Ashmari is one among the eight most difficult to cure diseases (Ashtamahagada) described in Ayurveda classical texts. The symptomatology of Ashmari resembles the clinical features of Urolithiasis mentioned in the contemporary medical science. Urolithiasis is third most common disease of the urinary tract. Conventional management of Urolithiasis does not have any effect on the pathogenesis of this disease and therefore, recurrence of disease occurs very commonly. Ayurveda has more radical approach and wide range of options in the management of urolithiasis. A 66-year old Indian male farmer presented with the complaints of pain in right side of abdomen, burning and difficulty in micturition since last 60 days. Per abdomen examination elicited tenderness on right lumbar region of abdomen and around right renal angle. No other abnormality detected during general and systemic examination. Ultrasonography (whole abdomen) revealed calculus in right Ureterovesical Junction (largest being 6 mm). And right kidney shows grade-1 hydronephrosis with dilated ureter. On Ayurvedic parlance, the present case was diagnosed as Ashmari based on the signs and symptoms. Patient was prescribed the Ayurvedic medicines, Vrikkashulantakvati, Pashanvajraras, Yavakshar, shwetparpti, Gokshuradichurun, Gokshuradiguggul and sidhaarkon OPD basis. Patient was advised to follow-up initially after 15 days and later after 7 days. Improvement in clinical features was there within 07 days.Patient showed complete relief in his complaints on 2nd follow up visit. Repeat Ultrasonography scan did not revealed any calculus in right Ureterovesical Junction. Clinically also, Trinapanchamulakwath, Gokshuradiguggulu and Pashanvajraras has provided complete relief in pain, burning micturition and dysuria. It can be concluded that Gokshuradiguggulu and Pashanvajraraslead to disintegration and expulsion of calculus and thus provide relief in signs and symptoms of Ashmari. This case illustrates the effective conservative management of Ashmari with Ayurvedic medicines with no adverse events and no episode of recurrence.
Ashmari, Urolithiasis, Renal calculus, GokshuradiGuggulu, Pashanvajraras
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