LEUCORRHOEA or SHVETA PRADAR



LEUCORRHOEA Or SHVETA PRADAR


Leuco or Shveta = White
Orrhoea or Pradar = Discharge

Normally the vagina is kept moist by a fluid exuded from the vagina. It is slightly white in colour and is acidic in nature composed of tissue fluid, cell debris, carbohydrate, lactoblacilli, lactic acid.
 Normal vaginal discharge is odorless and a clear or pale milky color which plays an important role in maintaining a healthy vagina by flushing out bacteria and other tiny organisms to prevent infection. There are cetain microorganisms in the secretion. These micro organisms produce lactic acid which destroys disease producing microoranisms. That is why the vagina is very resistant to infection. Under some diseased conditions, this normal secretion is increased. Then the disease is called Leucorrhoea.

This secretion increased physiologically at puberty, during pregnancy, during premenstrual congestion, during ovulation and also at the time of sexual excitement.

Pathologically, it is caused due to many reasons:
Among Pathological Leucorrhoea 90% of cases are relatively mild and is due to one of three main infective agents like Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis. Chlamydia trachomatis is a major cause of vaginal diseases. Worm affection(thread worm etc..) sometimes crawl into the genital organs and irritate them producing increased secretion.

 The remaining 10% are more serious. They may found associated with mucous polypus of the cervix, or carcinoma of the reproductive tract with debility and anaemia, and also with cervical erosion. They may cause painful sores, tumour-like lesions, spread into the pelvis or causes generalized infections.

Clinical features

The patient feels weak and tired with emaciation of the body.
Back ache, Pain in calves musles etc…
Itching of vulva due to candida or trichomonas
Complains of excessive amount of staining on clothing
Offensive smell
Painful Coition…etc…

Treatment.

Treatment should be done according to the clinical features of the patient. Treating the cause only helps in the proper cure of the condition. Too much vaginal douching is bad as it destroys natural protective bacilli.
In Ayurveda it is mentioned about Shveta pradara and Soma roga. Prime importance is given to understand the doshic Vitiation.
If the leucorrhoea is due to Vata Dosha, Its nature shall be watery or milk like, transparent , excess quantity, flowing down through the thighs.
If the leucorrhoea is due to Pitta Dosha, its nature will be excoriating, with burning sensation and with slight yellowish colour.

If it is due to kapha dosha, the secretion shall be like solid, white colour, curd like, with severe itching.

If it is due to Sannipatik that is due to the vitiation of all the vata, pitta and kapha dosha, it may associate with itching, burning, excoriating, yellowish or brownish or greenish in color.

The treatment is based on symptom totality in Homoeopathy.
So the proper cure of Leucorrhoea, one should have to consult an eminent doctor who should give utmost care in understanding the cause, the doshic vitiation,  etc…. 
For More details Contact @ 9020 78 50 50


Dhatu Rog / Spermatorrhoea



Spermatorrhoea or Dhatu Rog.


Spermatorrhea is the condition in which there is involuntary discharge of the vital fluid (semen or prostatic fluid). When it occurs at night, the condition is called Nocturnal emission and is generally accompanied by ‘erotic dreams’, but in cases of extreme debility may even occur without dreams. During waking hours, it may occur from sexual excitement caused by flirting with girls, reading obscene literature, seeing lewd pictures, gazing at the love scenes of animals or human beings (pornography) etc.. It may also occur due to the passage of hard stool through the rectum thereby causing pressure effect to the Prostatic gland.

      An occasional emission at night, say once in a fortnight or in some cases even once in a week is of no serious consequences, if it is not followed by any symptom of weakness or irritability, but on the other hand leaves only a sense of ease and comfort for the body and mind. If it occurs too frequently and is followed by weakness, irritability, mental depression, inability to concentrate, dyspeptic symptoms, any other mental and physical symptoms, the condition should be viewed with concern. The patient narrates his condition to his friends from whom he gets an exaggerated account of the evil consequences of his ailments which constantly fills his mind with evil forebodings rendering him incapable for any useful walk of life. He approaches the so-called specialists, many of them are quacks and imposters, and grabs at the much advertised specifics as a drowning man would catch at a straw. Experiments with these quack remedies, one after another in quick succession, results only in depletion of his monetary resources and finally when he realizes the truth that these so called specifics, for emissions and sexual weakness are only the sources of income of unscrupulous and mercenary minded quacks who earn their living by taking advantage of the fears and anxieties of their weak-minded fellow-creatures, he finds he is badly debilitated and almost impotent. My advise to these patients is that they should not be hoodwinked by these advertisements. Homoeopathic or Ayurvedic treatment or  both combined, if properly done, along with the observance of certain rules of health which are enumerated below, will cure any case of seminal emissions and weakness, leaving behind no bad effects.

      If the patient is hypochondriacal and melancholic owing to repeated loss of vital fluid, a change of environment will facilitate a cure. The bowel should be kept open by natural means and not by using laxatives. Good abdominal exercises such as the yoga poses(asanas), swimming, walking, jogging, are very conducive to the health of the abdominal organs which is quite essential for a normal and natural bowel movement. The patient should finish his night meals before sunset or just immediately after sunset, as the cause of the emissions in many case is an overloaded stomach. A glass of warm water mixed with the juice of half a lemon without the addition of sugar or salt may be taken on going to bed and on getting up from the bed in the morning. This will help in effecting a natural bowel movement. Before going to sleep, clean the prepuce or the skin covering the glans penis with cold water and also wash the legs with cold water below the knees. Too much walking or running as involved in football or other games should not be indulged in after 4. P.M as this causes congestion or rush of blood to the parts near about the sexual organs and may tend to cause an emission. The Yoga Asana named Sirsh Asan may be considered almost as specific in the treatment of this condition, which was performed daily by the late Prime Minister Mr. Jawahar Lal Nehru, and to which he attributed his never-failing health.

      The technique in performing it should be studied under someone who knows how to do it but it is worth studying it and doing it regularly as it is very efficacious in the treatment of most cases of seminal weakness.
Tobacco in all forms as chewing, smoking, snuffing etc.. and all stimulants like strong tea, coffea, alcohol etc …should be absolutely abandoned by the patients as all the stimulants have some aphrodisiac properties, i.e,  a power to excite sexual passion. Plenty of simple but nourishing food should be taken in order to give the body the necessary food elements which the body is deprived of. 

The mind should be kept constantly engaged in some good work as the “Idle brain is the devil’s workshop”, Spend a few minutes daily morning and night in prayer, meditation of the Almighty and let the brain be filled with good and pious thoughts while lying on bed awaiting sleep.

For the proper treatment, you can counsult Aayur Home doctors.
Call us at +91 9496 81 43 81

IMPOTENCE / Sexual Dysfunction


Sexual Dysfunction in Males

 The word “impotence” means want of sexual power, and in the male it implies that condition in which the man is unable to perform the sexual act effectively. It may be complete or partial. In Complete Erectile dysfunction, the man is completely unable to perform the marital act, while in partial erectile dysfunction, he may succeed in having more or less a complete erection, but seminal ejaculation occurs prematurely and the erection subsides long before the female has reached her climax.

Erectile dysfunction is not to be confounded with sterility, Sterility means barrenness or unproductiveness, an inability to impregnate a uterus.
Sterility is usually seen in persons suffering from impotency, but it may also exist in persons with full sexual power,

Impotency may be divided into three divisions:-
  1. Organic
  2. Functional
  3. Psychic

Organic Impotence:

Impotence originating from some organic (structural, anatomical) defects in the sexual organs or in the sexual nerve centers. This may be caused by:-
a)      A severe attack of mumps in children which may involve testicles too and thus hinder development causing atrophy.
b)      Removal of the testicles (castration) necessitated by an injury or other conditions is followed by complete impotence.
c)      The lower part of the spinal column, near the lumbar region, is connected with a group of nerves called the sexual plexus, which is concerned with the sexual organs, and any injury to this part may make one impotent. Injury to the cerebrum may also result in impotence.
d)      Hydrocele, Scrotal Hernia (varicocele) and Elephantiasis make the surrounding parts of the penis hypertrophied, and the penis enveloped by such huge mass of tissues is rendered unable to penetrate into the vagina.
e)      Unnatural means of sexual gratification and sodomy, prolonged involuntary seminal emission and senility cause sometimes such diminution in the size of the penis and testicles and distorts the shape of the penis in such a way as to make the man partially impotent.


                                       In the man the extremity of the penis called glans is highly sensitive to sexual feeling while in the female there are 3 such sensitive zones. They are the Clitoris, the Os Uteri, and the Vaginal Walls. These erotic zones are so constituted that they can sexually excited only by the rhythmic resistance and motion of a strong and normally sized male organ. This is not generally possible by an undersized and curved penis, which is the cause of impotence in some persons.

Organic impotence resulting from injuries to the male organs and cerebrum is almost incurable, while that arising from youthful indiscretions is curable to a great extent. The deformities of the sex organs and its dysfunction are to be treated by the rational way of treatment including properly indicated constitutional medicine, by taking nourishing diet, proper exercises and other adherence to Nature’s laws and avoid the causative factors.

Functional Impotence

It is a condition in which the man is rendered impotent due to a disturbed function of the sexual organs or the nervous system that controls sex. If seminal emission occurs too early before the erection is complete, or if the whole act is finished very soon, the man may be said to suffering from functional impotence.

Factors causing Functional Impotence:
  1. Excessive Masturbation
  2. Excessive Sexual Indulgence
  3. Sexually transmitted disease like Syphilis and Gonorrhoea
  4. Spermatorrhoea
  5. All causes which aid to undermine the general health: viz, taking tea, coffea, tobacco, alcohol, all kinds of drugs and stimulants.
  6. Suppression of sexual instinct; sexual excitements which are not satisfied for prolonged periods cause functional impotence,
  7. Frequent harbouring of lascivious ideas in the mind causes the cerebrum to send impulses to the erection centre, and this in turn send impulses to the penis as a result of which the penis gets engorged with blood. This chronic congestion and the frequent sending of impulses by the erection center must needs end in exhaustion of the erection centre causing functional impotence.


Psychic Impotence

Impotence due to mere psychological or mental factors are envisaged under this group. Any act or factor which can influence the imagination may lead to this condition. The more common factors are fear of venereal diseases, person who may addicted to unnatural or excessive indulgence.
     Treatment of this type of impotence should mainly be psychological. If this is properly done along with the administration of the indicated homoeopathic and ayurvedic remedy and adherence to Laws of Nature, a cure is possible.
      I would warm my reader against using any of the advertised patent rejuvenators, as the majority of these preparations contain some sort of stimulants, as Indian hemp, strychnine, alcohol, damiana etc..which though may be temporary benefit will in the long run do much harm. Like that, also the allopathic medicine such as Sildenafil, Taladafil etc..get some temporary benefit but produces harmful side effects including sudden loss of vision. As medicines, I would recommend only the use of homoeopathic or Ayurvedic medicines, selecting according to symptom-totality and that should be prepared and taken according to the strict ruled laid down in the literatures of both systems of medicines.

UTHARAVASTHI/MEDICATION THROUGH VAGINA/URETHRA Or PENIS



Uttaravasthi
(Female)

Usually in females, utharavasthi done by three ways.

                                    1 Vaginal douche by kashaya
2.Vaginal utharavasthi using sneha
3. Uterine (Intrauterine) utharavasthi using sneha

1. Vaginal douche


            Usually done in conditions like cervicitis, cervical erosion, HPV-human papilloma virus, trichomanas vaginalis infection, cervical intraepithelial neoplasia using decoction.

Materials required

1 Vaginal douche can
2        Cotton gauze
3        Dettol, savlon
4        Artery forceps
5        Sponge holding forceps
6        Kidney tray

Drugs required

            1 Nalpamaradi kashaya
            2 Triphala kashaya       
3 Aragwadadhi kashaya
4 Panchathikthaka kashaya

            Time of administration
                        9.30 am - 1 pm    in OPD base

            Dose                                      

1500ml of kashaya

            Procedure
                        Ask the patient to void the urges before the procedure. Give snehana and swedana over pelvic and lumbosacral region. Patient should lie in lithotomic position.  Clean the vulva region with the swab dipped in antiseptic lotion.
                        Take kashaya in vaginal douche can; confirm nozzle of the can is closed properly. Insert nozzle through vaginal orifice allowing flow of kashaya in all fornices and around cervix to wash out. After complete cleaning, remove nozzle and again swab out vagina with cotton gauze.
                        In case of infections, varthi like Kushtapippalyathi varthi can be used after vaginal douche.

2 .Vaginal utharavasthi

  Usually used in non infective conditions of vagina and cervix, 1 & 2 0 uterine prolapse, female infertility, cervical erosion, cervicitis, cervical intraepithelial Neoplasia, endometriosis etc.

Materials required

            1    Casco’s bivalve speculum
2        Sponge holding forceps
3        Artery forceps
4        Betadine, savlon
5        Sterilized gauze
6        Syringe 10-30 ml capacity
7        Kidney tray
8        Medicated sneha autoclaved

Drugs required

1                    Phalasarpis
2                    Dhanwantharam gritham
3                    Shatpala gritham
4                    Shashtika tailam
5          Varanadhi gritham
6          Jathyadhi gritham
7          Gugguluthikthaka gritha
8          Kalyanaka gritha
9              Mahathikthaka gritha

Time of administration
                        According to the condition, mostly in morning hours

            Dose of medicine
15-20 ml
Procedure

            Autoclave all required materials. Prepare the patient with local shaving of pubic hair. Snehana and swedana of katee pradesa should be done. After voiding urine, ask the patient to lie down on utharavasthi table in lithotomic position. Cover all other parts except genitalia with surgical towels and fix with towel clips. Clean the exposed area with cleaning agents using sponge holding forceps and gauze. Clean vagina using artery forceps and gauze. Fix Casco’s bivalve speculum for proper visualization of cervix. Take autoclaved medicine in syringe and slowly injecting vagina till it fully covers the os reaching external os. Keep plain gauze and remove Casco’s speculum. Ask the patient to lie down in supine position for 15-20 minutes.


3 Intrauterine utharavasthi

It is usually done in infertility, intrauterine pathologies with sneha
Materials required

      • Cusco’s bivalve speculum
      • Uterine sound
§        Ruben’s canula
§        Sponge holding forceps
§        Artery forceps
§        Sterile gauze
§        Towel with clips
§        Kidney tray
§        Medicated sneha

Drugs used

1 Phalasarpis
2 Kalyanaka gritha
3 Dhanwanthara gritha

Dose:                           2-4 ml.

Time of administration

      Done in rithukala after doing kashayavasthi with proper snehana and sodhana.

Procedure:

Snehana and swedana of kateeprdesha is done. Sodhana is done as yogavasthi or kala vasthi or rajayapana vasthi. Patient is prepared with shaving of the pubic hair. The patient is asked to lie down on the table in lithotomic position after voiding urine. Cover the part except genitalia with surgical towels and fix with towel clips. Clean the exposed area with cleaning agents using sponge holding forceps and gauze. Clean vagina with artery forceps and gauze. Fix the Casco’s bivalve speculum for proper visualization of cervix. Insert uterine sound to know the position of uterus. Remove the uterine sound and slowly insert Ruben’s canula in the same direction. Attach autoclaved medicine filled syringe to external end of Ruben’s canula. Push the medicine slowly. Remove the syringe, canula and speculum carefully. After the procedure keep a pichu in the vagina. Ask the patient to lie down in supine position for 15-20 minutes, remove the pichu when patient feels next urge of Micturition.

Complications


            Bleeding or spotting
                                    Medication is not required; it will subside on the next day.
            Abdominal pain           
Managed with dhanwantharam gutika, dhanwantharam kashaya and sapthasara kashaya

Precautions


1   Proper sterilization
2   TT injections before the procedure
3   Use of Biogest, Septilin tab during the procedure to avoid infection
4 Push medicines very slowly to avoid entry into the peritoneum, which may
   cause severe peritonitis, and spilling into appendages.


Utharavasthi in male

Utharavasthi is used in males, commonly in sexual dysfunctions like erectile dysfunction, premature ejaculation, and in certain seminal abnormality like oligosprmia.
Medicines used
Ksheerabala taila
Dasamoola taila
Bala taila
Brihat chagalyadi gritha
Mahanararayana taila.  etc

Procedure:-
                  Local shaving of pubic hair should be done and the patient is asked to void the urine just before the procedure starts. Patient must lie down on supine position on the clean table by exposing the part. The hands are flexed and clasped below head. Wash the genitalia and the surrounding area with the savlon by using sponge holding forceps & gauze. Retract the prepuce completely and wash thoroughly the glans penis & then apply Betadine to glans penis. The physician having gloves after washing hands spread the surgical towel over patient, exposing the penis. Towel clips may be applied. When once the assistant transfers the autoclaved medicine into steel bowel, the medicine is filled into the syringe.  Fix the catheter to the nozzle of the syringe, push the oil to the tip of the catheter. Lubricate the catheter with the xylocaine jelly. Gently introduce the catheter into the urethra. Slowly introduce the catheter into the bladder. Ensure the catheter has entered the bladder, and then slowly inject the medicine into the bladder. If more amount of medicine has to be injected clamp the catheter with artery forceps, remove the syringe & then inject the medicine with same syringe or by another. When once the injection of medicine is over remove the catheter & allow the patient to lie down in the same position for 5 to 10 minutes and then patient may be sent home. Check the tip of the catheter to ensure that there is no any bleeding.
Dose
      25–30ml
Retention:-
     Usually 3-6hrs


Anuvasana (Sneha) Vasthi



Anuvasana (Sneha) vasthi
          It is used in two ways as a supportive treatment for asthapana(decoction enema) in different protocols like yoga vasthi, kala vasthi, karmavasthi and as a kevala snehavasthi in the form of matravasthi. Mainly used in conditions of vatha for the purpose of snehana but in some cases like arsas, vasthi like Pippalyadi Anuvasana can be given.

Indications of Anuvasana Vasthi
All the indications of decoction enema is also indicated for Oil Enema
Persons having Ruksha (dry) body, having a strong agni and suffering from only Vatik disorders (kevala vata) are also indicated for Anuvasana vasthi

Contra-indications of Anuvasana Vasthi   
All the contraindications of decoction enema is also contraindicated for Oil enema
a)      Persons on empty stomach
b)      Suffering from fever of recent origin (nava jwara)
c)      Anaemia (pandu)
d)      Jaundice (kamala)
e)      Diabetes (prameha)
f)        Heamorrhoides (Arsha)
g)      Rhinitis (peenasa, pratishyaya)
h)      Splenic disorders (pliha)
i)        Kaphaja udara
j)        Diarrhea (athisara)
k)      Poisoned state (Visha)
l)        Conjuctivitis of Pitta & Kapha (Abhishyanda Of Pittaja & Kaphaja)
m)    Filariasis (Shleepada)
n)      Cervical lympadenitis etc…

Materials required:
1.                  Plastic polythene cover/ traditional putaka with vasthinetra
2.                  Gloves
3.                  Vessels
4.                  Anuvasana taila / ghrita (chikkana paka) - 1/4th of asthapana
5.                  Hot water for warming the sneha.

Preoperative procedure-

        Food is given just before Anuvasana as prescribed by the physician.

Procedure:-
·                    After taking food patient should walk little distance.
·                    Then advice the patient to lie down on the left lateral position with his   
            right leg flexed at knee and hip, left leg kept straight and left hand below  
            the head.
·                    Warmed sneha is taken in polythene cover.
·                    Wearing the hand gloves, per rectal examination is carried out to rule out  
            loaded rectum, or any other obstruction.
·                    Then the vasthinetra is carefully introduced into the anal canal in the  
            direction of vertebral column.
·                    Snehadravya should be pushed with uniform force not too slow not too
            fast.
·                    A little amount of snehadravya should be retained in the container and
            vasthinetra is removed slowly.

Time of administration:

Usually between 1-2pm. (Just after lunch)

 Post operative:-
·              Patient should lie supine.
·              Mild massage over abdomen is given.
·              Bend his legs at the knee, and buttocks are hit by his heels.
·              Patient is allowed to lie with pillow under his thighs.
·              Patient is advised to attend his urge.
·              For all purpose warm water should be used.
·              Till the sneha comes out, patient is not allowed to eat anything.
·              Usually sneha comes out with faeces within 1-5 hours.

Complications:-

      Abdominal pain: 
                                  Rx:   Hinguvachadi / ashta /vaisvanara choorna.

Nirooha Vasthi Or Decoction Enema



Nirooha Vasthi or Decoction Enema

             Nirooha is the procedure where, combinations of medicaments are administered through rectal route, for local as well as systemic effects. Depending on the dose and nature of ingredients, Nirooha is of several types like Ksheeravasthi, Yapana, Vaitharanavasthi etc

Indications of Decoction Enema
Persons suffering from
i)                   Vata disorders (Sarvanga vata/ ekaanga vata)-Rheumatic disorders including Paralysis, hemiplegia,
ii)                 Disorders of abdomen (kukshi roga)
iii)               Difficulty in passing stool, urine or flatus
iv)               Loss of strength, Lusture, Semen etc..
v)                 Worm infestation
vi)               Diarrhoea
vii)             Pain and inflammation in joints (Arthritis)
viii)           Splenic Diseases
ix)               Fistula-in-ano
x)                 Fissure-in-ano
xi)               Fever
xii)             Head ache
xiii)           Pain in ears
xiv)          Low Back Pain
xv)            Intra abdominal Swellings (gulma)
xvi)          Convulsions
xvii)        Wasting (emaciation)
xviii)      Vatic Disorders (Rheumatic Diseases)

Contra-indications of Decoction Enema


i)                   Indigestion
ii)                 Athi sneha (who is very unctuous)
iii)               Immediately after sneha pana
iv)               Utklesha dosha condition
v)                 Mandaagni
vi)               Exhausted due to hunger and thirst
vii)             Fatigueness
viii)           Emaciated conditions
ix)               Immediately after vamana and virechana
x)                 Cough, dyspnoea, Hiccough (shvasa, kasa, hikka)
xi)               Intestinal obstruction (Baddha udara)
xii)             Intestinal perforation (Chidrodara)
xiii)           Disorders due to ama
xiv)          Diarrhoea etc…


Materials required:-

1. Mortar and pestle
2. Vasthinethra
3. Polythene cover of at least 1&1/2 liter capacity/ Traditional Vasthi putaka
4. Hot water
5. Utensils
6. Good quality fine sieve
7. Cotton towel
8. Measuring apparatus
9. Cotton thread-1/2 meter
10. Cotton
11. Sterile glove.
12. Oil for Abhyanga
13. Medicaments as per prescription in the required quantity
14. Churner

Preparation of Vasthidravya:

v     Initially Saindhava is put in the Khalwa yantra and it is powdered well
v     Madhu is added in thin stream triturating properly to ensure a homogenous mixture.
v     It is followed by the mixing of appropriate tailam in required quantity mentioned in the yoga slowly by the side of the mortar and it is continuously stirred until it attains a uniform consistency.
v     The kalka, which is the fine paste of drugs mentioned in the yoga is added little by little along with proper grinding with pestle.
v     Then appropriate kwatha in required amount as per yoga is added slowly and properly mixed.
v     The Avapa, if mentioned in the yoga/if needed, is added at last followed by proper stirring.
v     The mixture is filtered through a fine sieve and finally made lukewarm by keeping over a hot water bath.
v     This mixture is churned well with the help of a churner.
v     When it is lukewarm (Sukhoshna), and comfortable for the patient, it is transferred to a  plastic cover  (vasti putaka) having sufficient thickness and then vasti netra of bronze or plastic is tied to it very well with plugging the other tip with a cotton varti.

Time of administration

v     Madhyahne kinchidavarthe,   Nathibubhukshitha
v     This time varies depending on desha and kala and is generally in between
      10 – 11am.

Poorvakarma of Nirooha

v     The procedure is usually done in empty stomach
v     Those who are Sukumara and Ksheena are asked to take very light food in early morning.
v     Sarvanga Abhyanga and sveda should be done before the procedure. .

Pradhanakarma:

v     Position of the patient
1. Patient is asked to lie on a cot of knee-height, in left lateral position.
2. His left lower limb extended and right lower limb flexed at knee and                            hip.
            3. His left upper limb is kept folded under his head.
v     Procedure
§         A small amount of plain ghee/medicated oil is smeared over the tip of Vastinetra as well as the anus of the patient for lubrication.
§         Wearing the hand gloves, per rectal examination is carried out to rule out loaded rectum, or any other obstruction.
§         Hold the vastinetra in the left hand and putaka in the right hand. 
§         Remove the plug from the tip of vastinetra and evacuate the air and close the tip with left index finger.
§         Vasthi netra is then gently introduced into the anus and putaka is pressed slowly and steadily to push the vasthidravya into the patient’s rectum.
§         Patient is asked to count up to 30 and to breathe deeply through the mouth during introduction.
§         Vastinetra is withdrawn with a little amount of medicament remained in the putaka to avoid the entry of air.
§         If the patient feels the urge for defecation during the procedure, he is allowed to pass stools after removing vasthinethra and the remaining medicine is administered later.

Paschathkarma

v           Patient is asked to lie in supine position till the urge for defecation occurs.
v           He is asked to clear the bowels as many times he feels Vega and advised
         to take bath in luke warm water.

v           Then diet according to dosha vitiation and satmya is given (preferably rice
               with mudgayoosha or mamsarasa).
v           Blood pressure, pulse rate, time of retention, number of evacuations and if
               discomforts any are observed.
v           He is asked to take rest and light food is given at night.

Complications
v     Abdominal discomfort and pain – after careful evaluation about the cause appropriate management can be adopted. General measures like abyanga, sweda, deepana anulomana drugs are advised.
v     Immediate evacuation without retention: - Another vasthi with less lavana, ushna and quantity should be administered immediately after ruling out sphincteral incontinence.
v     Giddiness, Low pulse, Cold extremities, Delirium: - Console the patient, Foot end elevation, Hot drinks, Warming extremities. Drugs like Sidhamakaradhwaja, Drakshadi kashaya, Dhanwantharam gulika etc can be given.
v     Vomiting: - Usually subsides without specific management. Drugs like Chandrakalarasa, Dhanwantharam gulika, Drakshadi kashaya, Mayoorapichabhasma etc can be given
v     Anaphylactic reaction: - Skin eruptions, Itching, Urticaria, Dyspnoea etc. Careful history taking to identify known allergens and avoiding them. Haridrakhanda, Thrikatu with sitha, Chandanasavam, Draksharishtam etc can be given.
v     Long retention: - Known causes like obstruction of anal canal by pile mass, enlarged prostrate, fecal matter etc should be excluded. Rubber tube or specific gudavarthis can be introduced into anal canal for evacuation.