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{{#seo:
{{#seo:
|title=Yonivyapat Chikitsa
|title=Yonivyapat Chikitsa
|type=article
|type=article
}}
}}
<big>'''[[Chikitsa Sthana]] Chapter 30. Management of disorders of genital tract </big>'''
<big>'''[[Chikitsa Sthana]] Chapter 30. Management of disorders of genital tract </big>'''
{{Infobox
{{Infobox
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|label6 = Translator and commentator
|data6 = Suman S. Wanjarkhedkar P., Sabnis M., Gujarathi J.,Deole Y. S.
|data6 = Suman S. Wanjarkhedkar P., Sabnis M., Gujarathi J., [[Yogesh Deole|Deole Y. S.]]
|label7 = Reviewer
|label7 = Reviewer
|data7 = Roy A.,Gujarathi J.
|data7 = Roy A., Gujarathi J.
|label8 = Editors
|label8 = Editors
|data8 = Gujarathi J., Deole Y.S., Basisht G.
|data8 = Gujarathi J., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
|label9 = Year of publication
|label9 = Year of publication
|data9 = 2020
|data9 = 2020
}}
}}
<big>''' Abstract </big>'''
<big>''' Abstract </big>'''
<div style="text-align:justify;">
<p style='text-align:justify;'>[[Yonivyapat Chikitsa]] mainly deals with the management of disorders of male and female genital tract and reproductive system. It also includes the abnormalities of breast milk and its impact on baby and some guidelines for the management of diseases in children. The last part comprises of some important general principles in clinical management of diseases like factors influencing disease process, time of administration of medicine and route of administration.
[[Yonivyapat Chikitsa]] mainly deals with the management of disorders of male and female genital tract and reproductive system. It also includes the abnormalities of breast milk and its impact on baby and some guidelines for the management of diseases in children. The last part comprises of some important general principles in clinical management of diseases like factors influencing disease process, time of administration of medicine and route of administration.
<br/>
The disorders of the female genital tract are described under twenty ''yonivyapat'' (''yoni''(vagina),''vyapat''(disorders)) based upon the vitiation of [[dosha]] and dushyas. ''Rakta yoni'' (per vaginal bleeding) and ''pradara'' (menorrhagia) are described separately considering its importance in gynecology practice. The local and generalized management of these disorders with [[Panchakarma]], [[basti]] and ''uttara basti'' procedures, vaginal douches are enlisted.
The disorders of the female genital tract are described under twenty ''yonivyapat'' (''yoni''(vagina),''vyapat''(disorders)) based upon the vitiation of [[dosha]] and dushyas. ''Rakta yoni'' (per vaginal bleeding) and ''pradara'' (menorrhagia) are described separately considering its importance in gynecology practice. The local and generalized management of these disorders with [[Panchakarma]], [[basti]] and ''uttara basti'' procedures, vaginal douches are enlisted.
<br/>
Various disorders of the male genital tract, causes of impotency, defects of semen and their management are elaborated further. The chapter is comprehensive manual of management of disorders of male and female genital tract as well as guidelines for pediatric practice.
Various disorders of the male genital tract, causes of impotency, defects of semen and their management are elaborated further. The chapter is comprehensive manual of management of disorders of male and female genital tract as well as guidelines for pediatric practice.
<br/>
'''Keywords''': ''Yonivyapat'' (disorders of female genital tract), ''shukra'' (semen and sperm), [[artava]] (menstruation), ''klaibya'' (impotency), disorders of male genital tract, ''stanya'' (breast milk), ''pradara'' (menorrhagia), dysmenorrhoea, pediatrics,circadian rhythm, ''aushadha sevana kala'', chrnonopharmacolgy.
'''Keywords''': ''Yonivyapat'' (disorders of female genital tract), ''shukra'' (semen and sperm), [[artava]] (menstruation), ''klaibya'' (impotency), disorders of male genital tract, ''stanya'' (breast milk), ''pradara'' (menorrhagia), dysmenorrhoea, pediatrics,circadian rhythm, ''aushadha sevana kala'', chrnonopharmacolgy.
</div>
</p>
== Introduction ==
== Introduction ==
<div style="text-align:justify;">
<div style="text-align:justify;">
*The faulty lifestyle habits, vitiated menstrual blood, defects in ''beeja'' (ovum, causing hereditary or congenital defects) and the destiny are four causative factors for diseases of female genital tract.
*The faulty lifestyle habits, vitiated menstrual blood, defects in ''beeja'' (ovum, causing hereditary or congenital defects) and the destiny are four causative factors for diseases of female genital tract.
*In addition to above, manifestation of ''yonivyapat'' (diseases of female genital tract) depends upon the vitiation of ''doshas'' due to their own causative factors.
*In addition to above, manifestation of ''yonivyapat'' (diseases of female genital tract) depends upon the vitiation of [[dosha]] due to their own causative factors.
*The manifestation of diseases of female genital tract can occur in two ways viz. structural abnormalities and functional abnormalities. This leads to defects in menstruation, difficulty in sexual intercourse, inability to conceive i.e. infertility or abortion.
*The manifestation of diseases of female genital tract can occur in two ways viz. structural abnormalities and functional abnormalities. This leads to defects in menstruation, difficulty in sexual intercourse, inability to conceive i.e. infertility or abortion.
*The diseases of female genital tract are influenced by various physiological factors like age, maturity, menstruation, sexual intercourse, pregnancy, labor, menopause and suppression of natural urges.
*The diseases of female genital tract are influenced by various physiological factors like age, maturity, menstruation, sexual intercourse, pregnancy, labor, menopause and suppression of natural urges.
*''Vata'' plays important role in all conditions of ''yonivyapat'', because the genital tract is inherent seat of ''vata dosha''.
*[[Vata]] plays important role in all conditions of ''yonivyapat'', because the genital tract is inherent seat of [[vata dosha]].
*The genetic defects in female genital tract are mainly caused by improper diet and lifestyle of mother during pregnancy and vitiation of ''vata dosha''.
*The genetic defects in female genital tract are mainly caused by improper diet and lifestyle of mother during pregnancy and vitiation of [[vata dosha]].
*Assessment of dominance of ''dosha'' must be done before starting treatment of ''yonivyapat'', because the treatment and procedures are highly specific to vitiation of ''dosha''.
*Assessment of dominance of [[dosha]] must be done before starting treatment of ''yonivyapat'', because the treatment and procedures are highly specific to vitiation of [[dosha]].
*The treatment is based upon assessment of dominance of ''dosha'', its purification, general pacification and local procedures with ''dosha'' alleviating medicines.
*The treatment is based upon assessment of dominance of [[dosha]], its purification, general pacification and local procedures with [[dosha]] alleviating medicines.
*The purification procedures advocated in females shall always be mild in nature. Strong purification is contra-indicated in females.
*The purification procedures advocated in females shall always be mild in nature. Strong purification is contra-indicated in females.
*The local examination of female genital tract, vaginal discharge, vaginal structure (unctuousness or dryness, stiffness or flaccidity, displacement) shall always be done before designing treatment protocol.
*The local examination of female genital tract, vaginal discharge, vaginal structure (unctuousness or dryness, stiffness or flaccidity, displacement) shall always be done before designing treatment protocol.
*In ''rakta yoni'' (bleeding through the vagina), the color of bleeding should be observed for the association of ''doshas'' and hemostatic drugs should be used according to the involvement of ''doshas''. (86)
*In ''rakta yoni'' (bleeding through the vagina), the color of bleeding should be observed for the association of [[dosha]] and hemostatic drugs should be used according to the involvement of [[dosha]]. (86)
*When the genital tract is purified and the seeds (sperm and ovum) are normal (in their own form), undamaged, then the ''jeevatama'' or consciousness wants to come into the fetus (''garbha'') then women conceive. (125)
*When the genital tract is purified and the seeds (sperm and ovum) are normal (in their own form), undamaged, then the ''jeevatama'' or consciousness wants to come into the fetus ([[garbha]]) then women conceive. (125)
*In males, the ''shukra'' (semen) gets ejaculated as a result of excitement and is the sign of masculinity. The seed as an effect of delighted coitus, has been described as ''shukra'' (semen), is the male characteristic. As the seed has capacity of reproduction in favorable conditions, the ''shukra'' possess capacity of reproduction.
*In males, the [[shukra]] (semen) gets ejaculated as a result of excitement and is the sign of masculinity. The seed as an effect of delighted coitus, has been described as [[shukra]] (semen), is the male characteristic. As the seed has capacity of reproduction in favorable conditions, the [[shukra]] possess capacity of reproduction.
*Improper diet, improper lifestyle, psychological factors and improper sexual habits impair quality and quantity of ''shukra dhatu''.
*Improper diet, improper lifestyle, psychological factors and improper sexual habits impair quality and quantity of [[shukra dhatu]].
*''Fenilam'' (frothy), ''tanu'' (slender), ''ruksham'' (arid), ''vivarnam'' (discolored), ''pooti'' (putrid), ''pichhilam'' (slimy), afflicted with other ''dhatus'', & precipitant are the eight ''shukra'' disorders affected by vitiated ''dosha''.
*''Fenilam'' (frothy), ''tanu'' (slender), ''ruksham'' (arid), ''vivarnam'' (discolored), ''pooti'' (putrid), ''pichhilam'' (slimy), afflicted with other [[dhatu]], & precipitant are the eight [[shukra]] disorders affected by vitiated [[dosha]].
*''Retah'' (virile semen) that is ''snigdha'' (unctuousness), ''ghana'' (viscous), ''picchila'' (slimy), ''madhura'' (sweet), ''avidahi'' (non-blazing), looking like white crystal quartz; are characteristics of normal (semen).
*''Retah'' (virile semen) that is ''snigdha'' (unctuousness), ''ghana'' (viscous), ''picchila'' (slimy), ''madhura'' (sweet), ''avidahi'' (non-blazing), looking like white crystal quartz; are characteristics of normal (semen).
*In case of diseases of semen, treatment principles with use of formulations mentioned in ''vajikarana'' (aphrodisiac), ''raktapitta'' and ''yonivyapat'' are applied.
*In case of diseases of semen, treatment principles with use of formulations mentioned in ''vajikarana'' (aphrodisiac), ''raktapitta'' and ''yonivyapat'' are applied.
*Impotency is caused by the ''beeja-upaghata'' (hereditary/congenital defect), ''dhwajopaghata'' (erectile dysfunction), ''jaraya'' (senility), ''shukrasamkshaya'' (diminished semen).
*Impotency is caused by the ''beeja-upaghata'' (hereditary/congenital defect), ''dhwajopaghata'' (erectile dysfunction), ''jaraya'' (senility), ''shukrasamkshaya'' (diminished semen).
*The treatment mentioned for the ''shukra'' (semen) disorders as well as ''kshataksheena'' shall be applied for alleviation of impotency. Indications are ''basti, ksheera-sarpi'' (combination of milk and ghee), ''vrishya yoga''(aphrodisiac), & ''rasayana prayoga'' (rejuvenating medicines); all together shall be administered for the treatment of impotency, caused by excess coitus, ''dhatu viparyaya'', considering ''deha-bala'' (strength of the patient), ''dosha–bala'' (degree of ''dosha'' vitiation), ''agni-bala'' (power of ''agni'') & ''bheshaja-kala'' (time of medicine administration).
*The treatment mentioned for the [[shukra]] (semen) disorders as well as ''kshataksheena'' shall be applied for alleviation of impotency. Indications are [[basti]], ksheera-sarpi'' (combination of milk and ghee), ''vrishya yoga''(aphrodisiac), & ''rasayana prayoga'' (rejuvenating medicines); all together shall be administered for the treatment of impotency, caused by excess coitus, [[dhatu]] viparyaya, considering ''deha-bala'' (strength of the patient), [[dosha]]–bala (degree of [[dosha]] vitiation), [[agni]]-bala (power of [[agni]]) & ''bheshaja-kala'' (time of medicine administration).
*The vitiated ''dosha'' affect menstrual blood and increase quantity and duration of menstruation leading to ''pradara''. The clinical manifestations of ''pradara'' depend upon ''dosha'' dominance involved in pathogenesis.
*The vitiated [[dosha]] affect menstrual blood and increase quantity and duration of menstruation leading to ''pradara''. The clinical manifestations of ''pradara'' depend upon [[dosha]] dominance involved in pathogenesis.
*If menstrual discharge (''artava'') comes after a month without stickiness (sliminess), burning sensation and pain, persists for five days, neither too little nor excess in quantity then it is considered as free from ''doshas'' or normal. In color, ''artava'' (menstrual blood) should be red like ''gunja'' fruit, red lotus flower or ''mahavara'' or red as ''indragopaka'' insect, such ''artava'' is considered as normal menstrual blood. (225-226)
*If menstrual discharge ([[artava]]) comes after a month without stickiness (sliminess), burning sensation and pain, persists for five days, neither too little nor excess in quantity then it is considered as free from [[dosha]] or normal. In color, [[artava]] (menstrual blood) should be red like ''gunja'' fruit, red lotus flower or ''mahavara'' or red as ''indragopaka'' insect, such [[artava]] is considered as normal menstrual blood. (225-226)
*The treatment of ''pradara'' is as per principles of management for ''raktatisara'' (diarrhea with expulsion of blood), ''raktapitta'' (internal hemorrhage) and ''raktarsha'' (bleeding piles).
*The treatment of ''pradara'' is as per principles of management for ''raktatisara'' (diarrhea with expulsion of blood), ''raktapitta'' (internal hemorrhage) and ''raktarsha'' (bleeding piles).
*The breast milk can be affected by vitiated ''dosha'' due to improper diet and lifestyle of mother or wet nurse. The clinical manifestation is observed in change in color and consistency of breast milk, signs on the breast milk fed baby and mother too. The treatment of mother or wet nurse is done in order to treat the defects.
*The breast milk can be affected by vitiated [[dosha]] due to improper diet and lifestyle of mother or wet nurse. The clinical manifestation is observed in change in color and consistency of breast milk, signs on the breast milk fed baby and mother too. The treatment of mother or wet nurse is done in order to treat the defects.
*The vitiation of ''dosha'', body elements, ''mala'' and the diseases which affect adults also affect children similarly, but to lesser degree.
*The vitiation of [[dosha]], body elements, [[mala]] and the diseases which affect adults also affect children similarly, but to lesser degree.
*The pediatrician should not administer emesis like purification procedures in children due to tender nature, dependency, inability to fully express themselves in speech and gestures. He should give only small doses of medicines as per the disease. Sweet decoction, medicated milk and medicines with mild potency shall be administered in children by wise pediatrician. The medicines, food and beverages with excess unctuousness, dryness, hot potency, sour, pungent in post digestive effect, and heavy to digest property are contraindicated in children. (282-286)
*The pediatrician should not administer emesis like purification procedures in children due to tender nature, dependency, inability to fully express themselves in speech and gestures. He should give only small doses of medicines as per the disease. Sweet decoction, medicated milk and medicines with mild potency shall be administered in children by wise pediatrician. The medicines, food and beverages with excess unctuousness, dryness, hot potency, sour, pungent in post digestive effect, and heavy to digest property are contraindicated in children. (282-286)
*The new diseases which are not described in this text due to their various names and clinical presentations shall also be treated according to the dominance of ''dosha'', etc.factors(as mentioned earlier). (291)
*The new diseases which are not described in this text due to their various names and clinical presentations shall also be treated according to the dominance of [[dosha]], etc.factors(as mentioned earlier). (291)
*The treatment that is opposite to ''dosha, dushya'' and ''nidana'' (causative factors) is always beneficial.
*The treatment that is opposite to [[dosha]], dushya and nidana (causative factors) is always beneficial.
*The medicines shall be prescribed after due consideration of ''desha'' (habitat), ''kala'' (season), ''pramana'' (dosage), ''satmya'' (adaptability) and ''asatmya'' (non-adaptability). If this is properly considered, then it is ''pathya'' (beneficial to body systems). Otherwise it is non-beneficial. (293)
*The medicines shall be prescribed after due consideration of ''desha'' (habitat), ''kala'' (season), ''pramana'' (dosage), [[satmya]] (adaptability) and ''asatmya'' (non-adaptability). If this is properly considered, then it is ''pathya'' (beneficial to body systems). Otherwise it is non-beneficial. (293)
*The medicines shall always be administered through nearest route to the site of affliction. If the ''doshas'' are located in stomach, then medicines shall be administered orally; if at head region, then through nose; and if at colon then medicines quickly act if given per rectum. The ''doshas'' at other body parts and diseases originated from them like ''visarpa, pidaka'' etc, shall be treated with ''pradeha'' etc. specific local pacification procedures. (294-295)
*The medicines shall always be administered through nearest route to the site of affliction. If the [[dosha]] are located in stomach, then medicines shall be administered orally; if at head region, then through nose; and if at colon then medicines quickly act if given per rectum. The [[dosha]] at other body parts and diseases originated from them like ''visarpa, pidaka'' etc, shall be treated with ''pradeha'' etc. specific local pacification procedures. (294-295)
*Medicines must be administered taking into consideration day (time), the diseased person, type of medicine, disease, digestive status, and season. The time of administration of medicine depends on the day like emetics should be given early in the morning.(296)
*Medicines must be administered taking into consideration day (time), the diseased person, type of medicine, disease, digestive status, and season. The time of administration of medicine depends on the day like emetics should be given early in the morning.(296)
*The time of administration of drug depends upon circadian rhythm of ''dosha'', status of digestion, interaction with food and type of ''vata'' vitiated in body.
*The time of administration of drug depends upon circadian rhythm of [[dosha]], status of digestion, interaction with food and type of [[vata]] vitiated in body.
*In vitiation of ''apana vayu'' medicines must be consumed before food , in vitiation of ''samana vayu'' food must be consumed in between meals, in ''vyana vayu'' vitiation, early morning medication is advised and in ''udana vayu'' vitiation medicine is advised after meals. When ''prana vayu'' is vitiated medicines is to be advocated along with each morsel and in between two morsel. In diseases like ''shwasa, kasa, pipasa'' (thirst) frequent doses of medicines must be given.
*In vitiation of apana [[vayu]] medicines must be consumed before food , in vitiation of samana [[vayu]] food must be consumed in between meals, in vyana [[vayu]] vitiation, early morning medication is advised and in udana [[vayu]] vitiation medicine is advised after meals. When prana [[vayu]] is vitiated medicines is to be advocated along with each morsel and in between two morsel. In diseases like ''shwasa, kasa, pipasa'' (thirst) frequent doses of medicines must be given.
*Good appetite, natural passage of urges like stools and urine, lightness in the body and unobstructed ''vata dosha'' are the symptoms of ''jeerna'' (complete digestion).
*Good appetite, natural passage of urges like stools and urine, lightness in the body and unobstructed [[vata dosha]] are the symptoms of ''jeerna'' (complete digestion).
*Generally ''kaphaja'' disorders are manifested in ''vasanta ritu; pittaja'' disorders appear during ''sharada ritu'' and ''vataja'' disorders manifest during ''varsha ritu''. (308-309)
*Generally [[kapha]]ja disorders are manifested in ''vasanta ritu; pittaja'' disorders appear during ''sharada ritu'' and [[vata]]ja disorders manifest during ''varsha ritu''. (308-309)
*End of night, end of day, end of rainy season time is prone for ''vataja'' disorders. Beginning of day, morning and evening times is susceptible for ''kaphaja'' disorders and middle time of day is prone for ''pittaja'' disorders.(310)
*End of night, end of day, end of rainy season time is prone for [[vata]]ja disorders. Beginning of day, morning and evening times is susceptible for [[kapha]]ja disorders and middle time of day is prone for [[pitta]]ja disorders.(310)
*In ''prathama vaya'' (childhood), there is predominance of ''kapha''; in ''madhya vaya'' (youth and adulthood), there is predominance of ''pitta'' and in ''anta vaya'' (old age), there is predominance of ''vata dosha''. These ''doshas'' have a natural predominance as per the age of the person.(311)
*In prathama vaya(childhood), there is predominance of [[kapha]]; in ''madhya vaya'' (youth and adulthood), there is predominance of [[pitta]] and in ''anta vaya'' (old age), there is predominance of [[vata dosha]]. These [[dosha]] have a natural predominance as per the age of the person.(311)
*Taking into consideration the time of digestion of food, when it gets completely digested, that is at the end of food digestion ''vata dosha'' disorders occur; in middle of digestion ''pitta dosha'' disorders manifest and immediately when food is under process of digestion ''kapha dosha'' dominant disorder may appear.(312)
*Taking into consideration the time of digestion of food, when it gets completely digested, that is at the end of food digestion [[vata dosha]] disorders occur; in middle of digestion [[pitta dosha]] disorders manifest and immediately when food is under process of digestion [[kapha dosha]] dominant disorder may appear.(312)
*The treatment shall always consider adaptability of an individual to food, lifestyle and medicines as per ''desha''(habitat).
*The treatment shall always consider adaptability of an individual to food, lifestyle and medicines as per ''desha''(habitat).
*The disease can relapse even after exposure to small amount of causative factors in an individual with weak strength. Hence for the better results of the medicines given before to treat the disease, ''pathya'' (wholesome diet) must be followed after the disease is completely treated.
*The disease can relapse even after exposure to small amount of causative factors in an individual with weak strength. Hence for the better results of the medicines given before to treat the disease, ''pathya'' (wholesome diet) must be followed after the disease is completely treated.
The four common factors responsible for ''yonivyapat'' are mentioned as :
The four common factors responsible for ''yonivyapat'' are mentioned as :
#''Mithyaachara'' – Faulty diet habits and unhygienic conditions with faulty sexual practices are responsible for vitiation of ''dosha'' leading to female reproductive system disorders.
#''Mithyaachara'' – Faulty diet habits and unhygienic conditions with faulty sexual practices are responsible for vitiation of [[dosha]] leading to female reproductive system disorders.
#''Pradushta artava'' – Menstruation is mirror of reproductive health. Any abnormality in menstrual cycle indicates pathology in the female reproductive system. Hence ''pradushta artava'' indicates any hormonal / organic pathology leading to menstrual abnormality.
# Pradushta [[artava]] – Menstruation is mirror of reproductive health. Any abnormality in menstrual cycle indicates pathology in the female reproductive system. Hence ''pradushta [[artava]] indicates any hormonal / organic pathology leading to menstrual abnormality.
#''Beeja dosha'' – Congenital anomalies occurs because of sperm or ovum defect. Here the word ''beeja'' refers to both male and female gametes.
#''Beeja dosha'' – Congenital anomalies occurs because of sperm or ovum defect. Here the word ''beeja'' refers to both male and female gametes.
#''Daiva'' – The deeds of the past are also held responsible for certain conditions related with the reproductive system. The unexplained factors of certain diseases can be considered as result of ''poorva janma karma'' (deeds of past life). [8]
#''Daiva'' – The deeds of the past are also held responsible for certain conditions related with the reproductive system. The unexplained factors of certain diseases can be considered as result of ''poorva janma karma'' (deeds of past life). [8]
==== ''Doshaja yonivyapat'' ====
==== [[Dosha]]ja yonivyapat ====
{| class="wikitable"
{| class="wikitable"
|-
|-
! scope="col"| ''Dosha''
! scope="col"| [[Dosha]]
! scope="col"| Clinical Correlation
! scope="col"| Clinical Correlation
|-
|-
| rowspan="2"|''Vataja''
| rowspan="2"|[[Vata]]ja
| Dysmenorrhea
| Dysmenorrhea
|-
|-
| Endometriosis
| Endometriosis
|-
|-
| rowspan="3"|''Pittaja''
| rowspan="3"|[[Pitta]]ja
| Trichomonas vaginalis
| Trichomonas vaginalis
|-
|-
| Pelvic inflammatory disease
| Pelvic inflammatory disease
|-
|-
| rowspan="2"| ''Kaphaja''
| rowspan="2"|[[Kapha]]ja
| Moniliasis
| Moniliasis
|-
|-
[16-37]
[16-37]
The complication of these diseases is infertility due to coital, vaginal, uterine and other factors. Along with the ''doshas'' which are aggravated and responsible for causing certain ailment of reproductive system also causes ailments of nearby systems like urinary, intestinal and rectum. [38-39]
The complication of these diseases is infertility due to coital, vaginal, uterine and other factors. Along with the [[dosha]] which are aggravated and responsible for causing certain ailment of reproductive system also causes ailments of nearby systems like urinary, intestinal and rectum. [38-39]
==== Principles of treatment of ''yonivyapat'' ====
==== Principles of treatment of ''yonivyapat'' ====
The general line of treatment should be targeted towards the ''dosha'', hence ''vataja, pittaja, kaphaja yonivypat'' should be treated accordingly with ''snehana swedana, raktapittahara sheeta, ruksha ushna'' therapies respectively. In all types of gynecological disorders, [[Panchakarma]] should be administered in mild form in order to eliminate the vitiated ''doshas'' and restoring normal reproductive health. Principles of surgical corrections of congenital anomalies and displaced organs are also given stating that the uterus which has been displaced from its original place should be regarded as ''shalya'' and the treatment of ''shalya'' is its removal. Hence this is the indication of hysterectomy in complete genital prolapse. The method of such procedure is not given in any classics. [41-46]
The general line of treatment should be targeted towards the [[dosha]], hence [[vata]]ja, [[pitta]]ja, [[kapha]]ja yonivypat should be treated accordingly with [[snehana]] [[swedana]], raktapittahara sheeta, ruksha ushna therapies respectively. In all types of gynecological disorders, [[Panchakarma]] should be administered in mild form in order to eliminate the vitiated [[dosha]] and restoring normal reproductive health. Principles of surgical corrections of congenital anomalies and displaced organs are also given stating that the uterus which has been displaced from its original place should be regarded as ''shalya'' and the treatment of ''shalya'' is its removal. Hence this is the indication of hysterectomy in complete genital prolapse. The method of such procedure is not given in any classics. [41-46]
Local treatments like douching, fomentation, keeping oil tampon, vaginal suppositories, fumigation. Indications and method of preparation of such medicines in form of oil, ghee, suppository and others are described later. Other preparations are in the form of ''churna, vati, kwath'', oil, ghee are to be used orally or in the form of ''basti'' (medicated enema) or ''uttarabasti'' (administration of medicine in uterus through vaginal route) are given in detail. [47-114]
Local treatments like douching, fomentation, keeping oil tampon, vaginal suppositories, fumigation. Indications and method of preparation of such medicines in form of oil, ghee, suppository and others are described later. Other preparations are in the form of ''churna, vati, kwath'', oil, ghee are to be used orally or in the form of [[basti]](medicated enema) or ''uttarabasti'' (administration of medicine in uterus through vaginal route) are given in detail. [47-114]
The importance of ''vata dosha'' in causing female reproductive tract disorders is highlighted as the location of genital organs is also the seat of ''apana vayu'' and all the functions like menstruation, pregnancy, labor are governed by ''apana vayu''. Hence considering the crucial role of ''vata'', the treatment should be aimed at ''vata'' alleviation along with other therapies.[114-116]
The importance of [[vata dosha]] in causing female reproductive tract disorders is highlighted as the location of genital organs is also the seat of apana [[vayu]] and all the functions like menstruation, pregnancy, labor are governed by apana [[vayu]]. Hence considering the crucial role of [[vata]], the treatment should be aimed at [[vata]] alleviation along with other therapies.[114-116]
The soul resides when the genital organs are cleansed with all therapies and the male and female gamete are favorable for conception and best. [126]
The soul resides when the genital organs are cleansed with all therapies and the male and female gamete are favorable for conception and best. [126]
==== Male genital tract and its disorders ====
==== Male genital tract and its disorders ====
By ''retovaha srotas'' the pathway through which the semen flows out shall be considered; which can be correlated to the seminal vesicles and ejaculatory duct. ''Retovaha srotas'' has been discussed separately to make it understand that is is different than ''shukravaha srotas''. As mentioned earlier ''shukravaha srotas'' comprises of ''medhra'' (the penis) and ''vrishana'' (the scrotum), which is referred for stationary semen; while ''retas'' is the word for virile semen, that is flowing semen. Therefore the words ''shukra'' and ''retas'' have been used separately in different context as per the suitability and the intention of description. [133-139]
By ''retovaha srotas'' the pathway through which the semen flows out shall be considered; which can be correlated to the seminal vesicles and ejaculatory duct. ''Retovaha srotas'' has been discussed separately to make it understand that is is different than ''shukravaha srotas''. As mentioned earlier ''shukravaha srotas'' comprises of ''medhra'' (the penis) and ''vrishana'' (the scrotum), which is referred for stationary semen; while ''retas'' is the word for virile semen, that is flowing semen. Therefore the words [[shukra]] and ''retas'' have been used separately in different context as per the suitability and the intention of description. [133-139]
===== Abnormal semen =====
===== Abnormal semen =====
====== The characteristics of abnormal semen ======
====== The characteristics of abnormal semen ======
The ''shukra dushti'' has been mentioned as of eight types by Sushruta, although the nomenclature is different.
The [[shukra]] dushti has been mentioned as of eight types by Sushruta, although the nomenclature is different.
'''Table : 1 Classification of ''shukra dushti'' according to Sushruta<ref>Sushruta. Sharira Sthana, Cha.2 Shukrashonitashuddhi Sharira Adhyaya verse 2-3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref> and ''Ashtanga Sangraha'''''
'''Table : 1 Classification of [[shukra]] dushti according to Sushruta<ref>Sushruta. Sharira Sthana, Cha.2 Shukrashonitashuddhi Sharira Adhyaya verse 2-3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref> and ''Ashtanga Sangraha'''''
{| class="wikitable"
{| class="wikitable"
! scope="col"| Clinical Conditions
! scope="col"| Clinical Conditions
|-
|-
| ''Vata dushta''
| [[Vata]] dushta
| ''Aruna, krishna varna, phenila, tanu, rooksha, alpa, vilambita vedana yukta''
| Aruna, krishna varna, phenila, tanu, rooksha, alpa, vilambita vedana yukta
| Oligospermia and azospermia, injury, chronic inflammation, low fructose, obstruction in seminal vesicle
| Oligospermia and azospermia, injury, chronic inflammation, low fructose, obstruction in seminal vesicle
|-
|-
| ''Pitta dushta''
| [[Pitta]] dushta
| ''Neela varna, ushna, putigandha, daha chosha'' type of pain during ejaculation
| Neela varna, ushna, putigandha, daha chosha type of pain during ejaculation
| Acute prostitis
| Acute prostitis
|-
|-
| ''Sleshma dushta''
| [[Kapha]] dushta
| ''Shukla varna, atipicchila, prabuta, kandu yukta, visra gandha''
| Shukla varna, atipicchila, prabuta, kandu yukta, visra gandha
| Chronic inflammatory condition, hypofunction of male sex accessory glands
| Chronic inflammatory condition, hypofunction of male sex accessory glands
|-
|-
| ''Kunapa – Shonita dushta''
| Kunapa – Shonita dushta
| Cadaver smelling, ''analpa'', associated with ''osha'' and ''chosha''
| Cadaver smelling, ''analpa'', associated with ''osha'' and ''chosha''
| Hemospermia (benign prostate hypertrophy) or acute injury to external genitals.
| Hemospermia (benign prostate hypertrophy) or acute injury to external genitals.
|-
|-
| ''Granthi–Kapha vata dushta''
| Granthi–[[Kapha]] [[vata]] dushta
| Clot formation
| Clot formation
| Prostatic dysfunction and inflammation
| Prostatic dysfunction and inflammation
|-
|-
| ''Putipuya - pitta kapha dushta''
| Putipuya - [[pitta]] [[kapha]] dushta
| Foul smelling, semen containing ''puya''
| Foul smelling, semen containing ''puya''
| Pyospermia, Chalmydia infection, STD
| Pyospermia, Chalmydia infection, STD
|-
|-
| ''Kshina – pitta vata dushta''
| Kshina – [[pitta]] [[vata]] dushta
| Hypospermia and oligospermia
| Hypospermia and oligospermia
| Decreased semen volume because of obstruction in seminal vesicle.
| Decreased semen volume because of obstruction in seminal vesicle.
|-
|-
| ''Mutrapurishagandhi - Tridosha''
| Mutrapurishagandhi - Tri[[dosha]]
| Semen with smell of urine and feces
| Semen with smell of urine and feces
| Carcinoma, recto – genital urinary tract fistula
| Carcinoma, recto – genital urinary tract fistula
===== Characteristics of normal semen =====
===== Characteristics of normal semen =====
The ''shuddha shukra'' should be white like ''sphatika'', liquid, viscous, sweet in taste, smell of honey also should look like mixture of oil and honey.
The shuddha [[shukra]] should be white like ''sphatika'', liquid, viscous, sweet in taste, smell of honey also should look like mixture of oil and honey.
Following are the criteria for normal semen according to modern science:
Following are the criteria for normal semen according to modern science:
These temporal characteristics of cardiovascular disease indicate the importance of careful timing in their assessment, monitoring, and treatment (120). [299]
These temporal characteristics of cardiovascular disease indicate the importance of careful timing in their assessment, monitoring, and treatment (120). [299]
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== References ==
== References ==