Critical analysis of nidanas of asrigdara in the pathogenesis of the disease

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Journal name: Ayushdhara
Original article title: Critical analysis of nidanas of asrigdara in the pathogenesis of the disease
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Author(s):

Khushbu Jain
Assistant Professor, Department of Prasuti tantra evam Stree roga, MJF Ayurved Mahavidyalaya, Harota, Jaipur.


Ayushdhara:

(A peer-reviewed, bi-monthly open-access journal)

Full text available for: Critical analysis of nidanas of asrigdara in the pathogenesis of the disease

Year: 2021 | Doi: 10.47070/ayushdhara.v8i2.699

Copyright (license): CC BY-NC-SA 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Asrigdara is a prevalent gynecological issue impacting women's health from menarche to menopause, manifesting as excessive menstrual bleeding or intermenstrual bleeding, distinguishing it from normal menstruation. This condition is categorized as a Raktadoshaja Vikara, which affects the psychological and physical well-being of women, potentially leading to serious consequences such as hysterectomy if not adequately addressed. The underlying causes or Nidanas of Asrigdara are critical in understanding its pathogenesis, with Ayurveda emphasizing the importance of identifying these causative factors for effective treatment and prevention.

The Role of Nidanas in Pathogenesis

Nidanas are central to the development of Asrigdara, as they lead to the initiation of the disease process. Various etiological factors mentioned in Ayurvedic texts, such as excessive consumption of salty, sour, and spicy foods, as well as high-fat and alcoholic substances, can aggravate the Doshas (Vata, Pitta, Kapha) and disturb the Rakta Dhatu. Factors like Lavana and Amla increase Pitta, leading to a rise in blood flow (Raja) in the uterine vessels, causing excessive bleeding. Moreover, modern scientific perspectives align with these traditional concepts, noting that stress and hormonal imbalances can further exacerbate the symptoms.

Emotional and Physical Contributors

The emotional state and lifestyle choices also play significant roles in the manifestation of Asrigdara. Stress and psychological factors, such as anxiety and emotional trauma, have been shown to influence reproductive health through hormonal pathways. Furthermore, excessive physical activity and sexual intercourse can lead to Vata Prakopa, increasing uterine congestion and contributing to abnormal bleeding. This interaction between physical and emotional health stresses the need to consider a holistic approach in both diagnosis and treatment to effectively address the complexities of Asrigdara.

Conclusion

Asrigdara represents a significant health concern for women, affecting their quality of life and necessitating comprehensive management strategies. A thorough understanding of Nidanas is essential, as it facilitates not only accurate diagnosis but also informs preventive measures and therapeutic interventions. By emphasizing Nidana Parivarjan, or the elimination of causative factors, Ayurveda provides a foundational approach that can prevent the escalation of Asrigdara into more severe complications, underscoring the importance of integrative and preventive healthcare practices.

FAQ section (important questions/answers):

What is Asrigdara, and how does it manifest in women?

Asrigdara is a common gynecological issue characterized by excessive or irregular menstrual bleeding. It affects women's daily activities and quality of life, manifesting as prolonged menstrual bleeding or scanty intermenstrual bleeding, similar to abnormal uterine bleeding.

What role do Nidanas play in the pathogenesis of Asrigdara?

Nidanas are the causative factors initiating the disease process of Asrigdara. They include dietary habits and environmental influences that lead to the aggravation of doshas and subsequent vitiation of Rakta and Apana Vayu, contributing to the disorder.

What is the significance of Nidana Parivarjan in treating Asrigdara?

Nidana Parivarjan, or the avoidance of causative factors, is emphasized as the first line of treatment in Ayurveda. Understanding and addressing the Nidanas associated with Asrigdara can help prevent its progression and ensure better treatment outcomes.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Critical analysis of nidanas of asrigdara in the pathogenesis of the disease”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Asrigdara (Asrgdara, Asrij-dara):
Asrigdara refers to a gynecological disorder manifesting as abnormal uterine bleeding. The condition, characterized by excessive menstrual bleeding, affects the physical and psychological health of women. Asrigdara is particularly associated with vitiated Rakta (blood) and Pitta dosha causing prolonged or intermenstrual bleeding.

2) Nidana:
Nidana refers to the causative factors or etiological agents leading to the disease. Understanding Nidana is crucial for diagnosing, preventing, and treating Asrigdara, as they initiate the disease's pathogenesis. In Ayurveda, Nidana Parivarjan, meaning the avoidance of these causes, is the first line of treatment.

3) Rakta:
Rakta refers to blood, which in the context of Asrigdara, becomes vitiated due to various Nidanas like excessive intake of Lavana and Amla Rasa. Vitiated Rakta increases the Raja (menstrual blood), leading to Asrigdara. Maintaining healthy Rakta is essential for preventing and managing this condition.

4) Pitta:
Pitta is one of the three Doshas in Ayurveda and is chiefly responsible for metabolic processes. In Asrigdara, Pitta dosha becomes aggravated due to Nidanas like excessive intake of Amla and Lavana Rasa, leading to excessive menstrual bleeding. Pitta's Ushna (hot) and Tikshna (sharp) qualities play a role in this.

5) Rasa (Rasha):
Rasa refers to the initial essence of digested food and acts as a precursor to Rakta (blood). In Asrigdara, improper formation of Rasa due to Agnimandya (digestive fire deficiency) leads to faulty Rakta formation. Thus, balanced Rasa is crucial for preventing the disorder’s pathogenesis.

6) Dosha (Dosa):
Dosha refers to the body's three fundamental bio-energies: Vata, Pitta, and Kapha, whose imbalance leads to diseases. In Asrigdara, vitiation of Pitta and Rakta Dosha occurs, aggravating the condition. Addressing the imbalances in Doshas is key to treating this gynecological disorder.

7) Disease:
Disease in the context of Asrigdara refers to any pathological condition associated with abnormal uterine bleeding. Understanding the various Nidanas and their roles in the pathogenesis helps in diagnosing, preventing, and treating the disease effectively.

8) Vata:
Vata is one of the three Doshas representing the air and space elements. In Asrigdara, aggravated Vata dosha, especially Apana Vayu, leads to diseases affecting the uterus. It interacts with Pitta, exacerbating symptoms like excessive menstrual bleeding.

9) Prakopa:
Prakopa refers to the aggravation of Doshas. In the case of Asrigdara, Nidanas like Lavana and Amla Rasa cause the Prakopa of Pitta and Vata Doshas, leading to vitiation of Rakta and ultimately resulting in excessive menstrual bleeding.

10) Amla:
Amla refers to the sour taste, which, when consumed excessively, leads to Pitta dosha aggravation. This, in turn, vitiates Rakta, causing conditions like Asrigdara, characterized by excessive menstrual and intermenstrual bleeding.

11) Kapha:
Kapha is one of the three Doshas representing the water and earth elements. Though primarily associated with causing heavy, thick qualities, its imbalance due to factors like excessive consumption of Snigdha (oily) and Guru (heavy) foods can indirectly influence Asrigdara.

12) Dhatu:
Dhatu refers to the body's tissues. In Asrigdara, vitiation of Rakta Dhatu (blood tissue) plays a central role in the disease's pathogenesis. Imbalances in Dhatus are crucial for understanding and treating various disorders in Ayurveda.

13) Lavana:
Lavana refers to the salty taste. Excessive intake of Lavana aggravates Pitta and increases Rakta, leading to conditions like Asrigdara. This type of Nidana makes the blood more liquid, contributing to abnormal uterine bleeding.

14) Dadhi:
Dadhi refers to curd. Its consumption in excess can cause vitiation of Pitta and Rakta due to its Ushna (hot) Veerya and Abhishyandi (obstructive) properties, which in turn can contribute to Asrigdara.

15) Annapana (Anna-pana):
[see source text or glossary: Annapana]

16) Vidahi:
[see source text or glossary: Vidahi]

17) Guru:
Guru means heavy, often linked to foods with heavy qualities. Excessive intake can lead to Kapha dosha aggravation and Rasavaha Strotodushti (channel obstruction), contributing indirectly to conditions like Asrigdara.

18) Katu:
Katu refers to the pungent taste. Excessive Katu Rasa intake aggravates Vata and Pitta doshas, leading to vasodilatation and platelet aggregation disruption, thereby causing or worsening Asrigdara.

19) Vayu:
[see source text or glossary: Vayu]

20) Guna:
Guna refers to the qualities or attributes of substances. In Asrigdara, qualities like Ushna (hot) and Tikshna (sharp) of substances like Amla and Lavana aggravate Pitta, contributing to the pathogenesis of the disease.

21) Pittadosha (Pittadosa, Pitta-dosha):
Pitta-dosha is responsible for metabolic and transformative processes. In Asrigdara, its aggravation due to Nidanas like Amla and Lavana Rasa plays a central role in the disease's pathogenesis, resulting in excessive bleeding.

22) Snigdha:
Snigdha refers to oily qualities. Excessive intake of Snigdha foods can lead to Ama (toxins), causing Kapha dosha aggravation, which indirectly contributes to Asrigdara by causing Rasavaha and Rakta strotasa obstruction.

23) Mamsa (Mamsha):
[see source text or glossary: Mamsa]

24) Blood:
Blood, or Rakta, is central to the pathogenesis of Asrigdara. Vitiation of Rakta due to aggravated Pitta and Vata doshas leads to abnormal uterine bleeding, a hallmark of this debilitating condition.

25) Samprapti:
Samprapti refers to the pathogenesis or progression of a disease. Understanding the specific Samprapti of Asrigdara, which involves vitiation of Pitta, Rakta, and Vata, aids in devising effective treatment protocols.

26) Katurasa (Katu-rasa):
[see source text or glossary: Katu-rasa]

27) Mastu (Mashtu):
Mastu is a fermented rice water preparation. Its consumption can aggravate Pitta dosha due to its Ushna (hot) properties, leading to the vitiation of Rakta and contributing to the pathogenesis of Asrigdara.

28) Agni:
Agni refers to the body's digestive fire. In Asrigdara, Agnimandya (weak digestive fire) leads to improper digestion and formation of Rasa, which subsequently results in impaired Rakta Dhatu formation, contributing to abnormal uterine bleeding.

29) Apanavayu (Apana-vayu):
Apana-vayu is a subtype of Vata dosha responsible for downward movements, such as menstruation. Its dysfunction or vitiation plays a critical role in the pathogenesis of Asrigdara, leading to excessive or irregular menstrual bleeding.

30) Amlarasa (Amla-rasa):
Amla-rasa, or sour taste, when consumed excessively, aggravates Pitta dosha. This results in Rakta vitiation and contributes to the occurrence of Asrigdara, characterized by excessive menstrual bleeding.

31) Vitiation (Vitiated):
Vitiation refers to the imbalance or derangement of bodily elements or Doshas. In the context of Asrigdara, vitiation of Rakta and Pitta due to various Nidanas like Amla and Lavana intake leads to the disease.

32) Vriddhi (Vrddhi):
Vriddhi means increase or growth. In Asrigdara, Vriddhi of Rakta and Raja is observed due to Nidanas like excessive intake of Pitta-aggravating substances, resulting in prolonged or excessive menstrual bleeding.

33) Sevana:
[see source text or glossary: Sevana]

34) Vyadhin (Vyadhi):
Vyadhi refers to disease. Asrigdara is a gynecological Vyadhi characterized by abnormal uterine bleeding, resulting from the vitiation of Pitta and Rakta due to various etiological factors or Nidanas.

35) Drava:
Drava means liquidity. Pitta dosha, when aggravated by Nidanas like Lavana, increases its Drava Guna or liquefying quality, leading to the vitiation of Rakta, which plays a key role in the pathogenesis of Asrigdara.

36) Shoka (Soka):
Shoka refers to grief or emotional distress, which aggravates Pitta dosha. This contributes to the vitiation of Rakta and can result in Asrigdara, manifesting as excessive or prolonged menstrual bleeding.

37) Apana:
[see source text or glossary: Apana]

38) Sura (Shura):
[see source text or glossary: Sura]

39) Roga:
Roga refers to disease. Asrigdara is a specific Roga characterized by abnormal uterine bleeding, requiring a detailed understanding of its Nidanas (causative factors) and Samprapti (pathogenesis) for effective management.

40) Raja:
[see source text or glossary: Raja]

41) Medas (Meda, Medash):
Meda refers to the adipose tissue or fat. Excessive Meda can lead to increased peripheral aromatization of estrogens, contributing to endometrial hyperplasia and excessive menstrual bleeding in Asrigdara.

42) Jala:
[see source text or glossary: Jala]

43) Dhatukshaya (Dhatuksaya, Dhatu-kshaya):
[see source text or glossary: Dhatukshaya]

44) Audakamamsa (Audaka-mamsa):
Audaka-mamsa refers to meat from aquatic animals, which aggravates Kapha dosha. This can lead to Rasavaha Strotodushti and excessive Artava (menstrual blood) production, contributing to the symptoms of Asrigdara.

45) Raktadhatu (Rakta-dhatu):
Rakta-dhatu refers to the blood tissue. In Asrigdara, vitiated Rakta-dhatu due to Nidanas like excessive intake of Lavana and Amla leads to increased menstrual bleeding, forming the crux of the disease.

46) Garbhashaya (Garbhasaya, Garbha-ashaya):
Garbhashaya means the uterus. Asrigdara affects the Garbhashaya by causing excessive menstrual bleeding. The role of Nidanas in vitiating Doshas and affecting the Garbhashaya is crucial in the pathogenesis of the disease.

47) Abhishyandi (Abhisyandi):
[see source text or glossary: Abhishyandi]

48) Vatapitta (Vata-pitta):
Vata-pitta dual dosha involvement is critical in Asrigdara. Vitiation of these Doshas due to Nidanas like Katu and Vidahi Annapana leads to pathological changes in Rakta, manifesting as excessive menstrual bleeding.

49) Ayurveda (Ayus-veda):
Ayurveda is a traditional system of medicine from India that emphasizes balance among the Doshas. In Ayurveda, understanding the Nidanas and Dosha imbalances is essential for treating diseases like Asrigdara.

50) Pradhana:
[see source text or glossary: Pradhana]

51) Prithvi (Prthvi):
[see source text or glossary: Prithvi]

52) Shonita (Sonita):
Shonita means blood. Vitiation of Shonita by aggravated Pitta and Vata doshas is central to the development of Asrigdara, manifesting as excessive menstrual bleeding.

53) Artava:
[see source text or glossary: Artava]

54) Kshaya (Ksaya):
[see source text or glossary: Kshaya]

55) Shukta (Sukta, Su-ukta):
[see source text or glossary: Sukta]

56) Ushna (Usna):
[see source text or glossary: Ushna]

57) Marga:
[see source text or glossary: Marga]

58) Milk:
Milk is relevant where certain Nidanas involve dairy products like Dadhi (curd). In Asrigdara, substances like Dadhi, containing Ushna (hot) properties, aggravate Pitta and vitiate Rakta, leading to excessive menstrual bleeding.

59) Menstrual blood:
Menstrual blood, or Raja, is affected in Asrigdara, characterized by excessive or irregular bleeding. Nidanas leading to Pitta and Rakta vitiation increase the menstrual blood flow and disturb the normal menstrual cycle.

60) Atipravritti (Atipravrtti, Ati-pravritti):
Atipravritti means excessive flow. In Asrigdara, Atipravritti refers to the excessive or prolonged menstrual bleeding caused by the vitiation of Pitta and Rakta due to various Nidanas.

61) Lavanarasa (Lavana-rasa):
[see source text or glossary: Lavana-rasa]

62) Adhyashana (Adhyasana):
[see source text or glossary: Adhyashana]

63) Rasadhatu (Rasa-dhatu):
[see source text or glossary: Rasa-dhatu]

64) Garbhapata (Garbha-pata):
Garbhapata refers to miscarriage. Post-abortion, the uterus may not involute properly, increasing the risk of excessive menstrual bleeding, a symptom of Asrigdara, due to retained products of conception or other complications.

65) Vatadosha (Vatadosa, Vata-dosha):
Vata-dosha, characterized by movement, is critical in Asrigdara. Particularly, Apana Vayu (a subtype of Vata) plays a role in menstruation. Its vitiation due to various Nidanas can lead to excessive menstrual bleeding.

66) Abhighata:
Abhighata refers to trauma. Trauma to the uterus, whether through medical procedures or physical injuries, can aggravate Vata and Rakta, leading to excessive uterine bleeding and contributing to Asrigdara.

67) Mahabhuta (Maha-bhuta):
[see source text or glossary: Mahabhuta]

68) Raktarsha (Raktarsa):
[see source text or glossary: Raktarsha]

69) Avarodha:
Avarodha refers to obstruction. In Asrigdara, Avarodha in channels like Rasavaha strotas due to Ama can lead to impaired blood flow, contributing to the disease's pathogenesis by increasing menstrual bleeding.

70) Samghata (Sanghata):
[see source text or glossary: Samghata]

71) Madhura:
[see source text or glossary: Madhura]

72) Bhedana:
[see source text or glossary: Bhedana]

73) Pramana:
Pramana denotes measure or quantity. In Asrigdara, there is an increase (Vriddhi) in the Pramana of Rakta and menstrual blood due to Nidanas like excessive intake of Amla and Lavana, leading to excessive bleeding.

74) Madhava:
[see source text or glossary: Madhava]

75) Prasuti:
[see source text or glossary: Prasuti]

[Note: The above list is limited to 75. Total glossary definitions available: 137]

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