ayurvedic perspective of varicose veinsuseful herbs for varicose veins 1. brahmi (bacopa monnieri)...

www.wjpr.net Vol 6, Issue 3, 2017.

296

Nidhi et al. World Journal of Pharmaceutical Research

AYURVEDIC PERSPECTIVE OF VARICOSE VEINS

Dr. Nidhi Garg*1 and Dr. Akhil Jain

2

1Assistant Professor in Agad Tantra Dept.,

2Assistant Professor in Shalakya Tantra Dept.

Ch. Devi Lal College of Ayurveda and Hospital Jagadhari.

ABSTRACT

Varicose veins is a common health complaint in people like security

guards, watchmen, cops, soldiers, vehicle pullers, porters, rikshaw

pullers, launderers, drivers, teachers etc. A condition, in which a vein

becomes dilated, elongated and tortuous, this is said to “Varicose”.

There are primary as well as secondary causes of varicose veins. The

superficial & perforating as well as the deep veins are involved in

varicose veins. The contemporary treatment for varicose veins includes

ligation, ligation with stripping surgical treatments. But these

treatments reoccurrence of this disease. Venous ulcers (stasis ulcers,

varicose ulcers) are the wounds occurring due to inappropriate

functioning of venous valves, usually of the legs. It is one of the most serious chronic venous

insufficiency complications. The overall incidence rate is 0.76% in men and 1.42% in

women. When a venous valve gets damaged, it prevents the backflow of blood, which causes

pressure in the veins that leads to hypertension and, in turn, venous ulcers. These are mostly

along the medial distal leg, which is often very painful, can bleed, and get infected. The

pathogenesis starts with dysfunction of venous valves causing venous hypertension which

stretches the veins resulting in ulcer formation. If not treated properly, the ulcer may get

infected leading to cellulitis or gangrene and eventually may need amputation of the part of

limb. In Ayurvedic literature this particular disease has been described as “Siragranthi”

(ie.Varicose vein).[1]

It can be managed with the specific s’odhana therapy. In Ayurvedic

prospective, varicose ulcers can be correlated with “Siragat Vat janya vran’. Sushruta has

advocated Jalauka (Leech) as one of the most effective method of bloodletting, useful even

in infected and non healing wounds. Patient with varicose ulcers was advised to take “Sariva

Ghana vati” internally, Teel oil “Dhara sweda” over the lower limb along with weekly

World Journal of Pharmaceutical Research SJIF Impact Factor 7.523

Volume 6, Issue 3, 296-310. Review Article ISSN 2277– 7105

*Corresponding Author

Dr. Nidhi Garg

Assistant Professor in Agad

Tantra Dept., Ch. Devi Lal

College of Ayurveda and

Hospital Jagadhari.

Article Received on

25 Dec. 2016,

Revised on 15 Jan. 2017,

Accepted on 04 Feb. 2017

DOI: 10.20959/wjpr20173-7901


297


application of Leech around the ulcer followed by dressing with „Yashtimadhu Ghrita As it is

not having a permanent solution, people come to Ayurveda to get the relief of vein

engorgement and aching pain. Also, they seek the ways to avoid the occurrence of the

complaint.

KEYWORDS: Basti karma, Dustha vrana, Nitya virechana, varicoseulcer, siragranthi,

jalauka, varicose.

INTRODUCTION

Varicose veins refer to the condition in which the veins of the legs become varicosed, i.e.

they appear swollen and bulging and can be made out from the outside. Majority of varicose

veins are seen mostly on the thigh and back of calf muscles and they lesser exteriorly on the

inner side of legs.[1]

The persons involved in the prolonged standing jobs e.g. Policeman,

conductor, etc. often suffer from varicose veins.[2]

The common symptoms includes heaviness

in the legs, muscle cramps,itching around the swollen vein and pain felt in the whole leg or in

the lower part of the leg. Particularly in modern science the treatment of varicose veins is

limb bandaging, surgical treatment (stiping of Saphenous vein), Scelerotherapy etc. but no

medicinal treatment is available. The therapy develops the immune mechanism in the blood

system by stimulating the antitoxic substances in the bloodstream.[3]

Varicose veins may be

dark in color or may retain their original color. They are always painful. In case of prolonged

varicose veins, there could be skin peeling and skin ulcers in certain affected parts of the legs.

The varicose vein is very common disorder in the society, inUK it is estimated to affect 20-

25% women and 10-15% men1 (Br JSurg. 1994; 81:167–73) Varicose veins are caused due

to excessive pressure caused on the legs or the abdomen. These are brought on by advancing

age, obesity, pregnancy, hormonal changes and a host of other factors. Some deficiencies in

the diet may cause the loss of elasticity of the veins, which may make them varicose. Also,

standing for a long time, engaging in physical activity that puts more strain on the legs,

wearing constrictive clothing and total lack of exercise can make the veins varicose. This

condition is more or less a vata problem. People with a predominance of vata dosha seem to

suffer more from this problem.

Venous ulcers (stasis ulcers, varicose ulcers) are wounds occurring due to improper

functioning of venous valves, usually of the legs. Damaged venous valves prevent the

backflow of blood and cause pressure in the veins. Hence an arterial pressure reduces

significantly than venous and therefore, blood is not pumped as effectively into the area. A


298


venous ulcer will not usually heal without expert advice and treatment. Without cleaning and

regular dressings, the ulcers usually spread quickly. Venous ulcers can be very painful and

may limit mobility and quality of life. The longer the duration of the venous ulcer, the more

is the damage to skin and greater the difficulty in healing. The annual prevalence of venous

leg ulcer among the elderly is 1.69%. The overall incidence rate is 0.76% in men and 1.42%

in women. Varicose ulcers appear when these enlarged veins become congested with fluid

buildup and infection occurs. It is the major cause of chronic wounds, occurring in 70% to

90% of chronic wound cases.[4]

The etiological factors include increased intravenous pressure, secondary to deep vein

thrombosis, chronic constipation, long standing occupation etc. The pathogenesis starts with

persistently increased intravenous pressure which damages the venous walls and results in

stretching, loss of elasticity, hyper lipo-dermato-sclerosis and finally ulcer formation.

Confirmation of diagnosis is done by Duplex Doppler ultrasound scanning of the lower limb

venous System.

Conservative management of venous ulcers includes use of compression stocking or bandage

to prevent worsening of varicose veins, foot elevation, antibiotics and regular cleaning and

dressing of u interruption of reflux source technique (TIRS) by sclerotherapy, laser ablation

of varicose veins or surgical correction of superficial venous reflux is performed.[5]

If

varicose ulcer is not treated properly or left untreated then, wound infection causing increased

pain, swelling, redness and pus, loss of mobility and even severe complications like

osteomyelitis, septicaemia or malignancy etc. may occur. Statistics revealed that recurrence

of venous ulcers is quite common, ranging from 54 to 78% by the fifth year after healing.

Hence, we can say that in spite of all advances in health sciences, varicose ulcer management

is still a difficult task for the surgeons.

In ayurveda this prakupit vata dosha compresses, raises and squeezes the net work of veins;[6]

In Ayurveda it is considered as Krichh sadhya vyadhi (curable with difficulty) in early stage

and asadhya in late stages affecting the vital parts of the body.[7]

Sushruta and Vagbhatta

mention Jalaukavcharna (leech therapy) in the treatment of all venous diseases. Leech

therapy comes under the Raktmokshana treatment which is one of the Ayurveda

Panchkarma.[8]

Siravedha (bloodletting) is most important parasurgical method and

considered as half of treatment among surgical procedures.[9]

Sushruta’s school of thought

considers the Rakta (blood) as dosha because the blood plays main role in the pathogenesis of


299


many disorders.[10]

siravedha is a purificatory procedure for rakta as the virechana

(Purgation) for Pitta and Vamana (emesis) for Kapha.

Varicose veins causes as per Ayurveda

Intake of abhisyandi (which occlude channels) food like curd, lassi, deep fried foods, heavy

non veg foods, junk foods, aerated drinks etc etc.

Excess work (shramatiyogat)

Weight lifting (Bharavahana)

Long walk (adwagamana)

Intake of heavy (guru), mild(manda), cold(hima), unctuous(snigdha) food stuffs etc.

Origin Of Siraja Granthi (Varicose veins)

Because blood vessels are involved, there is definitive involvement of Pitta Dosha.

Along with Pitta, Vata alone or Vata and Kapha are vitiated in their site of affliction, ie in

weight bearing area like calf and ankle.

Ultimately the imbalanced Doshas disturb the vessels and the blood of that particular area

(venous blood).

Thus the blood is stagnated due to obstruction of the pathway of the blood vessels. Hence, the

veins are dilated in their weak.

Casuative factors of Siragranthi.[11]

(Varicose veins)

a. Weak person who works hard or for a longer period for longer distance.

b. Weak person who walks for a longer time.

c. If he dips his leg in water (especially in cold water).

d. A person who does heavy exercise.

Due to various vata vitiating factors vata gets vitiated in the body and this vitiated vata

Dosha acquires sthansanshraya (ie.localization) in different parts of the body. Acharya

Sushruta described that vitiated vata dosha gets accumulated either in one part or one dhatu

by producing symptoms described above like Shotha (inflammation), shoola (painful) etc.[12]

If the proper management of vitiated vata dosha is not done at the same time then this


300


vitiated vata dosha spreads to the other body parts and if still neglected produces the various

diseases like siragranthi (ie.varicose veins).[13]

Pathogenesis (ie.Samprapti) of varicose veins.[14]

1. Upashaya - On rest.

2. Anupashaya – chankramana (excessive walking), Physical strain etc.

Vata vitiates rakta dhatu due to this; Sira undergoes sankochan, sampidana and vishoshana

causing Siragranthi (ie.varicose veins).If vitiated at the site of vein leads to signs and

symptoms of varicose veins. The change in the shape and size causes veins to become

sankuchit i.e. tortousity of veins. Also due to Ruksha guna (dryness) veins becomes rough

and hard (ie.visohoshana) and finally veins looks like a swelling that is painless and non

pulsatile.

Clinical features of Siragranthi.[15]

a. Sira Sankocha (tortous veins)

b. Sira Vakrata (irregular surface of veins)

c. Sira Utsedha (inflammation of veins)

d. Vishoshana (roughness and hardness of veins)

Prognosis of Siragranthi

While describing the siragranthi Acharya sushruta has explained the severity of disease i.e.

as per stage which type of treatment should be followed. In relation to siragranthi it is said

that if the granthi which is painful and movable is difficult to treat. If it is not painful but

large, immobile and situated at marmasthana (ie. at vital points) is also difficult to treat

(ie.kruchyasadhya).[16]

If it is large and we operate it will bleed profusely which will again

cause life threatening condition.

In ancient Indian medicine, such conditions are considered as duṣṭa vraṇa (non-healing

wounds) because they are produced by vitiated dośas inside the body. This can be treated

successfully with śodhana (purification) and śamana (pacification) therapy. So, the fore

mentioned benefits of Nitya virecana (liver and bowel cleansing therapy) and Manjishṭhā

basti (decoction enema therapy) were assessed in alleviating the symptoms and in the healing

process of varicose ulcer in the patient.


301


Useful Herbs for Varicose Veins

1. Brahmi (Bacopa monnieri)

The indigenous Indian herb, brahmi, is perhaps the best Ayurvedic treatment for varicose

veins. It provides the necessary nutrients required for the proper toning of the veins and

makes them less tortuous. Brahmi is taken in conjunction with some mineral supplement like

Jasad bhasma.

2. Garlic (Allium sativum)

Among its many advantageous properties, garlic also has effects in the treatment of varicose

veins. Garlic can break down the protein content in the body and distribute it evenly. This

increases the protein supply to the lower limb region. Hence, the condition of varicose veins

is avoided.

3. Ginger (Zingiber officinale)

Like garlic, ginger too breaks down and distributes the protein in the body.

4. Onion (Allium cepa)

Onion helps in the proper assimilation and distribution of protein in the human body. It gives

inner strength. Chomping on one onion everyday can help to solve the problem of varicose

veins permanently.

Dietary Treatments for Varicose Veins If the diet of the person is deficient in certain

nutrients, then it may cause the skin to lose its elasticity. This would lead to the condition of

varicose veins. For this reason, people must take good dietary care so as to provide the body

with the essential nutrients. The following are some points to remember: -

- Include whole food grains in the diet, instead of synthetically polished ones. Whole grain

wheat and millet are good.

- Fresh fruits are very much needed, since vitamin C deficiency is a prime cause of varicose

veins. Amalaki and other citrus fruits must be had in good amount.

- Have a protein-rich diet, which is necessary for building up the tissues. You must have one

egg daily, a glassful of milk, meat, legumes and other protein-rich food. But avoid red meat.

- Protein tends to accumulate in fixed pockets in the body. Hence to distribute this protein

properly, you must consume garlic, onion, ginger and pineapple.

- Fish must be included in the daily diet.


302


Basti karma (medicated drug enema)

In the context of Vraṇa Cikitsā (a chapter for the treatment of ulcer-like wound), Basti

Chikitsā (rectal enema therapy) is mentioned as a śodhana or a specific purification therapy

where medicines are administered through rectal route. The Vāta Doshaja Vraṇa and

Adhaṇkāyaja Vraṇa (ulcers prone to lower limbs) are treated with Basti karma or āsthāpana

Basti (medicines processed with kaśhyam administered through rectal route)āyam

administered through rectal route).

Drug action

Mañjiṣṭhā (Rubia cordifolia)

It has properties like tikta-kashāya rasa, kaṭu vipāka, uṣṇa vīrvya, kapha-pitta-shāmaka;

shleshma-śotha nāśaka. Also, a study proved the significance of Mañjiṣṭhā in chronic wound

healing.

Yaṣṭimadhu (Glycyrrhiza glabra)

Madhura rasa; śīta vīrya; pitta-vata shāmaka; vran.ashothahara; vedanāhara; are its properties.

It has anti-inflammatory activity.

Guḍūci (T. cordifolia)

Tikta-kaśāya rasa; madhura vipāka; uṣṇavīrya; tridośaśāmaka; dīpanīya and dāhanāśaka are

its properties. The chloroform and benzene extracts of gud.ūci were found to possess

significant antibacterial activity as compared with the standard. Gud.ūci leaf extract is useful

in infections due to Proteus vulgaris, Staphylococcus aureus, Streptococcus pyrogens,

Bacillus subtilis and Escherichia coli.

Ayurvedic Treatments for Varicose Veins

Ayurveda prescribes the Brahmi as the drug of choice for the treatment of varicose veins.

Brahmi is used for four continuous weeks to get permanent benefits. It is taken in doses of 10

to 20 milliliters twice a day. Along with brahmi, the Jasad bhasma is also prescribed. This

bhasma has three benefits – (i) it is a rich source of the mineral zinc, (ii) it helps in healing

and blood clotting through the formation of collagen and (ii) it helps in the concentration of

vitamin E in the blood. Other popularly prescribed medicines are Chandraprabha vati,

Nagarjunabhra rasa and Punarnavadi guggulu, among others.

There are some Ayurvedic oils available for local application to seek temporary relief. These

are Prasarini taila and Chandanabala taila. But care must be taken never to massage any oil


303


directly on the varicose veins, as it would increase pressure on them.

Yogic exercises can treat varicose veins without any medication. The best exercises for this

condition are Halasana, Pawanmuktasana and the Sarvangasana. Simple exercises like

walking, swimming, cycling and stretching the legs while sitting on a chair also help.

Home Remedies for Varicose Veins

1. Have a mixture of carrot and spinach juice daily. This will solve the vitamin deficiencies in

the leg.

2. Apply a mudpack on the leg in the night and wash it off in the morning.

3. Wearing stockings at night helps, but do not wear tight jeans in the daytime.

4. Have an alternating hot and cold hipbath daily.

5. Apply an oil containing vitamin E as its major component onto the legs. But take care not

to rub it too deeply into the legs.

6. Have a wholesome diet rich in proteins and vitamin C.

ayurvedic medicines

1 sahacharadi kashaya

2 sahacharadi thailam

3 rasa thailam

Nitya virecana (bowel and liver system cleansing therapy)

This therapy is indicated in śothāvasthā (edematous condition) where kaphadośa

predominance (retention of fluidity) is observed. It is helpful to reduce kledāmshatā (fluid

retention) in the Dhātu (tissues), thus reducing excess fluid retention extra- and

intracellularly, which in turn facilitates proper microcirculation and reduces the duration of

the edematous stage. This therapy involves laxative actions, using through processed

medicines like Nimba (A. indica and T. cordifolia), it stimulates the liver systemIn addition,

Dhātugata Agni (digestive and assimilation capacity and enzymatic functions through the

liver system) was improved by the Nitya virecana. By the laxative actions it creates osmotic

effects in the gut to suck the extra fluid retained anywhere in the body and is ultimately

helpful in the wound healing process. Therefore, Nitya virecana was the first line of

management in the present case. Three days of treatment with Nitya virechana results in good

appetite, reduction in the edematous swelling around the foot, and starting of granulation

tissue formation in the ulcerative wound.


304


Treatment of varicose veins in Ayurveda.[17]

1. Taila pana especially sahacharadi taila (Oleation therapy).

2. Upanaha (Poultice).

3. Basti karma(Enema).

4. Siravyadha (Blood letting)

Siravyadha (Blood letting)

According to Sushruta, blood letting (ie. siravydha) is a prime or half the treatment of

diseases in shalyatantra. So it is clear that patients having varicose veins can be treated by

siravedha and also can be prevented from further complications. As Sira granthi is the

disease due to vitiated vata mainly and rakta dhatu also, when blood letting performed the

pathogenesis of siragranthi will break.[18]

Poorvakarma of blood letting

Before performing siravedha, certain prerequisites have to fulfill the poorvakarma like

preparation of patient, preparation of equipments, collection of drugs and dressing materials

Pradhankarma of blood letting

Once all these pre-requisites are completed, the procedure can be proceeded ie. Siravydha.

The important steps for Siravedha are-

A. Proper positioning of the patient either sitting up or standing. An appropriate position aids

in the adequate flow of blood.

B. Selection of Sira (ie.vein) and making it adequately prominent.

Selection of sites of siravydha and amount of blood to be let out. All these conditions are

achieved by various means eg.(i) Tying above the site with any vastra (cloth), valkala

(bark),lata etc. (ii) Pressing with fingers by an assistant. Siravedha was actually done using

various instruments or shastra (ie.sharp instruments) in ancient period. The selection of sharp

instruments depends on the site of blood letting. Now-a-days a simple needle, 12 No blade

(curved), a scalp vein set or a trochar cannula serve the purpose. Appropriate quantity

(maximum) of blood that is to be let out from a strong individual is one prastha (ie.640ml).

According to Dalhana the blood can be let out in order of approximately one prastha


305


(ie.640ml), half prastha (ie.320ml) and one kudava (ie.160ml) in case of uttama, instruments)

in ancient period. The selection of sharp instruments depends on the site of blood letting.

Now-a-days a simple needle, 12 No blade (curved), a scalp vein set or a trochar cannula serve

the purpose. Appropriate quantity (maximum) of blood that is to be let out from a strong

individual is one prastha (ie.640ml). According to Dalhana the blood can be let out in order

of approximately one prastha (ie.640ml), half prastha (ie.320ml) and one kudava (ie.160ml)

in case of uttama, madhyam and hina matra. Appearances of features of proper blood letting

are important like decrease in the pain, happiness and blood stops flowing of its own.[19]

Sign and Symptoms of proper Siravedha

When appropriate amount of blood has been let out and features of proper blood letting are

obtained that indicates the end of the procedure.

A. Vedana santi (pain decreases)

B. Laghuta (sense of lightness),

C. Vyadhirvega prasamana (remission of signs and symptoms of disease)

D. Mana prasadana (happiness).[20]

It has been stated that all the dushta rakta (ie.vitiated blood) should not be removed

completely. Some of it can be left behind to avoid an accidental excessive blood loss. The left

over vitiated blood can be cleaned up by other forms of samshamana (ie.conservative)

treatment modality. Siravedha usually leads to the flowing out of vitiated blood like jet; this

has been illustrated quite clearly by Sushruta.

Postoperative care after Siravedha

Appearance of features of proper bloodletting indicates the end of procedure and to perform

postoperative care like application of haemostatic and antiseptic powders, tight bandage etc.

at the site of bloodletting. In Ayurvedic prospective, we can co relate varicose ulcers with

“Siragat Vat janya vran’. Sushruta has described wound management in a most scientific

way and lcer. How ever, if patient do not respond, then surgical measures like skin grafting,

terminal given the utmost importance to Bloodletting therapy and considered Leech as the

most unique and effective method of bloodletting even in infected wounds and abscesses.

ayurvedic treatment for siragata vata janya vrana

Acharya Sushruta has exclusively mentioned the treatment regime for ‘Siragata Vata’ which

includes local oleation and fomentation along with Leech therapy.3 Sushruta has advocated


306


60 procedures (Shashthi upakramas) for wound management which can be practiced as per

stage of wound and necessity. He has given the utmost importance to Bloodletting therapy

and considered Leech as the most unique, effective method of bloodletting even in infected

wounds and in abscess management. Sushruta has also specified that the wounds over the

lower limb delays in healing. References of indication of leech therapy in wounds: Leech

therapy is considered as most unique and effective method of bloodletting. It can be tried in

all mankind including Females, Children, Old and Patients having poor threshhold to pain. It

drains impure blood, useful in Pitta dushit Rakta diseases, various skin disorders and all types

of inflamatory conditions. In Sushruta samhita Chikitsasthana, chapter 12 and 16, Sushruta

has advocated that bloodletting by Leech can be practiced in all inflammatory, suppurative

and painful.

pathology in delaying varicose ulcer healing

The pathogenesis of varicose ulcer starts with dysfunction of venous valves causing venous

hypertension which stretches the veins. This allows blood proteins to leak into the extra

vascular space. It isolates extra cellular matrix molecule and growth factor, preventing them

from helping to heal the wound. Similarly, leaking of fibrinogen and deficiency in

fibrinolysis cause fibrin to build up around vessels preventing oxygen and nutrients from

reaching cells. This also plugs the vessels causing ischemia around the wound resulting in

delaying in wound healing. Further, the venous insufficiency causes leukocytes to accumulate


307


in small vessels which releases inflammatory factors causes chronic wound formation.

Ayurvedic treatment for siragata vata janya vrana: Acharya Sushruta has exclusively

mentioned the treatment regime for ‘Siragata Vata’ which includes local oleation and

fomentation along with Leech therapy.3 Sushruta has advocated 60 procedures (Shashthi

upakramas) for wound management which can be practiced as per stage of wound and

necessity. He has given the utmost importance to Bloodletting therapy and considered Leech

as the most unique, effective method of bloodletting even in infected wounds and in abscess

management. Sushruta has also specified that the wounds over the lower limb delays in

healing.References of indication of leech therapy in wounds: Leech therapy is considered as

most unique and effective method of bloodletting. It can be tried in all mankind including

Females, Children, Old and Patients having poor threshhold to pain. It drains impure blood,

useful in Pitta dushit Rakta diseases, various skin disorders and all types of inflamatory

conditions. In Sushruta samhita Chikitsasthana, chapter 12 and 16, Sushruta has advocated

that bloodletting by Leech can be practiced in all inflammatory, suppurative and painful.

causes of varicose veins

Varicose veins usually run in the family history. Thus, if you have people in the family

having them, you are more likely to get them.

There are valves that act as doorways and run through the veins in order to push the blood

flow back to the heart up from the feet. When such a doorway becomes too flappy, fluid

tends to accumulate in the veins. That makes them pop out more than usual.

Such a nature of the veins is often genetic in nature and there is not much that one can do

to prevent them from occurring.

symptoms of varicose veins

The symptoms of varicose veins are characteristic in those who suffer them. The symptoms

and signs are not as scary as they look.

Sometimes people may develop tenderness around the area surrounding the enlarged

veins.

There might occur mild swelling of the legs.

One could suffer from skin tightening or itching sensation in the legs.

One could even find the legs going heavy.

The size of the veins is not proportional to the amount of discomfort that they can cause.

The main complaint that emerges is that, it makes one’s legs appear ugly.


308


Hormonal imbalance can bring on enlarged varicose veins especially if one has genetic

predisposition towards it Elevating the legs.

One could have spent a long day on their feet after which they might find mild swelling:

That is remedied by elevating the legs

One can put up the legs on some pillows when they come home

The blood flow works with gravity and comes back to the hart Ice

One could use ice in the following manner:

It can be used to constrict the blood vessels

If there is swelling or discomfort one could apply an ice pack over the swollen veins

dilated in their weak

previous work done

Study on the effect of Sahacharadi thaila in Siragranthi(varicose vein) by Sreekumar.T-1985,

Dr B K R R Govt. Ayurveda College, A P University, Vijayawada.

To Study the effect of Rakthamokshana in Siragranthi by Babar sanjay-2000, Nasik Ayurved

Maha vidyalaya, Pune University, Pune.

A Study in the management of Siragranthi by Sugatha-2000, Govt. Ayurveda college,

Trivandrum, Kerala University.

A Clinical study on the management of vascular disorders w.s.r to Varicose vein with

Jalookavacharana and Lasunavati by Rao surya prakash-2004, A P University, Vijayawada.

CONCLUSION

The varicose vein is very common disorder in the society, estimated to affecting men and

women both. The most common cause is incompetent valves in the vein, while increasing

age, obesity, family history etc are risk factors. Ayurveda can give a ray of hope in the

treatment of varicose veins and ulcer. Leech therapy‟ proves to be effective, time saving,

affordable and acceptable treatment. Ayurveda is known to possess the rich collection of

medical and parasurgical techniques. Siravedha was found virtuous effort proper assessment

of the effect of siravedha was made and the necessities of dietary regimes were advised to the

patients to follow. After the course of treatment, they were requested to continue bandaging,


309


for proper support of their varicose veins and exercise to improve action of the calf pump

mechanism.

REFERENCES

1. Sushrut Samhita Ayurved Tatwa Dipika Hindi Commentary, Written by Shastri

Ambicadutt Kaviraj Vol-1st, Published by Chaukhamba Sanskrita Sansthan, Varanasi,

reprint edition, 2013; 11(8-9): 351.

2. Colin ogilive (1997) Chamberlain’s symptoms and signs in clinical medicine,

butterworth-Heinemann international edition, 12th edition ch-7,pp-185.

3. www.leeches.biz/leech-therapy.htm.

4. http://en.wikipedia.org/wiki/Venous_ulcer date 25/04/201313.

5. Bush, R. New technique to heal venous ulcers: Terminal interruption of the reflux source

(TIRS). Perspectives in Vascular Surgery and Endovascular Therapy, 2010; 22(3).

6. Dr. Anantram Sharma, “Sushrut vimarshini” commentary on Sushrut Samhita, Chikitsa

sthan- Chapter 4 (Vat Vyadhi chikitsa- Shlok 7) Volume 2, Published by Chaukhambha

Prakakashan- 2009, Page 205.

7. Shastri A.D., (2007) Sushruta Samhita with Ayurveda Tattva Sandipika-Hindi

Commentary (Reprint) Chaukhamba Sanskrit Sansthan; Varanasi; Vol.-2, Sutrasthan.

ch.11, pp. 539-540.

8. Tripathi R.D.(1995); Ashtanga Samgraha; Chaukhamba Sanskrit Series; Varanasi. Uttar

Tantra Ch; 34.

9. Astanga samgraha, Vidyotini hindi Commentary Written by Gupta Atridev Kaviraj,

Published by Chaukhamba Krishnadas Academy, Varanasi, reprint edition 2005.

AS.Sa.Su.36/3, page no-239.



reprint edition, 2013, Su.Su.21/3, page no-112.



reprint edition, 2013, Su.Ni.11/8-9, page no-351.

12. Astanga Hridaya, Vidyotini hindi Commentary Written by Upadhaya Yadunandana

Vaidya, Published by Chaukhamba Prakashan, Varanasi, reprint edition, 2012, AH.Ut.

29/2, page no-756.


310





14. Charak Samhita, Vidyotini Hindi Vyakha, Written by Shastri Pt Kashinath, Published by

b) Sushrut Samhita Ayurved Tatwa Dipika Hindi Commentary, Written by Shastri


reprint edition, 2013, Su.Su.21/19, page no-117-118.

15. Astanga Hridaya, Vidyotini hindi Commentary, Written by Upadhaya Yadunandana


29/10-11, page no-756.




17. Astanga Hridaya, Vidyotini hindi Commentary, Written by Upadhaya Yadunandana


20/7, page no-760.



reprint edition, 2013, Su.Su.14/34, page no-71. b Sushrut Samhita Ayurved Tatwa Dipika

Hindi Commentary, Written by Shastri Ambicadutt Kaviraj Vol-1st, Published by

Chaukhamba Sanskrita Sansthan, Varanasi, reprint edition, 2013, Su.Sa.8/22, page no-91.

19. Sarangdhar Samhita, Written by Tripathi Bramhanand, Published by Chaukhamba

Surbharti Prakashan, Varanasi, reprint edition, 2010, Sha. Ut.Kha.12/1, page no-415.

Sushrut Samhita Ayurved Tatwa Dipika Hindi Commentary, Written by Shastri


reprint edition, 2013, Su.Sa.8/15, page no-87.

20. Sushrut Samhita, Ayurved Tatwa Dipika Hindi Commentary, Written by Shastri


reprint edition, 2013, Su.Su.14/33, page no-71.36.

ayurvedic perspective of varicose veinsuseful herbs for varicose veins 1. brahmi (bacopa monnieri)...

Documents