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eISSN 2348 0173 : pISSN-2395-3985
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vi
CONTENTS
Article
Title & Author Page No
No.
REVIEW ARTICLES
1 YOGA AND PRANAYAMA DURING PREGNANCY 60-68

G.M.Kavya1*, Sushila Sharma 2
CONCEPT OF RAJONIVRITTI (MENOPAUSE) ACCORDING TO AYURVEDA WITH SPECIAL

2 69-74
REFERENCE TO MENOPAUSE
Radha Harshad Phadnis 1*, Neeta Mahesekar 2
3 A CONCEPTUAL OVERVIEW OF TRADITIONAL KNOWLEDGE DIGITAL LIBRARY (T.K.D.L.) 75-79

Pallavi Vyankatrao Bhange 1*, Yogesh Shivmurti Bhatambre 2
ORIGINAL RESEARCH ARTICLE
STANDARDIZATION AND COMPARATIVE STUDY OF SHILAJEETA W.S.R.T. MARKET

4 80-84
SAMPLE
Parhate Saroj M.1*, Khaparde P. H.2
IMPACT OF 2002 AMENDMENTS TO CONSUMER PROTECTION ACT, 1986: A

5 85-95
RETROSPECTIVE STUDY IN CASES OF MEDICAL NEGLIGENCE
Barapatre Nishant Bhimraj 1*, Joglekar Vishnu Prabhakar 2
6 USE OF RASONKALKA IN ADHMANA 96-100

Deshmukh Avinash Madhav1*, Amale Deepali J.2, Gaikwad Madhavi D.3
STUDY OF KUSUMBHA OIL (CARTHAMUS TINCTORIUS- LINN) W.S.R. LOMASHATANA

7 101-106
KARMA (HAIR GROWTH INHIBITING ACTION)
Vidya Vaijnath Yadav 1*
CASE REPORT
ANATOMICAL CHANGES IN TWAK SHARIR W.S.R. TO PEMPHIGUS VULGARIS - A CASE

8 107-110
STUDY
Dobade Deepak K.1*, Sharma Gopal B.2
EFFECT OF JALAUKAVACHARAN (BLOOD-LETTING BY LEECHES) IN ACUTE

9 111-114
APPENDICITIS: A CASE STUDY
Sarvesh Chikte 1*, Piyush Gandhi 2, Shailesh Deshpande 3, Jayant Phadke 4, Yogini Kulkarni 5
FUTURE EVENTS
10 CONFERENCES / SEMINARS / SYMPOSIA 115
Entire ISSUE IJAAM- Vol:4/ Issue:2/ March- April - 2016
*****

vii
INTENTIONALLY
KEPT
BLANK

viii
VOL 4 eISSN-2348-0173
INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE pISSN-2395-3985
ISSUE 2 (2016)
REVIEW ARTICLE
Scientific Journal Impact Factor 5.733 (2015) by InnoSpace Sci. Res., Morocco
YOGA AND PRANAYAMA DURING PREGNANCY
G.M.Kavya1*, Sushila Sharma 2
1. Ph.D. Scholar, Dept. of Prasuti Tantra, National Institute of Ayurveda, Jaipur-302002. India,
Contact No. +91 9902345121, Email dr.kavyajain@gmail.com
2. Associate Professor & HOD, P.G. Dept. of Prasuti Tantra, National Institute of Ayurveda, Jaippur-
302002. India, Contact No. +919660843984, Email - sushila.sharma.s@gmail.com
Article Received on - 18th Sept 2015

Article Revised on - 29th Feb 2016
Article Revised on - 29th Mar 2016
Article Accepted on - 27th May 2016
All articles published in IJAAM are peer-reviewed and can be downloaded, printed and
distributed freely for non commercial purpose (see copyright notice below).
(Full Text Available @ www.ijaam.org)
60
Page
2013 IJAAM
This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en_US), which permits unrestricted non commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
G.M.Kavya, Sushila Sharma, Yoga and Pranayama During Pregnancy, Int. J. Ayu. Alt. Med., 2016; 4(2):60-68
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
REVIEW ARTICLE
YOGA AND PRANAYAMA DURING PREGNANCY
*Corresponding Author ABSTRACT:

Yoga is an extraordinary spiritual science of self development and self realization
G.M.Kavya
that shows us how to develop our full potential in our many sided lives. Ayurveda is
Ph.D. Scholar, Dept. of Prasuti
Tantra, National Institute of the ancient medicine healing system for body, mind and spirit. Yoga and Ayurveda
Ayurveda, Jaipur-302002. have long been linked together as two complementary systems of human
India, development. A womens body is biologically created for certain specific functions.
Contact No. +91 9902345121, She has to undergo the four stages of life childhood, adolescence, middle age and
Email old age. In each of these four stages, she undergoes physiological changes and has
dr.kavyajain@gmail.com to face problems and internal conflicts. A woman who has looked after her health
will reap the reward by having a healthy pregnancy and delivery. It is absolutely
essential for a pregnant woman to maintain her physical and mental well being
both for her own sake and for the sake of the child within. There are mistaken
notions about yoga for pregnant women. Some women fear that it may lead to
QR Code IJAAM miscarriage. This is however nothing but an old wives tale. Women should begin
to practice yoga before conception to improve maternal health and ensure sound
health for future generations. Yogasanas are however nonviolent, improve blood
circulation and strengthen the body. These yogasanas are meant to avoid dangers,
complications occurring during pregnancy and delivery.
www.ijaam.org
Key Words: Antenatal care, Awareness, Pregnancy, Pranayama, Yogasana
INTRODUCTION who have renounced the world, can derive benefit

Yoga is a Philosophy and a way of life, where art from the practice of yoga, as the health and mental
and science meet. It is the art of knowing oneself poise that yoga gives are necessary to all. Ordinary
and knowing eternal truth. It is the study of the people those who are not inclined towards the
functioning of the body, the mind and intellect in spiritual aspect can practice yoga for its physical
the process of attaining freedom. [1] The great sage benefits. Here yoga frees them from lifes day to
Patanjali has defined yoga asyogah chitta vritti day stress and from the diseases and fluctuations
nirodhah means yoga controls the fluctuations of of the mind.
the mind, the intellect and ego. Just as the moon is
not reflected in the turbid water of a river, so also Motherhood is a womens ordained duty. This is
the soul is not properly reflected in an oscillating not merely a physical state but a divine position. A
mind. A clear mind alone reflects the soul. woman has to pay a high price physically and
Maharshi Patanjali explains yoga in 8 different psychologically in her multiple roles. The
forms viz., Astanga Yoga. stabilization of physical and mental states is
1. Yama is conduct towards others or Social achieved by asanas and pranayama. Her salvation
discipline. lies in practicing them. The saying As you sow, so
2. Niyama is conduct towards oneself or shall you reap is apt in the case of pregnant
Individual discipline. women. The tedious and strenuous process of
61
3. Asana is practice of poses for Physical pregnancy and delivery affects the physical health
discipline. as well as her mind and much of her energy is lost
Page
4. Pranayama is breath control for mental in coming to terms with life during the periods of
discipline. change. In giving birth, new responsibilities begin
5. Pratyahara is withdrawal or discipline of for her and she has to prove herself. Motherhood
Senses. adorns her with the sacred qualities of love,
6. Dharana is concentration. sacrifice, faith, tolerance, good will and hard work.
7. Dhyana is meditation. This is her highest religion, her svadharma.
8. Samadhi is self realization
Women should begin to practice yoga before
The Health of the body and mind is important to all conception, to improve health and ensure sound
whether they wish to succeed in their worldly health for future generations. Yogasanas are
pursuits or in self realization [2]. Even sanyasins, however nonviolent, they strengthen the pelvic
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
muscles and improve blood circulation. These yogasanas can be practiced in whole of pregnancy
yogasanas are meant to avoid dangers, period. The yogasanas advised during Pregnancy
complications occurring during pregnancy and period are as follows -
delivery. Under the guidance of yoga teacher, the
Table 1: Some of the Standing poses [1]
Sr. 1st 2nd 3rd

Yogasana
No. Trimester Trimester Trimester
1. Tadasana(Mountain pose) --
2. Vruksasana (Tree pose) --
3. Trikonasana (Triangle pose) --
4. Virabhadrasana (Warrior pose) --
5. Parshvakonasana (Extended side angle pose) --
6. Kati chakrasana, Parshva chrakasana --
7. Utthita Hasta Padangusthasana --
8. Bhujangasana (In ropes) --
9. Parshvottanasana
Table 2: Some of the Sitting poses [1]
Sr. 1st 2nd 3rd

Yogasana
No. Trimester Trimester Trimester
1. Siddhasana (Perfect sitting pose)
2. Swasthikasana
3. Vajrasana
4. Virasana (Hero pose)
5. Gomukhasana
6. Dandasana (Staff pose) --
7. Paschimottanasana --
8. Janusirsasana (Head to knee pose) --
9. Upavissta konasana (Open legs forward bend)
10. Badda konasana (Bound angle sitting pose)
Table 3: Some of the Inverted poses [1]
1st 2nd 3rd

Sl. No. Yogasana
Trimester Trimester Trimester
1. Padottanasana (Spread legs forward bend)
Adhomukha swhanasana (Downward facing
2.
dog)
3. Chaturanga dandasana (Plank pose)
4. Marjarasana (Cat pose)
Table 4: Some of the Lying down poses [1]
Sl. 1st 2nd

Yogasana 3rd Trimester
No. Trimester Trimester
1. Uttanasana --
62
2. Supta Padangushthasana
3. Makarasana --
Page
4. Savasana (Relaxation pose)
1.Tadasana or Samasthiti [1,3,4,5,6] It Brings stability to the body, removes the

Brings stability to the body. Counteracts cramps in stiffness in the neck, shoulders, elbows and wrist.
the calf muscles during night. Counteracts
curvature of the spine and pain in the hip. 2. Vrukshasana [1,3,4,5,6]
1.1 Urdhva Baddhanguliyasana in Tadasana Strengthens joints and bones of the body. Bring
Tones the shoulder muscles. Lifts the spine. flexibility in legs and hands. Enhances the
Revitalizes body and mind. measurement of the chest. Improves the stability
1.2 Paschima Namaskarasana and Gomukhasana in and centre of gravity of the body.
Tadasana
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3. Trikonasana and utthita Trikonasana [1,3,4,5,6] stiffness. Frees the abdomen from heaviness. Eases
Gives proper alignment of legs. Cures disorders of the morning sickness. Keeps the pelvic joints free
neck and shoulder joints. Very effective in and easy moving. Broadens the pelvic and
relieving pain and stiffness in these areas. abdominal regions. Gives lightness and freedom.
Strengthens the spine, hip joint, hands and palm. Makes delivery easier. Brings down high blood
Brings flexibility of these joints. All major joints pressure.
above the waist are properly activated; their
muscles are duly toned up. Frees space for the Some of the Sitting poses
diaphragm. Regulates blood pressure. Provides 1. Siddhasana [1] (Perfect sitting pose) and
space in the uterus and freedom to breathe 2.Swasthikasana [1]
through vertical and horizontal expansion and It is regarded as asana for improving vitality. Good
extension. Maintains proper kidney function, thus effect on the nervous system of the body. It
preventing water retension, kidney inflammation increases power of concentration. Acquiring state
and back pain. Tucks the tailbone in disturbing of mental equilibrium. A good curative effect on all
your weight evenly. Develops the vision power of the joints below the waist area. Hip, knee and
the eyes. Provides quality of mental attentiveness. ankles are effectively activated. Blood circulation
This gives relief to the lowered uterus during the is improved, synovial fluid is restored, Spasticity
latter stage of pregnancy, bringing freedom to the and pain are removed.
uterine and vaginal opening and easing delivery.
3. Vajrasana [1,3,4,5,6]
4. Virabhadrasana [1,3,4,5,6] Practicing this asana for 15-20min after food helps
Gives a sense of balance and firmness. Relieves the in proper digestion. Strengthens the musculature
heaviness in the abdominal area, relieves of the body. It works in the region of urinary
flatulence. Flushes the kidneys, Prevents urine bladder and surrounding area relieves urinary
retension. Reduces morning sickness. Massages complaints. It improves memory power, increases
the liver and spleen, improving digestion. confidence level. Relieves the complaint of
Strengthens the pelvic region. Lubricates the anaemia, sciatica.
spinal vertebrae.
4. Virasana [1,3,4,5,6]
5. Utthita parshvakonasana [1,3,4,5,6] Practicing this asana Reinstills Courage, boldness
Relieves hip and arthritic pains. Corrects and bravery. Enhances the blood circulation of the
digestion, flatulence and elimination problems. body restores health. Tones up the muscles of the
Removes backache and lower back pain. Helps in thigh and hip. Prevents and removes pain and
easy breathing and Creats lightness in the body. swelling in legs. Good strengthening effect on lungs
Prevents Urine retension. and the chest, Counteracts fatigue. Helps correct
overly concave lumbar (lower) spine. Improves
6. Kati chakrasana and Parshva chakrasana kidney function.
[1,3,4,5,6]
Strengthens the waist, neck, shoulders and calf 4.1 Parvatasana in Svastikasana and Virasana
muscles. Positions the shoulders. Stimulates [1,3,4,5,6]
Nervous system, relieves the hunch back position. Relieves backache. Relieves flatulence. Eases
Increases appetite and relieves constipation. breathing. Lessens fatigue. Creates space in the
abdomen for the safe growth of the fetus.
7. Utthita Hasta Padangushthasana [1,3,4,5,6]
63
Opens the pelvic floor. Strengthens the spine. 5. Gomukhasana and Paschima Namaskarasana
Removes back ache. Relieves rheumatism, in svasthikasana [1,3,4,5,6]
Page
lumbago and sciatica. Brings flexibility in the joints, Strengthens the

bones, Especially good for Arthritis. Removes
8. Bhujangasana (With Ropes) [1] stiffness in the neck, shoulders, elbow and wrist.
Gives Confidence. Relieves tailbone pain, especially Increases the measurement of the Chest. Reduces
in the last stage of pregnancy. Relieves hip pain. humpback.
Lessens abdominal heaviness. Rejuvenates the
spine. Creates space for the fetus to grow. 6. Dandasana [1,3,4,5,6]
Stretches the leg muscles. Massages the abdominal
9. Parshvottanasana [1,3,4,5,6] organs. Strengthens the waist muscles. Tones the
Strengthens the abdominal muscles. Eliminates kidneys.
lower back pain. Softens the diaphragm and
expands the chest cavity. Removes the body 6.1 Urdhva Hasta in Dandasana [1]
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Strengthens and stretches the leg muscles. Lifts compression of the vagina, anus and lower part of
the abdominal organs. Lifts the deposited fat in the spine.
the sides of the trunk. Strengthens the waist
muscles. Some of the Inverted poses
1. Padothanasana [1,3,4]
7. Paschimottanasana [1,3,4,5,6] This asana has good effect upon the spine, hip
This asana has effect on the whole of the spinal joints, hands and palms. It strengthens the lower
cord, the complete nervous system and all the spine and firms the waist muscles. Brings the
organs and glands of the abdominal area. As a flexibility to the spine, Beneficial pose for slipped
result of activation, disorders of these parts are disk. Since there is no compression of the spine,
corrected like back ache, neck stiffness, pain but rather a vertical extension. Improves digestion,
abdomen, flatulence etc. Helps to treat diseases of Relieves flatulence and constipation. Provides the
kidney and sluggish liver. Revitalizes the entire quality of mental attentiveness.
reproductive system. Stretches the pelvic region
and stimulates blood circulation, creates space for 2. Adhomukha Shvanasana [1,3,4]
the fetus. For the diabetic mothers it has a curative Increases the blood supply to the brain. Restores
effect because it activates the pancreases and the normal blood pressure and heart beat. Eliminates
glands of the endocrinal system. It regulates the shortness of breath, extreme fatigue and
functioning of the pancreas and it begins to secrete palpitations. Brings about a feeling of exhilaration
insulin in a normal way. and calm feeling. Lowers the blood pressure and
relieves headache. Lightens and softens the
8. Janu Shirshasana [1,3,4,5,6] diaphragm and enlarges the chest cavity. Tones the
Strengthens the spine and the muscles of the back nervous system and counteracts forgetfulness,
and waist. Relieves heaviness in the abdomen, moodiness and depression. Strengthens the spinal
lower back and tail bone . Gives the gravitational muscles and extends the spine. Removes pain from
pull on the spine. Decreases swelling in the legs. the lower back at the tail bone. Brings freedom of
Alleviates irritation in genitalia. Reduces the floating ribs and opens intercostals muscles.
perspiration and body heat. Helps to flush the Lessens swelling in the legs and ankles.
bladder. Tones and activates the liver, spleen and
kidneys. Lessens the feeling of sluggishness. 3.Chaturanga Dandasana [1]
Strengthens and stretches the leg muscles. Lifts the
9.Upavista konasana [1] abdominal organs. Lifts the deposited fat in the
The Badda konasana and upavista konasana sides of the trunk. Strengthens the waist muscles.
strengthens the muscles of the pelvic region and
lower back. It improves the circulation of blood in 4. Marjarasana [1]
the pelvis and abdomen. Toning the kidneys, This has a good effect on the spine, neck. It
especially important for urinary problems in strengthens Knee, Shoulders, palm and legs. Works
pregnancy. Helping to reduce vaginal discharge. on the dorsal and lumbar region of the spine,
Helps for descent of the fetus and dilatation of removing the stiffness and pain. Improves the
cervix. respiration, widens chest area. Improves digestive
capacity, helps to treat digestion related problems.
10.Baddha Konasana [1,4]
Smoothens the back area. Strengthens the muscles Some of the Lying down poses
of the pelvic region and lower back. Tones up the 1. Uttanapadasana [1,3,4,5]
64
kidney, Lessens the frequent passing of urine and This asana exercises all the abdominal muscles.
the associated burning sensation helps alleviate Takes away the extra weight of the abdominal
Page
urinary disorders. Alleviates heaviness in the area. Corrects the disorders of pancreas. Relieves
lower abdomen and eases breathing. Reduces the indigestion, intestinal disorders, constipation,
tension of the skin and abdominal muscles, which flatulence etc. It also has great curative corrective
causes stretching and itching sensation. Helps to effect on the back ache, troubles of the waist,
eliminate vaginal discharge and the resulting buttocks and hip joints. It strengthens the spinal
discomfort and irritation. Corrects pressure of the cord, energizes the inner cells and activates whole
uterus on the large veins in the pelvis, which cause nervous system.
obstruction in the circulation resulting in fluid
retention. Gives freedom to pelvic floor muscles 2. Supta Pandangushtgasana [1,3,4,5]
because of positioning of the legs which opens out Opens the pelvic muscles keeping the pelvic floor
like petals of the lotus flower. Relieves firm. Relives sciatica and stiffness of the hip joints.
Soothens the nerves around the hips. In advanced
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pregnancy, relieves pain in the region of the tail Nadi shodhana Pranayama
bone. Ujjai Pranayama
Bhramari Pranayama
3. Makarasana [1,3,4,5] Shitali Pranayama
It strengthens the vertebra and low back area. Sheetakari Pranayama
Improves digestion, removes flatulence, Suryabhedana Pranayama
constipation etc complaints. The muscles of lower Chandrabhedana Pranayama
limb become strong. Ease the pain of the baby
kicking. If there is feel of the kick on right side, Benefits
rotate to that side and vice versa. 1. Generates vital energy.
2. Areates the lungs. Supplies plentiful
4. Shavasana [1,3,4,5] oxygen. Increases lung capacity and opens
This asana should be done at the end of all asanas, and activates the air sacs. Heals
pranayama and other kriyas for 10-15 min daily. It respiration problems like shortness of
relaxes all muscles, nerves and the organs of the breath.
body. When the muscles, nerves and organs are 3. Increases endurance. Reduces anxiety.
fully relaxed, they gain strength and their normal Alleviates exhaustion. Tones and soothes
health is restored. For Pregnant ladies suffering the nervous system.
from insomnia, high and low blood pressure, 4. Steadies the wandering mind.
gastric troubles, lungs, cardiac disease and mental 5. In utero, oxygen is delivered through the
sickness practicing shavasana are a remarkable umbilical cord. Mother with adequate
kriya for providing immediate relief. In certain oxygenation can always nourish the fetus
cases of Pregnancy with hypertension and cardiac with plenty of oxygenated blood. Supply
patients, shavasana should be performed singly for of oxygenated blood and necessary
longer periods without practising any asana or nutrients to the growing fetus will
other kriya. Especially during later part of definitely nullifies the chance of growth
pregnancy there will be feeling of heaviness, lack retardation
of energy, tiredness, fatigue etc. Shavasana gives 1st Trimester Increases courage and endurance.
energy, strength and vitality in all such condition. Eliminates tiredness, low energy and nausea.
2nd Trimester Soothens and quiets the mind and
Pranayama [1,5,7] brain. Reduces over activity. Relieves strain,
For an expectant mother, practicing pranayama is weakness, High Blood pressure. Maintains the
as important as performing the asanas. body by the work load of uterus and its conceptus.
Pranayama and the asana together bestow 3rd Trimester Gives vitality and energy. Relieves
physical and mental health both to mother and Fatigue, shortness of breath, heaviness in the
fetus. Vyasa maharshi, Astavakra, Vamadeva, shuka abdomen. Feeling of ease and lightness.
and others are examples of luminaries who
reached intellectual maturity and spiritual Labour - Pranayama reduces tension, anxiety and
accomplishment, when they were still in their pain and it prepares the mind to take whatever
mothers womb. Pranayama means to make comes with calm. It can be of great help during
physical, intellectual, and spiritual energy become delivery, if women were practiced during
pervasive and comprehensive. Technically pregnancy. Pranayama strengthens the nerves to
speaking, it is a process of inhalation, exhalation enable to breathe calmly during labour in between
and retention. Its effect, however, is a process of contractions, which is essential easy delivery. It
65
channelling the energy, which renews awareness helps to relax the nerves and to avoid mental
and sharpens intellectual powers. In the process of tension.
Page
emptying your consciousness of unwanted,

uncultured thoughts and emotions were corrected Instructions to Pregnant ladies before practice
and polished thoughts, which lift you to higher of Yoga and Pranayama
intellectual level. 1. Before starting any Yoga regimen, the
pregnant lady should consult her
Pranayama should be practiced in whole of Obstetrician.
pregnancy period. Swastikasana and Vajrasana are 2. Asanas are to be advised on individual
the best pose for breathing techniques to be health merits.
followed. 3. There should be no detrimental effect.
Some of the pranayama specially advised during
pregnancy are
Anuloma and Viloma Pranayama
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4. The duration and intensity must not cause mothers temperature due to heat production by
strain on joints causing pain, fatigue or fetoplacental metabolism. Rise of temperature is
breathlessness. potentially teratogenic especially in the 1st
5. Practising Asanas and Pranayama during Trimester. Whereas practising postures of Yoga,
early morning and late evening are are actually nonviolent, methodical and goes hand
beneficial. practise after digestion of food, in hand with breathing technique.
and when not feeling hungry.
6. Avoid during illness and fever. 1st Trimester
7. Avoid practising Asana and Pranayama in 1. This is the important period of brain
hot and humid weather. development ie, Neural tube formation
8. Stop immediately - Feeling Fatigue, occurs in fetus8,9,10,11.
Dizziness, faintness, pain in abdomen or 2. Period for ill health ie, nausea, vomiting,
back, headache, cramping etc. symptoms. giddiness, urinary complaints etc [8,9,10,11]
9. Risk of exertion by increased and heavy 3. Unfortunately most of the pregnant ladies
practice of Yogasana Trauma to never approach a gynaecologist till the
Ligaments and muscles, more stress on end of 4 or 5 month.
heart, Dehydration, Hypoglycaemia, Fetal 4. Complications in the form of Blighted
distress, Preterm labour etc. ovum, miscarriage do occur in this period.
10. Following proper instructions is equally
important for complete benefit and Pregnancy is a healthy state and not an illness. A
prevents complications. well conditioned body will perform better.
Practice of Pranayama during this initial phase of
DISCUSSION mother hood gives a sense of Courage and
Concept of doing Yogasana and Pranayama Confidence in the Pregnant women. Yoga relieves
during Garbhini avastha stress, reduce anxiety and increase self esteem. It
1. Yoga and pranayama should be practiced calms the nerves, conquers fatigue. Yoga helps to
as a part of successful Antenatal care. improve the digestive capacity. It removes nausea,
2. It is nothing but lifestyle modification tastelessness and uneasiness Constipation etc
technique, Detoxifing procedure, symptom. The circulation is improved; toxins
Management of stress which is the need were removed from the body. Hence tiredness,
for present day high risk and precious sleepy mood will be relieved. Activation of
preganancy. abdominal pelvic floor muscles was going to
3. Practicing Yoga and Pranayama helps in relieve the urinary complaints to some extent1.
maintaining the health of the pregnant Positive mental status, proper body health is
lady. enough for the normal hormonal secretion. The
4. Necessary for the proper growth and adequacy of the hormones will protect the fetus by
development of the fetus. proper implantation, placentation and normal
5. The pregnancy induced complications can growth and development.
be very well prevented.
6. Mental status of the mother will be in 2nd Trimester
balanced condition throughout pregnancy. 1. Period for feeling of sense of life growing
7. Necessary for the normal vaginal delivery inside her womb. Active movements of
without any complications. her future delivering child is felt in the
8. Purpose of getting shreyasi praja is form of a fine kicks [8,9,10]. Unseen bonding
66
fulfilled in a traditional way of life. between Mother and child begins here.
2. Period for successful completion of
Page
There are certain physiological changes occurring Organogenesis.

during pregnancy, which are to be understood 3. Period for trouble in the form of back
before advising yogasana during pregnancy. It is ache, mild paedal oedema, varicose veins
advised on individual health merits. A Physically etc [8.9.10,11].
fit pregnant woman can perform yoga during 4. Period for beginning of Pregnancy induced
pregnancy under guidance of Yoga therapist complications like, Hypertension,
provided there are no contraindications. Brisk Diabetes, Thyroid abnormality [8.9.10,11].
exercises, heavy weight bearing exercises causes
abdominal and pelvic discomfort. Basal metabolic The growth of the uterus and fetus causes change
rate is increased during exercise. This generates in the centre of gravity of the pregnant woman.
additional heat and causes a rise of temperature. The Lumbar lordosis causes accommodative
Fetal temperature is 0.5 to 10 C. is more than changes in the musculoskeletal system of the
VOL 4 eISSN-2348-0173
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pregnant lady. The Hormones secreted for pregnant woman to learn straight positioning of
protection of pregnancy causes laxity of joints. the pelvis, so she will gain an instinctive and
There is increased risk of strains and sprains. confident sense of the direction in which to exert
Proper posture guidance advised was going to pressure during the bearing-down phase. The
solve half of the problem [9]. The nonviolent poses promote patience and confidence in ones
postures done methodically are going to own body and inner relaxation. This includes
strengthen the pelvic muscles, abdominal muscles, pranayama, which encourage deep breathing into
back muscles and improve circulation. They the pelvic floor. Deep breathing relaxes the
strengthen the reproductive system, exercise the muscles during and after labour and helps with
spine and make the period of pregnancy bearable. breathing through the pain, so that the mother can
Methodical practice of poses is going to relieve the gather strength and relax. In asanas the uterus is
complaint of backache [1]. Improving the exercised to become strong and to function more
circulation of the body is going to prevent venous efficiently so that the delivery can be normal.
stasis, fluid retention. Physiological oedema will
be subsided by itself1. Manifestation of Pregnant lady after regular practice of yogasana,
pathological oedema will not be there, when the keeping well conditioned body, is going to
lady is practicing yoga and pranayama regularly. overcome from regular labour complaints like
Proper strengthening of the abdominal muscles, delayed onset or absence of labour pain, in
pelvic floor muscles, keeping a calm, positive and coordinate uterine contraction failure in descent,
energetic state of mind are enough to prevent the cervical dystosia etc. There will be timely onset
pregnancy induced complications. Pregnant lady and good progress in labour. End in shorter labour,
has to keep her engaged in creative activities like with high apgar babies. Lesser need for obstetric
painting, drawing, singing, listening to music, intervention and fewer signs of fetal compromise.
putting rangoliy, listening to historical stories, The goal is to maintain a good fitness level
solving puzzle, chanting shlokas etc. All these throughout pregnancy and with a successful
activities are for the intellectual development of outcome.
the fetus.
CONCLUSION
3rd Trimester Every pregnancy is precious, regular Antenatal
1. Period for completion of growth and care can only bring fruitful results. Practice of
development of the fetus. Yoga and Pranayama should be the part of
2. Period for placental maturation [8,9]. Dinacharya and Garbhini paricharya. Successessful
3. Period for feeling of exhaustion, antenatal care should result in the form of easy
breathlessness, Pain and heaviness of the vaginal delivery and birth of High apgar babies.
abdomen etc. This is always complemented by our age old
4. Period for complications in the form of practice of Yoga and Pranayama. Yogasanas are
early onset of labour, Placental abruption not a means to control weight. Yoga and
due to Hypertension. Reduced fetal Pranayama not only helps in normal pregnancy
movement, intrauterine fetal death etc. period, but its role in preventing complications of
high risk cases is tremendous. So practice Yoga, be
This is the final period of pregnancy, where no fit and give birth to healthy baby.
complications are afforded. Pregnant lady should
keep keen observation of her fetal movement REFERENCES
[8,9,10,11]. Develop the habit of speaking with the 1. Geeta S.Iyengar, Rita keller and Kerstin Khattab, editors.
67
Iyengar Yoga for pregnancy. 1st ed. New York: Sterling
unborn child is going to help a lot in setting the
Publishing co; 2010.p.168-187, 194-212.
diurnal clock of the fetus. The future child will be 2. David Frawley and Sandra summerfield kozak, editors.
Page
silently listening to her would be mother. Yoga for your type. 2nd ed. New Delhi: New age books;
Pregnant woman and her fetus both are to be 2006.p. 32-39.
3. Eshwar Bharadwaj, editor. Saral Yogasana. 1st ed. New
made prepared for the act of Survival of fittest. ie,
Delhi: Satyam publishing house; 2005. p.26-30.
Parturition. Lady should be educated for the 4. Charu sapra, editor.Yoga aur Swasthya. 1st ed. New Delhi:
bearing efforts. Regular following of Pranayama Sports publication; 2004.P.93-96.
will help her in this final exam of parturition. The 5. Jayaprakash bharatiya, editor. Yogasan kyo aur kaise.
abdominal musculature, pelvic floor muscles back 1sted. Jaipur: Maya prakashan mandir; 2005. p.19-57.
6. Ramharsh singh, editor. Yog evam yogika chikitsa. 2nd ed.
muscles, muscles of thigh should be strengthened Delhi: Chaukhambha sanskrith pratisthan; 1999.p. 77-91.
specially. 7. K.N.Udupa, editor. Stress and its management by
Yoga.1sted. Delhi: Motilal Banarasidass Publishers
private limited; 1985.p. 120-143.
In preparation for birth, asanas are used to widen
the hips and pelvic floor. It is important for the
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8. D.C.Dutta, Hiralal Konar, editors. Text Book of 10. Narendra Malhotra, Randhir Puri, Jaideep Malhotra,
Obstetrics.7th ed. New Delhi: Jaypee Brothers Medical editors. Donald School Manual of Practical Problems in
publishers (P) LTD; 2013.p.46-56, 99-103. Obstetrics. 1st ed. New Delhi: Jaypee Brothers Medical
9. Sudha salhan, editor. Text Book of Obstetrics. 1st ed. New Publishers (P) Ltd; 2012.p. 1-16.
Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 11. Shirish N Daftary, Sudip Chakravarti, editors. Manual of
2007.p.124-133. Obstetrics. 1st ed. New Delhi: Reed Elsevier India (P)
Limited; 2003.p. 74-90.
CITE THIS ARTICLE AS

Source of Support Nil Conflict of Interest None Declared
68
Page
VOL 4 eISSN-2348-0173
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REVIEW ARTICLE
CONCEPT OF RAJONIVRITTI (MENOPAUSE) ACCORDING TO

AYURVEDA WITH SPECIAL REFERENCE TO MENOPAUSE
Radha Harshad Phadnis 1*, Neeta Mahesekar 2
1. PG Scholar, Dept. of Prasuti Tantra avum Streeroga, Hon. Annasaheb Dange Ayurved Medical
College, Ashta, Dist. Sangli, Contact No. +91 9545114545, Email radhakulkarni6@gmail.com
2. Professor & Head, Dept. of Prasuti Tantra avum Streeroga, Hon. Annasaheb Dange Ayurved
Medical College, Ashta, Dist. Sangli, Contact No. +91 9822627092, +919553965891, Email -
neeta_mahesekar@yahoo.com
Article Received on - 15th March 2016

Article Revised on - 24th May 2016
69
Page
2013 IJAAM
R.H. Phadnis, N. Mahesekar, Concept of Rajonivritti (Menopause) According to Ayurveda with special reference to Menopause, Int. J. Ayu.
Alt. Med., 2016; 4(2):69-74
VOL 4 eISSN-2348-0173
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REVIEW ARTICLE
CONCEPT OF RAJONIVRITTI (MENOPAUSE) ACCORDING TO AYURVEDA WITH

SPECIAL REFERENCE TO MENOPAUSE
Ayurveda is an ancient medical science of India. Ayurveda is deeply concerned with
Radha Harshad Phadnis
the woman health & it gave several remedy to maintain the health of woman.
PG Scholar, Dept. of Prasuti
Tantra avum Streeroga, During her life span, she undergoes different changes in her body & psyche. In spite
Hon. Annasaheb Dange of this,she performs her duties in all stages to stand up with changing demands of
Ayurved Medical College, the society. As a consequence of this, various health problems arises. During this
Ashta, Dist. Sangli, aging process she suffers from inevitable scars of menopause. Though in Ayurveda
Contact No. +91 9545114545, Menopause as a diseased condition is not described separately, we have to pay
Email attention to this phase of woman's life, &must have to search some remedy to avoid
radhakulkarni6@gmail.com the discomfort in this phase. Ayurvedic Texts shows references of age of Rajonivritti
(menopause) only, where in modern science menopause, its symptoms & treatment
QR Code IJAAM
is described in brief. In Ayurveda a special treatment is given for yapya or
swabhavik vyadhi i.e. Rasayan Chikitsa. This study made the efforts to correlate the
symptoms of rajonivritti (menopause) with jarajanya vyadhi or swabhavik vyadhi
described in Ayurvedic Texts.
Key Words: Rajonivritti, Menopause, Rasayanchikitsa, Jarajnyavyadhi,

www.ijaam.org Swabhavikvyadhi.
INTRODUCTION senility. In Ayurveda menopause deals with

Ayurveda is Indias traditional system of health and Jarapakvaavastha of body. Rajonivritti
healing. The propagation of species is a basic aim (menopause) is a representative syndrome of
of nature. In the multiplication of human race, Praudhavastha which lies in a sandhikala [3]
women have a pivotal role to play. Menopause is During this period there is a peak level of pitta;
generally defined as cessation of menstruation at during Jarakal vata remains in aggravated
the end of reproductive life due to loss of ovarian condition along with vitiated pitta and creates hot
follicular activity.[1] Menopause is a natural flushes excessive sweating, sleep disturbance,
phenomenon and a gradual transitional phase. It irritability, dryness of vagina etc. which are similar
occupies several years of womens life and involves to vataj pittaj symptoms.
biological and psychological changes. This period
is usually associated with unavoidable MATERIALS
manifestation of aging process in women. During Reviewed Ayurvedic texts, and modern texts
reproductive years women are protected by female related to rajonivritti (menopause) & menopause.
hormones i.e. estrogen and progesterone. In
menopause women enter in an oestrogen deficient Rajonivritti (Menopause)
phase which leads to aging process resulting to In Ayurvedic classics Rajonivritti (menopause) is
psychosomatic problems such as hot flushes, night not described separately as a pathological
sweating, cardio vascular symptoms, loss of libido, condition or severe health problem. The ancient
osteoporosis, vaginal dryness, mood swings and scholars termed it as a normal physiology.
70
lots of others which affect the quality of life during

climacteric period. The age of menopause ranges Rajonivritti Kala (Age of Menopause)
Page
between 45-55 yrs. Average age is 50 yrs. Clinical Rajonivritti (menopause) as a diseased condition is
diagnosis is confirmed following cessation of not described separately in the classics; but the
menstruation (amenorrhea) for twelve Rajonivritti (menopause) kala is mentioned by
consecutive months without any other almost all scholars without any controversy.
pathology.[2] In Ayurveda Rajonivritti (menopause) According to Sushruta and various other
as a diseased condition is not described separately references too, 50 years is mentioned as the age of
but Rajonivritti (menopause) Kala is mentioned by Rajonivritti (menopause), when the body is fully in
almost all Scholars without any controversy. grip of senility. Acharya Arundatta opines that the
age mentioned above is a probable age and not a
According to Sushruta and other references also 50 fixed one. There may be some variations in this
years is mentioned as the age of Rajonivritti regard. As Ayurveda has given more importance to
(menopause) when the body is fully in grip of Ahara and Vihara in the maintenance of heath,
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these factors too, should be considered for this (menopause) hetus too. Besides this, some very
fluctuation. [4], [5] specific factors also can be considered as the
causative factors (nidana) for Rajonivritti
Nidana of Rajonivritti (Menopause) (menopause)
As Rajonivritti (menopause) is not described as a
separate disease in the classics; we dont get the 1. Kala
information regarding its Nidana, Purvarupa, Rupa, 2. Swabhava
Samprapti etc. So we should have to concentrate 3. Vayu
on some basic principle of Ayurveda to understand 4. Karma / environment
this condition as disease. Some factors are 5. Dhatukshaya
mentioned by Scholars in the context of Rajah 6. Abhighata etc.
utpatti hetus can be considered as Rajonivritti
Table 1: Probable Hetus of Rajonivritti
KALA SWABHAVA VAYU DHATUKSHAYA KARMA ABHIGHATA

Vayu is
Kala is a causative Swabhava is defined responsible for
Scholar Sushruta
factor for many as a specific feature. initiation,
has mentioned
things such as According to progress, Two types of karmas
In old age due to that the viddhata
kshaya & vriddhi, swabhavoparam division, are there
dhatukshaya of the roots of
garbhavkranti wada nothing is destruction of 1] Purvajanmakrita
Updhatu Artava Artavavahastrotas
garbhvriddhi, Eternal. Being a any activity. 2] Ajanmakrita
formation is also i.e. garbhashaya &
bala, tarun, physiological entity Vitiated Ajanmakrita karmas
get suppressed, artavavahi
vriddhavastha & Rajah is also having vatadosha like pradnyaparadha
which results in dhamani will lead
mrityu [6, 7, 8 ,9, 10] , swabhava of affects the are responsible for
rajonivritti to artavnasha. [16]
specific kala is also degradation which utpatti of Akalaj Rajonivritti
(menopause). [13] i.e. Akalaj
mentioned for ultimately manifests artava leading (menopause) [ 14, 15]
Rrajonivritti
rajonivritti into Rajonivritti to Rajonivritti
(menopause)
(menopause) (menopause). [11] (menopause).
[12]
Types of Rajonivritti (Menopause) Akalaja Rajonivritti (menopause)

In Ayurvedic science all diseases are divided into 4 If Rajonivritti (menopause) occurs before or after
major types. its probable age (i.e. around 50 years) it is termed
1. Agantu as Akalaja Rajonivritti (menopause).
2. Sharira
3. Manas and Probable Samprapti of Rajonivritti
4. Swabhavika (Menopause)
As there is lac of brief description about
In Swabhavika type; all naturally occurring Rajonivritti (menopause) as a diseased condition in
conditions are included. Jara, Pipasa, Nidra, Ayurvedic Text some of the points in nidanas
Kshudha & Mrityu are mentioned in Swabhavik should be taken into consideration while stating
Vyadhis by Scholar sushruta. Whereas these the probable samprapti of Rajonivritti (menopause)
diseases are naturally occurring but sometimes according to Ayurvedic point of view; as all classics
they are being acquired also, which is described as have quoted the age around 50 years as the
"Doshaja". So, they are further divided into two probable age for Rajonivritti (menopause). This age
71
types viz. Kalakrita and Akalakrita. As Rajonivritti limit is dominated by "Vatadosha" and obviously
(menopause) too can be considered as Swabhavik during this time it is getting vitiated. This
Page
Vyadhi in every woman. So it can be also divided dominant vatadosha will have effect on all over the
into two types. female body including all anatomical as well as
physiological factors by virtue of its characters i.e.
1. Kalaja Rajonivritti (menopause) "laghuta" and "rukshata". [18] Due to jaravastha the
2. Akalaja Rajonivritti (menopause)[17] decline process starts in female body at the age of
50 yrs. So, considering these all points, the
Kalaja Rajonivritti (menopause) probable samprapti can be given as follows:
If Rojonivritti occurs at its probable age (i.e. around
50 years of age) it is called as Kalaja Ronivriti.
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Fig.1: Samprapti of Rajonivritti (Menopause)
Symptoms of Rajonivritti (Menopause) Doshajasymptoms:-

As there is no direct reference available regarding On the basis of available symptoms, they
symptoms of rajonivritti (menopause)in the can be differentiated as Vataja, Pittaja and
Ayurvedic classics, the clinical symptoms Kaphaja symptoms. As in this condition
manifested by the patients of rajonivritti generalized vatavriddhi is there, the
(menopause) have to be considered and can be Vataja symptoms are more dominantly
grouped under following Ayurvedic parameters. observed than Pittaja and Kaphaja
Doshaja symptoms. symptoms.[19]
Dhatukshayaja symptoms.
Manasika symptoms.
72
Table 2: Doshaja Symptoms of Rajonivritti (Menopause)

Page
Vataj lakshna Pittaj lakshna Kaphaj lakshna

Shirahshoola Ushnanubhuti Hriddravata
Hridspandanadhikya Daha Bhrama
Hastapadsupti Swedadhikya Angamarda
ShabdaAsahishnuta Ratrisweda Roukshya
Balakshaya Trisha
Adhmana Mutradaha
Atopa Glani
Vibandha Yonidaha
Anidra/ Alpanidra
Bhrama
Katishoola
Sandhivedana
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Dhatukshayaja symptoms:-
As Rajonivritti (menopause) is the generalized dhatukshayajanya avastha, hence dhatukshaya symptoms
are also observed in the patients, as follows:
Table 3: Dhatukshayaja Symptoms [20]
Rasa Rakta Mamsa Meda Asthi Majjja Shukra

kshaya Kshaya Kshaya Kshaya kshaya kshaya Kshaya
Shabda Asthi Yoni
Twakarukshata Sphikgandadishushkata Angarukshata Asthitoda
asahtva soushirya Vedana
Hrid Sandhi
Sirashaithilya Toda Shrama Asthitoda Shrama
dravata shaithilya
Shoola Rukshata Shosha Dourbalya Dourbalya
Shrama Glani Krushata Bhrama Panduta
Sandhi Tamah
Shosha
Sphutan darshan
Sandhi Sandhi
Trisha
Vedana Shunyata
Dhamanishaithilya
Manasika Symptoms
Manasika symptoms are very troublesome to the patients as well as for physician. Sometimes they may
disturb the whole family So, it is very necessary to treat these symptoms with proper medical help as well
as counselling and family support too. Following are the manasika symptoms commonly seen in the
patient of Rajonivritti (menopause).
Table 4: Manasika Symptoms of Rajonivritti
Krodha Smritihrasa Utsahahani Dhairyahani

Shoka Shirahshula Vishad Chinta
Bhaya Medhahrasa Alpa Harsh Parakramhani Dwesha & Priti
Sadhyasadhyata (Prognosis) menopause, though in Ayurvedic texts we dont get

Though prognosis of Rajonivritti (menopause) is the direct reference of menopause or its
not mentioned separately in classics, but as symptoms, but we can correlate its symptoms with
mentioned earlier, Rajonivriti is a Swabhavika the vata & pitta vriddhi symptoms, & can give the
Vyadhi as that of Jara and Mrityu . According to probable samprapti of menopause, as it can be
Acharya Charaka swabhavik vyadhis are incurable considered as swabhavik vardhakyajanya phase we
or having no treatment. But Acharya Chakrapani can treat it with Rasayana therapy, and can
while commenting on this, mentioned that the minimise the severity of the symptoms. According
word "Nishpratikriya" means ordinary treatment to modern science HRT is the hallmark treatment
and measures have no effect on aging. There is no of menopausal syndrome., but it has several
treatment for Kalakrita. But according to Acharya hazardous effects on long term use like breast
Dalhana they may become "Yapya" by Rasayana & cancer ,gall bladder diseases, hypertention, vaginal
pathya-aharavihara etc. Rajonivritti (menopause) is bleeding etc. so its not worth to give HRT while
also a naturally occurring condition and having treating menopause. So there is large scope to
good number of similarity with the process of introduce Ayurvedic drugs on the basis of Rasayana
73
aging, it should be considered as "Yapya" therapy like ashwagandha, amalaki, shatavari,

condition. With above said treatment person may bala, jatamansi and many more balya, rasayana &
Page
lives with the disorder without cure but without medhya drugs to treat menopause.
disturbed by the disease. Because it is said that in
"Yapya" stage the disease recurs immediately after CONCUSION
the withdrawal of treatment. [21] Ayurvedic concepts are being helpful in treating
new diseases arising due to faulty lifestyles and
DISCUSSION changing environment. As in Ayurveda menopause
In this era now a days menopause is becoming a is not described as diseased condition and is
major problem, as expectancy of life is increased, considered as natural phenomenon, it must occur
&near about one third of life span spent under the at certain age with no major symptoms which can
period of oestrogen deprivation stage with long hamper the day today life . But now a days it is
term symptomatic & metabolic complications. So it becoming a major problem, for which invention of
is necessity of this era to treat the complications of a safe & effective line of treatment is necessary. In
Alt. Med., 2016; 4(2):69-74
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our ancient Ayurvedic science, special branch 10. Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, Charak
Samhita, Delhi, Chaukhamba Sanskrita Pratishthana,
Rasayana is introduced by Scholars which is life
2006, p.694
promoting, & deals with aging problems, to 11. Anant Ram Sharma, Sushruta, Varanasi, Chaukhamba
improve health as well as longevity. Hence it will Surbharati Prakashan, 2006, p.44
be the opportune for Ayurvedic practitioners to do 12. Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, Charak
the further study of Rajonivritti (menopause) and
2006, p.686-87
introduce a new line of treatment of treating it for 13. Ibid, p.267
welfare of women health. 14. Ibid p.26
15. Ibid p.27
16. Anant Ram Sharma, Sushruta, Varanasi, Chaukhamba
REFERENCES
Surbharati Prakashan, 2006, p.122
1. D.C. Dutta, Hiralal Konar, Editors, Textbook Of
17. Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, Charak
Gynaecology, 6thEdition, Calcutta, New Central Book
Agency, 2013, p. 56
2006, p.203
2. Ibid, p.56
18. Subhash Ranade, Sampurna Kaychikitsa, 6th Edition,
3. Yadavji Trikamji, Narayan Ram, Sushruta
Pune, Anmol Prakashan, 2003, p.60-62
Samhita,4thEdition,Varanasi, Chaukhamba
19. Ibid p.62-65
Orientalia,1980, p. 634
20. Vidyadhar Shukla, Ravi Dutt Tripathi, Charak, Delhi,
4. Bramhanand Tripathi, Ashtang hridayam, Delhi,
Chaukhamba Sanskrita Pratishthana, 2006, p.694
Chaukhamba Sanskrit Sansthan, 2007, p.338
21. D.C. Dutta, Hiralal Konar, Editors, Textbook Of
5. Anant Ram Sharma, Sushruta Samhita, Varanasi,
Gynecology, 6thEdition, Calcutta, New Central Book
Chaukhamba Surbharati Prakashan, 2006, p.32
Agency, 2013, p.56-63
6. Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, Charak
22. Sir Norman Jeffcoat, Principles Of Gynecology, 8th Edition,
Samhita, Delhi, Chaukhamba Sanskrit Pratishthana, 2006,
New Delhi, Jaypee Brothers Medical Publishers, 2014,
p.267
p.82-90
7. Ibid, p.704
23. Marc A. Fritz, Leon Speroff, Clinical Gynecologic
8. Ibid, p.733
Endocrinology And Infertility 8th Edition, New Delhi,
9. Vidyadhar Shukla, Ravi Dutta Tripathi, Charak Samhita,
Wolters Kluwer ( India ) Pvt. Ltd., 2011, p.673-856
Delhi, Choukhamba Sanskrit Pratishthan, 2006, p.656-58

R.H. Phadnis, N. Mahesekar, Concept of Rajonivritti (Menopause) According to Ayurveda with special reference to
Menopause, Int. J. Ayu. Alt. Med., 2016; 4(2):69-74
74
Page
Alt. Med., 2016; 4(2):69-74
VOL 4 eISSN-2348-0173
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REVIEW ARTICLE
A CONCEPTUAL OVERVIEW OF TRADITIONAL KNOWLEDGE

DIGITAL LIBRARY (T.K.D.L.)
Pallavi Vyankatrao Bhange 1*, Yogesh Shivmurti Bhatambre 2
1. Lecturer, Dept. of Rasashastra and B. Kalpana, SSAM, Pune-28, Contact No. +91 9822745774,
Email - pybhatambre@gmail.com
2. Reader, Dept. of Rasashastra and B. Kalpana, SSAM, Pune-28, Contact No. +91 9822422297,
Email: ysbhatambre@gmail.com
Article Received on - 7th April 2016

75
Page
2013 IJAAM
P.V.Bhange, Y.S.Bhatambre, A Conceptual Overview of Traditional Knowledge Digital Library (T.K.D.L.), Int. J. Ayu. Alt. Med., 2016;
4(2):75-79
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
REVIEW ARTICLE
A CONCEPTUAL OVERVIEW OF TRADITIONAL KNOWLEDGE DIGITAL LIBRARY

(T.K.D.L.)
The project Traditional Knowledge Digital Library (T.K.D.L.) involves
Pallavi Vyankatrao Bhange
documentation of the traditional knowledge available in public domain in the form
Lecturer, Dept. of Rasashastra
and B. Kalpana, SSAM, Pune-28, of existing literature related to Ayurveda, Siddha, Unani and Yoga in digitized
Contact No. +91 9822745774, format in five international languages, which are English, German, French, Japanese
Email - and Spanish. The objective of the library is to protect the ancient and traditional
pybhatambre@gmail.com knowledge of the country from exploitation through bio privacy and unethical
patents, by documenting it electronically and classifying it as per international
QR Code IJAAM patent classification systems.
Key Words: Traditional knowledge, Digital library, Patent, Ayurveda

www.ijaam.org
INTRODUCTION over two lakh formulations, which have been taken

Traditional knowledge is knowledge, know - how, from Ayurveda, Siddha, Unani and Yoga texts.
skills and practices that are developed, sustained It is a dynamic database, where formulations will
and passed on from generation to generation be continuously added and continuously updated
within a community, often forming parts of its according to the inputs from the users of the data
cultural or spiritual identity. Traditional base. Formulations on Indian systems of Medicine
knowledge can be found in a wide variety of appear in the form of a text, which comprises the
contexts, including agricultural, scientific, following main components.
technical, ecological and medicinal knowledge as 1. Name of the drug
well as biodiversity related knowledge. As far the 2. Origin of the knowledge
medicinal knowledge is concerned, the Indian 3. Constituents of the drug with their parts used
systems of medicine includes Ayurveda, Siddha, and their quantity
Unani and Yoga as prior art. Traditional knowledge 4. Method of preparation of the drug and usage
in general sense embraces the content of of the drug
knowledge itself as well as traditional cultural 5. Bibliography details
expressions including distinctive signs and
symbols associated with traditional knowledge. OBJECTIVES OF T.K.D.L.
Digital library is a focused collection of digital 1. T.K.D.L. database is being created to prevent
objects that can include text, visual material stored the misappropriation of traditional
as electronic media formats (as opposed to print, knowledge at international patent office so
microform or other media), along with means for that the cases on bio privacy such as
organizing, storing and retrieving the files and Turmeric and Neem could be prevented.
media contained in the library collection. 2. In past years, some patents were wrongly
76
T.K.D.L. is thus a database with a tool to granted to traditional knowledge related

understand the codified knowledge existing for the inventions, which do not fulfill the
Page
above Indian systems of medicine i.e. Ayurveda, requirement of novelty and inventive step;
Siddha, Unani and Yoga. particularly due to existence of relevant prior
art e.g. Turmeric and Basmati - U.S. patent
Data: T.K.D.L. is not a diagnostic or usage and Trademark office and Neem - European
database. It is also not the prior art in itself, the grant office.
books on Indian systems of medicine are the prior
art which act as the formation for T.K.D.L. As per the science of Ayurveda is concerned, it
aims to protect the swasthya (health) of a Swastha
Contents: It contains Scanned images of Medicinal (healthy) person as well as to treat the diseases of
formulations from the original books. It covers the patients as described in Charak Samhita. [1]
4(2):75-79
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For the treatment of diseases, various herbal examiners in retrieval of information related to
medicines as well as mineral medicines have been prior art, before granting a patent in the area of
described in the texts of Ayurveda. In Rasashastra, traditional knowledge.
science relating to the preparation of medicines TKRC has structured and classified the Indian
using metals and minerals, importance of such Traditional medicine system in approximately
medicines has been well described as 25,000 subgroups for Ayurveda, Siddha, Unani and
Rasaushadhies are supposed to be superior to Yoga. TKRC has enabled incorporation of about
other drugs on account of their effectiveness in low 200 subgroups under A61K 36/00 in International
dosage, easy palatability and quick action. Patent classification instead of few subgroups
Rasaushadhies can be used in Asadhyavyadhies earlier available on medicinal plants under A
i.e.in incurable diseases, while ancient Acharyas 61K35/00 thus enhancing the quality of search
have given treatment only for curable diseases. [2] and examination of prior art with respect to patent
Such Ancient knowledge must be prevented from applications field in the area of traditional
its misappropriation and wrong grant. T.K.D.L. knowledge.
aims both of these.
TKRC is an integral part of TKDL, and it provides a
The practical obstacle is that patent examiners background on Ayurvedic concepts, definitions and
could not search relevant traditional knowledge, as scientific basis of Indian systems of medicine. In
they did not have access to traditional knowledge addition, it carries information on practitioners,
information in their classified non-patent hospitals and dispensaries. There are several
literature. The reasons for this non-accessibility search features incorporated in the format.
were that the Indian traditional knowledge exists
in local languages such as Sanskrit, Urdu, Arabic, The TKRC is mainly divided into the following
Persian, Tamil, etc. which either was not available sections: [3]
or not understood by patent examiners. In 2005, A - Ayurveda
the TKDL expert group estimated that about 2000 B - Unani
wrong patents concerning Indian systems of C - Siddha
medicine were being granted every year at Y - Yoga
international level mainly due to the fact that
Indias traditional medicinal knowledge which Section A i.e. Ayurveda is divided into the following
exists in local languages which is neither accessible classes:
nor comprehensible for patent examiners at the 01 - Pharmaceutical preparations (Kalpana)
International Patent Offices. 02 - Personal Hygiene Preparations
03 - Dietary (Food / Food stuff or Beverages)
T.K.D.L. breaks the language and format barrier by 04 - Biocides, Fumigatives (Dhupana, Krimighna)
scientifically converting and structuring the
available contents of the ancient texts on Indian The Pharmaceutical preparations are divided into
system of medicine into Five International following sub-classes based on the material used.
languages namely English, Spanish, German and 01A - Based on Plants (Audbhida)
Japanese with the help of information technology 01B - Based on Animals (Jangama)
tools and an innovative classification system TKRC, 01C - Based on Minerals (Parthiva)
in patent applications format, which is easily 01D - Characterised by Diseases (Roga)
understandable by patent examiners. T.K.D.L. is 01E - Characterised by Actions (Karma)
thus a tool providing defensive protection to the 01F - Mode of Administration
77
rich traditional knowledge of India. 01G - Miscellaneous

Page
Traditional Knowledge Resource Classification While discussing the T.K.D.L. it seems necessary to
(T.K.R.C.) know what exactly the patent is.
Traditional knowledge documentation lacked a Patent: A patent is an exclusive right granted for
classification system. Therefore a modern an invention, which is a product or a process that
classification system i.e. T.K.R.C., based on the provides a new technical solution to a problem. [4]
structure of the International Patent Classification
(IPC) was been evolved for Indian System of What kind of inventions can be protected?
medicine viz. Ayurveda, Siddha, Unani and Yoga. 1) The subject matter should be novel
T.K.R.C. is a structural classification consisting of 2) Should possess an inventive step and not be
sections, subclasses, groups and subgroups similar obvious to a person skilled in that art
to that included in IPC system, relating to Indian 3) Should be industrially applicable
traditional knowledge for facilitating the patent
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MATERIALS AND METHODS Procedure-

The activities of creation of TKDL began in Each Shloka [Verse] is read and converted into a
1999.The project T.K.D.L. was initiated in the year structural language using T.K.R.C. by the subject
2001. It provides information on traditional experts. The codes are then filled into the data
knowledge existing in the country in languages and entry screen. The Shloka are also saved in the
format understandable by patent examiners at database. The translated version of all the T.K.R.C.
International Patent Offices (IPOs), to prevent the codes is ported in the database. The abstraction is
grant of wrong patents. [5] done by the subject experts. The codes once saved
in Meta data directory are converted in different
T.K.D.L. thus works as a bridge between traditional languages based on Unicode technology. [7]
knowledge existing in local languages and the
Patent examiners at International Patent Offices Current Status: [8]
(IPOs).
It is a collaborative project between- No. of Texts
Transcribed
1. Council of Scientific and Industrial Research Discipline (including Vol.) used
for transcription
(CSIR), Ministry of Science and Technology
and Ayurveda 75 books 97,337
2. Department of AYUSH, Ministry of Health and Unani 10 books 1,75,150
Family Welfare and is implemented at CSIR [6] Siddha 50 books 23,016
3. TKDL is a pioneer initiative of India to
Yoga 15 books 1,680
prevent misappropriation of countrys
traditional medicinal knowledge at TOTAL 150 books 2,92,662
international patent offices on which
healthcare needs of more than 70%
population and livelihood of millions of DISCUSSION
people in India is dependent. TKDL is proving to be an effective deterrent
against bio-piracy and is being recognized as a
At present, as per the approval of Cabinet global leader in the area of traditional knowledge
Committee on Economic Affairs, access of TKDL is protection. In 2011, World Intellectual Property
available to nine International Patent Offices Organization (WIPO) organized an International
(European Patent Office, United State Patent & Conference in collaboration with CSIR on
Trademark Office, Japan Patent Office, United Utilization of Traditional Knowledge Digital
Kingdom Patent Office, Canadian Intellectual Library as a Model for Protection of Traditional
Property Office, German Patent Office, Intellectual Knowledge, at New Delhi. Pursuant to this, WIPO
Property Australia, Indian Patent Office and Chile in collaboration with CSIR and DIPP (Ministry of
Patent Office), under TKDL Access (Non- Commerce and Industry) organized an
disclosure) Agreement. Negotiations are under International Study Visit to TKDL for 19 countries
way to conclude the Access Agreement with interested in replication of TKDL.
Intellectual Property Office of Russia and Malaysia.
As per the terms and conditions of the Access In the year 2014, TKDL has achieved success in 24
agreement, examiners of patent office can utilize cases without any cost (whereas in single Basmati
TKDL for search and examination purposes only case only few claims could get revoked after an
and cannot reveal the contents of TKDL to any expenditure of about seven crores. Only towards
third party unless it is necessary for the purpose of the legal fee), in the patent applications filled a
78
citation. TKDL Access Agreement is unique in European Patent Office (EPO) - 12, United states
nature and has in-built safeguards on Non- Patent and Trademark Office (USPTO) - 3,
Page
disclosure to protect Indias interest against any Controller General of Patents Designs and
possible misuse. Trademarks (CGPDTM) - 6, Canadian Intellectual
Property Office (CIPO) -3, wherein the claims were
Experts involved in T.K.D.L.- not found to be novel by the patent examiners due
An interdisciplinary team of traditional medicine to prior art evidences available in TKDL. Also,
(Ayurveda, Siddha, Unani and Yoga) experts, access of TKDL has been given to Chile patent
Patent examiners, IT experts, scientists and office National institute of Intellectual Property
technical officers are involved in the creation of (INAPI)after signing TKDL access (Non-
T.K.D.L. for Indian system of medicine. disclosure)Agreement, which would further
contribute in protecting countrys traditional
knowledge.
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TKDL thus has made waves around the world, traditional knowledge. Thus, it helps in preventing
particularly in TK rich countries by demonstrating cases of biopiracy. TKDL has a rich database of
the advantages of proactive action and the power information and proved to be extremely useful to
of strong deterrence. The idea is not to restrict the research and industry, both in India and abroad,
use of traditional knowledge, but to ensure that providing an impetus to invention, and the
wrong patents are not granted due to lack of access development of products such as medicines, which
to the prior art for Patent examiners. TKDL is a would be of immense value to all of mankind.
dynamic database, where formulations will be
continuously added and continuously updated REFERENCES
according to the inputs. 1. Acharya Vidyadhar Shukla, Prof. Ravi Dutta Tripathi,
Charak Samhita of Agnivesha, edited with
Vidyamanorama Hindi commentary, Chaukhamba
CONCLUSION Sanskrit Pratishthan, Publication, Delhi. p. 978
Once the traditional knowledge is recorded in 2. Kaviraja Ambikadattashastri, editor,
TKDL, legally, it becomes public domain Rasaratnasamuchhaya, 9th edition, Varanasi,
Chaukhamba Amarbharti Publication, 1995. p. 21
knowledge. Under the patent law, this means that
3. http://www.tkdl. res.in [Accessed date-08.05.2016]
it is considered to be prior art and hence is not 4. http://www.wipo.int [Accessed date-07.05.2016]
patentable. Such a written record, in a form easily 5. http://www.gktoday.in [Accessed date-08.05.2016]
accessible to patent offices around the world, 6. http://www.ccrum.net [Accessed date-08.05.2016]
7. http://www.infinityfoundation.com [Accessed date-
would provide all such offices with are cord of
08.05.2016]
Indias prior art. Patent examiners could easily 8. http://www.csir.res.in [Accessed date-07.05.2016]
check this database and reject any patent
application that might be a mere copy of

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RESEARCH ARTICLE
STANDARDIZATION AND COMPARATIVE STUDY OF SHILAJEETA

W.S.R.T. MARKET SAMPLE
Parhate Saroj M.1*, Khaparde P. H.2
1. Associate Professor, Dept. of Rasa Shastra. Govt. Ayurved College, Raipur (C.G.). India, Contact No.
+91 8819925299, Email- saroj.parate@yahoo.co.in
2. Dean, Govt. Ayurved College, Osmanabad, Maharashtra State, Contact No. +91 9075408637, Email
prakash.khaparde@rediffmail.com

Article Accepted on - 6th June 2016
80
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2013 IJAAM
Parhate Saroj M., Khaparde P. H., Standardization and Comparative Study of Shilajeeta w.s.r.t. Market sample, Int. J. Ayu. Alt. Med.,
2016; 4(2):80-84
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
RESEARCH ARTICLE
STANDARDIZATION AND COMPARATIVE STUDY OF SHILAJEETA W.S.R.T.

MARKET SAMPLE
Shilajeeta is a natural substance found mainly in the Himalayas, formed for
Parhate Saroj M.
centuries by the gradual decomposition of certain plants by the action of
Associate Professor, Dept. of
Rasa Shastra. Govt. Ayurved microorganisms. It is a potent and very safe nutritional supplement, restoring the
College, Raipur (C.G.). India, energetic balance and potentially able to prevent several diseases. Recent
Contact No. +91 8819925299, investigations point to an interesting medical application toward the control of
Email- cognitive disorders associated with aging, and cognitive stimulation. Thus, fulvic
saroj.parate@yahoo.co.in acid, the main active principle, blocks tau self-aggregation, opening an avenue
toward the study of Alzheimer's therapy. In essence, this is a neutraceutical product
of demonstrated benefits for human health. Considering the expected impact
of Shilajeeta usage in the medical field, especially in the neurological sciences, more
investigations at the basic biological level as well as clinical trials are necessary, in
order to understand how organic molecules of Shilajeeta and particularly fulvic
acid, one of the active principles, and olio-elements act at both the molecular and
cellular levels and in the whole organism. In this study 9 marketed samples of
QR Code IJAAM Shilajeeta were collected, analysed and compared with parameters mentioned in
API. While comparing the list of modern indications for shilajeeta, only reputable
sources were taken into consideration and excluded shilajeeta sold by any sources.
In this study purposefully else included internet sources for this information as it
was felt that their claims were exaggerated beyond the reality.
www.ijaam.org Key Words: Ayurved, Rasashastra, Shilajeet
INTRODUCTION affirmed. Some of the most interesting studies

Shilajeeta is considered one of the wonder confirm Shilajeetas uses as an anxiolytic (anti-
medicines of Ayurveda. Neither a plant nor animal anxiety) agent and its nootropic (enhancer of
substance, it is a mineral pitch that oozes from the learning acquisition and memory retrieval)
rocks of the Himalayas, as they become warm in activity. Shilajeeta is generally considered safe in
the summer months. It is said to carry the healing moderate doses and is readily available in the
power of these great mountains. Shilajeeta is an United States both as a stand-alone product and in
important drug of the ancient Hindu material the traditional Ayurvedic formula Chandraprabha.
medica and is to this day used extensively by the It has also compounded in many patent medicines
Hindu physicians for a variety of diseases. Early from India. Those who sell Shilajeeta or products
Ayurvedic writings from the Charaka Samhita and containing it make many wild claims for
Susruta Samhita describe Shilajeeta as a cure for all Shilajeetas ability to cure diseases. Hopefully
disease as well as a rasayana (rejuvenative) able to Shilajeeta will not become a snake-oil in our
increasing longevity from 100 to 1000 years of age. modern world only to be cast aside by modern
It is composed of humus and organic plant researchers. Shilajeeta is truly a remarkable
material that has been compressed by layers of substance with a long history of human usage for
81
rock mixed with microbial metabolites. Traditional healing and should be subjected to further
uses primarily focus on diabetes and diseases of investigations.
Page
the urinary tract, but also include edema, tumors,

wasting, epilepsy and even insanity. Modern Shilajeeta also known in the north of India
indications extend to all system of the human body as salajit, shilajatu, mimie, or mummiyo is a
with a significant number of additions in the blackish-brown powder or an exudate from high
reproductive and nervous system. The Ayurvedic mountain rocks, especially in the Himalayans
energetics vary depending on the base rock that mountains between India and Nepal, although it
the Shilajeeta comes from but it is generally has been also found in Russia, Tibet, Afghanistan,
thought to be tridoshik and only aggravating to and now in the north of Chile, named as Andean
Pitta (Fire) when used in excess. Clinical research Shilajeeta [1]. Shilajeeta has been known and used
confirms many of the properties that Shilajeeta is for centuries by the Ayurvedic medicine, as a
used for. However, further investigations are rejuvenator and as anti-aging compound. There
required before many of Shilajeetas actions can be are two important characteristics of
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a rasayana compound in the ancient The health benefits of Shilajeeta have been shown
Indian Ayurvedic medicine: that is, to increase to differ from region to region, depending on the
physical strength and to promote human health [2]. place from which it was extracted [3, 4].
Table 1: Traditional Indications
System Diseases
Dermatological [5] Kushtha (obstinate skin diseases including leprosy)
Ama (disorders of poor digestive activities) Enlargement
Gastrointestinal [6]
of the abdomen, Rectal fistula, Worms
Jaundice, Elephantiasis. Poison begotten distempers,
Hematology, lymphatic, cancer, Anti-oxidant [7]
Fever, Chronic fever
Phthisis (wasting of the body), Gulma (internal tumors),
Immunology, aids, infectious diseases [8]
Malignant tumor, Benign tumor
Neurology, psychiatry [9] Loss of consciousness, Epilepsy, Insanity
Respiratory (lower and upper respiratory tract including ears,
Cough, Scrofula
nose, throat, sinuses) [10]
Rheumatological, orthopedic, muscles, contusions [11] Obesity
Urinary tract system (kidney, ureter, bladder) [12] Dysuria, Madhu-Meha, Gravel or stones in the bladder
MATERIALS & METHODS

Collection of Samples
The all nine samples collected from local market and various parts of India tabulated as following
Table no. 2: Sample of Shilajeeta collected and their coding
Sr. No. Coding of Sample Place of Collection

1 Sample A Jagat Pharmacy, Nagpur
2 Sample B Wagh Brothers, Nagpur
3 Sample C Maghanmal Hiralal Pharmacy, Nagpur
4 Sample D Siddhikalpa Ayurvedics, Vashi, Mumbai
5 Sample E ------------- ----------------------
6 Sample F Gondal Pharmacy, Baroda
7 Sample G Dabur Pharmacy, Shilajeeta Capsules
8 Sample H Krishna Gopal Kaleda Pharmacy, Ajmer
9 Sample I Ganga Ayu. Niketan Pharmacy, Virar, Mumbai
Figure 1: Samples of Shilajeeta collected from market and their coding
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These samples were coded and analyzed for organoleptic tests. Then these samples were subjected to
physicochemical analysis in govt. approved laboratory for certain parameters mentioned in API.
Table 3: Laboratory Tests- Shilajeetaa Panch-Bhautik Parikshana as per API
Parameter Result
Varna Krishna Varna
Smell Gomutra gandhi/ Karpur gandhi
Format Stone Like
Rasa Tikta rasa- Anurasa-lavan
Vipaka Katu Vipaka
Veerya Sheet Veerya
Table 4: Parameters for Laboratory Tests of Shilajeeta as per API
Parameter Range
Water to (Moisture) 9.5%
Sendriya Dravya (organic compounds) 36.70%
Parthiva Dravya (organic mass) 34%
Nitrogen 2.3%
Khatika (lime) 7.8%
Abhrak (mica) 13.7%
OBSERVATIONS Results obtained are compiled in following Table

no 5.
Table 5: Comparison of Results of Physicochemical tests of nine samples Shilajeeta used in study
Physical & Chemical Samples of Shilajeeta

Parameters A B C D E F G H I
Moisture % 8.23 10.11 9.74 10.70 9.71 11.20 7.92 6.97 33.25
Water Soluble % 8.91 83.24 80.99 87.99 97.61 80.04 44.40 81.32 89.73
Total Ash % 8.80 20.83 4.83 18.05 3.52 5.54 14.42 12.01 9.47
Water soluble Ash
12.69 22.53 11.74 19.56 11.41 11.21 17.05 15.27 3.87
%
Acid soluble Ash % 0.40 0.70 0.11 0.41 0.27 1.40 0.26 0.150 0.70
DISCUSSION moisture i.e. 33.25% whereas samples A, C, E, G &

Shilajeeta contains 84 types of minerals in natural H contain moisture within Normal limit. Sample A
ionic form which are very vital for maintaining the & G failed in solubility (in water) and rest all
equilibrium of energy metabolism in our body. The samples showed good solubility. Sample B, D & H
mineral in Shilajeeta are not similar to the mineral showed highest Ash value which denotes presence
supplements available in the Market. The minerals of organic material in larger quantity than other
are in ionic form and have previously been samples. Water soluble ash is nearly same in all
absorbed by rich plant life returned back to earth, samples except sample I.
so they are easily and completely absorbed by
body cells. Shilajeeta is truly remarkable substance CONCLUSIONS
with a long history of human usage for healing of In these nine samples after physiological and
83
Urinary System and for diabetes. Unfortunately, laboratory tests G. H & I samples looks a natural
many of those who sell shilajeeta or the product and of good quality that can be used in preparation
Page
containing it, make many wild claims for shilajeeta of Ayurved medicines which will improve the
ability to cure the disease. quality of medicine.
The clinical studies on Shilajeeta conducted have
While comparing the list of modern indications for so far; have been conducted on animal only. These
shilajeeta, only reputable sources were taken into studies seen very preliminary and my hope is that
consideration and excluded shilajeeta sold by any respected the scientist in United States, India, and
sources. In this study purposefully else included throughout the world, continues their
internet sources for this information as it was felt investigation into the healing substance shilajeeta.
that their claims were exaggerated beyond the
reality. REFERENCES
In analyzed samples of Shilajeeta when compared 1. Sushruta Samhita, edited by Kaviraj Ambikadutta Shastri,
Chaukhamba Sanskrit Sansthan, Varanasi, 2007.p.43
with API parameters, Sample I contain maximum
2016; 4(2):80-84
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2. Niagara Medical Leeches Available 8. http://www.herbalcureindia.com/shilajit.html [Accessed

from: http://www.leeches.biz/ [Accessed on 01 Mar on 03 Mar 2014].
2014]. 9. Ghosal, Shibnath; Singh, Sushil K.; Kumar, Yatendra;
3. http://en.wikipedia.org/wiki/Hirudo_medicinalis Srivastava, Radheyshyam; Goel, Raj K.; Dey, Radharaman;
[Accessed on 01 Mar 2014]. Bhattacharya, Salil K. (1988). "Anti-ulcerogenic activity of
4. Sushruta Samhita, edited by Kaviraj Ambikadutta Shastri, fulvic acids and 4-methoxy-6-carbomethoxybiphenyl
Chaukhamba Sanskrit Sansthan, Varanasi, 2007. p.43-44 isolated from shilajit". Phytotherapy Research 2 (4): 187
5. http://en.wikipedia.org/wiki/Varicose_veins [Accessed 191.
on 03 Mar 2014]. 10. Pal D, Bhattacharya S. Pilot Study on the Improvement of
6. www.naturalnews.com/029498_Shilajit_Himalayan.html Human Performance with ReVital ETTM as Energy
[Accessed on 03 Mar 2014]. Booster: Part-IV. 2006. Data on file. Natreon, Inc.
7. Bhattacharyya S, Pal D, Banerjee D, et al. Shilajit 11. Acharya, SB; Frotan, MH; Goel, RK; Tripathi, SK; Das, PK
dibenzopyrones: Mitochondria targeted antioxidants. (1988). "Pharmacological actions of Shilajit". Indian
Pharmacologyonline. 2009; 2:690-8. journal of experimental biology 26 (10): 7757.

Parhate Saroj M., Khaparde P. H., Standardization and Comparative Study of Shilajeeta w.s.r.t. Market sample, Int. J.
Ayu. Alt. Med., 2016; 4(2):80-84
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RESEARCH ARTICLE
IMPACT OF 2002 AMENDMENTS TO CONSUMER PROTECTION ACT,

1986: A RETROSPECTIVE STUDY IN CASES OF MEDICAL
NEGLIGENCE
Barapatre Nishant Bhimraj 1*, Joglekar Vishnu Prabhakar 2
1. Assistant Professor, Dept. of Agadtantra, Mahila Utkarsh Pratishthans Ayurved College, Degaon
Tq. Risod Dist. Washim, Contact No. +91-8149694530, Email- drnishantbarapatre@hotmail.com
2. Professor and HOD, Dept. of Agadtantra, Tilak Ayurved Mahavidyalaya, Pune, Contact No. +91-
9823931611, Email- joglekar.vp@gmail.com

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Barapatre N.B., Joglekar V.P., Impact Of 2002 Amendments to Consumer Protection Act, 1986: A Retrospective Study in Cases of Medical
Negligence, Int. J. Ayu. Alt. Med., 2016; 4(2):85-95
VOL 4 eISSN-2348-0173
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RESEARCH ARTICLE
IMPACT OF 2002 AMENDMENTS TO CONSUMER PROTECTION ACT, 1986: A

RETROSPECTIVE STUDY IN CASES OF MEDICAL NEGLIGENCE
The Doctor-Patient relationship has changed tremendously after formulation of
Barapatre Nishant Bhimraj
Consumer Protection Act in 1986. Now, doctor is considered as service provider
Assistant Professor,
Dept. of Agadtantra, only, providing the services of healthcare. So, there has been great rise in the
Mahila Utkarsh Pratishthans complaints of medical negligence. The Act was amended in 2002, enforcing many
Ayurved College, Degaon Tq. important changes and various new provisions. Therefore, these amendments
Risod Dist. Washim, were needed to be studied by the medical personnel. For that purpose, this
Contact No. +91-8149694530, retrospective study was conducted to find impact of 2002 amendments to CPA-
Email- 1986 in the cases of medical negligence under Wardha District Consumer Forum.
drnishantbarapatre@hotmail.com The judgments of Medico-legal Cases admitted in Wardha Forum were
downloaded from www.confonet.nic.in. Then personal visits were made for
verification of online records. Visits were made to State Commission (Mumbai)
and Circuit Bench (Nagpur) as well for information about Appeals. The Medico-
legal cases were divided into 2 groups i.e. before amendments (13 cases) and
after amendments (30 cases). The Medico-legal Cases were critically studied and
observations were made by comparing the cases in two groups. All observed data
was subjected to frequency analysis and descriptive statistics in order to
compare the two groups. Also, cases were analyzed qualitatively for case history,
remarks and results. The nature of negligence alleged, defense offered and
QR Code IJAAM
verdict delivered accordingly was noted. The study showed that the 2002
amendments have made a noteworthy impact to the Consumer Protection Act in
cases of Medical Negligence at Wardha Forum, though the impact has been to a
variable extent for the different provisions of the Act.
Key Words: Consumer Protection Act (CPA), Medical Negligence, 2002

www.ijaam.org Amendments
INTRODUCTION the completion of education by getting permission

The medical profession has been one of the oldest from the king and then only he could start his own
professions of the world; which has emerged with medical practice.[3]
the emergence of life on this planet earth.
However, the medical profession has been more or 3) However, we find evidences of unethical
less very similar right since the ancient times. practices and quacks in samhita period as well.
Sage Sushruta has very well explained about the
Similarity of Medical Profession - quacks with different words such as Vaidya
1) The medical profession has ethical guidelines Vidagdha[4], Ku Vaidya[5], Murkha Vaidya[6] and
thrust upon it, not by any law but by the profession Taskar Vrutti[7].
itself. The World Medical Association has adopted
Declaration of Geneva, consisting of a Physicians 4) To restrict these quacks and the doctors from
Oath.[1] In India, Indian Medical Council Act has violating the ethical guidelines, in the modern era,
86
prescribed the standards of professional conduct & Indian Penal Code has been empowered with
a code of ethics. Such ethical guidelines for good Section 304-A for providing a punishment for
Page
medical practices have been seen across the ages. death due to negligence.[8] In the cases of
Sage Agnivesha has formulated an oath for the professional misconduct, the registration of a
ethical conduct in medical profession. Hippocrates, doctor can be cancelled by the medical council and
the Father of Medicine has formulated a very a commission of inquiry can be conducted.[9]
famous oath The Hippocratic Oath which has Likewise, in the ancient times, we find the oldest
become a keystone of medical ethics.[2] medico legal code as The Code of Hammurabi
(Around 2000 BC) which had set drastic laws for
2) Like the registration process adopted by the the physicians. Doctors whose proposed therapy
Medical Councils; a registration process for proved wrong ran the risk of being killed. Even the
doctors was undertaken in the ancient times as Egyptian and Roman law had such similar
well. A doctor was needed to register himself after provisions like to cut the hand of the physician or
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surgeon for medical malpractice. In Kautilya In 1995, by the landmark decision of Supreme
Arthashastra, we find the penalties for the Court of India in case of Indian Medical Association
mistakes of the physicians. The serious patients vs. V.P. Shantha[12], the medical profession was also
had to be treated only after reporting to the brought under the purview of this act, considering
concerned authority, otherwise the physician was the patient as a consumer and medical practitioner
liable to be punished.[10] Also, there were as a service provider. Only the services availed
punishments for criminal abortion and non- totally free of cost were eliminated from the
reporting of epidemics as well. So, right since the purview of this act.
ancient times, the medical profession has been the
same as it appears today. But the beliefs of the
patients have changed over the time. The Consumer Protection Act and Key
Amendments -
Change in trend of Doctor-Patient Relationship- The Consumer Protection Act, 1986 is a very
Since the very ancient times, especially in India, a important legislation of the recent times, which
doctor has been compared to the God and medical has set up a three-tier Quasi-judicial system
profession has been considered as a noble consisting of the District Forum, the State
profession and are accorded due respect. Even the Commission and the National Commission for
ancient sages have given a physician the utmost disposal of complaints of the consumers. The Act
importance among the Four Limbs of No. 62 of 2002 which came into force on 15th
Treatment.[11] March 2003 has included many new provisions in
the Consumer Protection Act. There are ample of
With the changing trends of doctor-patient chances that many of these amendments can have
relationship, a doctor is no longer considered as a big impact on cases regarding medical
God; rather patients consider him as a service negligence. The following are the key amendments
provider only, providing the services of healthcare. to the Consumer protection act and their possible
And whenever a doctor is doubted for lack of skill impacts:-
or care; more often than not, he is charged for
medical negligence. 1. A legal heir or representative can be
substituted as a party to the complaint, in the
With the expansion of education and sources of event of the death of the complainant or the
information like internet, the patients are gaining opposite party[13]. So, the legal heir or
knowledge about the medical field. So, they are representative can initiate the action against
becoming more aware about their health. Also, the service provider (doctor) even after the
there has been a great awareness about the rights death of the consumer (patient). Also, if a
of consumers. So, whenever something wrong patient dies after filing a complaint by himself,
happens to the patient, they are prone to misjudge his complaint can't be dismissed and his
a doctor as negligent, even after all the possible relatives can continue the case.
efforts made by the doctor. So, this has led to rise 2. Pecuniary jurisdiction of the Consumer
in complaints of medical negligence. disputes redressal agencies has been
increased, so that the complaints involving
The Government of India has formulated value of goods or services and compensatory
Consumer Protection Act (CPA)-1986 to control claims
the unfair trade practices, providing an easy, Up to Rs. 20 lacs are entertained in District
cheap, speedy and effective redressal of the forum[14] (as against Rs. 5 lacs before)
87
complaints. The act is applicable to all goods and Above Rs. 20 lacs up to Rs.1 crore in State
services as well. Commission[15] (as against above Rs. 5 lacs
Page
up to Rs. 20 lacs before)

Though initially medical services were not under Above Rs. 1 crore in National
this act; however, there was an immense need for Commission[16] (as against above Rs. 20
speedy and effective adjudication of the cases of lacs before)
medical negligence. The other dispute redressal So, after 2002 amendments, even the complaints
systems like Medical Council and Courts had failed and claims above Rs. 5 lacs up to Rs. 20 lacs can
to serve efficiently. The jurisdictions by Medical also be redressed at the district level and need not
Council had been biased in favor of the doctors and to go to the State Commission for the same, thus,
they couldnt serve the compensation. On the other making it more convenient for the complainants.
hand, jurisdictions by Courts were very time Also it reduces the number of complaints filed at
consuming & expensive as well. State commission and National commission.
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3. Provisions have been made for charging of fee in 10. Appellant has to deposit either fifty per cent of
respect of complaints filed before the the amount of compensation/ fine or the
Consumer disputes redressal agencies[17]. For below mentioned amounts whichever is less,
a claim of compensation before he makes an appeal to the upper
Up to Rs. 1 lac Rs. 100 are charged. judicial level, namely
Up to Rs. 5 lac Rs. 200 are charged. a) Rs. 25000 in case of appeal to a State
Up to Rs. 10 lac Rs. 400 are charged. Commission from the District Forum[21]
Up to Rs. 20 lac Rs. 500 are charged. b) Rs. 35000 in case of appeal to National
This provision was inserted to decrease the Commission from the State Commission[22]
tendency to register false and fabricated c) Rs. 50000 in case of appeal to the Supreme
complaints, because plethora of frivolous and Court from the National Commission[23].
vexatious complaints were being filed as no court As a result of this, tendency of appealing and re-
fees was prescribed earlier, due to which genuinely appealing after the dismissal of claims might have
aggrieved complainants were being suffered. Also, been dropped down.
the tendency to claim more compensation might 11. On the application of the complainant or of its
have been decreased due to this provision. own motion, State Commission may, at any
4. The District Forum may allow the complaint to stage of proceeding, transfer any complaint
be proceeded with or rejected, after the pending before a District Forum to another
provisions of Act No. 62 of 2002 amendment District Forum within the state if the interest
[17]. So, the forum can decide whether the of justice so requires[24]. So, cases can be
complaint is genuine and has to be proceeded transferred in favor of justice and thus,
with, or whether it's frivolous arising from any complainant can get early relief at a suitable
misunderstanding or anti-doctor tendency. place.
5. After the 2002 amendments, the admissibility of 12. The amendments have made provisions for
the complaint has to be decided within 21 days creation of benches of the National
from the date of receival of complaint [17]. That Commissions and State Commissions as well
means, it makes a faster processing towards as holding of Circuit Benches of these
the acceptability or rejectability of the Commissions[25]. This will help the State
complaint. Commissions to dispose of the cases quickly
6. Where the complainant fails to appear on the where a large number of cases are pending. It
date of hearing before the District Forum, the can also be convenient for complainant to
District Forum may either dismiss the appeal at a circuit bench rather than
complaint or decide it on merits[18].So, if any approaching State Commission situated at the
complainant files a complaint just to annoy a capital of the state only.
doctor and doesn't appear to the hearings to
continue the case, then the complaint can be MATERIALS AND METHODS
dismissed by the forum. The study has been completed in two phases. In 1st
7. Amendments have made provisions for phase, collection of Medico Legal cases is done and
expeditious hearing of the complaint. It states in 2nd phase, the cases are divided into two groups
to make the endeavor to decide the complaint for their critical study and observations are made
within a period of 3 months where the accordingly. The ethical clearance for performing
complaint doesn't require any tests/analysis this study was obtained from the Institutional
and within a period of 5 months if it requires Ethical Committee at the time of formulation of
any tests/analysis[19]. So, the consumers can this study.
88
get justice within a short period of time

without much delay, because delay in justice is In 1st PHASE:-
Page
denial to justice. The data has been collected from online

8. No adjournment may be ordinarily allowed database. The judgments of all the Medico
unless for sufficient reason for grant of Legal cases registered at Wardha District
adjournment has been recorded in writing and Consumer Forum were downloaded from the
costs for such adjournment have also been website of ConfoNet project
specified in order[19]. This will facilitate (Computerization and Computer Networking
quicker disposal of cases. of Consumer Forums in Country) i.e.
9. Provision for interim orders has been made, in www.confonet.nic.in
cases where it is considered necessary by the Then Wardha District Consumer Forum has
Consumer disputes redressal agencies[20]. This been personally visited for verification of the
will provide speedy justice in appropriate collected data. The online records were
cases where the condition so requires. confirmed to match with the manual records.
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Some missing information in the online Also, the cases have been analyzed qualitatively for
records was obtained from the manual - Nature of Negligence Nature of Defence offered,
records e.g. date of admission of the cases. Verdict based on admitted facts
Then visits have been made to the office of
Maharashtra State Consumer Disputes Method of Statistical Analysis
Redressal Commission at Mumbai and its All observed data collected after the final
Circuit Bench at Nagpur. The information assessment was arranged in a master chart and
about appeal of these Medico Legal cases to statistical tables were constructed. In order to
upper judiciary level was obtained from these compare the two groups and to draw conclusion,
offices. the data has been subjected to frequency analysis
All the above personally collected data has and descriptive statistics. Further, diagrams and
been obtained under the provisions of Right charts have also been drawn to signify the
to Information (RTI) act, 2005. important findings.
In 2nd PHASE:- RESULTS

All the collected Medico Legal cases have been 1. After 2002 amendments, there is a high degree
divided into 2 groups. of rise in the number of cases being admitted.
Group A The Medico Legal Cases which are The total number of cases admitted before
admitted after 1st Jan 1995 and delivered amendment is 13 while the same after
judgments before 14th March 2003. These amendment is 35. Total 22 more cases have
cases were found to be 13 in number. been admitted in the post-amendment eight
Group B - The Medico Legal Cases which are years period as compared to the pre-
admitted after 1st Jan1995 and delivered amendment eight years period. (Fig. I)
judgments between 15th March 2003 to 31st 2. The year to year trend shows remarkable rise
Dec 2010. These cases were found to be 30 in in the number of cases admitted per year in
number. the post-amendment period. The first year of
amendments shows a significant shoot-up in
INCLUSION CRITERIA the number of admitted medico legal cases,
1. Medico Legal Cases only under the Consumer suddenly rising to 10 cases in that year. The
Protection Act. subsequent years also show a risen frequency
2. The cases admitted and delivered judgments of cases in the post-amendment period as
under Wardha district consumer forum compared to the period before amendments.
between 1st Jan 1995 to 31st Dec 2010. (Fig. II)
3. The percentage of cases being admitted
EXCLUSION CRITERIA against doctors running their private OPDs
1. The Medico Legal Cases which are admitted and also against the government hospitals has
and not delivered judgments under Wardha been slightly decreased after the 2002
district consumer forum between 1st Jan 1995 amendments i.e. by 4.33 % and 2.40 %
to 31st Dec 2010. respectively. However, the percentage of cases
being admitted against the private hospitals
The Medico Legal Cases have been critically has seen some rise in the post-amendment
studied for:- Study of case history, Study of period by 6.73 %. (Fig. III)
remarks, Study of results 4. After 2002 amendments, the percentage of
cases admitted against General practitioners,
89
Further, observations and analysis done by General physicians, Gynecologists,

comparing cases from 1995-2003 & 2003-2010 for Ophthalmologists, Urologist surgeons, Civil
Page
surgeons and District health officers (DHO)

1) Qualifications of Doctor & Type of Clinical have been decreased by 5.29 %, 0.79 %, 4.51
Establishment %, 0.79 %, 6.67 %, 7.45 % and 0.79 %
2) Nature of Verdict respectively. However, the medico legal cases
3) Time required for judgment admitted against Orthopedicians,
4) Compensation claimed & granted Pediatricians, General surgeons and
5) Whether appealed at upper judiciary level or Government medical officers have been
not increased by 1.38 %, 5.88 %, 11.77 % and 7.26
6) Other specifications as per the case % respectively. (Fig. IV)
5. After 2002 amendments, the percentage of
judgments as allowed have increased
negligibly by 0.25 %, judgments as dismissed
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
have increased by 2.83 % and judgments as withdrawn on pursis after 2005. This clearly
rejected have increased by 6.67 % which were shows that there is a marked decrease in the
zero before the amendments. However, the withdrawal of the cases. Out of the total 7
percentage of judgments as withdrawn on cases withdrawn on pursis, 6 were filed on the
pursis has been decreased by 9.75 %. (Fig. V) doctors running their private establishments
6. After amendments, the mean of time period and out of those, 5 were filed on general
required for delivering the judgments has practitioners. This shows that the private
been decreased by 2 months in allowed cases, practitioners have a greater tendency to settle
2.77 months in dismissed cases and 0.66 the cases outside the courtrooms. The general
months in cases withdrawn on pursis. Rejected practitioners have even a higher tendency for
cases have taken 5.5 months for their such settlements. The median time period
rejection. (Fig. VI) after which the pursis has been filed is 10
7. After 2002 amendments, the mean of months. This shows that the respondent
compensation claimed by the complainants doctors pursue the case for a considerable
has been increased by Rs. 5,40,533 time, but gradually decide for mutual
approximately, while mean of compensation settlement rather than spending more time
granted by Wardha District Consumer Forum and money.
has been increased by Rs. 2,38,408 12. In a case against a General physician running
approximately. (Fig. VII) his Private hospital, the complainant had
8. The mean of compensation claimed was on alleged that the doctor had extorted more
higher side, especially in the post-amendment money for the treatment and also had
period. However, the mean adjusted misbehaved when he had asked for
compensation calculated with the help of explanation about the fees charged for the
Consumer Price Index (CPI) to compare with treatment. The compensation asked by the
the ever increasing rise in the inflation, shows complainant was very minimum i.e. Rs. 4100
that the compensation asked was not much only. However, the complainant was
higher than the mean actual compensation continuously absent before the consumer
claimed before amendments. (Fig. VIII) forum for more than two months. Hence, the
9. The mean of compensation granted by the court concluded that the complainant doesnt
Consumer Forum has been increased in the seem to be interested in pursuing the
post-amendment period. However, mean complaint and therefore, the complaint was
adjusted compensation shows that the mean dismissed. This shows that the complainant
actual compensation granted was an had admitted the case only with an intention
excessively exaggerated figure, which was to annoy the doctor as a result of the quarrels
nearly half the actual compensation when occurring between them. He was neither
compared with the rate of inflation in the interested in the compensation nor in
subsequent years after amendments. (Fig. IX) pursuing the complaint. This is an anti-doctor
10. After 2002 amendments, the percentage of tendency which has to be stopped, otherwise it
cases appealing at the Maharashtra State can cause unnecessary sufferings and
Consumer Disputes Redressal Commission has discomfort to the doctors.
risen by 27.95 %. However, out of the 13 13. In 2 cases admitted in the year 2009, the
appeals made after the amendments, 8 have consumer forum relied on Landmark
been filed after creation of Nagpur circuit Judgment[26] in the case Martin F. Dsouza Vs
bench. So, this may be a major factor Mohd. Ashfaque delivered by Supreme Court
90
influencing the number of appeals. (Fig. X) stating that, when a complaint about medical
11. In 7 cases, the disputes were solved by both negligence is presented before a consumer
Page
the parties outside the courtrooms and hence, forum, the case should be verified by the
the complainants had filed pursis for experts in medical field before issuing a notice
withdrawal of their complaints. The to the respondents and depending on the
applications of the complainants were allowed reports of the experts, further orders should
and the complaints were disposed as be given. A committee was formulated
withdrawn. These cases show the tendency to accordingly having Wardha District Civil
settle the cases outside the courtrooms rather Surgeon as Chairperson and including
than spending time and money for pursual of minimum four subject experts, out of which
justice in the courtrooms. However, the one was necessarily a female. The committee
tendency to withdraw the cases on pursis has studied the cases in detail and concluded that
decreased in the post-amendment period by there was no negligence observed on the part
9.75 %. There hasnt been even a single case of doctors. The consumer forum rejected to
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
admit the above complaints on the basis of this Reply to each notice promptly and precisely.
report. However, it was made clear that the Produce your written statement on affidavit.
complainant can admit his complaint in an Provide details about your qualifications and
appropriate court. This shows that the prove your eligibility.
consumer forum has acquired a very efficient Make all the facts associated with the case
procedure since 2009 as guided by the above crystal clear, which are many a times
said Landmark Judgment delivered by the misinterpreted by the complainant.
Supreme Court. This can block the cases Provide all the details about treatments given,
arising from misunderstandings or anti-doctor procedures performed, investigations advised
tendency, thus, protecting the doctors from and diagnosis made etc.
unnecessary sufferings and discomfort. Furnish textual references from Medical
Textbooks to support your deeds.
DISCUSSION Submit statements of other doctors who were
From all the cases studied, it was noted that the involved in the case.
negligence alleged mostly are Provide opinion of the experts in related
1) The doctor has treated incorrectly causing subjects.
disability or death of patient. Rely on previous Landmark Judgments & raise
2) The doctor has treated incorrectly causing your defence on its basis.
prolongment of disease or causing further
expenses for treatment and/or surgery.
The important remarks and verdicts given by the
3) The doctor has extorted more money as costs
consumer forum are as follows
to the treatment.
1) Initially, the forum gives remarks about three
4) The doctor had misbehaved with the patient or
preliminary points viz. Limitation (whether
his relatives.
case is filed within 2 years from occurrence or
5) The doctor was not qualified sufficiently. For not), Jurisdiction (incidence of cause within
example, a GP pretending to be an Expert or an the Wardha district or not) and The
Ayurvedic doctor practicing Allopathic Consumer Dispute (whether the negligence is
treatments.
proved or not)?
2) Remarks about whether complainant is a
The defences offered mostly by the responding consumer as per the definition of Consumer
doctors are as follows and whether theres negligence or deficiency
1) The services are rendered free of cost; in service?
therefore, the complainant cannot be 3) Remarks about whether the respondent has
considered as a consumer.
given best possible treatment and assistance?
2) The complaint is not in limitation i.e. has been
Whether there was contributory negligence?
filed too late after a period of 2 years since the
4) Remarks about whether the complainant is
cause of action had taken place.
entitled to the compensation? If yes, then what
3) The complaint is not in the jurisdiction of the amount?
forum i.e. the cause of action has taken place 5) Remarks about whether all the respondents
outside the Wardha district. joined as a party are negligent and deficient in
4) The case is already filed under other tribunals providing services or not?
e.g. Motor Accident Claims Tribunal & cannot 6) The forum always relies upon the sound
be subsequently run in consumer forum. (Res principles of law laid down in the previous
Judicata) Landmark Judgments.
91
5) The patient has not followed instructions. 7) The case is dismissed when the complainant is
(Contributory Negligence) continuously absent, with a conclusion that the
Page
6) The patient did not appear for the follow up he is not interested to pursue the complaint.
and there was an intervening action in 8) When the respondents neither reply with their
between the period of his absence. (Novus
written statements nor appear before the
Actus Interveniens)
forum, the case is heard from the
7) The Insurance Company, the Pharmaceutical complainants side only and judged on the
Company, other doctors etc. are not joined as basis of presented facts.
necessary parties to the complaint. 9) Since 2009, the medical negligence cases are
8) The complainant has not produced any verified by a committee of medical experts &
experts opinion as evidence. then accepted or rejected accordingly.[26]
The best procedure of defense for the doctors
alleged of negligence can be
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
10) The hospital is held vicariously liable for the the case Martin F. Dsouza Vs Mohd. Ashfaque
wrong deeds of its employees and is liable to I CPJ (2009) 32 SC by Supreme Court.
pay the compensation. 3) The provision for deciding the admissibility of
11) There are two different remarks whether the the complaint within 21 days was applied after
Insurance Company has to be joined as a the above mentioned Landmark Judgment
necessary party to the case and whether the since 2009 only & it was found that the
complaint should be dismissed on this defense. committee of medical experts required five
The remark about Its not mandatory is more and a half months to decide on the
satisfactorily accepted. admissibility of the complaint.
12) However, failure to join the Pharmaceutical 4) The time period required for judgments has
Company or other doctors as necessary parties been reduced after the amendments. However,
to the case can lead to dismissal of the the provisions for expeditious hearing &
complaint. decision of complaint within 3-5 months
13) The Burden of Proof lies on the complainant havent been attained.
and he has to discharge the Burden of Proof by 5) The provisions for enhancement of pecuniary
adducing expert evidences. limits of jurisdiction have made an impact and
14) If the initial Burden of Proof is discharged by a significant increase is seen in the
the complainant, then Reverse Burden of compensation claimed and granted in the
Proof lies upon the respondent to disprove cases of medical negligence. After the
his claim. amendments, the largest claim was 20 lacs
15) There is no reason to disbelieve the doctors while the claims were limited to 5 lacs before
about the treatment provided where no the amendments. However, the mean adjusted
relatives of the patient are present. Ex.- ICU, compensation calculated with the help of
OT etc. Consumer Price Index shows that the
16) Just an impression that the doctor was compensation asked was not much higher than
negligent causing death cannot take the place the mean actual compensation claimed before
of Proof as required by settled principles of amendments taking the rate of inflation into
law. consideration. Also, the mean adjusted
17) No doubt that the permanent loss cant be compensation shows that the mean actual
compensated in terms of money, but whatever compensation granted was an excessively
granted is nothing more than mere exaggerated figure, which was nearly half the
Consolation. actual compensation when compared with the
18) Remarks about the causes of prolongment of rate of inflation in the subsequent years after
the case, the main cause being the amendments.
adjournments sought by the complainant. 6) The provision for deposition of some amount
19) Remarks about having discretion to award of compensation or fine to appeal to the upper
Additional Compensation for causing judicial level didnt have any impact. The
inconvenience & harassment to the tendency of appealing after the dismissal of
complainant. claims was expected to be reduced due to this
20) Application of the principle of Res ipsa provision, however, the Appeals have been
loquitor where the facts of the case are found to be increased.
sufficient to conclude that the doctor was 7) The provision for creation of Circuit Benches
negligent. seems to have caused a tremendous rise in the
Appeals of the cases, since the Nagpur bench of
92
The impacts of 2002 amendments on the cases State Commission was started in December
studied are 2006 due to convenience.
Page
1) The provision for substitution of legal heir or 8) The provision to transfer the pending
representative had no special impact as the complaints to another Forum had a
definition of Consumer already includes any noteworthy impact, as the cases were
beneficiary of such services other than the transferred from other Forums as soon as the
person who hires or avails of the services for amendments were decided to be brought into
consideration. The beneficiaries used to file a action.
case earlier as well in case of death of the 9) The provision for dismissal of the complaint in
patient. cases where complainant fails to appear
2) The provision for deciding about the before the Forum on the date of hearing has no
acceptability or rejectability of the complaint major role, as it was seen before the
was applied only after Landmark Judgment in amendments as well. Even when the
respondents failed to appear, the forum had
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
judged the cases on the basis of facts

presented by the complainant. However, the following provisions failed to show
the positive impact -
CONCLUSION 1) The provision for charging fees couldnt
The significant impacts of 2002 amendments are decrease the number of cases.
1. There is a high degree of rise in the number of 2) The provision for deciding about acceptability
cases being admitted. or reject ability of complaint.
2. The cases against Private OPDs & Govt 3) The provision for deciding the admissibility of
hospitals have slightly decreased. complaint within 21 days.
3. The cases against Private hospitals have seen 4) Provision for expeditious hearing & decision of
some rise. case within 3-5 months.
4. Cases against GPs, General physicians, 5) Provision for deposition of some amount of
Gynecologists, Ophthalmologists, Urologist compensation/fine to appeal to the upper
surgeons, Civil Surgeons & DHO have been judicial level in order to reduce the number of
reduced. Appeals.
5. Cases admitted against Orthopedicians,
Pediatricians, General Surgeons and The following provisions were already in practice
Government Medical Officers have been even before the amendments were made to the
increased. Consumer Protection Act.
6. The judgments as Allowed and Dismissed
have been increased. 1) Provision for substitution of legal heir or
7. The judgments as Rejected have increased representative.
remarkably from zero. 2) Provision for dismissal of the complaint when
8. The tendency to withdraw the cases on pursis complainant is absent.
has been decreased.
9. Time period required for delivering the Thus, we can reach to a conclusion that the 2002
judgments has been decreased. amendments have made a noteworthy impact to
10. Compensation claimed by complainants has the Consumer Protection Act (CPA), 1986 in the
been increased, though its not much cases of Medical Negligence at Wardha District
increased taking the rate of inflation into Consumer Forum, though the impact has been to a
consideration. variable extent for the different provisions of the
11. Compensation granted by the Consumer Act. However, a further study needs to be
Forum has been increased; however, this performed at other District Consumer Forums to
increase is lesser than what we observe when support this conclusion and to generalize these
compared with the rate of inflation in the findings as applicable to the whole country.
subsequent years after amendments.
12. Cases appealing at State Commission have
been increased remarkably after creation of
Nagpur circuit bench.
13. The pending complaints are transferred from
other Forums.
12
93
10
40
8
Page
30 6
20 4
2
10
0
0 1st 2nd 3rd 4th 5th 6th 7th 8th
Before Amendments After Amendments Before Amendments After Amendments
Fig. I- Impact of amendments on Total Number of Cases admitted Fig. II- Impact of amendments on change in the trend
against the medical professionals of filing a Medico Legal Case against doctors
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
25
50
20
40
Percentage of cases
30 15
20
10
10
5
0
0
Private
Private
OPD Govt
Hospital
Hospital
Before Amendments After Amendments

Fig. III- Impact of amendments on cases Fig. IV- Impact of amendments on cases
occurring on different clinical establishments occurring on differently qualified doctors
60
40 Rejected
Percentage of cases
50
Time of judgment (Months) 35
40 30
30 25 Withdrawn on
20 Pursis
20
15
10 Dismissed
10
0 5
Allowed Dismissed Withdrawn Rejected 0
on Pursis Allowed
Before After
Amendments Amendments
Fig. V- Impact of amendments on the nature Fig. VI- Impact of amendments on the time period
of verdict given by the Consumer Forum required for delivering the judgments
800000
700000
800000
Mean of Compensation (Rupees)
600000
600000 500000
400000
400000 300000
200000
200000 100000
0
0
1995 1997 1999 2001 2003 2005 2007 2009
Compensation Compensation
claimed granted
94
Before Amendments After Amendments Actual Adjusted

Page
Fig. VII- Impact of amendments on the compensation claimed Fig. VIII- Mean Compensation claimed every year as
by the complainants and granted by the Consumer Forum compared with Mean Adjusted Compensation according to
Consumer Price Index (CPI)
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
2000000
1800000
Percentage of cases appealing at state

1600000
45
1400000
40
1200000
1000000 35
commission
800000 30
600000 25
400000 20
200000
15
0
10
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
5
0
Actual Adjusted Before Amendments After Amendments
Fig. IX- Mean Compensation granted every year as compared Fig. X- Impact of amendments on the tendency
with Mean Adjusted Compensation according to CPI to appeal to the higher judiciary level
REFERENCES 11. Dr. Brahmanand Tripathi, Charaka Samhita, Reprint,

1. http://www.cirp.org/library/ethics/geneva.php Varanasi, Chaukhamba Surbharati Prakashan, 2009, p.
[Accessed Date 27th Jun 2013] 207, 211
2. K. Park, Parks Textbook of Preventive and Social 12. AIR 1996 SC 550 :1995 (6) SCC 651
Medicine, 19th Edition, Jabalpur, Banarasidas Bhanot 13. Section 2 Subsection (1) Subclause (b)(v) of Act No. 62 of
Publishers, 2007, p.3 2002
3. Dr. Anantram Sharma, Sushruta Samhita, Reprint, 14. Section 11 Subsection (1) of Act No. 62 of 2002
Varanasi, Chaukhamba Surbharati Prakashan, 2012, P.73 15. Section 17 Subsection (1) of Act No. 62 of 2002
4. Dr. Anantram Sharma, Sushruta Samhita, Reprint, 16. Section 21 Subsection (1) of Act No. 62 of 2002
Varanasi, Chaukhamba Surbharati Prakashan, 2012, P.76 17. Section 12 Subsection (2) of Act No. 62 of 2002
5. Dr. Anantram Sharma, Sushruta Samhita, Reprint, 18. Section 13 Subsection (2) Subclause (c) of Act No. 62 of
Varanasi, Chaukhamba Surbharati Prakashan, 2012, 2002
P.214 19. Section 13 Subsection (3-A) of Act No. 62 of 2002
6. Dr. Anantram Sharma, Sushruta Samhita, Reprint, 20. Section 13 Subsection (3-B) of Act No. 62 of 2002
Varanasi, Chaukhamba Surbharati Prakashan, 2012, 21. Section 15 of Act No. 62 of 2002
P.214 22. Section 19 of Act No. 62 of 2002
7. Dr. Anantram Sharma, Sushruta Samhita, Reprint, 23. Section 23 of Act No. 62 of 2002
Varanasi, Chaukhamba Surbharati Prakashan, 2012, P.35, 24. Section (17-A) of Act No. 62 of 2002
147 25. Section 17-B of Act No. 62 of 2002
8. Indian Penal Code, 1860. 26. Martin F. Dsouza Vs Mohd. Ashfaque I CPJ (2009) 32 SC
http://www.bombayhighcourt.nic.in/libweb/oldlegislati
on/ipc1860/Chapter%205.pdf [Accessed Date 4th Aug
2013]
9. The Indian Medical Council Act, 1956 (102 of 1956) as
published in the Gazette of the Government of India.
10. Dr. Raghunath Sinha, Kautiliyam Arthashastram, 1st
Edition, Varanasi, Chaukhamba Prakashan, 1983, p.
4:1:56:13

95
Barapatre N.B., Joglekar V.P., Impact Of 2002 Amendments to Consumer Protection Act, 1986: A Retrospective Study
in Cases of Medical Negligence, Int. J. Ayu. Alt. Med., 2016; 4(2):85-95
Page
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
RESEARCH ARTICLE
USE OF RASONKALKA IN ADHMANA
Deshmukh Avinash Madhav1*, Amale Deepali J.2, Gaikwad Madhavi D.3
1. Associate Professor, Dept. of Rognidan & Vikriti Vigyan, C.S.M.S.S. Ayurved College, Kanchanwadi,
Aurangabad -431002, Contact No. +919822363522, Email -avimdeshmukh@gmail.com
2. Professor and H.O.D., Dept. of Rognidan & Vikriti Vigyan, C.S.M.S.S. Ayurved College,
Kanchanwadi, Aurangabad-431002
3. Assistant Professor, Dept. of Rognidan & Vikriti Vigyan, C.S.M.S.S. Ayurved College, Kanchanwadi,
Aurangabad- 431002
Article Received on - 28th Sept 2015

Article Revised on - 16th Jan 2016
Article Revised on - 6th June 2016
Article Accepted on - 7th June 2016
96
Page
2013 IJAAM
Deshmukh A.M. et.al., Use of Rasonkalka in Adhmana, Int. J. Ayu. Alt. Med., 2016; 4(2):96-100
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
RESEARCH ARTICLE
USE OF RASONKALKA IN ADHMANA

Nowadays due to lifestyle changes and business or busy schedule in service, many
Deshmukh Avinash Madhav
people suffer from digestive system disorders. It may be due to junk foods like
Associate Professor,
Dept. of Rognidan & Vikriti pizza, bakery products and many other ready to eat food products, Vegavrodha ,
Vigyan, C.S.M.S.S. Ayurved Adhyashana ( eating food after meal ) Adhmana is a common symptom of many
College, Kanchanwadi, digestive system disorders. It may occur as a disease having its own Samprapti as
Aurangabad -431002, given in Madhav Nadana in Vatvyadhi .Modern medicine does not have satisfactory
Contact No. +919822363522, treatment for it. But in Ayurveda in different Samhitas Rasona is given as a good
Email - Vataghna Dravya, as well as it is also useful in Annavaha Strotasa vikruties. Rasona
avimdeshmukh@gmail.com is Ushna,Tikshna and can be used in Adhmana vyadhi .In this study we selected 100
patients having Adhmana for assessing use of Rasona . 50 patients were given
QR Code IJAAM
Rasona kalka along with tiltaila.50 patients were given sharkara powder as
placebo. Patients were examined for following objective parameters Adhmana,
Udarshool, Antrakoojan and Malavasthambha. Rasona kalka was found very
effective in Adhmana and Antrakoojan.
Key Words: Adhmana, Rasona,Kalka ,Vatvyadhi

www.ijaam.org
INTRODUCTION MATERIALS AND METHODS

Ayurveda is a science of life and it is useful in Total 100 patients were selected and studied.
maintaining Arogya by following Dincharya and (Ethical committee of CSMSS Ayurved College,
Rutucharya. But whenever there is Mithya Ahara Aurangabad permitted this study on date
Vihara,person may suffer from different Vyadhis 11/01/2014) These patients were selected in 2
according to khavaigunya and Doshdushya groups of 50 each. The patients were treated for 15
Sammurchana. Intake of Vatprakopak Ahara like days.
Turi ( pigeon pea), Vatane(peas),Matar (green 1) 50 patients were given Rasona kalka [5]
peas), Khaskhas(poppy seeds),Harbara(gram), along with tiltaila.
Kalingad(watermelon), Peru (guavas) 2) 50 patients were given sharkara powder
,Chavali(cowpea), wafers,Toast,dried powder of as placebo.
different leafy vegetables, sitting job ,working at
late night, regular use of fast food ;causes Selection of Patients:
Agnidushti [1] and then Adhmana [2]. As well as The patients were selected as per following criteria
Vegvidharana, Atichankramana may cause Inclusion criteria:
Vatprakopa. Rasona(Allium Sativum) is Snigdha, Age group: above 18 years
Tikshna [3] , Pichchil, Guru and Sara. Rasona Sex: both male and female
contains Amlavarjeet Panchrasa. There is prablya Lakshnas: Patients having signs and
(mainly) of Madhura and Katu Rasa. Due to these symptoms of Adhmana.
Gunas Rasona (Allium Sativum) is KaphaVataghna Exclusion Criteria:
97
[4]. It is used in many diseases. It is useful in various
Age: below 18 years
diseases of Annavaha Strotasa, as it is Amapachaka. Sex: Pregnancy and lactation.
Adhmana is mainly Vatvyadhi due to Agnimandya,
Page
Diseases: known cases of Diabetes

therefore Rasona can be used in the treatment of Mellitus, Hypertension and Peptic ulcer.
Adhmana. Objective Parameters
Patients were examined for following objective
AIM AND OBJECTIVES parameters
The present research work has been under taken Adhmana: present or absent
with the following aims & objectives: Udarshool: present or absent
1) To study Adhmana Vyadhi. Antrakoojan:present or absent
2) To study use of Rasona. Malavasthambha: present or absent
3) To study use of Rasona in Adhmana
Vyadhi. Follow up chart
Follow up was taken on First day, Fourth day,
VOL 4 eISSN-2348-0173
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Seventh day, Fifteenth day consume with meal 1 gm twice daily. All patients
were asked to visit on fourth, seventh and fifteenth
A case proforma was prepared. Patients were day. On visit every patient was examined according
selected according to specified criteria. Selected to criteria.
patients were examined accordingly with detailed
history taking and Strotas Parikshana. Patient Drug dose: 1 gm Rasona Kalka twice daily in
examination consisted Ashtavidha Pariksha and madhyabhukta avastha (during meals).
examination of abdomen. Out of 100 patients Anupana: Tila taila.
selected, 50 were asked to consume one gram of Duration: 15 days
Rasona Kalka in madhyabhukta avastha (during
meals) twice a day for fifteen days. Remaining fifty OBSERVATION
patients were given placebo, and were asked to
Table 1: Adhmana
Cure grade Total relief Moderate Mild No relief Total

Group I 30 8 7 5 50
Group II 00 10 5 35 50
Total 30 18 12 40
Table 2: Udershool

Group I 25 10 7 8 50
Group II 00 8 5 37 50
Total 25 18 12 45
Table 3: Antrakoojan

Group I 32 6 6 6 50
Group II 01 10 4 35 50
Total 33 16 10 41
Table 4: Malavastambha

Group I 15 8 7 20 50
Group II 00 6 6 38 50
Total 15 14 13 58
Statistical test CHI SQURE TEST

For application of Chi Square Test Patients having total and moderate relief were considered as cured,
while those who had mild or no relief were considered as not cured, for the ease of calculation.
Table 5: Adhmana:
Cure grade Cured Not cured total

Rasona Kalka 38 12 50
98
Control 10 40 50
Total 48 52 100
Page
Table 6: Statistical Table

E 24 E 26 50
Rasona Kalka O 38 O 12
D 8.17 D 7.54
E 24 E 26 50
Control O 10 O 40
D 8.17 D 7.54
Total 48 52 100
Chi square=31.42
VOL 4 eISSN-2348-0173
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Table 7: Udershool

Control 8 42 50
Total 43 57 100

E 21.5 E 28.5 50
D 8.48 D 6.40
E 21.5 E 28.5 50
Control O8 O 42
D 8.48 D 6.40
Total 43 57 100
Chi square=29.76
Table 9: Antrakoojan

Control 11 39 50
Total 49 51 100

E 24.5 E 25.5 50
D 7.44 D 7.15
E 24.5 E 25.5 50
Control O 11 O 39
D 7.44 D 7.15
Total 49 51 100
Chi square=29.18
Table 11: Malavastambha

Control 6 44 50
Total 29 71 100

E 14.5 E 35.5 50
D 4.98 D 2.04
E 14.5 E 35.5 50
Control O6 O 44
99
D 4.98 D 2.04
Total 29 71 100
Page
Chi square=14.04, Table value is 3.84

Thus it is found that Rasona Kalka is effective in
Since the calculated value of Chi-square is greater the treatment of Adhmana. It especially relieves
than the table value, the test is highly significant Adhmana and Antrakoojan while it is also useful in
statistically and hence the null hypothesis is relieving Udershool and Malavshtambha.
rejected. So, there is strong association between
the type of treatment and cure rate.
VOL 4 eISSN-2348-0173
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Table 13: Overall Results
Moderately Mild
Symptom Cured % % % Uncured %
Cured Cured
Adhmana. 30 60 8 16 7 14 5 10
Udershool 25 50 10 20 7 14 8 16
Antrakoojan 32 64 6 12 6 12 6 12
Malavshtambha 15 30 8 16 7 14 20 40
There is significant reduction in symptoms like it is effective in Antrakoojana.

Adhmana (60 % patients) and Antrakoojana (64 %
patients), Udershool is also relieved in 50 % CONCLUSION
patients, while Malavasthambha is moderately Rasona Kalka is definitely helpful in the treatment
reduced i.e. in 30 % patients. of Adhmana. It mainly relieves symptoms like
Adhmana, Antrakoojana. Rasona Kalka also
DISCUSSION relieves other symptoms like Udershool and
Out of 50 patients who were given Rasona Kalka Malvasthmbha.Rasona is easily available and can
32 patients got total relief from Antrakoojana, be consumed easily. It also cost effective. Also it
while 30 patients got total relief from Adhmana, 25 has other qualities helpful for health. Rasona
patients got total relief from Udershool, while 15 should be used with caution in Pittaprakruti
patients got total relief from Malavasthambha Persons and in hyperacidity, Peptic Ulcer. These
lakshana. In the same group 12 patients got mild to results of Rasona are encouraging and further
moderate relief from Antrakoojana, while 15 research is necessary.
patients got mild to moderate relief from
Adhmana, 17 patients got mild to moderate relief REFERENCES
from Udershool, while 15 patients got mild to 1. Srivijayaraksita, Srikanthdatta, editors. Madhavnidanam
moderate relief from Malavasthambha lakshana. In Part I, 21 st edition Varanasi: Chaukhamba Sanskrit
Sansthan; 1993, p. 445.
the same group 20 patients did not have any relief 2. Late Dr. Ganesh K. Garde, editors.Ashtanghridya , 7 th
from Malavasthambha. Thus we find that Rasona Edition Mumbai 28 : Shri Gajanan Book Depot 1983,p. 31.
Kalka given in Adhmana patients significantly 3. P.N.Mehta,editors, Sushrutasamhita, ninth edition,
Varanasi: Chaukhamba Sanskrit Sansthan, 1995 ,p. 204.
reduces Adhmana, Antrakoojana. Moderately
4. Dr. Shailaja Srivastava,editors.Sharangadhar Samhita.
reduces Udershool and slightly helpful in Second edition Varanasi 221001(U.P.): Chaukhamba
Malavasthambha lakshana of Adhmana. Rasona is Orientalia 1998, p. 168.
Snigdha, Tikshna and Sara; due to which it is 5. Vd. Yadavaji Trikamjee Acharya,editor. Caraka Samhita
effective in Adhmana, Udershool and Part II, fourth edition Varanasi : Chaukhamba Sanskrit
Sansthan , 1994, p. 386
Malavasthambha Lakshana. Due to its Vatghnatwa

100
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VOL 4 eISSN-2348-0173
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RESEARCH ARTICLE
STUDY OF KUSUMBHA OIL (CARTHAMUS TINCTORIUS- LINN) W.S.R.

LOMASHATANA KARMA (HAIR GROWTH INHIBITING ACTION)
Vidya Vaijnath Yadav 1*
1. Assistant Professor, Dept. of Dravyaguna, Dr. J.J.M.A.M. College, Jaysingpur, Dist. Kolhapur,
Maharashtra, Contact No. +91 9881525332,+919421214623, Email- vvy2015@ rediffmail.com
Article Received on - 5th April 2016

101
Page
2013 IJAAM
Vidya Vaijnath Yadav, Study of Kusumbha Oil (Carthamus tinctorius- linn) w.s.r. Lomashatana Karma (Hair Growth Inhibiting Action),Int.
J. Ayu. Alt. Med., 2016; 4(2):101-106
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
RESEARCH ARTICLE
STUDY OF KUSUMBHA OIL (CARTHAMUS TINCTORIUS- LINN) W.S.R.

LOMASHATANA KARMA (HAIR GROWTH INHIBITING ACTION)
A smooth and silky hairless face is the dream of every woman that can maximize
Vidya Vaijnath Yadav the beauty & appeal of her appearance. Approximately 22% of women are affected
Assistant Professor, by the facial unwanted hair, which can cause embarrassment & lead to anxiety &
Dept. of Dravyaguna, Dr. depression. The present methods of removal of unwanted hair are depilatories,
J.J.M.A.M. College, Jaysingpur, electrolysis, Laser, Anti-androgens, etc. and are costly, not 100% effective having lot
Dist. Kolhapur, Maharashtra, of adverse effects. So considering the increased demand of Unwanted hair remover,
Contact No. +91 9881525332,
+919421214623,
'Kusumbha Oil (Carthamus tinctorius- Linn) was selected for screening & re-
Email- establishing its specific effect for the Lomashatana (Hair removal). So clinical trial
vvy2015@ rediffmail.com was conducted on 60 female subjects. These subjects were divided into two groups.
Study drug Kusumbha oil was compared with Placebo drug Tila oil (Sesamum
indicum - Linn). The Kusumbha oil was given for massage for two months. The
QR Code IJAAM results of the present study is found to be encouraging when analyzed statistically
with Studentst test & found significant (P(T <=t) at 0.05 *significant level in case
of hair growth retardation. Hair count test was clinically significant. These results
suggest that Kusumbha oil is effective for hair growth retardation & it is less
effective for permanent removal of hair.
www.ijaam.org Key Words: Lomashatana, Hair remover, Kusumbha oil
INTRODUCTION sexes. But the hair growth in the women on

In mammals, hair is an important tool as heat exposed part of the body like chin, upper lip, hands
insulator and serves the ornamental purpose. The & legs may be due to disturbed hormonal levels or
body hair of mammals serves to biologically it can be hereditary. Review of Ayurvedic text
protect important organs such as head chest and suggest that the herbs like Snuhi [3,8] (Euphorbia
feet. Beyond it, hair has no vital function in nerifolia), Koshataki [4] (Lufa acutangulata), Shami
humans; yet its psychological impact is [2,5,10] (Prosopis spicigera,) Kusumbha [4,7,8,9]
inestimable. Hair are important cosmetically and (Carthamus tinctorius), Bhallataka [7] (Semicarpus
used as an ornament. Loss of scalp hair causes anacardium) & Minerals like Hartala [7,8,10] (Arsenic
anxiety in both man and women, while in women di-sulphide) Shankhabhasma [3,4,7,8] (Conch
growth of facial and body hair in excess is equally powder), Manshiila [4,7,8](Arsenic tri sulphide) etc.
distressing. It is not just the women who want to can be used for removal of unwanted hair. So
get rid of their unwanted hair to add to their sex considering the increased demand of Unwanted
appeal. Hair remover for Men, Bodybuilders, hair remover, present study of 'Kusumbha Oil' was
Strippers & Swimmers have also gained equal conducted for screening & re-establishing its
importance. A smooth and silky hairless face is the specific effect for the Lomashatana (Hair
dream of every woman that can maximize the removal). Chakradatta & Bhaishajyaratnavali
beauty & appeal of their appearance. mentioned the Lomashatana action of Kusumbha
Approximately 22% of women are affected by the oil in 'Yonivyapada Chikitsa[7] & in Kshudraroga
102
facial unwanted hair [1], which can cause Chikitsa[8]. Scientifically it is known as Carthamus
embarrassment & lead to anxiety & depression. At tinctorius Linn & Safflower in English. According
present methods of removal of unwanted hair are to Charaka & Susrut samhita it is most
Page
depilatories, electrolysis, Laser, anti-androgens, unwholesome [2, 3] article in the diet. Apart from
etc. which are costly and are not 100% effective food substances, it has been used for dying
and have lot of adverse effects. According to purpose [10] since Vedic era. Its oil is sour, hot in
Ayurveda Hair is the Mala (by product) of Asthi potency, causes heart burn, not good for the eyes
Dhatu [2] (bony tissue) & embedded in the sixth (vision), bestows strength, increase Raktta, Pitta &
layer (Dermis & Epidermis) of the skin. & its hair Kapha. Lomashatana action of Kusumbha oil may
growth cycle varies in individual & area of the be its owing properties. It is useful in diabetes,
body. According to modern science, the urinary calculus, ulcers, arthritis, itching, etc.
development of body hair during puberty is From the references of research work done, many
controlled by male hormone androgen in both biological activities of Kusumblha oil like,
Vidya Vaijnath Yadav, Study of Kusumbha Oil (Carthamus tinctorius- linn) w.s.r. Lomashatana Karma (Hair Growth Inhibiting Action),Int.
J. Ayu. Alt. Med., 2016; 4(2):101-106
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
Antimicrobial [11], Antitumor,[12]Anti-inflammatory Grouping: 60 subjects were classified in two

activity,[13] etc. have been screened; but its hair groups & in each group, 30 subjects were enrolled
removal activity remains untouched. It is cheap by random sampling method.
easily available & easy for application.
Group A Study Group: Kusumbha oil was given
Plan of Work for local application & massage.
Aims and Objectives Group - B Placebo Group: Tila oil (Seasmum

The study was designed aiming at - indicum) having same color, odour, etc. was given
Aim :- as Placebo for local application & massage.
1. To assess the Lomashatana action (Hair
growth inhibitors or Retardation in re- Kusumbha oil & Tila oil was given for massage in
growth of hair.) of Kusumbha oil. the opposite direction of hair growth, on the
2. To observe the adverse effects of extensor aspect of right hand after removing hair
Kusumbha oil if any. by waxing method, for ten minutes daily at
morning (i.e. at 9 -10 am) for two months. Hair
Material & Methods: was counted in 2 cm sq. area by using Hair follicle
Kusumbha seeds were collected from genuine count test, after every 15 days & before & after
sources & authenticated scientifically. Kusumbha treatment. The period of study was 2 months &
oil was expressed from Kusumbha seeds by after that follow up for one month. To determine
conventional method. After that, standardization the adverse effect of Kusumbha oil, Skin Sensitivity
was done at Agharkar Research Institute & test (Patch Test) was carried out before
T.A.M.V. Pune, which is based on a comprehensive prescribing it to the patients. Nobody shows any
monogram derived from the guidelines given by type irritation, redness, itching, burning, etc. at
W.H.O., I.P. & A.I.P. that area. The test revealed the safety of Kusumbha
oil.
Clinical Study:
Method :- Single blind randomized clinical trials Primary End Points: - Retardation in re-growth of
were carried out on 60 healthy female subjects hair from selected area & reduction in no. of hair.
having excessive hair on the forearm to assess the
Lomashatana action of Kusumbha oil, at D.G. Secondary End Points: - Re-growth of hair was
department T.A.M.V. Pune. (Institutional ethics not occurring for two months.
committee clearance no. RSTH/PG/IEC/93/2007).
Written consent was taken from each selected Criteria of Assessment of Drug Effect:
subjects before starting the project. A detailed A detailed proforma incorporating gradation of
proforma incorporating gradation of excessive hair excessive hair on their hands as well as physical &
on their hands was prepared. Subjects were mental examination was prepared. Hair was
advised same dietary pattern & daily regimen. counted by using Hair follicle count test.
Inclusion criteria: Hair Follicle Count Test:

1 Healthy female subjects of the age group of 2cm. Sq. area was selected for hair follicle count
18 38 years. on middle part of extensor aspects of right hand.
2 Subjects were selected irrespective of cast & Hair follicle falling on left & top border of the
religion. window was counted & hair follicle falling on
103
3 Subjects fulfilling the condition of proforma bottom & right border were not counted. Every
& willingly participated in trials. visit the window was placed on the same spot. The
Exclusion criteria: result was assessed on the basis of reduction in re-
Page
1 Age group less than 18 years & more than 38 growth of the hair especially in measured area up
years. to the completion of the treatment i. e. two months.
2 Subjects showing hypersensitivity to This is measurable criteria for the assessment of
Kusumbha oil i.e. positive results to Patch test. efficacy of Kusumbha seed oil. The gradation was
3 Known subjects of endocrine disorders were given according to re-growth of number of hair
excluded. E.g. Cushings syndrome, Polycystic follicle.
ovary, Acromegaly, etc.
Vidya Vaijnath Yadav, Study of Kusumbha Oil (Carthamus tinctorius- linn) w.s.r. Lomashatana Karma (Hair Growth Inhibiting
Action),Int. J. Ayu. Alt. Med., 2016; 4(2):101-106
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
Table 1: Global assessment
Grade Re-growth of hair

Grade- 0 100% Re-growth of hair.
Grade- 1 10 No Re-growth of hair
Grade- 2 30 No Re-growth of hair
Grade- 3 50 No Re-growth of hair.
Table 2: Degree of Recovery
Sr. No. Response Grade No. No Re-growth of hair in Percentage.

1 Excellent Response Grade -5 100 No Re-growth of hair.
2 Very good Response Grade -4 75% NoRe-growth of hair.
3 Good Response Grade -3 50% No Re-growth of hair.
4 Poor Response Grade -2 25% No Re-growth of hair.
5 No Response Grade -0 100% Complete Re-growth of hair.
Global Assessment of the Effect: Results:- The results of the present project is
Global effect of the Lomashatana action of found to be encouraging when analyzed
Kusumbha oil was assessed with the help of statistically & found significant (P(T <=t) at 0.05
statistical analysis. Student t test was applied to *significant level in case of hair growth
compare the result of Study drug with Placebo retardation; Hair count test was clinically
drug. significant.
Statistical Analysis: Study group A
Table 3: Showing the effect of Study drug on Hair Growth Retardation by Paired t Test.
Significant
Sr No Observations Calculated t value Table t value d. f. S. D. S. E.
Level
1 15 days 17.035 < 2.045 29 4.51 2.20 0.050
2 30 days 14.480 < 2.045 29 8.08 1.47 0.050
3 45days 11.774 < 2.045 29 9.97 1.82 0.050
4 60 days 10.601 < 2.045 29 11.19 2.04 0.050
5 75 days 10.601 < 2.045 29 11.19 2.04 0.050
6 90 days 10.601 < 2.045 29 11.19 2.04 0.050
The above table shows calculated t value is greater level. It means there is significant hair growth
than table T value at 29 d.f. at 0.050 significant inhibition action of Kusumbha oil.
Statistical Analysis: Study group B
Table No -4 showing the effect of Study drug on Hair Growth Retardation by Paired t Test.
Significant
Sr No Observations Calculated t value Table t value d. f. S. D. S. E.
Level
104
1 15 days 14.401 < 2.045 29 7.11 1.29 0.050

2 30 days 9.135 < 2.045 29 8.60 1.57 0.050
3 45days 4.43 < 2.045 29 11.63 2.12 0.050
4 60 days 00.00 2.045 29 13.15 2.40 0.050
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5 75 days 00.00 2.045 29 13.15 2.40 0.050

6 90 days 00.00 2.045 29 13.15 2.40 0.050
The above table shows that calculated t value is 2.045 which is greater than calculated t value. It
greater than table T value at 29 d. f. at 0.050 means there no effect of Tila oil in the hair growth
significant levels after 15, 30, 45, days but after retardation.
that calculated t value is zero & table T value is
VOL 4 eISSN-2348-0173
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Table 5: Showing the effect of Study drug & Placebo drug by Unpaired t Test.
Sr No Study Group & Placebo Group

1 15 days P( T <= t) two tailed 9.2119
3 45days P( T <= t) two tailed 0.00023
The above table shows calculated t value is greater effect of Kusumbha oil on hair growth retardation. .
than table T value (Table No. 1 & 2) at 0.050 It shows that there is no effect of Tila oil in the hair
significant level (P(T< =t)). There is significant growth retardation.
Table 6: Global Assessment: Table showing the comparative effect of Study drug & Placebo drug in percentage
Result Group- A % Group-B %

Good Results 2 6.66 0 0
Poor Results 24 80 0 0
No Results 4 13.33 30 100
Excellent Results 00 00 00 00
Comparison between Study group & Placebo 6.66%, subjects good response was observed.
group: Hair growth retardation was observed by
When Study Group A is compared with Placebo Kusumbha oil compared with Tila oil. In Group B
group B for the study of Lomashatana action of Tila oil is not effective for Lomashatan action & all
Kusumbha oil in female subjects ; before & after subjects shows 100% re-growth of hair.
treatment it was seen that Kusumbha oil has poor
response in 80% subjects while there was no effect CONCLUSION
of Tila oil for Lomashatan. Significant (P<0.05) Lomashatan Karma was
achieved on body hair after application of
DISCUSSION Kusumbha oil. Kusumbha oil is effective for hair
Discussion on Observation: growth retardation & it is less effective for
In the present study, all healthy female subjects permanent removal of hair. There is no effect of
were selected for the clinical trial of the age group Tila oil in retardation of re-growth of hair.
of 18 to 32 years. There were no males in the study
of the same age group. Hence, Lomashatana karma REFERENCES
of Kusumbha oil in male remains untouched. Due 1. J. Shapiro M.D., FRCPC; H. Lui M.D., FRCPC, Treatment for
unwanted facial hair. Disclosure Skin therapy letter,
to individual variations observed while undergoing
2005(10); 1-4
Dashvidha Pariksha, it is difficult to come to any 2. Agnivesha, Revised by Charka & Drudhabala,
conclusion & correlate these Dashavidha bhava Gangasahaya Pande, editors, Charka Samhita,
with Lomashatana action. Hair growth retardation Chaukhamba Publisher Varanasi, Reprint 2007, p. 411
3. Maharishi Susruta, Acharya P. V. Sharma, editors.
or no complete re-growth of hair served as
Susruta Samhita, Chaukhamba Oriantalia Varanasi,
parameter of assessment. Hair follicle count test Reprint 2009, p.206
served as criteria of assessment of the efficacy of 4. Pandit Sharangdharacharya, Shrimati Shailaja Shrivastav,
Kusumbha oil. editors. Sharangdhar Samhita, Chaukhamba Oriantalia,
Varanasi, Reprint edition 2011, p. 432
105
5. Mahrishi Vagbhata, Shivprasad Sharma, editors. Ashtanga

Discussion on Results: Hrudaya, with Shashilekha Sanskrit commentary by
The results of the present project are found to be Indu, Chaukhamba Sanskrit series office, Varanasi,
encouraging when analyzed statistically & found Reprint 2006, p. 63
Page
6. Vrudhha Vagbhata, Shivprasad Sharma, editors. Ashtanga

significant. (P(T<=t) at 0.05* significant level in
Sangraha, with Shashilekha Sanskrit commentary by
case of hair growth retardation. Hair count test Indu, Chaukhamba Sanskrit series office, Varanasi,
was clinically significant. These results suggest Reprint 2006, p. 44
that Safflower oil is mainly effective for the 7. Shree Chakrapanidatta, P.V. Sharma,editors. Chakradatta,
A Treatise On Principle & Practices Of Ayurvedic
retardation in re-growth hair & less effective for
Medicine, 3rd Edition 2002 , Chaukhamba Publisher
permanent removal of hair. Varanasi, Yoni. Vyap. Chi./ 55-58., 60-62.
8. Shri Govind Das, Shree Brahmashankar Mishra, editors.
Discussion on Global assessment: Bhaishajya ratnavali, Chaukhamba Oriantalia, Varanasi,
Reprint edition 2015, p. 961
In Group- A 80% subjects shows poor response of
Kusumbha oil on hair growth retardation. Only in
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
9. Kirtikar K. R. & Basu B. D., E. Blatter, F. Caius, K. S. 12. Jia-Ming Chang, Le- Mei Hung, Yau Jan Chyan. Antitumor
Mhaskar, editors. Indian Medicinal Plants Vol- 1,. 2nd activity of Carthamus tinctorius. Division of research &
Edition, Reprint 1987, p. 123 development, development center for Biotechnology,
10. Shree Bhavmishra, Commentary by Dr. K. C. Chunekar, Xizhi City, Taipei County, Taiwan 221, R. O. C.
Dr. G. S. Pande, editors. Bhavprakasha Nighantu (Indian 13. Jun MS, Ha YM, Kim HS, Jang HJ, Kim YM, Lee YS et al.
Materia Medica), Chaukhamba Bharati Acadamy, Anti-inflammatory action of methanol extract of
Varanasi, 10th Edition, 1995, p.112, 546 Carthamus tinctorius involves in heme oxygenase-1
11. Sedigheh Mehrabian, Ahmad Majd, & Iman Majd. induction. J Ethnopharmacol 2011; 133: 524-30.
Antimicrobial Activity of Carthamus tinctorius-Linn; 14. K. V. Billore, M. B. Yelne, T. J. Dennis, B.G. Chaudhari,
Faculty of science, Dep. Of Biology, Tarbit Moallem Uni., Database on Medicinal Plants used in Ayurveda -Vol-2,
Teharan. C.C R.A.S. New Delhi, 2004, p.133

Vidya Vaijnath Yadav, Study of Kusumbha Oil (Carthamus tinctorius- linn) w.s.r. Lomashatana Karma (Hair Growth
Inhibiting Action),Int. J. Ayu. Alt. Med., 2016; 4(2):101-106
106
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VOL 4 eISSN-2348-0173
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CASE REPORT
ANATOMICAL CHANGES IN TWAK SHARIR W.S.R. TO PEMPHIGUS

VULGARIS - A CASE STUDY
Dobade Deepak K.1*, Sharma Gopal B.2
1. P.G. Scholar, Dept. of Rachana Sharir, Government Ayurved College and Hospital, Nagpur, Contact
No. +918600104979, Email- deepakdobade.dd@gmail.com
2. Professor, Dept. of Rachana Sharir, Government Ayurved College and Hospital, Nagpur. Contact
No.+919422187016, Email- dr.gopalsharma28@rediffmail.com
Article Received on - 21st Feb 2016

Article Revised on - 22nd May 2016
107
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2013 IJAAM
Dobade Deepak K., Sharma Gopal B., Anatomical Changes in Twak Sharir w.s.r. to Pemphigus vulgaris - A Case Study, Int. J. Ayu. Alt.
Med., 2016; 4(2):107-110
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
CASE REPORT
ANATOMICAL CHANGES IN TWAK SHARIR W.S.R. TO PEMPHIGUS VULGARIS - A

CASE STUDY
*Corresponding Author
ABSTRACT:
Ayurveda is an oldest system of Indian medicine. In ayurvedic classics sharirsthan
Dobade Deepak K. has given vast description about internal and external body features, out of these
P.G. Scholar, samhitas sushruta sharirsthana has great anatomical importance hence it is said
Dept. of Rachana Sharir, that Sharire sushruta shrestha. Twacha is dominent Dnyanendriya which occupies
Government Ayurved College all other Indriyas and whole body. Twak sharir has its great importance regarding
and Hospital, Nagpur, various vyadhies and their etiopathogenesis, hence studying the anatomy of Twak
Contact No. +918600104979, sharir and its applied aspect is important. Twak layers has described by our
Email-
deepakdobade.dd@gmail.com
acharyas. Each layer has importance for specific vyadhi. Sushrutacharya has
described seven layers, which is more accurate description compare to other
Aacharya. Dr. Bhaskar Govind Ghanekar has compared these layers with modern
science. Pemphigus vulgaris is most frequently diagnosed form of pemphigus, in
which vesico-bullous lesions over oral cavity, chin, chest, front, back and genitals of
QR Code IJAAM body present along with fever, burning sensation and excruciating pain. Here in this
article we have described a case study of Pemphigus vulgaris, in which Punch
biopsy was performed. During the study it was found that the clinical features of
Pemphigus vulgaris were mostly identical with one of the Kshudraroga known as
Visphotaka described by our ancient acharya in ayurvedic classics.
www.ijaam.org Key Words: Twak sharir, Pemphigus vulgaris, Punch biopsy, Visphotak
INTRODUCTION and the Middle East. The Jewish race, especially

The skin, largest organ covers the entire surface of Ashkenazi Jews, have an increased susceptibility to
the human body. The skin is sometimes called the Pemphigus vulgaris. Predisposition to pemphigus
cutaneous membrane or the integument. Because is linked to genetic factors [2] .The most common
the skin has several accessory organs, it is also form of pemphigus vulgaris is a chronic progressive
possible to speak of the integumentary system. The condition with widespread superficial bullae
skin has two regions, the epidermis and the arising in normal skin. In about half of the cases
dermis. The hypodermis, a subcutaneous tissue, is this is preceded by blisters and erosions in the
found between the skin and any underlying mouth. The bullae are easily broken, and even
structures, such as muscle. Usually, the rubbing apparently normal skin causes the
hypodermis is only loosely attached to underlying superficial epidermis to slough off [Nikolsky sign].
muscle tissue, but where no muscles are present, These changes are associated with the deposition
the hypodermis attaches directly to bone. of immunoglobulin in the epidermal intercellular
Epidermis is made of Stratified squamous spaces.[3] Genesis of Twak had described by
epithelial cells and has Stratum corneum, S. Sushrutacharya in Garbhavyakran sharir adhyaya.
lucidum, S. Granulosum, S. Spinosum, S. Basale Here, Sushrutacharya has given Drushtanta of
layers. The dermis, a deeper and thicker region Santanika that is cream of milk. During the
than the epidermis, is composed of dense irregular combination of Shukra [Semen] and Shonita
108
connective tissue. The dermis contains collagenous [Fertilized ovum], the Aatma [soul] participate in it
and elastic fibres. It has Papillary and Reticular and by the processing of Agni development of body
layer. Hypodermis, or subcutaneous tissue, lies organs occur. At the same time Garbha [Foetus]
Page
below the dermis. The hypodermis is composed of starts developing and during the process of
loose connective tissue, including adipose [fat] development seven layers of Twak formed in the
tissue [1]. same way as layers deposited and formed on the
surface of milk.[4]
Pemphigus derived from the Greek Word pemphix
meaning blister or bubble. Pemphigus vulgaris AIM AND OBJECTIVES
affects all races and both sexes .It is a disease of 1. To study an anatomical changes in Twak
middle age. Pemphigus vulgaris accounts for Sharir with special reference to Pemphigus
around 70% of all cases of pemphigus and may be Vulgaris.
the commonest autoimmune blistering disease in 2. To study the microanatomy of Twak Sharir
Eastern countries such as India, Malaysia, China with the help of histopathological study.
Med., 2016; 4(2):107-110
VOL 4 eISSN-2348-0173
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3. It will help Ayurvedic physician to diagnose times/ day], spicy junk food and strenuous labour
and treat Pemphigus Vulgaris by Ayurvedic work [Rakta-Pitta Prakopak]. Patient had no
view. history of drug allergy, diabetes mellitus,
hypertension, HIV and any other major illness.
CASE STUDY Patient was clinically diagnosed by Ayurvedic
A 50 yr old female patient was observed at IPD of approach. Asthavidha parikshan [Ayurvedic
Dermatology department of Government Medical examination] of the patient was done which is
college, Nagpur on 6th Aug.2013 with complaints of stated as below-
multiple fluid filled vesico-bullous lesions over 1. Nadi-70/min, niyameet,
chest, back, face, scalp and upper limb, Burning 2. Mala - Grathit Malapravrutti,
sensation, Fever, pain, oral ulcer, mild itching and 3. Mutra - Alpa,
difficulty in swallowing since last 8-10 days. 4. Jivha - Saam,
Clinical Diagnosis of Pemphigus vulgaris had been 5. Shabdha - Avishesha,
made after history of skin lesions that had 6. Sparsha - ushna,
progressed from erosions in the patients oral 7. Druka - alpashwetata,
cavity to multiple bullae and crusted erosions on 8. Akruti - Krusha
face, scalp and other parts of body. Nikolskys sign
[Apply pressure to affected Skin, where Blister is Strotas parikshan reveals dusti of Ras, Rakta and
located, Perilesional Skin or normal Skin in Mansavha strotas.
patients with suspected Pemphigus Vulgaris.
Positive response there is extension of the Blister According to ayurveda the diagnosis was made as
or removal of Epidermis in the area immediately Visphotaka, a kshudrarog after thorough ayurvedic
surrounding the Blister] which is strongly examination of the case and due to the explanation
associated with the disease was also positive. that had given by our ancient ayurvedic classics. [5]
Patient had history of excess intake of tea [4-6
Table1: Comparison between Pemphigus vulgaris and Visphotak Vyadhi
Sr.no. Visphotak Pemphigus vulgaris

1 Agnidagdha nibha sphota Burn like Vesicobullous lesions.
2 Sajwara With fever.
3 Saparidah With burning sensation.
4 Saruja With pain.
5 Ghoran kurvanti visphotan Life threatening Vesicobullous disease.
6 Kandu Itching in kapha dominant variety [less common].
PROCEDURE OF PUNCH BIOPSY complete clinical details of the case for

Written consent was taken from the patient. Inj. histopathological examinations. Histopath
Tetanus Toxoid 0.5 cc was given IM and Xylocaine examination showed Epidermis with supra-basal
sensitivity test done intra-dermaly. Under all intra-epidermal cleavage with acantholytic cells in
possible aseptic precautions, site of lesion was it, dermis showed lymphocytic inflammatory
cleaned with Povidone-Iodine solution and locally infiltrate, these histological features were
anesthetized with xylocaine 2%.The punch biopsy consistent with the clinical diagnosis of Pemphigus
instrument is held vertically over the skin and vulgaris.
109
rotated downward with twirling motion created by
first two fingers on the dominant hand. Once the DISCUSSION
instrument has penetrated the dermis into Acharya Bhaskar Govind Ghanekar has compared
Page
subcutaneous fat, it is removed. The cylindrical Twachasttar with modern skin layers. There he has
skin specimen is elevated with needle held in non compared Tamra Twachasttar with Stratum
dominant hand. The scissors held in dominant Malpighi layer [S.Basale+S.spinosum] [6]. While
hand cut the specimen free from the subcutaneous describing various Twachasttar, Acharya Sushruta
tissue. The cut is made below the level of dermis. has mentioned that Tamra is the fourth layer of
Good haemostasis achieved, antibiotic ointment Twacha and is the Adhisthana of Kilas and Kustha
and a bandage were then applied. Vyadhies [7]. But, while describing Visphotaka as a
Kshudraroga in ancient Ayurvedic literature, our
The collected specimen was then put in 10% Acharyas has not evaluated about the skin layer
formalin solution. The specimen was properly where the Visphotaka actually occurs. Hence
labelled and sent to pathology department with according to above study we can say that
Med., 2016; 4(2):107-110
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
Adhisthana of Kshudraroga Visphotaka is in Tamra Changes found in skin layer were in stratum basale
Twacha. Comparison of Twacha layers with layer, indicating that Visphotaka lies in Tamra
modern science is as follows- twacha Sttar. Addiction of Tea has significant
association with the prevalence of the disease but
1. Avabhasini layer-Stratum corneum. for statistical positive results, study should be
2. Lohita layer-Stratum lucidum. conducted on larger sample size.
3. Shweta layer-Stratum Granulosum.
4. Tamra layer-Stratum Malpighi. REFERENCES
5. Vedini layer-Papillary layer. 1. Sylvia S. Mader, Understanding Human Anatomy and
Physiology, fifth edition, The Mcgraw-Hill companies
6. Rohini layer-Reticular layer.
Publication, 2004. p. 70-71
7. Mansadhara layer-Subcutaneous layer. 2. Tony Burns, Stephen Breathnach, Neil cox, Christopher
Griffitns, Rooks Textbook of Dermatology, eight edition,
Also in Nyay-chandrika commentary Acharya Wiley-blackwell publication,2010. p.40.3
Gayadas has mentioned that Visphotaka is not a 3. Paul k. Buxton, ABC of Dermatology, fourth edition, BMJ
Publishing group, 2003. p.41
type of Visarpa vyadhi but its some symptoms 4. Sharma Anant, Forwarded by Acharya priyavrat Sharma,
present in Doshik types of Visarpa. In Sushruta Sushruta Samhita edited with Susrutavimarsini Hindi
samhita of Maharshi Sushruta Edited with Ayurved commentary, Chaukhamba surbharati prakashan,
Varanasi, 2010. p. 46
Tattva Sandipika by Kaviraj Ambikadutta Shastri in
5. Sri Madhavakara, Madhavnidan with Madhukosh
Kshudrarog nidan Adhyaya has mentioned that Sanskrit commentary by Vijayarakshita and
Visphotaka Kshudrarog can be compared with Srikanthadatta with the Vidyotini hindi commentary,
Bullous eruptions or Pemphigus. In Charma Roga Chaukhambha Sanskrit Sansthan, Varanasi, 1993.p.180
6. Ghanekar Bhaskar, Susruta Samhita: Sharirsthana with
Nidarshika Published by Shree Baidyanath
Ayurvedrahasyadipika hindi commentary, Meharchand
Ayurved Bhavan, Acharya Raghuvir Prasad Trivedi Lachhmandas Publications, New Delhi, 2012. p.107
has stated that Visphotaka Kshudrarog can be 7. Sharma Anant, Forwarded by Acharya Priyavrat Sharma,
compared with Pemphigus vulgaris. [8] Sushruta Samhita edited with Susrutavimarsini Hindi
commentary, Chaukhamba Surbharati Prakashan,
Varanasi, 2010. p.47
CONCLUSION 8. Acharya Raghuvir Prasad Trivedi, Charma-rog Nidarshika,
Thus, from our observational descriptive study we Shree Baidyanath Ayurved Bhavan Publication, 3rd
can conclude that the Pemphigus vulgaris can be edition, 2011. p. 34
compared with Visphotaka vyadhi, a Kshudrarog.

Dobade Deepak K., Sharma Gopal B., Anatomical Changes in Twak Sharir w.s.r. to Pemphigus vulgaris - A Case Study,
Int. J. Ayu. Alt. Med., 2016; 4(2):107-110
110
Page
Med., 2016; 4(2):107-110
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
CASE REPORT
EFFECT OF JALAUKAVACHARAN (BLOOD-LETTING BY LEECHES) IN

ACUTE APPENDICITIS: A CASE STUDY
Sarvesh Chikte 1*, Piyush Gandhi 2, Shailesh Deshpande 3, Jayant Phadke 4,

Yogini Kulkarni 5
1. PG Scholar, Dept. of Agadatantra, College of Ayurved and Research Centre, Akurdi, Pune, Contact
No. +918855828326, E-mail-sarvesh.chikte1@gmail.com
2. Reader, Dept. of Rasashastra, College of Ayurved and Research Centre, Akurdi, Pune, Contact No.
+919860202543, E-mail-drpkgandhiji@rediffmail.com
3. Reader, Dept. of Kayachikitsa, College of Ayurved and Research Centre, Akurdi, Pune, Contact No.
+919763104451, E-mail-dr.shaileshd@gmail.com
4. Professor & H.O.D. Dept. of Agadatantra, College of Ayurved and Research Centre, Akurdi, Pune,
Contact No. +919822615265, E-mail-jayantphadke10@gmail.com
5. Professor H.O.D. Dept. of Research and Methodology, College of Ayurved and Research Centre,
Akurdi, Pune, Contact No. +919822419089, E-mail-dryoginik01@gmail.com

Article Revised on - 31st May 2016
Article Accepted on - 1st June 2016
111

Page
2013 IJAAM
Sarvesh Chikte et.al., Effect of Jalaukavacharan (Blood-Letting by Leeches) in Acute Appendicitis: A Case Study, Int. J. Ayu. Alt. Med.,
2016; 4(2):111-114
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
CASE REPORT
EFFECT OF JALAUKAVACHARAN (BLOOD-LETTING BY LEECHES) IN ACUTE

APPENDICITIS: A CASE STUDY
*Corresponding Author
ABSTRACT:
Conservative management of acute appendicitis using Ayurvedic treatment is a
Sarvesh Chikte challenging task. A patient with vomiting, severe abdominal pain and mild fever
PG Scholar, came to the outpatient department along with sonological findings suggestive of
Dept. of Agadatantra, acute appendicitis. Patient had rebound tenderness at Mc Burney point along with
College of Ayurved and tachycardia. Considering differential diagnoses mentioned in classical Ayurvedic
Research Centre, Akurdi, Pune, literature it was diagnosed as a case of Amaavastha of Antarvidradhi. As classical
Contact No. +918855828326, treatment of Antarvidradhi suggests raktamokshana (blood letting by leeches) it
E-mail-
sarvesh.chikte1@gmail.com
was decided to do Jalaukavacharan (blood letting by leeches) along with
Shankhavati (500 mg bid) and Avipattikar Choorna (5 gm HS).After
Jalaukavacharan (blood letting by leeches) significant reliefwas seen in agony of
pain, fever and tachycardia. After subsequent settings of Jalaukavacharan (blood
letting by leeches) it was found that patient was not only free from symptoms but
QR Code IJAAM also significant remission was seen in size, inflammation and diameter of internal
lumen of appendix. Hence conservative management of acute appendicitis is
possible using classical Ayurvedic treatment. However efficacy of such treatment
must be further explored to find precise indications and contraindications for such
treatment.
Key Words: Acute Appendicitis, Raktamokshana, Abhyantar Vidradhi,

www.ijaam.org Conservative Management.
INTRODUCTION Treatment of choice for acute appendicitis is

The vermiform appendix though considered as surgical removal of appendix.
vestigial part has got its importance due a
condition known as acute appendicitis which CASE REPORT
occurs due to its inflammation.[1]In teenagers and A 24 years old female patient came in outpatient
young adults, the male female ratio increases to department with complaints of vomiting, fever and
3:2 at age 25; thereafter, the incidence in male pain in abdomen since four hours. Patient had four
declines.[1] Low dietary fiber and increased refined episodes of vomiting after lunch at four in
carbohydrate may increase incidence of acute afternoon along with mild fever (axillary
appendicitis.[1] Obstruction of appendicular lumen temperature 1000 F). After two hours after
either by faecolith or stricture, that happens in vomiting, patient started to suffer from severe pain
majority cases, leads to enhance the inflammation in abdomen. Hence patient went for ultra-
inside the lumen. Yet in few cases of early acute sonography of abdomen and pelvis that
appendicitis lumen remain intact despite the significantly dilated and inflamed appendix. It
presence of mucosal inflammation and lymphoid shows maximum calibre up to 15mm and length
hyperplasia.[1] A faecolith is composed of up to 6 cm along with a 10 mm faecolith is seen at
inspissated faecal material, calcium phosphates, the proximal end, which were consistent with
bacteria and epithelial debris. There may be an acute appendicitis. When thoroughly examined,
112
incidental finding of a faecolith. [1] patient had tachycardia (radial pulse rate -98 per
minute). Patient was normotensive (blood
Appendicitis occurs when mucus, stool or a pressure 110 /70 millimetres of Hg.) Patient had
Page
combination of the two, blocks the opening of the rebound tenderness at right iliac fossa. These all
appendix that leads to the inflammation. Bacteria finding along with findings in ultra-sonography
proliferate in the trapped space and infect the confirmed the diagnosis.
lining of the appendix which results in to
Appendicitis.[1] Acute appendicitis presents with Ayurvedic Diagnosis
symptoms like vomiting, acute severe or mild According to classical Ayurvedic texts the
abdominal pain, nausea and low grade fever. differential diagnoses considered were Gulma,
Rebound tenderness is seen at Mc Burney Shula and Abhyantar Vidradhi which have
point.[1]The diagnosis of acute appendicitis is Udarashula (abdominal pain) as common finding.
essentially clinical that is confirmed by using ultra- Also in all above diseases site of pathology is in the
sonography where signs of inflammation are seen. organs in Mahastroras (Gastrointestinal tract)
2016; 4(2):111-114
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
which have Koshtha (lumen).[2],[3],[4]Faulty dietary due care as mentioned by classical texts was taken
habits, food at improper times leads to during the procedure.[6] Patient also received
accumulation of mala and dosha in the small parts Shankha vati 500 mg twice a day with luke- warm
of Koshtha (lumen)that leads to obstruction. But water and Avipattikar Choorna 5 grams at night
patient of gulma is usually emaciated and along with warm water. Jalaukavacharan (blood
pathology of Gulma is relatively chronic.[2] letting by leeches) was repeated on 10th day, 24th
Generally Gulma is not converted into pakavastha day, 30th day and 35th day.
(formation of pooya (pus) or vrana).[5]In shula
though the pain is acute but it is related with Treatment outcome [Table No: - 1]
ingestion, digestion of food. Pain is relieved Patient showed significant relief. Immediately after
intermittently in vataj shula for short duration. first setting of Jalaukavacharan (blood letting by
Also pain in the abdomen is generalised and leeches) complete remission was seen in intensity
without tenderness at specific site. But in view of pain and fever. Pulse was normal and patient
severe pain and its ability to get converted into was very much comfortable. Hence it was decided
pakavastha in short duration of time it was clearly to continue the treatment. Ultra-sonography after
a case of Abhyantar Vidradhi precisely Ama two days showed slight reduction in inflammation.
Avastha of Abhyantar Vidradhi.[4] Further follow up showed minimal dilatation and
inflammation while ultra-sonography done after
Management Protocol 35 days showed normal findings. Patient continued
Patient underwent Jalaukavacharan (blood regular follow up and other oral medications
letting by leeches) at the point of maximum pain throughout the period and was absolutely
immediately. Total five leeches were used for symptom free.
Jalaukavacharan (blood letting by leeches). All
Table 1: Timeline showing treatments outcome
Date Treatment Outcome

Right iliac fossa shows significantly dilated and inflamed appendix. It shows maximum calibre up to
14.09.2013
15mm and length up to 6 cm. The blind end is directed inferolaterally. A 10 mm faecolith is seen at the
1st setting of
proximal end. No obvious free fluid is seen. Surrounding mesentery and bowel loops also shows
(blood letting by
significant inflammation without obvious mass formation at this stage. Findings are consistent with
leeches)
Acute Appendicitis.
Abdominal pain was relieved.
Pulse is decreased to
16.09.2013 Body temperature was normal
After 1st setting of USG findings
(blood letting by 16.09.2013 Follow up case of acute appendicitis. A persistently dilated and inflamed appendix is seen
leeches) in RIF. The inflammation slightly reduced as compared to last USG. It shows maximum calibre up to 13
mm. and length up to 5 cm. The blind end is directed inferolaterally. No obvious free fluid/ nodes /
bowel mass are seen.
24.09.2103 No symptoms were present.
2nd and 3rd setting USG findings
of 5.10.2013- Follow up case of Appendicitis. Appendix shows minimal dilation and inflammation.
(blood letting by Maximum calibre up to 8mm. The inflammation has significantly reduced a compared to last USG. No
leeches) associated nodes/ free fluid/ obvious bowel mass is seen.
No symptoms were present.
USG findings
19.10.2013
22.10.2013- Follow up case of Appendicitis. Appendix is still seen at right iliac fossa and shows
4th and 5th setting of
minimal dilatation and inflammation. It measures up to 3 cm. in length and maximum calibre up to
113
(blood letting by
6mm.
leeches)
There is no significant surrounding inflammation. No associated nodes/ free fluid/ obvious bowel
mass are seen.
Page
DISCUSSION occur both externally and internally. Internally it

Treatment of acute appendicitis is occurs in the organ of gastrointestinal like heart,
appendicectomy. There is perception that urgent Kloma (Pancreas), Liver, Spleen, Kidney and
operation is needed to prevent the increased appendix. Improper food at wrong time in large
morbidity and mortality due to peritonitis.[1] As in quantity leads to the accumulation of mala part of
this case, the patient had less severity of infection rakta, mansa in the lumen of ashaya (Organs with
(pulse below 100 per minute and mild fever)it was Lumen) which cause obstruction and leads to the
decided to give Ayurvedic treatment. Appendix is growth.[4] It resembles with pathology of acute
produced from the mala of rakta-dhatu.[7] Ancient appendicitis due to faecolith. Severe abdominal
seers discussed the concept of vidradhi which pain, a main symptom mentioned by our Acharyas.
2016; 4(2):111-114
VOL 4 eISSN-2348-0173
ISSUE 2 (2016)
Ancient seers mentioned Jalaukavacharan (blood CONCLUSION

letting by leeches) and pachan treatment in the Above case report emphasise the importance of
Amaavastha of vidradhi. So patient was advised blood-letting in the disease of Abhyantar Vidradhi
shankh vati for pachan of Ama and also prevents like Acute Appendicitis. If principles of Ayurvedic
the further formation of Ama (undigested dosha) treatment regime are followed, many of such
which may aggravate the pathology by further conditions can be treated. But before proceeding
blocking the lumen. Raktadosha dominancy in for the treatment of Acute Appendicitis it is always
pathology of Abhyantar Vidradhi leads to better to assess the patient for its severity by both
formation of pus which may cause life threatening clinically and by ultra-sonography. If it is a severe
condition as there are chances of bursting of case of acute appendicitis, it is always better to go
appendix.[8] To prevent further progress for operative procedure mentioned by modern
Jalaukavacharan (blood letting by leeches) was science.
done using by using five leeches. After procedure
of Jalaukavacharan (blood letting by leeches) REFERENCES
abdominal pain was reduced and pulse became 1. Williams NS, Christopher JK, Bulstrode, O Connell PR,
editors. Bailey and Loves Short practice of Surgery. 25th
normal. Patient does not have episodes of
ed. London, Hodder Education; 2008. p. 1204 - 1218.
vomiting. Patient went to his home on that day 2. Acharya YT, editor. Charak Samhita of Agnivesha. Reprint
itself and was advised to take oral medicine for 1984. Varanasi, Chaukhamba Sanskrit Sansthan; 1984.p.
further one month to prevent the indigestion of 436
food which may leads to the formation of mala 3. Acharya YT, editor. Charak Samhita of Agnivesha. Reprint
1984. Varanasi, Chaukhamba Sanskrit Sansthan; 1984.p.
which may block the lumen of appendix. 617.
Vaghabhat also recommends mild purgation which 4. Acharya YT, editor. Charak Samhita of Agnivesha. Reprint
may leads to the expulsion of accumulation of mala 1984. Varanasi, Chaukhamba Sanskrit Sansthan; 1984.p.
104.
(undigested food).[9] So Avipattikar Choorna was
5. Upadhyay Y, editor. Madhav Nidan. Reprint 2009.
given as mild laxative. After seeing the encouraging Varanasi, ChaukhambaPrakashan; 2009.p. 544.
results in relieving symptoms and no further 6. Kasture HS. Ayurvediya PanchakarmaVidnyan. Nagpur,
progress in the diameter of inflamed appendix in ShriBaidyanath Ayurved Bhawan Ltd; 2008. p. 511.
7. Acharya YT, editor. Sushruta Samhita of Sushruta. 12th ed.
ultra-sonography as mentioned above, further we
Varanasi, Chaukhamba Sanskrit Sansthan; 2001. P.32.
had done four settings of blood -letting by using 8. Acharya YT, editor. Charak Samhita of Agnivesha. Reprint
five leeches. After total five settings of 1984. Varanasi, Chaukhamba Sanskrit Sansthan; 1984.p.
Jalaukavacharan (blood letting by leeches), ultra- 104.
9. Paradkar HS, editor. Astangahrudayam of Vagbhata.
sonography reports showed no signs of faecolith
Reprint 2000. Varanasi, Chaukhamba Sanskrit Sansthan;
and inflammation. 2000. p.681.

Sarvesh Chikte et.al., Effect of Jalaukavacharan (Blood-Letting by Leeches) in Acute Appendicitis: A Case Study, Int. J.
Ayu. Alt. Med., 2016; 4(2):111-114
114
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2016; 4(2):111-114
VOL 4 eISSN-2348-0173
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1 YOGA AND PRANAYAMA DURING PREGNANCY 60-68

CONCEPT OF RAJONIVRITTI (MENOPAUSE) ACCORDING TO AYURVEDA WITH SPECIAL

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STUDY OF KUSUMBHA OIL (CARTHAMUS TINCTORIUS- LINN) W.S.R. LOMASHATANA

ANATOMICAL CHANGES IN TWAK SHARIR W.S.R. TO PEMPHIGUS VULGARIS - A CASE

EFFECT OF JALAUKAVACHARAN (BLOOD-LETTING BY LEECHES) IN ACUTE

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YOGA AND PRANAYAMA DURING PREGNANCY

G.M.Kavya1*, Sushila Sharma 2

Article Received on - 18th Sept 2015

YOGA AND PRANAYAMA DURING PREGNANCY

*Corresponding Author ABSTRACT:

INTRODUCTION who have renounced the world, can derive benefit

Table 1: Some of the Standing poses [1]

Sr. 1st 2nd 3rd

Table 2: Some of the Sitting poses [1]

Sr. 1st 2nd 3rd

Table 3: Some of the Inverted poses [1]

1st 2nd 3rd

Table 4: Some of the Lying down poses [1]

Sl. 1st 2nd

4. Savasana (Relaxation pose)

1.Tadasana or Samasthiti [1,3,4,5,6] It Brings stability to the body, removes the

lumbago and sciatica. Brings flexibility in the joints, Strengthens the

emptying your consciousness of unwanted,

There are certain physiological changes occurring Organogenesis.

CITE THIS ARTICLE AS