i patra pin a sveda and kukkutānḍa mardana in...
TRANSCRIPT
AAMJ / Vol. 2 / Issue 6 / November – December 2016
A A M J Anveshana Ayurveda Medical Journal
www.aamj.in ISSN: 2395-4159
Case Report
Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in
Manyāsthambha w.s.r to Cervical Spondylosis - A Case Study
Jadhav Bhagyashree 1 Bhagyalaxmi K S 2 Vinay kumar K N 3 Kiran M Goud 4
A b s t r a c t
Cervical spondylosis is a common degenerative condition of the cervical spine presenting
with the complaint of neck pain, stiffness, numbness, restricted neck movements, painful
neck movements and weakness. By considering the sign and symptoms of cervical
spondylosis it can be correlated with manyāsthambha. The incidence rate of Cervical
spondylosis is 83 per 1,00,000 population and prevalence rate ranging up to 3.3 cases
per 1000 population. The line of treatment of Manyāsthambha goes in the same line of
vāta vyādhi chikitsa. Bāhya Snehana and Svedana are the two modalities of Bahirpari-
mārjana chikitsa indicated for the ailments of vātavyādhi. Hence in the present study
Nirgunḍi patra pinḍa sveda and Mardana with Kukkutānḍa was adopted as line of treat-
ment. In the present case study the above treatment was adopted for 7 days. The result
was found significant in parameters like Neck pain, Neck stiffness, restricted neck move-
ments, painful neck movements.
Key words: Manyāsthambha, Cervical Spondylosis, Mardana, Kukkutānḍa, Nirgunḍi
Patrapinḍa Sveda
1 & 2 PG Scholar, 3 Reader, 4 Professor, Department of PG Studies in Panchakarma, SKAMCH &
RC, Bangalore.
CORRESPONDING AUTHOR
Dr. JADHAV BHAGYASHREE
PG Scholar,
Department of Panchakarma,
SKAMCH & RC,
Bangalore, Karnnataka, (India).
Email: [email protected]
Jadhav et.al : Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in Manyāsthambha w.s.r to Cervical Spondylosis - A Case study
AAMJ / Vol. 2 / Issue 6 / November – December 2016 1065
INTRODUCTION
oday is the era of modernization and fast life. In
this era, human being is prone for numerous de-
generative problems, because of unwholesome life
styles, food habits and professional strain, in associa-
tion with road and traffic situation.[i] The Cervical
Spondylosis is one of the commonest degenerative, neu-
rological condition by which the major population has
been affected. By considering the signs and symptoms
of Cervical Spondylosis, it can be correlated with
Manyāsthambha which is one among vātaja nānātmaja
vyādhi [ii], the symptoms of which includes Ruk and
stambha in manya pradeśa and associated asthi and
sandhi. Due to the nidāna, the vāta doṣa gets vitiated
and takes aśraya at manya pradeśa and causes
stambha and ruja of neck. Hence, pain at manya
pradeśa and stambha of manya occurs. The stambha is
the resultant spasticity of neck muscles, which stretches
and makes neck stiff. Bāhya Snehana and Svedana are
the two modalities of Bahirparimārjana chikitsa indi-
cated for the ailments of vātavyādhi.[iii] Svedana is iden-
tified as best to relieve shoola and stambha pradhāna
vāta vyādhis. As cervical spondylosis is vāta predomi-
nant disorders, nirgunḍi patrapinḍa sveda was selected
as a modality of treatment. Nirgunḍi has vedanāsthā-
pana, śothahara, dīpana, pāchana and rasāyana
properties which are helpful for this condition. In addi-
tion to svedana Mardana with Kukkutānḍa, ajaya,
saindhava lavaṇa as a bāhya snehana was adopted.
As described by Bhavprakash which may improve the
strength of fibrous tissue increases movement and flexi-
bility of the joints and relives the pain and stiffness.
Kukkutānḍa is Uṣṇa Singdha in guṇa so it is helpful to
decrease vitiated vāta doṣa. According to modern egg
yolk strengthens the muscles. Ayurvedic approach to the
disease Manyāsthambha is to retard the degeneration
and to strengthen the Dhātus for pacifying the vāta
doṣa.
CASE REPORT
A female patient aged 53 years with a moderate built
visited panchakarma O.P.D of SKAMCH & RC Benga-
luru. She was having following complaints, pain in the
neck, stiffness in neck and headache since 1 year, Tin-
gling sensation and weakness of arms, patient was hav-
ing giddiness sometimes. Onset of pain in neck was
gradual but since last 6 months pain had aggravated
and patient was having severe pain in the movement of
neck and at rest also. All other vitals were normal.
Investigation done:
Blood test CBC, ESR, RBS, X ray of cervical spine
antero-posterior and lateral view
Reports: CBC was normal, ESR was slightly in-
creased, X ray of cervical spine showed degenera-
tive changes.
The assessment was done based on symptoms.
TREATMENT APPROACH
Nirgunḍi patrapinḍa svedana followed by
Kukkutānḍa mardana with Kukkutānḍa drava,
ajjya, saindhava lavaṇa for 7 days.
Pūrva karma:
Pottali is prepared with the nirgunḍi patra .
Kukkutānḍa drava, ajjya, lavaṇa taken in a vessel
and kept in hot water bath and should be heated till
in attains thick consistency.
Pradhāna karma:
The patient was asked to lie comfortably in prone posi-
tion with the neck and head straight and well exposed
and arms keeping under head. Then sthānika nirgunḍi
patra pinḍa was given for 15 minutes on affected area.
Then Mardana was done with the Kukkutānḍa drava for
15 min maintaining the temperature. After mardna the
part was cleaned with cloth dipped in warm water.
Paśchāt karma:
Affected part should be cleaned with the cloth.
ASSESSMENT OF RESULT
Subjective parameter:
Parameter Before treatment After treatment
Neck pain 2 0
Neck stiffness 2 0
Tingling sensation 1 0
Headache Present Absent
Objective parameter:
Parameter Before
Treatment
After
Treatment
Tenderness 2 0
Mobility of
cervical
spine
Flexion 2 0
extension 2 0
Rt.lateral
rotation 2 1
Lt.lateral
rotation 2 1
T
Jadhav et.al : Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in Manyāsthambha w.s.r to Cervical Spondylosis - A Case study
AAMJ / Vol. 2 / Issue 6 / November – December 2016 1066
DISCUSSION
Manyāsthambha is described in all the samhitas. Vari-
ous āhāraja and vihāraja, mānsika and other
vātaprakopa nidāna are mentioned in samhitas which
causes vātavyādhi. Common line of treatment
vātavyādhi is snehana and svedana. Acharya
Bhavaprakasha mentioned in bhavaprakasa.
Kukkutānḍa with its contents is heated with saindhava &
ājya(ghrita) & applied to the grīva pradeśa and the
mardana is done to pacify manya stambha. Kukkutānḍa
has snigdha guṇa, kaphahara and vātahara properties
helps in reliving the pain and provides nourishment,
lavaṇa due to its sūkśma and tīkśna properties, it helps
to pass the drug molecules in systemic circulation.
Ghrita is having madhura guṇa and vāta kapha hara
property mainly acts on rūkśata and helps in the provid-
ing nourishment. Along with this nirgunḍi patra pinḍa
svedana was given which is snigdha sveda. Nirgunḍi
has vedanāsthāpana, śothahara properties. Local hy-
perthermia produced during svedana procedure has
very vital physiological and therapeutic effect and
proved very much effective in joint degenerative condi-
tions. It improves local blood and lymphatic circulation
and thereby improving local tissue metabolism. Hyper-
thermia relaxes local musculature by physical effect of
heat and thereby reduces stiffness and spasm of para-
vertebral muscles and reduces stiffness of neck muscles
reduces pain and helps in the restricted neck move-
ments. Because of this pressure gradient on cervical
spine get reduced. Thermal and pain signals are locat-
ed in skin parallel to each other. Among these two sen-
sations the stronger one is received, which is thermal
sensation and pain sensation ceases.
CONCLUSION
The result was assessed on the basis of symptomatic
improvement using VAS. Improvement was observed in
most of the symptoms due to reduction in inflammation
and spasm provided by nirgunḍi patra pinḍa sveda and
Kukkutānḍa mardana. Degenerative joint changes be-
ing progressive and irreversible treatment, is aimed at
the relief of the symptoms and to check the disease pro-
cess and to induce regeneration if possible.
^^^^
Gradings:
Neck pain
No neck pain 0
Mild neck pain 1
Moderate neck pain 2
Severe neck pain 3
Neck stiffness
No neck stiffness 0
Mild neck stiffness 1
Moderate neck stiffness 2
Severe neck stiffness 3
Radiation of pain
No Radiation 0
Radiation to one arm occasionally 1
Radiation to one arm continuously 2
Radiation to both arm occasionally 3
Radiation to both arm continuously 4
Painful neck movements
No painful neck movements 0
Mild painful neck movements 1
Moderate painful neck movements 2
Severe painful neck movements 3
Weakness of upper limb
No Weakness of upper limb 0
Mild Weakness of upper limb 1
Moderate Weakness of upper limb 2
Severe Weakness of upper limb 3
Giddiness
No Giddiness 0
Mild Giddiness 1
Moderate Giddiness 2
Severe Giddiness 3
Right lateral rotation
Normal i.e. able to make complete right lateral rotation 0
Rotation with mild difficulty 1
Rotation with moderate difficulty 2
No rotation 3
Left lateral rotation
No Restriction I.E. Able To Touch The Interclavicular Line 0
Up To 2 Cms Difference Between The Chin And Inter-
clavicular Line 1
2.1 – 4 Cms Difference Between The Chin And Interclavi-
cular Line 2
More Than 4 Cms Difference Between The Chin And In-
terclavicular Line 3
Normal i.e. able to make complete left lateral rotation 0
Rotation with mild difficulty 1
Rotation with moderate difficulty 2
No rotation 3
Extension
No Restriction I.E. Patient Is Able To Look Up To The Ceil-
ing 0
Up To 4 Cms Difference Between The Chin And Inter-
clavicular Line 1
3.9 – 2 Cms Difference Between The Chin And Interclavi-
cular Line 2
< 2 Cms Difference Between The Chin And Interclavicular
Line 3
Jadhav et.al : Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in Manyāsthambha w.s.r to Cervical Spondylosis - A Case study
AAMJ / Vol. 2 / Issue 6 / November – December 2016 1067
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Source of Support: Nil.
Conflict of Interest: None declared
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How to cite this article: Jadhav et.al : Role of Nirgunḍi
Patra Pinḍa Sveda and Kukkutānḍa Mardana in
Manyāsthambha w.s.r to Cervical Spondylosis - A Case
Study AAMJ 2016; 6:1064 – 1067