-1 Mild moistness
Gr-2 Moderate moistness
Gr-3 Severe moistness
3) Extensive pruritis
Gr-O No Pruritis
Gr-1 Occasionally pruritis
Gr-2 Pruritis through out the day
Gr-3 Increases particular time of day/night
4) General weakness
Gr-O No Weakness
Gr-1 Patient is able to involve in routine
activity
Gr-2 Patient is slow to involve in routine
activity
Gr-3 Patient feels exhausted to involve in
routine activity
5) Pain in lumbar region
Gr-O No Pain
Gr-1 Mild
Gr-2 Moderate
Gr-3 Severe
6) Dragging sensation in abdomen
Gr-O Normal
Gr-1 Mild
Gr-2 Moderate
Gr-3 Severe
7) Vaginal Smear
Gr-O Negative (No abnormal findings)
Gr-1 Inflammatory smear
Gr-2 Inflammatory smear with organisim
Investigators Note
Signature of Guide:
(Dr. Kuber Sankh,) M.D (Ayu),
Signature of Scholar:
(Dr. Kalavati D. Petlur)