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{{#seo:

|title=Yonivyapat Chikitsa

|title=Yonivyapat Chikitsa

|type=article

|type=article

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<big>'''[[Chikitsa Sthana]] Chapter 30. Management of disorders of genital tract </big>'''  

<big>'''[[Chikitsa Sthana]] Chapter 30. Management of disorders of genital tract </big>'''  

{{Infobox

{{Infobox

|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|label6 = Translator and commentator

|label6 = Translator and commentator

|data6 = Suman S. Wanjarkhedkar P., Sabnis M., Gujarathi J.,Deole Y. S.

|data6 = Suman S. Wanjarkhedkar P., Sabnis M., Gujarathi J., [[Yogesh Deole|Deole Y. S.]]

|label7 = Reviewer  

|label7 = Reviewer  

|data7  = Roy A.,Gujarathi J.

|data7  = Roy A., Gujarathi J.

|label8 = Editors  

|label8 = Editors  

|data8  = Gujarathi J., Deole Y.S., Basisht G.  

|data8  = Gujarathi J., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication  

|label9 = Year of publication  

|data9 = 2020

|data9 = 2020

}}

}}

<big>''' Abstract </big>'''

<big>''' Abstract </big>'''

<div style="text-align:justify;">

<p style='text-align:justify;'>[[Yonivyapat Chikitsa]] mainly deals with the management of disorders of male and female genital tract and reproductive system. It also includes the abnormalities of breast milk and its impact on baby and some guidelines for the management of diseases in children. The last part comprises of some important general principles in clinical management of diseases like factors influencing disease process, time of administration of medicine and route of administration.  

[[Yonivyapat Chikitsa]] mainly deals with the management of disorders of male and female genital tract and reproductive system. It also includes the abnormalities of breast milk and its impact on baby and some guidelines for the management of diseases in children. The last part comprises of some important general principles in clinical management of diseases like factors influencing disease process, time of administration of medicine and route of administration.  

 

The disorders of the female genital tract are described under twenty ''yonivyapat'' (''yoni''(vagina),''vyapat''(disorders)) based upon the vitiation of [[dosha]] and dushyas. ''Rakta yoni'' (per vaginal bleeding) and ''pradara'' (menorrhagia) are described separately considering its importance in gynecology practice. The local and generalized management of these disorders with [[Panchakarma]], [[basti]] and ''uttara basti'' procedures, vaginal douches are enlisted.  

The disorders of the female genital tract are described under twenty ''yonivyapat'' (''yoni''(vagina),''vyapat''(disorders)) based upon the vitiation of [[dosha]] and dushyas. ''Rakta yoni'' (per vaginal bleeding) and ''pradara'' (menorrhagia) are described separately considering its importance in gynecology practice. The local and generalized management of these disorders with [[Panchakarma]], [[basti]] and ''uttara basti'' procedures, vaginal douches are enlisted.  

 

Various disorders of the male genital tract, causes of impotency, defects of semen and their management are elaborated further. The chapter is comprehensive manual of management of disorders of male and female genital tract as well as guidelines for pediatric practice.   

Various disorders of the male genital tract, causes of impotency, defects of semen and their management are elaborated further. The chapter is comprehensive manual of management of disorders of male and female genital tract as well as guidelines for pediatric practice.   

 

'''Keywords''': ''Yonivyapat'' (disorders of female genital tract), ''shukra'' (semen and sperm), [[artava]] (menstruation), ''klaibya'' (impotency), disorders of male genital tract, ''stanya'' (breast milk), ''pradara'' (menorrhagia), dysmenorrhoea, pediatrics,circadian rhythm, ''aushadha sevana kala'', chrnonopharmacolgy.

'''Keywords''': ''Yonivyapat'' (disorders of female genital tract), ''shukra'' (semen and sperm), [[artava]] (menstruation), ''klaibya'' (impotency), disorders of male genital tract, ''stanya'' (breast milk), ''pradara'' (menorrhagia), dysmenorrhoea, pediatrics,circadian rhythm, ''aushadha sevana kala'', chrnonopharmacolgy.

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== Introduction ==

== Introduction ==

<div style="text-align:justify;">

<div style="text-align:justify;">

==== Principles of treatment of ''yonivyapat'' ====

==== Principles of treatment of ''yonivyapat'' ====

The general line of treatment should be targeted towards the ''dosha'', hence ''vataja, pittaja, kaphaja yonivypat'' should be treated accordingly with ''snehana swedana, raktapittahara sheeta, ruksha ushna'' therapies respectively. In all types of gynecological disorders, [[Panchakarma]] should be administered in mild form in order to eliminate the vitiated ''doshas'' and restoring normal reproductive health. Principles of surgical corrections of congenital anomalies and displaced organs are also given stating that the uterus which has been displaced from its original place should be regarded as ''shalya'' and the treatment of ''shalya'' is its removal. Hence this is the indication of hysterectomy in complete genital prolapse. The method of such procedure is not given in any classics. [41-46]

The general line of treatment should be targeted towards the [[dosha]], hence [[vata]]ja, [[pitta]]ja, [[kapha]]ja yonivypat should be treated accordingly with [[snehana]] [[swedana]], raktapittahara sheeta, ruksha ushna therapies respectively. In all types of gynecological disorders, [[Panchakarma]] should be administered in mild form in order to eliminate the vitiated [[dosha]] and restoring normal reproductive health. Principles of surgical corrections of congenital anomalies and displaced organs are also given stating that the uterus which has been displaced from its original place should be regarded as ''shalya'' and the treatment of ''shalya'' is its removal. Hence this is the indication of hysterectomy in complete genital prolapse. The method of such procedure is not given in any classics. [41-46]

Local treatments like douching, fomentation, keeping oil tampon, vaginal suppositories, fumigation. Indications and method of preparation of such medicines in form of oil, ghee, suppository and others are described later. Other preparations are in the form of ''churna, vati, kwath'', oil, ghee are to be used orally or in the form of ''basti'' (medicated enema) or ''uttarabasti'' (administration of medicine in uterus through vaginal route) are given in detail. [47-114]

Local treatments like douching, fomentation, keeping oil tampon, vaginal suppositories, fumigation. Indications and method of preparation of such medicines in form of oil, ghee, suppository and others are described later. Other preparations are in the form of ''churna, vati, kwath'', oil, ghee are to be used orally or in the form of [[basti]](medicated enema) or ''uttarabasti'' (administration of medicine in uterus through vaginal route) are given in detail. [47-114]

The importance of ''vata dosha'' in causing female reproductive tract disorders is highlighted as the location of genital organs is also the seat of ''apana vayu'' and all the functions like menstruation, pregnancy, labor are governed by ''apana vayu''. Hence considering the crucial role of ''vata'', the treatment should be aimed at ''vata'' alleviation along with other therapies.[114-116]

The importance of [[vata dosha]] in causing female reproductive tract disorders is highlighted as the location of genital organs is also the seat of apana [[vayu]] and all the functions like menstruation, pregnancy, labor are governed by apana [[vayu]]. Hence considering the crucial role of [[vata]], the treatment should be aimed at [[vata]] alleviation along with other therapies.[114-116]

The soul resides when the genital organs are cleansed with all therapies and the male and female gamete are favorable for conception and best. [126]

The soul resides when the genital organs are cleansed with all therapies and the male and female gamete are favorable for conception and best. [126]

==== Male genital tract and its disorders ====

==== Male genital tract and its disorders ====

   

   

By ''retovaha srotas'' the pathway through which the semen flows out shall be considered; which can be correlated to the seminal vesicles and ejaculatory duct. ''Retovaha srotas'' has been discussed separately to make it understand that is is different than ''shukravaha srotas''. As mentioned earlier ''shukravaha srotas'' comprises of ''medhra'' (the penis) and ''vrishana'' (the scrotum), which is referred for stationary semen; while ''retas'' is the word for virile semen, that is flowing semen. Therefore the words ''shukra'' and ''retas'' have been used separately in different context as per the suitability and the intention of description. [133-139]

By ''retovaha srotas'' the pathway through which the semen flows out shall be considered; which can be correlated to the seminal vesicles and ejaculatory duct. ''Retovaha srotas'' has been discussed separately to make it understand that is is different than ''shukravaha srotas''. As mentioned earlier ''shukravaha srotas'' comprises of ''medhra'' (the penis) and ''vrishana'' (the scrotum), which is referred for stationary semen; while ''retas'' is the word for virile semen, that is flowing semen. Therefore the words [[shukra]] and ''retas'' have been used separately in different context as per the suitability and the intention of description. [133-139]

===== Abnormal semen =====

===== Abnormal semen =====

====== The characteristics of abnormal semen ======

====== The characteristics of abnormal semen ======

The ''shukra dushti'' has been mentioned as of eight types by Sushruta, although the nomenclature is different.  

The [[shukra]] dushti has been mentioned as of eight types by Sushruta, although the nomenclature is different.  

'''Table : 1 Classification of ''shukra dushti'' according to Sushruta<ref>Sushruta. Sharira Sthana, Cha.2 Shukrashonitashuddhi Sharira Adhyaya verse 2-3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>  and ''Ashtanga Sangraha'''''  

'''Table : 1 Classification of [[shukra]] dushti according to Sushruta<ref>Sushruta. Sharira Sthana, Cha.2 Shukrashonitashuddhi Sharira Adhyaya verse 2-3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>  and ''Ashtanga Sangraha'''''  

{| class="wikitable"

{| class="wikitable"

! scope="col"| Clinical Conditions

! scope="col"| Clinical Conditions

|-

|-

| ''Vata dushta''

| [[Vata]] dushta

| ''Aruna, krishna varna, phenila, tanu, rooksha, alpa, vilambita vedana yukta''

| Aruna, krishna varna, phenila, tanu, rooksha, alpa, vilambita vedana yukta

| Oligospermia and azospermia, injury, chronic inflammation, low fructose, obstruction in seminal vesicle  

| Oligospermia and azospermia, injury, chronic inflammation, low fructose, obstruction in seminal vesicle  

|-

|-

| ''Pitta dushta''

| [[Pitta]] dushta

| ''Neela varna, ushna, putigandha, daha chosha'' type of pain during ejaculation  

| Neela varna, ushna, putigandha, daha chosha type of pain during ejaculation  

| Acute prostitis

| Acute prostitis

|-  

|-  

| ''Sleshma dushta''

| [[Kapha]] dushta

| ''Shukla varna, atipicchila, prabuta, kandu yukta, visra gandha''

| Shukla varna, atipicchila, prabuta, kandu yukta, visra gandha

| Chronic inflammatory condition, hypofunction of male sex accessory glands  

| Chronic inflammatory condition, hypofunction of male sex accessory glands  

|-

|-

| ''Kunapa – Shonita dushta''

| Kunapa – Shonita dushta

| Cadaver smelling, ''analpa'', associated with ''osha'' and ''chosha''

| Cadaver smelling, ''analpa'', associated with ''osha'' and ''chosha''

| Hemospermia (benign prostate hypertrophy) or acute injury to external genitals.

| Hemospermia (benign prostate hypertrophy) or acute injury to external genitals.

|-

|-

| ''Granthi–Kapha vata dushta''

| Granthi–[[Kapha]] [[vata]] dushta

| Clot formation

| Clot formation

| Prostatic dysfunction and inflammation  

| Prostatic dysfunction and inflammation  

|-

|-

| ''Putipuya - pitta kapha dushta''

| Putipuya - [[pitta]] [[kapha]] dushta

| Foul smelling, semen containing ''puya''

| Foul smelling, semen containing ''puya''

| Pyospermia, Chalmydia infection, STD

| Pyospermia, Chalmydia infection, STD

|-

|-

| ''Kshina – pitta vata dushta''

| Kshina – [[pitta]] [[vata]] dushta

| Hypospermia and oligospermia

| Hypospermia and oligospermia

| Decreased semen volume because of obstruction in seminal vesicle.  

| Decreased semen volume because of obstruction in seminal vesicle.  

|-

|-

| ''Mutrapurishagandhi - Tridosha''

| Mutrapurishagandhi - Tri[[dosha]]

| Semen with smell of urine and feces  

| Semen with smell of urine and feces  

| Carcinoma, recto – genital urinary tract fistula  

| Carcinoma, recto – genital urinary tract fistula  

===== Characteristics of  normal semen =====

===== Characteristics of  normal semen =====

   

   

The ''shuddha shukra'' should be white like ''sphatika'', liquid, viscous, sweet in taste, smell of honey also should look like mixture of oil and honey.

The shuddha [[shukra]] should be white like ''sphatika'', liquid, viscous, sweet in taste, smell of honey also should look like mixture of oil and honey.

Following are the criteria for normal semen according to modern science:

Following are the criteria for normal semen according to modern science:

These temporal characteristics of cardiovascular disease indicate the importance of careful timing in their assessment, monitoring, and treatment (120). [299]

These temporal characteristics of cardiovascular disease indicate the importance of careful timing in their assessment, monitoring, and treatment (120). [299]

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== References ==

== References ==