Date: 1st April 2008

No: 07
Vol: 02
Web site : www.keralaayurveda.biz
E-mail : clinicalresearch@keralaayurveda.biz
hospital@keralaayurveda.biz

n Frankly Speaking - 03
n Darshan 2008-Kateegraha - 05
n An Exploration on Oushadhopayogakaalam - 17
n Male Sexual Dysfunction and.... - 19
n Mucuna or Cowhage - 24
n Kapikachu-Ayurvedic View - 29
FROM THE EDITOR
Measuring the essence of Ayurvedic science
in modern parameters sometimes
culminates in success and sometimes in
failure. This is a tough problem to all who
may work in the research field of any other TM

Alternative systems of medicine. Compar

ison on some areas may look irrati onal and
ridiculous. It is likely that a significant EDITORIAL COMMITTEE
proportion of advantage from even rational
interventions is due to nonspecific effects. PATRON
Hence again the bias in comparative studies Dr.K.Rajagopalan
accumulates. Also in a good number of
situations Ayurvedic treatment compli- ADVISORY COMMITTEE
ments the modern medicine. Special Sri. Sonjoy Mohanthy
evaluation methods should be generated in Dr.K.Anil Kumar
such areas. Existing rules are rudimentary Dr.C.I.Jolly
and new ones have to be formed. It is often Dr.C.R.Agnives
a dynamic area where contributions and Dr.Jacob Jayan B.
comments are invited. In this point of view
I really want to congratulate Dr.San- MANAGING EDITOR
deep.K.M for making a few modest steps in Dr.K.Sasidharan
research activities designed by him and few
colleagues (see the article in this issue ‘An EDITOR IN CHIEF
exploration on Oushadhopayogak- Dr.Sahny.M.Soman
alam’).These types of scientific interventions
could culminate in triumph though the EDITORS
beginning would be simple as here they have Dr.Binoy D.Das
put their scientific spirit as the only initial
Dr.K.Vasanthakumari
investment.
Dr.V.Jayakumar
I think we shouldn’t move away from any of
the positive things we plan to start; keep in EDITORIAL TEAM
mind the axiom ‘An expert is someone who Dr.Geetha.G.Pillai
has made all of the possible mistakes in a Mrs.Dulari.S.S
very narrow field of study.’ So don’t wait in Mr.Bose R.C.
search of inspiration to start with. Action
always generates inspiration. Finding new PUBLICATION OFFICE
methods and translating the available Kerala Ayurveda Hospital
research methods to suit to our clinical Bank Road
settings are the current challenges ahead of Aluva-01
the Clinical Research Wing. I seek co- Tel : 0484-3221365, 2626119, 2623578
operation from all in the upcoming activities. E-mail : clinicalresearch@keralaayurveda.biz
Thanking you hospital@keralaayurveda.biz

Dr.Sahny.M.Soman BAMS, MBBS

14
LETTER TO THE EDITOR
It gives immense pleasure to read Kerala
Ayurveda News & Views. All the articles
are very informative and interesting. I
suggest that pharmacological actions of
kashaaya or lehya or coorna or vati can be
included in every issue which would help
freshers to rethink and guide them in the right
path of treatment. My hearty wishes to all
those scholars whose hard work has yielded
this bi-monthly in house journal.
Dr.Gija Gangadharan
Trainee Co-ordinator
Kerala Ayurveda
Our knowledge is growing and now we are
keen in enhancing our abilities in managing
different clinical entities. In this regard the
articles in our in house magazine really help
emerging physicians like me. In order to
elaborate our ideas and views and to explore
Ayurveda, the articles in the columns “Drug
Review” and “My Memorable Patient” serves
as beckon of hope.
Dr.Pinchu Paulson BAMS
House Surgeon
ALN Rao Memorial Ayurvedic Medical
College, Koppa, Karnataka
I have read the last two issues of Kerala
Ayurveda News & Views. The articles are
very impressive and useful also. I request you
to include the rare cases of experienced
physicians too.
Dr.Nishana.N.K
Trainee Medical Officer
Kerala Ayurveda Hospital, Aluva
2
The content in the magazine is really
informative and fascinating specially “My
Memorable Patient” and “Classical Drug
Review”. It gives one the guidelines about the
diagnosis and the approach according to
textual references and Rasa, Guna, Veerya
and Vipaaka. But I think it is necessary to
include the clinical diagnosis of diseases as per
modern science with their lab investigations
also. With this we can analyze the fate of the
disease and accordingly we can decide
whether patients needs Ayurvedic treatment
or the modern treatment.
Dr.Ranjan Kapoor
Trainee Medical Officer
Kerala Ayurveda Hospital, Aluva
After joining Kerala Ayurveda Hospital as a
trainee doctor, I got the opportunity to read
few issues of the in-house magazine. The
information provided in it were quiet helpful
to recall my knowledge regarding the given
topics. All the articles are very impressive
specially “Frankly speaking”. So I sincerely
congratulate the editorial team for letting our
ancient path come up in such a simple way
that even a lay man can easily understand.
Dr.Anupama.R.Bara
Medical Officer (Trainee)
Kerala Ayurveda Hospital, Aluva

THE OBSTINATE DOCTOR
Chief Editor, Kerala Ayurveda Vaidyam
Frankly speaking, at times I am an obstinate
doctor. I insist that my patient should do this
or that and I now regretfully admit that most
of my such obstinacies were prompted by my
convictions, the majority of those erroneous.
I may explain one or two of such obstinacies.
After coming from Moscow, once I chanced
to travel in an autorikshaw. On reaching the
destination, the young driver did not receive
the fare from me. I insisted him to receive
the fare. But at any cost he will not receive it.
He said, “ Don’t you remember me Sir. You
have treated my mother. I am highly thankful
to you and how can I receive any money from
you?”
I scanned my memory in futility. He added.
“She had such a severe consistent headache
and you have treated her.” On hearing this I
was happy that I have cured a chronic
headache. But my happiness was short lived.
I asked him. “How is the headache now?” To
this he answered. “My mother is no more sir.
She had brain tumor.” I immeadiately realized
my folly of not recognizing the headache as
the herald of a brain tumor. It is a clear case
of wrong diagnosis from the part of the
physician. Regaining my wits I asked
him. “Anyhow, I did not cure the
headache of your mother. Then why
should you be thankful to me?”.
He answered with a smile. “Yet you have done
a great service to me. You insisted that the
root cause of her headache was rotten teeth
which she had many. You made her extract
the teeth one by one excepting one or two.
When it was diagnosed as brain tumor, the
oncologists insited in removing the remaining
teeth too to aid radiation treatment. If you
3
Frankly speaking
Dr. C.R.Agnives B.Sc, MD(Ay)
haven’t made her extract most of the teeth, it
would have been difficult to extract them all
at a stretch. Hence your obstinancy that the
teeth shall be extracted to cure the headache
was very useful.”
I hoped I could vanish into thin air using some
old magical measure such as Indian vanishing
trick. For a few seconds I felt I was not
existing in this world . When I came to
recognize the surroundings and the
seriousness of my erroneous obstinacy, thank
God!, he had left with his vehicle leaving a
small cloud of exhaust fumes.
On recap, I remembered the case and many
other similar cases of headache. During my
days as a Saalaakya doctor in Kottakkal
college, all sorts of headaches were referred
to me. This was not because I was an expert
curer of headaches, but doctors who attended
the general OPD wanted to reduce the crowd
there by shunning some cases to other
departments. Most of the cases thus directed
to attend Saalaakya OPD were cases either
of fever or constipation which could be very
well managed in gneral OPD. But I admit that
there is no harm in examining the visual acuity
of the person complaining of headache. But
when there was a palpable temperature above
102o F, it is not reasonable for a GP to refer
the case to an ophthalmologist. This sort of
irresponsible referring usually irritated me
and I had expressed my disapproval to the
referring doctors only to add their disapproval
of me and to confirm their conviction that I
am a horrible personality.
Cutting the tale short, on those days I had to
attend a lot of headache cases. It became the
part of my diagnostic ritual of headache to ask

the patient to open his or her mouth widely
so that I can count the carious teeth.
Whenever I find a carious tooth it was my
routine to advise the patient to consult a
dental surgeon. On those days, most of the
dental surgeons extracted the carious tooth
or teeth. Today they won’t do so. They will
try to retain the defective tooth to the
maximum, as now they have recognized that
teeth, especially defective teeth, are their
bread and butter. So, now they try to retain
the teeth as far as possible. All the dental
surgeons of the viscinity were highly thankful
to me for providing them ample supply of
patients and became my friends. It was on
such a back drop that this mother of the
autorikshaw driver came to me with a chronic
headache and thirtytwo carious teeth. Most
of the teeth were dead and she felt no
toothache at all. She too was insistant not to
extract the teeth. I had to convince her by
threatening and lecturing about the
consequences of carious teeth left intact in
mouth. She tried to defend stating that she
had no toothache. I retorted blatantly that the
teeth are not aching as they are dead and she
is carrying corpses of teeth in her mouth those
rot and damage the general health. I am aware
of the hesitation of Muslim women to extract
teeth as they are age conscious and losing
teeth meant to them as aging and this
naturally posed a threat to marital harmony
as the husband was free to choose a younger
wife. But I usually promise them the
possibility of having more beautiful and
convenient artificial dentition as an additional
attractiveness to their charm and after a
series of arguments and counter arguments
most of them succum to my obstinacy. This,
incidentally is such a case that has finally fell
victim to my obstinate conviction.
Headache is a difficult complaint. Anything
may cause a headache. It may be a minor error
of visual acuity, it may be an alcoholic
4
Frankly speaking
husband, it may be a mischievous son, it may
be a loving husband who died early, it may be
a guilt complex, it may be a tiresome job, it
may be an extra marital relation ship of the
spouse, it may be an unrewarding job, a
sinusitis, constipation, a carious tooth, a space
occupying lesion in brain or its viscinity
conducive to increase of intracranial pressure,
a chronically infected ear, hyperpyrexia and
what not? So to me who consider that
treatment is discarding the etiology, the
treatment of headache consisted of making a
checklist of probable causes and discarding
them one by one. When no other etiological
factor is evident and when a carious tooth is
spotted, it is too natural to accuse the tooth
as the culprit. I have did so here too. But I
should have also thought of a silent tumor in
the brain.
Usually brain tumors notify their existance by
headache. But headaches of brain tumors
usually are accompanied by sickness or
vomiting, papilledema and even exophthalmia
(if the tumor is retrobulbar or if it generates
hydrocephaly). Very rarely the headache of
a brain tumor may be without
accompaniments. This was such a case. Today
I will send such patients for scanning. But on
those days, scanning was not that popular
among Ayurvedic physicians. Hence the folly
of diagnosis.
Another victim of my obstinate diagnosis was
a muslim girl of eighteen years. She was
brought to me for severe pain in both the
ankle joints and difficulty to walk. She was
carried on hands and was unable even to
stand. I conducted a thourough check up and
found nothing to substantiate her claim of pain.
There was no tenderness, edema or redness
in both the joints. Hence to me the severe pain
was not supported by any organic findings. On
those days I was simply convinced that when
there is no organic evidence to support the
(Contd. on page 13)
DARSHAN 08
KATEEGRAHA (LOW BACK PAIN)
ABSTRACT

(In Darshan 2008 held on March 4 Dr.Sreeraj.I.P, Medical Officer, Kasargod had
delivered an elaborative presentation on Kateegraha. In an one hour lengthy presentation he
narrated the anatomy of lower spine, causes of low back ache, IVDP of lower spine in detail,
differential diagnosis of low back ache, clinical examination of the lumbar spine and mentioned
the management of low back ache and presented a few case summaries and prevention of
low back pain. The anatomical aspects covered vertebral bodies, anterior elements and posterior
elements of vertebral bodies, the pedicles, joints, inter vertebral disc, ligaments and muscles.
Every one enjoyed the presenter’s mind-set to share his clinical cases with others. Due to
space limitations we are able to publish only the summary of the presented paper.)

Kateegraha is a very common disease we Karothi adhara kayeshu tamstaan

come across in clinical practice. A thorough
knowledge of the disease is necessary for its
diagnosis and treatment. Brhath Trayees say
Kateegraha as a symptom of Pakvaasaya
Vaatakopa.
‘Tatra Pakvasaye Krudha Soolanaaha
andhra koojanm
Malarodhasma vardha trika prshta
Kateegraham
krchraanupadravan’.
Kateegraha (Low back pain) is said to be the
price man pays for his erect posture. Actually
low back pain is not a disease but a symptom.
There are many causes for this. The most
common cause for LBA is Inter Vertebral Disc
Prolapse (IVDP). Ayurveda has very effective
and safe treatment for the same compared to
other systems.

Causes of Low Back Pain

1. IVDP
2. Local Lesions (In the Back)

Congenital Functional defect Degenerative

Traumatic Inflammatory Neoplastic

3. Remote Lesions (Other than the back)

Abdominal disorder Genito Urinary

Causes
Pelvic disorders Vascular disorders

Somatoform disorders
5
DARSHAN 08

Common causes of back pain in various age groups.

Children Adolescents Young Adults Middle Age
Scoliosis Scheuermann’s disease Mechanical Back Mechanical Back
disease pain pain
Spondylolisthesis Scoliosis Prolapsed
Mechanical back intervertebral Primary osteo
Pyogenic pain disc. arthritis.
infections Intervertebral disc- Spondylolisthesis
syndrome Spinal fracture Prolapsed inter
Tuberculosis Pyogenic or- Ankylosing vertebral disc.
tuberculous spondylitis.
Calve’s disease infections. Coccydynia
Pyogenic infections
Tuberculosis
Spinal stenosis

Lumbar Disc Diseases fracture of the end plates. It initiates the

Physicians interested in back pain are not
inclined to read essays on anatomy; they are
more interested in the bottom line how do I
treat? However physicians need an
understanding of Anatomy to appreciate
which element of the lower spine can be
injured and to offer treatment on a rational
basis.
Bio Mechanics:
The cardinal movements of the lumbar spine
are flexion, extension, compression, axial
rotation and lateral flexion. Our day to day
life gives compression, bending, and torsion
to the discs. Flexion, extension, lateral flexion
gives compressive stress to the discs. Rotation
gives shear stress. The vertebral end plates
are only weakly attached to the vertebral
body so that the disc weakly react, with
horizontal shearing forces. Compression
injuries of the IVD may result from excessive
axial loading. One of compression injury is
process - internal disc disruption. In the first
stage of disc degeneration fibrillation occurs
in annulus fibrosus producing radial fissures
without affecting disc height. There are three
types of nucleus herniation.
1. Protrusion (without tear on annulus)
2. Extrusion (Tear occurs in annulus but
inside posterior longitudinal ligament)
3. Sequestration (Go to spinal canal)
Lumbar Disc Diseases
The main cause of back pain in age group of
30-50 is lumbar disc problems. Heavy
manual work, lifting weight may be the acute
reason. The pain starting from hip region
extends to sacroiliac region, then buttocks and
back of thigh.
Symptoms of Disc Herniation:
. Severe pain. Pain reduces when taking
rest, increases while bending. Pain is
more in legs. Pain increases while

6
DARSHAN 08
sneezing and coughing. Pain may occur
in scrotum and perineum.
. Numbness
. Weakness may occur according to the
neurological level of involvement.
. If the herniation of disc is high it may
compress cauda equina. In such
condition numbness occur in legs, rectal
pain, numbness in perineum,
incontinence of bowel and bladder are
the symptoms. This is an emergency
condition.
. In acute IVDP case, there is paraspinal
spasm while moving and walking. When
pressed with finger there will be pain at
the region of spinous process of the
corresponding disc. If there is nerve root
irritation as a result of compression of
sciatic nerve there will be symptoms of
sciatica. There is pain in the sciatic notch
and popliteal space. SLR test will be
positive in this case. Lassegue’s sign will
also be positive. We can correlate sciatica
as Grdhrasi.
“Parshnim Pratyanguleenaam ya kandara
maarutardita
Saktyulkshepa Nigrhnaati Grdhraseem
taam pracakshate”
. In L3-L4 Disc herination L4 nerve root
is affected and pain will be in the medial
side of the leg. Numbness in antero
medial side of the leg would be present.
There will be weakness of Quadriceps
and hip adductors. Sensation will be less
in L4 dermatomes.
. In L4-L5 disc herniation, L5 nerve root
is affected. Numbness and pain will be
on anterolateral side of leg and dorsum
of foot.
7
. In L5 SI disc rupture S1 nerve is
affected.
. 90% of Lumbar disc prolapse occurs
between L4 and L5.
Differential Diagnosis
History taking plays an important role in
the diagnosis of causes of low back pain.
History in LBA will give the diagnosis 80%
of the time. A doctor who cannot take a
good history and a patient who cannot
give one are both danger, for a better
outcome expected. An accurate diagnosis
is exceedingly important. Short and
obese people have a greater chance of
IVDP and tall and lean people are also
prone for IVDP.
. If it is a case of LBA in the early
decades of life look for
a. Spina bifida - due to failure of fusion of
the posterior part of the spine.
Usually it affects one vertebra, most
commonly in Lumbo sacral region.
b. Spondylolisthesis
This means forward shift of the spine. The
shift nearly always takes place between L4
and L5 or between L5 and S1. 75% of the case
is congenital. Degenerative variety constitutes
about 20% of the cases. Traumatic variety
constitutes about 5% of cases. In congenital
variety there is developmental defect of the
pedicle of the 5th lumber vertebra. This part
which is called ‘pars interarticular’ is divided
into two parts being connected by fibrous
tissue. The lower articular process remains
with the sacrum insitu while the upper
articular processes along with the spinal
column above move forward. The main
complaint is the back ache which becomes
DARSHAN 08
more obvious after exercise or strain. The
pain may radiate down to the legs and there
may be weakness of the lower extremities.
This is due to the pressure on the cauda
equina and the emerging root. Disc prolapse
is liable to occur. This condition may affect
any age. But degenerative variety is
obviously rare before the age of 40.
The upper angle of sacrum forms a distinct
prominence on the back with depression just
above it. On palpation a definite prominence
at the upper angle of the sacrum will be
obvious when the clinician runs the fingers
down along the spinous process.
In all cases of LBA rule out
A. Clinical conditions arising from
the regions other than the back:
(a) Abdominal Disorders:
(a) Pancreatitis - Pain occurs in
the middle of vertebral column.
Increased serum amylase level in
blood is an indication.
(b) Cholecystitis - inflammation of gall
bladder.
(c) Biliary calculi
(d) Peptic ulcer.
(b) Pelvic Disorders:
Inflammatory condition of the ovaries
and tubes.
(c) Genito Urinary Causes:
Renal infection, Renal or ureteric calculus
Prostatitis, Prostatic carcinoma.
(d)Vascular Disorders:
Ischaemic pain from occlusion of aorta or
iliac arteries.
(e). Somatoform disorders
B. Functional Defect:
a) Scoliosis - This means deviation of the
spine to one side. In all cases of scoliosis
one must not forget to examine the heart
8
and lungs as congenital heart disease may
be associated with this condition.
b) Kyphosis - excessive posterior convexity
of the thoracic spine.
c) Antero posterior imbalance due to
pregnancy, pot belly etc.
C. Inflamatory conditions:
a) Tuberculosis of spine (Pott’s disease)
It affects children and adolescents more
commonly than the adults.
b) Osteomyelitis of the spine - very rare.
Characterized by sudden onset of fever and
severe local pain.
c) Ankylosing spondylitis.
d) Myositis, Fibrositis.
e) Rheumatoid arthritis.
D. Degenerative diseases:
a) Osteo arthritis (spondylosis)
b) Senile osteoporosis
c) Degenerative Disc disease.
E. Traumatic:
a) Lumbo Sacral strain
b) Injury to Intervertebral joints and
muscles
c) Spondylo listhesis.
d) Compression fracture
e) Vertebral process fracture
f) Ruptured disc.
F. Neoplastic:
a) Primary tumours - eg. multiple
myeloma
b) Metastatic tumours from breast,
bronchus, kidney etc.
Examination of the Lumbar Spine
1. Darsana Pareeksha - According to the
posture of the patient.
2. Sparsana Pareeksha - Contour of spine,
tenderness, SLR test.
SLR Test: The patient lies supine on the
examination table. The patient is now asked
to raise one lower limb keeping knee straight.
He should continue to raise the leg till he
DARSHAN 08
experienced pain. The angle in which the pain changes in this joint due to trauma etc.
is experienced is noted. If the pain is evoked can be taken as Sandhi Bhanga.
under 40o it suggests impingement of the . The symptoms of IVDP is like that of
protruding inter vertebral disc on a nerve Vaatavyaadhi- cheshtaahaani, Soola
root. If it is above 40o it is not necessarily etc.
due to IVDP.
Lassegue’s Sign: In SLR, at the angle when So we should do the treatment for IVDP as
the patient experiences first twinge of pain a combination of Vrna cikitsa, Bhagna
the ankle is passively dorsiflexed. This cause cikitsa and Vaatavyaadhi cikitsa.
aggravation of the pain. It suggests irritation
on one or more nerve roots either by IVDP Vrna Cikitsa in IVDP
or from some space occupying lesion.
Femoral nerve stretch test: Patient is Apatarpana, Alepa, Parisheka, Abhyanga,
asked to lie on his abdomen and flex the knee Sveda, Vimlaapana, Upanaaha, Visraavana,
of affected side. If pain in thigh region Snehana, Virecana. These Kriyaas in Vrna
increases it is positive. L2-L3 IVD is
Cikitsa can be used.
protruded in this case.
Special Investigations:
Apatarpana - Restriction of food. To avoid
1 Lab
oily food etc. To reduce body wt in obese
Hb,TC,DC, ESR
patients.
S.Alkaline Phosphatase
S.Acid Phosphatase
Alepana - Lepam with medicines in Kadee
2. Roentgenography (X-rays)
pradesa. We can do lepa with Nagaraadi
Usually done in AP view and lateral view in
some cases oblique view is also taken. Coornam, Jadamayaadi Coornam,
3. Myelography: Karuttamarmani etc. in Dhanyaamla. It will
Now it is very rarely used. reduce the oedema in Kadeepradesa and will
4. Computed Tomography (C.T.Scan) reduce pain also.
5. Magnetic Resonance Imaging (MRI) Parisheka- If there is severe pain Parisheka
The accuracy of MRI is said to be— (Dhara) with Dhanyaamla have very good
effect
88%
6. Positron Emission Tomography (PET)
Abhyangam - Also found to be useful when
done with vaatahara preparations
Treatment of IVDP
Svedana - After Abhyanga we can do
We can treat disc prolapse according to the
Svedana. It will give very good result in
treatment principles of Vrna Cikitsa, Bhagna
IVDP case. Usually we are doing Patrapotala
Cikitsa and Vaatavyaadhi Cikitsa.
svedam, Jambeera pinda svedam, Valukaa
. While considering disc prolapse it can be
svedam etc.
taken as Vrna. The nucleus is coming out
through annulus making a tear in it.
Vimlaapana - We can do spinal massage,
. The joint including two vertebrae and
Traction massage etc. Traction with pelvic
disc can be considered as one unit. The
traction belt can be used. Skin traction is also

9
DARSHAN 08
beneficial. We can decide the weight of
traction according tot the weight of the patient.
Usually 2Kg + 2Kg, 2.5Kg + 2.5Kg is used.
From my experience, my advice is not to use
traction weight more than 2.5Kg + 2.5Kg. If
we are using more weight, it may lead to neck
pain.
Upanaaha - Upanaaha with Jadaamayaadi
Coorna is good. We can use Eranda leaf for
Upanaaha Karma. Datura fruit or Eranda
seed and sesamum made into a paste with
milk can be used for Upanaaha. It gives good
result.
Visraavana - Raktamoksha can be done in
suitable patients.
Snehapaana - We can use Indukaanta
Gh rt am, Thiktaka Gh rt am for Sneha
paanam.
Virecana - It is a very important treatment
method in IVDP cases. Virecana can be done
with Gandharvahastaadi Erandam, Trvrut
Lehyam or Avipatti Coornam. We can give
Gandharvahastaadi Kashaayam with
Gandharvahastaadi Erandam in empty
stomach for Doshanulomana.
Bhagnacikitsa in IVDP
Angchana, Bandhana, Kapaatasayana and
Snehavasty is used here.
Angchana - Traction is mentioned here.
Traction massage, pelvic traction, skin
traction etc have great importance in the
treatment of disc prolapse.
Bandhana- Bandage in Kadeepradesa is an
important treatment. Usually we are doing
bandage with Murivenna. We are advising
the patient to wear L.S. corset while sitting
or walking.
Kapatasayanam - Taking full rest in bed. It
will reduce the muscle spasm.
10
Snehavasty - Snehavasty or Mathravasty is
a good treatment here. Snehavasty can be
done with Sahacharadi Sevyam, or
Dhanvantaram Sevyam. Usually we can do
Maatravasty with 75ml Sneham.
Principles of Vaata Vyaadhicikitsa in
IVDP
Snehanam, Svedanam and Sodhanam are
the principles of treatment here.
These are done in disc prolapse. In Snehana
we can use Vaatasamana tailam. Here I
would like to say about Kerala Ayurveda’s
product- Myaxyl oil. In my experience it gives
quick relief and a highly compliant drug.
Patrapodala svedam, Jambeera Svedam etc.
can be used here. After that we can select
Vasty or Virechana. Usually we are doing
Yogavasty ie 5 Snehavasty and 3
Kashaayavasty. Sahacaraadi Sevyam,
Dhanvantaram Sevyam can be used for
Snehavasty. Madhuthailika Vasty is used for
nirooha. In some cases Vaitarana Vasty and
Ksheeravasty can also be used. In some cases
where Vaatakopa is more Mathravasty with
Gandharvahastaerandam gives very good
result, usually applied in 60ml dose.
Kadeevasty:
Kadeevasty has a very important role in the
treatment of Kateegraham. In the beginning
stage we can do Kadeevasty. Kadeevasty
with Murivenna gives very good result. Picu
also gives good result. As Samanoushadha
we can give Sahacaaradi Kashaayam,
Gandharvahastaadi Kashaayam, Guggul
utiktakam Kashaayam, Guggulutiktakam
Gh r tam, Maharaasnaadi Kashaayam,
Raasnasaptakam Kashaayam etc.
. Yogasanaa like Bhujangaasana, Pavana
muktaasana etc. give good relief in most
of the IVDP cases.
DARSHAN 08
History taking plays an important role in the 2. Clinical Orthopaedics India. By. Dr.
diagnosis of causes of low back pain. History C.S.Kulkarni
in LBA will give the diagnosis 80% of the time. 3. Clinical Surgery By. S.Das
A doctor who cannot take a good history and 4. Short practice of Surgery By. Bailey and
a patient who cannot give one are both danger Love
- in danger of bad treatment. An accurate 5. Atlas of Orthopaedic Anatomy By. Frank
diagnosis is exceedingly important. Short and H. Netter
obese people have a greater chance of IVDP 6. Seminar Report. AVS
and tall and lean people are also prone for 7. Susruta Samhita Cikitsa Staana
IVDP. 8. Ashtaanga Hrdayam
References
1. A practical guide for the primary care
Clinician By Cole &Herring

“““““““

How to Prevent back ache:

1. Maintain your weight/height ratio with in normal limits.

2. Do regular exercise. Avoid continuous sitting for more than one
hour.
3. Avoid lifting over weight, loads.
4. Keep good posture while sitting and standing while sitting use back
support always.
5. Do Abhyangam regularly

(Contd. from page 30)

treatment offered in each individual cases.
In future the processing of data may help
in better clinical performance, research
activities and business purposes.
Consequently Clinical Research Wing,
Aluva Hospital had developed a protocol for
Clinical News
this purpose named Elementary
Assessment form on Clinical
management. This assessment format is
going to be implemented at Aluva hospital
from 01/04/2008on a trial run.

“““““““

11
DARSHAN 08
MY PRACTICE - MEMORABLE CASES IN LOW BACK ACHE
(These cases were presented by Dr. Sreeraj.I.P. in Darshan 08 held on March 4th)
Case 1
One male patient 38 yrs came to Kerala
Ayurveda Hospital, Kasargode with severe
pain on Low back region. The pain started
while lifting weight. He was working in UAE.
He was suffering from severe pain. He could
not walk without support. There was severe
back pain while coughing and sneezing. He was
admitted in a hospital at UAE for IP Allopathic
treatment care. But pain didn’t subside after
10 days. So he approached me. MRI report
suggests L4-L5 IVDP. The patient was
admitted. O/E-SLR positive. He couldn’t
move both legs mainly right leg. On the first
day I gave him Patrapodala svedam with
Sahacaaradi Tailam & Myaxyl oil. The same
day evening Kadeevasty was also done.
Lumbar Traction with 2kg+2kg weight was
also done. The same day evening he got
remarkable changes. He got considerable
relief in pain and could move his leg. I
continued the treatment. With in 7 days he
got 90 % relief. He could walk. SLR became
negative. Virecana with Avipaty coornam
was done on the last day. I advised him to
continue medicines for 3 months.
Medicines used were
. Gandharva hastaadi Kashaayam
. Dhanvantaram Gulika
. Balaarishtam
. Gandha Tailam 5 drops twice daily with
milk
Case 2
A 28 year old female patient came to me with
almost same symptoms as that of case 1. The
patient was lean and her body wt.34 kg.
12
Memorable Cases
Before approaching me she had taken
Allopathic Treatment and got temporary
relief.
O/E-SLR found positive
Patrapodala svedam done. Lumbar traction
with 1.5kg +1.5 kg done.
I tried to do Kadeevasty, but she couldn’t lie
on prone position at least for two minutes. For
the first 3 days there were no remarkable
changes. On the 3rd day I started Matravasty
with Dhanvantara Sevyam +
Gandharvahastaadi Erandam (30ml+30ml).
On the same day evening she got some relief.
I decided to administer Yogavasty in that
patient. Subsequently I have completed the
same. Maadhutailikam was selected as the
Kashaayavasty. After this Njavara Kizhi was
applied for three days. Traction was given on
all days. On the 10th day she was discharged.
Almost all symptoms were reduced
considerably and SLR became negative.
Medicines used were
. Sahacaraadi Kashaayam
. Balaarishtam + Asvagandhaarishtam
. Yogaraajaguggulu gulika 1—-0—-1
. Gandha Tailam 5 drops twice a day with
milk.
. Trvrut Lehyam at bed time.
. Asvagandhaadi Lehyam 2 tsp twice daily.
Case No.3
Here I remember one female Patient who was
at her eighties, from Asok Nagar Kasaragod.
Her family members brought her to our
hospital. Previously she was admitted in a
nearby Allopathic Hospital for 5 days. She had
very severe pain on Low back region, radiating
pain to both hip region and legs. They said she
DARSHAN 08
developed severe pain after a fall. Even if
Allopathic treatment was taken pain persisted
and she couldn’t walk. There she was given
treatment for IVDP–Traction Physio
Therapy etc. After examining the patient I
suggested to take an X-ray of lower spine. But
due to severe pain, we failed to move her to
the imaging centre. Kaadidhaara done on the
1st day and Balm Myaxyl was used for external
application. She got some relief. But the next
“““““““
(Contd. from page 4)
peril of the patient it was having a psychic
factor involved. I tried to assess the
psychological status of the patient. On doing
so I was fairly confident that the girl is a bit
showy or even hysteric and the inability to
walk is just a subconscious trick to attract
attention of the loving relatives. I wanted to
provide psychologic assistance to the patient.
For this I had to prove that she can walk, if
she realy wanted to do so. I made the girl
stand up on the floor. This she was able to do
with support under shoulder from two
relatives. I insisted that the support should
be withdrawn. The relatives hesitated a bit
and the patient beggd me not to do so. But
you know, I am a committed physician and
once I decided to do something, I did it. The
support was withdrawn. Oh! She was able to
stand without support. I considered this as a
mark of my success. I have proved that the
patient could stand without support. But the
patient was in pain and tears rolled down her
cheek as though she is suffering from
excruciating pain. This I considered to be an
act of the malicious mind of the patient since
I was convinced that the patient is showy. I
ordered her to walk. She walked a few steps
yelled and fell down. The byestanders
“““““““
13
Memorable Cases
day also she had severe pain. I again insisted
to do X-ray, routine blood and urine
examination. In the X-ray there were so many
patches in and hip bone vertebrae. ESR was
154 mm/hr, Hb-6 mg%. Urine-Bence Jones
Protein +ve. It was a case of Multiple
Myeloma. I told the bystander about her
condition and referred her to Medical College
Mangalore.
Frankly speaking
interfered in time and captured her so that
the fall was promptly checked. She was taken
back to her cot on arm cradle. In the evening
there was swelling and redness of both the
ankles! I was wrong. She was cent percent
correct. There is now organic evidence of her
pain. She was a patient of rheumatoid disease.
When I recapitulate the case, I regret
my obstinacy and I shrink of shyness.
I was rather inhuman and brutal in
insisting that the patient should walk
before me. I could have simply believed
the words of the patient.
What would have I lost if I believed her words
and put her on therapy for pain? Nothing!
Instead I insisted on evidence. It was a case
which taught me a valuable lesson. I learned
to believe the patient, as far as possible. The
incident taught me that I should not be
oversmart and I should have more humility
in regarding the patients. But believing the
patient also may be risky. (That may be
discussed in a later issue.) So the doctor
should have discriminative intelli
gence in believing the patient. In most
cases it is wise to believe them, if you
have no reason to believe that there is
malicious motive.
DARSHAN 08
BACK PAIN- CLINICAL APPROACH
(Dr. Jacob Jayan.B. BAMS, MBBS, MD, Dip.GM (Geri.Med) had done a presentation on
the modern clinical approaches in back pain in Darshan 2008 held on March 4th. Due to space
limitations we are able to publish only the summary of the presented paper. )
Back pain is
• A symptom not a disease.
• A common problem affects both sex and
all ages.
• The final common pathway of many
processes.
• The pathologic basis may be within or
outside spine.
“Seek facts and classify them and you will
be the workmen of the science.”
- Nicholas Maurice Arthus.
Classification
• Spondylogenic – pain from spinal column
and associated structures.
• Neurogenic – Pain from nerve roots due
to compression irritation or tension and
may radiate.
• Viscerogenic – Pain derived from
disorders of visceral organs.
• Vascular – Regional vascular problems
(aneurysms, POVD etc) pain may mimic
neurogenic pain.
• Psychogenic – Though rare it is not
uncommon. No organic cause can be
located. Clouding and confusion of clinical
picture by emotional overtones.
14
Causes
• Congenital/Developmental:
Spondylolysis/listhesis, kyphoscoliosis,
spinabifida occulta, teathered cord
• Traumatic: Strain/sprain–Falls/RTA,
IVDP
• Atraumatic: Osteoporosis, Neoplastic
diseases, Steroid use, IVDP
• Neoplastic: Metastatic,
hematologic,Primary bone tumors.
• Arthritis: Spondylosis,Facet/Sacroiliac
arthropathy & Autoimmune (Ankylosing
spondylitis, Reiters syndrome)
• Degenerative: Disk osteophyte complex,
internal disk disruption, spinal canal
stenosis with neurogenic claudication.
• Infection/Inflammation: Vertebral
osteomyelitis, Spinal epidural abscess,
septic disc, menigitis, lumbar arachnoiditis.
• Metabolic: Osteoporosis-Hyper
parathyroidism, Immobility &
Osteosclerosis (Paget’s disease)
Other causes:
1. Referred pain from other visceral
disease.
2. Postural.
3. Psychiatric – Malingering, chronic pain
syndrome.
4. Abdominal aortic dissection.
Back pain- Evaluation
• “It is important to know as much about
the man who has the pain as it is to know
about the pain the man has.” - Great Greek
Physicians
DARSHAN 08
Pain: An unpleasant sensory and emotional Examination of the back
experience, associated with actual or
potential tissue damage, or described in terms • Abdomen, rectum, costo-vertebral
of such damage. angles
• Spine-curvatures
• Local pain.
• Para spinal muscles
• Pain referred to the back.
• Pain of spinal origin. • Hip movements
• Radicular pain origin. • SLR test
• Pain associated with muscle spasm. • Neurological / Vascular
• Pain at rest.
• Postural pain • Pelvic examination

CLAUDICATION
Features Vascular Neurogenic
Pain Sharp, Cramp Vague, Radicular
Location Exercised Radicular/Diffuse
muscle
Radiation Rare after onset Very Common
proximal to distal
Aggravation Walking (up) Walk or stand
Relief Stop Activities Lying/Sitting
(rest) Quick Slow Relief
Relief
Focal Neurological
Deficit Not seen Usually seen
Pulse Absent Present
SLR Negative May + ve /- ve
*It is highly important to differentiate most commonly caused by protrusion of a low
claudication of vascular origin from that of lumbar intervertebral disc.
Neurogenic origin
• Leg pain including buttock is dominant to
Diagnostic criteria for Acute that of LBA.
Radicular Syndrome (ARS) • Neurologic symptoms seen(parasthesia
in dermatomes)
Acute Lumbosacral radicular syndrome • Significant SLR changes.
(LRS) is defined as pain, radiating from the • SLR<50% of normal
back into the leg to below the knee, in • Bowstring discomfort
combination with either Lassegue’s sign, or • Crossover pain
with segmental disorder characterized by • Focal Neurological Deficit
paresis, sensory disorders and/or changes in
reflexes reducible to a single nerve root. It is

15
DARSHAN 08
Cauda equina syndrome (Bilateral
ARS)
Even though low back pain is common and
usually subsides without surgery, cauda
equine syndrome, a rare disorder affecting the
bundle of nerve roots (cauda equina) at the
lower (lumbar) end of the spinal cord, is a
surgical emergency. Cauda equina syndrome
occurs when the nerve roots are compressed
and paralyzed, cutting off sensation and
movement. Nerve roots that control the
function of the bladder and bowel are
especially vulnerable to damage.
• Back pain (sudden worsening)
• B/L leg pain

Common neurological changes in ARS

Affected nerve roots
Features
L4 L5 S1
Motor weakness Knee extension Ankle dorsi Ankle plantar
flexion flexion
Middle shin to Dorsum of foot Lateral border
Sensory loss of feet and
knee and lateral calf
posterior calf
region
region
Reflexes Knee jerk- Ankle jerk- Ankle jerk-
diminished diminished diminished
Tibialis Calf, Minimum
Wasting Thigh
posterior and in thigh
Calf, Minimum
in thigh

• Saddle anesthesia • Elderly (65 - 85yrs) - Compression

• B/L lower extremity weakness fracture, tumor, infection
• Bowel, bladder involvement Conclusion
* Emergency MRI for diagnosis and Surgical • LBA common problem
decompression are unavoidable in the • DD are broad
management of A/c Compression at L3-L4, • Precise diagnosis is not very easy
L4-L5 /L5-S1 • Identify patients who require more/
Back pain- patterns urgent detailed evaluation
• Juveniles & adolescents (10-20yrs) – • Differentiate infection/cancer/
Infection, tumor, scheuermann’s d/s, inflammation/degeneration with ARS
spondylolysis. and vascular.
• Conservative management needed in
• Youngadults(20-40yrs)-Spondy majority.
loarthropathy, fracture(trauma)
• Middle age(35-70yrs) - Degenerative disc “Physicians think that they do a lot for a
diseases patient when they give his disease a name”-
IMMANUEL KANT.
“““““““
16
 AN EXPLORATION ON OUSHADHOPAYOGAKAALAM
Chronobiology is the study of biologic rhythm
and their underlying mechanisms. Many
normal human biologic functions exhibit
predictable cyclic patterns or rhythms that
can be defined in terms of specific
characteristics (cyclic length) and amplitude
(peak trough ratio). A daily reproducible
pattern of peak and troughs is seen in many
physiologic variables. A well known example
is the secretion of growth hormone. It will be
in its peak during sleep. Levels of plasma
testosterone and the cortisol which typically
peaks at the early morning are other
examples.
Human body have a built in 24 hours cycle
known as Circadian rhythm. Researchers have
started to realize that these natural rhythms
also apply to medical conditions and have
implications for treatment. When a medicine
is administered in a particular time, the
efficacy of the medicine will be more.
So keeping the goal to match the timing of the
treatment with the intrinsic timing of illness
would be clinically significant. Theoretically
optimum therapy is more likely to result when
the right amount of drug is delivered to the
correct target organ at the most appropriate
time. In contrast many side effects can be
minimized if a drug is not given when it is not
needed. The above said principles bear some
similarity with the Ayurvedic principles. I
thought it would be worthwhile if I could apply
this principle to verify the directions regarding
times of usage of drugs (Oushadhopayoga
Kaalam) in classical Ayurvedic texts.
Incidentally I found some interesting facts
about Galaganda. Vaagbhataacaarya has
explained types of galaganda. In kaphaja
17
Dr.Sandeep.K.M
Physician
Kerala Ayurveda
galaganda he says there will be increase in
the body weight, Ghurghurata - hoarseness
of voice and Krchra vaakyata - difficult to
speak. While explaining the Kaphaja disorders
S aarangadhara point out the following
symptoms; Thandra - drowsiness, atinidrata
- disturbed sleep, gaurava – feeling of
heaviness, saitya - cold feeling, aalasya -
laziness, manda budhitva – reduced
intelligence acetana - loss of concentration
and swinging of mood, Ghurghurata -
hoarseness of voice, avakyata-difficult to
speak.
An eager team of physicians including me
correlated these to Hypothyroidism. We
worked out on the possibility of when there
will be increase in kapha. It is said that
morning is the kapha kaala and in morning
and cold hours there will be increased secretion
of TSH and T4 levels.
“Madhura snighdha seetaadi bhojyair
divasa nidraya.
Mande agnau ca prabhate ca bhukta
matre tathaa sramaat
Sleshma prakopam yatyebhi
pratyaneekaisca saamyathi.”
Sha 2/35.
Also Kapha attains Prakopa
. By intake of sweet, oily, fatty, cold
food items
. By day sleep
. Physical inactivity
. In the morning and immediately after the
meals.
It is said that in kaphaja diseases oushadha
has to be given in morning before the food.
“Kaphodrake gade annam pratha: “ Consequently we the group of doctors made a
AH 21 clinical assessment on cases of Kaphaja
Saarngadhara also says that in diseases of galaganda correlated to hypothyroidism. We
kapha and pitta and for purpose of vamana, studied the efficacy of administering
virecana and lekhana medicines should be Kaanjcanaara Guggulu in morning time on
given in the morning. empty stomach against administering it after
food.
“praya: pitta kaphodraeke vireka
vamanarthayo: Considering all the above factors we
Lekhanartham ca bhaishajyam prabhathe concluded that for kapha roga and for
that samaharet” lekhanaartha the administration of
Sh 2/3 Kaanjcanaara Guggulu in the morning and
And also in Kaanjcanaara Yoga preparation before break fast would be the most effective
its indication and time of administration is as far as time of administration is concerned.
explained as he says … Kaanjcanaara To reestablish the above principles we have
Guggulu has to be given in morning time. divided the patients into 2 groups. And for one
group we have given treatment according to
Kaanjcanaara tvaco graahyam palaanaam the Oushadhopayoga kaalam, as mentioned
dasakam budhai: above. In the second group, we have given
…………. Kaanjcanaara Guggulu after food we have
Gudika saana maatrena praatargraahya conducted the study only in a limited no of
yathocitam patients, but the outcome was well along the
Gandamaalanaam jayati atyugram apaci lines of the classical Oushadhopayoga
arbudaani ca kaalam. See the tables given below.
Sh 4/15-129.
Drug given in
Group I (Early morning and Empty stomach)
No of Age Sex Treatment Initial Interim Final
Patients duration Value Value Value
PI 45 yrs F 12 weeks T3 - 1.6 1.8 1.8
T4 - 7.0 6.8 7.0
TSH - 6.9 6.6 6.6
P II 26 yrs F 5 weeks T3 - 0.6 — 0.9
T4 - 4.2 — 4.8
TSH - 10.2 — 10.0
P III 34 yrs F 8 weeks T3 - 0.9 3.2 13.5
T4 - 0.8 3.6 10.2
TSH - 0.8 3.7 10.0
P IV 22 yrs F 5 weeks T3 - 1.1 — 1.2
T4 - 5.2 — 5.5
TSH - 11.0 — 10.6
[* T3-ng/dl, T4-µg/dl, TSH-mIU/L]
(Contd. on page 32 )

18
MALE SEXUAL DYSFUNCTION AND MEDICINAL PLANTS WITH
APHRODISIAC POTENTIALS
Mr. Bose R. C., Dr. Sarala Samuel, Dr. C. I. Jolly
Aphrodisiac
Aphrodisiac was named after Aphrodite, the
Greek goddess of sexual love, beauty and
fruitfulness identified in Roman Mythology
with the goddess Venus, who was the
daughter of Zeus and Dione. However, the
Greek word ‘aphros’ means ‘foam’ and
according to the tradition recounted by
Hesoid, Aphrodite arose from the foam
generated when the severed genitals of
Uranius personification of Heavens were
thrown into the sea. Several ancient
authorities agreed that she was the wife of the
lame blacksmith, Hephaestus. An aphrodisiac
can therefore be described as any substance
that enhances sex drive and or sexual
pleasure. The Kama Sutra suggested that one
boils the testicle of a ram or goat and add milk
and sugar before consumption. In England, it
was believed that plants with any phallic-like
features such as asparagus, parsnips and
carrots were likely to be aphrodisiac in their
effect. Ukrainians celebrate carrots and celery
as folk aphrodisiac. In Chinese culture, much
of the aphrodisiac power of ginseng and
rhinoceros horn comes from their appearance
rather than their chemical composition.
Sexual dysfunction, that is the repeated
inability to achieve normal sexual intercourse,
which include various forms like premature
ejaculation, retrograded, retarded or
inhibited ejaculation, erectile dysfunction,
arousal difficulties (reduced libido),
compulsive sexual behaviour, orgasmic
disorder and failure of detumescence are on
19
R&D, Kerala Ayurveda
the increase world wide, because of aging
population and other increasing etiological
factors
One of the main aims of marriage is the
procreation (reproduction) and more
importantly for sexual fulfillment of both
partners. For life to continue, an organism
must reproduce itself before it dies. In Homo
sapiens, reproduction is initiated by the
mating of a male with a female in sexual
intercourse which facilitates the coming
together of sperm and egg for the purpose of
fertilization, for there to be a normal sexual
intercourse and sexual fulfillment in males,
the male sexual organs (the copulatory organ,
the penis) and factors relating to erection must
function normally. Inability to perform this
function effectively is a major problem facing
the reproductive process. This is known as
sexual dysfunction
Aphrodisiac can also be viewed as any food,
drug, scent or device that can arouse or
increase sexual drive or libido.
Male sexual function
Sexuality is a complex, multi-dimensional
phenomenon that incorporates biological,
psychological, interpersonal and behavioural
dimensions. For better sex, a person should
have good balanced hormone, physical
condition, mental condition, and neuronal
function.
Male Sexual act
Control of Male sexual function by
hormones;
A major share of the control of sexual
functions in both the male and the female
begins with secretion of gonadotropin –
releasing hormone (GnRH) by the
hypothalamus. This hormone in turn
stimulates the anterior pituitary gland to
secrete two other hormones called
Gonadotropic hormones (luteinizing
hormones (LH) and Follicle stimulating
hormones). The LH is the primary stimulus
for the secretion of testosterone by the testis
and FSH is mainly for the production of new
sperm cells.
Neuronal stimulus to perform the
male sexual act
The most important source of sensory nerve
signals for initiating the male sexual act is the
20
glans penis. The glans contains a special
sensitive sensory end organ system that
transmits into the central nervous system.
The erection is triggered and controlled by the
various events. Impulses may also enter the
spinal cord from areas adjacent to the penis
to aid in stimulating the sexual act.
Emission and Ejaculation-Function of
the Sympathetic Nerves.
Emission and ejaculation are the culmination
of the male sexual act. When the sexual
stimulus becomes extremely intense, the
reflex centers of the spinal cord begin to emit
sympathetic impulses that leave the cord and
pass to the genital organs through the nerve
plexuses to initiate emission, the forerunner
of ejaculation.
Emission begins with contraction of the vas
deferens and the ampulla to cause expulsion
of sperm into the internal urethra. Then,
contractions of the muscular coat of the
prostate gland followed by contraction of the
seminal vesicles expel prostatic and seminal
fluid also into the urethra, forcing the sperm
forward. All these fluids mix in the internal
urethra with mucus already secreted by the
bulbourethral glands to form the semen. The
process up to this point is emission.
Possible cause of Impotency
Many common medicines produce impotence
as a side effect. These include high blood
pressure drugs, antihistamines,
antidepressants, tranquilizers, appetite
suppressants, and cimetidine (an ulcer drug).
It is believed that psychological factors cause
10 to 20 percent of cases of impotence. These
factors include stress, anxiety, guilt,
depression, low self-esteem, and fear of
sexual failure. Such factors are broadly
associated with more than 80 percent of cases
of impotence, usually as secondary reactions
to physical causes.
Other possible causes of impotence are
smoking, which affects blood flow in veins and
arteries, and hormonal abnormalities, such as
insufficient testosterone.
The normal male sexual response cycle can
be functionally divided into five interrelated
events that occur in a defined sequence:
libido, erection,ejaculation,orgasm, and detum
escence.
1. Libido or sexual desire- Libido is
defined as the biological need for sexual
activity (the sex drive) and frequently is
expressed as sex-seeking behaviour. Its
intensity is variable between individuals as
well as within an individual over a given time.
Higher serum testosterone appears to be
21
associated with greater sexual activity in
healthy older but not younger men.
2. Erection- Erection is the enlarged and
rigid state of the sexually aroused penis
sufficient enough for vaginal penetration. It
results from multiple psychogenic and
sensory stimuli arising from imaginative,
visual, auditory, olfactory, gustatory, tactile,
and genital reflexogenic sources.
3. Ejaculation- Ejaculation is the act of
ejecting semen. It is a reflex action that occurs
as a result of sexual stimulation. It is made up
of two sequential processes. The first process
called emission is associated with deposition
of seminal fluid into the posterior urethra
while the second process is the true
ejaculation, which is the expulsion of the
seminal fluid from the posterior urethra
through the penile meatus.
4. Orgasm- This is the climax of sexual
excitement. The entire period of emission and
ejaculation is known as the male orgasm.
5. Detumescence- This is the subsidence
of an erect penis after ejaculation.
Male sexual dysfunction
Sex disorders of the male are classified into
disorders of sexual function, sexual
orientation, and sexual behaviour. In general,
several factors must work in harmony to
maintain normal sexual function. Such factors
include neural activity, vascular events,
intracavernosal nitric oxide system and
androgens. Thus, malfunctioning of at least
one of these could lead to sexual dysfunction
of any kind. Sexual dysfunction in men refers
to repeated inability to achieve normal sexual
intercourse. It can also be viewed as disorders
that interfere with a full sexual response cycle.
These disorders make it difficult for a person
to enjoy or to have sexual intercourse. While
sexual dysfunction rarely threatens physical
health, it can take a heavy psychological toll,
bringing on depression, anxiety, and
debilitating feelings of inadequacy.
Unfortunately, it is a problem often neglected
by the health care team who strive more with
the technical and more medically manageable
aspects of the patient’s illness. Sexual
dysfunction is more prevalent in males than
in females and thus, it is conventional to focus
more on male sexual difficulties. It has been
discovered that men between 17 and 96 years
old could suffer sexual dysfunction as a result
of psychological or physical health problems.
Sexual dysfunction takes different forms in
men. A dysfunction can be life-long and
always present, acquired, situational, or
generalized, occurring despite the situation.
A man may have a sexual problem if he:
ƒ Ejaculates before he or his partner desires
ƒ Does not ejaculate, or experiences delayed
ejaculation
ƒ Is unable to have an erection sufficient for
pleasurable intercourse
ƒ Feels pains during intercourse
ƒ Lacks or loses sexual desire.
Male sexual dysfunction can be categorized
as disorders of desire, disorders of orgasm,
erectile dysfunction, disorders of ejaculation
and failure of detumescence.
A. Disorders of desire: Disorders of desire
can involve either a deficient or compulsive
desire for sexual activity.
B. Erectile dysfunction (ED): This is a
problem with sexual arousal. ED can be
defined as the difficulty in achieving or
maintaining an erection sufficient for sexual
activity or penetration, at least 50% of the
time, for a period of six months
C. Disorders of ejaculation: There exists
a spectrum of disorders of ejaculation ranging
22
from mild premature to severely retarded or
absent ejaculation.
D. Disorders of orgasm: Male orgasmic
disorder is defined as a persistent or recurrent
delay in, or absence of orgasm after a normal
sexual excitement phase during sexual
activity.
E. Failure of detumescence: is a
prolonged erection usually lasting for between
4 h or greater. It is painful and always
unaccompanied by sexual desire despite the
fact that it is often preceded by usual sexual
stimuli.
General Methods used in Assessing
Aphrodisiac Properties
A. Physical Methods
1. Mating Behaviour Test
I. Mount frequency
II. Intromission frequency
III.Mount latency
IV. Intromission latency
V. Ejaculatory latency
VI. Post-ejaculatory interval
VII. Index of libido
2. Test for libido
3. Test for potency
4. Penile microcirculation study
5. Intracavernous Pressure (ICP)
Study
B. Biochemical Methods
1. Determination of Testicular and
Serum Cholesterol
2. Hormonal Determination
3. Assay for Neuronal Nitric Oxide
Synthase and Androgen Receptor
Protein
Sexual function is an important component of
quality of life and subjective well being in
humans. Sexual problems are widespread and
adversely affect mood, well being, and
interpersonal functioning. Sexual problems
are related to sexual desire and male erectile
dysfunction. Successful treatment of sexual
dysfunction may improve not only sexual
relationships, but also the overall quality of
life.
Treatments Available
Vasoactive injection, Sex Therapy, Oral
Medication Viagra, Yohimbine, Self-Injection
& Urethral suppositories containing
prostaglandin, Vacuum Devices, Surgical
Treatments, Penile Implants, Vascular
Reconstructive Surgery, Naturopathic
(Natural) Treatment, Herbal Medicine,
psychotherapy and Yoga.
AJAX
Ajax is a unique formulation of herbal
combination of highest quality introduced by
the department of Kerala Ayurveda Ltd. This
is one of a kind, potent and extraordinarily
effective natural sex enhancer which helps to
increase libido and sexual desire and works
as a powerful male sex stimulant. This ignites
the passion, love and romance in ones life and
helps to achieve new levels of erotic intimacy
and emotional closeness in the relationships.

SN Ingredients Sanskrit Hindi Malayalam Qty

1 Curculigo orchioides Musli Musli Musli 100 mg
2 Astercantha
longifolia Kokilaksha Talimakhava Vayalchulli 100 mg
3 Mucuna pruriens Atmagupta Kaunch Naykkorna 100 mg
4 Tribulus terrestris Gokshura Gokharu Nerinnil 100 mg
5 Withania somnifera Aswagandha Asgandh Amukkuram 50 mg
6 Yasadha bhasmam Yasadha Yasadha 30mg
bhasmam bhasmam

Benefits
• Improves Vigour and virility in male
• Prevents Premature ejaculation
• It helps to restore potency and Increase Libido
• Helps to Make more Sustained erections
• Increase Sexual desire
“““““““

Your valuable responses can be sent to us either in our postal address or in e-mail.
Kerala Ayurveda News & Views
Kerala Ayurveda Hospital
Bank Road
Aluva-01
Tel : 0484-3221365, 2626119, 2623578
E-mail : clinicalresearch@keralaayurveda.biz
hospital@keralaayurveda.biz

23
 MUCUNA OR COWHAGE
Dr.Sarala Samuel, Dr.C.I.Jolly andRemya.M.B.
In recent years science has made
breakthroughs in the understanding of sexual
dysfunction. But, for hundreds of years,
civilizations around the world have known
about locally grown herbs that achieve
wonderful results with far fewer side effects
than prescription drugs. One such plant, which
claims various medicinal properties is Mucuna
pruriens Linn. belonging to the botanical
family Leguminoseae. It is one of the popular
and important medicinal plants of India. It is
a constituent of more than 200 indigenous
drug formulations. The plant is an important
cover crop (or green manure crop) in many
parts of the world, especially among
subsistence farmers. .
This plant is widely used in Ayurveda, which
is the ancient traditional medicinal system in
India. All parts of Mucuna pruriens possess
valuable medicinal properties and there is a
heavy demand of Mucuna in Indian and
International drug markets.
24
R&D, Kerala Ayurveda
Where is it found?
It is indigenous to tropical regions, especially
Africa, India, and the West Indies. It is widely
spread over most of the subcontinent and is
found in bushes, hedges, and dry-deciduous,
low forests throughout the plains of India.
In India, 14 species of Mucuna are found in
the foothills of the Himalayas, the plains of
west Bengal, Madhya Pradesh, Karnataka,
Kerala, Andhra Pradesh, Uttar Pradesh, the
Andaman & Nicobar islands and Srilanka .
How does it look like?
Cowhage or Velvet bean (Mucuna pruriens)
is an annual herbaceous twining, climbing
legume with long, thin branches and opposite,
trifoliolate, lanceolate leaves 15 to 30 cm
length. Leaflets are broadly ovate, elliptic or
rhomboid ovate, unequal at base. Its flowers
are white to dark purple and hang in long
clusters or pendulous racemes. The fruit of
the plant is a pod, which is thick and leathery.
It is covered with reddish-orange coloured
long stiff hairs that are readily dislodged and
responsible for itching in workers involved in
collection of the plant. The species name
‘pruriens’ (from Latin, “itching sensation”)
refers to the results from contact with the
seedpod hairs. Pods curved, 5-10 cm x 1.5-
1.8 cm, longitudinally ribbed, turgid, densely
clothed with persistent pale brown or gray,
irritant bristles. Seeds, known as Mucuna
beans are black, 4-6 in a pod, hilum ovoid (6-
12 mm long) with funicular hilum.
What does it contains?
The plant is reported to have L-Dopa as a
major constituent mainly in seeds. Alkaloidal
constituents viz., mucunadine, mucunine,
prurienidine, prurienine are reported from
seeds. Numbers of amino acids are reported
from this plant. Epoxy fatty acids viz., cis-12,
13- epoxyoctadec-trans-9-cis-acid, cis-12,
13-epoxyoctadectrans-
9-enoic acids are reported. Lecithin is
reported to be present in seed. According to
Dr. Duke’s phytochemical and ethnobotanical
databases Mucuna pruriens contains many
diverse phytochemicals like 1-methyl-3-
carboxy-6,7-dihydroxy-1,2,3,4-tetrahy
droisoquinolone,5-hydroxy tryptamine,5-
methoxy-n,n-dimethyltryptamine-noxide, 5-
oxyindole-3-alkylamine, 6-methoxyharman,
alanine, arachidic acid, arginine, aspartic acid,
Ayurvedic Properties and Uses:
Seeds of the mucuna are usually prescribed
in the Indian traditional system of medicine,
especially in Ayurveda, for sexual and
nervous diseases. Seeds has a long history of
use in Ayurvedic medicine, where it is used
25
behenic acid, H-carboline, H -sitosterol,
bufotenine, choline, cystine, leucine, linoleic ac
id, myristic acid, n,ndimethyltryptamine,n,n-
dimethyltry ptamine-n-oxide, nicotine, oleic
acid, palmitic acid, palmitoleic acid,
phenylalanine, phosphorus, proline, protein,
saponins, serine, stearic acid, threonine,
tryptamine, tyrodine, valine and vernolic acid
. Recently three new lipid derivatives were
reported from n-hexane extract of seeds of
Mucuna pruriens, namely (Z)-Triactont-
5,7,9- triene; (Z)-Docos-2,4,6-trien-1,8-diol
and (Z)-Docos-5- en-1-oic acid. Misra and
Wagner reported isolation of four 1,2,3,4 tetra
hydroisoquinoline alkaloids from the seed.
for worms, dysentery, diarrhea, snakebite,
sexual debility, cough, tuberculosis,
impotence, rheumatic disorders, muscular
pain, gonorrhea, sterility, gout, delirium,
dysmenorrhea, diabetes, and cancer. In India,
it is considered as an aphrodisiac,
emmenagogue, uterine stimulant, nerve
tonic, diuretic, and blood purifier. Seeds are
astringent, laxative, anthelmintic, aphrodisiac,
alexipharmic and tonic. They are useful in
gonorrhoea, sterility, vitiated conditions of
vaata and general debility.
Mucuna pruriens can improve sexual
behavior, libido, and performance. Mucuna
pruriens when administered in a dose of 75
mg/kg body weight daily increased the sexual
activity of male albino rats considerably by
stimulating testosterone level. A ten fold
increase in the mounting frequency was
observed. Research shows that sexually
active animals had increased sexual desire and
improved sexual performance after 21 to 28
days. However, impotent animals did not
derived any benefits.(AminKMY)
Another research shows that Mucuna
pruriens heightened arousal and increased
sexual activity to a moderate extent but also
sustains it for a longer time as indicated by
the increase in below Ejaculation Latency and
decrease in Post Ejaculatory Interval. Mucuna
prueins is shown to possess central depressant
activity. The delay in ejaculation could be due
to toning down of hypersensitity of genitals
and hyperexcitation of the regulatory centers.
This study show that Mucuna pruriens can
be used to improve libido and delay
premature ejaculation ( Giuliano F).
The traditional aphrodisiac property of this
plant is scientifically analyzed and proved by
several experiments using seeds of M.
pruriens. According to the studies of Amin et
al , Mucuna pruriens stimulates sexual
function in normal male rats which was
observed by increase in mounting frequency,
intromission frequency and ejaculation
latency where as, Rajendran et al proved the
decrease in sexual function in female rats.
How to grow it in your garden?
Velvet bean is a minor leguminous crop, many
cultivars of which are suitable for the more
26
humid regions of the tropics, while others, e.g.
the Mauritius velvet bean, are suitable for dry
land farming. They can be grown successfully
on soils unsuitable for cowpeas, but have the
disadvantage of a longer growth period and
are more difficult to thresh. Moreover, the seed
is not highly valued for human or animal
feeding, because of the prolonged soaking and,
or, boiling required before it can be consumed
safely. The leaves and vines make an excellent
fodder.
Velvet beans are frequently grown mixed with
other vigorous growing crops such as
sugarcane or maize. They are also grown as a
green manure or cover crop and are
particularly valuable as an anti-erosion crop.
In India the wild species is often used as a
cover crop in coconut plantations. When grown
as a mixed crop with cereals, such as maize or
millet, it is usual to plant every alternate or
third row with velvet beans.
For optimum results the seedbed should be
well prepared to a depth of at least 15 cm and
completely free from weeds. Little is known
of the crop’s precise requirements, but it
responds to applications of phosphate.
Harvest: When grown for seed the crops can
be harvested approximately 180 to 270 days
after planting. When grown for forage, the
plants are usually harvested between 90 and
120 days after sowing. The pods should be
thoroughly ripe before being harvested. As
they are liable to shatter, they are often hand-
picked and are usually left to dry for several
days before being threshed. Threshing can be
carried out by hand or machine, but
whichever method is used only fully mature,
dry pods can be threshed without difficulty.
Propagation
Multiplication: Seeds are used, germination is
hypogeal and usually occurs within 5-7 days,
with a rate of between 90-95%. Inoculation
of the seed is not usually necessary if velvet
beans are grown in areas where the cowpea
has been cultivated, otherwise inoculation
with a commercial cowpea inoculum may be
necessary.
Planting: When grown for the production of
seed, planting is usually in rows, but when
grown as a fodder or green manure crop, the
seeds are often broadcast. Adapted maize
planters with thick plates and enlarged holes
are sometimes used for planting in countries
such as USA, S. Africa and Australia. In Asia
the crop normally receives little attention, but
the suppression of weeds during the early
stages of growth and the provision of supports
for the vines to climb is beneficial. When
grown for seed, velvet beans are frequently
planted in rows 90-180 cm apart, with 15-90
cm between the plants. In India the average
seed-rate is reported to vary between 28-50
kg/ha, in most other countries it normally
varies from 11-22 kg/ha, when the crop is
planted in rows, and from 45-90 kg/ha when
broadcast.
What are the vernacular names?
It is referred to as Aatmagupta/Kapikachu
in Sanskrit. Gonca is the Hindi name. In
South Indian languages it is known as
Punaikkali, pillaidugu or Masuganni. In
Malayalam it is commonly known as
Naykkurana and in English it is commonly
called as cowhage or velvetbean
Forklore Uses:
. In Central America, velvet beans have
been roasted and ground to make a coffee
substitute for decades; its goes by the
common name of “nescafé” in these
regions, as well as in Brazil, for this reason.
. It is still grown as a food crop by the
Ketchi indigenous people in Guatemala;
the bean is cooked as a vegetable.
. In Brazil the seed has been used internally
for Parkinson’s disease, edema,
impotence, intestinal gas, and worms. It
27
is considered a diuretic, nerve tonic, and
aphrodisiac. Externally it is applied to
ulcers.
. Velvet bean has a long history of use in
Indian Ayurvedic medicine, where it is
used for cancer, catarrh, cholera, cough,
debility, delerium, diabetes, diarrhea,
diuretic, dysentery, edema, fertility, gout,
impotency, kidney stones, menstrual
disorders, nervousness, scorpion sting,
snakebite, sterility, tuberculosis, worms,
and as an aphrodisiac and uterine
stimulant
REFERENCES
1. D. Buckles. Velvet bean(Mucuna pruriens)
: A “new” plant with a history.
Economic Botany 49(1): 13-25 (1995).
2. J.F. Caius. The medicinal and poisonous
legumes of India, (Scientific Publishers,
Jodhpur, 1989) pp. 70-71.
3. The Wealth of India. Raw materials Vol.
6, (CSIR, New Delhi, 1985) pp. 442.
4. P.K. Warrier, Nambiar and Ramakutty.
Indian medicinal plants-a compendium of
500
species, Vol. 4, (Orient Longman Ltd,
Madras, 1995) pp. 68-72.
5. R.P. Rastogi and B.N. Mehrotra.
Compendium of Indian medicinal plants,
Vol.5,
(CDRI, Lucknow, 1994) pp.554.
6. A.A. Farooqi, B.S. Sree Ramu. Cultivation
of medicinal and aromatic crops,
(Universities Press, New Delhi, 2001)
pp.74.
7. S. P. Agharkar. Medicinal plants of
Bombay presidency, (Scientific
publishers,
Jodhpur, 1991) pp. 1-2.
8. Amin KMY, Khan MN, Zillur-Rehman S,
et al. (1996).”Sexual function improving
effect of Mucuna pruriens in sexually
normal male rats”. Fitoterapia, jrg.67
(nr.1): pp. 53-58. Quote: The seeds of
Mucuna pruriens are widely used for treating
male sexual dysfunction in Tibb-e-Unani
(Unani Medicine), the traditional system
of medicine of Indo-Pakistan sub-
continent.
9. Giuliano F, Allard J. Dopamine and male
sexual function. 2001. Eur Urol 40:601-
608. PMID 11805404
10. Giuliano F, Allard J. Dopamine and sexual
function. 2001. Int J Impot Res 13 Suppl
3:S18-S28.DOI10.1038/
sj.ijir.3900719PMID 11477488
11. C.S.T. Sastry and Y.Y. Kavathekar. Plants
for reclamation of wastelands,
(Publications and Information
Directorate, New Delhi, 1990) pp. 317-
318.
12. D.M. Verma, N. Balakrishnan and R.D.
Dixit. Flora of Madhya Pradesh.
(Botanical
Survey of India, Lucknow, 1993) pp.190-
191.
13. G.V. Satyavati, A.K. Gupta and N. Tandon.
Medicinal Plants of India. Vol II, (Indian
Council of Medical research, New Delhi,
1987) pp. 282-289.
14. P.C. Sharma, M.B.Yelne and T.J.Dennis.
Database on medicinal plants used in
Ayurveda. Vol 1. (Central council for
Research in Ayurveda and Siddha, New
Delhi,
2000) pp. 200.
15. E.A. Bell and D.H. Janzen. Medical and
ecological considerations of L-Dopa and 5-
HTP in seeds. Nature 229: 136-7 (1971).
16. M. Damodaran and R. Ramaswamy.
Isolation of 1-3,4dihydroxyphenylalanine
“““““““
28
from the seeds of Mucuna pruriens .
Biochem. J. 31: 2149-52 (1937).
17. M.E. Daxenbichler, C.H. VanEtten, E.A.
Hallinan, F.R. Earle and A.S. Barclay.
Seeds as sources of L-dopa. Journal of
Medicinal Chemistry 14: 463-465 (1971).
18. J.C. Mehta and D.N. Majumdar. Indian
medicinal plants. Part V. Mucuna
pruriens
bark. (N.O. Papilionaceae) Part I. Indian
J pharm. 6: 92-95 (1944).
19. D.K. Santra and D.N. Majumdar. The
Mucuna pruriens D.C. Part II. Isolation
of
water soluble alkaloids. Indian J pharm.
15: 60-61 (1953).
20. D.N. Majumdar and C.D. Zalani. Mucuna
pruriens , D.C. Alkaloidal constituents.
Part III. Isolation of water soluble
alkaloids and a study of their chemical and
physiological charaterisations. Indian.
J.Pharm. 15: 62-65 (1953).
Pharmacognosy ReviewsVol 1, Issue 1,
Jan- May, 2007 PHCOG REV.An official
Publication of Phcog.Net
21. R. Pant, C. Rajagopalan Nair, K.S. Singh
and G.S. Koshti. Amino acid composition
of some wild legumes. Curr Sci. 43: 235-
239 (1974).
22. G.S. Niranjan and S.K. Katuyar. Chemical
composition of some legumes. J. Indian.
Chem. Soc. 56: 822-823 (1979).
23. S.Q. Hasan, M.R.K. Sherwani, I. Ahmad,
F. Ahmad and S.M. Osman. Epoxy acids
of
Mucuna prurita seed oil. J. Indian Chem
Soc. 57(9): 920-923 (1980).
 KAPIKACHU (Mucuna pruriens) -AYURVEDIC VIEW
Kapikachu enjoys an important place among
aphrodisiac herbs in India since ancient times.
Susrutha mentions the use of its seeds as
promoters of virility, as also Bhaavamisra.
Yogaratnaakara has reference of its use in
formulations for tremors.
Kapikachu literally means one who
scratches the body like a monkey. The surface
of pods of this climber is covered with bristles,
which are allergic to skin. On touching, it gives
intensive itching sensation. Hence aptly it is
named as Kapikachu.
It is categorized as V r shya – the
substance that improves sexual vitality and
functioning. Use of Kapikachu as anti
helmenthic has also mentioned in older books
on traditional medium.
Synonyms of Kapikachu are ‘Makati’,
‘Kauca’, ‘Aatmagupta’.
Its seed contains L-3, 4 dihydroxy
phenylalanines (L-Dopa) which is found to be
effective in Parkinsonism disease. The plant
extract showed marked hypotensive and
hypocholestremic effect in normal rats.
PROPERTIES
• Rasa-Madhura, Tikta
• Guna-Guru, Snigdha
• Vipaaka-Madhura
• Veerya-Ushna
“““““““
29
Dr.Pinchu Paulson, House Surgeon
ALN Rao Memorial Ayurvedic
MC Koppa, Karnataka
USES
• Alleviates Vaata, Pitta and Kapha
• Daatupushti
It is seldom used externally. Seeds are
the most tonics for impotency and for
enhancing sexual vitality. It works well as
restorative for conditions of debility and
weakness. It has been shown to increase the
testosterone levels, helps the deposit of
proteins in muscles and increase muscle mass
and strength. Its extract is known to enhance
mental alertness and improve co-ordination.
• Balavardhaka
• Maintains blood circulation
• It is said that Kapikachu and Kokilaksha
impart very potent effect on sexual
function, when taken with sugar and
followed by milk. It augments the seminal
fluids, vitality and vigor.
• The hot Kashaaya of the Beeja is an
excellent panacea for premature
ejaculation in men seed is useful as
Galactogouge in lactating mothers.
• Roots are mootrala and helps to regulate
the Aartavacakra. The Kashaaya of
moola is beneficial for renal problem and
dysuria.
• In Vaata vikaara like Ardita,
Apabaahuka, Kampavaata,
Pakshaaghaata etc, the decoction of
Kapikachu is rewarding.
• In bronchial Asthma the seed powder,
honey and ghee are an effective
combination.

• A work out on hyper cholestero
lemia
An in house study on Hypercholesterolemia
planned in the 2nd week of December 2007
was started on 1 st of January 2008 was
successfully completed on 3 rd week of
February. The study intended to focus on the
cardiovascular health profile of Kerala
Ayurveda’s staffs and relatives with a
preferred age group of 35 years and above.
The study faced an over whelming response
of participation of 41 subjects. Inclusion
criterion primarily poised the value of Total
cholesterol, of 200mg/dl and above. Fifty
percentage of cases fell outside the inclusion
criterion and most of them where having a
safe lipid level status. An appealing thing
noted among them was fish items (curry
preparations) formed the bulk in the non
vegetarian part of their diet; mainly small
fishes like Indian mackerel or scomber (Mal-
Ayala) and Sardinella (Mal-Caala/Mathi).
The incorporated subjects were randomized
and included in 3 groups, where in one group
Tab.Liposem was administered and in
another group Rasonaadi Kashaayam was
administered. Both these were compared
against the third one where Rasonaadi
Kashaayam + Tab.Liposem were given. Total
duration of the study was 4 weeks offered as
a complete free of cost programme. Best cure
in controlling Total cholesterol was met with
groups Liposem and Rasonaadi + Liposem.
Best cure in controlling LDL was met with
group Liposem. Best cure in controlling
Triglycerides was met with group Rasonaadi
+ Liposem and Rasonaadi Kashaayam was
found to be superior over Liposem in
controlling Triglycerides. In elevating HDL to
safe level a mild to moderate effect was
observed with the group Rasonaadi +
Liposem. A final and detailed report will be
published soon. Dr.Sahny.M.Soman, Clinical
Research Co-ordinator was the investigator
30
Clinical News
of the study. Support from Department of
R&D and Mr.Bose.R.C, Deputy Manager,
Clinical Research helped in completing the
study within the stipulated time. A more
predictive study is planned and being
conducted in another group to bring out more
substantiating outcome.
• Protocol on LBA
From the monthly clinical data received from
KAL clinics it was found that 60% of the total
cases reported were related with lower spine
diseases. Out of which 80% fall under
degenerative diseases of lower spine. As per
the discussions conducted among the panel of
physicians in Kerala Ayurveda Hospital Aluva
those cases where diagnostically included as
Gambheeravaatarakta and again more than
75% of such cases of were age group 35 years
and above. These scientific data tempted
clinical research wing to conduct a structured
study on spondylosis of lumbosacral spine. In
this perspective a common workup protocol
named “Degenerative Diseases of Lower
Spine Evaluation” was developed by the
clinical research wing. It was presented to the
doctors of Kerala cluster on 4th March 2008
Darshan. Doctors are expected to interact
with the clinical research wing for the
successful implementation of the same.
• Elementary assessment form
In a research review meeting held at Kerala
Ayurveda Hospital, Aluva on 27/03/2008
under the presidency of Dr.K.Anilkumar (The
participants were Dr.K.Sasidharan, Dr. Sahny
M.Soman and Dr.K. Vasanthakum ari) it was
decided to do assessment on the clinical
management on all the patients attending our
clinics, by working on a common protocol. This
aims to report the safety and efficacy of
(Contd. on page 11)
 Profession and Economy
Profession and Economy
Kerala Ayurveda had newly opened two clinics in Koramangala and Pondichery. The
Koramangala Clinic inaugurated by Mr.Jithu Mehta, President of Katra Group on 19th March
2008, at 9.30 am and the Pondichery Clinic inaugurated by Mr.Sonjoy Mohanty, MD & CEO,
Kerala Ayurveda Ltd, on 24th March 2008, at 9.30 am. Franchise operation division received
appreciation from all in putting their untiring efforts to place Kerala Ayurveda as a unique
entrepreneur in the Ayurvedic field. The clinics’ addresses are given below

Kerala Ayurveda Clinic Kerala Ayurveda Clinic

NSS Enterprises, No.400, 18th Main, Old No.21, New No.33
6th Block, Koramangala Bangalore LalliTollendaStreet,Pondichery
560 095, Tel: 080 6532005566 605 301, Tel: 0413-2221100

Darshan-2008 – Report
Kerala Ayurveda Health Service division
organized a one day interactive session for the
doctors of Kerala cluster on 4th March 2008 at
Aluva as a part of continuing medical education
programme (CME) “DARSHAN-2008”. The
programme started with a prayer of
Dr.K.Vasanthakumari and inaugurated by well
known physician Padmasree Dr.K.Rajagopalan
in the presence of Dr.K.Anilkumar ED&T,
Kerala Ayurveda Ltd, Dr.K.Sasidharan,
Medical Superint endent Kerala Ayurveda
Hospital, Aluva and Ms.Dulari.S.S, Manager
(M&A). Twenty two doctors participated in the function. After that Dr.I.P.Sreeraj, Manager
and Physician, Kerala Ayurveda Clinic, Kasargod presented a paper on “KATEEGRAHA”.
Dr.K.Rajagopalan and Dr.K.Sasidharan were the moderators of all the sessions. Dr Jacob Jayan
presented a papaer on the clinical approaches in back pain. Dr Sahny. M. Soman, Clinical
research co-ordinator explained about the data management of Kateegraha and presented a
protocol on “Degenerative Diseases of Lower Spine Evaluation”. The interactive session started
at 4 PM with an introductory speech on the topic by Padmasree Dr K Rajagopalan. He reminded
the importance of sticking to the basic principles of Ayurvedic pathophysiology and treatment
though it is vital to utilize the modern knowledge and tools for patients’ benefit.
After the interactive session the certificate of merit was given to Dr.I.P.Sreeraj. Other
participants were given certificates for their participation. Ms.Dulari.S.S extended the vote
for thanks to all participants. The programme was coordinated by Dr.Tiju.M.Thomas. One
and all congratulated the health service and the organizing chairman Dr.K.Sasidharan for the
accomplishment of the program.

31
 Profession and Economy
Freshly promoted
Dr.Induchoodan has been recently promoted as Manager (Marketing & Administration). He
has been working with Kerala Ayurveda for the past one year. During this period he had
proven his talent in practice and academic activities. His last assignment was as Asst.Manager
in Health service. Everybody wished him success in his new endeavor.
Darshan 08-Chennai
The program of “Darshan 2008” in Chennai cluster is planned on 22nd of April. The presenter
would be Dr.P.V.Haridas Warrier, Adayar Clinic. All the doctors from Chennai are expected
to participate in this program. The topic of presentation selected is “Stress Management”.
The presenter will be awarded the certificate of merit and each participants will be given the
certificate of participation. Dr.K.Sasidharan, Medical Superintendent would be the moderator.

“““““““

(Contd. from page 18)

Drug given in
Group II (After food)

No of Age Sex Treatment Initial Interim Final

Patients duration Value Value Value
PI 26 yrs F 3 months T3 - 1.8 — 1.9
T4 - 7.1 — 7.5
TSH - 12.1 — 9.2
[* T3-ng/dl, T4-µg/dl, TSH-mIU/L]

Unfortunately due to the lack of research
settings and patient preferences we were
unable to conduct the study in a properly
designed form, including the total duration
there by standardizing the treatment.
However the observed values are enlisted in
the table.
From the observations it was found that the
administration of drug at Dosha prakopaav
asta will have more effect than the drug
administered not in the dosha
prakopaavasta. The essence of circadian
rhythm and the chronobiology were found
thousands of years back by our great
aacaaryas in the form of Dosha avastha and
Oushadha Kaala. I think this chosen study in
a considerable sample size, could bring more
trustworthy results, if conducted in a well
designed form.

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32
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