Bhagandara –a critical review
Journal name: World Journal of Pharmaceutical Research
Original article title: Bhagandara –a critical review
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Pushkar Mishra
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Bhagandara –a critical review
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr202311-28887
Copyright (license): WJPR: All rights reserved
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Summary of article contents:
Introduction
Bhagandara, a prevalent condition in the ano-rectal region, is characterized by complicated abscesses and fistulas as discussed in ancient Ayurvedic texts. This condition, considered a "Mahagada," is noted for its difficulties in treatment. Renowned figures such as Sushruta and Charaka have elaborated on the etiology, classification, and management strategies for Bhagandara. Various causative factors, symptom patterns, and treatment protocols are examined, revealing the structured approach of Ayurveda in addressing this specific ailment.
Understanding the Pathogenesis of Bhagandara
The pathogenesis of Bhagandara can be explained through six distinct stages, which illustrate the disease's progression. Initially, there is a stage of "Sanchaya," where the accumulation of dosha occurs due to inappropriate dietary habits or local trauma. This is followed by "Prakopa," where dosha aggravation continues due to persistent exposure to etiological factors. This leads to "Prasara," indicating the migration of vitiated dosha throughout the body, culminating in "Sthana Samshraya," where dosha settles in and around the anal region, causing symptoms such as burning, itching, and swelling. The "Vyakti" stage denotes visible manifestations, while the final stage "Bheda" refers to complications where the disease might invade neighboring organs, leading to further complications and possibly rendering it incurable.
Classifications and Types of Bhagandara
Bhagandara has multiple classifications based on the nature of the disease. Sushruta and Vagbhata notably categorized Bhagandara into varying types like Shataponaka, Ushtragreeva, and Parikshepi, among others, each defined by particular characteristics and treatment protocols. For instance, Shataponaka refers to abscesses with multiple openings resembling a sieve, while Ushtragreeva presents as a raised lesion likening to a camel's neck. Each classification carries specific doshic involvement, guiding tailored treatment strategies as emphasized by numerous ancient authors.
Treatment and Management Strategies
The management of Bhagandara combines medical and surgical interventions, adapted to the stage and severity of the disease. General principles outlined by Charaka include practices like Virechana (purging), probing, incision, cauterization, and wound management. During the early stage when suppuration is absent, treatments aim to prevent progression, focusing on local bloodletting and avoidance of aggravating factors. Once suppuration occurs, surgical options become paramount, employing techniques like excision of the fistulous tract followed by chemical or thermal cauterization. Post-surgical care heavily emphasizes wound irrigation and the use of medicinal pastes for healing.
Conclusion
In summary, Bhagandara illustrates a complex interplay of dosha imbalances leading to significant discomfort and complications. A thorough understanding of its pathogenesis, varied classifications, and detailed treatment protocols from ancient Ayurvedic literature underscores the system's holistic approach to managing this condition. While some types of Bhagandara are deemed difficult or incurable, a combination of medical and surgical approaches, aligned with preventive measures, can vastly improve patient outcomes. The Ayurvedic framework not only delineates the treatment avenues but also accentuates the importance of individualized patient care and lifestyle modifications for effective management.
FAQ section (important questions/answers):
What is Bhagandara and its significance in Ayurveda?
Bhagandara is a common disease affecting the ano-rectal region, considered difficult to treat. Ancient texts like Sushruta's provide detailed descriptions, highlighting its complexity and the necessity for comprehensive management.
What are the general and specific causes of Bhagandara?
General causes include poor diet, trauma, or unhealthy lifestyle choices. Specific causes relate to unique doshic imbalances and various aetiological factors identified by Ayurveda, which aggravate Bhagandara.
How is the pathogenesis of Bhagandara explained?
The pathogenesis includes six stages: Sanchaya (accumulation), Prakopa (provocation), Prasara (propagation), Sthana samshraya (localization), Vyakti (manifestation), and Bheda (complication), explaining disease progression and symptoms.
What are the different types of Bhagandara classified by Ayurveda?
Ayurveda classifies Bhagandara into types such as Shataponaka, Ushtragreeva, Parisravi, Shambukavarta, Unmargi, and Riju, each differing in symptoms, treatment options, and detailed descriptions from ancient texts.
What management principles are used for treating Bhagandara?
Management includes general principles like Virechana (purgation), Eshana (probing), and Patana (incision). Surgical and medical treatments, alongside preventive measures, are essential for the effective management of Bhagandara.
What dietary and lifestyle recommendations are given for Bhagandara patients?
Patients should follow a balanced diet, avoiding heavy foods and excessive physical strain. Specific dietary recommendations include consuming suitable cereals, pulses, and avoiding triggers like alcohol, anger, and indigestion.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Bhagandara –a critical review”. 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) Bhagandara (Bhagamdara):
A chronic disorder affecting the ano-rectal region characterized by abnormal openings or tracks, leading to the discharge of flatus, feces, and sometimes urine. It is considered one of the challenging diseases in Ayurveda, requiring careful diagnosis and management due to its complexity and associated complications.
2) Mishra (Misra):
Refers to Dr. Pushkar Mishra, the author of the review article on Bhagandara. His contributions include interpreting ancient medical texts and elucidating the causes, symptoms, and management strategies for this condition within the framework of Ayurvedic medicine.
3) Pain:
One of the primary symptoms of Bhagandara, often described as pricking, burning, or throbbing in nature. Managing this symptom is crucial in treatment protocols, as pain can significantly impact a patient’s quality of life and ability to engage in daily activities.
4) Karma (Karman):
In the context of Ayurveda, 'Karma' often refers to actions or procedures, including surgical interventions and therapeutic measures. Understanding the karmic implications is essential for effective treatment and managing diseases like Bhagandara.
5) Guda:
Represents the ano-rectal region in Ayurvedic terminology. It is the anatomical site affected by Bhagandara, necessitating specific diagnostic and treatment approaches tailored to this sensitive area.
6) Vata:
One of the three doshas (body energies) in Ayurveda, associated with air and movement. In Bhagandara, vitiated Vata can contribute to symptoms such as pain and discomfort, highlighting the importance of balancing this dosha in treatment.
7) Kapha:
Another dosha in Ayurvedic medicine, associated with water and earth elements. Imbalances in Kapha can affect the body’s constitution and contribute to the formation of certain types of Bhagandara, necessitating an integrated treatment approach.
8) Pidika:
Refers to the swelling or ulceration seen in Bhagandara. It is a crucial feature in identifying the condition and has implications for treatment strategy, indicating potential suppuration and the need for care.
9) Pitta:
The third dosha affecting bodily functions, associated with fire and transformation. Elevated Pitta can lead to inflammation and burning sensations, common in Bhagandara, thus guiding treatment choices aimed at pacifying this dosha.
10) Incision:
Surgical cut made during the treatment of Bhagandara to excise affected tissues. Different incision techniques are recommended based on the specific type of Bhagandara, influencing recovery and management outcomes.
11) Dosha (Dosa):
Similar to dosha, this term signifies the imbalances of Vata, Pitta, and Kapha affecting health. Identification and correction of dosa is crucial in treating Bhagandara.
12) Kshara (Ksara):
A type of alkaline medication used for chemical cauterization in the treatment of Bhagandara. It is effective for destroying unhealthy tissue and facilitating wound healing.
13) Mamsa (Mamsha):
Denotes muscle or flesh in Ayurvedic terminology. In the context of Bhagandara, it refers to the affected tissues that may become inflamed or infected, influencing treatment methodologies.
14) Rakta:
Referring to blood, this term is significant in understanding the role of circulation and potential hemorrhage in the pathology of Bhagandara, as well as considering blood-letting techniques for treatment.
15) Agni:
Symbolizes digestion and metabolism in Ayurveda. In Bhagandara, the strength of Agni is crucial for healing and ensuring the proper functioning of bodily processes.
16) Disease:
Represents the pathological condition of Bhagandara. Understanding the complexities of this disease is central to effective diagnosis, treatment planning, and prognosis in Ayurvedic medicine.
17) Drug:
A single medicinal substance used within therapeutic formulations. In the context of Bhagandara, drugs must be carefully chosen based on their compatibility with the patient's constitution and the disease's characteristics.
18) Cauterisation (Cauterization):
A method used in surgical treatments of Bhagandara involving the application of heat or chemicals to destroy tissue. This technique aims to promote healing and prevent the spread of infection.
19) Angula (Amgula):
Plural form of angula, indicating multiple measurements or specifications involved in surgical practices related to Bhagandara management, essential for precision in procedures.
20) Table:
Refers to comparative data presented in the article, summarizing various characteristics described by different authors concerning Bhagandara, aiding in the understanding of treatment divergences.
21) Itching:
A common symptom associated with Bhagandara, indicating irritation or inflammation in the anal area. Addressing itching is essential for improving patient comfort and compliance with treatment regimes.
22) Yantra (Yamtra):
A specific surgical instrument used in the treatment of Bhagandara. Its design facilitates examinations and procedures necessary for effective management of the disease.
23) Sthana:
refers to the site or location of the disease, which is significant in both diagnosis and treatment strategies in Ayurveda, especially in the context of Bhagandara.
24) Krimi (Krmi):
Refers to parasites; understanding their involvement is significant in diagnosing and managing conditions like Bhagandara where infections might complicate treatment.
25) Bhaga:
An anatomical term relating to the genital and perianal regions. In discussing Bhagandara, 'bhaga' highlights its significance in the location and nature of the disease.
26) Nadi (Nadin):
Refers to the channels or pathways in the body through which doshas and dhatus flow. Understanding nadi helps elucidate the pathophysiology of Bhagandara and guides treatment.
27) Riju (Rju):
A specific type of Bhagandara characterized by its straight nature, necessitating distinct treatment approaches. Riju highlights the variety within the condition and informs surgical technique.
28) Raktamokshana (Raktamoksana, Rakta-mokshana):
A bloodletting technique employed in Ayurveda to relieve pressure and inflammation. It is utilized in the management of Bhagandara to prevent disease escalation.
29) Agnikarma (Agni-karma):
Thermal interventions used in Ayurveda to manage ailments, especially in Bhagandara, where burning out diseased tissue enables effective treatment and recovery.
30) Vagbhata:
An ancient Ayurvedic physician whose contributions include comprehensive descriptions and classifications of diseases like Bhagandara. His works influence current understanding and treatment methods.
31) Vitiation (Vitiated):
Refers to the imbalance or disturbance of doshas that contribute to disease pathology. Understanding vitiation is key in diagnosing and treating Bhagandara effectively.
32) Burning (Burn, Burned, Burnt):
Refers to tissue damage from heat; recognizing the potential for burn-like symptoms in conditions such as Bhagandara is important for patient management.
33) Arshas (Arsa, Arsha, Arsas):
Commonly known as hemorrhoids; understanding the connections between Arshas and Bhagandara is essential for comprehensive treatment approaches.
34) Camel:
Used metaphorically in Ayurveda to describe certain types of swelling like 'Ushtragreeva', resembling the neck of a camel, aiding in clinical identification and treatment planning.
35) Accumulation (Accumulating, Accumulate):
In Ayurvedic terms, refers to the buildup of dosha at normal sites leading to pathological changes. In Bhagandara, this stage is critical for understanding disease progression.
36) Pradhana:
Refers to primary or major treatment methodologies in Ayurveda. In the case of Bhagandara, understanding pradhana approaches is essential for successful management.
37) Asadhya:
Denotes conditions deemed incurable or challenging to treat. Bhagandara types categorized as Asadhya require specialized management strategies to cope with limitations.
38) Ghrita (Ghrta):
Refers to clarified butter, often used in Ayurvedic preparations for its soothing, healing properties. Ghrita plays a role in patient diet and topical formulations for Bhoagandara treatment.
39) Nature:
Indicates the inherent characteristics of doshas and disease manifestations in Ayurveda. Understanding the nature of Bhagandara informs treatment and precaution strategies.
40) Varti (Vartin):
A medicated wick used in the management of Bhagandara, inserted into the tract to facilitate healing and provide therapeutic effects for wound care.
41) Kandu (Kamdu):
Refers to itching or irritation, a common symptom observed in Bhagandara that requires appropriate symptomatic management to improve patient comfort.
42) Varna:
Describes the color associated with discharge or skin symptoms in Bhagandara. Variations in varna can inform clinicians about infection and healing stages.
43) Vrana:
Denotes a wound or injury in Ayurveda. Understanding the nature of vrana is essential for appropriate management in conditions like Bhagandara.
44) Vaca:
An herbal remedy used to treat various ailments in Ayurveda, including those related to Bhagandara, assisting in purging and healing processes.
45) Meat:
Refers to animal products relevant in dietary discussions, which can influence gut health and the pathogenesis of conditions such as Bhagandara when consumed excessively.
46) Burning sensation:
A symptom frequently described by patients suffering from Bhagandara, crucial for diagnosis and treatment consideration in managing discomfort associated with the condition.
47) Pradhana-karma:
Refers to primary actions taken in treatment protocols for Bhagandara. This includes surgical and therapeutic interventions aimed at addressing the disease effectively.
48) Paschat-karma:
Post-operative management strategies applied after surgical interventions for Bhagandara, focusing on wound care and recovery to prevent infection or recurrence.
49) Ksharasutra (Ksarasutra, Kshara-sutra):
A special thread coated with medicinal substances used in treating Bhagandara. It acts as a chemical cauterizing agent to help remove the affected tissue.
50) Parisheka (Pariseka):
Refers to the pouring of medicated liquids over a wound to aid in healing. It is a crucial aspect of wound care in Ayurveda for Bhagandara.
51) Splitting:
Describes the nature of discharge or tissue appearances associated with Bhagandara, which can impact treatment choices as it indicates the stage of the disease.
52) Ayurveda (Ayus-veda):
An ancient system of medicine originating in India, emphasizing balance within the body and natural therapies. Its principles guide the diagnosis and treatment of Bhagandara.
53) Anutaila (Anu-taila):
A type of medicated oil used in Ayurveda for various therapeutic applications, including lubrication and healing after surgical procedures for Bhagandara.
54) Swelling:
A common symptom associated with Bhagandara, indicating inflammation or accumulation of fluids that requires careful management, often impacting patient comfort.
55) Chandra:
Refers to the moon in Ayurveda, sometimes used metaphorically to describe certain conditions or characteristics. In Bhagandara, it may relate to calming properties in treatment.
56) Upanaha:
A type of poultice or pack used in Ayurveda that helps with localized treatment of wounds. This is employed often in post-surgical care for Bhagandara.
57) Haridra:
An herbal remedy known for its anti-inflammatory and healing properties, frequently used in Ayurvedic treatments to support recovery in conditions like Bhagandara.
58) Dipika:
Refers to illuminating substances or methods used in treatment, particularly with regard to enhancing other therapeutic approaches in managing conditions.
59) Gamana:
Implies mobility or movement, which can affect the expression and exacerbation of conditions like Bhagandara, influencing treatment protocols.
60) Ropana:
Refers to the healing process, emphasizing the importance of promoting tissue repair and regeneration in managing wounds associated with Bhagandara.
61) Dushya (Dusya):
Refers to tissues affected by dosha imbalance; identifying dushya can provide clarity on how to approach treatments for patients with Bhagandara more effectively.
62) Shalya (Salya):
Refers to foreign bodies or objects that may cause pain and inflammation, crucial in diagnosing and treating conditions like Bhagandara, especially when injury is involved.
63) Pidaka:
Refers to the swelling or abscess associated with Bhagandara; understanding its nature aids in determining treatment strategies and patient management.
64) Sutra:
Refers to a thread or formula used in surgical treatments, particularly in managing Bhagandara, where it serves both diagnostic and therapeutic roles.
65) Asthi (Ashthi):
Refers to bone; its interaction with doshas in pathology may inform certain aspects of treatment strategies in Bhagandara, especially when considered holistically.
66) Taila (Thaila):
Refers to oil in Ayurvedic practices, often used in treatments and preparations for its soothing, nourishing properties, enhancing wound care in Bhagandara.
67) Hingu (Himgu):
An herbal remedy known for its digestive and anti-inflammatory properties; used in various Ayurvedic preparations as part of managing gastric-related symptoms or conditions.
68) Aruna:
Describes a reddish color often associated with inflammation; in Bhagandara, this may indicate active disease processes to monitor and manage appropriately.
69) Ulcer:
A sore or open wound that can develop in the context of Bhagandara, necessitating specific treatment and management strategies to ensure healing and avoid complications.
70) Blood:
Essential in understanding the physiological responses associated with Bhagandara, including potential hemorrhaging and the need for interventions like Raktamokshana.
71) Bahu:
Refers to multiple or numerous aspects, often indicating extensive disease processes or symptoms in treatments for conditions like Bhagandara necessitating careful assessment.
72) Wall:
Poses architectural relevance to descriptions of affected anal structures in Bhagandara, leading to essential considerations in surgical exploits or interventions.
73) Line:
Can refer to the direction or tracking of a fistula in Bhagandara, emphasizing the linear nature that requires particular surgical techniques.
74) Sthanasamshraya (Sthana-samshraya, Sthanasamsraya):
Refers to the local accumulation of doshas leading to disease development. Identifying this aspect helps practitioners understand the underlying pathology of Bhagandara.
75) Purvakarma (Purvakarman, Purva-karman):
Refers to preparatory actions taken before the main treatment in Bhagandara management, crucial for ensuring patients are ready for surgical interventions.
[Note: The above list is limited to 75. Total glossary definitions available: 246]
Other Science Concepts:
Discover the significance of concepts within the article: ‘Bhagandara –a critical review’. Further sources in the context of Science might help you critically compare this page with similair documents:
Vata, Pitta, Kapha, Bheda, Vagbhata, Bhagandara, Prakopa, Prasara, Sthanasamshraya, Vyakti, Sushruta, Raktamokshana, Virechana, Sanchaya, Mahagada, Agnikarma, Nidan, General cause, Specific cause, Surgical management, Kshara-Karma, Acharya Charaka, Nidana Parivarjana, Sadhyasadhyata, Medical management, General Principles of Management, Pathogenesis of Bhagandara, Shatkriya kala, Shambukavarta bhagandara.