AYUSHDHARA ISSN: 2393-9583 (P)/ 2393-9591 (O)

An International Journal of Research in AYUSH and Allied Systems

Review Article

SHODHANA CHIKITSA AND STHANIK CHIKITSA IN STREE ROGA

Reshma Dattatraya Nangare1*, Vijay Nawale2, Salim Mulla3
*1P.G.Scholar, 2Associate Professor and Guide, 3Professor and Head, Dept. of Stree Rog Avum Prasutitantra,
S.M.B.T’s Ayurved College and Hospital, Nandi Hills, Dhamangaon Tal. Igatpuri, Dist. Nashik, Maharashtra
State, India.
KEYWORDS: Stree rog, ABSTRACT
Shoshana karma, Sthanik Healthy status of women is very much needed for society. In today's fast
chikitsa. and competitive world, there is change in the lifestyle of women which
leads to their physical and mental stress, women mostly gets affected by
this environment and are prone to gynaecological problems. She always
face many more very common health problem or gynaecological problem
like white discharge, foul smell discharge, itching at vulval region,
burning micturation etc., which are described detail in Stree rog vyadhi.
As Ayurveda oldest system of health gives various Panchakarma and
Sthanik chikitsa for such gynecologic problems and it gives an excellent
result in above mentioned gynaecological problem. Sthanik chikitsa is
cheap, easy, non surgical procedure.
*Address for correspondence
Anushastra Karma or parasurgical procedures means surgical procedure
Dr Reshma Dattatraya Nangare
P.G.Scholar, performed by non-surgical items or in absence of surgical instruments.
Dept. of Stree Rog Avum Acharya Sushruta has described 60 Upkarma, 25 Upyantra and 14
Prasutitantra, S.M.B.T’s Ayurved Anushastra for the management of wound in different conditions. Shasti
College And Hospital, Nandi Hills, upkarma includes Kshara karma, Agni karma and Uttar basti etc., Kshar
Dhamangaon Tal. Igatpuri, Dist. has given utmost importance and it is included under Shasti Upkarma
Nashik, Maharashtra State, India. upyantra and Anushastra, whereas Agnikarma is under Uyantra and
Mobile: 9420557839 Anushastra. Uttar basti is included under Shasti upkarma and Anushastra.
Email: Jaulaka is classified under Anushstra. Regarding Stree roga Yoni pichu,
[email protected] Yoni prakshalanam, Kshar karma, Uttar basti karma, are quite popular
due to its excellent result and no adverse effect if followed properly.

INTRODUCTION
Woman undergoes various physical and Management of Stree Roga is by Shoshanna karma
physiological changes during her reproductive (Vaman, Virechana, Basti) Sthanik karma
period i.e., from menarche (onset of menstruation) (Yonidhawan, Yonipichu, Dhupan etc) purification
to menopause. Awareness and management of methods. Panchakarma does Shuddhi of Sharir from
these changes are necessary for a woman to remain all vitiated Dosha. Ayurveda mentioned that
healthy. Most of the female related diseases belongs purification therapy (Shodhana Karma) helps to
from the disturb functioning of genital tract. manage various Stree Rog related to unhygienic
Diseases of women arise as a result of improper condition. Shodhana Karma that helps to maintain
food and regimen. This results in the arrangement clean condition and remove toxins and pacify
of three Doshas Vata, Pitta and Kapha. Blood, aggravated Doshas thus reduces pathological
situated in the reproductive organ is giving rise to progression of various Stree roga related to
several diseases. The most common symptoms of unhygienic condition of genital tract. Literary study
gynaecological disorders include pelvic pain, revealed that Shodhana Karma along with Shaman
vaginal itching, vaginal discharge, abnormal vaginal and Sthanik Chikitsa significant improvement in
bleeding and breast pain and lumps. Depending symptoms of female disorders. This article want to
upon the combination of the Doshas involved the emphasize the concept and contribution of
diseases exhibit characteristic symptoms. Ayurveda such as Shoshana chikitsa, Sthanik
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 Reshma Dattatraya Nangare et al. Shodhana Chikitsa and Sthanik Chikitsa in Stree Roga
Chikitsa (Yoni Pichu, Yoni Dhavan, Uttarbasti) etc Basti
these are certain procedure mentioned in Medicated Dravya given through
Ayurvedic text to treat various medical and surgical Adhomarga i.e., enema, vitiated Vata dosha along
illnesses of female reproductive track.[1-3] Although with Dushan of Rakta and Artava are the major
it is more of local treatment but their effect is factors associated with Yoni dosha. Basti Karma
systemic and capable of preventing complications helps to pacify aggravated Vata and reduced disease
of diseases consequently these are parasurgical progression. Basti karma offers relief in vitiated
because it doesn't involve the sharp instrument it Vata dosha associated with gynaecological disorder.
helps to avoid impending major surgery Sthanik Chikitsa
consequently to diseases. Anushastra karma (para 1) Yoni Pichu (tampons)
surgical procedure) can be performed with least
‘Vatartanam cha yoninam sekabhyanga
complication and enlist complicated facility.
pichu Kriya’.[4] This is one of the simplest Sthanik
OBJECTIVES Karma that gives the continuous drug delivery to
1. To study the literary view of Shodhan Chikitsa the target organ another advantage is that there is
from various Ayurvedic texts. no need of sophisticated instruments and trained
2. To study the literary view of Sthanik Chikitsa expert rather than patient can do itself after little
from various Ayurvedic texts. instruction. Pichu is made up of cotton swab
3. To study the probable mode of action of wrapped with gauze piece and tied with long thread
Shodhan Chikitsa. it should be immersed in medicated oil or liquid oil
4. To study the probable mode of action of Sthanik are mostly prepared due to its retention ability
Chikitsa. circular and elongated Pichu is used for shallow and
deep insertion inside vagina respectively it should
MATERIAL AND METHODS
be kept for 5 to 6 hours upto retention of urine.[5-6]
This is a conceptual type of study. Textual
Mode of action depending upon the
materials are used for study from which various
medicine used as different medicines have different
references have been collected. Many Ayurvedic
mode of action. Pichu used in pregnancy And
text used in this study are Charaka Samhita,
Labour helps to soften the vaginal canal enabling
Sushruta Samhita, Ashtanga sangraha, Ashtanga
easy delivery and easy expulsion of placenta.
hrudayam, commentaries also included in it, various
online journals, research papers, articles have been Example
searched from PubMed etc., internet media to 1. Tampon soaked with Udambar or Triphala
collect the information. kwath is used in Kaphajayoniroga.
Ayurvedic Treatment for Gynecology Includes: 2. Tampon soaked with Jatyadi Taila or Ghrita is
used in Mahayoni.
Shodhana Chikitsa for Streerog
3. Tampon soaked with Dashmoolkwath or Ghrita
Vamana
is used in Vataja yonivyapada.
Vamana, therapeutic vomiting is a
Indications
medicated emesis therapy. Vamana removes Kapha
toxins accumulated in the body, Kaphaj 1. Yonidaha, Yonikandu, Yonipaka.
predominant Artava dushti may be treated with 2. Vivrutta Yonivyapad [7]
Vaman Karma, Vamana also recommended for 3. Yoni paicchilya and Yoni strava[8]
Soumya Dhatu nirharan and Agneya Dhatu vruddhi 4. Yoni karkashata[9]
does increases Artava matra. 5. Vataj yonivyapad
Virechana 6. Pittaj yonivyapada
Virechana therapy is medicated purification 7. Vamini, Upapluta yonivyapad[10]
therapy, cleansing the body from excess Pitta
8. Nine months of pregnancy
accumulation, purifying blood and clearing toxins.
Vitiated Pitta dosha along with Dushan of Rakta and 9. Retained placenta
Artava are major factors associated with Yoni dosha. 2) Yoni Dhawan/Parisheka- (Vaginal douche)
Virechana Karma helps to pacify these aggravated It is a procedure in which the vagina, vaginal
factors and thus reduce disease progression. passage, and mouth of uterus is washed with
Virechana Karma offers beneficial effect in Pittaja medicated decoction or other liquids. Dhawan
Yonidosha. means cleaning or purification of wound with water
or other medicated material, Kwatha, Kshirapak,
Siddha jala, Taila are have aseptic, wound healing,

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 AYUSHDHARA, 2018;5(3):1758-1762
pain alleviating, and bactericidal action. They treatises that are used in various elements for
prevent growth of bacterial organism and restore curative purpose and also Dhupas are employed for
the altered pH of vaginal cavity. It gives quality to prevention of disease.
vaginal muscles. This is general purifying measures Yoni Dhupan is also used for local disinfection of
of genital organs to maintain a strategic distance genital organs.
from parasitic or yeast diseases. Absorption of drug Example
through the mucus and blood circulation also helps
Fumigation with Haridra and Brahti is used in Yoni
to have beneficial effect on the uterus it should
kadu.
performed in Ritukala from 6th day of menses for 8
day and duration is 1-1.5min.[11] Fumigation with Kustha, Guggalu, Agara mixed with
Ghrita is used in Sutikaparicharya.
Example
Indications
1. With decoction of Lodhra and Trikatu is used in
Kaphaja artavadushti. Yonikandu, Shwetapradara, Garbhsanga,
2. With decoction of Triphala[11] is used in Aparasanga, Sutika paricharya.
Kunapgandhi artavadushti. 5) Yoni Lepan (vaginal painting)
Indications In Lepan the drug penetration is higher on
1. Yonikandu the vagina, the efficacy of Lepana relates to both its
inherent potency and the ability of the drug to
2. Kunapgandhi Artava dushti
penetrate the skin, muscle and mucosa.
3. Kaphaj Artava dushti
Example
4. Yoni paicchilya and yoni strava
With powder of burnt broken earthan pots and
5. Yoni arsha Triphala mixed with Ghrita is used in Yoni Arsha.
6. Leucorrhea[12] Indications: Vivrutta yoni, Yoni arsha etc.
3) Yoni Varti[13] (pessary) 6) Yoni Purana (vaginal packing)
Varti is prolonged and long lasting worthy Yonipurana involves feeling of vaginal cavity
can be used effectively in infections and dealing using Churna, Kalka and medicated oil. It offers local
with their recurrence, University helps to clear therapeutic action. This therapy employed when
vagina and also provides the opportunity to large amount of drug needs to be employed for
recreate the optimum vaginal health. longer duration of time.
Example Example
Pessary prepared with powdered Yava With Vesawara (minced meat or oleo mixed with
(barley) and Masa (a type of bean) is used in drug) is used in Prasansini yoni.
Kaphaja yonivyapada.
Indications
Indications
Mahayoni, Prasansini yoni etc
Yoni paicchilya, Kaphaj Yonivyapada, Vipluta
7) Uttara Basti
Yonivyapada, Karnini Yonivyapada, Anartava.
Uttarbasti is an important para surgical
4) Yoni Dhupan[14] - (fumigation of vagina with
procedure among the 60 Karma as told by Acharya
medicated smokes)
Sushruta, Vagabhatt has mentioned Basti as Ardha
Medicines which are used in the form of chikitsa. Basti chikitsa is best for Vata dosha.
smoke by burning are called as Dhupana. Insertion of medicated oil decoction into
Fumigation is done on wound, a part of the body or Uttarmarga i.e., true the passage located above or in
on the whole body depending on the need. front part of anus that is vagina or urethra is known
Fumigation is the exposure till the action of smoke as Uttar Basti. Entire technique used in Uttar Basti
or of fumes of any kind as a means of disinfection or chikitsa is more or less similar to the Hystero-
eradication. The fumigation carried out using fine salphingography (HSG) and cystourethrography
powder of selected drugs with the intention of done now days as important investigation of female
Nirjantukaran (disinfection) is called as Dhupana. infertility. It is important to treat previous
Dhupana is process explained from time infections completely before giving Uttarbasti. It is
immemorial from the period of Samhita. It is widely administered during Ritukala (after menstrual
used not just in Ayurveda pharmaceutics from bleeding stops). Because during this period the
disinfecting drug stores to prevent degradation of mouth of uterus is open and it readily receives the
raw drug, but also as pre-processing in various fluid injected. It is usually carried out under aseptic
Kalpana. Different Dhupakalpas are explained in

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 Reshma Dattatraya Nangare et al. Shodhana Chikitsa and Sthanik Chikitsa in Stree Roga
precaution in minor OT, no need of any anaesthetic parasurgical procedure are safe and effective,
agent or analgesic during and after the procedure. reduce hospital stay. Vaman Virechana, Basti, Yoni
Example pichu, Yoni dhawan /Prakshalan, Kshara karma,
Basti with oil medicated with Jivaniya group Agnikarma, Uttarbasti are the important
of drug. (Shushka yoni, Acharanayoni, Aticharana, parasurgical procedure of Ayurveda to treat various
karnini yonivyapada). reproductive tract diseases of female. Multicentered
clinical trial and Proper training to present human
Indications
resources of healthcare sector can produce lot of
Tubal Blockage[15] changes in present situation. The vagina is a
For conception, for pacifying Vata, diseases potential space that connects the lower portion of
of urinary bladder, prolapse uterus, severe pelvic the uterus cervix to the outside environment. it is
pain, Asrugdara, menstrual disorders, pathological one of the Bahya Strotas in women. Drug transport
amenorrhea, for all reproductive tract disorders, all across the vaginal membrane may occur by
20 types of Yonivyapada. transcellular route or intercellular route. The
Contraindications vaginal wall is well suited for the absorption of drug
Cervical cancer, virginity vesico vaginal for systemic use, since it contains a vast network of
fistula hypersensitivity disorder. blood vessels. Moreover the automatically
8) Kshara karma backward position of the vagina may help in self
Kshara Karma is said to be superior to any containing of drug thereby holding it in situ for a
other surgical or parasurgical measures due to its longer duration. Uttarbasti helps in endometrial
function like Chedan, Bhedan, Lekhan, Patan conditions by improving thickness of endometrium,
Karma[16]. It can be applied in the narrowest place improve the quality of endometrium, helps in
and internally where surgical procedure cannot be curing endometriosis etc., absorption is very fast
performed. Kshara acts as a corrosive or caustic gives quicker result.
agent and generates healthy base for healing. CONCLUSION
Application of Kshara in case of cervical erosion is Shoshana karma, Sthanik karma Chikitsa are
an effective form of herbal cauterization (incision cheap, safe, effective and with no adverse effect.
and excision). This therapy clears the erosion with This can be helpful to prove like a boon to
minimal recurrence and complications. Kshara is of Stree rog in Ayurveda when the Vaidya supply this
two types namely Paniya kshara and Pratisaraneeya therapies in there gynaecological practice logically
Kshara. and carefully and under aseptic precautions. Each
Kshara karma is considered as satisfactory Shodhan karma, Sthanik chikitsa holds its own
approach to treat cervical erosion instead of electro importance and show tremendous results when
cauterization in which chances of recurrence and applied with proper indications, strict aseptic
complications are more, like secondary precaution and extreme carefulness.
hemorrhage, infertility, cervical stenosis etc.[17] REFERENCES
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Cite this article as:

Reshma Dattatraya Nangare, Vijay Nawale, Salim Mulla. Shodhana Chikitsa and Sthanik Chikitsa
in Stree Roga. AYUSHDHARA, 2018;5(3):1758-1762.
Source of support: Nil, Conflict of interest: None Declared

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