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BRAJRATNADAS PRACHYAVIDYA GRANTHMALA - 36 STRIROGA VIJNANA

Edition : First, 2019

STRIROGA VIJNANA © Copyright Reserved

(ILLUSTRATED)

(Hand Book on Ayurvedic Gynecology) Publisher :

CHAUKHAMBHA PRAKASHAK
K. 37 / 116, Gopal Mandir Lane, Golghar
(Near Maidagin) Varanasi-221001 (India)
Telephone : 0542-2335929
E-mail : c_prakashan@yahoo.co.in

BY
Dr. P. MALLIKARJUNA RAO. M.D AYU.
Assistant professor,
Sri Jayendra Saraswathi Ayurveda College and Hospital,
Nasarath pet, Chennai 600123
Also can be had from:
CHAUKHAMBHA PRAKASHAN
Post Box No. 1150
K. 37 / 116, Gopal Mandir Lane, Golghar
(Near Maidagin) Varanasi-221001 (India)
Telephone : 0542-2335929
E-mail : c_prakashan@yahoo.co.in

Printed at:
Gauri Shankar Press
Varanasi

CHAUKHAMBHA PRAKASHAK © CHAUKHAMBHA PRAKASHAK, VARANASI

Post Box No. 1150 All rights reserved (Including Text) by the publishers. No part of this work may
be reproduced, stored in a retrieval system or transmitted in any form or by any
K. 37 / 116, Gopal Mandir Lane means, electronic, mechanical, photocopying, recording or otherwise, without the
Varanasi prior written permission of the copyright owner
 4 StrÍroga VijáÂàa

ogy practice are presented accordingly complied from authentic

PREFACE
books which are very helpful for practice.
The book STRIROGAVIJNANA-(ILLUSTRATED) is A Hand Latest terminology, Techniques, Treatment methods are in-
Book on Ayurvedic Gynecology, was designed as per the syllabus troduced as per the need of an Ayurvedic Physician in this work
rd
of Stri Roga Vijnana subject of 3 year B.A.M.S. Degree exami- hence will be well understood.
nations prescribed by Central Council of Indian Medicine, New
Delhi.
All the Sanskrit terms are taken italic font for the benefit of
The book is very student friendly in nature as presented top- readers etc all are few highlights of this work and I am sure that
ics strictly according to the syllabus; this work is unique of its rd
the book Stri Roga Vijnana will help 3 profession B.A.M.S stu-
nature, used very simple English with help of Sanskrit references dents as they need not refer any other books for final exam prepa-
and tried my level best to give accurate information about topics ration also helpful for BAMS graduates, Post graduate students
from syllabus. Unlike other Stri Roga Vijnana books, in this book of Prasuti-Stri Roga Vijnana subject, research scholars and
instead of dumping all reference quotes, important, popular and Ayurvedic practitioners.
selected slokas are gathered, presented where ever is needed, so
that readers can interpretate and understand well. 
First preference is given for reference quotes from Charaka
Samhita, Sushrita Samhita, Kashyapa Samhita followed by
Ashtaanga Hridayam and Ashtaanga Sangraham, etc.
After considering entire syllabus the topics are well designed
to intend the student to read of a comparative study of the topic in
modern Gynecology and Ayurvedic perspective there by one can
assess the in-depth knowledge of our ancestors.
As per topics, presided information was collected from mod-
ern Gynecology books and how much is essential being an
ayurvedic graduate was well decided and presented.Most of the
information collected from standard reference books are referred
and gathered to avoid controversy.
Frequently Asked Questions, Multiple Choice Questions are
included as Annexure, which helps to students to get prepared
instantaneously for final exams and post graduate entrance ex-
ams.
Table forms and charts of all speedy reference for Gynecol-
 6 StrÍroga VijáÂàa

I thank to my wife P. Asha jyothi, without her help I couldn’t

ACKNOWLEDGEMENTS able to bring out this book and my best wishes to my son P.
I express my in-depth gratitude to my parents P.Sambasivudu Shivananda and my daughter P.R. Nandini.
and P.Varalakshmi, as they are my first gurus and every level guided
me to complete this work. Finally I must thank to my students Dr.Indumati, Dr.Dwani,
I am beholden to Dr. M.Ramasundara Rao sir, Ex-Principal Dr.Shireesha and Dr.Vinay for their kindly help in bringing this
of Dr. Nori Ramashastri Government Avurveda College, book in a nice manner.
Vijayawada, without his guidance this work may not be completed
and this dedication is a token of my gratitude to a great teacher. Dr. P. Mallilkarjuna Rao.
I should thank Dr. K. Ganapriya, Medical Director,
G.R.Hospital, G.R.Nagar, Raamapuram, Chennai, who Directed,
Guided, Care taken for, discussions made, case presentations,
application of text, procedures and management in Obstetrics etc
and taught me.
I must thank Dr. K. Vijaya Kumari M.D. Ayurveda, who
taught me Prasuti Tantra, during my under graduation at Dr. N.
R. S. Govt Ayurveda College, Vijayawada.
I convey my deepest pranaams to all my gurus and well
wishers, I also thank Prof Dr.Ramadas M., Principal, Sri Jayendra
Saraswathi Ayurveda College and Hospital, for his great support
in completing this work.
I must thank to my head of the department Prof. Dr. P. R.
Swaminathan, Prof. Dr. L. Ratnakar, Dr. Rajendra H. M and my
colleges for their timely help.
I extend my sincere thanks to Prof. Dr.Philip Anandakumar,
Prof. Dr. C. Ravi Kumar for mending me to a shape and encour-
aging in every aspect and I extend my thanks to Dr. D. Anil Kumar,
Dr. G. V. Mohandas, Dr. Prem Kumar, Dr.Aravind, Dr. Gopinath
for their kind co-operation.
I am extremely thankful to Shri Arpit Gupta ji, Chaukhambha
Prakashan, Varanasi, for giving constant inspiration to complete
this work.
 LIST OF PICTURES:
LIST OF TABLES:
1. Sites of Endometriosis 62
1. Ashrigdhara Nidaana- Opinions of Acharyas. 2. Uterine fibroids. 72
2. Classification of Yonivyapaths According To Charaka. 3. Prolapse types. 79
3. Classification of Yonivyapaths According To Susrutha. 4. Rectocele. 79
4. Classification of Yonivyapaths According To Vagbhata. 5. Uterine pessaries 82
6. Retroverted and Retroflexed uterus. 84
5. Vandhya samprapti ghatakas.
7. Cervical erosions. 93
6. Yoni Varti in the Classics.
8. Bartholin cyst. 110
7. X-Ray Effective Dose Specifications. 9. Yonyarshas. 112
8. Drugs Used In Gynecology-Miscellaneous Conditions. 10. Ovarian cysts. 121
 11. Symptoms of ovarian cysts. 121
12. Spread of cancer. 128
13. Multiple neuro fibromatosis. 130
14. Normal cells-Cancer cells. 131
15. Types of Sarcoma. 134
16. Congenital Anomalies of the uterus. 163
17. Congenital Anomalies of the hymen. 164
18. Transverse vaginal septum. 166
19. Vertical vaginal septum. 166
20. Acute Mastitis. 197
21. Breast abscess. 200
22. FNAC test. 206
23. Lumps of Breast. 208
24. Allis' Forceps. 268
25. Artery Forceps. 269
26. Ayre's Spatula. 269
27. Babcock's Forceps. 270
28. Band Applicator. 270
29. Cusco's Speculum. 270
30. Doyen's Retractor. 272

7 8
 List of Pictures 9 10 StrÍroga VijáÂàa

31. Right Angle Retractor. 272 63. Hysto-salpingography. 291

32. Deaver's Retractor. 272 64. Birth control implants 314
33. Episiotomy scissors. 273 65. Birth control rings. 317
34. Foleys Catheter. 273 66. Cervical cap. 318
35. Green Armytage Forceps. 274 67. Diaphragm. 318
36. Hegar's Dilator. 274 68. Female condoms. 319
37. Kocher's Forceps. 275 69. Copper-T- IUD. 321
38. Karmans syringe. 276 70. Copper-T in uterus. 322
39. Rubin's Cannula. 276 71. Tubal ligation. 326
40. Leech Wilkinson's Cannula. 277 72. Vasectomy. 327
41. Combined Uterine Manipulator and 
Cannula for Laparoscopy. 277
42. Needle Holder. 277
43. Ovum Holding Forceps. 278
44. Purandare's Dilator. 278
45. Feto Stethoscope. 279
46. Sims' Anterior Vaginal Wall Retractor. 279
47. Sims' Speculum. 279
48. Sponge Holding Forceps. 280
49. Suction Curette. 281
50. Shirodkars Cerclage Needle. 282
51. Surgical Blades with Handle. 282
52. Surgical blades. 282
53. Trocar and Cannula. 283
54. Umbilical Cord Clamp-Cutting Scissors. 283
55. Uterine Curette. 283
56. Uterine Sound. 284
57. Bladder Sound. 284
58. Vulsellum. 284
59. Tenaculum. 285
60. Vantouse. 286
61. Wrigleys Forceps. 286
62. Hysteroscopy. 289
 12 StrÍroga VijáÂàa

PAPER-2 CHAPTER- 6
Congenital Malformations of Female Genital Tract. 163
STRI ROGA VIJYANA-SYLLABUS- INDEX.
PART-A CHAPTER-7
SUKRA VIJNANAM.
CHAPTER-1 Sukra –kshaya, vridhi, dushti hetu lakshana and chikitsa.
ARTAVA VYAPAD. 7.1. Male infertility. 173
1.1. Artava-kshaya vridhi, Ashtartavadushti lakshana chikitsa. 1
1.2. Asrigdara lakshana samprapti Chikitsa. 10 CHAPTER-8:
Benign and Malignant tumors of Genital Tract. 184
CHAPTER-2
MENSTRUAL DISORDERS. PART-B
2.1. Anaartava-Amenorrhoea. 18
2.2. Hypomenorrhoea. 24 CHAPTER-1
2.3. Oligomenorrhoea. 26 STANA ROGA CHIKITSA.
2.4. Dysmenorrhoea. 27 1.1. Stanakeela- Nidana lakshana chikitsa. 189
2.5. Abnormal uterine Bleeding. 29 1.2. Stanavidradhi. 192
1.3. Stanashopha-Mastitis. 197
CHAPTER-3 1.4. Breast abscess. 200
YONI VYAPAD CHIKITSA: 1.5. Stanagranthi-Galactocele. 203
3.1. Yoni Vyapad Sankhya, Nidana, Lakshana, 1.6. Stanaarbudam-Lumps of breast-Etiopathology, clinical
Upadrava evam Chikitsa. 34 features, diagnosis, prognosis and complications. 208
3.2. Endometriosis. 62
3.3. Fibroid uterus. 71 CHAPTER-2
3.4. Genital Prolapses. 77 STHANIK CHIKITSA.
3.5. Retroverted Uterus. 84 2.1. Physiological factors responsible for absorption of
drug through vagina. 211
3.6. Pelvic infections and Pelvic Inflammatory Diseases. 85
2.2. Anti-microbial defense mechanism in vagina. 213
3.7. Cervical erosion. 92
2.3. Yoni-Snehana-Swedana. 215
CHAPTER-4 2.4. Yoni dhavanam. 216
VANDHYATWA 2.5. Yoni pichu. 217
4.1. Vandhyatwa -Prakar, Nidana ,Chikitsa-Infertility, Causes, 2.6. Uttarabasti. 219
Types, Investigations and Management. 96 2.7. Dhupana. 224
2.8. Lepana. 225
4.2. Yoni Kanda (Bartholin cyst). 109
2.9. Yoni – Varti. 226
4.3. Yoni Arsa. 112
2.10. Yoni purana. 228
4.4. Yoni-Granthi, Arbud-Cysts and tumours of yoni. 115
2.11. Yoni Parisheka. 228
4.5. Sexually Transmitted Infections, HIV, AIDS, Preventive measures. 135
2.12. Yoni panda dharana. 228
4.6. Phiranga roga. 143
2.13. Ksharakarma. -Practical knowledge of all these procedures
4.7. Syphilis. 149
along with indications, complications and management. 229
4.8. Gonorrhea. 154
CHAPTER-3
CHAPTER-5 SHASTRA KARMA:
MENOPAUSE. Surgical procedures, Indications and Contraindications of following.
Changes during menopause, menopause syndrome 3.1. Cauterization of cervix. 231
and management. 156
 Index 13 14 StrÍroga VijáÂàa

3.2. Cervical dilatation and curettage. 234 36. Mahaa kalyaanaka ghritam. 263
3.3. Female surgical sterilization. 237 37. Brihat garbha chintaamani ras. 263
3.4. Knowledge of indication and procedure of PAP smear. 241 38. Garbhapaala ras. 264
3.5. Endometrial biopsy and interpretation of the reports. 244 39. Prataapa lankeshwara ras. 264
40. Garbha rakshani gulika or 264
CHAPTER-4 41. Loha parpati. Mahaa dhanwantaram gulika. 264
Prasuti-Stree roga sambandhita Oushada-Shastra-Yantra parichaya. 42. Lavangaadi chrunam. 265
4.1. STRI ROGA SAMBANDHITA PRAMUKHA AUSHADHYAI: 43. Dhatakyaadi tailam. 265
1. Ashokarishta. 246 44. Mahaatiktaka ghritam. 266
2. Ashokaadhya ghritam. 247 45. Raja:pravartani vati. 267
3. Shataavari ghritam. 248 46. Bolabaddha ras. 267
4. Dhaatree ghritam. 248 47. Pradara ripu. 267
5. Laksmanaadhyarishtam. 249 48. Nashta pushpaantaka ras. 268
6. Usheeraasavam. 249 4.2. Prasuti & Stri Roga Chikitsa Upayogi Yantra Shastra Parichaya.
7. Kumaaryaasavam. 250 1. Allis’ Forceps. 268
8. Sutikaabharana ras. 250 2. Artery Forceps. 269
9. Lakshmi naaraayana ras. 251 3. Ayre’s Spatula. 269
10. Soubhagya shunti. 251 4. Babcock’s Forceps. 269
11. Laghu maalinee vasanta ras. 251 5. Band Applicator. 270
12. Laakshaadi tailam. 252 6. Cusco’s Speculum. 270
13. Panchajeeraka ghritapaanam. 252 7. Doyen’s Retractor. 272
14. Sahacharaadi kwaadham. 252 8. Right Angle Retractor. 272
15. Jeerakaadhyarishtam. 252 9. Deaver’s Retractor. 272
16. Daadimaadi ghritam. 253 10. Episiotomy scissors. 273
17. Phala ghritam. 253 11. Foleys Catheter. 273
18. Devadaarvyaadi kwadham. 254 12. Green Armytage Forceps. 274
19. Vajra kaanjikam. 254 13. Hegar’s Dilator. 274
20. Hreeberaadi kashayam. 254 14. Kocher’s Forceps. 275
21. Sutikaa dashamuala kwadham. 254 15. Karmans syringe. 276
22. Dashamulaarishtam. 255 16. Rubin’s Cannula. 276
23. Pushyaanuga chrunam. 256 17. Leech Wilkinson’s Cannula. 277
24. Balaadhya ghritam. 257 18. Laparoscopic Uterine Manipulator-cannula. 277
25. Kaashmaryaadi ghritam. 258 19. Needle Holder. 277
26. Guduchyaadi tailam. 258 20. Ovum Holding Forceps. 278
27. Brihat shataavari ghritam. 258 21. Purandare’s Dilator. 278
28. Udumbaraadi tailam. 259 22. Feto Stethoscope. 279
29. Dashamula ghritam. 260 23. Sims’ Vaginal Wall Retractor. 279
30. Sahacharaadi kwadham. 260 24. Sims’ Speculum. 279
31. Amritaadi kwadham. 260 25. Sponge Holding Forceps. 280
32. Prabhanjana vimardhana tailam. 261 26. Suction Curette. 281
33. Sukumaara ghritam. 261 27. Shirodkars Cerclage Needle. 282
34. Dhanwantaram kwadham. 262 28. Surgical Blades with Handle. 282
35. Dhanwantaram tailam. 262 29. Trocar and Cannula. 282
 Index 15 16 StrÍroga VijáÂàa

30. Umbilical cord Cutting Scissors. 283 8. Observation of Method of sterilization, MTP, Surgical
31. Uterine Curette. 283 procedures Hysterectomy,
32. Uterine Sound. 283 Oopherctomy.
33. Bladder Sound. 284 DISTRIBUTION OF PRACTICAL MARKS
34. Vulsellum. 284 1. Case taking-2cases –one Gynic, one obstetric: - 30marks
35. Tenaculum. 285 2. Instruments, Drugs &Models: - 20 marks
36. Vantouse. 286 3. General Viva: - 40 marks
37. Wrigleys Forceps. 286 4. Record -2-(one Prasuti, one streerog): - 10 marks
4.3. Vyadhivinischaya Upaya, Investigative and Diagnostic Aids Total = 100 marks.
like Laproscopy, Hysteroscopy, Hysterosalphingography, USG,
X-RAY, Colposcopy and Cervical Biopsy. 287 
4.4. Granthi evum Granthi nirharan samanyajnan
(Myomectomy and Hysterectomy). 304
4.5. Garbhanirodhak Upaya. 312
4.6. Ayurvedic contraceptives. 327

CHAPTER-5
NATIONAL HEALTH PROGRAMMES:
5.1. Parivar Niyojana. 331
5.2. Reproductive and Child Health Care. 332
5.3. National AIDS/HIV control Programme. 334
5.4. MCH, Janani shishu surakshaa kaaryakramam,
Janani surakshaa yojana. 336
5.5. National-Nutritional Programmes of current India. 342
5.6. PNDT Act. 348
5.7. MTP Act and importance. 350

CHAPTER-6
Knowledge of important commonly used Allopathic drugs used in
Prasutitantra and Streeroga.
6.1. Pharmaco-therapuetics of allopathic drugs used in Gynaecology. 357
6.2. Pharmaco-therapuetics of allopathic drugs used in Obstetrics. 359
6.3. Record keeping. 365
6.4. Ethical and medico legal issues in Streeroga and Prasutitantra. 369
GYNAECOLOGICAL SKILLS -To perform independently of:
1. History taking and examination of gynecological cases.
2. Recording 10 gynecological cases, 5 gynecological procedures
3. Taking vaginal smear, high vaginal swab.
4. Practical knowledge of sthanika chikitsa
5. Observation and practical knowledge of minor
gynecological procedures
6. Observation of Surgical procedures
7. Identification, uses and Demonstration of surgical instruments.

PAPER-2: STRÊROGA VIJÜÀÛA
PART-A
CHAPTER-1
ÀRTAVA VYÀPAD:
1.1. ÀRTAVA-KëAYA VäDDHI, AëTÀRTAVADUëTI LAKëAÛA
CIKITSÀ.
StrÍroga VijáÂàa is a branch of Medical Science in Ayurveda
which denotes all aspects of the diseases localize to the female genita-
lia. Though, on the name of the Gynecology, it is a separate branch of
science in modern medicine but in all Ayurvedic classics StrÍ rogÂs
were studied under KoumÂrabhçityam, mentioned with little indications
and management, Not as separate branch but Charaka, Suïçta, VÂgbhaòa
and BhÂvamiïra mentioned few conditions in the name of StrÍ-
RogÂdhikÂra.
MÂdhava nidÂna the only clinical medicine in ayurveda also men-
tioned certain diseases in StrÍroga. Though it looks as a small branch,
for a medical practitioner it is essential because every third women in
the world after her 14th year definitely complain one or other StrÍ roga.
The total StrÍ rogÂs may be classified broadly into 3 categories:
1. Yoni vyÂpaths
2. Àrtava vikçthis and
3. Viïiîta vyÂdhis.
1. The structural and functional varieties of female genitalia ei-
ther a congenital or acquired, come under Yoni vyÂpaths.
2. Due to any cause or any pathogenesis the Ârtava, its volume,
Quality, Flow, Duration, Period etc. come under Àrtava
vikçthis.
3. There are specific disorders in women due to metabolic causes
like Soma roga or Phiraági roga which are sexually transmit-
ted are known as Viïiîta vyÂdhis.
This textbook on Gynecology deals in details with the above fac-
tors.
2 StrÍroga VijáÂàa
Àrtavam is considered as StrÍgata ìukram and StrÍbÍjam-which
is prime responsible for Garbham-conception from female end.
Àrtava kîaya-Vçddhi lakîaàÂs are mentioned by Suïçta is very
important topic one must keep in their mind as the very basic concept
for the StrÍe-roga vijáÂàam.
jòeâue#eCeceele&Jeb ieYe&ke=âÛÛe ieYeex ieYe&ue#eCeb~
mlevÙeb mleveÙeesjeheervelJepeveveb peerJeveb Ûesefle~~
le$e efJeefOeJeled heefjj#eCeb kegâJeealed~~
S.S.Su.15.5-6.
Àrtavam will have all the qualities of Raktam as this is upadhÂtu
of Rakta dhÂtu, it is responsible for Garbham-GarbhalakîaàÂs (Posi-
tive progeny signs), increases the stanya quantity in breast and
jÍvanÍyam-for maintaining health of the woman hence at most care is
paid to control excess loss of Àrtavam.
A) ÀRTAVA-KëAYA VäDDHI LAKëAÛA-CIKITSÀ:
Àrtava kîaya lakîaàa:
Deele&J e#eÙes ÙeLees ef Û elekeâeueeoMe& v eceuhelee Jee Ùees e fv eJes o vee Ûe le$e
mebMeesOeveceeivesÙeeveeb Ûe õJÙeeCeeb efJeefJeOeJeogheÙeesie: mleve#eÙes mleveÙeescuee&velee
mlevÙeemebYeJeesÓuhelee Jee le$e Mues<ceJeOe&veõJÙeesheÙeesie: ieYe&#eÙes ieYee&mhevove-
cevegVelekegâef#elee Ûe le$e Øeehleyeefmle keâeueeÙee: #eerjyeefmleØeÙeesiees cesÅeeVeesheÙeesie§esefle~~
S.S.Su.15.12.
Decrease of Àrtava-Menstrual blood, gives non appearance at the
appropriate time or scanty appearance with pain in vagina etc seen as
cardinal symptom.
Stanyam secretions get decreased there by wasting of the breasts;
Garbha kîayam, absence of Garbha spandana-absence of movements
of the fetus in garbham and non-development of abdomen etc are seen
as Ârtava kîaya lakîaàÂs.
The treatment explained for Àrtava kîaya is samïhodanam of body
which includes Vamana, Virechana and Vasti therapies and use of ÀhÂra,
PÂnÍya and drugs which act as DÍpana-PÂchana in nature are useful.
 Chapter-1 3 4 StrÍroga VijáÂàa

KîÍra basti, KîÍra pÂna, Snehayukta food items to be given for ASHTA-ÀRTAVADUëTI- LAKëAÛA-CIKITSÀ:
proper development of garbham will be sufficient in treating Ârtava Àrtavavaha Srotas According to ÀchÂrya Suïçta, they are two in
kîaya. number, their roots in GarbhÂïhaya and Àrtavavahi Dhamanis.
Àrtava Vçddhi lakîaàas: Deele&Jens És leÙeescet&ueb ieYee&MeÙe Deele&JeJeeefnvÙe§e OecevÙe:~
Àrtava Vçddhi is characteristic by producing the following symp- le$e efJeæeÙee JevOÙeelJeb cewLegveemeefn<CeglJeceele&JeveeMe§e~~
toms., S.S.Sh.9.12.
Deele&JeceÁceo&ceefleØeJe=efòeb oewie&vOÙeb Ûe mlevÙeb mleveÙeesjeheervelJeb cegngceg&ng: ØeJe=efòeb Injury to these produces infertility, dyspareunia and amenorrhea.
leesob Ûe ieYeex pe"jeefYeJe=efæb mJesob Ûe~~ As the word Àrtava has got two meanings viz. the Àrtava or ìonita
les<eeb ÙeLeemJeb mebMeesOeveb #eheCeb Ûe #eÙeeo efJe®æw: ef›eâÙeeefJeMes<ew: ØekegâJeeale~~ (menstrual blood) and the StrÍ BÍja (ovum); the Àrtavavaha Srotas can
S.S.Su.15.16-17. be compared with the blood vessels and capillaries of the uterus and
fallopian tubes.
Great increase of Àrtava- menstrual blood produces body pains,
flow of more quantity with bad smell, great increase of breast milk, GarbhÂïhaya: The word GarbhÂïhaya is composed of two words
increase size of the breasts, frequent milk ejection, mild pain in breast, i.e. Garbha and Àïhaya. The word Àïhaya means the place to rest thus
huge enlarged garbha-abdomen and heavy perspiration etc are seen. the GarbhÂïhaya is a place where the Garbha lies or develops.
Àrtava Vçddhi is treated with respective Paáchakarma procedures Puruîa ìhÂrÍra is comprised of Sapta Âïhaya, where stri possess
and doîa-ïÂmaka drugs followed by remedial measures which won’t GarbhÂïhaya as one extra Àïhaya.
contradictory to condition are adapted. ÀchÂrya Suïçta has mentioned the shape of GarbhÂïhaya resemble
Author’s opinion: Author opines that the intention of ex- mouth of rohit fish. GarbhÂïhaya is situated in third Àvarta of Yoni
plaining garbha-stanya, Vçddhi-kîaya lakîaàÂs with the contest of behind the Basti, in between PittÂïhaya and PakvÂïhaya.
Àrtavam is Àrtavavaha Dhamani: There are AdhogÂmini Dhamanis, 2
Dhamanis meant for the formation (PrÂdurbhava) and 2 Dhamanis meant
ie=nerleieYee&CeeceeleJeJeneveeb œeeslemeeb Jelcee&vÙeJe®OÙevles ieYexCe lemceeoddie=nerle-
for excretion (Visarga) of Àrtava.
ieYee&Ceeceele&Jeb ve ÂMÙeleslelemleoOe: ØeeflenlecetOJe&ceeielecehejb ÛeesheÛeerÙeceevece-
SHUDDHÀRTAVA LAKëAÛA:
hejslÙeefYeOeerÙeles Mes<eb ÛeesOJe&lejceeieleb heÙees OejeJeefYeØeefleheÅeles lemceeûefYe&CÙe:
heerveesVeleheÙeesOeje YeJeefvle~~ S.S.Sh.4.24. MeMeeme=keäØeefleceb Ùeòeg ÙeÉe uee#eejmeeshececed~
Suïçta explains that during antenatal period the pregnant lady will leoele&Jeb ØeMebmeefvle ÙeÉemees ve efJejÀeÙesled~~
not have menstrual flow because the Ârtava-vaha srotuses are blocked S.S.Sh.9.17.
by the fetus there by the Ârtavam flows upwards and divided into three The menstrual blood which resembles the blood of rabbit or
parts, one part nourishes garbham, one part nourishes or takes care of lÂkîÂrasam and that which does not stain the cloth is considered as char-
breast development and the remaining one part will takes care of preg- acteristic features of ïuddhÂrtavam.
nant lady by helping in dehapuîti-she put on weight, hence the three Charaka explains few more characters to ïuddhÂrtavam:
are the prime duties of Àrtavam in women and Àrtava kîaya-Vçddhi
ceemeeefVeef<heÛÚoeneefle& heÃeje$eevegyeefvOe Ûe~
lakîaàÂs will reflects in these three terms.
vewJeeefleyeng veelÙeuheceele&Jeb MegæceeefoMesled~~
 Chapter-1
iegÀeeHeâuemeJeCeË Ûe he©eeueòeâkeâmeefVeYeced~
Fvõieeshekeâme¿eMeceele&Jeb MegæceeefoMesled~~
C.S.Ch.30.225-226.
The menstruation which appears every month, which is free from
stickiness of discharge, burning sensation, pain, continues for 5 nights
and is neither excessive nor scanty, is to be considered as normal.
The menstrual discharge which is of the color of Guája fruits or
of lotus or of Indra-Gopa (trombidium) is considered as ïhuddhÂrtavam.
NidÂna of Àrtava duîti: Charaka did not mention any nidÂnam
for Àrtava duîti but it should be understood that doîa respective nidÂna
factors provokes doîÂs and causes the 8 varieties of Àrtava doîÂs.
K.S.Si.4.
jpemJeueeÙee $e+legJÙee&heÅeles~
KÂïhyapa says that introduction of Nasya karma in rajaswala leads
to menstrual disorders and Atyuîàa ÂhÂra-anupÂna sevanam leads to
Àrtava doîÂs.
Mçdu koîhta patient takes excess swedana and sneha karma causes
Àrtava doîÂs.
Àrtava duîti was specially emphasized by Charaka and Suïçta.
The vitiated menstrual blood presentation will be.,
Deeòe&Jeceefhe ef$eefYeoex<ew: MeesefCeleÛelegLez: he=LeiÉvÉw: mecemlew§eesheme=°ceyeerpeb
YeefJele leefohe oes<eJeCe&JesoveeefoefYeefJe&%esÙeced~ les<eg kegâCehe«eefvLeheteflehetÙe#eerCecet$e-
hegjer<eØekeâeMecemeeOÙeb meeOÙecevÙeÛÛesefle~ S.S.Sh.2.5.
Suïçta and Charaka both enumerates 8 Àrtava doîÂs namely VÂta,
Pitta, Kapha, Kuàapa, Grandhi, Pöti-pöya, KîÍna and Mötra-PurÍîa, be-
comes incapable of producing garbha. Features like color, discomfort
of vitiated menstrual blood should be recognized as connected to doîÂs.
Among them Pöti-pöya, Kuàapa, Grandhi, Scanty micturition and
Mötra-PurÍîa doîÂs are asÂdhyam-impossible to purify; where as other
kinds are sÂdyam-curable.
ÀRTAVA-DUëTI LAKëAÛÀS:
JeeleefheòeMues<cekegâCeheieefv Oe«eefvLehetÙ e#eer Cecet$ ehegj er<ejsleebefmelJeyeer peeefv e
YeJeefvle~ le$e leveg ¤#eb Hesâefveuece®Ceceuheb efJeefÛÚVeb me®peb efÛejeÛÛe efveef<eÛÙesle
5 6 StrÍroga VijáÂàa
Jeelesve~ efkeâefÃelheerleceefheefÛÚueceeveerueb Jee onefoJe ØeJele&les efheòesve~ ceppeeshemebme=°b
ØeYetleb efJeyeæb ÛeecYeefme Ûe efkeâefÃevceppeefle Mues<ceCee~ kegâCeheievOÙeveuheb jòesâve~
«eefvLeYetleb JeeleMues<ceYÙeeced~ heteflehetefÙeveYeb efheòeMues<ceYÙeeced~ #eerCeb JeeleefheòeeYÙeeced~
leogòebâ memeeOeveb Øeekeâd~ cet$ehegjer<eieefvOe meefVeheelesve~~ A.S.Sh.1.13.
1. VÂtaja: Àrtava will be red-black in colour, Scanty, Scattered,
Delay-Difficult in discharge and Painful.
2. Pittaja: Àrtava will be yellow or blue or red in colour, Putrid-
pus smell, thin consistency, Burning and dysuria.
3. Kaphaja: Àrtava will be white-yellow in colour, looks majja,
Putrid smell, Thick-unctuous, stiff, dysuria or anuria, Idleness,
Lethargy and Anidra.
4. Kunapa Gandhi: Àrtavam will be bright red in colour, excess
in amount, Putrefied smell with burning in yoni.
5. Granthibhöta: Presence of clots in Àrtavam with features of
VÂta-Kapaha duîhta Ârtavam are seen.
6. Pötipöya: Àrtavam looks pus and pus smell and Pitta-Kapha
dushta Ârtava lakîaàÂs are seen.
7. KîÍna: Scanty menstrual blood, Delay in flow and occurrence,
Pain in vagina and Pitta-VÂta duîhta Ârtava lakîaàÂs are seen.
8. Mötra-PurÍîa Gandhi: Menstrual blood flows with urine - faces
and has smell of urine - faces.
In a nutshell Àrtava doîÂs are 8 in number; Àrtava doîa leads to
various Ârtava vikçiti eg: Aïhçigdhara, NaîhtÂrtava and KaîhtÂrtava etc.
Regular menstrual cycle indicates the normal physiological func-
tion of H.P.O axis-Hypothalamo-Pitutory and Ovarian axis.
Treatment for Àrtava duîti-SÂmÂnya CikitsÂ:
efJeefOecegòejJemlÙevleb kegâÙee&oele&JeMegæÙes~~
ŒeerCeeb mvesneefoÙegòeâeveeb Ûeleme=<Jeele&Jeeefle&<eg~
kegâÙee&lkeâukeâeved efheÛetb§eeefhe heLÙeevÙeeÛeceveeefve Ûe~~
«eefvLeYetles efheyesled hee"eb $Ùet<eCeb Je=#ekeâeefCe Ûe~
ogie&efvOehetÙeme¿eMes ceppeleguÙes leLeeÓleJes~~
 Chapter-1
efheyesÆõ efßeÙe: keäJeeLeb ÛevovekeäJeeLecesJe Ûe~
Meg›eâoes<enjeCeeb Ûe ÙeLeemJeceJeÛeejCeced~~
Ùeesieeveeb MegefækeâjCeb Mes<eemJehÙeele&Jeeefle&<eg~
DeVeb MeeefueÙeJeb ceÅeb efnleb ceemeb Ûe efheòeueced~~
S.S.Su.2.12-16.
For women suffering from the first four kinds of vitiation of men-
strual blood therapies ending with uttaravasti accompanied with sneha-
sweda karmÂs, the same respective doîhara oushadÂs are used for in
kalka form for Yoni-pichu dhÂraàm and kaîhÂyam of those drugs used
for Yoni-prakîhÂlanam purposes.
In case of Grandi of Àrtava doîam: PÂtha, TrÂyamÂàa and Vçkîaka
should be given internally.
Dourgandhya, Puya sanga Ârtava doîam is treated by chandana-
dwaya KaîÂyam and for remaining Ârtava doîÂs are similarly treated
with recipes mentioned to purify ìukragata doîÂs.
Food prepared from ìÂli, yava and mÂïa which increases pitta are
beneficial.
Viïiîta CikitsÂ:
Jeelepes heg<heoes<es Yee*ddieeaceOegkeâYeõoe®efmeæb meefhe&<heeveced~ keâeMceÙe&#egõ-
meneefmeæb Jee #eerjced~ ceOegkeâme=ieeueefJeVeekeâukebâ heÙemmeefhe&mmeefnleb efØeÙeÁÏefleuekeâukebâ
Jee Ùeesveew OeejÙesled~ mejuecegûheCeeakeâ<eeÙe: Øe#eeueveced~ A.S.Sh.1.16.
1. VÂtaja Ârtava duîti: VÂtaja Ârtava duîti is considered as
Oligomenorrhoea with Dysmenorrhoea it is treated with BhÂraági,
Madhöka and DevadÂru kçita KîÍra pÂkam given internally.
2. KÂîhmari and KantakÂri sidda KîÍram is also equally helpful.
3. KaîhÂyam of Musta, pippali, Bçihati and PÂtala added with
gudam is given internally during çitukÂlam.
Madhöka, ìhÂlaparài, VidÂri and Sarpi kalkam or Priyaágu and
Tila-KalkadhÂranam in yoni is advised followed by YoniprakîhÂlanam
with Sarala and Mudgaparài KaîhyÂm.
2. Pittaja Ârtava duîti: Pittaja Ârtava duîti is considered as chronic
pelvic infective conditions or Pelvic cellulitis.
7 8 StrÍroga VijáÂàa
I. It is treated with KaîhÂyam of KÂkoli dwayam and VidÂri or
Utpala and Padmaka kîayam or Madhöka-puîhpa and GambhÂri phala
kwÂdham or Chandana KaîhÂyam mixed with sugar and honey is given
internally.
efheòepe keâekeâesueerÉÙeefJeoejercetuekeäJeeLeceglhehe©ekeâkeäJeeLeb ceOetkeâheg<hekeâeMceÙe&-
HeâuekeäJeeLeb Jee meMeke&âjb efheyesled~ ÕesleÛevovekeäJeeLeb Jee me#eewõced~ OeJeOeelekeâerkeâukebâ
Jee Ie=lesve Jee ceOegkeâceOegjmeece=Éerkeâekeâukeâced~ MecÙeekeâ ieJee#eer#eerjb efJejskeâ:~ Ûevove-
heÙemÙeekeâukebâ Ùeesveew OeejÙesled~ ieewefjkeâeefj°keâ<eeÙe: Øe#eeueveced~~ A.S.Sh.1.16.
II. Kalkam of Dhava and DhÂtaki puîhpam with GhçtaØ or
Madhöka, Gudöchi and DrÂkîha kalkam or ìamyÂka and GavÂkîÍ
(IndravÂruni) KîÍrapÂkam is given internally to induce virechanam.
III. YonidhÂraàam should be done with Chandana and Vidaari
kalkam.
NimbÂriîta or KaîhÂyam is used for YoniprakîhÂlaàam purposes
in treating pittaja Ârtavaduîti.
3. Kaphaja Àrtava duîti CikitsÂ: Kaphaja Àrtava duîti is con-
sidered as chronic endometriosis and endocervicitis based on the clini-
cal presentations.
This can be treated with KaîÂyam made out of Kutaja, Katuki
and Aïvagandha internally. The tender leaves of Nyagrodha, Udum-
bhara, Aïwartha, PÂrÍîa and Plakîha etc KaîÂyam is made and given
internally by adding honey-ghee.
Muewef<cekesâ kegâšpekeâšgkeâeÕeievOeekeäJeeLeb efheyesled~ meceeef#ekebâ Jee #eerefjJe=#e-
ØeJeeuekeäJeeLecesle<eecesJe Jee ÛetCeË ceOegIe=leeYÙeeb efue¢eeled~ ceoveHeâuekeâ<eeÙesCe Jeceveced~
lelkeâukeâcesJe Ûe Ùeesveew OeejÙesled~ ueesOeÇeflevogkeâkeâ<eeÙe: Øe#eeueveb yemleces<ecet$eb Jee~~
A.S.Sh.1.16.
Vamanam is advised to be done with madana phala KaîhÂyam.
YonidhÂraàam is done with Madana phala kalkam.
YoniprakîhÂlaàam is done with Lodhra KaîhÂyam or Tinduka
KaîhÂyam or Goats urine etc are done to treat Kaphaja Ârtavaduîti.
4. Raktaja Àrtava duîti or Kunapa Gandhi Ârtava duîti
CikitsÂ: Both VÂgbhaòÂs mentioned that vitiated rakta produces
 Chapter-1
Kunapagandhi or Raktaja Ârtavaduîti. The symptoms explained for
which is usually found in necrosis of tissue and in malignant condi-
tions, menstrual blood have such smell.
The condition is treated with DhÂtaki puîpa, Kadhira, Arjuna and
DÂdima kçita ghçitam is given internally followed by Triphala kalka
dÂraàam in yoni-TriphalÂkaîhÂya-YoniprakîhÂlaàam should be done.
Chandana kîayam is given internally and for YoniprakîhÂlaàam,
Ckandana kalakam is used for yoni-dÂranam.
kegâCehejsleefme Oeelekeâerheg<heKeefojepeg&veoeef[cew: efmeæcemeveeefoefYeJee& meefhe&:
heeÙeÙesled~
kegâCehehetÙeele&Jes ÛevovekeäJeeLeb efheyesled~
ef$eHeâueekeâukeâkeäJeeLeew Ûee$e OeejCeeÛeceves~~
A.S.Sh.1.17.
5. Grandi Ârtava duîti CikitsÂ: Grandi Ârtava duîti symptoms
are seen with common menstrual disorders including malignant cases.
It is treated with PalÂîha bhasmam, PÂîhÂàa bedÂdi KaîÂya, PÂtha,
Trikatu and VçikîhakÂdi KaîhÂyam is given internally.
«eefvLejsleefme hee<eeCeeefYeoe heueeMeYemcevee Jee~
leLee «evLÙeele&Jes hee"eef$ekeâCškeâJe=#ekeâkeäJeeLeced~~
A.S.Sh.1.17.
6. Puti-Puya Àrtava duîti CikitsÂ: in Pöti-Pöya Ârtava duîti,
Pitta-Kapha doîÂs are involved and symptoms can be correlated with
acute pelvic inflammatory conditions and treated with ParöîakÂdi and
NyagrodÂdi gaàa KaîÂyam is given internally and used externally for
yoni prakîhÂlaàam, Kalkam of same drugs used for yoni dhÂranam will
gives symptomatic relief.
hetÙejsleefme he¤<ekeâeefovÙe«eesOeeefoYÙeeced~
kegâCehehetÙeele&Jes ÛevovekeäJeeLeb efheyesled~
ef$eHeâueekeâukeâkeäJeeLeew Ûee$e OeejCeeÛeceves~~
A.S.Sh.1.17.
7. Mötra-PurÍîa gaàdi Ârtava duîti CikitsÂ: Mötra-PurÍîa gandi
9 10 StrÍroga VijáÂàa
Ârtava duîti lakîaàÂs are very presided as the smell of urine and faeces
seen with menstrual blood is only possible with Vesicovaginal or Vesi-
couterine and Rectovaginal fistula etc. The fistulous conditions usually
seen with advanced malignant stages of genital organs or uterus hence
it is considered as AsÂdhyam.
cet$ehegjer<ejsleefmeJeeÙegveeefleefJeke=âlesefnÁÒMeerjefÛe$ekewâjLeJee efÛe$ekeâefJelegVekeâefØeÙeÁÏ-
efnÁÏmeceÁece=CeeueefmeæcesueeceesÛeÛetCe&ØeleerJeeheced~ A.S.Sh.1.17.
The condition is treated to produce symptomatic relief only.
Chöràa preparation for Mötra-PurÍîa gaàdi Âdrtava duîti
CikitsÂ: Hiágu, UîhÍra, Chitraka, Chitra, Bala, Priyaágu, Samaág and
MçinÂla etc drugs are taken, made into vastragÂlita Cöràam (Fine pow-
der), the same cöràam is used for external dusting and Yoài-
prakîhÂlaàam purposes.
meJex<eg Ûe Meg›eâele&Jeoes<es<eg Œeerhegbmeew mvesneefokeâce&efYeefJe&Mes<esCe ÛeesòejyeefmleefYe:
hegve: hegve®heeÛejsled~ ÙeLeemJeb Ûe Ùeesveew keâukewâ: efheÛegefYe§e~~ A.S.Sh.1.18.
Viïheîha CikitsÂ: All the varieties of ìukra, Àrtava duîties are
best treated with sneha karma especially uttara vasti with indicated drugs
KaîhÂyam or kçita snehÂs.
The same drugs kalkam may be used for yoni-dÂraàam and
KaîhÂyam for yoni-prkaîhÂlaàam.
1.2. AìHäGDHARA LAKëAÛA SAÕPRÀPTI-CIKITSÀ:
MeMeeme=keäØeefleceb Ùeòeg ÙeÉe uee#eejmeeshececed~
leoele&Jeb ØeMebmeefvle ÙeÉemees ve efJejÀeÙesled~~
leosJeeefYeVemeÁsve ØeJe=òeceve=leeJeefhe~
Deme=iojb efJepeeveerÙeeoleesÓvÙeõòeâue#eCeeled~~
Deme=iojes YeJesled meJe&: meeÁceo&: meJesove:~
lemÙeeefleJe=òeew oewye&uÙeb Yeücees cetÛÚe& lecemle=<ee~~
oen: Øeueehe: heeC[glJeb levõe jesiee§e Jeelepee:~
le®cÙee efnlemesefJevÙeemleceuheesheõJeb efYe<ekeâd~~
jòeâefheòeefJeOeevesve ÙeLeeJeled mecegheeÛejsled~~
S.S.Sh.2.17-21.
 Chapter-1 11
The menstrual blood which resembles the blood of rabbit or lÂkîhÂ
rasam and that which does not stain the cloth is considered as charac-
teristic features of ïhuddhÂrtavam, any altered presentations should be
considered Aïhçigdhara.
The menstrual blood coming out in more quantity, flows even a
part form the regular period is to be understood as Aïhçigdhara.
In all kinds of Aïhçigdhara the symptoms are painful bleeding,
body aches, when the flow is profuse, weakness, giddiness, fainting,
darkness in eyes, thirst, feeling of burning sensation, delirium, skin dis-
coloration to yellow or pale (Anemia), Stupor and diseases of VÂta ori-
gin will manifest.
The physician should treat this condition with treatments advo-
cated for Raktapitta-bleeding diseases.
In young woman who takes only patya ÂhÂras can be treated in
very easy manner for other it is difficult to cure.
Author’s opinion:
1. In women menstrual flow commences from about the age of
12-14 years and stops at about 40-40 years.
2. In majority women there is a regular periodicity usually of 28
days but variation are common. The flow is painless in few women it is
with pain in the lower abdomen this condition is known as dysmenor-
rhoea.
3. Flow lasts for 3-5 days stops automatically.
4. Its quantity varies from a few drops to about 100ml in total and
quantity more than 200ml is generally abnormal and is known as men-
orrhagia.
5. Menstrual blood is dark red, slightly thick due to the presence
of mucus and other secretions it does not clot and does not stain the
cloth.
NidÂnam of Aïhçigdhara: According to ÀchÂrya Charaka, Suïçta
and VÂgbhaòa etc. have described different causes of Aïhçigdhara in
their texts which are given below.
12 StrÍroga VijáÂàa
Table: 1- Aïhçigdhara NidÂnam- Opinions of ÀchÂryas:
SaØhita NidÂnam considered for Aïhçigdhara
1. Charaka Excessive intake of Lavana, Amla, Katu,
VidÂhi, KçuïÂravikÂra, Mastya, Guru,
Snigdha and MithyÂhÂrsevana respective to
doîas.
2. Suïçta Pittavçita apÂna vÂyu causes Aïhçigdhara
3. AîhtÂága Saágraha Increase in amount of blood-Ativçddhi of
Rakta.
4. AîhtÂága Hçidaya PittÂvçita apÂna vÂyu causes Aïhçigdhara.
5. MÂdhava NidÂna Viçuddha Bhojana, Madyam, Garbha-
prapata, Ati-maithuna, Atikarîhana, Ati-
mÂrgagamana, AbhighÂta, Diva-ïayana and
AìHäIGDHARA - PRADARA:
Ùe: hetJe&cegòeâ: Øeoj: ëe=Ceg nslJeeefoefYemleg leced~~
ÙeeÓlÙeLeË mesJeles veejer ueJeCeecueieg¤efCe Ûe~
keâštvÙeLe efJeoenerefve efmveiOeeefve efheefMeleeefve Ûe~~
«eecÙeewokeâeefve cesÅeeefve ke=âMejeb heeÙemeb oefOe~
Megòeâcemlegmegjeoerefve YepevlÙee: kegâefheleesÓefveue:~~
jòebâ ØeceeCeceg<›eâcÙe ieYee&MeÙeielee: efmeje:~
jpeesJene: meceeefßelÙe jòeâceeoeÙe leõpe:~~
ÙemceeefÉJeOe&ÙelÙeeMeg jmeYeeJeeefÉceevele:~
lemceeome=iojb Øeengjsleòev$eefJeMeejoe:~~
jpe: ØeoerÙe&les Ùemceeled Øeojmlesve me mce=le:~
meeceevÙele: mecegefö°b keâejCeb efueÁcesJe Ûe~~
ÛelegefJe&Oeb JÙeemelemleg JeeleeÅew: meefVeheelele:~
C.S.Ch.30.225-226.
If a woman takes excess of Lavana, Amla, Guru, Katu, TÍkîhna
and SnigdhÂhÂram, taking heavily non-vegetarian diet, Kçiïhara (a
preparation of rice and pulses), PÂyasa (a preparation of milk and rice),
Dadhi, Sura, ìhukta, KÂmbalikam etc of reasons provokes VÂtam, the
 Chapter-1 13
VÂta causes increase in the quantity of blood and gets lodged in the
channels which go to uterus carrying menstrual fluid.
Since by propelling blood of the body to these menstrual fluids
immediately because of the liquid nature of the former blood is called
Aïrigdagara (menorrhagia) by the experts of gynecology a specialty of
medicine. Since the quantity of menstrual fluid is augmented or ex-
panded it is called Pradara.
Pradara is of 4 varieties, namely VÂtaja-Pradara, Pittaja-Pradara,
Kaphaja-Pradara and SannipÂtaja-Pradara.
1. VÂtaja pradara nidÂna-lakîaàa:
¤#eeefoefYecee&®lemleg jòeâceeoeÙe hetJe&Jeled~
kegâefhele: Øeojb kegâÙee&uue#eCeb lemÙe ces Me=Ceg~~
Hesâefveueb leveg ¤#eb Ûe MÙeeJeb Ûee®CecesJe Ûe~
efkebâMegkeâesokeâme¿eMeb me®peb JeeÓLe veer®peced~~
keâefšJe*d#eCeùlheeÕe&he=‰ßeesefCe<eg cee®le:~
kegâ®les Jesoveeb leer›ecesleÉeleelcekebâ efJeog:~~
C.S.Ch.30.211-213.
The excess intake of Rökîha, VÂtakara ÀhÂra-vihÂrÂs provokes
VÂta doîam and alters the colour of menstrual blood to brownish black
or Kimïhukodaka sankÂsa-pink or like the juice of PalÂïha, which may
or may not be associated with pain, as it is due to aggravated VÂta causes
excruciating pain in the waist, groins, cardiac region, sides of chest,
back and hips, then this is to be diagnosed as VÂtaja-pradaram.
2. Pittaja pradara nidÂna-lakîaàa:
Decuees<CeueJeCe#eejw: efheòeb Øekegâefheleb Ùeoe~~
hetJe&Jeled Øeojb kegâÙee&led hewefòekebâ efueÁle: Me=Ceg~~
meveerueceLeJee heerlecehÙeg<Ceceefmeleb leLee~~
efveleevlejòebâ œeJeefle cegngceg&ngjLeeefle&celed~~
oenjeiele=<eeceesnpJejYeücemeceeÙegleced ~
Deme=iojb hewefòekebâ mÙeeÛÚuewef<cekebâ leg ØeJe#Ùeles~~
C.S.Ch.30.213-216.
When the Pitta is aggravated by the excess intake of Amla, Uîàa,
14 StrÍroga VijáÂàa
Lavana and KîhÂra pradÂnÂhÂra-Pittaprkopakara vihÂras causes Pittaja-
Pradaram.
If the menstrual blood is blue, yellow, excessively hot, black or
red coloured, if it flows frequently associated with pain, if the patient
complaints’ burning sensation, redness, thirst, unconsciousness, fever
and giddiness then this is diagnosed as Paittaja-Aïrigdagara.
3. Kaphaja pradara nidÂna-lakîaàa:
iegJee&efoefYenxlegefYe§e hetJe&Jeled kegâefhele: keâHeâ:~
Øeojb kegâ®le lemÙe ue#eCeb leòJele: Me=Ceg~~
efheefÛÚueb heeC[gJeCeË Ûe ieg® efmveiOeb Ûe Meerleueced~
œeJelÙeme=keâd Mues<ceueb Ûe Ieveb cevo®peekeâjced~~
ÚÅe&jesÛekeâùuueemeÕeemekeâememeceefvJeleced ~~
C.S.Ch.30.217-219.
Kapha aggravated by the intake of ingredients which are heavy,
etc., causes Kaphaja-Pradara. In this type of Pradara, the menstrual dis-
charge is sticky, pale in colour, heavy, unctuous, cool in touch, with
mucous or dense. There will be dull pain associated with vomiting,
anorexia, nausea difficulty in breath and cough.
4. SannipÂtaja pradara nidÂna-lakîaàa:
ef$eefueÁmebÙegleb efJeÅeeVewkeâeJemLeceme=iojced~~
veejer lJeefleheefjefkeäue°e Ùeoe Øe#eerCeMeesefCelee~
meJe&nslegmeceeÛeejeoefleJe=æmleoeÓefveue: ~~
jòeâceeiexCe me=peefle ØelÙeveerkeâyeueb keâHeâced~
ogie&vOe efheefÛÚueb heerleb efJeoiOeb efheòelespemee~~
Jemeeb ceso§e ÙeeJeefæ mecegheeoeÙe JesieJeeved~
me=pelÙehelÙeceeiexCe meefhe&ce&ppeJemeeshececed~~
MeÕeled œeJelÙeLeeœeeJeb le=<CeeoenpJejeefvJeleced~
#eerCejòeâeb ogye&ueeb me leecemeeOÙeeb efJeJepe&Ùesled~~
C.S.Ch.30.217-219.
In this type of Pradara, all the signs and symptoms of aforesaid 3
types of Pradara are manifested in complete form. This SannipÂtika
Pradara is not characterized by the signs and symptoms of only one of
them and mixed symptoms are seen.
 Chapter-1 15
If a woman who is excessively exhausted and who is excessively
depleted of blood, resorts to all the aforesaid factors described in re-
spect of VÂtaja, Pittaja and Kaphaja having opposite attributes through
the channels of blood.
The Kapha being afflicted by the heat of Pitta becomes foul smell-
ing, Slimy and yellow. The aggravated VÂta moving rapidly makes this
Kapha with VÂsa (muscle fat) and Medas (adipose tissue) to be dis-
charged through the vaginal tract.
The fluid, thus discharged appears like Ghee, Majja (bone mar-
row) and Vasa.
This discharge from the vaginal tract takes place constantly and
the patient suffers from morbid thirst, burning sensation and fever. When
patient blood is depleted and is very weak is incurable so the physician
must avoid treating such case.
TREATMENT OF AìHäIGDHARA:
Treatment has described under following headings:
I. Principles of treatment
II. General treatment
III. Specific treatment according to Doîas.
I. Principles and Line of Treatment:
1. Use of treatment that is described for Raktayoni i.e., use of
haemostatic drugs according to Doîas diagnosed on basis of
color and smell of blood.
2. Use of treatment described in YonivyÂpada chapter as per re-
spective Doîa.
3. Treatment prescribed for RaktÂtisÂra, Raktapitta and RaktÂrîhas
is given.
4. Treatment of Guhyaroga and abortions should be used.
5. Basti should be used and Virechana cures aïhçigdhara and other
menstrual disorders.
6. Raktavardhaka or Treatment of PÂndu-Anemia can also be
adapted.
16 StrÍroga VijáÂàa
II. General treatment:
This consists of external, local, internal and systemic both i.e.
some remedies are effective by their local application to cure aïhçigdhara
and some are beneficial to treat the disease by their internal use. Both
of these i.e. external and internal medicines are broadly described in
detail under different headings and given below:
Drugs for External and Local Use:
1. The root of VyÂghranakhi which is situated in north direction
and sacred place during Uttarphalguni Nakîhatra and tied in
the waist cures Raktapradara.
2. Inhalation and massage of ìhatapuîpa tailam is beneficial in
aïhçigdhara.
3. Use of Uttarbasti is also beneficial. In aïhçigdhara vasties like,
ChandanÂdi Niröhabasti, RÂsnÂdiniröhabasti, MadhökÂdi
anuvÂsanabasti, KuîÂdi-RodhrÂdi, RÂsnÂdi ÂsthÂpanabasti and
MustÂdi Yapanabasti are used in aïhçigdhara.
Drugs for internal use:
1. Rasauîadhi KalpanÂs: Pradararipu rasa, Bolaparpati etc are
given internally.
2. Vati Kalpana: GokîhurÂdi Guggulu and Chandraprabh Vati.
3. KwÂth Kalpana: DarvyÂdi, NyagrodhÂdi KaîÂyÂs are benefi-
cial.
4. Ariîta & Àsava Kalpana: LodhrÂsava, PatrÂágÂsava and
AïokÂriîta.
5. Awalehya Kalpana: Khanda-köîmÂndÂwaleha, DhÂtakilehyam,
Bçhat-köîhmÂndÂwalehya, KhandaköîmÂndaka and KhandÂ-
malaka yogam etc.
6. KîhirapÂka Kalpana: Aïhoka twak KîirapÂka.
7. Ghçita and Taila Kalpana: ìÍtakalyÂnaka Ghçita, ìÂlmali
Ghçita, MudgÂdya Ghçita, ìatÂvari Ghçita, MahÂtiktaka Ghçita,
ìatÂvari taila and ìatapuîpa taila.
8. Kalka and Chöràa Kalpana: Tanduliyaka kalkam with honey,
RasÂájana and honey should be given internally with Tandu-
lodakam.
 Chapter-1 17
PuîyÂnuga Chöràa, Indrayava Cöràam given with Tandu-
lodakam internally.
9. Use of Aïhoka, Kamala, Dörva swarasa, Kutaja and NÂgkesara
drugs etc.
10. BhömyÂmalaki Chöràa: Its ïÍta vÍrya helps in reducing blood
flow and acts as Pitta ïÂmaka and DÍpana-PÂchana properties
corrects the metabolic disorders of body and balances hor-
monal disturbances.
Virechanam: ìodhana with Virechna karma is a good alterna-
tive to Hormonal therapy as it has no side effects with minimal recur-
rence rate. Once, ìodhana is done there is less chance of recurrence of
the disease.
Virechana is most appropriate and superior therapy among
Paáchkarma for Pitta doîa and Rakta doîa.
As vitiation of Pitta doîa is seen in Raktapradra-Virechna karma
was advocated according to the general condition of the patient. More-
over KÂïhyapa has quoted that purgation cures disorders of menstrual
bleeding.
Aïhçigdhara can be put parallel to Menorrhagia in modern medi-
cine on the basis of signs & symptoms. By improving the general health
of women, increasing personal hygiene one can prevent the incidence
of Menorrhagia.
Treatment of Aïhçigdhara is mainly based on the use of drugs
which are having predominance of KaîÂya rasa and Rakta-pitta ïÂmaka
properties.
Santarpana cikits also play important role to prevent the inci-
dence and treatment.

CHAPTER - 2
MENSTRUAL DISORDERS:
Àrtava duîti is of 8 varieties described previously, if Àtava duîti
is ignored and untreated leads to Àrtava vyÂpaths like Aïhçigdhara,
NaîhtÂrtava and KaîhtÂrtava etc. Now Àrtava vyÂpaths are described
one by one with their modern pathological relevance and management.
2.1: ANÀRTAVA- AMENORRHEA:
Suïçta says Àrtava-naîham or AnÂrtavam will happens on injury
to the Àrtava-vaha srotus.
Deele&Jens És leÙeescet&ueb ieYee&MeÙe Deele&JeJeeefnvÙe§e OecevÙe:~
le$e efJeæeÙee JevOÙeelJeb cewLegveemeefn<CeglJeceele&JeveeMe§e~~
S.S.Sh.9.12.
Where the treatment explained for AnÂrtavam is similar to
PÂnduroga, when quantity of Rakta dhatu reduced in body, even it can
be well observed that women suffering from anemia complaints of
Amenorrhea and Hypo-menorrhea etc.
oes<ewjeJe=leceeie&lJeeoele&Jeb veMÙeefle efŒeÙee:~~
le$e celmÙekegâuelLeecueefleuecee<emegje efnlee:~
heeves cet$ecegoefÕeÛÛe oefOe Megòebâ Ûe Yeespeves~~
#eerCeb Øeeieerefjleb jòebâ meue#eCeefÛeefkeâeflmeleced~
leLeeÓhÙe$e efJeOeeleJÙeb efJeOeeveb ve°jòeâJeled~~
S.S.Sh.2.21-23.
Àrtava vaha srotuses are very common obstructed by Kapha-VÂta
doîÂs hence always the drugs which all are Uîàa vÍrya, DÍpana and
PÂchana drugs are very selective in treating most of the Gynecological
disorders.
In AnÂrtavam Mastya, Kulattha, AmlakÂájikam, Tila, MÂîa,
Madya (Alcohol variety) Go-Mötra, Udwaïit, Dadhi, Amla-chÂágeri
and ìukiti etc are used internally, externally and as anupÂnam.
The drugs will also helpful to increase the Rakta-dhÂtu in quality and
quantity.
 Chapter-2 19
Raja: Pravartakam-
In ayurvedic literature a unique action was introduced to Pharma-
cology where so-far modern pharmacology has not identified such ac-
tion with any of their drugs.
The action is much useful in most of the gynecological condi-
tions the action is well known as Àrtava pravarka or Raja:pravartaka-
Menstrual-gogue action.
Raja:pravartakam is a stimulant type of action which makes the
menstrual flow easier without any spasmodic pain and micturition. The
most of the drugs has such effect on menstrual flow by the presence of
Uîàa vÍryam is responsible for the same and few authors’ comments
that as prabhÂvam plays a role in exhibiting the action.
Examples for Àrtava pravartaka drugs: Hiágu, KumÂri niryÂsa,
Bola, Tila, Aîta-kîÂrÂs, IndravÂruni, Vacha, Aïoka, ìigru, KumÂri,
Guggulu, ìimîupa, Jyotiîmati, Madhöka, Laîuna, Manjiîta and Eranda-
karkati etc.
Compound preparations used frequently to induce menstruation
in ayurveda are:
Rajah: pravartani vati, KumÂryÂsavam, Bolabaddha ras,
PuîyÂnuga chrönam, NaîtapuîpÂntaka ras, DaïamölÂriîta and Phala
GhçtaØ.
AMENORRHEA: Amenorrhea is as absence of menstruation.
One or more missed menstrual periods. Women who have missed
at least three menstrual periods in a row have amenorrhea, as do girls
who haven’t begun menstruation by age 15 years.
The most common cause of amenorrhea is pregnancy. Other causes
of amenorrhea include problems with the reproductive organs or with
the glands that help regulate hormone levels. Treatment of the underly-
ing condition often resolves amenorrhea.
Symptoms: The main sign of amenorrhea is the absence of
monthly periods. Depending on the cause of amenorrhea, signs or symp-
toms seen such as:
I. Milky nipple discharge
II. Hair loss
20 StrÍroga VijáÂàa
III. Headache
IV. Vision changes
V. Excess facial hair
VI. Pelvic pain and Acne.
Causes: Female reproductive system: Amenorrhea can occur
for a variety of reasons. Some are normal during the course of a woman’s
life, while others may be a side effect of medication or a sign of a medi-
cal problem.
Definition: Amenorrhea is the medical term for the absence of
menstrual periods, either on a permanent or temporary basis.
Amenorrhea can be classified as Primary and Secondary.
In Primary amenorrhea, menstrual periods have never begun by
age 16, whereas secondary amenorrhea is defined as the absence of
menstrual periods for three consecutive cycles or a time period of more
than six months in a woman who was previously menstruating.
1. Primary amenorrhea: In a board way reason for Primary amen-
orrhea is very difficult to find out and treat. Primary amenorrhea is typi-
cally the result of a genetic or anatomic condition in young females that
never develop menstrual periods by age 16 and is not pregnant.
Many genetic conditions that are characterized by amenorrhea
are circumstances in which some or all of the normal internal female
organs either fail to form normally during fetal development.
A) Gonadal dysgenesis: A condition in which the ovaries are
prematurely depleted of follicles and oocytes (eggs), leads to prema-
ture failure of the ovaries. It is one of the most common cases of pri-
mary amenorrhea in young women.
B) Turner’s syndrome: In which women are lacking all or part
of one of the two X chromosomes normally present in the female.
Ovaries are replaced by scar tissue and estrogen production is
minimal, resulting in amenorrhea. Estrogen-induced maturation of the
external female genitalia and sex characteristics also fails to occur in
Turner syndrome.
Congenital adrenal hyperplasia and Poly-cystic ovarian syndrome
etc causes of primary amenorrhea.
 Chapter-2 21
2. Secondary amenorrhea: Cause of secondary amenorrhea can
easily found out.
a) Natural amenorrhea: During the normal course of life, women
may experience amenorrhea for natural reasons, such as Pregnancy,
Breast-feeding and Menopause.
b) Contraceptives: Some women who take birth control pills may
not have periods. Even after stopping oral contraceptives, it may take
some time before regular ovulation and menstruation return. Contra-
ceptives that are injected, intrauterine devices or implanted also may
cause amenorrhea.
c) Medications: Certain medications can cause menstrual peri-
ods to stop, including some types of: Antipsychotics, Chemo drugs used
to cure Cancer, Antidepressants, Anti-hypertensive drugs and Anti-
histamins.
d) Lifestyle: Sometimes lifestyle factors contribute to amenor-
rhea, for instance:
1. Low body weight: Excessively low body weight about 10 per-
cent under normal weight interrupts many hormonal functions in woman
body, potentially halting ovulation. Women who have an eating disor-
der, such as anorexia or bulimia, often stop having periods because of
these abnormal hormonal changes.
2. Excessive exercise: Women who participate in activities that
require rigorous training, such as ballet, may find their menstrual cycles
interrupted. Several factors combine to contribute to the loss of periods
in athletes, including low body fat, StrÍss and high energy expenditure.
3. Stress: Mental Stress can temporarily alter the functioning of
hypothalamus, that which controls the hormones and regulate menstrual
cycle. Ovulation and menstruation may stop as a result. Regular men-
strual periods usually resume after the Stress decreases.
4. Hormonal imbalance: Many types of medical problems can
cause hormonal imbalance, including:
I) Polycystic ovarian syndrome (PCOS): PCOS causes relatively
high and sustained levels of hormones, than fluctuating levels seen in
normal menstrual cycle.
22 StrÍroga VijáÂàa
II) Thyroid malfunction: Hyperthyroidism and Hypothyroid-
ism can cause menstrual irregularities including amenorrhea.
III) Pituitary tumor: A noncancerous benign tumor in pituitary
gland can interfere with the hormonal regulation of menstruation.
IV) Premature menopause: Menopause usually begins around
at 50 years but for some women the ovarian supply of eggs diminishes
before the age 40 and menstruation stops.
e) Structural problems: Problems with the sexual organs them-
selves also can cause amenorrhea. Examples include:
I) Uterine scarring or Asherman’s syndrome: is a condition in
which scar tissue builds up in the lining of the uterus can sometimes
occur after a dilation and curettage, cesarean section or treatment for
uterine fibroids. Uterine scarring prevents the normal buildup and shed-
ding of the uterine lining.
II) Lack of reproductive organs: Sometimes problems arise
during fetal development that lead to a girl being born without some
major part of her reproductive system, such as uterus, cervix or vagina.
Because her reproductive system didn’t develop normally, she can’t
have menstrual cycles.
III) Structural abnormality of the vagina: An obstruction of
the vagina may prevent visible menstrual bleeding. A membrane or wall
may be present in the vagina that blocks the outflow of blood from the
uterus and cervix.
IV) Hysterectomy: Naturally woman after removal of uterus at-
tains Amenorrhea.
Risk- Factors that may increase risk of amenorrhea may in-
clude:
A) Family history: If a woman in her family has experienced
amenorrhea, she may have inherited a predisposition for the problem.
B) Eating disorders: If a woman has an eating disorder, such as
anorexia or bulimia, she is at higher risk of developing amenorrhea.
c) Athletic training: Rigorous athletic training can increase risk
of amenorrhea.