Ayurvedic Management of Puyalasa (Chronic Dacryocystitis)
Journal name: Ayushdhara
Original article title: Ayurvedic Management of Puyalasa (Chronic Dacryocystitis)
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Gagana V N
PG Schoalr, Dept. of Shalakyatantra, SJGAMC, Koppal, Karnataka
Veerayya R Hiremath
Professor and HOD, Dept. of Shalakyatantra, SJGAMC, Koppal, Karnataka.
Gururaj N
Associate Professor, Dept. of Shalakyatantra, SJGAMC, Koppal, Karnataka.
Shashikala K
Associate Professor, Dept. of Shalakyatantra, SJGAMC, Koppal, Karnataka.
Raju S N
Assistant Professor, Dept. of Shalakyatantra, SJGAMC, Koppal, Karnataka.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Ayurvedic Management of Puyalasa (Chronic Dacryocystitis)
Year: 2023 | Doi: 10.47070/ayushdhara.v10i6.1446
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Puyalasa, classified as one of the Sandhigata Vyadhi by ancient Ayurvedic scholars Acharya Sushruta and Vagbhata, correlates with chronic dacryocystitis—an infection of the lacrimal sac caused by obstruction of the nasolacrimal duct. Symptoms include pus discharge, swelling, pain, and epiphora. This case study examines the Ayurvedic management of a 62-year-old female patient suffering from chronic dacryocystitis, treated through a combination of topical and internal medications over a 45-day period. The approach aimed to address the underlying Tridosha imbalance and alleviate symptoms effectively.
Jaloukavacharana: A Unique Therapeutic Approach
One of the key treatment modalities employed in this case was Jaloukavacharana, or leech therapy. This technique involves applying leeches to the affected area to remove impure blood and promote healing. The saliva of the leeches contains bioactive substances that provide anti-inflammatory and analgesic effects, aiding in the reduction of pain and swelling. In the case study, the patient underwent three sittings of Jaloukavacharana, leading to observable improvements in her symptoms, including reduced swelling and pus discharge. The method proved particularly effective for a patient within the suggested demographic, which includes women and the elderly.
Therapeutic Interventions and Herbal Treatments
In addition to Jaloukavacharana, the treatment regimen included several Ayurvedic medications such as Nimbadi Guggulu and Gandhaka Rasayana. Nimbadi Guggulu was utilized for its anti-inflammatory and wound-healing properties, and it helped reduce swelling and pain. Gandhaka Rasayana, known for its antimicrobial properties, was also administered to combat infection and facilitate healing. Complementary therapies like Triphala kwatha netra pariseka, a medicated wash, and Mardana with Jatyadi taila, promoted localized relief and improved the absorption of the herbal treatments. The multi-faceted treatment protocol showed significant results in alleviating the patient’s condition, showcasing the efficacy of traditional Ayurvedic practices.
Conclusion
The successful management of Puyalasa (chronic dacryocystitis) in this case study illustrates the potential of Ayurvedic treatments in providing relief from chronic conditions. The combination of Jaloukavacharana and herbal medications tailored to address the specific dosha imbalances resulted in significant clinical improvement, successfully alleviating symptoms and reducing the rate of recurrence. As evidenced by the lack of adverse reactions and continued symptom relief, this comprehensive Ayurvedic approach offers a valuable alternative to conventional methods, emphasizing the importance of integrated care in managing chronic ailments.
FAQ section (important questions/answers):
What is Puyalasa and how is it related to chronic dacryocystitis?
Puyalasa refers to chronic dacryocystitis, characterized by pus discharge, inflammation, and pain in the lacrimal sac area. It is classified as a Tridoshaja Sadhya vyadhi, indicating it arises from an imbalance of the three doshas in Ayurveda.
What treatment was used for the 62-year-old patient?
The patient underwent Jaloukavacharana (leech therapy) combined with the internal administration of Gandhaka Rasayana and Nimbadi Guggulu. Additionally, Triphala kwatha netra pariseka was performed to manage symptoms of inflammation, pain, and pus discharge effectively.
What were the observed results after treatment for Puyalasa?
Post-treatment, significant improvement was noted, with reduced swelling, pain, and pus discharge from the lacrimal sac. Complete relief from symptoms was achieved after one month, with no recurrences or adverse effects reported during follow-up.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Ayurvedic Management of Puyalasa (Chronic Dacryocystitis)�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Swelling:
Swelling is a symptom associated with chronic dacryocystitis or Puyalasa. In the study, the patient exhibited swelling over the lacrimal sac area, which was treated as part of the Ayurvedic management protocol. The reduction of swelling was a significant marker of improvement during the treatment process.
2) Pain:
Pain, also termed as Vedana in Ayurvedic texts, is one of the primary symptoms of Puyalasa. The patient in the case study experienced pain in the lacrimal sac area. The treatment aimed at relieving this pain using therapies like Jaloukavacharana and internal medications including Gandhaka rasayana and Nimbadi guggulu.
3) Blood:
Blood, specifically vitiated blood, is targeted by Jaloukavacharana (leech therapy) in Ayurvedic treatment. The leeches help in bloodletting which removes toxins and vitiated Doshas, aiding in reducing inflammation and infection in the lacrimal sac area.
4) Gandhaka (Gamdhaka):
Gandhaka, or sulfur, is a key component in Gandhaka rasayana. It has antimicrobial properties and helps in wound healing. In the study, the patient was administered Gandhaka rasayana to manage the chronic infection and aid in the healing process of Puyalasa.
5) Inflammation:
Inflammation, referred to as Shopha in Ayurveda, is a common symptom in Puyalasa. The case study treated the inflammation of the lacrimal sac with various Ayurvedic methods including Jaloukavacharana and the application of anti-inflammatory properties of herbs.
6) Rasayana (Rasa-ayana):
Rasayana refers to rejuvenating therapies in Ayurveda, aimed at enhancing vitality and health. Gandhaka rasayana was used in the study for its antimicrobial, antibacterial, and wound-healing properties, providing significant relief from chronic dacryocystitis symptoms.
7) Parisheka (Pariseka):
Parisheka, a form of local irrigation therapy, was used with Triphala Kwatha in the study. This therapy helped in reducing local symptoms like inflammation and pain by enhancing the absorption of medicinal properties through the skin.
8) Guggulu:
Guggulu is a class of resin used in Ayurvedic medicine for its anti-inflammatory and analgesic properties. Nimbadi guggulu was administered internally to the patient in the case study to reduce inflammation and manage symptoms of chronic dacryocystitis.
9) Haridra:
Haridra, also known as turmeric, is used in Ayurvedic practice for its anti-inflammatory and antiseptic properties. During Jaloukavacharana, Haridra jala (turmeric water) was used to activate the leeches, ensuring they are effective in bloodletting therapy.
10) Nimbadi:
[see source text or glossary: Nimbadi]
11) Drug:
Various Ayurvedic drugs like Gandhaka rasayana, Nimbadi guggulu, and Jatyadi taila were used in the treatment protocol to manage symptoms like pus discharge, inflammation, and pain in the case of chronic dacryocystitis or Puyalasa.
12) Jatyadi:
[see source text or glossary: Jatyadi]
13) Sandhi (Shandhi, Samdhi):
Sandhi, meaning joint, is a critical term in Ayurveda. Puyalasa is a disease involving Kaninika sandhi, which refers to the junction of structures surrounding the eye. The involvement of these sandhis was essential in diagnosing and managing the condition according to Ayurvedic methods.
14) Dosha (Dosa):
Dosha refers to the three fundamental bodily bio-elements (Vata, Pitta, and Kapha) in Ayurveda. Puyalasa is a Tridoshaja Sadhya Vyadhi, which means a disease caused by the vitiation of all three Doshas. Managing these Doshas was key to the treatment process in the case study.
15) Taila (Thaila):
Taila, meaning oil, is used in various medicinal formulations in Ayurveda. Jatyadi taila was applied in the treatment of the case to reduce inflammation, treat the wound, and provide analgesic and antimicrobial effects to the affected area.
16) Gagana:
[see source text or glossary: Gagana]
17) Vedana:
Vedana, meaning pain, is a significant symptom of Puyalasa. The study aimed to alleviate Vedana using Ayurvedic treatments like Jaloukavacharana and internal medications such as Gandhaka rasayana and Nimbadi guggulu, which have analgesic properties.
18) Cotton:
Cotton is used during Jaloukavacharana to safeguard other sensitive parts like eyes and nose. Wet cotton is also used to cover the leech to maintain its temperature during the bloodsucking process, ensuring effective treatment for Puyalasa.
19) Pitta:
Pitta is one of the three Doshas in Ayurveda, associated with heat and metabolism. The eye, or Chakshu, is considered the site of Pitta, specifically Bhrajakapitta in Ayurveda. Treatments aimed at balancing Pitta, like Pitta hara therapies, were employed in the case study.
20) Karma (Karman):
Karma, in Ayurveda, refers to the action or treatment steps. For instance, in Jaloukavacharana, specific steps like Purva Karma (pre-treatment), Pradhana Karma (main treatment), and Paschat Karma (post-treatment) were followed to ensure effective management of Puyalasa.
21) Netra:
Netra means eye in Sanskrit. Treatments like Triphala Kwatha Netra Pariseka (eye washing with Triphala decoction) and diagnostic techniques focused on the Netra were essential parts of the case study for managing chronic dacryocystitis or Puyalasa.
22) Vrana:
Vrana, or wound, is a symptom of Puyalasa. Patients experience a wound-like inflammation near the lacrimal sac, which was treated using Ayurvedic methods like Jatyadi taila for its wound-healing properties, contributing to the overall healing process.
23) Karnataka:
[see source text or glossary: Karnataka]
24) Substance:
[see source text or glossary: Substance]
25) Vagbhata:
Vagbhata is one of the ancient Acharyas (scholars) who contributed significantly to Ayurvedic literature. His descriptions, along with those of Acharya Sushruta, provided the framework for diagnosing and treating Puyalasa, as referenced in the case study.
26) Triphala (Tri-phala):
Triphala, a traditional Ayurvedic formulation, was used in the form of Triphala Kwatha Pariseka in the case study. It helped in local drug absorption through the eyelids, reducing inflammation, and pain, and effectively managing symptoms of chronic dacryocystitis.
27) Medicine:
Various Ayurvedic medicines including Gandhaka rasayana, Nimbadi guggulu, and Triphala kwatha were used in this case study. These medicines played pivotal roles in reducing inflammation, pus discharge, and pain, and ultimately treating Puyalasa.
28) Disease:
The disease in focus here is Puyalasa, which correlates with chronic dacryocystitis in modern medicine. It includes symptoms like pus discharge, swelling, pain, and inflammation. Ayurvedic treatments target the underlying Dosha imbalances to manage the disease effectively.
29) Vyadhin (Vyadhi):
Vyadhi means disease in Ayurveda. Puyalasa is described as a Sandhigata Vyadhi that affects the eye, causing symptoms like pus discharge, swelling, and pain. Accurate diagnosis and appropriate treatment of Vyadhi followed the principles of Ayurvedic medicine.
30) Shrava (Srava):
Srava, which means discharge, refers to the pus discharge observed in Puyalasa. The patient experienced pus discharge from the lacrimal sac area, which was treated successfully through Ayurvedic protocols including Jaloukavacharana and other internal medications.
31) Hara:
Hara in Ayurveda refers to the alleviation or reduction of symptoms. Pitta hara treatments aimed at balancing Pitta dosha were employed in this case. The efficacy of these treatments reduced symptoms like pain (Vedana) and inflammation (Shopha).
32) Jala:
Jala refers to water. In the context of this study, Haridra jala was used to activate leeches during Jaloukavacharana. Additionally, Sheeta jala (cold water) was used for Pariseka to aid in the treatment of Puyalasa.
33) Butter milk (Buttermilk):
Butter milk was mentioned as a method to induce vomiting in leeches after they have sucked the blood. This ensured that the leeches expelled the vitiated blood effectively after being used in Jaloukavacharana therapy [see source text or glossary: Butter milk].
34) Shalakyatantra (Salakyatantra, Shalakya-tantra, Shalakyatamtra):
Shalakyatantra, the branch of Ayurveda dealing with ailments above the clavicle, was central to this study. The treatment of Puyalasa, a disease affecting the eye's lacrimal apparatus, was managed through Ayurvedic techniques described by Shalakyatantra specialists.
35) Pradhana-karma:
Pradhana Karma refers to the main action or treatment procedure in Ayurveda. In Jaloukavacharana, Pradhana Karma involves the actual application of leeches to the affected area, allowing them to suck the vitiated blood to treat Puyalasa [see source text or glossary: Pradhana-karma].
36) Antibiotic (Antibacterial):
Anti-bacterial properties are crucial in the treatment of chronic dacryocystitis. Gandhaka rasayana and Jatyadi taila contain anti-bacterial ingredients which helped in clearing the infection and promoting healing in the patient's lacrimal sac area.
37) Paschat-karma:
Paschat Karma refers to post-treatment care in Ayurveda. After Jaloukavacharana, the leeches were made to vomit the vitiated blood by placing them in Haridra churna and butter milk. Paschat Karma ensures complete detoxification and wellbeing.
38) Bhrajakapitta (Bhrajaka-pitta):
[see source text or glossary: Bhrajakapitta]
39) Purvakarma (Purvakarman, Purva-karman):
Purva Karma refers to pre-treatment preparations in Ayurveda. Before Jaloukavacharana, steps like explaining the procedure, obtaining consent, and ensuring the patient is in the correct position are all part of Purva Karma to ensure an effective treatment.
40) Netraroga (Netra-roga):
Netra-roga means eye disease in Ayurveda. Puyalasa, classified under Sandhigata netra roga, involves conditions affecting the eye joints. Various Ayurvedic therapies were employed to treat symptoms and restore eye health in the study.
41) Pittahara (Pitta-hara):
Pitta-hara therapies aim to balance the Pitta dosha which governs heat and metabolism. For treating Puyalasa, Pitta hara treatments were crucial as the eye (Chakshu) is considered a site of Pitta, specifically Bhrajakapitta.
42) Tridoshaja (Tridosaja):
Tridoshaja refers to the involvement of all three Doshas (Vata, Pitta, Kapha) in a disease. Puyalasa is described as a Tridoshaja Sadhya Vyadhi, indicating that all three Doshas are imbalanced and need to be treated for effective disease management.
43) Discussion:
The discussion section of the case study elaborates on the methods and efficacy of various Ayurvedic treatments employed. It covers the impacts of therapies like Netra Pariseka, Jaloukavacharana, and internal medications such as Gandhaka rasayana and Nimbadi guggulu.
44) Detachment:
[see source text or glossary: Detachment]
45) Krimighna (Krmighna, Krimi-ghna):
[see source text or glossary: Krimighna]
46) Akshipaka (Aksipaka, Akshi-paka):
[see source text or glossary: Akshipaka]
47) Ayurveda (Ayus-veda):
Ayurveda, the ancient Indian system of medicine, forms the basis for the treatment discussed in the case study. Using a combination of Ayurvedic therapies and medications, chronic dacryocystitis or Puyalasa was effectively managed, showcasing Ayurvedic medical practices.
48) Tridosha (Tridosa, Tri-dosha):
Tridosha refers to the three bodily humors (Vata, Pitta, Kapha) in Ayurveda. Puyalasa is a Tridoshaja condition, meaning all three Doshas are involved in the pathology, necessitating a treatment approach that balances each Dosha.
49) Lakshana (Laksana):
[see source text or glossary: Lakshana]
50) Pradhana:
[see source text or glossary: Pradhana]
51) Mokshana (Moksana):
Mokshana, meaning liberation or release, refers to bloodletting treatments in Ayurveda. Shonita mokshana (bloodletting) through Jaloukavacharana was utilized to detoxify the blood, thereby aiding in the treatment of Puyalasa by removing vitiated Doshas.
52) Vomiting:
Vomiting, induced in leeches after Jaloukavacharana, ensures the leech expels the vitiated blood it has sucked. This post-treatment step is crucial for maintaining the leech's health and ensuring its effectiveness for future therapeutic use.
53) Mardana:
[see source text or glossary: Mardana]
54) Shonita (Sonita):
Shonita, meaning blood, is crucial in Ayurvedic treatments like Jaloukavacharana, where bloodletting helps remove vitiated Doshas. This method was used in the case study to treat chronic dacryocystitis or Puyalasa by allowing leeches to suck the vitiated blood.
55) Bhavana (Bha-vana):
Bhavana refers to the process of triturating medicines with specific liquids. In the case study, Gandhaka Rasayana involves Bhavana dravyas, which enhance its therapeutic properties including antibacterial and anti-inflammatory effects critical for treating Puyalasa.
56) Dusita (Dushita):
[see source text or glossary: Dushita]
57) Upanaha:
[see source text or glossary: Upanaha]
58) Tantra (Tamtra, Tantrism):
Tantra refers to the specialized branches in Ayurveda. Shalakya tantra, focused on ailments of the head and neck, was responsible for diagnosing and treating Puyalasa. It employs various Tantric techniques for holistic disease management.
59) Dravya:
Dravya, meaning substance or material, pertains to the ingredients used in Ayurvedic formulations. The case study mentioned Dravyas like Gandhaka (sulfur) and medicinal oils that played a significant role in treating chronic dacryocystitis (Puyalasa).
60) Sadhya:
Sadhya in Ayurveda means treatable. Puyalasa is a Tridoshaja Sadhya vyadhi, indicating that it is a disease caused by all three doshas but is treatable. The case study outlines an effective treatment protocol using various Ayurvedic methods.
61) Shopha (Sopha):
Shopha refers to swelling or inflammation. It is a key symptom in Puyalasa. Managing Shopha was central to the treatment protocol, using therapies such as Pariseka with Triphala Kwatha and internal medications like Gandhaka rasayana and Nimbadi guggulu.
62) Dhara:
[see source text or glossary: Dhara]
63) Rakta:
[see source text or glossary: Rakta]
64) Ushna (Usna):
Ushna means hot in Ayurveda. Medicinal preparations with Ushna Guna (hot properties) were used for Pariseka to reduce Ama (toxins) and enhance the absorption of medicinal properties through the thin skin of the eyelids, aiding in the treatment of Puyalasa.
65) Purva:
[see source text or glossary: Purva]
66) India:
India, the country where Ayurveda originated, provides the cultural and scientific context for this study. The treatment of Puyalasa took place at SJGAMC, Koppal, Karnataka, India, highlighting the application of traditional Indian medicine to modern health problems.
67) Ayus (Ayush):
[see source text or glossary: Ayush]
68) Roga:
Roga in Ayurveda refers to disease. The term was extensively used to describe the ailment Puyalasa or chronic dacryocystitis, underlining its symptoms and treatment through various Ayurvedic methods such as Jaloukavacharana and internal medications.
69) Seka (Sheka):
[see source text or glossary: Seka]
70) Guna:
[see source text or glossary: Guna]
71) Milk:
[see source text or glossary: Milk]
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