Ayurveda's conservative approach for acute disc prolapse: A case study.

| Posted in: Scientific

Journal name: Journal of Ayurveda and Integrative Medicine
Original article title: Conservative management of acute prolapsed inter-vertebral disc with ayurveda: A case report
The Journal of Ayurveda and Integrative Medicine (JAIM) is an open-access publication promoting collaboration between Ayurveda, traditional medicine, and biomedicine, publishing research on integrative health sciences
This page does not contain the article itself; See source (below) for actual content.

Original source:

This page only sums up technical details and meta-data hence you should visit the source to read the original article which includes the author, publication date, notes and references.

Author:

Shailesh V. Deshpande, Vaishali S. Deshpande, Ashutosh Bhosale, Maruti Kadam


Journal of Ayurveda and Integrative Medicine:

(A monthly peer-reviewed publication)

Full text available for: Conservative management of acute prolapsed inter-vertebral disc with ayurveda: A case report

Year: 2022 | Doi: 10.1016/j.jaim.2022.100561

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


Download the PDF file of the original publication


Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Ayurveda's conservative approach for acute disc prolapse: A case study.”. 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) Table:
Table refers to a structured arrangement of data, typically organized in rows and columns. In the context of medical studies, tables are crucial for summarizing treatment protocols, patient outcomes, or statistical analyses. They provide clarity and facilitate comparisons, making complex information accessible to readers and researchers, which is vital in scientific communication.

2) Pain:
Pain is a sensory and emotional experience often associated with injury, illness, or emotional distress. In medical contexts, understanding pain levels is essential for diagnosis and treatment effectiveness. Particularly in cases like herniated discs, pain assessment is crucial to determine guidance of therapeutic interventions, as pain directly impacts a patient's quality of life.

3) Ayurveda (Ayus-veda):
Ayurveda, a traditional Indian system of medicine, emphasizes holistic health and balance through natural methods. Its principles use dietary strategies, herbal remedies, and lifestyle changes for treating various ailments. In the discussed study, Ayurveda provides a framework for non-surgical treatment of prolapsed inter-vertebral discs, highlighting its relevance in modern healthcare discussions.

4) Basti:
Basti refers to a specific Ayurvedic therapeutic procedure involving medicated enemas. It is designed to detoxify and rejuvenate the body, particularly the lower gastrointestinal tract. This treatment can address various conditions, including those related to the musculoskeletal system. In the case presented, Basti was pivotal for managing the patient's debilitating symptoms.

5) Stiffness:
Stiffness describes a state where muscles or joints exhibit limited flexibility or range of motion, often accompanied by pain or discomfort. In the medical narrative, the patient's stiffness indicated the severity of her condition. Understanding stiffness helps healthcare providers gauge the extent of physical dysfunction and tailor appropriate rehabilitation strategies.

6) Medicine:
Medicine encompasses a broad field concerned with diagnosing, treating, and preventing illnesses. It includes various practices, from conventional pharmaceutical approaches to alternative therapies like Ayurveda. The article presents the role of Ayurvedic medicine in managing acute prolapsed inter-vertebral disc cases, showcasing diverse treatment methodologies in contemporary healthcare.

7) Taila (Thaila):
Taila is a Sanskrit term for oil, important in Ayurveda for therapeutic practices. Medicinal oils, like Vishagarbha Taila, are often used for external application to relieve pain and inflammation. In the case study, the role of Taila in the patient’s treatment underscores its value in Ayurvedic healing traditions.

8) Eranda (Eramda):
Eranda, or Ricinus communis, is a herb noted for its medicinal properties in Ayurveda. It has been traditionally used for its laxative, anti-inflammatory, and analgesic effects. In the patient's Ayurvedic treatment plan, Eranda played a vital role, especially in formulations like medicated enemas prescribed to alleviate her condition.

9) Nirgundi (Nirgumdi):
Nirgundi, known as Vitex negundo, is a plant used widely in Ayurvedic practices for pain relief, particularly musculoskeletal pain. Its anti-inflammatory and analgesic properties make it useful in treating conditions like sciatica and lumbar pain. In the discussed study, Nirgundi was a key component of the patient's treatment regimen.

10) Study (Studying):
Study refers to systematic investigations intended to establish facts or principles. The mentioned case describes an Ayurvedic study focusing on treating acute prolapsed inter-vertebral disc without surgery. The study's findings contribute valuable insights into treatment efficacy, potentially advancing knowledge in both Ayurveda and conventional medical practices.

11) Bhaishajya (Bhaisajya):
Bhaishajya is the Ayurvedic term for medicine or pharmacology. It encompasses various formulations and treatments used to prevent and relieve ailments. The significance of Bhaishajya in the context of the case reflects the reliance on traditional pharmacological principles to formulate treatment regimens for complex conditions like inter-vertebral disc prolapse.

12) Writing:
Writing is the act of composing text, which is pivotal in academic and scientific communication. In the article, effective writing presents the case study findings, treatment processes, and scholarly discourse regarding Ayurvedic practices. Good writing improves understanding and accessibility, crucial for disseminating medical knowledge to various audiences.

13) Shukla (Sukla):
Shukla is likely a surname that signifies the contribution of a researcher or academic involved in the study. Its mention highlights collaboration among authors and potential expertise in the discussed subject. Collaborative writing enhances research credibility and provides diverse perspectives essential for thorough exploration of health interventions like Ayurveda.

14) Delhi:
Delhi, the capital city of India, is a significant cultural and political center. It is also a hub for medical institutions and research in both conventional and alternative therapies. The location of medical studies in Delhi highlights its importance in shaping healthcare practices and policies relevant to the Indian population.

15) Rock salt:
Rock salt, or halite, is a naturally occurring mineral used in various culinary and medicinal applications. In Ayurveda, it serves as a dietary additive and ingredient in certain treatments. Its mention in the case underscores its relevance in detoxification and therapeutic formulations meant to aid in the patient's recovery.

16) Vatavyadhi (Vata-vyadhi):
Vatavyadhi is a Sanskrit term referring to diseases caused by vitiation of 'Vata', one of the three doshas in Ayurveda. It encompasses various conditions affecting the musculoskeletal system, highlighting the theoretical framework within Ayurveda for diagnosing and treating ailments like inter-vertebral disc prolapse through holistic approaches.

17) Gridhrasi (Gridhrashi, Grdhrasi):
Gridhrasi is an Ayurvedic term comparable to sciatica in Western medicine, characterized by pain radiating down the leg. It includes symptoms linked to lower back pain and nerve root irritation. The case mentions Gridhrasi to contextualize the patient’s condition within traditional Ayurvedic pathology, exemplifying treatment methodologies.

18) Siddha:
Siddha is another traditional Indian system of medicine, closely associated with Ayurveda. While both systems share foundational philosophies, Siddha offers unique therapeutic approaches, particularly focusing on mineral and herb combinations. Acknowledging Siddha in the context of Ayurveda provides insights into the diverse healing paradigms present in Indian medical traditions.

19) Tagara:
Tagara, known as Valeriana wallichii, is valued in Ayurveda for its sedative and pain-relieving properties. It is often utilized in formulations aimed at alleviating pain and promoting relaxation. The inclusion of Tagara in the patient’s treatment signifies its role in addressing the symptoms associated with acute prolapsed inter-vertebral discs.

20) Tikta:
Tikta translates to 'bitter' in Ayurveda, describing a taste associated with certain medicinal herbs. It is believed to have detoxifying and metabolic enhancing properties. Herbs with Tikta qualities are often included in treatments to address conditions like inflammation and digestive issues, playing a role in the management of complex ailments.

21) Ghana:
Ghana in Ayurveda refers to a concentrated preparation or extract derived from medicinal plants. This method enhances the potency of substances, optimizing therapeutic effects. In the context of the case study, using Ghana formulations indicates a commitment to employing concentrated therapeutic agents to achieve better patient outcomes.

22) Arrow:
An arrow is often used symbolically in literature and discussions to denote direction or pinpoint specific areas of focus. In medical texts, arrows may be employed in illustrative materials to highlight findings on diagrams or imaging studies. Their purpose is to direct attention to critical aspects of the analysis presented.

23) Honey:
Honey is considered a natural sweetener with numerous health benefits in Ayurveda. It possesses antimicrobial and anti-inflammatory properties, making it valuable in medicinal preparations. Its mention in the treatments showcases Ayurveda’s approach to utilizing natural substances in managing diseases, emphasizing the importance of dietary inclusions in health regimens.

24) Salt (Salty):
Salt has significant roles in both culinary and medicinal contexts. It is essential for bodily functions and balances electrolytes. In Ayurvedic practices, particular types of salt, like rock salt, are often combined with herbs for therapeutic applications. Its relevance in treatment underlines the holistic perspective of Ayurveda on nutrition and health.

25) Tinospora cordifolia:
Tinospora cordifolia, commonly known as Guduchi, is an important herb in Ayurveda recognized for its immunomodulatory and anti-inflammatory properties. Its active components support body healing mechanisms, making it significant in treating conditions like disc prolapse. The herb's inclusion signifies a tailored approach for complex health issues in traditional medicine.

26) New Delhi:
New Delhi, the capital of India, holds a prominent position as a center for medical research and education. It is significant in the context of the case, indicating the potential integration of traditional treatments like Ayurveda with modern medical practices, reflecting the city's diverse health landscape and commitment to holistic care.

27) Ricinus communis:
Ricinus communis, or Eranda, is a potent medicinal plant used in Ayurvedic treatment for its laxative and anti-inflammatory properties. Its effectiveness in addressing conditions involving pain and inflammation highlights its importance in developing herbal formulations. The use of Ricinus communis in the discussed treatment exemplifies traditional knowledge applied to modern issues.

28) Activity:
Activity refers to the engagement of biological or chemical functions in living systems. In the context of medicine, understanding the activity of various compounds helps healthcare professionals design appropriate treatments. The case illustrates the activities of herbal preparations in addressing symptoms of herniated discs, contributing to evidence-based practice in Ayurveda.

29) Disease:
Disease indicates a pathological condition characterized by dysfunction, causing physical or mental disturbances. In the context of the article, it highlights the importance of understanding specific diseases, like inter-vertebral disc prolapse, to apply effective treatments. This promotes better outcomes in patient care through tailored approaches in both traditional and modern medicine.

30) Developing:
Developing refers to the process of growth, improvement, or advancement of ideas, practices, or conditions. In the context of medical research, it underscores the importance of ongoing studies that enhance understanding, implement better treatment methodologies, and help integrate traditional practices like Ayurveda into modern healthcare settings for holistic patient management.

31) Anuvasana:
Anuvasana is a term referring to a type of enema in Ayurveda, particularly using oil-based formulations. It is aimed at nourishing the body and alleviating ailments through rectal administration. In this case, Anuvasana was included as part of the therapeutic strategy, emphasizing the practical application of Ayurvedic recommendations for patient care.

32) Ratnakara (Ratna-akara, Ratna-kara):
Ratnakara refers to a significant Ayurvedic text. Its mention indicates the historical depth of Ayurvedic practices and formulations. Texts like Ratnakara establish foundational knowledge in herbal medicine, allowing practitioners to derive effective treatment methodologies. This context promotes the relevance of ancient wisdom in contemporary Ayurvedic practices highlighted in the study.

33) Agnivesha (Agnivesa, Agni-vesha):
Agnivesha is an ancient Ayurvedic scholar known for significant contributions to Ayurvedic texts, including the Charaka Samhita. His work continued to influence modern Ayurveda practices. Understanding Agnivesha’s contributions contextualizes the integration of traditional knowledge in treatment methodologies, exhibiting continuity in practices from historical frameworks to present-day applications in medicine.

34) Samgraha (Sangraha):
Sangraha pertains to the collection or compendium of Ayurvedic knowledge, including remedies and therapeutic techniques. Documents that follow this format provide practitioners with accessible information for application in patient care. The presence of Sangraha in Ayurvedic discussions emphasizes the importance of systematic knowledge storage to support clinical practice.

35) Tamarind:
Tamarind is a tropical fruit used in culinary practices and traditional medicine. In Ayurveda, it is known for its digestive properties and versatility in formulations. Its inclusion in the treatment protocol signifies the holistic approach of Ayurveda, which integrates various natural elements for therapeutic purposes, enhancing patient care through dietary interventions.

36) Bharata:
Bharata references the Indian subcontinent and is often associated with its rich cultural and historical significance, especially in traditional medicine practices like Ayurveda. The mention underlines the significance of regional practices and how local traditions form the basis for health systems that inform current medical practices and patient care strategies.

37) Samhita:
Samhita refers to a compilation or collection of Ayurvedic texts, crucial for establishing the principles of traditional medicine. These texts serve as foundational guides for practitioners, detailing various treatments, including herbal formulations and therapeutic techniques. Their significance in the case emphasizes the depth and continuity of Ayurvedic medicinal philosophy.

38) Guggulu:
Guggulu is an important herbal resin used in Ayurveda, known for its anti-inflammatory and analgesic properties. Its applications in treating conditions like arthritis and disc-related pain underscore its role in Ayurvedic formulations. The use of Guggulu in the study highlights a practical approach towards integrating traditional knowledge with therapeutic strategies.

39) Shunthi (Sunthi, Sumthi, Shumthi):
Shunthi, or dried ginger, is commonly used in Ayurveda for its medicinal properties, particularly in digestion and pain relief. Its warming nature and ability to enhance circulation make it valuable in formulations for conditions like disc prolapse. The inclusion of Shunthi in treatment plans reflects Ayurveda's reliance on herbs for holistic care.

40) Pannaga (Panna-ga):
Pannaga is a term often related to a specific type of plant or herbs referenced in Ayurvedic texts. Indicating the use of traditional plants reinforces the significance of botanical knowledge in making treatment decisions. In the context of the case, Pannaga likely represents elements focused on promoting overall well-being.

41) Mineral:
Minerals are naturally occurring inorganic substances vital for various physiological functions in the body. In Ayurveda, certain mineral preparations are integrated into formulations for therapeutic purposes, emphasizing the fusion of natural healing with nutrient supplementation. The mention of minerals in the study accentuates the multi-faceted approach to patient treatment and recovery.

42) Jaggery:
Jaggery, an unrefined sugar made from sugarcane or palm sap, is used in Ayurvedic practices for its health benefits, including digestive support and blood purification. Its mention indicates a focus on using natural sweeteners that complement herbal treatments and enhance therapeutic efficacy, showcasing Ayurveda's holistic dietary approach to care.

43) Mishra (Misra):
Mishra, as a name, often denotes someone's authorship or contribution to a study or publication. In this context, it indicates collaboration among researchers, which is essential in scientific inquiry. The synergy found in collaborative work is key to producing comprehensive research outcomes, giving weight to diverse insights and methodologies.

44) Niruha:
Niruha refers to a type of medicated enema using herbal decoctions in Ayurveda. It is particularly aimed at cleansing and rectifying internal issues. Its application in therapies illustrates the value of traditional Ayurvedic practices in modern healthcare environments, providing non-invasive options for addressing complex conditions like inter-vertebral disc prolapse.

45) Graha:
Graha in Ayurvedic context refers to capturing or attracting qualities, especially relating to diseases. Understanding Graha is essential for diagnosing ailments and applying suitable therapies. The term emphasizes the holistic perspective of Ayurveda, which considers physical, mental, and spiritual aspects in treating health issues, as reflected in the case study.

46) Matra:
Matra indicate the measurement or dosage of substance in Ayurvedic practice, pertinent for ensuring therapeutic efficacy and safety. Proper dosage is crucial in medicine to avoid adverse reactions while maximizing benefits. The term’s presence underscores the meticulous approach provided in Ayurvedic treatment protocols to achieve optimal patient outcomes.

47) Ajmer:
Ajmer is a city in India known for its cultural sights and historical significance. It also represents a geographical reference for practices and teachings in Ayurveda. Including locations like Ajmer indicates the widespread nature of Ayurvedic practices throughout India, promoting the regional application and adaptation of traditional knowledge in healthcare.

48) Kumar:
Kumar is often used as a common surname in India, indicating the personal identification of contributors to research. It signifies collaboration among various stakeholders in scientific studies, enhancing credibility and providing a broader perspective essential for comprehensive research. Understanding these contributions fosters better recognition of interdisciplinary approaches.

49) Water:
Water is a fundamental substance for life, crucial for physiological processes and treatments. In Ayurveda, it is essential in herbal preparations, detoxification, and maintaining hydration. The significance of water emphasizes the holistic view of Ayurveda, illustrating how natural elements are integrated into treatment regimens, enhancing the overall health and wellness approach.

50) Rules:
Rules establish guidelines and principles that govern practices within disciplines, including medicine. In the context of research, understanding rules ensures adherence to ethical standards, safety protocols, and methodological rigor. This recognition reinforces the importance of structured inquiry in advancing knowledge, particularly in fields like Ayurveda where evidence-based practices are vital.

51) Hara:
Hara is often referenced in Ayurveda within the context of natural healing and the balance of body systems. It conveys a holistic view of health, further corroborated by the case study. Hara’s significance reflects the essential role of maintaining balance in achieving optimal health outcomes through traditional practices.

52) Vati:
Vati is a term used in Ayurveda to describe medicated tablets or pills, often derived from herbs and minerals. It's a common method of preparation in traditional medicine aimed at delivering therapeutic compounds efficiently. The emphasis on Vati indicates a focus on accessible forms of medication tailored to patients' needs in Ayurvedic practice.

53) Kati:
Kati refers to the lower back in Ayurvedic terminology, an area of focus for conditions like IVDP. Understanding its significance helps tailor treatments that directly address pain, stiffness, and dysfunction in that region. This emphasizes how anatomy is central to Ayurvedic diagnosis and treatment strategies for targeted interventions.

54) Sara (Shara):
Sara in Ayurvedic context typically refers to the essence or core quality of something. Understanding the 'Sara' of a herb or treatment means recognizing its primary therapeutic qualities, allowing practitioners to select appropriate remedies effectively. This concept is foundational in Ayurveda and crucial in developing treatment plans for patients.

55) Arya:
Arya may denote a scholarly title or common surname in Indian contexts. In this setting, it reflects individuals who contribute meaningfully to research and practice in Ayurveda and other fields. Acknowledging Arya the scholarship highlights the critical role of individuals in advancing traditional knowledge and its integration into modern medical frameworks.

56) Hela (Helá):
Hela generally refers to a state of wellness or health within various cultural contexts. Within Ayurveda, maintaining a Hela state is integral to holistic treatment approaches. This emphasis on Hela underlines the importance of viewing health not just as the absence of disease but as a balanced and harmonious state.

57) Food:
Food represents essential nourishment for the human body, closely tied to health and wellness. In Ayurveda, the quality and type of food consumed play pivotal roles in balancing the doshas and promoting health. Acknowledging food emphasizes the holistic nature of Ayurveda, recognizing dietary habits as critical components of health management.

58) Ghi (Ghee):
Ghee, or clarified butter, is revered in Ayurveda for its nutritional and therapeutic properties. It is believed to enhance digestion, support neurological functions, and nourish bodily tissues. Its prominent role in the treatment plan highlights Ayurveda's integration of dietary fats as vital elements for comprehensive wellness and recovery strategies.

59) Valeriana wallichii:
Valeriana wallichii, commonly known as Tagara, is an herb valued in Ayurveda for its sedative and relaxing properties. It is used in various formulations to manage anxiety, stress, and pain. The incorporation of this herb in patient treatment reflects the consideration of natural plant resources in Ayurvedic health effector regimes.

60) clarified butter:
Clarified butter, known as ghee, is a staple in Ayurvedic cooking and medicine. Its properties improve digestion and enhance absorption of nutrients. In the discussed study, ghee's mention signifies the holistic dietary approach utilized in Ayurveda to support traditional therapies, emphasizing both nutritional and therapeutic benefits in treatment strategies.

61) Peer review:
Peer review is a quality control process wherein scholars evaluate each other's work before publication. This procedure assures that research meets high standards of quality and rigor. The mention of peer review reinforces the scientific credibility of the case study, demonstrating the commitment to scholarly integrity in publishing findings.

62) Anuvasanabasti (Anuvasana-basti):
Anuvasana-basti is a type of Ayurvedic enema involving oil, aimed at nourishing and detoxifying the body from within. Its focus on direct internal administration reflects a deep understanding of treatment mechanics in Ayurveda. In the patient treatment, Anuvasana-basti highlights the efficacy of traditional therapies in modern integrative medicine.

63) Purification:
Purification in Ayurveda refers to the detoxifying processes that aim to cleanse the body of impurities. This can involve various methods, including dietary regulations and therapeutic procedures. The emphasis on purification signifies a core principle of Ayurveda, ensuring treatments not only address symptoms but also restore the body's natural equilibrium.

64) Matra-basti:
Matra-basti is a specific Ayurvedic enema treatment that utilizes controlled medicinal oils. It is designed to balance doshas while promoting the internal health of the body. The application of Matra-basti in the clinical case indicates a well-planned treatment approach that underscores Ayurveda's nuanced understanding of bodily functions and its holistic therapeutic practices.

65) Observation:
Observation refers to the systematic examination of a subject to gather data. In clinical practice, it is crucial for assessing patient conditions and evaluating treatment effectiveness. The article’s emphasis on observation underscores the importance of meticulous documentation and analysis in Ayurvedic research to advance knowledge and validate treatment strategies.

66) Discussion:
Discussion is a critical component of research articles, offering interpretations of findings and implications for future study. It synthesizes results with existing literature, providing a platform for scholarly dialogue. In this context, the discussion about Ayurvedic treatment effectiveness deepens insights into alternative medicine's place in modern healthcare frameworks.

67) Science (Scientific):
Scientific refers to knowledge acquired through systematic observation, experimentation, and validation. Emphasizing scientific approaches in traditional medicine, such as Ayurveda, plays a crucial role in bridging traditional practices and modern healthcare, enhancing credibility and acceptance among broader audiences and stakeholders in the medical community.

68) Vaishali (Vaisali):
Vaishali is a name that refers to a contributor in the research, emphasizing collaboration within medical studies. As research often relies on multiple perspectives and expertise, individual contributions like those from Vaishali are vital in enriching discussions and outcomes through shared knowledge and insights across interdisciplinary platforms.

69) Abhyanga (Abhyamga):
Abhyanga is a therapeutic Ayurvedic massage using oil to promote physical, emotional, and spiritual well-being. It is believed to enhance circulation and reduce stress. The mention of Abhyanga in treatment protocols illustrates the focus on comprehensive care, emphasizing that physical therapies are integral to holistic wellness and recovery in Ayurveda.

70) Devadaru (Deva-daru):
Devadaru, or Cedrus deodara, is essential in Ayurveda known for its medicinal and therapeutic properties. Used in formulations for pain relief and inflammation reduction, it reflects the diversity of plant-based treatments in traditional medicine. Devadaru's inclusion in the case highlights the importance of utilizing natural resources for effective patient care.

71) Varanasi (Varanashi):
Varanasi, a prominent city in India, holds significant cultural and spiritual importance. It is also a center for traditional Ayurvedic practices and education. Mentioning Varanasi reflects the geographical diversity where Ayurvedic knowledge thrives, reinforcing the need for preserving and promoting ancient practices in contemporary medical discussions.

72) Sanskrit:
Sanskrit is an ancient language integral to Ayurveda and Indian culture, used in classical texts that outline medicinal principles and practices. Understanding Sanskrit provides insights into the origins of Ayurvedic tradition. Its inclusion underscores the historical context and linguistic richness that form the foundation of Ayurvedic knowledge systems.

73) Gopala (Go-pala):
Gopala often denotes a name associated with practitioners and contributors to Ayurveda. It symbolizes the lineage of knowledge passed down through generations. Recognizing individuals like Gopala emphasizes the personal dimensions of knowledge transmission, highlighting their roles in maintaining and cultivating traditional medical practices in modern contexts.

74) Maruti:
Maruti can denote several meanings, often referencing strength and reliability in the context of Ayurveda. As a name, it may refer to individuals involved in research contributing to Ayurveda. The reference helps contextualize collective efforts and contributions aiming to modernize and validate traditional Ayurvedic practices within broader therapeutical frameworks.

75) Bashpa (Baspa):
Bashpa refers to steam therapy, which is part of Ayurvedic treatments meant to alleviate various conditions related to pain and stiffness. It promotes relaxation and enhances the effectiveness of herbal treatments. This inclusion underlines the integrative strategies of Ayurveda, employing multiple therapies for achieving holistic wellness.

[Note: The above list is limited to 75. Total glossary definitions available: 88]

Let's grow together!

I humbly request your help to keep doing what I do best: provide the world with unbiased sources, definitions and images. Your donation direclty influences the quality and quantity of knowledge, wisdom and spiritual insight the world is exposed to.

Let's make the world a better place together!

Like what you read? Consider supporting this website: