Case presentation: 'Uterine-fibroid' by Vaidya Pawan Madaan

This is a case that proves that components/basic consideration of Samprapti & Principles of management described by Acharya Charak are applicable in every branch of Ashtanga-ayurveda whether it is Shalya, Shalakya or Stri-roga-prasuti-tanatra etc.

Vaidya Pawan Madaanji cured this case effectively with regulating the Apan-vayu & concerned srotasas in broader perspective by applying the classical consideration of basic samprapti and its 'Vighatana'.

Dr. Surendra A. Soni 

CLINICAL CASE PRESENTATION –

UTERINE FIBROID

A
CASE OF

-52
year female

-presented
with USG report showing uterine fibroid of the size of 15 x 12 mm in the
anterior uterine wall

with

-complaints
of headache on and off

-generalized
pain in lower limbs

-pain
in the knees - on and off

-generalized
weakness in the body

-complaint
of breathlessness sometimes or feeling of difficulty taking breath

PAST HISTORY –

-in
the last 10-15 years she was having increased frequency of headache which was
non-specific, not associated with nausea or vomiting, usually due to anxiety

-she
is a known hypertensive and taking allopathic medicines amlodipine + atenolol
for this daily  x  10-12 years

-also
taking some multivitamins on and off

-no
any other specific history of any other illness or treatment being taken in the
last 15-20 years

MENSTRUAL HISTORY –

-during
the reproductive years no any menstrual disturbance regarding the regularity,
flow or pain during menstrual cycles

ROGI PAREEKSHAA –

ANNAVAHA SROTAS –

-KSHUDHAA
– sometimes ok sometimes less

-KANTHADAAHA,
URODAAHA – on and off

-HRILAAS
/ VAMI – no

-UDARA
SHOOL – no

-distended
but lax abdomen, bowel sounds heard clearly, no organomegaly, no any scar, no
spider naevi, no caput medullaris, no any tenderness abdominal either on
superficial or deep palpation

PUREESHAVAHA SROTAS –

-VIBANDHA
- ++

-MALA
PRAVRITTI – usually daily but hard stools, sometimes missed for one day

SHUKRAVAHA SROTAS –

-menstrual
periods are still coming but irregular with irregular bleeding, sometimes with
clots, sometimes little increased bleeding, sometimes normal bleeding

-no
any tenderness in the pelvic area either with superficial or with deep
palpation

PRANAVAHA SROTAS –

-no
DNS, no any increased secretions in the nose

-throat
– normal looking, no any increase in tonsils

-trachea
in normal position on palpation

-chest
– normal vesicular breathing, no any wheezing, ronchi, crepiitations, rub or
stridor

-normal
shaped chest, normal respiratory rate

-difficulty
in breathing on and off was found to be associated with stress and anxiety

ASTHI SANDHI VAHA SROTAS –

-tenderness
on tibial shaft and wrist joints with mild pressure

-knee
joints – mild genu varum - thus disturbed gait, mild swelling around knees,
good crepitations heard in the knee joints

-generally
joints looking week and KRISHA

-can`t
stand for long periods, feels pain in lower legs after standing for about 10 –
15 minutes

-can
walk only for about 500 metres to1 km at a stretch

ASHTAVIDHA PAREEKSHAA –

JIHWAA
– AAMYUKTA

NAKHA
– ROOKSHA

MALA
– SHUSHKA

MUTRA
– normal, TAIL BINDU PAREEKSHA not done

NETRA
– sunken eyes without luster, no pallor, no ictrous, no KF rings

NAADI
– MANDA AND VEGAWATI

SHABDA
– sharp voice

SPARSHA
and AAKRITI – KHARA SPARSHA, medium built body

GENERAL PARAMETERS –

WEIGHT
– 79 KG

BP
– 110/70

PULSE
– 80 per min

SAMPRAAPTI –

DOSHA
– VAATA PRADHAANA TRIDHOSHA

DUSHYA
– RAKTA, ASTHI, MAANSA

ADHISHTHAANA
– SHUKRAVAHA SROTAS, uterus

SROTAS
– RASAVAHA SROTAS, SHUKRAVAHA SROTAS

SROTODUSHTI
– SANGA

AGNI
– VISHAMA

KOSHTHA
- KRURA

NIDAANA –

RASA
DUSHTI / AARTAVA VAHASROTO DUSHTI / ASTHIKSHYA

CHIKITSA TATVA – (LINE OF TREATMENT)

-RASA
RAKTA PRASAADAKA

-ASTHI
PAACHAKA / ASTHI POSHAKA

CHIKITSA VICHAAR –

The uterus, ovaries,
fallopian tubes, breasts, their contents, secretions and connective tissues all
belong to ARTAVA VAHA SROTAS, the channels carrying out female reproductive functions
and the functions of ARTVA VAHA SROTAS are dependent on correctly functioning
RASA DHAATU as well as RASA VAHA SROTAS.

The uterus has three
main linings: innermost mucosal layer, middle muscular layer and a thicker
outer wall.

When there is KAPHA
DUSHTI as a result of RASA DUSHTI and other reasons, there could be manifestation
of ARBUDA like fibroids in the uterus.

As ARTAVA VAHA SROTAS
acts as one system, its components are all subject to fibrotic cellular changes,
so if the uterus is removed and KAPHA accumulation remains unchecked, these
KAPHA deposits tend to migrate to the remaining ARTAVA sites.

This KAPHA here is
the DUSHTA MALA ROOPA KAPHA which basically takes its origin from the DOOSHITA
RASA DHAATU so by focusing on the treatments of DOOSHITA RASA DHAATU, the
treatment of uterine fibroids is achievable.

Within ARTAVA VAHA
SROTAS, VAATA(Apaan) governs the functions of timing, communication and coordination
with other psycho-biological cycles. PITTA governs the circulatory functions,
and their functional interface with ARTAVA VAHA SROTAS. Each lunar cycle
between menarche and menopause, rich deposits of blood and mucous accumulate
along the inner surface of the uterus in preparation for possible conception.
KAPHA governs the mucosal properties of thickness, viscosity and adherence
affecting these three linings when uterine fibroid form.

PITTA
when causes the DOOSHANA of the RAKTA which is a factor in the normal menstrual
functions and when it is associated with the DOOSHITA RASA DHAATU, can lead to
formation of abnormal growths in the uterus.

CHIKITSAA GIVEN --

28-5-2015

HARAD
PAAKA

5
GM at night

Tab
NITYANAND RASA

2-2

Tab
KAANCHANAARA GUGGULU

2-2

Tab
TAPAYAADI LOH

1-1

ASTHIMAJJA
POSHAKA COMPOUND – (SELF MADE)

(A
combination of powders of LAJJAWANTI, SAFED MOOSLI AND BEEJDANA)

1-2
GM BD twice a day

This
treatment continued for almost 3 months with other medicines whenever needed
for minor problems.

23-9-2015

USG
– size of the fibroids 10 x 10 mm

-      
Bilateral
renal calculi around 3 mm size

The
HARAD PAAKA was omitted now and the other same treatment was given for 3 more
months till January 2016, after this patient discontinued the treatment

20-4-2016

She
again presented with added complaints of generalized pains in lower limbs.

Again
started with the following treatment –

Tab
Nityanand Rasa

2-2

Tab
Kanchnaar Guggulu

2-2

ASTHIPOSHAKA
COMPOUND as described above.

With
added

Tab
Shigru

1-1

This
treatment was continued for 3 more months and then she stopped the treatment.

27-9-16

She
came with the USG report showing NO FIBROIDS in the uterus.

The relevant PATHYA APATHYA was
suggested time to time as per the requirement and was followed by the patient.

She
was a bit anxious patient so time to time counseling sessions were given as per
the need.

VAIDYA PAWAN MADAAN

CONSULTANT
AYURVEDA PHYSICIAN

AMRIT
AYURVEDA CLINIC

ADARSH
NAGAR

JALANDHAR
CITY, PUNJAB

CURRENTLY

Senior
Ayurveda Physician

Jiva
Ayurveda Clinic

Sector
21-B

Faridabad.

drmadaan@gmail.com

www.ayurvedhelpline.com