19.6.19

genital herpes / HSV / ayurvedic medicine for genital herpes / ayurvedic treatment for genital herpes / how to cure genital herpes / natural way to cure genital herpes / permanent solution for genital herpes / permanent treatment for genital herpes / permanent cure for genital herpes / HSV 1 & 2


TITLE:  VISARPA CURRENT DIAGNOSIS & MANAGEMENT.

Author : Dr. Chethan Jagalur. BAMS. MD(Ayu) MSS&C,BPH

   Secretary of Shree Ujwala Ayurdhama® 

Shree Ujawala Ayurvedic Hospital.

Shree Ujawala Ayurveda Pharmaceuticals.

Jagalur-577 528 Davangere (Dist), Karanataka.

 

Phone  No. 7204737423 / 09844606423.

E-mail Id: chethan03ayu@gmail.com

 Branchs:- BANGALORE Malleswaram, MYSORE, HUBLI-DHARWAD, HASSAN, Rest of the days in JAGALUR Branch

 On-line Consultation Timing:- 10Am to 10pm

Key words:  Visarpa, Nita group of virus (Harpies group) of viruses this classification made according to afflicting chemical, physical, and serological criteria.


Objective: Clinical condition of Visarpa and Nita group of virus with clinical experience

Introduction:  Diagnosis of Visarpa in clinical practice is very controversial. Visarpa is an extreme forma viral and spread in similar to that of cobra venom.  If not attended properly readily inflict as death.   Hence Visarpa is known as extreme form of atyayika roga. 
Visarpa is an infectious disease caused by Nita group (Harpes group) of viruses this classification made according to afflicting chemical, physical, and serological criteria. Herpes simplex 1, Herpes simplex 2, Herpes zoster, Vericella zoster, Vericella, Cytomogalo virus and secondary infection to streptococcus pyogenes (Hemolytic streptococci of group A)  80 types of streptococcus pyogenes  are have been recognized so far.  Parisarpana is due to these infections having lot of similarities in clinical condition of Visarpa.  Visarpa is caused by chardi vega dharana janya udavartha and also caused due to wounds fractures, crush injuries, cutting of immature part affliction by banda and fall the deranged and vitiated vatadi doshas get aggravated and there by afflicted the twak mamsa and rakta speedily gives rise to a sort of shifting elevated shotha marked by the characteristic symptoms any of them involved in the samprapthi this swelling tends to extend all over the body.  This disease is called Visarpa from the fact of extending or shifting character.

Clinical features:

Vatika Visarpana:  The patient has same type of constitutional features as in vataja fever, inflammation, twitching, pins and needles, tearing sensation pain on movement, horripilation (Ah. Ni. 13/47).

        Giddiness, davathu (burning sensation in eyes), thirst, pricking pain, malaise, cramps, tremors, fever, tamaksvasa, kasa, pain in bones and joints and their dislocation, shivering, anorexia, indigestion, cloudiness of the eyes, lacrimation and a feeling as if ants are crawling over the body.
·  The space through which the Visarpa spreads becomes grayish or pinkish in colour and oedematous. The space become excessively affected with pricking pain, breaking  pain, colic pain, expansion, contraction and tingling and throbbing sensation if not treated, the space become accumulated with instantaneous cracking, pustules which are small in size and pink/grayish in colour and secretion of liquid which is thin, transparent small quantity.
·   Arrest of voiding of flatus, urine and stool.
·   The patient feels comfortable with ingredients having opposite attribute to vata.

Paittika Visarpam :
         The pittaja Visarpa is rapidly spreading in character, deep red in color and the patient presents with constitutional features of pittaja fever (Ah.Ni 13/48)
The discolouration of the affected part will be haridra, harita, nila, krisnam, etc., with sravam.  The space, in which this spreads, becomes coppery, green, yellow, blue, black, or red coloured. The space becomes full of pustules, which are excessively swollen and associated with excessive burning sensation and breaking pain.  The exudates from these pustules have the colours like those of pustules.  The pustules get suppurated very quickly.  Factors described to cause pitta Visarpa are not homologatory to such a patient. 

Kaphaja Visarpa:  The kaphaja Visarpa patient presents with the same constitutional feature as in care of kaphaja jvara.There is numbness, stiffness, heaviness and less pain the body.  The space, in which Visarpa spreads, becomes oedematous, pale yellow, not very red and unctuous.  The pustules in this space get suppurated very late, they become chronic, they appear in large number, the skin over these pustules get covered with sticky material and these pustule are either white or pale yellow in colour.  When there is eruption of these pustules then exudates which is white, slimy, fibrous, dense, knotty and unctuous.  After the eruption of these pustules, the space is covered with ulcer which is deep seated, stable, surrounded by the capillary network, unctuous and covered with many skin scabs.  The ulcer continues to stay for long time.The upper part of the body (urdhva bhagam) becomes afflicted with the ulcer of the above mentioned symptoms, because the upper part of the body is the abode of kapha

Sannipatika Visarpa:
The sannipatika type of visarpa is caused by the all-etiological factors, the signs and symptoms described in respect of each of the vatadi verities Visarpa.  It pervades all the dhatus (tvak, lasika, rakta, mamsa). It spreads instantaneously and is incurable in nature.

Agni Visarpa: 
In this type vata and pitta simultaneously aggravated because of their respective causative factor, gain strength from each other and spread over the body along with burning sensation, which is called agneya visarpa.  Fever, vomiting, attacks of swooning diarrhea, thirst, dizziness, splitting pain in regional glands, diminished digestive power, respiratory distress and anorexia, the patient feels as if the whole body is covered with burning charcoal, all those sites where the Visarpa spreads, get quickly studded with blister as after with thermal burn and appears blackish, bluish or reddish like an extinguished charcoal.
On account of fast spreading tendency, it quickly pervades into the vital areas (marmas) as result of which vata becomes overwhelmingly powerful and gives rise to pain all over the body, loss of consciousness, sleeplessness, dyspnoea and hiccough. The patient who has reached this stage does not find any relief by any measures. He remains restless and attempts to lie down on the ground or sit or adopt any other posture resulting in extreme agony, mental confusion and bodily inactivity and finally results in death.

Kardama Visarpa: 
The disease generally spread in slow speed in the amasaya and gets localized there.  The space, in which this type of Visarpa spreads, becomes as if studded with eruption of red, yellow and pale yellow colour.   The space looks muddy, black, dirty and unctuous and it is excessively hot, heavy with dull pain, oedema and deep-seated suppuration.   These eruptions are free from exudations and become sloughy very quickly. The skin and muscle tissue over these eruption are shriveled, sticky and suppurated.  The pain over this space is less and it appears gradually.  By rubbing, these eruptions get cracked and when pressed sticky and purified muscle tissue comes out of these eruptions.  In the space at the bottom of this eruption (after taking out the slough), one can visualize vessels and ligaments and smells like cadaveric as emitted from this space.  The patient loses consciousness and memory.

Granthi Visarpa
It is one of the Visarpa involving vata and kapha as main vitiated dosa.  Intake of sthira, guru, kathina, madhura, sita, snigdha, abishyandi, Lack of exercise, Habitually avoiding administration of elimination therapy (panchkarma therapies) at the appropriate time.  The channels of circulation of vayu get obstructed by the aggravated kapha (which causes further aggravation of vata). Both these vitiated dosas get excessively aggravated and vitiate dusyas giving rise to Visarpa.
Aggravatd vata, in turn, causes splitting of cough into several parts gradually giving rise to a series of granthis (grandular enlargements) in the abodes of kapha (ura: pradesa). These enlarged glands get suppurated very slowly and is difficult to cure.
In a person having excess of blood (aggravated vata and kapha) vitiate the blood giving rise to a series of glandular enlargements located in vessel, ligaments (or nerves), muscles and skin. These enlarged glands are extremely painful; some of them might be big in size and shape and some are red in colour.

Complication of Visarpa:
All types of Visarpa usually have following complications: fever, diarrhea, vomiting, tearing of the skin, muscle fatigue, anorexia, and indigestion.
Based on dosa dominance: (C.Ci.21/42):
Single dosa involvement:   vatika, pittaja, kaphaja, Visarpa types are curable.
Double dosa involvement; agniVisarpa (vatapittaja) and kardamaVisarpa (kaphapittaja) can be alleviated by the habitual use of general therapeutic measures (to counteract the respective etiological factors) only when the vital organs (like heart) are not afflicted and there is no softening of vessels, ligaments and muscle tissue. If not properly treated. Any one of these two may cause instant death like snake poison.
Granthi Visarpa is treatable only when it is without any complications otherwise difficult to treat.
Three dosas involvement: Sannipatika type of Visarpa is incurable because it pervades all the tissue elements, it spreads instantaneously and its treatment involves mutually contractor therapeutic measures.

Differential Diagnosis:  
Positive and complete findings are the tools to arrive at a definite diagnosis, to estimate the prognosis and to adopt appropriate line of treatment for the disease. Studying the various stages of the disease and the consequential changes can make a correct diagnosis.
Seven dhatus and tridosa are involved in the pathogenesis of Visarpa and kustha (a group of obstinate skin diseases).  In spite of the identify of these seven elements there is difference between these two diseases in as much as Visarpa is characterized by its spreading nature, and kustha by its chronic condition. Visarpa should also be differentiated from diseases in which rakta, lasika, tvak, mamsa are vitiated i.e. from kushtan, vidhradhi, visphota, apaci.
Other:
·         When are aggravated pitta together with rakta spreads within the skin, it causes red swelling which known as Visarpa
·         When the aggravated pitta is located in tvak (skin) and rakta, this will also causes red swelling which known as pidika (vesicle).
·         When the aggravated pita gets dried up in combination with rakta, this causes skin diseases like tilaka (black moles), vyanga (red moles) and nilika (blue moles) (C.su. 18/23-25).
·         In Visarpa inflammation is without swelling (annunat sotha) while arbuda, granthi, vidhadhi have swelling (sotha).
·         In Visarpa clinical diagnosis is based on dosa dominance and morphological feature therefore they should be differentiated from kushtha with similar dosa dominance.

Nita group of viruses with Visarpa:

Visarpa is an inflammatory disease some types of Visarpa are due to the Nita group of virus classified made according to affecting chemical, physical and serological criteria.
·         Herpes simplex 1
·         Herpes simplex 2
·         Herpes zoster,
·         Vericella zoster
·         Vericella
·         Cytomogalo virus are comes under this group
It is having particle size 100-200ยต nucleic acid DNA, type of symmetry cubic number of cap so meters 162 sensitive, Family-Herpes viridae, genomic type – DSDNA
Vericella zoster, herpes simplex – 1 Herpes simplex – 2 are concerned with skin eruption system.
Cytomegalovirus and epsein barr virus are concerned with hematopoietic disorder.
And also some of the Visarpa are due streptococcus pyogenes (hemolytic streptococci of group A). These streptococci pyogenes (Hemolytic streptococci of Group A) are I. Gram positive cocci, these are spherical or oval in shape, 0.5 to 1.0 in diameter, arranged in chains. They are important human photogenes, causing pyogenic infections with a characteristic tendency to spread. These may be sub divided into types based on the protein (MTR) antigens present on the cell surface. About 80 types of streptocci pyogenes have been recognised so far.
Even though the parisarpana is due to sara and chala guna of vata property any our acharyas are not enumerate the vataja Chikitsa, instead of that they explained the krimihara Chikitsa. Visahara Chikitsa. It indicates that the parisarpana is may be due to microbial infection spreding. The nature of spreading and the cliniical present of Nita group of virus and streptococcal pyeogene (group A,B,C) and Visarpa are one the same.
Visarpa is an infection disease which spreads from place to place quickly involving the raktha twacha mamsa snayu and lasika, having painful Visarpa on the twacha leads on to suppurating tumors, gangrene and multilation of the body. It has been identified with several discuss like erysipelas, cellulities, herpes zoster, moist gangrene, eczema erpitivum, chicken pox, herpes labials, herpes simplex, acute myeloid leukemia, acute lymphoid leukemia, carcinoma of stomach. Some kind of dermatitis etc., by modern scholors.
Herpes simplex
Herpes simplex occurs naturally only in man. There are two types of herpes simplex virus, herpes simplex virus 2. There are different modes of visaprana or prisarpana are seen herpes simplex are transmission occurs by close contact and may be venereal in genital herpes after contact, the virus probably enters the tissue through defects in the skin and mucus membranes. There is then phase of local multiplication with cell to cell spread and local lymph nodes are involved. The virus can also travel along with the nerve fibers and may be able to reach CNS in man. In general primary infections are localized. The avakasho Visarpa anusarpayatin of vataja Visarpa shows as that of typical herpes lesion, they are thin walled humiliated vesicles that rapidly becomes pustules and scabs and heal without scaring. In the vataja Visarpa davahuhu indicates the morbidity presenting chakshuradi indrayas like commonest site herpes simplex is the eyes, face on the cheeks, chin, around the mouth or on the forehead. Lesions may also appear on the buttocks as napkin rash an occupational variety of cutanious herpes is the herpetic whitlow.
            Eczema herpectium is a generalized eruption caused by herpes infection in children suffering from eczema. Vagbhata Visarpa mainly straps from the affected area with wide spread ulceration. A clinically indistinguishable picture in also produced by vaccine virus infection both designated kaposis karicelliform eruption.
Herpes virus simiae (B virus)
Herpes virus simiae infects monkey in the same manner that herpes simplex infexts in man, herpes virus simiae is similar to herpes simplex properties. The disease in man is usually fatal. The rare patients who survive have serious neurological sequelae.
Vericella – Zoster virus
Mode of spread: Very rapidly whole body is sprinkled with live charcol
In pathology of agni Visarpa aggravated the vata and pitta simultaneous aggreavated with each other. These doshas shows effect in all over the body within a short period of time along with burning sensation. The incubation period of V-Z virus is 14-16 days, prodromal symptoms are minimal. These include mild favour malaise and impaired appetite as that of agni Visarpa. These rashes appear on the first day.

Management:

Samanya Chikitsa with clinical interpretation:-
Chikitsa sutra : - “Langanam ullekanam shaste tikta nam cha sevanam” ||(cha, chi)
Langana:-
            One who fit for the langana, langana pachana, dashava sechanaand accourding to ama which is particular stana, rogabala, rogibala and also as per the doshas. The different langana therapies are to be adopted. Langana causes vata vruddi, jataragni vardana, amarpachana in the Visarpa patient. The adoption of different types of langana reduces the jwara, swayathu, angamardu etc lakshanas of Visarpa and by the langana therapy, avakasho Visarpa anusarpati have the lakshanas like svayathu, paka, kleda are also reduces. Langan is a therapy  which has the natural auto ammune power enhancing property in the body which helps in fight aginest the Nita group of virus (herpes viruses) and streptococci pyogenes infection which reduces the symptoms up to som extents.

Langana Tiktakam Cha Sevanam
            Compounds with a tikta rasa pradana may reflexly increases the flow of gastric juice in the stomach acts as ama pacana and also having the Visarpa hara property. So our acharya highlighted the lagana Chikista with tikta dravya is ideal one. The drugs having the properties like langana-Visarpahara tikta rasa pradanya are to selected. E.g guduchi, musta, patola, nimbi, ushira, kirata tikta, nishi and katuki. In the purvarupa and amavasta of the Visarpa. These dravyas can be adopted as a front the treatment along with the peya mandadi ahara dravyas which are used for langana  as well as the kwatadi oushadis.

Langana Rukshana
Other acharyas also enlighten about langana rukshana. In the purvaropa Chikitsa langana followed by rukshana  or rukshana rupi langana chikitsa should be carried out so, the drugs having the properties like langana rukshana Visarpa hara are to be selected example, trivruth, musta, nimba, patola, kiratatikta, chandana, amalaki,  usheera, lodra, draksha, shunti, katuki.
Ullekana chikitsa in Visarpa:-

Ullekanam iti vamanam (chakrapani)
The ama which is present in pithastana and kaphastana vamana should be conducted.  If Visarpa is caused by rather kapha or pitha or both kapha and pitha.  Then vamana should  be conducted.  Kardama Visarpa should be treated by quickly by administration of vamana.

Sneha pana:
11)      Mahatiktaka ghruta,       2)   Trayamana ghruta

Vamana yogas:
·         Madana, maduka, nimba, vatsaka patra kwata, 
·         Madana patola, pippali, nimba should be made into kwata and used.

Vamanopaka dravya:
·         nimba,  musta, patola kwata (C.S)
·         Patoladi phanta (A.S)
In pitha pradana Visarpa after the vamana virechana should be administer.

Virechana:
In both dosha dushta Visarpa and initial stage virechana should be selected

Sneha pana:
The medicated ghruta for sneha parartha should be administered which are having purgation property, otherwise which causes the paka of the twak, mamsa, rakta.  After ama pachana sneha pana should be administered with tikta rasa pradana ghrutas.
1)      Triphala ghruta     2)   Traya mana ghruta

The virechana yogas: 
Trivruth, draksha, triphala, trayamana  (A.S)
            Trivruth churna should be boiled by adding ghruta or ksheera and administered with warm water or mrudvika swarasa.   Similarly boiled with trayamana (C.S) in kardama Visarpa for producing virechana should be made to drink trivruth churna along with either ghruta ksheera draksha rasa or ushna jala.  If pitha is aggravated greatly should drink milk boiled with trayamana. 

Mode of action of virechana in Visarpa: 
The main action of Visarpa dravya is adobaga hara. The vitiated pitha dosha is alleviated and expelled out through the mechanism of virechana so, the disease process is arrested.  The virechana dravya spreads through the body at cellular level due to its pharmacological action. Ushna and theekshna properties of virechana drugs produces chetana of dosha durshya sambanda, which are already soften due to snehamsha of shodananga snehapana.  Thus, liquid doshas are dragged towards to koshta due to the predominance of pruthvi and jalamahabhoota present in virechana kalpa.

Rakta mokshana in Visarpa:
Rakta mokshana should be administered as a front line treatment because of rakta dusti is the main factor of pathogenesis in Visarpa.  According to predominance of doshas associated with rakta, different methods of rakta mokshana should be conducted.  If dushta rakta associated with vata then avasechana should be done with the shrunga yantra.  If dushta rakta is associated with kapha alabu karma should be administered.  If Rakta dusti with is assocated with pitha jalauka charana should be administered.  Rakta  mokshana acts as auto immune enhancing property.  So, develop the resistance against the Nita group of virus and strepto coccus pyogenes.  Jaluka is having haparin which climes to exert some anti inflammatory activity and wound healing property.

Tiktanam cha sevanam:
Tikta dravya having the dosha prashamana, thrushna prashamana sheeta ruksha lagu and vidagda pitha hara property.  So, recipies which are dominant of tikta dravya pecifies the vitiation of rakta and pitha, which are the main causative factor for Visarpa.  The role of ama is cause in Visarpa is most important.  Due to the deepana pachana rukshana langana property of tikta dravya are acts as avapachana in Visarpa. tikta dravya which acts as samprapti vigatana with the property of tawk in mamsa sthira karana which gives stability immunity and also increases brachaka pitta.  If we administered the virechana and other shodana therapies from the tikta dravya. Visarpa is mainly due to Nita group of virus and strepto coccus pyogenes. The Use of  tikta dravya by internally and externally which acts against these microbes due to the krimi hara property.  Due to the vishagna property of tikta dravya acts as the anti dote for virus and toxins produced by these infetion. 

Shamana Yogas:  
1.      Kasisadi ghruta for external application tid.
2.      Balaguduchyadi kashaya (anubhutha yoga) 15 ml. bid, before food. 
(In clinically experienced that balguduchyadi kashaya 15 ml per every one hour once
Visarpa in initial stage relived that symptoms and lesions.  Within 3 days).
3.      Panchatikta guggulu ghruta without ballataka 10 ml with milk twice a day after food.
4.      Triphala churna 1 tea spoon with hot water at bed time.  
5.      kustagna vati (anubhutha yoga): 1 tablet bid after food.

Some special clinical case presentation:

Case 1:
            Patient name Anjali aged 14 years complaining of blisters as a avakasho visarpa anusarpa yathi with full of water, pain, daha over the anterior shoulder since 3 days.  She undergone allopathic treatment but not relived.  This condition is diagnosed as Herpes zoster Vataja Visarpa
Treatment: 
1.      Kasisadi ghruta for external application tid.
2.      Balaguduchyadi kashaya.  15 ml every one hour once  
3.      Panchatikta guggulu ghruta without ballataka 10 ml with milk twice a day after food.
4.      Triphala churna 1 tea spoon with hot water at bed time.  It will gives virechana effect.
5.      kustagna vati: 1 tablet bid after food.
Case 2:
            Patient named Marakka aged 75 years w/o Durgappa, uneducated complaining of granthi mala with tipical avakasho visarpa anusarpayathi over the back, daha, jvara, kandu lakshanas Since 6 months. A granthi like peedakas with puya srava starts in the left buttock and gradually developed over the right buttock then spreads into all over the back.
            Vikruti taha, primary infection due to herpes zoster virus and secondary to streptococci pyogens. Kapha and vata dosha, mamsavaha, lasikavaha,& rasvaha srotas, are involved sangha, vimargamana ati pravrutthi, as srotho dusti. Due to the nidana sevana, kapha avatha dosha prokapa takes place which anusaprayathi over the back, Due these lakshanas as per acharyas diagnosed as granthi visarpa, through the modern perspective which is originated from herpes zoster virus and secondary to streptococcal auras it is one of the daruna, kasta sadya and bahya roga margasritha vyadhi.

Result: Treatment is started with sukha virechana, orally tikta dravya pradhana dravas and externally applications. Because of the vrudda, bahu dosha ukta and also chronic disease was considered as the yapya roga.
Case 3:
            Patient name lakshmi w/o lakshmana aged 26 years, complaining of shopha, vrana, shula, Kunapa Gandhi, jwara, daha, kandu, srava, avkasho visarpa anusarpayathi lakshanas in the vrana since 7 months, these lakshanas are transferred through the buffalos while milk squeezing  8 to 9 months back and also since 3 to 4 months her family members also suffered from these type of problems. Patient lakshmi already under gone the allopathic treatment but not improved.
            Vikruthi taha pariksha shows due to herpes virus similes (B virus) caused by buffalos.
            In this condition kapha, vatha dosha dusti takes place, rasa, raktha, mamsa,  thwak, lasikadi dhatus are involved.  There are no abnormalities seen in the general examination. Due to these lakshanas as per our acharya this disease can be diagnosed as agni Visarpa.  Through the modern perspective which is originated from the Herpes simplex B virus or Herpes virus simile . It is one of the daruna, kasta sadya vyadi.


CASE 4 :-
            Patient name kousar bai w/o panduranga aged 34 years, complaining of blisters, shopha, vrana, shula, Kunapa Gandhi, jwara, daha, kandu, srava, avkasho visarpa anusarpayathi lakshanas in the vrana since 3 days , these lakshanas are transferred through the while paper collection in garbage. This case simmilor to previous one (Case3)
            Vikruthi taha pariksha shows due to herpes virus similes (B virus).

            In this condition kapha, vatha dosha dusti takes place, rasa, raktha, mamsa,  thwak, lasikadi dhatus, mamsa vaha srotas, rasa vaha srotas, lasika vaha srotas are involved. This shows the sroto dusthi lakshanas are sanga, vimarga gamana and athi pravruthi.  There are no abnormalities seen in the mala and general examination. Laboratory investigations done. Due to these lakshanas as per our acharya this disease can be diagnosed as agni Visarpa.  Through the modern perspective which is originated from the Herpes simplex B virus or Herpes simile. It is one of the daruna, kasta sadya vyadi.

Case 5:-

            Patient name shivanandappa aged 72 years complaining of blisters as a avakasho visarpa anusarpa yathi with block pimple, pain, daha over the back since 3 days. This condition is diagnosed as post hepatic neuralgia (Herpes zoster) Vataja Visarpa.

Case 6:-
            Patient name govinda aged 32 years complaining of blisters as a avakasho visarpa anusarpa yathi with full of water, pain, daha over the neck, unable to flex the neck & unable to sit properly, since 8 days. She undergone allopathic & fockler treatment but not relived. There family members concluded that he daid within 3 days. This condition is diagnosed as vericella pittaja visarpa.
 Case 7:-
            Patient name manju aged 8 years complaining of blisters as a avakasho visarpa anusarpa yathi with full of water, pain, daha over the around the eye since 3 days. This condition is diagnosed as herpes orbitalis vataja visarpa.

Case 8:-
           Patient name hruthik aged 4 years complaining of blisters as a avakasho visarpa anusarpa yathi with full of water, pain, daha over the pennies since 2 days.  This condition is diagnosed as Herpes genitals Vataja Visarpa.

Case 9:-
          Patient name harish aged 16 years complying of blisters all over the body burning, discomfort, diagnosed vericella zoster –small pox –agni visarpa as at time of SSLC exams, luckily having 1 days gap for next paper, he wrote an exam and got distension marks.


Case 10:-
            Patient name mallakka aged 50 years complaining of blisters as a avakasho visarpa anusarpa yathi with previously full of water, after 10 bisters become dry & crocks, pain, daha around the lips. She undergone allopathic treatment but not relived every one treat like lip crock.  This condition is diagnosed as Herpes labialis Vataja Visarpa. 

CONCLUSIONS:
            Visarpa is still a relevant clinical condition in general and specialty practice.  Visarpa is vector born inflammatory spreading disease,  Inflammation is mainly due to Nita of viruses this classification made according to afflicting chemical, physical, and serological criteria. Herpes simplex 1, Herpes simplex 2, Herpes zoster, Vericella zoster, Vericella, Cytomogalo virus and secondary infection to streptococcus pyogenes (Hemolytic streptococci of group A)  80 types of streptococcus pyogenes  are have been recognized so far. 
            The general line of treatment of visarpa includes langhana, langana rukshana, tikta dravya sevana ama pachana, ullekhana, shamana, and bahir parimarjana.  Tikta rasa is predominanat herbs like Musta,  Bala, Guduchi, Yashti, Chandana, Usheera are formed effective in many ways, due their anti-viral, anti-bacterial, anti-inflammatory, anti-oxidant, anti-tumor activity.
            Kasisadi ghruta for external application gives in excellent result in Nita group of virus. 
            Agni Visarpa is herps simile virus induced disease and it is diagnosed and it is clinically diagnosed and managed.  Vataja Visarpa is disease of herpes zoster virus it is also clinically diagnosed and managed. Granthi visarpa is disease of herpes virus and secondary infection to streptococci pyoens group A.
            So, every physician must try to evaluating the cases of Visarpa based on the evidence.


Author : Dr. Chethan Jagalur. BAMS. MD(Ayu) MSS&C,BPH

   Secretary of Shree Ujwala Ayurdhama®

 

Shree Ujawala Ayurvedic Hospital.

Shree Ujawala Ayurveda Pharmaceuticals.

Jagalur-577 528 Davangere (Dist), Karanataka.

 

Phone  No. 7204737423 / 09844606423.

E-mail Id: chethan03ayu@gmail.com

 

Branchs:- BANGALORE Malleswaram, MYSORE, HUBLI-DHARWAD, HASSAN, Rest of the days in JAGALUR Branch

 

On-line Consultation Timing:- 10Am to 10pm


heart attack / Ayurvedic treatment for heart attack without operation / Ayurvedic medicine for heart attack without bypass surgery / solution for heart attack without stunt operation / remedy for heart attack permanent / prevention for heart attack / how to cure heart attack / metabolic X syndrome

TITLE: - AYURVEDIC MEDICATION FOR CORONARY ARTERY BLOCKAGE WITH CLINICAL EXPERIENCE

Author : Dr. Chethan Jagalur. BAMS. MD(Ayu) MSS&C,BPH

   Secretary of Shree Ujwala Ayurdhama®

 

Shree Ujawala Ayurvedic Hospital.

Shree Ujawala Ayurveda Pharmaceuticals.

Jagalur-577 528 Davangere (Dist), Karanataka.

 

Phone  No. 7204737423 / 09844606423.

E-mail Id: chethan03ayu@gmail.com

 

Branchs:- BANGALORE Malleswaram, MYSORE, HUBLI-DHARWAD, HASSAN, Rest of the days in JAGALUR Branch

 

On-line Consultation Timing:- 10Am to 10pm

 

Key words: - Coronary Artery Blockage, pluck-fat cells, plasma cholesterol, Tab HRUDAYA VATI 

Objective: - Clinical Condition of Coronary Artery Blockage with Scientific study and Clinical Experience.

Brief Introduction regarding Coronary Arterial Blockage:-

            Coronary artery block is the most common disease and also causes of premature death in the present era. Comparatively male sex is more prone to the arterial blockages than female. 
            Heart muscles are needed the blood supply, oxygen molecules and nutrients to function properly. Coronary arteries are those which are supplied blood to the heart muscles, the blockages in the coronary arteries which cause the lack of blood supplement to the heart muscles. Coronary artery blockages are caused due to the build-up of the cells, fat and cholesterol which is called as pluck. This causes the lock of supply of blood to the heart muscles. When the person is more active, running, more stress heart needs even more blood supply, but when the coronary artery is block there might not be the lack of blood supply to the heart muscles that lack of blood supplement of the heart muscles are called as ischemic heart disease, this shows the symptoms irregular heart rhythm, shortness of the breath, angina other name of the angina are pain, tightness, or pressure in the chest. These symptoms are may not see in the few minutes depend on the longer the heart not needs the blood. As longs the time heart goes not needed the blood worst the problem might be. The overtime heart muscles not getting oxygen sometimes they get permanently damage and death of cell in the heart muscles this is what happened in the heart attack. Long period of ischemia which cause the sever irregular heart rhythms and heart failure which can be fail.

Coronary artery disease tests:-   

            There are several test are available to diagnose or look for possible coronary artery disease. They are electrocardiogram, exercise stress, nuclear scan test, stress thallium test, and cardiac catheterization. Choice of which and have many test to preform, depending the history of heart problem and current symptoms. some of these test includes electrocardiogram this test uses the patches on the superficial skin of the chest, arms and legs to record the electrical activity of the heart the test dose not identify the specific  area of blockages but the test identify the general area of the heart concerned to the blockages. Other test includes exercise stress test nuclear scan, stress thallium the purpose of these tests is to check the blood supply to the heart muscles where you are active and where you are resting. The test may the real area in heart are not getting the specific amount of blood may indicate heart disease or previous heart attack. Like an electrocardiogram these test don’t locate or identify the specific blockages but these test identify the general area of the blockages in the heart.

            Cardiac catheterization is another procedure we can see inside the heart with the special die and the X-RAY, this will find the any problem inside the heart and inside the arteries, at this time cardiac catheterization is the most accurate test for looking at your coronary arteries and to identify the location, number and severity of blockages that may be affecting the heart muscles.

Treatments:-
            If the coronary artery disease is diagnosed there are many way to treated, this includes lifestyle changes, medication, procedure or surgery

Life style changes:-
            Includes daily exercises, changes in the diet and quitting smoking.

Medication:-
            In allopathic system of medicine through the medication can only help the symptoms of blocked coronary arteries it cannot fix them.

Procedure or surgery:-
            If medication is not that much effective invasive procedure is necessary ex:- balloon angioplasty during an balloon angioplasty there may be an balloon which helpful to an expand the blockage and restore the blood flow, sometimes stent which is expandable devise may then be used.
            In more several cases of the coronary artery blockages surgery is needed to make new pathway of the blood this procedure is called coronary artery bypass graft in this procedure blood vessel is taken some more else of the body and is used to bypass the damaged over blocked vessel blood in the heart this improves the delivery of the blood in the heart muscles and in turn improve the delivery of oxygen and nutrients to the heart muscle.

AYURVEDIC APPROACH:-

            The way of understanding of medoroga prakarana according to ************* and other acharyas are unique. Even stoulya and medoroga is caused due to medo vruddi. ************* and other acharyas explain stoulya prakarana and medo roga prakarana in separately. It indicates that Stoulya includes fatty deposition in the adipose tissue. Likewise Medo roga including fat molecules and plasma cholesterol in the blood. Due to the more quantity of the fat molecules and plasma cholesterol in the blood May causes several disorders including coronary artery blockage, gallbladder stones, X-syndrome etc.

            Clinically sometimes person may lean but suffering from coronary artery disease or gallbladder stones, hyper cholestremia, higher plasma cholesterol levels. Sometimes we can’t find these conditions in obese persons. But obese person are have more chance to suffering from these problems.

Ayurvedic Medication:-

Line of treatment:-
            katu rasa pradan, laghu, teekshna, sukshma and lekhana guna pradana, Kapha-vata hara, medo hara, ushna veerya, ushna brumhana and ushna rasayana drug should be select.
So,
                        HRUDAYA VATI 1000mg 2times before food or chewing also can do.
                        Avipattikara churna 1tsf after food are the drug of choice.

Note:-
            At the pluck formation stage or pluck developmental stage in arteries and before the thrombus formation there is very much need full for the plasma cholesterol management. So in this stage ************* told by the ************* is the drug of choice. Even from 5% to 100% of the coronary artery blockages we can treat with these medications without any surgical procedures.

Scientific Studies on HRUDAYA VATI Ingredients

******* (******)
            Katu rasa, Guru, Ruksha Teekshna guna, Ushna veerya, Vata Kapha hara , Deepana, Bhedana Vibhanda Hruth. Pandu and Hrudroga are one of the indications.
Scientific studies:-
            In hyper cholestrerolaemic rats, shunti reduced the serum & hepatic cholesterol level significantly in 24 days(giri).
            (E)-8 beta, 17-exoxylabel-12-ene-15, 16-dial (ZT) showed inhibitory effect on the cholesterol biosynthesis (Tanable).
            Other properties Anti-Inflammatory, potent GI stimulant, effective in blood sugar, serum cholesterol, hyper cholestremia, Anti-motor sickness action possibly by central & peripheral Anti-Cholingric and Anti-Histemic effect, bio-availability enhancing property and Anti-Histemic effects, Hyper Lipedamia and also having anti-oxidant property, Anti-Microbial property against E-coli, s.Typhimirium, step Aurius, Step Viridense,

******* (******)
            katu rasa, laghu, teekshna guna, ushna veerya, katu vipaka, kapha-vata hara, ahrushya, deepana, pramati, hrudroga and krimi is one of the indications.
Scientific studies:-
            piperine showed that it interacts with lipid environment to produce effects which lead to increased permeability of intestinal cells.(Bioche. pharmaol)
            pipperine Exhibits antibacterial & anti-tumour activities against pseudo (chem. Abst)
            Aqeous extract of pippali Lead to moderate raise in blood pressure in dogs(sridharan)

******* (******)
            katu rasa, laghu, snighda, teekshana guna, ushna veerya, madhura vipaka, vata-kapha hara, deepana, vrushya, rasayana.
Scientific studies:-
            Piperlongumine showed marked anti-spasmodic action on isolated tissues, whereas piperiene produced spasmodic action on rabbit ileum. The ether of the plant produces complete cessation of frog heart beats for a short period, which could not be blocked by atropine. Piperene showed a stimulants action on frog’s heart and also a hypertensive effect which could be blocked by regitine. The ether extract of P.longum and piperlongumine caused a dose-related transient fall in BP. The ether extract was toxic to guinea pigs in a dose of 1200mg/kg (Prasad & chowdhury). 
            Piperlongumine also helpful for lypocitosis

******* (******)
            Pancha rasa kashaya rasa pradana, laghu rusha guna, ushna veerya, madhura vipaka, tridosha hara, anulomana, rasayana, prajahstapana, hrudya lekhaniya.
Scientific studies:-
            Haritaki is found to be effective in reducing the levels of total lipids, serum TG, serum cholesterol, LDL and VLDL significantly. On the other hand level of HDL is increased significantly (sood & sharma).
            Various extracts prepared from the fruit ring of T.Chebula have shown cardiotonic activity. When tested on normal as well as hypo-dynamic isolated frog hearts. The extracts increased the force of contraction and cardiac output without altering the heart rate. (reddy)
             Possess a strong Hypolipidemic action and anti-anaphylactic action. Anti-bacterial activity against gram positive & gram negative bacteria, anti-fungal.
            Other properties include significant antioxidant activity, wide anti-bacterial, anti-fungal spectrum.

******* (******)
            Kashaya rasa, ruksha, laghu guna, ushna virya, madhura vipaka, kapha-pitta hara, bhedaniya guna.
Scientific studies:-
            It shows significant protective effect on microsomal lipid per oxidation (anand/1994)

******* (******)
            Amla pradana pancha rasa, sita virya, madhura vipaka, tridosha hara, vayastapana, rasayana, vrushya.
Scientific studies:-
            Amlaki fruit have prevented the development of experimental atheroma both in aorta & coronary artery & also reduces the level of serum, aortic & hepatic cholesterol (bordia).
            Amla fruit showed hypolipidemic & anti-atherosclerotic activity (Mand /1991).
            Other properties Possess Immunomodulation, hypo-cholesteraemic, antimicrobial, anti-oxident.

******* (******)
            Katu rasa, ushna veerya, laghu, ruksha guna, katu vipaka, kapha-vata hara, dipana-pachana.
Scientific studies:-
            Pipeline exhibited CNS depressant as well as muscle relaxant effect (chem. Abstr)

******* (******)
            Katu rasa, laghu, ruksha, tiksna guna, ushna veerya, katu vipaka, vata-kapha hara, deepana grahi.
Scientific studies:-
            Plumbagin administered to hyperlipidaemia rabbits reduced serum cholesterol by 53-86% and LDL-cholesterol by 61-91%. It lowered Cholesterol/Phospholipid ratio by 45.8% and elevated HDL-cholesterol significantly. It prevented accumulation of cholesterol and triglycerides in liver and aorta & regressed atheromatus pluck. Plumbagin treated hyperlipidaemia subjects excreted more faecal cholesterol and phospholipids. (ind.J.Physiol.pharmacol.1991,35,10)

******* (******)
            Katu, tikta rasa, laghu, ruksha una, ushna virya, katu vipaka, kapha-vata hara, rasayana, balya, shopha, pandu.
Scientific studies:-
            PE extract of the seeds produced a rise in blood pressure on anaesthetized dogs and caused stimulation of intestinal smooth muscle both in vivo and in vitro. (gupta/1962)

******* (******)
Laghu, Snighdha, Sukshma guna. Agni Deepana, Pachana, Rushya, Hrudya, Vrushya. Sheeta Virya, Tridosha Hara. 
                        It contains pure minerals such as Calcium, Iron, Zinc, Potassium, Magnesium, Copper and all the other 84 minerals, Sweet, cooling, light, carminative and digestive. Helps in high blood pressure, anaemia and heat in the blood. Stimulating blood circulation and mineral balance. Stimulating blood circulation and mineral balance.
Chemical properties:-
            Sodium chloride (NaCl)-97.6%w/w
            Sodium bi carbonate (NaHCo3)-0.07% w/w
            Insoluble matter-0.031%w/w
minor quantities of magnesium Chloride, calcium Chloride & calcium sulphate.

******* (******)
            Laghu, Ushna, Tikshna guna, Ruksha, Vyavayi, Deepana, Hrudya, Vatanumana. Ushna Veerya. Kapha Pittahara. Hrudroga.

******* (******)
            Katu in rasa and Kshara, Guru, Snighda, Sheeta virya, Vata Nashana, Teekshna & Utkleshana karma
Chemical Property:-
            Sodium chloride (NaCl)-94.10% w/w
            Total sulphate – 0.042%w/w
            Sodium bicarbonate (NaHCO3)-0.049% w/w
******* (******)
            Laghu, Sukshma, Vishada, Sasneha guna, Ushna veerya, Deepana, Pachana, Rochana, Bedhana, Pittajanashaka, Vata shamaka.
Chemical properties:-
            Sodium chloride (NaCl)-97.8% w/w
            Total sulphide (Na2S) -0.918 w/w
            Iron (Fe)-0.03% w/w
            Insoluble matter-0.07% w/w

******* (******)
                         In the Lauha Bhasma with HgCl 2 treated group mild fatty changes and cell depletion was observed. In Mandura Bhasma with HgCl 2 treated group only mild fatty changes with moderate cellularity in the cyto-architecture of spleen was observed.
            Cell depletion, fibrosis and necrosis were observed in the cyto-architecture of spleen in HgCl2 treated group.
             Possess Haematinic and cyto-protective activities.

Method of Preparation:-
            All the ingredients are made into fine power separately, equal quantity of each ingredients are do mardana after complete mixing add honey and ghrutha again subjected to mardana after fine mixing made it into pills form about 500mg or whatever convenient dose. Then dry them in shadow or with the help of drier.

Mode of use:-
            1000 mg bid before food or Chewing.
Mode of administration of hrudaya vati through sub-lingual is more effective.

Anupana:-
            Water, Honey or Ghrutha.

Other indication:-
            Hyper Lipidemia, Gall Bladder Stones, Lipid Profile Abnormalities, Metabolic X-Syndrome.

Case Discussion:-
CASE 1:-
            Male Patient name Appaji sab, Jangali hatty, Jagalur Karnataka aged 72 Years completing of irregular heart rhythm, palpitation, difficulty in breathing and tiredness while little bit walking, chest pain, tightness or pressure in the chest since 8 months.
            Previously treatment taken in Jayadeva hrudroga Hospital Bangaluru and Shree Shiradi sayibaba cordiac Hospital Bengaluru, both they are advised for Balloon Angioplasty procedure. 

On examination: -
            Low built, shortness of the breath, on auscultation third heart sound, irregular heartbeat, BP-130/80mm of hg, pluse-78/min.

On Investigation:-
            Angiograph results: - Right coronary artery blockage up to 76%.

Treatment given:-
 corse: 1
            Tab hrudaya vati 1000mg Bid before food for chewing.
            Avipattikara churna 5gm Bid after food with hot water. For 21days.
Corse:- 2
After 21 days Angina, Palpitation, Shortness of Breath & other symptoms are decreased.
Advice:-
            Tab Hrudaya 1000mg Bid before food for chewing.
            Avipattikara churna 5gm Bid after food with hot water. For 21days.

Corse:-3
            After 21 days Angina, Palpitation, Shortness of Breath completely reduced but having light palpitation.
Advice :-
            Tab Hrudaya vati 1000mg Bid before food for chewing.
            Avipattikara churna 5gm Bid after food with hot water. For 21days.

Result:- (After a month)
Angiogram:- Result shows there is no blockage and other abnormalities are seen
            Then advice to continue Hrudaya vati 500mg as a preventive measure.

CASE 2:-
            Male Patient name Hanumanthappa, layer, Jagalur Karnataka aged 56 Years completing of tiredness, tightness chest, palpitation since 1year. Known case of hypertension & DM. non-smoker, obese.
            Previously diagnosed & treated in Jayadeva hrudroga Hospital Bangaluru.

On examination: -
            On auscultation third heart sound, irregular heart-rhythm , BP-130/90mm of Hg, pluse-76/min.

On Investigation:-
            TMT:- Ischemic heart disease (IHD) 
            Angiograph results: - Right coronary artery blockage up to 40%.

Treatment given:-
Corse:- 1
            Tab hrudaya vati 1000mg Bid before food for chewing.
            Bilwadi vati 1 gm Bid after food with water. For 21days.
Corse:-2
            After 21 days Angina, tiredness, tightness chest, palpitation and other symptoms are decreased, along with Observed gastric irritation.        
                                                        
Advice:-   Hrudaya vati 1000mg Bid before food for chewing
                        Balaguduchyadi Q 15ml Bid before food for 21days.
            After 21 days Angina, tiredness, tightness chest, palpitation and other symptoms are decreased completely.

Result:- (After 15days)
            Angiogram:- Result shows there is no blockage.
Then advice to continue ************* 500mg as a preventive measure.

CASE 3:-
            Male Patient name Rudramuniyappa, musturu, Karnataka aged 80 Years, completing of difficulty in breathing, tiredness, chest pain, palpitation since 2 year. Chronic smoker.
            Previously diagnosed & treated in Narayana Hrudayalaya Bengaluru.
On Examination:-
            Normal built, Auscultation third heart sound, irregular heartbeat, BP-130/80mm of Hg, pluse-78/min.
Angiogram Results:-  Right Coronary Artery Blockage up to 60%. 
Serological investigation:-
            changes in the LDL, HDL and VLDL above the level

Treatment given:-
Corse:1
            Tab************* 500mg Bid BF Chewing.
            Balaguduchyadi Q 15 ml Bid AF Hot Water.            For 21days
Corse: 2                                  
            After 21 days completing of difficulty in breathing, tiredness, chest pain, palpitation and other symptoms are decreased moderately.
Advice:-
            Tab *************500mg Bid BF chewing.
            Avipattikara churna 5gm Bid AF hot water. For 21 days.    
Corse 3:-
            After 21 days difficulty in breathing, tiredness, chest pain, palpitation and other symptoms are decreased.
Advice:-
            Tab ************* 500mg Bid BF chewing.
            Avipattikara churna 5gm Bid AF hot water. For 21 days.    
Result:- (After a month)
            Angiogram:- Result shows that there 20% 0f the blockage.
            We observed 67% of the result in prescribed duration.

CASE:- 4
            Pt name N.P.Nagaraj, 64years, Bank manager in SBM chitrdurga, Karnataka c/o chest pain, tiredness, palpitation. Since 9 months.
On Examination:-
            Normal built, Auscultation third heart sound, irregular heartbeat, BP-130/80mm of Hg, pluse-78/min.
Angiogram Results:-  Right Coronary Artery Blockage up to 20%. 
Treatment given:-
            Tab ************* 500mg Bid BF Chewing. For 21days
Result:- After 21 days all the symptoms are normal.
After 21 days advice Tab ************* 250 mg daily as a preventive measure.

CONCLUSION:-
            Coronary artery Blockage is caused due to Medo Vruddi in the blood that may accumulate in the coronary artery vessels. That will cause the ischemia in the heart muscles i.e. craving of the blood supply to the heart muscles. That may produce the symptom like irregular heart rhythm, shortness of the breath, angina. After that may leads to thrombus formation it will leads to myocardial infraction.
            Sometimes 100% blockage with cholesterol, fat molecules and cells i.e. pluck May not show any symptoms but some time even 20-30% of blockage will forms the thrombus that may leads to myocardial infraction. So in the higher cholesterol level or in the hyper cholestremia conditions and in the early stages of the pluck formation only everyone needs medication.
            By absorbing the different scholar’s scientific study of all the ingredients of Hrudaya vati with respect to regularise the cholesterol level and break down of pluck formation, We concluded that Hrudaya vati is the drug of choice for the coronary artery blockages. 
            Through the clinical study we absorbed that at the stage of pluck formation in the coronary artery and other arteries also by advising *Hrudaya vati completely removes the pluck formation and clears the pathway of the blood vessels.
            So, every physician must try to understand the condition of the coronary artery blockages and prevent the further complications based on the evidence.

Reference:-
1.      “************”, Vidyotini Hindi Tika Vaidya Shri Lakshmipathi Shastri, Varanasi: Chaukhamba Sanskrit Sansthan, Charu printers, reprint 2005, p no 22-23.
  1. Bhavamishra, Bhavaprakasha, Vidhyotini Hindi Vyakya,Shri Bhramashankar Shastri(Purvardha),4th edition ,Sirija,Varanasi,Chaukhamba Samskritha,1961
  2. Database on Medicinal Plants used in Ayurveda, Central Council for Research in Ayurveda and Sidda, New Delhi: Yugantar Prakashan; 2000, vol.1.
  3. Kirtikar - Basu, “Indian Medicinal Plants with Illustrations”, 2nd ed, Dehra Dun, Uttaranchal: Oriental Enterprises; 2001, vol-3.
  4. Prof.  P. V. Sharma, “Dravyaguna Vignana (Vedic Plants and History of Dravyaguna)”, Varanasi: Chaukhamba Bharathi Academy; Reprint 1999, p no 234.
6.      Dravyaguna vignana by J.L.N. shastry. Volume 2 Varanasi: Chaukhamba Bharathi Academy.
7.      Harrisons Principles of Internal Medicine Volume 2. 17th edition. Fauci Braunwal, kasper, loscalzo.
8.      www.Google.com
9.      www.youtube.com

Dr. Chethan Kumar.A.T BAMS. MD(Ayu)., MSS&C(Pshy). BPH(Pranic)

Award winner of “VAIDYARATNAM P.S WARRIERS”Winner of “KSHITIJ 2012 Best Presenter”Winner - “Young Scientist” Award.

Author : Dr. Chethan Jagalur. BAMS. MD(Ayu) MSS&C,BPH

   Secretary of Shree Ujwala Ayurdhama®

 

Shree Ujawala Ayurvedic Hospital.

Shree Ujawala Ayurveda Pharmaceuticals.

Jagalur-577 528 Davangere (Dist), Karanataka.

 

Phone  No. 7204737423 / 09844606423.

E-mail Id: chethan03ayu@gmail.com

 

Branchs:- BANGALORE Malleswaram, MYSORE, HUBLI-DHARWAD, HASSAN, Rest of the days in JAGALUR Branch

 

On-line Consultation Timing:- 10Am to 10pm