Ayurved Management of Pittaj Mukhapak (Aphthous ulcer): A Case Study

210 Journal of Ayurvedic and Herbal Medicine 2020; 6(4): 210-212 Case Report ISSN: 2454-5023 J. Ayu. Herb. Med. 2020; 6(4): 210-212 © 2020, All rights reserved www.ayurvedjournal.com Received: 10-09-2020 Accepted: 14-01-2021 *Corresponding author: Dr. Ravindra B. Ghaywate Associate Professor, Departments of Panchakarma, RK University Ayurved College and Hospital Bhavnagar Highway, Rajkot, Gujarat, India Email: ravindra.ghaywate@rku.ac.in Ayurveda Management of Pittaj Mukhapak (Aphthous ulcer): A Case Study Ravindra B. Ghaywate 1 *, Pallavi M. Ghuge 2 , Ravikumar S. Suryavanshi 3 , Sandip Lanje 4 1 Associate Professor, Departments of Panchakarma, RK University Ayurved College and Hospital Bhavnagar Highway, Rajkot, Gujarat, India 2 MD (Scholar), Department of Samhita, Bhau Saheb Mulak Ayurved College, Nandanvan, Nagpur, Maharashtra, India 3 Associate Professor, Departments of Shalyatantra, RK University Ayurved College and Hospital Bhavnagar Express Highway Rajkot, Gujarat, India 3 Associate Professor, Department of Sharir Rachana, Shree Balahanuman Ayurved Mahavidyalaya, At & Po. Lodhra. Tal. Mansa Dist. Gandhinagar, Gujarat, India ABSTRACT Oral hygiene is very important for Health. Tongue is the mirror of GIT (Gastrointestinal Tract). Mukhapak (Stomatitis) i: e the inflammation of Mucous membrane present in lips, tongue and cheek. It is common problems faced by all persons. Though it looks minor problem but it restricted the daily activity. Stomatitis occurs due to hot and spicy, oily food, Smoking, tobacco, Gutkha chewing, Some Medicine, infection, Vitamin B-Complex deficiency. Ayurveda has described 4 type of Mukhapaka. Vataj, Pittaj, Kaphaj, Sannipataj. Different types of Mukhapak have different type of symptoms. The treatment of Aphthous ulcer/Stomatitis mainly pain reliever, mouth lotion, Corticosteroids, Vit.B complex. Present case study of 26 year male Patients having symptoms of Toda (Pricking Pain), Daha (Burning), Aasyvairasya (Diminish Taste of food), Constipation, Difficult to engulfed food, Chittodweg (Anxious). Diagnosis done as a Pittaj Mukhapak, undergo the Ayurveda treatment as Gandush Vidhi and Shaman treatment for 7 days. After 7 day Patients was much relieved. Present Case Study Was done to Study the concept of Pittaj Mukhpak (Apthous Ulcer) in Ayurveda View, to study the effect of Ayurveda treatment on Symptoms, To Study Effect of Gandush Vidhi and Shaman treatment in Pittaj Mukhpak. Keywords: Pittaj Mukhapak, Ayurved, Stomatitis, Gandush. INTRODUCTION Ayurveda is Ancient science of India. Health is uttermost things described by Ayurveda. Ayurveda is work on Preventive and Curative aspects.Pittaj Mukhapak is occurred in recurrent.Mukhpak is also called as Sarvasara roga.The symptoms of Stomatitis is mouth ulcers, Burning pain, Difficult to engulfed the food, redness, Anxiety, Lymph node enlarge associate with fever. The Nature of Mukhavran is single or multiple. The structure of mouth ulcers is round, whitish-yellow patch surrounding with red corners. Mukhapaka is mentioned under the 40 Nanatmaja pitta rogas according to Charaka. Dalhana on his commentary on Sushruta samhita Mentions Mukhapaka as basically and purely a pittaja vikara but Sushruta Acharya has classified Sarvasara mukharoga as vataja, pittaja, kaphaja and raktaja, the aggravated vatadi doshas afflict the Mukha to produce paka and vrana. CASE STUDY A 26 year Male Patient came in OPD with the symptoms of - Toda (Pricking Pain) -Daha (Burning) -Difficult to engulfed food -Asyavairasya (Diminish Taste of food) -Mukhavran (Mouth Ulcer) -Malavstambh (Constipation) - Chittodweg (Anxious)

211 Journal of Ayurvedic and Herbal Medicine|October-December|2020 History of Present Illness Patient was apparently alright 15 Day before. Gradually he experienced mukhavran from 7 days. Begining day number of Mukhavran single with yellow-white red corner, increase in number in 3 day. Before he had history of taking fast food, spicy along with constipation. Family History Father-HTN Mother-NAD O/E (On Examination) GC -Fair Pulse-72/min Bp-120/80 mm/hg Spo 2-97 RR-19/min Asthvidh Pariksha Nadi-Vata-Pitta Mala-Malavstambh Mutra-Prakrut Jiva-Sam, Red Shabd-Prakrut Sparsh-Ushna Druka-Prakrut Aakruti-Madhyam S/E (Systemic Examination) RS-AE=BS CVS-S 1 S 2 Normal CNS-Conscious Oriented GIT-Liver, Spleen Not Palpable Local Examination of Mukhavran Colour -Yellow-white with red corner Number-Multiple in Nature MATERIAL AND METHODS Presenting Complaints of Patient Treatment Plan as Table 1: Drug name Sr. No Name Of Drug Dose of Drug Kal Frequency and Anupan 1 Kaishor Guggulu 2 Tab After Food Twice a day with Lukewarm water 2 Avipattikar Churna 4 Gm. After Food Twice a day with Lukewarm water 3 Gandush Method: Gandush Vidhi Patients was ask to do his primary morning schedule like Mal visarjan, Dant dhawan, and light food taken. He was made to seat comfortable on chair where sunlight come.Nadi swedan and Abhyag was done in Urdhwajatrugat region i.e. above the neck and shoulder. A freshly prepared koshn khadir, haridra kwath was given with full of mouth to hold till ashrustrav and nasastrav observed.after that sukhoshna jal given to wash the mouth and observed the samyak Gandush symptoms, this same procedure followed subsequently for 7 day and assess the symptoms of Mukhapak. RESULT Table 2: Symptoms before treatment Sr No Symptoms Before Treatment First Follow Up After 1 day Second Follow Up After 3 Day Third Follow Up After 7 Day 1 Toda (Pricking Pain) +++ ++ - 2 Daha(Burning Sensation) +++ ++ - 3 Difficult to Engulf Food +++ ++ - 4 Constipation ++ - - 5 Mukhavran +++ +++ - 6 Chittodweg +++ ++ - Table 3: Figures, befor and after treatment Before Treatment After Treatment Figure I Figure II Figure III DISCUSSION Mukharoga (Mouth Diseases) are 65 different type. There site Lips,Gums,Teeth,Jivha,Talu,,Kanth and Whole oral cavity according to Sushrut Acharya,A world first surgeon.Charak have described 64 type of Mukharoga,Vaghbhat Described 75 Type of Mukha roga.Mukhapak also called as Sarvasara roga. Type of Mukhapak are Vataj, Pittaj,

212 Journal of Ayurvedic and Herbal Medicine|October-December|2020 Kaphaj, sannipataj. Pittaj Mukhapak and raktaj Mukhpak are the same. Vatadi Dosh aggravated in mukha region causing Vrana(Ulcer) in mukha called as Mukhapak.Gandush, kavala,lepan, Virechan, shaman are different type Treatment done in Mukhapak.Mukhapak resemble with Stomatitis or Aphthous ulcer in modern.it is common in now days because of changing aahar, Vihar style. The focus of Treatment in Stomatitis according to modern view is local pain reliever, mouth lotion, Corticosteroids, Vit B complex.it is not satisfactory and symptomatic treatment Samprapti Ghatak Dosh-Pittaj Dushya-Rasa, Rakt Marga-Abhyantar Agni-Jathargnimandya Strotas-Rasavah, Raktvaha, Mamsavaha Sthan-Mukha Action of medicine 1) Gandush of Khadir and Haridra Kwath A full of mouth of liquid,tail,ghrita,honey without any movement inside mouth is called as Gandush.Holding full of mouth of liquid cause mechanical pressure on salivary gland. Salivary gland produces saliva. Saliva has bacteriostatic action not permit to the infectious origins.khadir, haridra have tikta, kashaya rasa, and it has Vran ropan property. 2) Kaishore Guggulu Kaishore guggulu contains: Giloy or Guduchi (Tinospora cordifolia) Amla (Amalaki) (Emblica officinalis) Bibhitaki (Terminalia Billerica) Haritaki (Terminalia chebula), Shuddha Guggulu (Commiphora mukul), Shunthi (Zingiber Officinale),Pipali (Long Pepper)Pepper Longum, Vidanga (Embelia Ribe), Nisoth (Operculina Turpethum),Danti Mool(Baliospermum Montanum) kaishore Gugglu have antibacterial, antiinflammatory activity.Guduchi act as rasayan in nature. 3) Avipattikar Churna Avipattikar churna contains amla, behada, black pepper, cardamom, clove, ginger, haritaki, Indian bay leaf, long pepper, nut grass, turpeth, mishri and vidanga. All these ingredients are dried and powdered into a churna. Avipattikar Churna is used for digestive and excretory system. It balance the pitta by Mild Virechan.Avipattikar churna have strong Adhmanhar (Carminative), Digestive property. CONCLUSION It is clear that Gandush of Khadir, Haridra kwath, Kaishore Guggulu, Avipattikar churna very effective in management of Pittaj mukhpak (Stomatitis /Aphthous ulcer) but the more study needs to evaluate the results in Pittaj mukhapak. REFERENCES 1 Acharya Vidyadhara Shukla and Ravidatta tripathi, Charak Samhita 1 st part, Chaukhamba Sanskrit pratishthan, Delhi, 2012, Sutrasthan 20/14-16, Page no 295-296. 2 Acharya Vidyadhara Shukla and Ravidatta tripathi ,Charak Samhita 2 nd part ,Chaukhamba Sanskrit Pratishthan, Delhi, 2012, Chikitsasthan 26/119- 123 Page no 644-645. 3 Anantram Sharma, Sushruta Samhita volume-1, Chaukhamba Sanskrit Samsthan Varanasi 12 th edition 2006, Nidansthan 16/64-66, Page no 583- 586. 4 Anantram Sharma, Sushruta Samhita volume-2, Chaukhamba Sanskrit Samsthan Varanasi 12 th edition 2006, Chikitsa Sthan 22/67-72, Page no 346-347. 5 Brahmanand Tripathi.Shrimad Vagbhat, Ashtang Hrudaya, Chaukhamba Sanskrit Pratishthan Delhi, 2015, Sutrasthan 22/10-11, Page no 258. 6 Brahmanand Tripathi, Shrimad Vagbhat, Ashtang Hrudaya, Chaukhamba Sanskrit Pratishthan Delhi, 2015, Uttartantra 21/1, Page no 1022. 7 Brahmanand Tripathi, Shrimad Vagbhat, Ashtang Hrudaya, Chaukhamba Sanskrit Pratishthan Delhi, 2015, Uttartantra 21/58-61, Page no 1032- 1033. 8 Dr.Sidharth Shah, A.P. I Text Book of Medicine, 8 th edition, published by Association of Physicians of India, 2009. 9 Baidynaath Ayurved Bhavan, Ayurved Sara Sangraha, 20 th Edition, Baidynath Ayurved Bhavan limited Great Nag Road Nagpur, India, 2000, Page no 515-578. HOW TO CITE THIS ARTICLE Ghaywate RB, Ghuge PM, Suryavanshi RS. Ayurveda Management of Pittaj Mukhapak (Aphthous ulcer): A Case Study. J Ayu Herb Med 2020;6(4):210-212.