Auto immune vasculopathy and scleroderma ayurvedic perspective

1. AUTO IMMUNE VASCULOPATHY ANDAUTO IMMUNE VASCULOPATHY AND
SCLERODERMASCLERODERMA
AYURVEDIC PERSPECTIVEAYURVEDIC PERSPECTIVE
DR.PRASHANTH.A.SDR.PRASHANTH.A.S
MD(Ay), PhD, MHA,PGMHMD(Ay), PhD, MHA,PGMH
ProfessorProfessor
Department of Post Graduate Studies in PanchakarmaDepartment of Post Graduate Studies in Panchakarma
Ayurveda Maha VidyalayaAyurveda Maha Vidyalaya
Hubli, Karnataka – 580024Hubli, Karnataka – 580024
Telephone: 0836-2335575Telephone: 0836-2335575
Mob: +91-94481-35575Mob: +91-94481-35575
Mail:Mail: drprashanthas@gmail.com

2. AUTO IMMUNE DISORDERS
•Autoimmune diseases are conditions in which the immune system of
thebody treatsitsown tissuesasforeign And triesto destroy them
•There are more than 80 different types of autoimmune disorders.
Autoimmune diseases arise from an overactive immune response of the
body against substances and tissues normally present in the body. In
other words, thebody actually attacksitsown cells.
•Thismay berestricted to certain organsor involveaparticular tissuein
different places.

3. CAUSECAUSE
•Normally theimmunesystem'swhiteblood cellshelp protect thebody
from harmful substances, called antigensand blood or tissuesfrom
another person or species. Theimmunesystem producesantibodiesthat
destroy theseharmful
substances.
•In patientswith an autoimmunedisorder, theimmunesystem can't tell
thedifferencebetween healthy body tissueand antigens. Theresult isan
immuneresponsethat destroysnormal body tissues. Thisresponseisa
hypersensitivity reaction similar to theresponsein allergic conditions.

4. • Thecausesmay includemolecular mimicry, or thepresenceof foetal
cellsin thematernal bloodstream, and infections with someviruses
and bacteria.
An autoimmunedisorder may result in
•Thedestruction of oneor moretypesof body tissue
•Abnormal growth of an organ
•Changesin organ function

5. Organsand tissuescommonly affected by autoimmune
disordersinclude:
• Blood vessels
• Connectivetissues
• Endocrine glandssuch asthethyroid or pancreas
• Joints
• Muscles
• Red blood cells
• Skin

6. COMMON SIGNS ANDSYMPTOMSCOMMON SIGNS ANDSYMPTOMS
Symptomsof an autoimmunediseasevary based on the
diseaseand location of theabnormal immuneresponse. Symptoms
that often occur with autoimmunediseasesinclude:
• Fatigue
• Fever
• General ill-feeling (malaise)
• Anxiety or depression
• Blood sugar changes
• Fatigue
• Infertility or reduced sex drive(low libido)
• Irritability
• Weaknessand stiffnessin musclesand joints
• Weight Changes
• Low or high blood pressure

7. COMMON AUTO IMMUNEDISEASES
• Addison'sdisease
• Celiac disease- Sprue
• Dermatomyositis
• Gravesdisease
• Hashimoto'sThyroiditis
• MultipleSclerosis
• MyastheniaGravis
• PerniciousAnemia
• ReactiveArthritis
• Rheumatoid Arthritis
• Sjogren Syndrome
• Systemic LupusErythematous
• TypeI diabetes

8. VASCULOPATHYVASCULOPATHY
Any disorderof theAny disorderof the bloodblood vesselsvessels

9. VASCULITIS
• Vasculitisrefersto avaried group of
disorderswhich all shareacommon
underlying problem of inflammation of a
blood vessel or blood vessels. The
inflammation may affect any sizeblood
vessel, anywherein thebody. It may affect
either arteriesand/or veins.
• Theinflammation may befocal, meaning that
it affectsasinglelocation within avessel; or
it may bewidespread, with areasof
inflammation scattered throughout a
particular organ or tissue, or even
affecting morethan oneorgan system .

10. CLASSIFICATION
• It can beclassified by theunderlying cause.
• It can beclassified by thelocation of the
affected vessels.
• Vasculittiscan beclassified by thetypeor sizeof the
blood vesselsthat they predominantly affect.
However, thecauseof many formsof vasculitisarepoorly
understood. Thereisusually an immunecomponent, but thetrigger is
often not identified.
Vasculitic disorderscan causeproblemsin any organ system,
including thecentral (CNS) and peripheral (PNS) nervoussystems.
Thesearecharacterized by thepresenceof inflammatory cellsin
and around blood vessels, and secondary narrowing or blockageof
theblood vesselsthat nourish thebrain, spinal cord, or peripheral
nerves.

11. vasculitisisoften classified by thecaliber of thevessel affected.
However, therecan besomevariation in thesizeof thevessels
affected.
Large vessel
Behçet'ssyndrome, Polymyalgiarheumatica, Takayasu'sarteritis,
Temporal arteritis.
Medium vessel
Buerger'sdisease, Cutaneousvasculitis, Kawasaki disease,
Polyarteritisnodosa.
Small vessel
Churg–Strausssyndrome, cutaneousvasculitis, Henoch–Schönlein
purpura, Microscopic polyangiitis, Wegener'sgranulomatosis.
CLASSIFICATION

12. SYMPTOMS
General symptoms:
Fever, weight loss
Skin:-
Palpablepurpura, livedo reticularis
Musclesand joints:-
Myalgiaor myositis, arthralgiaor arthritis
Nervoussystem:-
Mononeuritismultiplex, headache,
stroke, tinnitus, reduced visual acuity,
acutevisual loss

13. Heart and arteries:-
Myocardial infarction,
hypertension, gangrene
Respiratory tract:-
Nosebleeds, bloody cough, lung
infiltrates
GI tract:-
Abdominal pain, bloody stool,
perforations
Kidneys:-
Glomerulonephritis

14. ANCA VASCULITIS
•ANCA vacuitiesisatypeof autoimmuneswelling caused by
autoantibodies.
•ANCA standsfor Anti-Neutrophil Cytoplasmic Autoantibody.
•Autoantibodiesareabnormal antibodiesthat attack one’sown cells
and tissues(autos= self). ANCAS
areautoantibodiesthat attack theinside(cytoplasm)
of acertain typeof whiteblood cellscalled neutrophils.
•When ANCAsattack theseneutrophils, they causethe
whiteblood cellsto attack thewallsof small vessels
in different tissuesand organsof thebody. Thiscauses
vacuities.

15. SCLERODERMA (SYSTEMIC SCLEROSIS)
• Theword “scleroderma” comesfrom two Greek words: “sclero”
meaning hard, and “derma” meaning skin.
• Sclerodermaisadiseaseaffecting theskin and other organsof
thebody. Sclerodermaisoneof theautoimmunerheumatic
diseases, meaning that thebody’simmunesystem isacting
abnormally.
• Themain finding in sclerodermaisthickening and tightening of
theskin, and inflammation and scarring of many body parts
leading to problemsin thelungs, kidneys, heart, intestinal system
and other areas.
• Thecondition affectsadultsand children, but it ismost common

16. TheTwo Main TypesOf SclerodermaAre
Localized scleroderma,
•which usually affectsonly theskin, although it can spread to the
muscles, jointsand bones. It doesnot affect other organs. In some
cases, thistypeof sclerodermaisjust acosmetic problem. Symptoms
includediscolored patcheson theskin (acondition called morphea); or
streaksor bandsof thick, hard skin on thearmsand legs(called linear
scleroderma). When linear sclerodermaoccurson thefaceand
forehead, it iscalled en coup desabre.
Systemic scleroderma,
•which isthemost seriousform of thedisease, affectstheskin,
muscles, joints, blood vessels, lungs, kidneys, heart and other organs.

17. SIGNS ANDSYMPTOMS
Skin symptoms
•systemic sclerosiscauseshardening
and scarring. Theskin may appear tight,
reddish or scaly. Blood vesselsmay also
bemorevisible.

18. Musculoskeletal
Thefirst joint symptomsnon
specific joint pains, which can lead
to
arthritis
Patientsmay develop muscle
weakness, or myopathy.

19. Lungs
•Someimpairment in lung function with
diffusesclerodermaon pulmonary
function testing;
•Progressivepulmonary hypertension, or
elevation in thepressuresof the
pulmonary arteries. Thiscan belead to
right sided heart failure.
•Theearliest manifestation of thismay
beadecreased diffusion capacity on
pulmonary function testing.

20. Digestive tract
•Reflux esophagitis,
•Dysphagia, pseudo-obstruction or
ischemic colitis
•upper gastrointestinal bleeding or
iron deficiency anemia
•Malabsorbtion

21. • Blood vesselsthat can beaffected includethetiny arterioles
of thefinger tips, toes, and elsewhere.
• Thesevesselscan haveatendency to spasm when theareas
areexposed to cold, leading to blueness, whiteness, and
rednessof involved fingers, toes, and sometimesnoseor
ears.
• Thesecolor changesarereferred to asRaynaud's
phenomenon

22. RAYNAUD'S PHENOMENON
It refersto thespasm of thetiny artery vesselssupplying
blood to thefingers, toes, nose, tongue, or ears. Theseareas
turnsblue, white, then red after exposureto extremesof cold, or
even sometimeswith extremesof heat or emotional upset.
Thiscan lead to tiny areasof
Damageto thetipsof thefingers
(digital ulcers) or larger areas
of dead skin on theendsof the
fingers.

23. CLASSIFIED INTO TWOCLASSIFIED INTO TWO
1. Primary Raynaudsphenomenon or Raynaudsdisease
(idiopathic)
2. Secondary Raynaudsphenomenon or Raynauds
syndrome
Commonly seen in..
• Seen inCollagen vascular diseaseeg: scleroderma, SLE,
RA
• Neurological disorderseg: IVDP, syringomyelia, CTS
• Trauma

24. PRIMARY RAYNAUDS PHENOMENONPRIMARY RAYNAUDS PHENOMENON
• Raynaud's disease
• Women affected 5 times than men
• Age – 20-40yrs
• Finger more than toes
• Initially one or two fingers,may include all fingers in
later stages
• Toes affected in 40% of cases

25. SECONDARY RAYNAUDSPHENOMENONSECONDARY RAYNAUDSPHENOMENON
• Raynaudssyndrome
• Occursin 80 to 90% ptswith scleroderma
• Ischemic finger ulcer may develop
• Progressto gangreneand auto amputation

26. ATHEROSCLEROSISATHEROSCLEROSIS
• Atherosclerosis is a progressive inflammatory disorder
of the arterial wall that is characterized by focal
lipid rich
deposits of atheroma.
• Arteries are blood vessels that carry oxygen and
nutrients from
heart to the rest of the body. Healthy arteries are
flexible, strong
and elastic.
• Over time, however, too much pressure in the arteries
can make
the walls thick and stiff — sometimes restricting
blood flow to the

27. FORMATION OFATHEROMAS INFORMATION OFATHEROMAS IN
ARTERIESARTERIES

28. RISKFACTORSRISKFACTORS
• Ageand sex
• Family history
• Smoking
• HTN
• Hyperlipidaemia
• DM
• Physical activity
• Obesity
• Alcohol
• Diet
• Personality

29. ATHEROSCLEROSISATHEROSCLEROSIS
Early atherosclerosis
• Fatty streakstendsto occur at thesiteof arterial shear stress
• Abnormal endothelial function
• Receptorsexpressed by endothelial cells
• Monocytesbindsto thereceptors
• Migrateto intima
• Takeup oxydised LDL from plasma
• Macrophages
• Cytokinesand growth factorsby macrophages
• Smooth musclecell migrateto theintima
• Stabilizestheatherosclerotic lesion
STABLE ATHEROSCLEROTIC PLAQUE
 Early And Advanced

30. Advanced Atherosclerosis
• Macrophagesmediateinflammation
• Smooth musclepromoterepair
• Inflammation predominates
• Plaquebecomeactiveor unstable
• Ulceration
• Cytokineproduction by macrophages
• Intimal smooth musclethinning
• Protectivefibrouscap thinning

31. BUERGER'S DISEASE (TAO)BUERGER'S DISEASE (TAO)
•Thromboangitisobliteransisararediseasein which blood vesselsof the
handsand feet becomeobstructed.
•TAO isinflammatory thrombosisof small and medium-sized arteriesand some
perficial veins, causing arterial ischemiain
distal extremitiesand superficial
thrombophlebitis. Tobacco useistherisk factor.
•Thromboangiitisobliterans
(Buerger'sdisease) iscaused by
vasculitis(inflammation of theblood vessels).
•Theblood vesselsof thehandsand feet are
especially affected, becoming constricted or totally blocked. Thisreduces
blood flow to thehand and foot tissues, resulting in pain and eventually damage.

32. CHURG STRAUSS SYNDROME(CSS)CHURG STRAUSS SYNDROME(CSS)
• CSSisavasculitic diseasethat involvesinflammation of small- to
medium-sized blood vessels.
•CSSischaracterized by asthmaand theproliferation of eosinophil's, a
typeof whiteblood cell.
• Damageto sinuses, lungs, heart, skin, gastrointestinal tract, nerves,
and occasionally kidneysand jointsmay occur.
• Asthmaisoneof thecardinal
featuresof CSS.
• It leadsto vasculitis,eosinophilia,
• numbess, shooting pains, and
severemusclewasting/powein
thehandsor feet.

33. CRITICALLIMBISCHEMIACRITICALLIMBISCHEMIA
• Defined asrest (night) pain with or
without tissueloss.
• Continuouspain, aching in type
• Changesin thesomatic nerves- cry
of dying nerves
• Painful part becomevery sensitive
and any movement or pressure
causesacuteexacerbation
• Multiplelevel
• Risk of loosing their limb or life
• End stagedisease
• Elderly-multi system co-morbidity

34. MYOSITISMYOSITIS
• Myositis isararediseasein which theimmunesystem chronically
inflamesthebody'sown healthy muscletissue. Persistent
inflammation progressively weakensthemuscles.
Inflammatory Conditions Causing Myositis.
• Many of thesecausesareautoimmuneconditions
• Inflammatory conditionscausing potentially severemyositisinclude
1.Dermatomyositis
2.Polymyositis
3.Inclusion body myositis
Other inflammatory conditionstend to causemyositis
•Systemic lupuserythematosus(lupus)
•Scleroderma
•Rheumatoid arthritis

35. SYMPTOMS OFMYOSITISSYMPTOMS OFMYOSITIS
•Themain symptom of myositisismuscleweakness. Theweakness
may benoticeableor it may only bedetectablewith testing. Muscle
pain (myalgias) may or may not bepresent.
•Dermatomyositis, polymyositis, and other inflammatory myositis
conditionstend to produceweaknessthat getsworseslowly over
weeksor months. Peoplewith dermatomyositisalso haveaskin rash,
although it can sometimesbevery mild.
•Theweaknessaffectslargemusclegroups, including theneck,
shoulders, hips, and back. Muscleson both sidesareusually affected.
Juvenile Myositis (JM)
•Although somechildren develop juvenileformsof PM and IBM,
children usually get juvenileDM with symptomsof muscle
weakness, skin rash and dysphagia.

36. DIAGNOSTIC TESTSDIAGNOSTIC TESTS
• Thediagnosisof an autoimmunediseaseisbased on an
individual'ssymptoms,findingsfrom aphysical examination.
• A common featureof thetestsisthedetection of antibodiesthat
react withhost antigens.
• An elevated amount of antibodiesindicatesthat ahumeral
immunereaction isoccurring.
 ANA (Antinuclear Antibody) Test
 C-ReactiveProtein

37. AYURVEDICAYURVEDIC
CONCEPTCONCEPT

38. • Most of theconditionsor diseasesmentioned abovecan be
included under ‘AMAVATA , VATARAKTA AND
RAKTHAVRUTA VATA’ according to Ayurveda.
• It isnecessary to explain themeaning and application of both
termsi.e. Amaand vataaswell Vatadoshaand Raktadhatu.
• TheTridosha(Vata, Pittaand Kapha) work in coordination
and cooperation. If theseTridoshaaredisturbed, thematter,
functionally and structurally disturbed, resultsin disease,
decay, degeneration or death.
AYURVEDIC CONCEPT

39. VATA KOPA NIDANAMVATA KOPA NIDANAM

40. RAKTHA KOPA NIDANAM

41. SIGNSAND SYMPTOMSSIGNSAND SYMPTOMS
• ACCORDING TO DOSHA DOMINENCE
VATA DOSHAMVATA DOSHAM

42. PITTA DOSHAMPITTA DOSHAM

43. KAPHA DOSHAMKAPHA DOSHAM

44. RAKTHARAKTHA

45. COMPLICATIONCOMPLICATION

46. • TheTridoshawhen in normal quantity, quality and function serveas
Dhatu, i.e. they support thebody. When slightly vitiated, they serve
asDoshaand when they excessively vitiatethey aretermed asMala.
• Theimmunebodies, when normal in quantity, quality and function
support thebody, but when excessor lessproducedisease.
ThusimmunecomplexesserveasAma. Based on that themajority
of thediseasesof connectivetissueareto betreated likeAma- Vata
and Vatarakta.
Thusit can bestated that-
• Amaisundigested and un metabolized product produced by the
weaknessof digestiveand metabolic enzymes(Agnimandya).
DOSHIKCONCEPTDOSHIKCONCEPT

47. • Amaisalso called wastematter (Mala), which should be
removed from thebody. If Amamalaremainscontinuously in the
body, it islikely to causediseaseand degeneration.
• AmaisPichila(sticky) in nature
• Theexcessof Collagen materials, Immunebodiesor Crystalslike
Uric acid, can beconsidered asAma.
• Amawhen mixesor reactswith Vata, producesStiffnessof the
joints, Atheroscelerosis(Dhamani pratichaya), Deposition
(Sanchaya) and drynessin thebody tissue(Srotoriktata?) e.g.
S.L.E. or Sclerodermaor Sclerosis.
• Thechief complaintsgenerally noticed arestiffnessand pain in
thebody, especially joint pain, swelling and muscular pain etc.

49. • Themanagement involvesthemethodsof treatment that
aredirected at treating thedoshaand breaking the
samprapti.Depending on thebasic classification of
Vatarakta,AmaVataand Rakthavruthavata
• General lineof management of Vataraktahasbeen advised
in thetextsof Charaka, Sushruta, Vagbhata, Yogaratnakara.
• Lineof treatment in thefirst stageremoval of Ama:
• Thedrugshaving Tikta, Katu rasa(i.e. bitter and pungent taste)
and Deepaniyaproperty (enhancing digestiveability) areAma
pachaka.
• Langhanaand Swedana, Virechana, Snehapanaand Vasti areto
beemployed to alleviateand control the‘vitiated vata’.

50. GENERAL LINE OF TREATMENT
• ASPER CHARAKA SAMHITA
• ASPER ASHTANGA HRIDAYA

51. MANAGEMENTACCORDING TO DOSHAMANAGEMENTACCORDING TO DOSHA
PRADHANYATA:PRADHANYATA:
VATADHIKA
• Ghrita, Taila, Vasa, MajjaprayogaasPana, Abhyangaand Vasti.
• SukhoshnaUpanaha
• Snehapanaby puranaghrita
• Ajaksheera+ Ardrataila+ Prushni parni + Madhu or theseare
cooked with Shyama, Rasnaetc.
• Administration of tailaprepared out of Kakolyadi GanaKalka
ShathapakaBalaTaila.
• Application of Yastimadhu siddhalepas.

52. PITTADHIKAPITTADHIKA
• Virechana, Ghritaand Ksheerapana, Parisheka, Vasti, Sheeta
nirvapa, Raktamokshana.
• Kashayasprepared of,
Draksha, aragvadha,Shatavari, yasti, Patola,Guduchi kwatha.
Chandanadi ganadravyas.
• Lepa–
Shali, shasti, lavanapasted with dhanyamlamixed
with takraand kanji and applied.
• Vataraktaharaoushadhi siddhakwathaparisheka.
RAKTHADHIKARAKTHADHIKA
• Virechana, Ghritaand Ksheerapana, Parisheka, Vasti,
SheetanirvapaRaktamokshana

53. KAPHADHIKA
• Mrudu Vamanaand RookshanaLanghana.
• Kwathas- Amalaki and haridrawith madhu or triphalakwatha.
• GudaHaritaki prayoga.
• Parishekawith taila, gomutra, sura, suktaand kaphagna
oushadhi siddhakwatha.
• Abhyanga - mastu, mutra, sura, sariva, padmakasiddhagritha.
• Pradeha- Tila, sarshapa, atasi yavachurnamixed with
sleshmantaka; kapittha, madhu, sheegru with ksharodhakaand
gomutra; swethasarshapakalka; tilashwagandhakalka; madhu,
sheegru, punarnavakalkawith ksharodaka.
• Lepa- shalaparni, prushni parni, bruhati with ksheera.

54. ANTARPARIMARJANA CHIKITSA
Rakta Mokshana
• Raktamargavaranaisthepredominant pathology of Vatarakta
and thisleadsto theaccumulation of dushitarakta.
Raktamookshanahelpsin relieving theobstruction in thepath of
Vayu also.
HenceRaktamokshanaisconsidered asfirst lineof treatment of
Vatarakta.

55. • Shringavacharanaisthebetter choiceif thepatient of
Vataraktahassymptomslikesupti, kandu, chimachimayanaetc
• If theillnessprogresswith spreading,
Raktamokshanaby Pracchanamethod isthebetter
option.
• Raktamokshanaby theJalaukavacaranamethod ispreferred
if theaffected siteexhibitssymptomslikeruk, dahatoda
and shula.

56. SNEHAPANASNEHAPANA
• Both shodhanangasnehaaswell asshamanangasnehais
indicated in Vatarakta.
• Aspreparation of patient prior to Virechanaor Vamanapatient
issubjected to shodhanangasneha.
• Asshamanaalso different GhritaYogaand TailaYogaare
explained

57. VIRECHANAVIRECHANA
• According to condition both SnigdhaVirechanaaswell asRuksa
Virechanaisindicated in Vatarakta.
• TikshnaVirechanaworsenstheVatakopa, mrudu Virechanais
allwaysindicated in patientssuffering from Vatarakta.
• In casePittanugaand raktanugaVataraktaVirechanaisconsidered
asbetter.
• RuksahaVirechanaisalso ideal in patentssuffering from
margavaranadueto kupitaKaphaand Medas.

58. VAMANAVAMANA
• Vamanaisindicated asashodhanaprocedurein Vatarakta.
• In KaphanugaVataraktashodhanaisbest achieved by
Vamana..
• In snigdhaperson Vamanaiscarried out with minimal or
no prior snehapana.
• In patientswith rukshatain thebody, administration
Vamanakarmawith prior snehapanaisideal.
• Only mrudu Vamana is justified astikshnaVamanatend to
increasetheof Vatadosha.

59. VASTIVASTI
• Vasti karmaincludesboth asthapanaVasti aswell as
anuvasanaVasti.
• VatanugaVataraktaisbetter treated by Vasti chikitsa.
• ThesymptomslikeVasti shula, Vanksanashula, Parshvashula
and Udarashulawhen present Vasti isthetreatment of choice
• Administration of KsheeraVasti isemphasized in all variety
of Vatarakta.
• Further if themargavaranaisdueto accumulation of kapha
and medasLekhanaVasti isindicated asthisVasti iscapable
of clearing themargavaranaalong with negating the
detrimental effect kupitaVataDosha.

60. BAHIPARIMARJANABAHIPARIMARJANA CHIKITSACHIKITSA
PARISHEKAPARISHEKA
• Dominanceof Vatadoshawhen present characterized by
severepain in theaffected part, then ushnaparishekashould
beprescribed.
• Contrary to thisif dahaisthesymptom dueto predominance
of Pittadoshaand Raktadhatu, sheetaparishekaisideal to
relievethediscomfort.
• DHANYAMLA

61. ABHYANGAABHYANGA
• Treatment with abhyangaover theaffected part isplanned according
to thepresenceof symptomsor thedominanceof affected Dosha.
• In severepain duetovatadoshawarm oil processed with Vatahara
dravyaisused for abhynga.
• Burning sensation dueto Pittadoshaor Raktadhatu. Cold
application of theghritaprocessed with pittaharadravyaisideal.
• If kandu dueto Kaphadosha, tailaprocessed with Kaphaharadravya
isused for abhyanga.
• Prasarinyadi
• Balaguduchyadi
• Asanadi
• Chandanadi.
• Pindatailam

62. PRADEHAPRADEHA
• Warm application of kalka(paste) ispreferred if thepatient
suffering from sever pain dueto dushitaVatadosha.
• Medicinal pasteprepared by adding Ghritaapplied cool on the
affected part if thepatient hasburning sensation dueto Pitta
dosha.
• Medicinal pasteprepared with herbshaving ushnaquality is
preferred if relativedominanceof KaphaDoshaor Vata-Kapha
doshaisidentified.

63. • Specific herbal powder madeinto apasteby the
addition of kanji or such other liquidsisapplied when
warm asupanaha, and isvery useful in relieving pain
dueto Vatadosha.
• Sarsapakalka
• Tilakalka
• Erandabeejakalka
• Shatahvakalka
• Vesavara+ sneha+ jeevaneeyaganadravya.
UPANAHAUPANAHA

64. COMON DRUGSCOMON DRUGS
• KASHAYAKASHAYA
Mustadi kashaya, Haritaki kashaya, Panchamoolakashaya, Variyadi
kashaya, Navakarshikakashaya, Guduchyadi kashaya, Kashmaryadi
kashaya, Patoladi kashaya, Laghu manjistadi kashaya, Brihat
manjistadi kashaya.
• GUGGULU:GUGGULU:
Sivagulika,Kaishoraguggulu, Amritaguggulu, Chandraprabha
gutika, Punarnavaguggulu, Samasharkaraguggulu, Triphala
guggulu, Simhanadaguggulu, Langaleegutikaetc.

65. GHRITA:GHRITA:
Shatavaryadi ghrita, Shravanyadi ghrita, Balaghrita,
Amritadi ghrita, Parushakaghrita, MahatiktaghritaJeevaneeya
ghrita, Sthiradi ghrita, Padmakadi ghrita, Drakshaghritaetc.
TAILA:TAILA:
Madhuyastyadi taila, Sthiradi taila, Sarivadi taila, Sukumarak taila
Padmakadi taila, Nagabalataila, Shatahvadi taila, Mahapadma
taila, Khuddakapadmakataila, Shatapakamadhukataila,
Guduchyadi taila, Drakshadi taila, Madhukadi taila, Shatapaka
Sahasrapakabalataila, Pindataila, Erandataila, Laghu
marichyadyataila,
Brihan marichyadyataila, Jeevakadi mahasnehatailaetc:

66. KSHEERA:KSHEERA:
Guduchi ksheera, Dashamooladi ksheera, Drakshadi ksheera,
Baladi ksheera, Jeevaneeyaganasiddhaksheera.
LEPA:LEPA:
Madhukadilepa, Jeevaneeyaganalepa,
Tiladi lepa, Madhuchistapralepa, Prapoundarikadi lepa,
Sarshapadi lepa, Shigru lepa, Kapithadi lepa, Grihadhoomadi
lepa, Tagaradi lepa, Sitopaladi lepa, Madhushigru lepa, Erandadi
lepa,
Shatahvadi lepa, Shatadhoutaghritalepaetc.

67. SWARNA KALPASSWARNA KALPAS
Swarnabhasma,Swarnamahayograj guggulu,swarnamalini
vasantha,
RASAYANAMRASAYANAM
• BhargavaProkthaRasayanam, Silajathu Prayoga, Kanmadam,
Sudhaguggulu,Chyavanaprasam, Brahmarasayanam,
Lasunaprayogam.

68. THANK YOUTHANK YOU
Dr. PRASHANTH. A. S.
M.D. (Ay),(Ph.D.),MHA,PGMH
PROFESSOR
DEPARTMENTOFPOSTGRADUATESTUDIES IN PANCHAKARMA
AYURVEDA MAHAVIDYALAYA, HUBLI(KARNATAKA)