STR

“A STUDY ON NAIDANIKA SAMPRAPTI OF SHONITA DUSHTI W.S.R.
TO
ESSENTIAL HYPERTENSION AND ITS SAMPRAPTI VIGHATANA USING
JATAMAMSI CHOORNA”
By
Dr. RADHIKA T.P.
Dissertation submitted to the Rajiv Gandhi University of Health Sciences,

Bangalore, Karnataka.
For the partial fulfillment of Degree of
AYURVEDA
VACHASPATHI
DOCTOR OF MEDICINE
IN
ROGANIDANA
Under the guidance of
Dr. R.K. HIBARE M.D. (Ayu)
Professor & H.O.D.
Department of Post Graduate Studies in Roganidana,
Government Ayurvedic Medical College, Bangalore
DEPARTMENT OF POST GRADUATE STUDIES IN ROGANIDANA

GOVERNMENT AYURVEDIC MEDICAL COLLEGE
DHANWANTARI ROAD, BANGALORE – 560009
2011-2012
i
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,
KARNATAKA
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation entitled “A STUDY ON NAIDANIKA
SAMPRAPTI OF SHONITA DUSHTI W.S.R. TO ESSENTIAL
HYPERTENSION AND ITS SAMPRAPTI VIGHATANA USING
JATAMAMSI CHOORNA” is a bonafide research work carried out by me under
the guidance of Dr. R.K. HIBARE M.D. (Ayu), Professor and H.O.D., Department
of PG studies in Roganidana, Govt. Ayurvedic Medical College, Bangalore.
Date: Signature of the candidate

Place: Dr. Radhika T.P.
DEPARTMENT OF POST GRADUATE STUDIES IN ROGA NIDANA
i
CERTIFICATE BY THE GUIDE
This is to certify that the Dissertation entitled “A STUDY ON NAIDANIKA
JATAMAMSI CHOORNA” is a bonafide research work done by Dr. RADHIKA
T.P. in partial fulfillment for the degree of Ayurveda Vachaspathi, Doctor of
Medicine (Ayurveda) in Roga nidana of the Rajiv Gandhi University of Health
Sciences, Bangalore.
I recommend this dissertation for the above degree to the University for
Assessment and approval.
Date: Signature of the Guide
Place: Dr. R.K. HIBARE M.D. (Ayu)
Professor and HOD

Department of Postgraduate Studies
in Roga Nidana
ii
GOVERNMENT AYURVEDIC MEDICAL COLLEGE
Dhanwanthari Road,
Bangalore –560 009
ENDORSEMENT BY THE HOD and PRINCIPAL
This is to certify that the dissertation entitled “A STUDY ON NAIDANIKA
JATAMAMSI CHOORNA” is a bonafide research work done by Dr. Radhika
T.P. under the guidance of Dr. R.K. Hibare M.D. (Ayu), Professor, Department of Post
graduate studies in Roganidana, Government Ayurvedic Medical College, Bangalore.
Signature of the HOD Signature of the Principal

Dr. R.K. Hibare MD (Ayu) Govt. Ayurvedic Medical College
Professor & HOD Bangalore
Department of PG Studies in Roga Nidana
Govt. Ayurvedic Medical College
Bangalore
Date: Date:
Place: Place:
iii
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the Rajiv Gandhi University of Health Science,
Karnataka shall have the rights to preserve, use and disseminate this dissertation
in print or electronic format for academic/ research purpose.
Date: Signature of the candidate
Place: Dr. Radhika T.P.
© Rajiv Gandhi University of Health Sciences, Karnataka
iv
DEDICATED TO MY
FAMILY
&
REVEREND TEACHERS
v
ACKNOWLEDGEMENT
By grace of Lord Mahalingeshwara and
Blessing of my Family.
This work is the outcome of the combined endeavor of a good number of people who
include researchers, academicians, friends, colleagues, parents and above all the patients who
cooperated with us in all aspects. Moreover it is the grace of Lord Almighty that this work
could be accomplished smoothly and timely.
At this moment of submitting this dissertation in this Post Graduate study, my head bows down
with great humility in the feet of Lord Dhanwantari, Lord Shiva, Lord Krishna without whose
blessings, I would not have been able to attain these stages in my life. I take this opportunity to
acknowledge with holy passion and sincere gratitude, the unique guidance, enthusiasm and
knowledge to me by my reverend and proficient guide Dr. R.K. Hibare, Head of the Department of
Roga Nidana, Govt Ayurvedic Medical College Bangalore. I take this opportunity to express my
sincere gratitude with due respect to Dr.M. Ramesh Department of Roga Nidana, Govt Ayurvedic
Medical College Bangalore for his kind support and valuable guidance. I am very much thankful
to our Principal Dr. H.T. Sreenivas, Incharge Principal Dr. Ashalatha M. and Ex-Principal
Dr.S.G. Mangalagi, who gave me a chance to complete this work successfully. And also I thank
Dr. S.K. Hugar, Dr. Lalitha B.R., Dr. Shyla R. Yoganand, Dr.Shylaja Kumari & Dr.Anant
Desai for providing all sorts of help to carry out this research study. I also thank Dr. M.S. Ramesh
Lecturer Department of Roganidana Govt Ayurvedic Medical College, Bangalore who helped me
during the preparation of this work. I sincerely bow my head to my mother Smt Padmavathi T.S.
and my father Shri Thukaram S. for cultivating basic virtues which has lead me to where I am
now. And also I am very much obliged to my brother Prashanth T.P. for his moral support.
vi
I express my sincere thanks to all of my Colleagues Dr. Dileep, Dr. Pradeep, Dr.Nazima,
Dr.Jyothi and Dr. Sachin for their kind help and support. I am very thankful to my juniors Dr.
Rashmi, Dr. Chethana, Dr. Arun, Dr. Moh’d Yunus, Dr. Sangeeta, Dr. Indira Priyadarshini, Dr.
Priyanka, Dr. Madhusudan, Dr. Sudeesha and Dr. Kishore for their timely help and support. And
also I want to thank Dr. Navya for her suggestion which helped me in completing this work
successfully.
I also express my thanks to Dr. K.P. Suresh, Biostatistician who helped in completing my
statistics work. I also want to thank Dr. Sandeep K.C. for his in timely help in completing my
research work. I also express my warm thanks to staff of hospital and library for their positive
approach and prompt co-operation. Medicinal research cannot be carried out without the
enthusiastic attitude and due patience of the patients; I sincerely thank all my patients who
kindly allowed me to carry out the research studies on themselves. At last I express my thanks to
each & every person who are directly or indirectly associated in the smooth completion of this work.
Date:
Place: Bangalore Dr. Radhika T.P.
vii
ABBREVIATIONS
1. A.C.E. : Angiotensin Converting Enzyme

2. A.H : Astanga Hridhaya
3. A.S : Astanga Sangraha
4. A.T : After Treatment
5. B.T : Before Treatment
6. B.P : Blood Pressure
7. C.S : Charak Samhita
8. E.C.F : Extra Cellular Fluid
9. Hb% : Heamoglobin Percentage
10. HTN : Hypertension
11. S.B.P. : Systolic Blood Pressure
12. D.B.P. : Diastolic Blood Pressure
13. S.S : Sushruta Samhita
viii
ABSTRACT
Hypertension is the term used to describe high blood pressure. Blood
pressure is the pressure exerted by blood on the walls of the blood vessel. The arterial
hypertension having no definable cause is designated as essential hypertension. It is
estimated that 600 million people are affected worldwide. In India 14 % of people
suffers from hypertension, and majority of them have essential hypertension.
The present study entitled “A Study on naidanika samprapti of Shonita
Dushti w.s.r.to Essential Hypertension and its Samprapti Vighatana using Jatamamsi
Choorna” is an attempt to evaluate the role of Jatamamsi Choorna in the Samprapti
vighatana of Shonita Dushti. The present study is based upon a reference from Bhava
mishra eÉOûÉqÉÉÇxÉÏ..... qÉåkrÉÉ........ xuÉÉ²Ï ÌWûqÉÉ Ì§ÉSÉåwÉÉxÉëSÉWûÌuÉxÉmÉï MÑü¹lÉÑiÉç || pÉÉ.mÉë. qÉkrÉqÉ
ZÉhQû.89.
Jatamamsi being Medhya, Tridoshahara and Rakta doshahara helps in pacifying the
Shonita Dushti.
The present study is carried out with the following objectives:-
 To study the Naidanika Samprapti of Shonita Dushti.
 To evaluate the efficacy of Jatamamsi Choorna as a means of Samprapti
Vighatana in patients suffering from Essential Hypertension.
 To study the effect of Pathya Aahara and Vihara in Samprapti Vighatana of

Shonita Dushti.
Study Design: It is a randomized comparative open clinical study with Pre-test and
Post-test design.
Setting: Shri Jayachamarajendra Institute of Indian Medicine Hospital (Teaching
Hospital of G.A.M.C.), Bangalore.
ix
Study Selection: 40 patients suffering from Shonita Dushti of either sex between the
ages of 30 to 60 years were selected for the study.
Intervention:
Present study comprised of 40 patients divided into 2 groups, Group A
and Group B Randomly, with both the groups containing 20 patients each. The
findings was recorded in a special proforma and given due regard to the Past History,
Present History, Family History, and Personal History.
Patients in Group A-were administered 1gm t.i.d. of Jatamamsi Choorna
and also kept on appropriate Pathya Ahara and Vihara. Patients in Group B-were kept
as Control Group on only Pathya Ahara and Vihara. The study was carried out for a
period of 30 days. Blood Pressure of patients was recorded before and after the trial at
a particular time.
Subjective parameters: Headache, Dizziness, Palpitation and Easy Fatigue.
Objective parameters: Systolic and Diastolic Blood Pressure.
Main Outcome Measures: The data were graded based on standard methods and
analyzed statistically using Paired and Unpaired Student ‘t’ Test and Chi-
square/Fisher Exact Test.
RESULT: The trial produced highly significant result among patients of Group A
with regard to Systolic B.P., Diastolic B.P., Headache, Dizziness and Easy Fatigue
and Significant result with regard to Palpitation after trial in comparison to Group B.
The data thus obtained among patients of group A & group B leads one to the
interpretation that the trial employed for patients of group A is much superior in
comparison to group B.
Key Words: Shonita Dushti, Jatamamsi Choorna, Pathya Ahara and Vihara, Essential
Hypertension.
x
CONTENTS
SL. NO. CONTENTS PAGE NO.
1 Introduction 1-5
2 Objectives 6
3 Review of Literature
i. Historical Review 7-11
ii. Disease Review:
1) Etymological Derivation 12
2) Nidana 13-17
3) Samprapti 18-25
4) Rupa 26-32
5) Chikitsa 33-37
6) Pathya-Apathya 38
7) Sadhya-Asadhyata 39-40
iii. Drug Review 41-44
4 Methodology 45-49
5 Observations & Results 50-110
6 Discussion 111-125
7 Conclusion 126-128
8 Summary 129-130
9 Bibliography & References 131-139
10 Annexure 140-150
ix
LIST OF TABLES
Table Name of the Tables Page

No. no.
1. Nidana of Shonita Dushti 13-14
2. Samprapti Ghataka of Shonita Dushti 21
3. Drugs with Hypotensive Action 36
4. Guna Panchaka of Jatamamsi Choorna 42
5. Karma of Jatamamsi Choorna 43
6. Diagnostic Criteria 46
7. Exclusion Criteria 47
8 Study Design 47
9. Distribution of patients according to Age 50
10. Distribution of patients according to Sex 51
11. Distribution of patients according to Religion 52
12. Distribution of patients according to Education 53
13. Distribution of patients according to Marital Status 54
14. Distribution of patients according to Occupation 55
15. Distribution of patients according to Socio-Economic Status 56
16. Distribution of patients according to Family 57
17. Distribution of patients according to Habit/Place 58
18. Distribution of patients according to Diet 59
19 Distribution of patients according to Dominant Rasa Intake 60
20. Distribution of patients according to Diet Habit 61
21. Distribution of patients according to Appetite 62
22. Distribution of patients according to Bowel Habit 63
23. Distribution of patients according to Sleep Habit 64
24. Distribution of patients according to Presence of Mental Strain 65
25. Distribution of patients according to Exercise 66
26. Distribution of patients according to Addiction 67
27. Distribution of patients according to Emotional Makeup 68
28. Distribution of patients according to Nature of Work 69
x
29. Distribution of patients according to Rest taken during work 70
30. Distribution of patients according to Built 71
31. Distribution of patients according to Nourishment 72
32. Distribution of patients according to Deha Prakruti 73
33. Distribution of patients according to Dosha 74
34. Distribution of patients according to Satva 75
35. Distribution of patients according to Satmya 76
36. Distribution of patients according to Samhanana 77
37 Distribution of patients according to Pramana 78
38 Distribution of patients according to Vaya 79
39 Distribution of patients according to Sara 80
40 Distribution of patients according to Purva Kaleena Vyayama 81
Shakti
41. Distribution of patients according to Adyatana Vyayama Shakti 82
42. Distribution of patients according to Purva kaleena Abhyavaharana 83
Ahara Shakti
43. Distribution of patients according to Adyatana Abhyavaharana 84
Ahara Shakti
44. Distribution of patients according to Purva Kaleena Jarana Ahara 85
Shakti
45. Distribution of patients according to Adyatana Jarana Ahara Shakti 86
46. Distribution of patients according to Agni 87
47. Distribution of patients according to Koshta 88
48. Distribution of patients according to Aharatah Nidana 90
49. Distribution of patients according to Viharatah Nidana 91
50. Distribution of patients according to Manasika Nidana 92
51. Distribution of patients according to Other Nidana 93
52. Distribution of patients according to Rupa/Lakshana 94
53. Distribution of patients according to Dosha 95
54. Distribution of patients according to Dushya 96
55. Distribution of patients according to Family History 97
56. Distribution of patients according to Main Complaints 98
57. Distribution of patients according to Blood Pressure 99
58. Distribution of patients according to duration of Hypertension 100
59. Comparative evaluation of Headache in two groups of patients 101
studied
xi
60. Comparative evaluation of Dizziness in two groups of patients 103
studied
61. Comparative evaluation of Palpitation in two groups of patients 104
studied
62. Comparative evaluation of Easy Fatigue in two groups of patients 106
studied
63. Comparative evaluation of SBP (mm of pg) in two groups of 107
patients studied
64. Comparative evaluation of DBP (mm of pg) in two groups of 108
patients studied
65. Assessment of Overall Response (based on 6 parameters) 109
xii
LIST OF GRAPHS
Graph Name of the Graphs Page no.

No.
1. Distribution of Age 51
2. Distribution of Sex 52
3. Distribution of Religion 53
4. Distribution of Education 54
5. Distribution of Marital status 55
6. Distribution of Occupation 56
7. Distribution of Socio-Economic Status 57
8 Distribution of Family 58
9. Distribution of Habitat/Place 59
10. Distribution of Diet 60
11. Distribution of Dominant Rasa intake 61
12. Distribution of Diet Habit 62
13. Distribution of Appetite 63
14. Distribution of Bowel Habit 64
15. Distribution of Sleep Habit 65
16. Distribution of Mental Strain 66
17. Distribution of Exercise 67

18. Distribution of Addiction 68
19 Distribution of Emotional Makeup 69
20. Distribution of Nature of Work 70
21. Distribution of Rest Taken during Work 71
22. Distribution of patients according to Built 72
23. Distribution of Nourishment 73
24. Distribution of Deha Prakruti 74
25. Distribution of Dosha 75
26. Distribution of Satva 76
27. Distribution of Satmya 77
xiii
28. Distribution of Samhanana 78
29. Distribution ofPramana 79
30. Distribution of Vaya 80
31. Distribution of Sara 81
32. Distribution of Purva Kaleena Vyayama Shakti 82
33. Distribution of Adyatana Vyayama Shakti 83
34. Distribution of Purva Kaleena Abhyavaharana Ahara Shakti 84
35. Distribution of Adyatana Abhyavaharana Ahara Shakti 85
36. Distribution of Purva Kaleena Jarana Ahara Shakti 86
37. Distribution of Adyatana Jarana Ahara Shakti 87
38. Distribution of Agni 88
39. Distribution of Koshta 89
40. Distribution of Aharatah Nidana 90
41. Distribution of Viharatah Nidana 91
42. Distribution of Manasika Nidana 92
43. Distribution of Anya Nidana 93
44. Distribution of Rupa/Lakshana 94
45. Distribution of Dosha 95
46. Distribution of Dushya 96
47. Distribution of Family History 97
48. Distribution of Main Complaints 98
49. Distribution according to Blood Pressure 99
50. Distribution according to duration of Hypertension 100
51. Comparative Evaluation of Headache in two groups 102
52. Comparative Evaluation of Dizziness in two groups 103
53. Comparative Evaluation of Palpitation in two groups 105
54. Comparative Evaluation of Easy Fatigue in two groups 106
55. Comparative Evaluation of SBP (mm of Hg) in two groups 108
56. Comparative Evaluation of DBP (mm of Hg) in two groups 109
57. Assessment of Overall Response (based on 6 parameters) 110
xiv
LIST OF PHOTOS
Photo Name of the Photos Page no.

No.
1. Jatamamsi Plant 44
2. Jatamamsi Plant 44
3. Jatamamsi Moola 44
4. Jatamamsi Choorna 44
xv
LIST OF FLOW CHARTS
Chart Name of the Charts Page no.

No.
1. Schematic representation of Samprapti of Shonita Dushti 20
2. Schematic representation of Pathogenesis of Essential 25
Hypertension
3. Schematic representation of Samprapti and Samprapti 125
Vighatana of Shonita Dushti by Jatamamsi Choorna
xvi
INTRODUCTION
INTRODUCTION 2012
INTRODUCTION
Hypertension is the term used to describe high blood pressure. Blood
pressure is the pressure exerted by blood on the walls of the blood vessel. The arterial
hypertension having no definable cause is designated as essential hypertension. It is
also known as primary or idiopathic hypertension. An elevated arterial pressure is
sometimes asymptomatic, readily detectable, and usually easily treatable and often
leads to lethal complications if left untreated.1
It is estimated that 600 million people are affected worldwide. In India
14% of people suffers from hypertension, and majority of them have essential
hypertension. Hypertension being a chronic illness constitutes an important public
health challenge in the pesent era because of its prevalence and concomitant risk of
cardiovascular disease. As most of the patients are asymptomatic, diagnosis is either
missed or delayed.In more than 95% of Hypertension cases, a specific underlying
cause of hypertension cannot be found and is termed as Essential Hypertension.2
The signs and symptomatology of Shonita Dushti could be corelated to
Essential Hypertension. An indepth study of nidana and samprapti of shonita dushti
will provide us with sufficient clarity regarding the chikitsa siddhanta to be employed
in this disorder. Thus the present study is expected to contribute significantly in the
amelioration of shonita dushti which is assuming epidemic proportions because of
modern life style. Shonita dushti corelated to essential hypertension has so far awaited
proper identification of pathogenesis so far as modern medicine is concerned. This is
the subject matter of the present research work.
“A STUDY ON NAIDANIKA SAMPRAPTI OF SHONITA DUSHTI W.S.R. TO ESSENTIAL HYPERTENSION & ITS
SAMPRAPTI VIGHATANA USING JATAMAMSI CHOORNA” – Dr. RADHIKA T.P.
DEPARTMENT OF PG STUDIES IN ROGA NIDANA, G.A.M.C., BANGALORE
1
INTRODUCTION 2012
Explanation of Hypertension in realm of Ayurveda is a moot point till
date. Attempts are made to explain hypertension according to the morbidity of Dosha.
The affliction of different Dhatu is argued in the pathogenesis of hypertension. Few
names are suggested representing the essential hypertension. Some of the
Academicians of Ayurveda suggested different names to exemplify the Phenomena of
hypertension. Although none of these names are universally accepted, in the fraternity
of Ayurveda.
Following is the small list of terms referred to essential hypertension coined by many
of the academicians.3
1) Raktagata Vata ( Y.N. Upadhyaya-1950 )
2) Rakta Vikshepa ( Shukla J.P.-1954 )
3) Shiragata Vata ( Acharya G.N. Chaturvedi-1962 )
4) Avrita Vata ( Acharya R.K. Sharma-1966 )
5) Rakta Chapa ( Ravani & Mahaishkar U.B.-1967 )
6) Rakta Sampeeda ( Pandey S.B.-1972 )
7) Vyana Bala ( Triguna B.-1974 )
8) Dhamani Prapurnata ( Acharya A.D. Athavale-1977 )
9) Rasa Bhara ( Athavale T.S.-1979 )
10) Rakta Vriddhi ( Acharya G.N. Chaturvedi-1981 )
11) Rudhira mada ( Dwivedi V.N.-1991 )
12) Rakta Vata ( Sharma P.V.-1993 )
Leaving behind all these names, the essential hypertension when thought
2
INTRODUCTION 2012
adapting the principle of dosa, dhatu and mala theory, the pathology seems to be
centered on shonita dhatu and tridosha.
To make the concept clear, affliction of rakta Dhatu may cause
unique group of illness pertaining to different srotus. Abnormal colouration of body is
manifestation of Shonita dushti and is seen diseases like pandu, kamala4. Another
characteristic of Shonita dushti is different types of skin lesions that are collectively
called as kushta. Bleeding tendency is also indicative of affliction of rakta dhatu and
resultant diseases are raktapitta, raktapradara, rakta meha and so on.5A group of
vascular disorders explained under vatarakta. And some of mucosal inflammations as
mukapaka, akshiraga, upakusha and pootigrana are also regarded as maladies of
shonitha dushti.6
The list of the diseases caused due to shonitadushti does not end here.
Unique category of clinical presentations comprising shiroruk, klama anidra, bhrama,
buddhi sammoha, kampa etc. do not fall under any of the above said class.7 Also it is
interesting to note that all these symptoms are akin to manifestations of hypertension.
More to add, mada, moorcha and sanyasa, the different diseases caused by
Shonitadushti are described also as progressive manifestation of increasing Shonita
dushti. So also, such a sequel is equally true in relation to malignant hypertension. All
these deliberation corroborates parlance of the shonita dushti and its different clinical
manifestations of mada, moorcha and sanyasa to the essential hypertension as well as
malignant hypertension.
3
INTRODUCTION 2012
The clinical studies carried out in the past exploring the different
diagnostic and therapeutic aspects of the essential hypertension in aurveda are enlisted
below.
1.2001- Pathania Sunil Kumar- Role of Takra Dhara and Sarpagandha Ghana vati
in the management of Uchcha Raktachchapa ( Essential Hypertension )8
2. 2001- Dhamle Madhumati- Study of Yojana Chatushka of Charaka and
Yojana for the managmnt of Raktashrita Vyadhi ( HTN )9
3. 2005- Kale Atul- A clinical study on the ayurvedic samprapti of Essential
Hypertension and its management with Sarpagandhadi vati10
4. 2005- Shah Pragna- Role of Virechana with Snuhi bhavita katuki in the
managment of Essential hypertension11
The lifelong and palliative treatment as prescribed in modern medicine for
Essential Hypertension is far from satisfactory. Therefore to attain and to maintain
good health, hypertensive patients are looking towards Ayurveda. So it has become an
important duty of Ayurvedic research scholars and physicians to study the theory of
Hypertension and to chalk out its proper approach of treatment.
Hence an effort has been made here to Evaluate the Naidanika Samprapti
of Shonita Dushti and its Samprapti Vighatana using Jatamamsi Choorna is expected
contribute towards better understanding of Essential Hypertension and there by a
better line of treatment. The present study entitled – “A study on Naidanika Samprapti
of Shonita Dushti w.s.r. to Essential Hypertension and its Samprapti Vighatana using
Jatamamsi Choorna” was carried out.
4
INTRODUCTION 2012
The present study has been carried out in two parts; Conceptual Study and
Clinical Study. Conceptual Study includes disease review and drug review. Disease
review starts with derivation of shonita dushti, nidana, roopa, samprapti, chikitsa,
pathya-apathya, sadhya-asadhyata and comparison of Shonita Dushti with Essential
Hypertension.
Drug Review starts with the basic information regarding the drug
Jatamamsi, its detailed explanation, chemical constituents, active principle and its
dosage.
This study was carried out on two groups namely Group A and Group B.
Group A was given with Jatamamsi Choorna and kept under proper pathya ahara and
vihara; Whereas Group B was considered as control group with only pathya ahara and
vihara.
5
OBJECTIVES
OBJECTIVES 2012
OBJECTIVES
Objectives of the Study:-
The study is conducted with the following Objectives:
 To study the Naidanika Samprapti of Shonita Dushti.
 To evaluate the efficacy of Jatamamsi Choorna as a means of samprapti
vighatana in the remission of symptoms in patients suffering from Essential
Hypertension.
 To study the effect of Pathya Aahara and Vihaara in Samprapthi Vighatana of
Essential Hypertension.
 To compare the efficacy of Jatamamsi Choorna in Group A and Pathya Ahara
and Vihara in Group B.
6
REVIEW OF
LITERATURE
HISTORICAL REVIEW 2012
HISTORICAL REVIEW
The History is the witness of the times. It tells us about the past time
and how the development and evolution of the mankind occurs. It helps to reveal
hidden facts and ideas of concerned subject. It also assists to pave pathway for future,
but these facts can be put together with structure to know what these facts are
supposed to tell us. Though Hypertension is a little older than a century, but its
relevant organ like Heart and relevant physiology like blood circulation etc. can be
traced back in our epics. The understanding of Nadi has been known since antique
times. Description o f Blood circulation is found in vedas.
VEDIC KALA:
• Hridaya has been called as pundareeka (blossom of Nelumbo Nucifera of
Nymphaceae family). Deva kosha , kosha are also term attributed to Hridaya.12
• In samaveda, virat word has been used for Hridaya.
• Hridaya is word derived from hrida.13
• Hridaya is the one which does the dharana.14
• Atharvaveda explained types of Rakta gati, they are teevra gati and jata gati.15
• Hridaya is considered to be the seat of Shubha-Ashubha sankalpa in humans.
• Hridaya is said to have nava dwara.
• The description of Vanaspati (Herbs) is given in Atharvaveda. Among them the
Hridya Arjuna serves the Madhya sharira (the seat of Hridaya).
In Ayurveda, the vessels described as Hira, which carries Lohita
(Blood). This can be understood as a circulation of Rasa Rakta within the body.16
7
BRAHANMANASA AND UPANISADS:
• Appearance of heart and lungs correlated with hamsa pakshi.
• Physical examination of heart has been explained, further there is relation
between body temperature and heart beat. Heart beats can be heard till the
temperature in the body is maintained.
• Also we can get references for different types of heart sounds .They are compared
with sound produced from ratha (ninaada), ghosha.
• Hridaya parimana is angushta matra. Hridaya rachana jnaana is considered as
brahma jnaana.
• Blood supply of hridaya has been explained. Anta hridaya nadi s are distributed
within the heart like thousand times divided hair, heart receives nourishment
through it.
• How the nadi s are present in leaf of Ashwatha tree in the same way nadi s are
distributed over the hridaya.
• Hridaya has got two parts vama aksha and dakshina aksha .
• Different internal parts of hridaya are, antarhita nadi, rakta keshika, hita,
hridayakasha, samstaava, veshma, lohita pinda, Indha, virat, sruti sancharanee.
• The explanation of word Hridaya is given in Chhandogyopanisad. The Hridaya is
composed of three words i.e. Hri-Da-Ya means the organ performs the duties of
Aharana, Dana and Yachati i.e. Rasa-Rakta Parivahana.17
• The Rasa is collected in Hridaya and from Hridaya it circulates throughout the
body is described in Mandukopanisad. (Ma. Upa. 2/9)
8
SAMHITA KALA:
(A) Bhela Samhita:
 Adhistana of Manas is said to be in between Shiras and Talu.
(B) Charaka Samhita:
 Hridaya is narrated as a root of Pranavaha srotasa and Rasavaha srotus.
 Hridaya is said as the seat of Para Oja.
 It is a root cause for maintenance of six Angas, Vijnana, Indriyas,
Pancha Arthas, Trigunas, Atma and Mana; including its various
Vishayas.18
 It is mentioned among 10 life spots.19
 Shonitha dusti, nidana , roopa, cikitsa explained elaborately. 20
(C) Sushruta Samhita:
 Hridaya is said to be the seat of Chetana and Sadhaka pitta.21
 It is the root of Pranavaha and Rasavaha srotus.
 It is considered to be the seat of Trigunas (Sattva, Raja, Tama).
(D) Kashyapa Samhita:
 Hridaya is said to be the seat of Shonita. Hridaya motivates the
Mana and Indriyas. (Ka. Sa. Garbhavakranti)
(E) Ashtanga Hridaya and Ashtanga Samgraha also h a s discrete description
regarding Hridaya, Dhamani, Sira, Rasa-Rakta Parivahana etc.
9
NIGHANTU KALA:
(A) Bhava Prakasha Nighantu:
 Jatamamsi is said to be Medhya, Balya, Tridoshaghna, Rakta dosha
hara and Dahahara.22
(B) Raja Nighantu:
 Jatamamsi is said to be Kaphahara, Pittahara, Dahahara and Hridya.23
(C) Nibandha Sangraha:
 Jatamamsi is said to be Balya, Tridoshahara, Dahahara and Rakta
Doshahara.24
Historical milestones in blood pressure
A.D.
131 : Blood circulation described by GALEN first time. He also established the
autonomous movement without the control of nervous system.
1628 : The inventor of blood circulation “William Harvey” was the first to learn
the whole structure.
1733 : Reverend Stephen Hales performed that blood rose to a height of 8 feet 3
inches in a glass tube placed in the artery of a horse.
1828 : Blood pressure in animals measured directly with a mercury
sphygmomanometer by Jean-Leonard Marie Poiseuille.
1855 : Introduction of the Sphygmograph by Kari Vicrodt.
1877 : Relation between Hypertension and Heart enlargement by Evoled and
Troube.
10
1880 : Introduction of the Sphygmomanometer by Van Basch.
1891 : Development of the Sphygmomanometer by Riva Rocci.
1897 : Hill and Barnard developed an armoccluding Sphygmomanometer.
1904 : Theodore Janewaydrew attention to the striking response to stresses such
as surgery, tobacco and anxiety.
1905 : The Russian surgeon Nicolai Korotkov presented the technique
of auscaltatory measurement of systolic and diastolic blood pressure.
1911 : Frank – First to give the name Essential Hypertension.
1944 : Smirk assessed blood pressure behavior in the individual by
measuring based blood pressure.
1964 : George Pickering showed for the first time the profound fall in
blood pressure record during sleep.
11
ETYMOLOGICAL DERIVATION 2012
ETYMOLOGICAL DERIVATION
SHONITA DUSHTI
Shonita
SHONA (dhatu)VARNE - Shabda Kalpa Druma25
SHONA -RED (CRIMSON) Sir M.Monier Williams26
Dushti
Dush (dhatu) - Shabda Kalpa Druma
To be bad or corrupted or suffer damage - Sir M.Monier Williams Sanskrit to
English dictionary.
Thus Shonita Dushti on the whole means blood that is defiled or corrupted.
HYPERTENSION
Hyper = Above (Greek)

Tension =Tonus (Latin)
Tension or tonus above normal; a condition in which person has a higher pressure
than normal for his age- Clarence Wilbur Taber medical dictionary Hypertension or
High blood pressure is a circulatory state; arising from any cause, in which the
pressure of the blood in the arteries becomes elevated beyond normal limits. In
general the term includes, any rise in arterial pressure whether temporary involving
systolic pressure, diastolic pressure or both of any origin. (British encyclopedia of
medical practice. P. 508.)
12
NIDANA 2012
NIDANA
The term Shonita dushti refers to the abnormalities of Raktadhatu caused
due to morbidity of any, some or all Dosha. Resultant diseases exhibit plurality
from trivial mouth ulcers to extremes of altered state of consciousness and death. It is
equally true that Shonita dushti arise due to plethora of etiologies ranging from
dietary elements to behavioral factors. Following table enlists the etiological factors of
Shonita dushti.
Etiology of Shonita Dushti and hypertension:
Table no.1: Nidana of Shonitadushti
Sl. No. ETIOLOGICAL FACTORS CITATION

Charaka Sushruta Vagbhata
Dietary factors
1 Bahu teekshna ushna madya + - +
2 Ati lavana + - -
3 Ati kshara ahara + - +
4 Ati amla ahara + - +
5 Ati katu ahara + - +
6 Ati Dadhi sevana + - -
7 Ati Kulatha sevana + - +
8 Drava snigda guruni cha atyaadana + + -
9 Pindalu ,moolaka + - -
10 Jalaja mamsa sevanat, , + - -
11 Virudda upaklinna pooti bhakshana + - -
13 Ati amla sevana, + - -
14 Ati mastu sevana, + - -
15 Ati sura souveeraka sevana, + - -
16 Ati masha sevana, + - +
17 Ati nishpava sevana, + - +
18 Ati tilataila sevana, + - +
19 Anupamamsa sevanat + - -
20 Bailanam mamsa sevanat + - -
21 Prasahanam sevanat + - -
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NIDANA 2012
Environmental conditions
1 Sharath kala swabhavatcha + - +
Sedentary habits
1 Bhuktva diva praswapanam + + -
Shareerika (physical strain)

1 Shrama + + -
2 Abhigata + + -
Psychological
1 Krodha + + -
Miscellaneous
1 Chardivega pratighaatat + - -
2 Ajeerna + - -
3 Tat purakruta daiva - - +
Among the diverse etiological factors of Shonita dushti enlisted in Charaka
Samhita, some of them are Particular in predisposing even hypertension.
Consumption of alcohol, good nutrition with sedentary habits, too much intake
of dietary salt, mental stress and physical strain are said to cause Shonita dushti and
same causative factors are analogous to trigger of hypertension. The modes of these
etiological factors leading to Shonita dushti and hypertension are discussed at full
length in the following paragraphs.
Alcohol intake :U
Excessive consumption of Madya or Sura (alcoholic beverages), that are
stale; having either Ushna or Tikshna property leads to Shonitadushti.27 By
consumption of excessive alcohol renders aggravation of Vata & Pitta Dosha which in
turn afflicts Raktadhatu precipitating Shonita dushti. On the other hand, alcohol has
direct effect on excitability as well as contractibility of the heart muscle. Hence,
intoxicating doses of alcohol raises heart rate, cardiac output and hence increasing
systolic as well as pulse pressures. Most epidemiological studies have shown a close
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NIDANA 2012
relationship between alcohol consumption and blood pressure. In heavy drinkers,
hypertension is common and if they drink more, it boosts up their blood pressure
also. Needless to say alcohol consumption has direct bearing in causing hypertension
as well as Shonita dushti.
Salt intake:
Excessive use of Lavana is described as the cause of Shonitaja Roga.28
Moreover, literature also stress that, Lavana should not be consumed in excess and for
longer duration29. Lavana possessing properties like Ushna and Tikshna tend to
abnormally increase in the liquid portion within the body. Evidently, excessive
consumption of dietary salt causes fatigue, lassitude and weakness in the body and are
attributed to the morbid change in Rakta dhatu. In parlance, an excessive intake of salt
(sodium chloride) in the diet enhances ability of blood to hold water eventually
increasing the blood volume in the body. As the blood volume is directly proportional
to the blood pressure, excessive consumption of salt precipitates hypertension.
U Sedentary habits:
Excessive consumption of foods that are heavy for digestion and also
having Madhura rasa and Snigdha property tend to increase the Kapha and Medas.
Lack of physical exercise and day sleep further adds to the pathogenesis30. These
factors in turn contribute to the Upalepa of the Srotas precipitating the Margavarana.
Identical to this explanation; it is said that, nutritious food habit with sedentary
behavior leads to abnormal increase of lipids in the blood, eventually predisposing
atherosclerosis. Atherosclerosis increases the peripheral resistance and thus
contributes to the increased risk of hypertension.31
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NIDANA 2012
Mental stress: U
It is clear that psychological factors like stress, anger, anxiety etc, may
play a major role in the causation of Shonitadushti.32 When person is calm, heart
beat is regular, pulse is even, blood pressure is relatively low and visceral organs
are well supplied with blood. Contrary to this with stress – vessels of visceral
organs constrict, blood flows in larger quantities to muscles, heart beats faster and
work harder. As the heart speeds up, pulse quickens and blood pressure mounts. Due
to chronic emotional stress the hypertension becomes chronic and persistent.
Physical strain:
Isotonic exercises like jogging and swimming that does not cause any
physical strain helps in lowering the body weight. Isometric exercises like weight
lifting increases blood pressure. Corroborating the same in Ayurveda it is said that,
the word Shrama refers to such workout that cause strain to the body and
heart there by precipitating Shonita dushti as well as hypertension.33
Seasonal influences:34
Low environmental temperature tends to constrict the blood vessels to
prevent heat loss. Volume of blood remains same, but vascular compartment is
reduced due to constriction. Disparity in blood volume and vascular compartment
leads to elevation of blood pressure.
More to add:
Clues into the etiology of Hypertension may also be obtained from
comparison of different racial groups. Most studies of blood pressure in black and
white people have reported a higher average blood pressure in blacks, and
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NIDANA 2012
consequently, higher prevalence of Hypertension. By contrast, however, blacks living
in rural area have low blood pressure and no rise with advancing age.35
There is a clearly recognized heredity factor or more probably combination
of factors. The concept that genetic factors play an important role in blood pressure
regulation is well established in literature.36 Hypertension is much more frequent
in some communities and some families than others. Some has suggested that the
hypertension is inherited as mandolin dominant. It has been estimated that if
both parents have hypertension, the incidence of this disease in children is about 45%
and if one parent has hypertension, the incidence is about 30% and in normotensive
individual 3% incidence is shown (Boyd).
There is no question that a positive correlation exists between obesity
and arterial pressure. A gain in weight is associated with an increase state of
Hypertension in subjects with normal blood pressure and weight loss in obese subjects
with Hypertension. It lowers their arterial pressure, because obese people take more
sodium & less potassium and therefore may develop a rise of blood pressure due
to dietary factors.
From the above references it is clear that certain etiological factors of
Shonita dushti may also influence in causing the illness hypertension. To be more
precise salt intake, alcohol intake, sedentary habits, mental stress, physical strain and
seasonal influence predisposes to hypertension, so also shonita dushti.
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SAMPRAPTI 2012
SAMPRAPTI
Series of pathological events taking place during the journey of a healthy
human body towards any disease is known as Samprapti.37 Dosha, dushya, srotus,
agni, ama etc. involved are of great importance and are known as samprapti
ghatakas. On the other hand, Acharya Sushruta’s concept of kriyakala describes the
mode and stages of the development of disease. A good knowledge and
understanding of it is very essential for early diagnosis, prognosis and for adapting
preventive and curative measures. The six distinct consecutive steps of kriyakala’s are
chaya, prakopa, prasara, sthanasamshrya, vyakti and bheda avasthas.38
The set of symptoms indicative of shonita dushti that include Headache,
Dizziness, Irritability, Anger are the commonest clinical symptoms of symptomatic
Essential Hypertension. Further to add Delirium, Altered states of consciousness are
indicative of progressive shonita dushti pointing towards Malignant Hypertension.
These are also suggestive of morbid doshas in association with shonita dushti,
afflicting the shiro marma eventually manifest with different clinical conditions of
Essential HTN. With this perspective following analysis of samprapti ghataka are
attributed to shonita dushti.
The Nidanas like Aharaja, Viharaja, Manasika and Anya which are already
explained before will cause Jatharagni and Dhatwagni mandya. Due to this there will
be Vata pradhana Tridosha prakopa, Rajo guna bahulata and Dushta shonita affecting
Sanjnavaha srotas. These tridosha incriminating the rakta dhatu, circulates all over the
body gets localized in head and siras, as a resultant of sanga and vimargagamana
manifest as shonita dushti. The detail of the same is shown in Flow Chart no. 1.
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SAMPRAPTI 2012
In a nut shell morbid doshas in association with rakta dhatu afflicting
Shiras, Hridaya and Indriya presents with clinical symptoms ranging from trivial
headache to fatal unconsciousness. These progressive stages of shonita dushti
corresponds Asymptomatic Hypertension, Symptomatic HTN, Delerium, Malignant
HTN.
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SAMPRAPTI 2012
Flow Chart 1: Schematic representation of Samprapti of Shonita Dushti w.s.r. to

Essential Hypertension
NIDANA
AHARAJA NIDANA VIHARAJA NIDANA MANAS IKA NIDANA ANYA NIDANA
JATHARAGNI & DHATWAGNI MANDYA
VATA PRADHANA TRIDOSHA PRAKOPA,

RAJO GUNA BAHULATA, DUSHTA
SHONITA AFFECTING SANJNAVAHA
SROTAS
SARVA SHAREERA SANCHARA
SANGA & VIMARGA GAMANA
ADHISTANA IN SHIRAS
SHONITA DUSHTI
(ESSENTIAL HYPERTENSION)
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SAMPRAPTI 2012
Samprapti Ghataka:
Table No. 2: Samprapti Ghataka
Sl No Catagory Factors Symptoms
1 Dosha Vata Shiroruk, Bhrama, Kampa

Pitta Akshiraga, Krodha-pracurata, Ati sveda, Tikta
amla udgara, Moorcha
Kapha Guru gatrata, Nidra atiyoga
2 Dushya Rasa Atidourbalya , Guru gatrata, Tandra
Rakta Tamasaatidarshana, Shiroruk, Akshiraga,
Dourbalya, Klama , Krodha pracurata
Asthi Vaivarnya
Majja Bhrama, Moorcha, Tamodarshana
3 Srotas Rasa, Rakta
Meda, Majja,
Sanjnavaha
4 Srotodushti Sanga,
Vimarga
gamana
5 Udbhava Ama
pakvashaya
5 Sancharastana Sarva sharira Santapa, Gurugatrata
6 Adhistana Shiras
7 Vyakta sthana Sarva sharira
8 Rogamarga Madhyama
9 Agni Jatharagni-
Dhatwagni
mandya
10 Ama Rasagata
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SAMPRAPTI 2012
PATHOGENESIS OF ARTERIAL HYPERTENSION:
In most cases of HTN the high blood pressure must be secondary to
increased peripheral resistance because of other two factors which determine the
height of the blood pressure i.e. cardiac output and the viscosity of the blood, are
unchanged. Increased resistance occurs chiefly in the arterioles and is more severe in
the renal vessels.
MECHANISM OF HYPERTENSION:
Renin-Angiotensin system (Hypothesis)
Renin – a protein with molecular weight 40,000 – 43,000
Site of production – Kidney (uncertain- Juxtaglomerular cells)
Elimination – Liver & kidney
Half Life – about 15-20 min39
Angiotensin II has a wide range of action on the various organs of the body.40
1) Heart & Blood Vessels: Increases the blood pressure sharply and increases the
force of contraction of the heart.
2) Kidney: It has a double action. In small doses it causes decrease in urine
quantity and also salt or sodium content of the urine. But in large doses it
causes the opposite effect.
3) Adrenal Gland: Increases the secretion of aldosterone which causes retention
of water and salt in the body. The salt retention in turn reduces the secretion of
renin. This is called feedback mechanism.
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SAMPRAPTI 2012
MECHANISM OF ESSENTIAL HYPERTENTION:
Though the etiology of Essential HTN is ill defined, but the heredity is an
important factor. General causes include anxiety, worry, modern city life, alcoholism,
excessive intake of dietary salts, cigarette smoking, tobacco chewing, prolonged
mental strain, especially when combined with sleeplessness and lack of regular
exercise.41
Even without knowing the specific lesion, it is reasonable to conclude that
alterations in renal sodium homeostasis and/or vessel wall tone or structure underlie
Essential HTN. In established HTN, both increased blood volume and increased
peripheral resistance contribute to the increased pressure.42
Causes like anxiety, worry will cause disturbance in Hypo-thalamo
adrenalin axis. It causes Hypothalamus to produce neurologic stimuli. It stimulates
Vasomotor Centre. Due to this there will be vaso constriction. It in terms constricts
Renal vessels. It leads to Renal Ischemia. So that there will be excessive liberation of
Renin. Renin acts on a plasma protein called Renin substrate and converts it into a
substance called Angiotensin I. This is converted in to a substance called Angiotensin
II by a converting enzyme which is seen in maximum concentration in the lungs. It
leads to more secretion of Aldosterone to cause water and salt retention and also
contracts the musculature of the blood vessels to increase blood pressure.
With the retention of water and salt the circulatory blood volume also
increases and leads to increase in blood pressure. This suppresses the secretion of
renin which leads to reduction in the level of angiotensin and aldosterone. If there is a
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SAMPRAPTI 2012
break in this smooth cycle of control mechanism, the production of these substances
leads to hypertension.43
Reduced renal sodium excretion in the presence of normal arterial pressure
is probably a key initiating event; indeed, it is a final common pathway for the
pathogenesis of most forms of HTN. Decreased sodium excretion will cause an
obligatory increase in fluid volume and increased cardiac output, thereby elevating
blood pressure. At the higher setting of blood pressure, enough additional sodium will
be excreted by the kidneys to equal intake and prevent fluid retention. Thus, a new
steady state of sodium excretion would be achieved, but at the expense of an elevated
blood pressure.
Vascular changes may involve functional vasoconstriction or changes in
vascular wall structure that result in increased resistance. Chronic functional vaso-
constriction could also conceivably result in permanent structural thickening of the
resistant vessels.
Although we frequently cannot point to a discrete cause, the accepted
wisdom is that Essential HTN results from interplay of multiple genetic and
environmental factors affecting cardiac output and/or peripheral resistance.44
The symptoms commonly are loss of energy, easy fatigue, insomnia,
headache, dizziness, palpitation and vertigo.
The schematic representation of the same is shown in Flow Chart no. 2.
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SAMPRAPTI 2012
Flow Chart 2: Schematic representation of Pathogenesis of Essential

Hypertension
ETIOLOGICAL FACTORS
DISTURBANCE IN DEFECTS IN FUNCTIONAL DEFECTS IN VASCULAR

HYPO- THALAMO- RENAL SODIUM VASOCONSTRICTION SMOOTH MUSCLE
ADRENALIN AXIS HOMEOSTASIS GROWTH & STRUCTURE
NEUROGENIC INADEQUATE
STIMULI FROM SODIUM
HYPOTHALAMUS EXCRETION
STIMULATES WATER & SALT RETENTION

VASOMOTOR & CONTRACTION OF
CENTRE MUSCULATURE OF BLOOD
VESSELS
VASO CONSTRICTION
RENAL VASO
CONSTRICTION
EXCESSIVE
LIBERATION OF RENIN
NATRIURETIC
HORMONE
PRODUCTION OF
ANGIOTENSIN I VASCULAR
PLASMA & ECF VASCULAR WALL
ACE REACTIVITY
VOLUME THICKNESS
PRODUCTION OF
ANGIOTENSIN II
TOTAL PERIPHERAL
CARDIAC OUTPUT
SECRETION OF RESISTANCE
(AUTOREGULATION)
ALDOSTERONE
ESSENTIAL HYPERTENSION
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RUPA 2012
RUPA
Continuing the paralleling of the hypertension and shonita dusti in the
context of rupa also following contention seems to be very much appropriate.
It appears that, adequate similarity exists in the clinical presentation of hypertension
and shonita dushti. Even the different stages of hypertension regards to severity
matches with the progressive manifestations of the shonita dushti. Following
paragraphs reveal the clinical manifestation of these two at full length.
Affliction of rakta dhatu may cause group of illness pertaining to different
srotus. Abnormal coloration of body is manifestation of Shonita dushti and is seen in
diseases like pandu and kamala. Another characteristic of Shonita dushti is different
types of skin lesions that are collectively called as kushta.45
Bleeding tendency is also indicative of affliction of rakta dhatu and
resultant diseases are raktapitta, raktapradara and rakta meha46. A group of vascular
disorders explained under vatarakta. And some of mucosal inflammations as
mukapaka, akshiraga, upakusha and pootigrana.47
Further there is another list of symptoms of shonitha dushti that
comprises of Shiroruk, Klama, Anidra, Bhrama, Krodha-pracurata, Tamo
darshana, Dourbalya Buddi sammoha, Kampa48 these does not fall under any of the
above said categories and these symptoms are akin to manifestations of hypertension.
Shonita dushti includes list of illness ranging from obstinate skin disorders to
abnormality of blood coagulation. It also includes clinical manifestation akin to
hypertension.
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Shiroruk (Headache):49
Head ache is caused due to the Shonita dushti. The illness is said to be
asymptomatic in most of the hypertensive’s, except in cases of malignant
hypertension as well as hypertensive encephalopathy where a number of emblematic
symptoms manifest. As no symptoms that signals the illness hypertension, as the
patient does not suffer from any sort of discomfort; the condition is likely to be
unnoticed. Furthermore, about 40% of the patients suffering from the hypertension
more particularly the malignant type develop head ache. And is said to be present on
awakening and in some patients this is throbbing type, characteristically occipital in
nature. In others there is no specificity of the site of head ache.
Sushruta has stated “Vata Drute Nasti Ruja”.50 That is any type of
Shoola cannot occur without the vitiation of vata. Charaka has included shira shoola
in 80 types of nanatmaja vata vyadhi. Further, Charaka while explaining samanya
samprapti of shiro roga mentions that prakupita vatadi dosha cause dushti of rakta
and then by localizing in shiras, produce shiro roga, which includes shira shoola also.
In this way in shira shoola vata dushti may be considered as a leading factor.
U Ati Dourbalya (General debility):
Undue exhaustion is another symptom of hypertension as quoted in
Harrison’s text book of medicine. The exact pathophysiology of this symptom is not
clear. Charaka also opines that it is a symptom of shonita dusti. Ati dourbalya and
klama are the two words mentioned in Charaka samhita referring to tiredness.
U Klama (Easy Fatigability):
Without any physical or mental work, tiredness of the body and mind is
called as Klama.51 Charaka has mentioned Klama under Shonitaja roga because due to
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Dusti of Rakta, it is manifested.52
Bhrama (Dizziness):
Bhrama meaning dizziness is a symptom of Shonita dushti. Frequent dizzy
spell is seen in some patients suffering from hypertension. This may be transient or
persistent. Sometimes it may be mild and the patient is likely to ignore the
symptom. And in some the dizziness is likely to affect the routine functioning of the
patient there by making patient to seek medical help. Bhrama is one of the 80 types of
nanatmaja diseases of vata. The involvement of pitta also occurs with excessive raja
(manasa guna) causes bhrama. Obviously vata and pitta are main dosha in producing
bhrama.
Tamodarshana (Darkness infront of eyes):53
Feeling of darkness in front of eyes is called tamodarshana. Charaka has
described tamodarshana in rakta pradoshaja vyadhi, because it appears due to
srotorodha in raktavahinis of shiras. Visual disturbances may be due to transient
cerebral ischemia or strokes.

U
Krodha-pracurata (Anger):
Karmata vriddhi of sadhaka pitta leads to krodha-pracurata (Cha.Si.12/11
on Chakrapani Teeka). It is also mentioned in the rakta pradoshaja vyadhi by
Charaka. Pitta prakopa leads to raktadushti as well as manovaha srotodushti (by
sadhaka pitta), may results in krodha-pracurata.
U Akshiraga (Redness of Eyes):
Redness of eyes occurs due to some arterial changes, leads to bilateral
hemorrhages and exudates, which usually happen in the patient of hypertension. Pitta
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and rakta are said to be of same nature.54 Sushruta also authenticate that redness of
eyes is due to raktavriddhi.55
Insomnia:
Disturbance of sleep is not uncommon in hypertension. Some patients of
hypertension seek medical help for the same complaint. And the sphygmomanometer
examination reveals the hypertension. Charaka has clearly stated that disturbance in
sleep is a symptom of Shonita dushti. It is a result of psychological and mental strains
like anxiety, stress, drug abuse etc; opines modern science.
Vomiting:
15% of the patients suffering from malignant hypertension are likely to
present with vomiting along with other symptoms. This is also true in case of
Shonita dushti as stated in Charaka Samhita.56 The vomitus may contain the
foods, gastric acidic content, or bile. Accordingly the patient feels the taste in
the mouth, and also according to the vomitus the associated symptom may vary.
Altered states of consciousness:
This is seen in patients suffering from malignant type of hypertension
associated with hypertensive encephalopathy.57 It is understood that in malignant
hypertension the cerebral edema is a consequence. Arteriolar fibrinoid necrosis as
well as spasm of the vessels are said to precipitate cerebral edema. This cerebral
edema presents with altered state of consciousness. A study shows that about 50
to 90% of the patients suffering from malignant hypertension develop this altered
state of consciousness. This may range from the simple confused state to stupor and
coma. The same is attributed to Shonita dushti in Ayurvedic literature.58
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Seizures:
About 50 to 90% of patients of malignant hypertension suffer from
convulsions and is usually generalized one. Kampa is the word mentioned in
Ayurveda to explain this involuntary movement in shonita dushti.59
Visual disturbances including transient blindness:
Hypertension is characterized by retinopathy with or without papilledema
associated with necrosis of small arteries and arterioles.60 This in turn
results in visual disturbances as well as transient blindness. This manifestation is
said to be found in about 40% of patients suffering from hypertension. Abnormality
of the visual perception is also a feature of shonita dusti as cited in the following lines
of Charaka Samhita.
Focal neurological signs:
In about 5% of the patients the cerebral edema as well as necrosis results in
focal Neurological signs it may be in the form of monoplegia or other kinds of
neurological Deficits. The following reference from Charaka samhita reveals the same
opinion.
Abnormality of the urinary system:
Oliguria, proteinuria, haematuria and decline in the renal function are the
manifestation of the malignant hypertension. Haematuria is described in Ayurveda as
manifestation of Shonita dushti .61
Illness shonita mada simulates Malignant hypertension:
Commonest presentation of malignant hypertension is delirium. In this
stage mental faculties are deranged, ability of perception may be affected, patients
attention cannot be drawn easily, when patient is aroused fails to understand the
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surroundings with all earlier precision, continuous stimulation is needed to keep him
in alert. This is popularly known as clouding of sensorium.
Delirium is one of important feature of malignant hypertension62. This is
also a feature of shonita mada. Tremulousness i n speech, irrelevant speech,
irritability and r e s t l e s s n e s s unusual hyperactivity for a trivial stimulation are the
features of vataja mada.63
Pittaja mada64 presents with unwanted anger, agitation and aggression.
Just speaking may irritate patient and is likely to respond in scolding words,
indicative of pitta dominance.
Clouding of conscious, can’t be aroused by simple verbal stimulation, not
maintain alertness, appears thinking and concentrating, speak less, are suggestive of
kaphaja mada.65 Known as hypo kinetic delirium or quiet delirium.66
Autonomous nervous system:
Due to increased activity of autonomous nervous system, the conjunctiva
are injected, rapid pulse, raised temperature, increased sweating, scanty urination, and
raised specific gravity, inability to sleep, vivid hallucinations, extreme agitation,
tremulousness, patient will have a tendency to convulse.
Different causes of mada:
Patient of shonitha mada may not give history of alcohol intake or
poisoning. Spontaneous onset for no apparent reason, variable course, and
spontaneous remission is characteristic of rudhiraja mada. If left untreated leads to
moorcha, sanyasa67 as in hypertension leading to stupor and coma.
31
RUPA 2012
Progressive illness:
In case of non availability of treatment or poor response, delirium to
clouding of conscious, stupor, coma i.e. hypertensive encepahalopathy.68 Also
rudhiraja mada progresses to moorcha, sanyasa.
Finally based on etiology, clinical manifestation of shonita dushti it can be
compared with hypertension. Several etiological factors of rakta dushti are also
etiological factors for hypertension. Category of symptoms of shonita dushti
pertaining to psychological change and altered state of conscious is similar to
symptoms of malignant hypertension.
Based on the criteria of naming of diseases by their leading symptoms
the rudhiraja mada is related to symptomatic phase of malignant hypertension.
Asymptomatic hypertension can very well be considered as avyakta stage of illness
or may be simply referred to shointa dushti. Whole concept is best understood by
establishing equality between shonita dusti/shonita mada/ with systemic hypertension.
32
CHIKITSA 2012
CHIKITSA
The sole pathology of shonita dusti in relation to hypertension is centered
on the morbid dosha incriminating the rakta dhatu afflicting the shiras. The rationality
of treatment hence depends upon the removal of mobid dosha as well as
rectification of rakta dhatu clearing the shiras. With this understanding following
treatments may be adapted in shonita dusti/essential hypertension.
 Virechana69
 Rakta mokshana (siravyadha vidhi)70
 Upavasa/Apatarpana71
 Rasayana72
 Murdhni Taila
 Raktapittahara Medications
 Nidana Parivarjana
Rakta mokshana:
Rakta plays significant role in the samprapti of Shonita dushti as the very
name indicates. Clinical symptoms are result of all the tridosha incriminating the rakta
dhatu, circulating all over body localizing in head and siras, as a resultant of sanga
and vimargagamana manifest as shonita dusti. Rakta mokshana being important
shodhana karma is very much benefecial in samprapti vighatana by eliminating
morbid shonita.
Apatarpana chikitsa:
Since Shonitadushti may also caused by excess consumption of drava
33
CHIKITSA 2012
snidga ahara without any physical exertion Another important treatment has been
quoted for Shonitadushti i.e upavasa.By upavasa there will be digestion of kapha
medas.
Rasayana:
There are different rasayana preparations have been mentioned in literature
such as, Vardhamana Pippali rasayana ,shilajatu rasayana73 etc. which are said to be
Vyadhihara rasayana and are particular to shonitadushti. Administration of
them with prior purification of body by Shodhana gives beneficial results
to patients. Shilajatu eventhough a rasayana dravya, it does not increase rasa
raktadi dhatus, rather it reduces the kapha and medas by virtue of its ruksha, lekhana
guna. Because of its kapha medohara action, it has got wide Clinical application i.e.
vatarakta, madhumeha, hridroga, sthoulya, shonita dusti and so on.
Murdhni Taila:
Which includes shiroabhyanga, shiropichu, shiroseka and shiro basti.
Shirobasti is the one among the Murdhni Taila’s explained in literature for Vata
disorders of Urdvajatrugata as Nidranasha, Shirashoola, Bhrama, and Ardita e.t.c.
And some of these complaints are also the symptoms of Shonita dushti/essential
hypertension, so a hypothesis can be framed that Shirobasti may be helpful in
relieving the above symptoms and decrease the blood pressure. Different institutions
carried out studies on effect of Jala dhara, takra dhara in the patients of essential
hypertension. Studies proved that these are beneficial in relieving symptoms of
hypertension also the blood pressure.
As in the pathology, morbid doshas along with rakta dhatu afflicting
shiras, hridaya and indriya, leads to plethora of manifestations ranging from headache
34
CHIKITSA 2012
to fatal unconsciousness. Presenting features are due to localization of dosha in
shiras. So murdhni taila, a procedure specially mentioned for shiras is useful.
Rakta pittahara medications:
Among the different shamana drugs sarpagandha is one of the common
prescription in day today practice. Sarpagandha Ghana vati 150 -250 mg prescribed
once a day. Several researches are going on to evaluate hypotensive action of
some of herbal drugs. Following are few drugs which are proved to have
hypotensive action.
Table no. 3 shows few drugs which are proved to have hypotensive action.
35
CHIKITSA 2012
Table No. 3: Drugs with Hypotensive Action
Sl. no Drug name Latin name

1 Sarpagandha Rawolfia serpentina
2 Jatamamsi Nardostachys jatamamsi
3 Apamarga Achyranthes aspera
4 Ankola Alangium salvifolium
5 Brahmi Bacopa monniera
6 Ashwagandha Withania somnifera
7 Bhringaraja Eclipta alba
8 Durva Cyodon dactylon
9 Ishwari Aristolochia bracteata
10 Japakusuma Hibiscus rosa sinensis
11 Haridra Curcuma longa
12 Karpasi Gossypium arboreum
13 Kokilaksha Astercantha longifolia
14 Kushmanda Benincasa hispida
15 Palandu Alium cepa
16 Parpataka Fumaria parviflora
17 Rasona Allium sativam
18 Shigru Morings pterigosperma
19 Shankapushpi Convolvulus pluricaulis
20 Tanduliyaka Amaranthua spinosus
Nidana Parivarjana:
Ahara and Achara come under nidana parivarjana. The patient and the
disease carefully and collectively must be in the mind of physician at the time of
therapy for any ailment. Variations relating to dushyas, dosha, drug, place, time,
36
CHIKITSA 2012
strength, body, diet, mind, constitution and agni should be minutely observed. By this
proper care and stepwise journey to the disease physician never fail in the selection of
medicaments and therapies. As it has been said in literature as Nidana parivarjanmeva
chikitsa, avoiding causal factors are equally important as chikitsa.
MODERN PERSPECTIVE:
 General measures - 1) Relief of stress
2) Diet- Salt restriction
Caloric restriction
3) Regular exercises
 Drug therapy – 1) Diuretics – eg. Lasix
2) Anti adrenergics- eg. Amlodepin, Atenolol
3) Vasodilator
4) Angiotensin converting enzyme inhibitors
5) Calcium channel antogonists- eg. Nefidepine
37
PATHYA-APATHYA 2012
PATHYA-APATHYA
Invariable involvement of Tridosha with shonita with in the Raktavaha strotas
is the characteristic pathogenesis of Shonita dushti/mada/moorcha. Accordingly any
dietetic or behavioral factors that facilitate the remission of the Tridosha and shonita are
likely to be the Pathya of Shonita dushti. Following list unravels the Pathya and Apathya
in Shonita dushti
PATHYA: 74, 75
 Shooka Varga : shali purana Yava
 Shimbi Varga : Mudhga.
 Krutana Varga : Mudga Yusha, laghu anna.
 Dugdha Varga : Go-Dugdha
 Shaka Varga : Kushmanda , haritaki, mocha, madhooka pushpa, patola
Tanduliyaka.
 Phala Varga : Dadima, Narikela .
APATHYA: 76
 Ahara Varga : Virudda annapana, Pancha shaka, Tamboola, Katu rasa dravya,
takra, Ati lavana sevana, Drava snigda guru ahara, Teeksha
madya, Jalaja anoopa mamsa, Dadhi.
 Vihara : Atapasevana, vyavaya , divaswapna
 Vegadharana : Mutra, pureesha vega rodha, chardi vega rodha.
38
SADHYA-ASADHYATA 2012
SADHYA-ASADHYATA
According to Ayurveda, Sadhya-Asadhyata of a disease depends upon a
number of factors including Dosha, Dushya, Purvarupa, Rupa of the disease, Prakriti
of the patient etc. According to modern science, the prognosis of the disease depends
upon the severity of the disease, chronicity and associated complications.
To consider the disease shonitadushti, in terms of Sadhya-asadhya
category, samprapti of the disease is considered. shonitadushti is a Vata pradhana
Tridoshaja Vyadhi with vitiated Doshas being held up in the Madhyama Rogamarga.
Along with this, involvement of all the 3 Mahamarmas (Shira, Hridaya, Basti) is
evident from the etiopathogenesis of the disease. The disease is known to run a
chronic course. Thus summing up the above facts it can be said that:
1) Shonita dushti is Vata pradhana Tridoshaja Vyadhi. All Vata vyadhi after
certain period of time become Durupkrama or Kricchasadhya and Tridoshaja
Vata Vyadhi is Pratyakhyeya according to Agnivesha.
2) It is Yapya as per the involvement of three Mahamarma and
Madhyama Rogamarga.
3) As the disease is associated with chronicity and Updravas, it is again Yapya in
nature.
From the above discussion, it can be concluded that, disease when it is
benign and present without complications and is treated at an early state is Yapya.
After the disease gets associated with complications or it is malignant and present for
longer duration, it is Pratyakhyeya. This is supported by the clinical findings that
patients are free from symptoms as long as medicines are administered.

39
SADHYA-ASADHYATA 2012
The extent of end organ damage related principally to the duration of
essential hypertension and its severity. Thus by detecting Essential hypertension at an
early stage and treating it effectively, prognosis can be improved.
Risk factors for an adverse prognosis in Hypertension.77
 Black race
 Youth
 Male sex
 Persistent diastolic pressure >115mmHg
 Smoking
 Diabetes mellitus
 Hypercholesterolemia
 Obesity
 Excess Alcohol intake
 Evidence of end organ damage
(a) Cardiac : Cardiac enlargement
ECG - signs of ischemia or Left ventricular strain
Myocardial infarction
Congestive heart failure
(b) Eyes : Retinal exudates and hemorrhage
(c) Renal : Impaired renal function
(d) Nervous system : Cerebro vascular accident
40
DRUG REVIEW 2012
DRUG REVIEW
Name – Jatamamsi
Botanical Name – Nordostachys jatamansi
Family – Valerianaceae
English Name – Spikenard
Synonyms – Bhootajata, Tapasvinee, Sulomasha, Nalada, Mura, Pishita78
HABITAT:
Habitat of Jatamamsi plant is Alpine regions of Himalaya at 3,000-5,000
meters, extending b/w Panjab to Sikkim at 17,000 ft and in Bhutan. Also found
growing in Nepal and China.
HABIT:
Jatamamsi is a flowering plant. The plant grows to about 1 meter in height
and has pink, bell-shaped flowers. The leaves are opposite, grow from the rhizome,
and are 15 to 20 cm long, 2.5 cm wide, spatulate and narrow toward the petiole. The
cauline leaves are sessile, opposite, 2.5 to 7.5 cm. long and narrow-ovate. The finger-
thick, woody rhizome is covered with reddish brown fibers from the remains of the
petioles.
CHEMICAL COMPOSITION:79
Jatamansone, jatamansic acid, Acitinidine, carotene, aristolens,
calarene, calerenal, elemol, droaristolene, b-eudesmol, jatamols A & B, nardol,
nardostachonol, nardostachone, patchouli alcohol, valerinal, valeranone, virolin,
jatamansin, jatamansinol, oroselol etc.
41
DRUG REVIEW 2012
HISTORY:
The plant has a rich history of medicinal use and has been valued for
centuries in Ayurvedic (Indian) and Unani (ancient Greco-Arab) systems of medicine.
The rhizomes of the plant are used in the Ayurvedic system of medicine as a bitter
tonic, stimulant, antispasmodic, and to treat hysteria, convulsions, and epilepsy. The
root has been medically used to treat insomnia and blood, circulatory, and mental
disorders. Some preparations of the plant have been used as a heptotonic, cardiotonic,
analgesic, and diuretic in the Unani system of medicine. The plant is of economic
importance and has been used to produce perfumes and dyes80.
USEFUL PART: Rhizome/moola81
DOSE: 2-4 gm/day82
GUNA PANCHAKA:83
Table No.4: Guna Panchaka of Jatamamsi choorna
S.No. Guna Panchaka
1 Rasa Tikta, Kashaya, Madhura
2 Guna Laghu, Snigdha
3 Veerya Sheeta
4 Vipaka Katu
5 Prabhava Bhootaghna, Manasa Dosha Hara
42
DRUG REVIEW 2012
KARMA:
Table No.5: Karma of Jatamamsi choorna
S.No. Karma
1 Dosha Tridosha hara84
2 Abhyantara Sanjnasthapana, Medhya85, Akshepa shaman, Balya86,
Nadi Vedana sthapana, Nidra janana87
Samsthana
3 Raktavaha Rakta Doshahara88, Hridaya Niyamaka89
Samsthana
4 Mootravaha Mootra virechaka
Samsthana
5 Pachana Deepana, Pachana, Anulomana, Yakrit uttejaka, Pitta
Samsthana saraka, Shoola Prashamana90
6 Samsthanika- Daha prashamana91
Bahya
Other Uses:
Benefits the nervous system and useful in treatment of stress-related
conditions such as headache, insomnia and nervous tension.
43
DRUG REVIEW 2012
Photos of the drug Jatamamsi:
Photo no. 1: Jatamamsi Plant Photo no. 2: Jatamamsi Plant
Photo no.3: Jatamamsi Moola Photo no.4: Jatamamsi Choorna
44
METHODOLOGY
METHODOLOGY 2012
METHODOLOGY
AIMS AND OBJECTIVES :
 To study the Naidanika Samprapti of Shonita Dushti.
 To evaluate the efficacy of Jatamamsi Choorna along with Pathya Ahara and
Vihara as a means of samprapti vighatana in the remission of symptoms in
patients suffering from Essential Hypertension.
 To study the effect of Pathya Aahara and Vihaara in Samprapthi Vighatana of
Essential Hypertension in Group B.
 To compare the efficacy of Jatamamsi Choorna in Group A and Pathya Ahara
and Vihara in Group B.
SOURCE OF THE DATA :
The study was conducted on 40 patients of Shonita dushti selected
randomly from O.P.D. and I.P.D of Shri Jayachamarajendra Institute of Indian
Medicine Hospital (Teaching Hospital of G.A.M.C), Bangalore, Karnataka.
METHOD OF COLLECTION OF DATA :
Patients of either sex diagnosed as having Essential Hypertension, based
on inclusion criteria was selected.
A detailed proforma was prepared considering the following points like
history, causative factors and probable pathogenesis.
45
METHODOLOGY 2012
DIAGNOSTIC CRITERIA:
1) Patients with clinical features like shiroruk, krodha prachurata, tamasatidarshana,
bhrama, atidourbalya, akshiraga, anidra, klama and atisveda.
2) The patients suffering from Pre and Stage 1 essential HTN were included in the
study; the systolic and diastolic pressure of the same is depicted in the Table no.
6.
Table No. 6: Diagnostic Criteria
STAGE Systolic B.P. in mm of Hg Diastolic B.P. in mm of Hg
Pre HTN 120 – 139 80 – 89
Stage 1 140 - 159 90 – 99
INCLUSION CRITERIA:
1) The patients suffering from Pre HTN and Stage 1 Essential HTN were taken for
the study.
2) Patients may be presenting with symptoms of Shonita dushti that includes
headache, dizziness, easy fatigue and palpitation.
3) Patient aged between 30 to 60 years.
EXCLUSION CRITERIA:
1) The patients suffering from Stage 2, Stage 3 and Stage 4 essential HTN were
excluded from the study; the systolic and diastolic pressure of the same is
depicted in the Table no. 7.
46
METHODOLOGY 2012
Table No.7: Exclusion Criteria
STAGE Systolic B.P. in mm of Hg Diastolic B.P. in mm of Hg
Stage 2 160 – 179 100 – 109
Stage 3 180 – 209 110 – 119
Stage 4 >210 >120
2) Patients suffering from HTN with complications such as cardiovascular and
cerebrovascular diseases.
3) Patients suffering from secondary HTN.
4) Patients suffering from malignant HTN.
STUDY DESIGN :
It is a randomized comparative open clinical study. The 40 patients were
subdivided into 2 groups with both the groups containing 20 patients each, randomly
selected in lieu of comparing efficacy of the therapy. The treatment schedule decided
for each group is depicted in the table no: 8
Table No. 8: Study Design
GROUP No. OF PATIENTS METHOD DOSE DURATION
A 20 Jatamamsi Choorna with 3 gms/day 30 Days
Pathya Ahara and Vihara
B 20 Only Pathya Ahara And As required 30 Days
Vihara
47
METHODOLOGY 2012
CRITERIA FOR ASSESSMENT:
Subjective Parameters & Scoring Pattern:
1) Headache; Present=1, Absent=0
2) Dizziness; Present=1, Absent=0
3) Palpitation; Present=1, Absent=0
4) Easy Fatigue; Present=1, Absent=0
Objective Parameters:
1) Systolic B.P.
2) Diastolic B.P.
INVESTIGATIONS:
Following hematological, biochemical and ancillary investigations are
carried out as a routine procedure.
1. Hematological Tests :
1) Hb% ( Acid haematin method )
2) Total Leukocyte Count
3) Differential Count
4) Erythrocyte Sedimentation Rate ( Westergren’s Method )
2. Biochemical Test :
1) Random Blood Sugar
3. Routine Urine Analysis :
1) Micro
2) Albumin
3) Sugar
48
METHODOLOGY 2012
A special proforma was prepared in regards to Shonita Dushti and
Essential HTN, with all points of history taking, physical signs and laboratory
investigations to confirm the diagnosis as mentioned in our classics as well as allied
sciences. 40 patients with confirmed diagnosis of Shonita Dushti/Essential HTN
fulfilling the diagnostic inclusion criteria were recruited for the study. The recruited
patients were informed about the clinical study.
49
OBSERVATIONS
AND
RESULTS
OBSERVATIONS & RESULTS 2012
OBSERVATIONS & RESULTS
In this clinical study 40 diagnosed patients of Shonita dushti were taken
who fulfilled the inclusion criteria and all the patients completed the treatment. The
observed data were recorded in well designed proforma before and after the treatment.
Total observed data and the results are divided into two sections as demographic data
and data related to disease stated as below,
DEMOGRAPHIC DATA:
Distribution of patients according to age:
Among 40 patients 25% belongs to age group ranging from 30-40 years, 45% belongs
to 41-50, 30% belongs to 51-60. Detail of the same is elaborated in following Table
no. 9 and Graph no.1.
Table No. 9: Distribution of Patients according to Age
Age Group(yrs) No. Of Groups Total %
Group A Group B
30 – 40 04 06 10 25%
41 – 50 09 09 18 45%
51 – 60 07 05 12 30%
Total 20 20 40 100%
50
Graph No.1. Distribution of Age
Age
Age
45%
50%
40% 30%
25%
30%
20%
10%
0%
30-40 41-50 51-60
Distribution of patients according to Sex:
Among 20 patients selected for the study 60% were males and 40% were
females. Detail of the same is elaborated in following Table no. 10 and Graph no.2.
Table No. 10: Distribution of Patients According to Sex
Sex No. Of Groups Total %
Group A Group B
Male 15 14 29 72.5%
Female 05 06 11 27.5%
Total 20 20 40 100%
51
Graph No.2. Distribution of Sex
72.50%
Sex
80.00% Sex
60.00%
27.50%
40.00%
20.00%
0.00%
Male Female
Distribution of patient according to Religion:
The patients belonging to Hindu, Muslim, Christian religions were present in
the study. Among them 87.5% of patients were Hindus, 7.5% were Muslim and 5%
belonged to Christian community. Details are given in following Table no. 11 and
Graph no.3.
Table No. 11: Distribution of Patients according to Religion
Religion No. Of Groups Total %
Group A Group B
Hindu 18 17 35 87.5%
Muslim 1 2 3 7.5%
Christian 1 1 2 5%
Other 0 0 0 0%
Total 20 20 40 100%
52
Graph No.3. Distribution of Religion
Religion
Religion
87.50%
100.00%
50.00%
7.50% 5% 0%
0.00%
Hindu Muslim Christian Other
Distribution of patient according to Education:
The study showed that majority of patients were Graduates 35%, followed by 20% of
patients completed their High School, 15% with Pre University, 12.5% with Post
graduation, 10% with Primary and 7.5% of Uneducated. Detail is depicted in Table
no. 12 and Graph no.4.
Table No. 12: Distribution of Patients according to Education
Education No. Of Groups Total %
Group A Group B
Uneducated 2 1 3 7.5%
Primary 3 1 4 10%
High School 6 2 8 20%
Pre University 2 4 6 15%
Graduate 5 9 14 35%
Post Graduate 2 3 5 12.5%
Total 20 20 40 100%
53
Graph No.4. Distribution of Education
EDUCATION
EDUCATION
35%
40.00%
30.00% 20%
15% 12.50%
20.00% 10%
7.50%
10.00%
0.00%
Distribution of patient according to Marital Status:
Analysis of the 40 patients revealed that 97.5% were married while 2.5% of patients
were unmarried. Details are shown in below Table no. 13 and Graph no.5.
Table No.13: Distribution of patient according to Marital Status
Status No. Of Groups Total %
Group A Group B
Married 20 19 39 97.5%
Unmarried 00 01 01 2.5%
Widow 00 00 00 0%
Total 20 20 40 100%
54
Graph No.5. Distribution of Marital Status
Marital Status
Marital Status
97.50%
100.00%
80.00%
60.00%
40.00%
20.00% 2.50% 0%
0.00%
Married Unmarried Widow
Distribution of patient according to Occupation:
The study revealed that among 20 patients 40% were Employee, 25% were
Businessmen, 20% were Housewife, and 12.5% were Laborer and 2.5% were
Agriculturist. Details are stated in the Table no. 14 and Graph no.6.
Table No.14: Distribution of patient according to Occupation
Occupation No. Of Groups Total %
Group A Group B
Business 4 6 10 25%
House wife 3 5 8 20%
Employee 8 8 16 40%
Laborer 4 1 5 12.5%
Agriculturist 1 0 1 2.5%
Total 20 20 40 100%
55
Graph No.6. Distribution of Occupation
Occupation
Occupation
40%
40% 25% 20%
12.50%
20% 2.50%
0%
Distribution of patients according to Socio-Economic Status:
The study revealed that 52.5% of patients belonged to Middle class while 25% were
of Upper Middle Class, 17.5 % of patients were of Lower Middle Class and 2.5%
each belonged to Poor and Upper Class. Details are depicted in Table no. 15 and
Graph no.7.
Table No. 15: Distribution of Patients according to Socio-Economic Status
Socio-Economic Status No. Of Groups Total %
Group A Group B
Poor 1 0 1 2.5%
Lower Middle Class 5 2 7 17.5%
Middle Class 9 12 21 52.5%
Upper Middle Class 5 5 10 25%
Upper Class 0 1 1 2.5%
Total 20 20 40 100%
56
Graph No.7. Distribution of Socio-Economic Status
Socio-Economic Status
Socio-Economic Status
52.50%
60.00%
40.00% 25%
17.50%
20.00% 2.50% 2.50%
0.00%
Poor Lower Middle Upper Upper
Middle Class Middle Class
Class Class
Distribution of patients according to Family:
The study revealed that 70% of patients belonged to Nuclear Family and 30% of
patients belonged to Joint Family. Details are shown in Table no. 16 and Graph no. 8.
Table No. 16: Distribution of patients according to Family
Family No. Of Groups Total %
Group A Group B
Nuclear 13 15 28 70%
Joint 7 5 12 30%
Total 20 20 40 100%
57
Graph No.8. Distribution of Family
Family
Family
70%
100% 30%
0%
Nuclear Joint
Distribution of patients according to Habitat/Place:
The analysis showed maximum percentages of patient i.e. 90% were urban dwellers
and only 7.5% were rural dwellers and 2.5% were Slum dwellers. The details are
stated in below Table no. 17 and Graph no.9.
Table No. 17: Distribution of patients according to Habitat/Place
Habitat/Place No. Of Groups Total %
Group A Group B
Rural 2 1 3 7.5%
Urban 17 19 36 90%
Slum 1 0 1 2.5%
Total 20 20 40 100%
58
Graph No.9. Distribution of Habitat/Place
Habitat/Place
Habitat/Place
90%
100.00%
50.00% 7.50% 2.50%

0.00%
Rural Urban Slum
DATA RELATED TO PERSONAL HISTORY:
Distribution of patients according to Diet:
Both Vegetarians and Non vegetarians were observed in the study. Among which
67.5% of patients were of mixed diet and 32.5% of patients were Vegetarians. Details
are stated in Table No.18 and Graph No. 10.
Table No.18: Distribution of patients according to Diet
Diet No. Of Groups Total %
Group A Group B
Vegetarian 5 8 13 32.5%
Mixed 15 12 27 67.5%
Total 20 20 40 100%
59
Graph No.10. Distribution of Diet
Diet
Diet
67.50%
100.00% 32.50%
0.00%
Vegetarian Mixed
Distribution of patients according to Dominant Rasa intake:
Among the 40 patients 47.5% had Katu rasa as Dominant rasa intake, 30% had
Madhura rasa, 10% each had Amla and Lavana rasa, 2.5% had Kasahaya rasa and no
one was taking Tikta rasa as dominant rasa. The details are depicted in Table No. 19
and Graph No. 11.
Table No.19: Distribution of patients according to Dominant Rasa intake
Dominant No. Of Groups Total %

Rasa Group A Group B
Madhura 4 8 12 30%
Amla 3 1 4 10%
Lavana 2 2 4 10%
Katu 10 9 19 47.5%
Tikta 0 0 0 0%
Kashaya 1 0 1 2.5%
Total 20 20 40 100%
60
Graph No.11. Distribution of Dominant Rasa intake
Dominant Rasa
Dominant Rasa
60% 47.50%
40% 30%
20% 10% 10%

0% 2.50%
0%
Distribution of patients according to Diet Habit:
Among the 40 patients 50% were indulged in Akala Bhojana, 25% habituated for
Adhyashana, 20% habituated for Kala Bhojana, 2.5% each habituated for Samashana
and Adhyashana and no one was habituate for Anashana. Details are shown in Table
No. 20 and Graph No.12.
Table No. 20: Distribution of patients according to Diet Habit
Diet Habit No. Of Groups Total %

Group A Group B
Akala Bhojana 11 9 20 50%
Kala Bhojana 5 3 8 20%
Samashana 0 1 1 2.5%
Adhyashana 3 7 10 25%
Vishamashana 1 0 1 2.5%
Anashana 0 0 0 0%
Total 20 20 40 100%
61
Graph No.12. Distribution of Diet Habit
Dietary Habit
Dietary Habit
60% 50%
40%
25%
20%
20%
2.50% 2.50% 0%
0%
Distribution of patients according to Appetite:
Among the 40 patients 2% had Poor Appetite, 57.5% had Moderate Appetite and
37.5% had Good Appetite. The details are given in the following Table No. 21 and
Graph No. 13.
Table No.21: Distribution of patients according to Appetite
Appetite No. Of Groups Total %
Group A Group B
Poor 2 0 2 5%
Moderate 10 13 23 57.5%
Good 8 7 15 37.5%
Total 20 20 40 100
62
Graph No.13. Distribution of Appetite
Appetite
Appetite
57.50%
60% 37.50%
40%
20% 5%
0%
Poor Moderate Good
Distribution of patients according to Bowel Habit:
Among the 40 patients 55% had Regular Bowel Habit, 45% had Constipation and
none had Irregular Bowel Habit. The details are depicted in Table No. 22 and Graph
No. 14.
Table No.22: Distribution of patients according to Bowel Habit
Bowel Habit No. Of Groups Total %
Group A Group B
Regular 11 11 22 55%
Irregular 0 0 0 0%
Constipated 9 9 18 45%
Total 20 20 40 100%
63
Graph No.14. Distribution of Bowel Habit
Bowel Habit
Bowel Habit
100% 55% 45%

50%
0%
0%
Regular Irregular Constipated
Distribution of patients according to Sleep Habit:
Among the 40 patients 5% had Sound Sleep, 67.5% had Disturbed Sleep and 27.5%
had Delayed Sleep Habit. The details are shown in Table No. 23and Graph No. 15.
Table No.23: Distribution of patients according to Sleep Habit
Sleep Habit No. Of Groups Total %
Group A Group B
Sound 2 0 2 5%
Disturbed 12 15 27 67.5%
Delayed 6 5 11 27.5%
Total 20 20 40 100%
64
Graph No.15. Distribution of Sleep Habit
Sleep Habit
Sleep Habit
67.50%
80%
60%
27.50%
40%
20% 5%
0%
Sound Disturbed Delayed
Distribution of patients according to presence of Mental Strain:
Among the 40 patients maximum had Mental Strain i.e. 97.5% and in 2.5% of them
Mental Strain was absent. The details are shown in the Table No. 24 and Graph No.
16.
Table No.24: Distribution of patients according to presence of Mental Strain
Mental Strain No. Of Groups Total %
Group A Group B
Present 19 20 39 97.5%
Absent 1 0 1 2.5%
Total 20 20 40 100%
65
Graph No.16. Distribution of Mental Strain
Mental Strain
Mental Strain
97.50%
100.00%
50.00%
2.50%
0.00%
Present Absent
Distribution of patients according to Exercise:
Among the 40 patients maximum were reported with Less Exercise i.e. 50%, 35% had
Adequate Exercise and 15% had Excess Exercise. The details are shown in the Table
No. 25 and Graph No. 17.
Table No.25: Distribution of patients according to Exercise
Exercise No. Of Groups Total %
Group A Group B
Less 12 8 20 50%
Adequate 4 10 14 35%
Excess 4 2 6 15%
Total 20 20 40 100%
66
Graph No.17. Distribution of Exercise
Exercise
Exercise
50%
50% 35%
15%
0%
Less Adequate Excess
Distribution of patients according to Addiction:
Among the 40 patients 45% had the habit Tea, 17.5% had habit of Coffee, 25% were
addicted to Alcohol, 35% were addicted to Cigarette Smoking and 10% had the habit
of Tobacco Chewing. Details are shown in the Table No. 26 and Graph No. 18.
Table No.26: Distribution of patients according to Addiction
Addiction No. Of Groups Total %

Group A Group B
Tea 11 7 18 45%
Coffee 2 5 7 17.5%
Alcohol 7 3 10 25%
Cigarette Smoking 9 5 14 35%
Tobacco Chewing 2 2 4 10%
Snuffing 0 0 0 0%
Tranquilizers 0 0 0 0%
Total 20 20 40 100%
67
Graph No.18. Distribution of Addiction
Addiction
45% Addiction
50% 35%
25%
17.50%
10%
0% 0%
0%
Distribution of patients according to Emotional Makeup:
Among 40 patients 27.5% had Anxiety, 35% had Tension, 5% had Depression, 10%
had Jolly mood, 7.5% were Sentimental and 15% had Normal Emotional makeup. No
one had Phobic Emotional makeup. Details are shown in the Table No. 27and Graph
no. 19.
Table No.27: Distribution of patients according to Emotional Makeup
Emotional Make up No. Of Groups Total %

Group A Group B
Anxiety 7 4 11 27.5%
Tension 8 6 14 35%
Depression 1 1 2 5%
Jolly 3 1 4 10%
Sentimental 0 3 3 7.5%
Phobic 0 0 0 0%
Normal 1 5 6 15%
Total 20 20 40 100%
68
Graph No.19. Distribution of Emotional Makeup
Emotional Make up
Emotional Make up
35%
40.00% 27.50%
30.00% 15%
20.00% 10% 7.50%
5%
10.00% 0%
0.00%
DATA RELATED TO OCCUPATIONAL HISTORY:
Distribution of patients according to Nature of Work:
Among the 40 patients 32.5% were doing Manual work, 27.5% were doing Sedentary
work, 10% were doing Labor work, 17.5% were Travelers, 2.5% had Walking and
10% were doing Mental work. No one was reported as Studying. Details are depicted
in the Table No. 28 and Graph No. 20.
Table No.28: Distribution of patients according to Nature of Work
Nature of Work No. Of Groups Total %

Group A Group B
Manual 7 6 13 32.5%
Sedentary 5 6 11 27.5%
Labor 3 1 4 10%
Travelling 3 4 7 17.5%
Walking 0 1 1 2.5%
Studying 0 0 0 0
Mental 2 2 4 10%
Total 20 20 40 100%
69
Graph No.20. Distribution of Nature of Work
Nature of Work
Nature of Work
40.00% 32.50%
27.50%
30.00%
17.50%
20.00% 10% 10%
10.00% 2.50% 0%
0.00%
Distribution of patients according to Rest taken during work:
Among the 40 patients 37.5% had Adequate Rest, 62.5% had Inadequate Rest and
none was recorded as having Excessive Rest. The details are shown in the Table No.
29 and Graph No. 21.
Table No.29: Distribution of patients according to Rest taken during work
Rest No. Of Groups Total %
Group A Group B
Adequate 7 8 15 37.5%
Inadequate 13 12 25 62.5%
Excessive 0 0 0 0%
Total 20 20 40 100%
70
Graph No.21. Distribution of Rest taken during work
Rest
Rest
100.00%
62.50%
37.50%
50.00%
0%
0.00%
Adequate Inadequate Excessive
DATA RELATED TO GENERAL EXAMINATION:
Distribution of patients according to Built:
Among 40 patients 27.5% were of Well Built, 65% were of Moderate Built and 7.5%
were of Poor Built. The details are shown in the Table No. 30 and Graph No. 22.
Table No. 30: Distribution of patients according to Built.
Built No. Of Groups Total %
Group A Group B
Well 5 6 11 27.5%
Moderate 13 13 26 65%
Poor 2 1 3 7.5%
Total 20 20 40 100%
71
Graph No.22. Distribution of patients according to Built
Built
Built
80.00% 65%
60.00%
40.00% 27.50%
20.00% 7.50%
0.00%
Well Moderate Poor
Distribution of patients according to Nourishment:
Among the 40 patients 52.5% had Well Nourishment, 40% had Moderate and 7.5%
had Poor Nourishment. The details are shown in the Table No. 31 and Graph No. 23.
Table No.31: Distribution of patients according to Nourishment
Nourishment No. Of Groups Total %
Group A Group B
Well 10 11 21 52.5%
Moderate 8 8 16 40%
Poor 2 1 3 7.5%
Total 20 20 40 100%
72
Graph No.23. Distribution of Nourishment
Nourishment
Nourishment
52.50%
60.00% 40%
40.00%
20.00% 7.50%
0.00%
Well Moderate Poor
DATA RELATED TO DASHA VIDHA PAREEKSHA:
Distribution of patients according to Deha Prakruti:
Among the 40 patients 42.5% each were of Vata Pittaja and Pitta Kaphaja Prakruti.
15% were of Vata Kaphaja Prakruti. None were of Vataja, Pittaja, Kaphaja and of
Sama Prakruti. The details are shown in the Table No. 32 and Graph No. 24.
Table No. 32: Distribution of patients according to Deha Prakruti
Deha Prakruti No. Of Groups Total %

Group A Group B
Vataja 0 0 0 0%
Pittaja 0 0 0 0%
Kaphaja 0 0 0 0%
Vata Pittaja 10 7 17 42.5%
Pitta Kaphaja 6 11 17 42.5%
Vata Kaphaja 4 2 6 15%
Sama 0 0 0 0%
Total 20 20 40 100%
73
Graph No.24. Distribution of Deha Prakruti
Deha Prakruti
Deha Prakruti
42.50% 42.50%
50%
40%
30% 15%
20%
10% 0% 0% 0% 0%
0%
Distribution of patients according to Dosha:
Among the 40 patients 87.5% had Vata and Pitta Dosha and 5% had only Pitta Dosha
as Vikruti. The details are shown in the Table No. 33 and Graph No. 25.
Table No. 33: Distribution of patients according to Dosha
Dosha No. Of Groups Total %
Group A Group B
Vata & Pitta 16 19 35 87.5%
Pitta 4 1 5 12.5%
Kapha 0 0 0 0%
Total 20 20 40 100%
74
Graph No.25. Distribution of Dosha
Dosha
Dosha
87.50%
100.00%
50.00%
12.50%
0%
0.00%
Vata & Pitta Piita Kapha
Distribution of patients according to Satva:
Among the 40 patients 25% were of Pravara Satva, 70% were of Madhyama and 5%
were of Avara Satva. The details are shown in the Table No. 34 and Graph No. 26.
Table No. 34: Distribution of patients according to Satva
Satva No. Of Groups Total %
Group A Group B
Pravara 4 6 10 25%
Madhyama 15 13 28 70%
Avara 1 1 2 5%
Total 20 20 40 100%
75
Graph No.26. Distribution of Satva
Satva
Satva
70%
80%
60%
40% 25%
20% 5%
0%
Pravara Madhyama Avara
Distribution of patients according to Satmya:
Among the 40 patients 22.5% were of Pravara Satmya, 72.5% were of Madhyama and
5% were of Avara Satmya. The details are shown in the Table No. 35 and Graph No.
27.
Table No. 35: Distribution of patients according to Satmya
Satmya No. Of Groups Total %
Group A Group B
Pravara 3 6 9 22.5%
Madhyama 16 13 29 72.5%
Avara 1 1 2 5%
Total 20 20 40 100%
76
Graph No.27. Distribution of Satmya
Satmya
Satmya
100.00% 72.50%
50.00% 22.50%
5%
0.00%
Distribution of patients according to Samhanana:
Among the 40 patients 25% were of Pravara, 72.5% were of Madhyama and 2.5%
were of Avara Samhanana. The details are shown in the Table No. 36 and Graph No.
28.
Table No. 36: Distribution of patients according to Samhanana
Samhanana No. Of Groups Total %
Group A Group B
Pravara 3 7 10 25%
Madhyama 17 12 29 72.5%
Avara 0 1 1 2.5%
Total 20 20 40 100%
77
Graph No.28. Distribution of Samhanana
Samhanana
Samhanana
72.50%
80%
60%
40% 25%
20% 2.50%
0%
Distribution of patients according to Pramana:
Among the 40 patients 17.5% were of Pravara Pramana, 77.5% were of Madhyama
and 5% were of Avara Pramana. The details are shown in the Table No. 37 and Graph
No. 29.
Table No. 37: Distribution of patients according to Pramana
Pramana No. Of Groups Total %
Group A Group B
Pravara 3 4 7 17.5%
Madhyama 16 15 31 77.5%
Avara 1 1 2 5%
Total 20 20 40 100%
78
Graph No.29. Distribution of Pramana
Pramana
Pramana
77.50%
80.00%
60.00%
40.00% 17.50%
20.00% 5%
0.00%
Distribution of patients according to Vaya:
Among the 40 patients everyone belonged to Madhyama Vaya. The details are shown
in the Table No. 38 and Graph No. 30.
Table No. 38: Distribution of patients according to Vaya
Vaya No. Of Groups Total %
Group A Group B
Bala 0 0 0 0%
Madhyama 20 20 40 100%
Vriddha 0 0 0 0%
Total 20 20 40 100%
79
Graph No.30. Distribution of Vaya
Vaya
Vaya
100%
100%
50% 0% 0%
0%
Bala Madhyama Vriddha
Distribution of patients according to Sara:
Among the 40 patients 27.5% were of Twak Sara, 37.5% were of Rakta, 32.5% were
of Mamsa and 2.5% were of Asthi Sara. None were of Meda, Majja, Shukra and
Sarva Sara. The details are shown in the Table No. 39 and Graph No. 31.
Table No. 39: Distribution of patients according to Sara
Sara No. Of Groups Total %

Group A Group B
Twak 6 5 11 27.5%
Rakta 3 12 15 37.5%
Mamsa 10 3 13 32.5%
Meda 0 0 0 0%
Asthi 1 0 1 2.5%
Majja 0 0 0 0%
Shukra 0 0 0 0%
Sarva 0 0 0 0%
Total 20 20 40 100%
80
Graph No.31. Distribution of Sara
Sara
Sara
37.50%
40.00% 32.50%
27.50%
30.00%
20.00%
10.00% 0% 2.50% 0% 0% 0%
0.00%
Twak Rakta Mamsa Meda Asthi Majja Shukra Sarva
Distribution of patients according to Vyayama Shakti:
Purva Kaleena:
Among the 40 patients 65% had Pravara and 35% had Madhyama Purva Kaleena
Vyayama Shakti. No one was reported having Avara Purva Kaleena Vyayama Shakti.
The details are shown in the Table No. 40 and Graph No. 32.
Table No. 40: Distribution of patients according to Purva Kaleena Vyayama
Shakti
Purva Kaleena No. Of Groups Total %
Group A Group B
Pravara 11 15 26 65%
Madhyama 9 5 14 35%
Avara 0 0 0 0%
Total 20 20 40 100%
81
Graph No.32. Distribution of Purva Kaleena Vyayama Shakti
Purva kaleena
Purva kaleena
100% 65%
35%
50%
0%
0%
Distribution of patients according to Adyatana Vyayama Shakti:
Among the 40 patients 10% had Pravara, 82.5% had Madhyama and 7.5% had Avara
Adyatana Vyayama Shakti. The details are shown in the Table No. 41 and Graph No.
33.
Table No. 41: Distribution of patients according to Adyatana Vyayama Shakti
Adyatana No. Of Groups Total %
Group A Group B
Pravara 0 4 4 10%
Madhyama 19 14 33 82.5%
Avara 1 2 3 7.5%
Total 20 20 40 100%
82
Graph No.33. Distribution of Adyatana Vyayama Shakti
Adyatana
Adyatana
82.50%
100%
50% 10% 7.50%

0%
Distribution of patients according to Ahara Shakti:
Abhyavaharana:
Purva Kaleena:
Among 40 patients 70% had Pravara, 30% had Madhyama Purva Kaleena
Abhyavaharana Shakti. No one was reported to have Avara Purva Kaleena
Abhyavaharana Shakti. The details are shown in the Table No. 42 and Graph No. 34.
Table No. 42: Distribution of patients according to Purva kaleena Abhyavahrana
Ahara Shakti
Group A Group B
Pravara 12 16 28 70%
Madhyama 8 4 12 30%
Avara 0 0 0 0%
Total 20 20 40 100%
83
Graph No.34. Distribution of Purva kaleena Abhyavaharana Ahara Shakti
Purva kaleena
Purva kaleena
100% 70%
30%
50% 0%
0%
Distribution of patients according to Adyatana Abhyavaharana Ahara Shakti:
Among the 40 patients 27.5% had Pravara, 67.5% had Madhyama and 5% had Avara
Adyatana Abhyavaharana Ahara Shakti. The details are shown in the Table No. 43
and Graph No. 35.
Table No. 43: Distribution of patients according to Adyatana Abhyavaharana
Ahara Shakti
Group A Group B
Pravara 5 6 11 27.5%
Madhyama 13 14 27 67.5%
Avara 2 0 2 5%
Total 20 20 40 100%
84
Graph No.35. Distribution of Adyatana Abhyavaharana Ahara Shakti
Adyatana
Adyatana
100.00% 67.50%
27.50%
50.00% 5%
0.00%
Distribution of patients according to Jarana Ahara Shakti:
Purva Kaleena:
Among the 40 patients 75% had Pravara and 25% had Madhyama Purva Kaleena
Jarana Ahara Shakti. No one was reported to have Avara Purva Kaleena Jarana Ahara
Shakti. The details are shown in the Table No. 44 and Graph No. 36.
Table No.44: Distribution of patients according to Purva Kaleena Jarana Ahara
Shakti
Group A Group B
Pravara 12 18 30 75%
Madhyama 8 2 10 25%
Avara 0 0 0 0%
Total 20 20 40 100%
85
Graph No.36. Distribution of Purva Kaleena Jarana Ahara Shakti
Purva Kaleena
Purva Kaleena
75%
100%
25%
50% 0%
0%
Distribution of patients according to Adyatana Jarana Ahara Shakti:
Among the 40 patients 27.5% had Pravara, 67.5% had Madhyama and 5% had Avara
Adyatana Jarana Ahara Shakti. The details are shown in the Table No. 45 and Graph
No. 37.
Table No.45: Distribution of patients according to Adyatana Jarana Ahara
Shakti
Group A Group B
Pravara 5 6 11 27.5%
Madhyama 13 14 27 67.5%
Avara 2 0 2 5%
Total 20 20 40 100%
86
Graph No.37. Distribution of Adyatana Jarana Ahara Shakti
Adyatana
Adyatana
100.00% 67.50%
27.50%
50.00% 5%
0.00%
Distribution of patients according to Agni:
Among the 40 patients 25% had Sama, 50% had Vishama, 22.5% had Teekshna and
2.5% had Manda Agni. The details are shown in the Table No. 46 and Graph No. 38.
Table No. 46: Distribution of patients according to Agni
Agni No. Of Groups Total %
Group A Group B
Sama 4 6 10 25%
Vishama 10 10 20 50%
Teekshna 6 3 9 22.5%
Manda 0 1 1 2.5%
Total 20 20 40 100%
87
Graph No.38. Distribution of Agni
Agni
Agni
50%
60%
40% 25% 22.50%

20% 2.50%
0%
Sama Vishama Teekshna Manda
Distribution of patients according to Koshta:
Among the 40 patients 25% had Mridu, 27.5% had Madhyama and 47.5% had Krura
Koshta. The details are depicted in the Table No. 47 and Graph No. 39.
Table No. 47: Distribution of patients according to Koshta
Koshta No. Of Groups Total %
Group A Group B
Mridu 4 6 10 25%
Madhyama 6 5 11 27.5%
Krura 10 9 19 47.5%
Total 20 20 40 100%
88
Graph No.39. Distribution of Koshta
Koshta
Koshta
60% 47.50%
40% 25% 27.50%
20%
0%
Mridu Madhyama Krura
DATA RELATED TO NIDANA PANCHAKA:
Distribution of patients according to Nidana Sevana:
Aharatah Nidana:
Among the 40 patients maximum were found to be consuming Ati Lavana i.e. 80%,
followed by Ati Amla Sevana i.e. 77.5%, 72.5% Ati Katu Sevana, 60% each Ati
Dadhi and Ati Anupa Anupa Mamsa Sevana, 55% Ati Masha Sevana, 37.5% Ati
Moolaka Sevana, 35% Ati Kshara Sevana, 25% Ati Teekshna Ushna Madya Sevana,
22.5% Ati Kulatha and 20% Ati Jalaja Mamsa Sevana. None were found to be
consuming Ati Tila Taila, Ati Pindalu and Ati Nishpava. The details are depicted in
the Table No. 48 and Graph No. 40.
89
Table No. 48: Distribution of patients according to Aharatah Nidana
Aharatah Nidana No. Of Groups Total %

Group A Group B
Ati Lavana 17 15 32 80%
Ati Kshara Ahara 8 6 14 35%
Ati Katu 15 14 29 72.5%
Ati Amla 16 15 31 77.5%
Ati Kulatha 5 4 9 22.5%
Ati Masha 11 11 22 55%
Ati Tila Taila 0 0 0 0%
Ati Pindalu 0 0 0 0%
Ati Moolaka 9 6 15 37.5%
Ati Nishpava 0 0 0 0%
Ati Dadhi 13 11 24 60%
Ati Teekshna, Ushna Madya 7 3 10 25%
Ati Jalaja Mamsa Sevana 4 4 8 20%
Ati Anupa Mamsa Sevana 13 11 24 60%
Graph No.40. Distribution of Aharatah Nidana
Ahara
Ahara
80%
77.50%
72.50%
80%
70%
60% 55% 60% 60%
50% 35%
40% 37.50%
30% 22.50%
20% 25%
10% 20%
0% 0 0%
0%
Ati Lavana
Ati Kshara
Ati Katu
Ati Amla
Ati Kulatha
Ati Masha
Ati Tila Taila
Ati Pindalu
Ati Moolaka
Ati Nishpava
Ati Dadhi
Ati Teekshna Ushna Madya
Ati Jalaja Mamsa
Ati Anupa Mamsa
90
Distribution of patients according to Viharatah Nidana:
Among the 40 patients maximum were indulged in Shrama i.e. 85%, followed by Ati
Adana and Ati Atapa i.e. 52.5% each, 40% were indulged in Adhyashana, 37.5%
Santaapa and 15% were found to be indulged in Bhuktwa Diva Praswapanam. The
details are depicted in the Table No. 49 and Graph No. 41.
Table No. 49: Distribution of patients according to Viharatah Nidana
Vihara No. Of Groups Total %
Group A Group B
Ati Adana 12 9 21 52.5%
Bhuktva Diva Praswapanam 3 3 6 15%
Ati Atapa 12 9 21 52.5%
Santaapa 8 7 15 37.5%
Shrama 18 16 34 85%
Adhyashana 6 10 16 40%
Graph No.41. Distribution of Viharatah Nidana
Vihara
Vihara
85%
100.00% 52.50% 52.50% 37.50% 40%
50.00% 15%
0.00%
91
Distribution of patients according to Manasika Nidana:
Among the 40 patients 100% were found to be indulged in Chinta and 95% were
found to be indulged in Krodha. The details are depicted in the Table No. 50 and
Graph No. 42.
Table No. 50: Distribution of patients according to Manasika Nidana
Manasika No. Of Groups Total %
Nidana Group A Group B
Chinta 20 20 40 100%
Krodha 18 20 38 95%
Graph No.42. Distributionof Manasika Nidana
Manasika Nidana
Manasika Nidana
100%
95%
100%
90%
Chinta Krodha
Distribution of patients according to Anya Nidana:
Among the 40 patients 40% had Ajeerna and none were found to be indulged in
Chardi Vega Pratighata. The details are depicted in the Table No. 51 and Graph No.
43.
92
Table No. 51: Distribution of patients according to Anya Nidana
Anya Nidana No. Of Groups Total %
Group A Group B
Ajeerna 9 7 16 40%
Chardi Vega 0 0 0 0%
Pratighata
Graph No.43. Distributionof Anya Nidana
Anya Nidana
Other Nidana
40%
40%
20% 0%
0%
Ajeerna Chardi Vega
Pratighata
Distribution of patients according to Rupa/Lakshana:
Among the 40 patients in 100% Krodha Prachurata, Anidra and Ati Sveda was seen,
in 97.5% Shiroruk, in 92.5% Klama, in 87.5% Bhrama, in 55% Atidourbalya, in
52.5% Tamasaatidarshana and in 25% Akshiraga was seen along with Krodha
Prachurata, Anidra and Ati Sveda. The details are depicted in the Table No. 52 and
Graph No. 44.
93
Table No. 52: Distribution of patients according to Rupa/Lakshana
Rupa/Lakshana No. Of Groups Total %

Group A Group B
Shiroruk 20 19 39 97.5%
Krodha Prachurata 20 20 40 100%
Tamasaatidarshana 14 7 21 52.5%
Bhrama 17 18 35 87.5%
Atidourbalya 14 8 22 55%
Akshiraga 9 1 10 25%
Anidra 20 20 40 100%
Klama 18 19 37 92.5%
Ati Sveda 20 20 40 100%
Graph No.44. Distribution of Rupa/Lakshana
Rupa/Lakshana
Rupa/Lakshana
100%
97.50%
100.00% 100% 100%
87.50% 92.50%
80.00%
60.00% 52.50% 55%
40.00%
20.00% 25%
0.00%
94
DATA RELATED TO SAMPRAPTI GHATAKA:
Distribution of patients according to Dosha:
Among the 40 patients in 100% only Vata and Pitta Dosha was involved in Samprapti
Ghataka and in 15% Kapha Dosha was involved along with Vata and Pitta Dosha.
Details are stated in Table no. 53 and Graph no. 45.
Table No. 53: Distribution of patients according to Dosha
Dosha No. Of Groups Total %
Group A Group B
Vata 20 20 40 100%
Pitta 20 20 40 100%
Kapha 4 2 6 15%
Graph No.45. Distribution of Dosha
Dosha
Dosha
100% 100%
100%
50%
15%
0%
Vata Pitta Kapha
95
Distribution of patients according to Dushya:
Among the 40 patients 100% had Rakta as Dushya, 90% had Majja and 60% had Rasa
as Dushya. Details are stated in Table no. 54 and Graph no. 46.
Table No. 54: Distribution of patients according to Dushya
Dushya No. Of Groups Total %
Group A Group B
Rasa 15 9 24 60%
Rakta 20 20 40 100%
Majja 18 18 36 90%
Graph No.46. Distribution of Dushya
Dushya
Dushya
100%
90%
100%
60%
50%
0%
Rasa Rakta Majja
DATA RELATED TO DISEASE:
96
Distribution of patients according to Family History:
The study revealed that 87.5% of patients had Family History and in 12.5% of
patients Family History was absent. Details are shown in Table no. 55 and Graph no.
47.
Table No.55: Distribution of patients according to Family History
Family History No. Of Groups Total %
Group A Group B
Present 15 20 35 87.5%
Absent 5 0 5 12.5%
Total 20 20 40 100%
Graph No.47. Distribution of Family History
Family History
Family History
87.50%
100.00%
50.00% 12.50%
0.00%
Present Absent
Distribution of patients according to Main Complaints:
97
Among the 40 patients selected for the study, about 100% of people had Fatigue,
Head Ache was seen in 97.5% of people, 90% had Dizziness and 32.5% had
Palpitation. Details are shown in Table no. 56 and Graph no. 48.
Table No. 56: Distribution of patients according to Main Complaints
Main No. Of Groups Total %
Complaints Group A Group B
Head Ache 20 19 39 97.5%
Dizziness 18 18 36 90%
Palpitation 10 3 13 32.5%
Easy Fatigue 20 20 40 100%
Graph No.48. Distribution of Main Complaints
Main Complaints
Main Complaints
97.50% 100%
90%
100.00%
80.00%
60.00%
32.50%
40.00%
20.00%
0.00%
Headache Dizziness Palpitation Easy Fatigue
Distribution of patients according to Blood pressure:
98
Among the 40 patients 67.5% had Moderate Hypertension and 32.5% had Mild
Hypertension. Details are depicted in the Table no. 57 and Graph no. 49.
Table No. 57: Distribution of patients according to Blood pressure
Blood Pressure No. Of Groups Total %
Group A Group B
Mild 7 6 13 32.5%
Moderate 13 14 27 67.5%
Total 20 20 40 100%
Graph No.49. Distribution according to Blood pressure
B.P.
B.P.
100.00% 67.50%
32.50%
50.00%
0.00%
Mild Moderate
Distribution of patients according to duration of Hypertension:
99
Among the 40 patients i n 65% duration of illness was less than a year. In
remaining 35% duration of illness was more than a year. Details are predicted in
Table no.58 and Graph no.50.
Table No.58: Distribution of patients according to duration of Hypertension
Duration Of No. Of Groups Total %
Hypertension Group A Group B
New 10 16 26 65%
Old 10 4 14 35%
Total 20 20 40 100%
Graphe No.50. Distribution according to duration of Hypertension
Duration
Duration
100% 65%
35%
50%
0%
New Old
Results:
The effect of the therapy was analyzed statistically by calculating the t and
p values by using Unpaired Student t test for quantitative data in between the groups.
The effect of the therapy was analyzed statistically by calculating the p values by
using Chi-Square/Fisher Exact test for qualitative data.
100
Following results were obtained through statistical analysis:-
EFFECT OF JATAMAMSI CHOORNA AND PATHYA AHARA AND

VIHARA ON GROUP A AND EFFECT OF ONLY PATHYA AHARA AND
VIHARA ON GROUP B:
Effect on Headache:
Table No. 59: Comparative evaluation of Head ache in two groups of patients
studied
Head ache
BT AT %
(n=20) (n=20) Change
No. % No. %
Group A
• Absent 0 0% 15 75% +75.0%
• Present 20 100% 5 25% -75.0%
Group B
• Absent 1 5% 6 30% +25.0%
• Present 19 95% 14 70% +25.0%
‘p’ value - 0.004 -
Remark - HS -
Graph No.51. Comparative evaluations of Head ache in two groups
101
HEAD ACHE
Present
Absent
100
90 25
80
Percentage
70
70
60
50 100 95
40 75
30
20
30
10
0 0 5
BT AT BT AT
GROUP A GROUP B
Among the 40 patients, all 20 patients of Group A and 19 patients of Group B
presented with Headache before the clinical trial. After the trial, Headache was
relieved in 15 patients with 75% results in Group A and 6 patients in Group B with
25% result.
Statistical analysis showed that patients in Group A showed Highly Significant
improvement with ‘p’ value 0.004 in comparison to patients in Group B. Clinically
75% of patients in Group A showed improvement as shown in Table No. 59 and
Graph No. 51.
Effect on Dizziness:
102
Table No. 60: Comparative evaluation of Dizziness in two groups of patients
studied
Dizziness
BT AT %
No. % No. %
Group A
• Absent 2 10% 16 80% +70.0
• Present 18 90% 4 20% -70.0
Group B
• Absent 2 10 6 30.0% +20.0
• Present 18 90 14 70% -20.0
‘p’ value - 0.001 -
Remark - HS -
Graph No.52. Comparative evaluation of Dizziness in two groups
DIZZINESS
Present
Absent
100
90 20
80
Percentage
70
70
60
90 90
50
40 80
30
20
30
10
10 10
0
BT AT BT AT
GROUP A GROUP B
103
Among the 40 patients, 18 patients each of Group A and Group B presented with
Dizziness before the clinical trial. After the trial, Dizziness was relieved in 16 patients
with 70% result in Group A and 6 patients in Group B with 20% result.
Graph No. 52.
Effect on Palpitation:
Table No. 61: Comparative evaluation of Palpitation in two groups of patients
studied
Palpitation BT AT %
No. % No. %
Group A
• Absent 10 50% 19 95% +45.0
• Present 10 50% 1 5% -45.0
Group B
• Absent 17 85% 18 90% +5.0
• Present 3 15% 2 10% -5.0
‘p’ value - 1.000 -
Remark - NS -
104
Graph No.53. Comparative evaluation of Palpitation in two groups
PALPITATION
Present
Absent
100 5
15 10
90
80
Percentage
50
70
60
50
95 90
40 85
30
20
50
10
0
BT AT BT AT
GROUP A GROUP B
Among the 40 patients, 10 patients of Group A and 3 patients of Group B presented
with Palpitation before the clinical trial. After the trial, Palpitation was relieved in 9
patients with 45% result in Group A and 1 patient in Group B with 5% result.
Statistical analysis showed that patients in Group A showed Insignificant
Graph No. 53.
105
Effect on Easy Fatigue:

Table No. 62: Comparative evaluation of Easy Fatigue in two groups of patients
studied
Easy Fatigue
BT AT %
No. % No. %
Group A
• Absent 0 0% 16 80% +80.0
• Present 20 100% 4 20% -80.0
Group B
• Absent 0 0% 5 25% +25.0
• Present 20 100% 15 75% -25.0
‘p’ value - <0.001 -
Remark - HS -
Graph No.54. Comparative evaluation of Easy Fatigue in two groups
EASY FATIGUE Present

Absent
100
90 20
80
Percentage
70
60 75
50 100 100
40 80
30
20
10 25
0 0 0
BT AT BT AT
Group A Group B
106
Among the 40 patients, all the patients of Group A and Group B presented with Easy
Fatigue before the clinical trial. After the trial, Easy Fatigue was relieved in 16
patients with 80% result in Group A and 5 patients in Group B with 25% result.
improvement with ‘p’ value <0.001 in comparison to patients in Group B. Clinically
Graph No. 54.
Effect on Systolic B.P.:
Table No. 63: Comparative evaluation of SBP (mm of Hg) in two groups of
patients studied
SBP (mm of Hg)
BT AT
Group A 147.20 120.20
(9.14) (4.67)
Group B 145.20 142.00
(8.11) (8.58)
‘t’ value - 9.974
‘p’ value - <0.001
Remark - HS
107
Graph No.55. Comparative evaluation of SBP (mm of Hg) in Group A and

Group B
Group A
Group B
147.2 145.2 142

150 120.2
100
50
0
BT AT
Statistical analysis regarding Systolic BP of patients in Group A showed Highly
Significant improvement after trial with ‘t’ value 9.974 and ‘p’ value <0.001 in
comparison to patients in Group B. Details are shown in Table No. 63 and Graph No.
55.
Effect on Diastolic B.P.:
Table No. 64: Comparative evaluation of DBP (mm Hg) in two groups of patients
studied
DBP (mm of Hg)

BT AT
Group A 93.8 80.0
(3.77) (1.49)
Group B 89.50 86.8
(4.80) (4.27)
‘t’ value - 6.026
‘p’ value - <0.001
Remark - HS
108
Graph No.56. Comparative evaluation of DBP (mm Hg) in two groups

Group A
Group B
93.8
95 89.5
86.8
90
85 80.7
80
75
70
BT AT
Statistical analysis regarding Diastolic BP of patients in Group A showed Highly
Significant improvement after trial with ‘t’ value 6.026 and ‘p’ value <0.001 in
comparison to patients in Group B. Details are shown in Table No. 64 and Graph No.
56.
ASSESSMENT OF OVERALL RESPONSE IN GROUP A AND GROUP B –

COMPARATIVE STATISTICS:
Table No. 65: Assessment of overall response (based on 6 parameters)
Overall Response GROUP A GROUP B
No % No %
No Response 0 0.0 7 35.0

Mild Response
(<20% improvement) 0 0.0 7 35.0
Moderate Response
(20-50% Improvement) 10 50.0 6 30.0
Marked response
(>50% Improvement) 10 50.0 0 0.0
Total 20 100.0 20 100.0
109
Graph No.57. Assessment of overall response (based on 6 parameters)

Group A
80
Group B
70
60
50
Reponse
40
30
20
10
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
-10
Patient number
Overall response is significantly better in patients of Group A (Moderate/Marked
response: 100%) when compared to patients of Group B (30%) with P<0.001. Details
are shown in Table no. 65 and Graph no. 57.
110
DISCUSSION
DISCUSSION 2012
DISCUSSION
Observations itself do not help one in reaching a comprehensive
conclusion, if the conclusion is to be logical and appropriate a thorough discussion of
all the aspects of data obtained in observation is essential. The discussion takes care
of different dimensions of the problem that was analyzed and the data obtained. In
short discussion provides a different dimension to the problem.
A hypothesis is the essential pre-requisite of each and every research work.
The hypothesis invariably and unconditionally follows a philosophy. The hypothesis
is to be discussed, experimented practically, the results obtained are to be analyzed
properly for merits and demerits, and necessary modifications are to be made on the
basis of these findings. In the present study the Naidanika Samprapti of Shonita
Dushti and its Samprapti Vighatana using Jatamamsi choorna along with Pathya ahara
and vihara and only Pathya ahara and vihara has been studied in 2 groups of patients
Trial and control group. The data obtained during these trials is opened to discussion.
The clinical study has been discussed under the following headings:
1. Discussion on Need for the Study
2. Discussion on Historical Review
3. Discussion on Drug Selection
4. Discussion on Methodology
5. Discussion on Observations and Results
6. Discussion on Samprapti vighatana of Shonita Dushti by Jatamamsi Choorna
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DISCUSSION 2012
Discussion on Need for the Study:
OPD of most hospitals deals with the cases of Essential Hypertension in
day to day clinical practice. Hypertension being a chronic illness constitutes an
important public health challenge in the pesent era because of its prevalence and
concomitant risk of cardiovascular disease. As most of the patients are asymptomatic,
diagnosis is either missed or delayed. In more than 95% of Hypertension cases, a
specific underlying cause of hypertension cannot be found and is termed as Essential
Hypertension. The signs and symptomatology of Shonita Dushti could be corelated to
Essential Hypertension.
Treatment as prescribed in modern medicine for Essential Hypertension is
far from satisfactory and is often accompanied with several side effects. Hence the
evaluation of naidanika samprapti of Essential Hypertension and its samprapti
vighatana using Jatamamsi choorna being made here is expected contribute towards
better understanding of Essntial Hypertension and there by a better line of treatment.
Dicussion on Historical Review:
Hridaya is one among the vital organ in living beings. It maintains the
blood circulation in the body. It is said to be the mula of Manas according to Acharya
Chraka and Acharya Sushruta. But Acharya Bhela opines that adhistana of Manas is
in between Shiras and Talu. While considering these opinion we can conclude that
though Hridaya is said to be the mula of Manovaha Srotas, its Adhistana is in Shiras.
Discussion on Drug Selection:
For the samprapti vighatana of shonita dushti Jatamamsi choorna was
selected along with shali, mudga, go dugdha adi pathya aharas.
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DISCUSSION 2012
Jatamamsi being snigdha pacifies vata dosha; being sheeta veerya and
tikta, kashaya and madhura rasa pacifies pitta dosha; being tikta and kashaya rasa and
katu vipaka pacifies kapha dosha; being tikta rasa and sheeta veerya pacifies rakta
dosha; and through prabhava pacifies manasa doshas namely rajas and tamas.
Its main action is sanjnasthapana. Also it is said to be medhya, hridya,
balya and nidrajanaka. Thus Jatamamsi choorna very much suits for the samprapthi
vighatana of Shonita dushti. Hence it has been taken for the samprapthi vighatana
along with suitable pathya ahara and vihara mentioned for Shonita dushti.
Discussion on Methodology:
Study comprises of two groups
1. Group A – Jatamamsi choorna along with pathya ahara and vihara (Trial Group)
2. Group B – Only pathya ahara and vihara (Control Group)
Different parameters were used to understand the process of samprapti
vighatana through data obtained in the clinical trials.
The general observations pertaining to the age, sex, occupation etc. of 40
patients of Essential Hypertension recorded in this series is discussed here under.
Discussion on Observations:
The observations were made in the patients of both groups excluding
dropouts. These observations were based on the clinical trial on 46 patients registered
in the study. The data was collected in the case sheet and were analyzed after the
completion of the study.
Dropouts:
Of the total 46 patients registered for the study, there were 6 drop outs
among which 4 patients belonged to group A and 2 belonged to group B. The exact
113
DISCUSSION 2012
cause of discontinuity could not be elicited.
Data Related to Demographic Details:
Age: Data obtained pertaining to the age group of the patients (Table no.9) shows that
highest incident of Essential HTN is seen in the patients belonged to age group of 41-
50 years (45%). The different survey studies at different places have shown
prevalence of the essential hypertension during the 4th and 5th decade of the
individuals. The present study corroborating the same recorded highest percentage of
patients belonging to the same age group.
Sex: Sex wise distribution of patients (Table no.10) shows that highest incidence is
seen in Males (72.5%). This tally well with the general understanding that incidence
of Essential hypertension is higher in males than in females. This is because females
are more stress tolerant by nature while compared to males.
Religion: Data obtained pertaining to the religion of the patients (Table no.11) shows
that highest incidence of Essential HTN is seen in Hindu Community (87.5%). This
may not be due to any particular reason, but because of Hindu dominated population
in the area from where the patients were selected.
Education: Data obtained pertaining to the education of the patients (Table no.12)
shows that highest incidence is seen in educated people and were Graduates (35%),
followed by 20% with High School Education. This only indicates that educated
people are more conscious towards their health.
Occupation: Data obtained pertaining to the Occupation of the patients (Table
no.14) shows that highest incidence is seen in Employee (40%). It shows that they are
more prone to stress because of their work schedule.
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DISCUSSION 2012
Socio-economic Status: Data obtained pertaining to the Socio-economic status of
the patients (Table no.15) shows that highest incidence is seen in the patients from
Middle Class family (52.5%) followed by upper middle class 25%. It shows that
middle class people are more stress prone compared to other classes in society at
today’s scenario.
Family: Data obtained pertaining to type of family of the patients (Table no. 16)
shows that highest incidence is seen in the patients from Nuclear Family (70%). It
shows that increasing stress in nuclear family compared to joint family.
Habitat/Place: Data obtained pertaining to habitat/place of the patients (Table no.
17) shows that highest incidence is seen in numbers of patients i.e. 90% were Urban
Dwellers, which can be attributed to the study area which is an urban locality.
Data Related to Personal History:
Diet: Data obtained pertaining to diet of the patients (Table no. 18) shows that
highest incidence of Essential HTN is seen in patients habituated to Mixed Diet
(67.5%). It goes well with the Ayurvedic theory that Rajo Guna Bahulata is seen
maximum in the persons habituated for mamsahara. And also Non-vegetarian diet is
low in fibers and high in fat content, which may be a predisposing factor for
Hypertension.
Dominant Rasa: Data obtained pertaining to the distribution based on dominant
rasa shows those patients (Table no.19) consuming Katu rasa had the highest
incidence of Essential Hypertension i.e. 47.5%. It shows that vitiation of Vata and
Pitta dosha took place; there by Rakta dhatu got vitiated. As it is said in the classics
that rakta dhatu is the ashraya for pitta dosha.
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DISCUSSION 2012
Diet Habit: Data obtained pertaining to diet habit of the patients (Table no. 20)
shows that highest incidence is seen in the patients indulged in Akala Bhojana i.e.
50%, followed by 25% were indulged in Adhyashana. It shows that akala bhojana and
adhyashana are among the causes of shonita dushti as it is said in the classics.
Sleep Habit: Data obtained pertaining to sleep habit of the patients (Table no. 23)
shows that highest incidence is seen in the patients with Disturbed Sleep (67.5%),
followed by 27.5% with Delayed Sleep. It indicates the involvement of manas in the
commencement of Essential Hypertension.
Mental Strain: Data obtained pertaining to mental strain in patients (Table no. 24)
shows that highest incidence of Essential HTN is seen in the patients with mental
strain (97.5%). It once again indicates the involvement of manas in the
commencement of Essential Hypertension.
Exercise: Data obtained pertaining to exercise (Table no. 25) shows that highest
incidence is seen in the patients reported with Less Exercise (50%). It goes well with
the present scenario that HTN is seen in the persons with sedentary life style.
Addiction: Data obtained pertaining to addiction in patients (Table no. 26) shows
that highest incidence is seen in the patients addicted to Tea (45%), followed by
Cigarette Smoking (35%), Alcohol (25%), Coffee(17%) and Tobacco Chewing
(10%). As it is already mentioned in the etiological factors these all causes HTN.
Emotional Makeup: Data obtained pertaining to the distribution based on emotional
makeup of the patients (Table no.27) shows that highest incidence of Essential
Hypertension was recorded among patients with Tension (35%), followed by Anxiety
(27.5%). It once again shows the involvement of mind in Essential Hypertension.
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DISCUSSION 2012
Data Related to Occupational History:
Nature of Work: Data obtained pertaining to the nature of work (Table no. 28)
shows that highest incidence is seen in the patients whose occupation involved with
Manual Work (32.5%); followed by Sedentary Work (27.5%) and Travelling
(17.5%). Physical strain and stressful life may be the reason for more number of
Manual work laborers in the present study.
Rest Taken during Work: Data obtained pertaining to the rest taken during work
(Table no. 29) shows that highest incidence is seen in the patients reported with
Inadequate Rest (62.5%) during work time. It indicates the increased workload which
in turn causes mental strain leading to Essential HTN.
Built: Data obtained pertaining to the built of the patients (Table no. 30) shows that
highest incidence of Essential HTN is seen in the patients with Moderate Built (65%);
followed by Well Built (27.5%). It shows that there is no relation to the body weight
and Essential HTN.
Nourishment: Data obtained pertaining to the nourishment of the patients (Table no.
31) shows that highest incidence is seen in the patients with Well Nourishment
(52.5%), followed by Moderate Nourishment (40%). It shows the improved
economic status in urban dwellers.
Deha Prakruti: Data obtained pertaining to the deha prakruti of the patients (Table
no. 32) shows that highest incidence of Essential HTN is seen in the patients of Vata
Pittaja and Pitta Kaphaja prakruti (42.5% each), followed by Vata Kaphaja prakruti
(15%). It shows that though Vata pradhana tridoshas are involved in Shonita dushti,
Piita dosha plays an important role in the commencement of Shonita Dushti. It is
because Pitta and Rakta shares Ashraya Ashrayee Sambandha.
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DISCUSSION 2012
Agni: Data obtained pertaining to Agni of the patients suffering from Essential HTN
(Table no. 46) shows that highest incidence is seen in the patients with Vishama Agni
i.e. 50%, followed by 25% Sama, 22.5% Teekhna and 2.5% Manda Agni. It shows
that Agnivaishamya found to influence the development of Shonita Dushti.
Koshta: Data obtained pertaining to Koshta of the patients (Table no. 47) shows that
highest incidence is seen in the patients with Krura Koshta (47.5%), followed by
27.5% Madhyama and 25% Mridu Koshta. It signifies that the Shonita Dushti is more
prevalent in people with Krura Koshta. This can be attributed to Vata dushti along
with Pitta Dosha.
Data Related to Nidana Panchaka:
Data Related to Nidana:
Aharatah: Data obtained pertaining to aharatah nidana of the patients suffering
from Essential HTN (Table no.48) shows that highest incidence is seen in the patients
consuming Ati Lavana (80%), followed by Ati Amla (77.5%), Ati Katu (72.5%), Ati
Dadhi and Ati Anupa Anupa Mamsa (60% each), Ati Mash (55%)a, Ati Moolaka
(37.5%), Ati Kshara (35%), Ati Teekshna Ushna Madya (25%), Ati Kulatha (22.5% )
and Ati Jalaja Mamsa (20%). It tallies well with the current understanding of
excessive intake of salt leads to Essential HTN. And also other above said Aharatah
Nidanas like Ati Amla, Ati Katu etc. is said to be the cause for Shonita Dushti
according to our Acharyas.
Viharatah: Data obtained pertaining to viharatah nidana of the patients suffering
indulged in Shrama (85%), followed by Ati Adana and Ati Atapa (52.5% each),
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DISCUSSION 2012
Adhyashana (40%), Santaapa (37.5% ) and Bhuktwa Diva Praswapanam (15%). It
shows that physical strain in turn lead to mental strain there by vitiating Rakta Dhatu.
Manasika: Data obtained pertaining to manasika nidana of the patients suffering
indulged in Chinta (100%), followed by Krodha (95%). It tallies well with the current
understanding that mental strain is one among the causative factor behind Essential
HTN.
Other Nidana: Data obtained pertaining to other nidana of the patients suffering
with Ajeerna (40%). It shows that Agnimandya plays an impotant role in commencing
Shonita Dushti.
Data Related to Rupa/Lakshana: Data obtained pertaining to rupa/lakshana of the
patients suffering from Essential HTN (Table no. 52) shows that highest incidence is
seen in the patients with the lakshanas like Krodha Prachurata, Anidra and Ati Sveda
(100% each); followed by Shiroruk (97.5%), Klama (92.5%), Bhrama (87.5%),
Atidourbalya (55%), Tamasaatidarshana (52.5%) and Akshiraga (25%). It signifies
the predominance of Vata dosha with the involvement of Pitta and Kapha dosha.
Data Related to Samprapti Ghataka:
Dosha: Data obtained pertaining to dosha of the patients suffering from Essential
HTN (Table no. 53) shows that Vata and Pitta is the pradhana dosha which underwent
dooshana as observed in the study attributing to prevalence of 100% followed by
Kapha Dosha which attributed for prevalence 15%. It signifies the importance of Vata
and Pitta Dosha dushti in commencing Shonita Dushti.
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DISCUSSION 2012
Dushya: Data obtained pertaining to dushya of the patients suffering from Essential
HTN (Table no. 54) shows that highest incidence is seen in the patients with Rakta
(100%) as Dushya; followed by Majja (90%) and Rasa (60%) as Dushya. This is
mainly because Pitta and Raktha share ashraya ashrayi sambandha.
Data Related to Disease:
Family History: Data obtained pertaining to family history of the patients suffering
from Essential HTN (Table no. 55) shows that highest incidence is seen in the patients
with Family History (87.5%). Textual references also mention considerable evidence
that Blood Pressure levels are determined due to specific genetic factors.
Main Complaints: Data obtained pertaining to main complaints of the patients
suffering from Essential HTN (Table no. 56) shows that highest incidence is seen in
the persons having Easy Fatigue (100%) as a main complaint; followed by Head
Ache (97.5%), Dizziness (90%) and Palpitation (32.5%). It shows the deterioration
physical strength in the persons afflicted with Shonita Dushti.
Discussion on Results:
40 patients who completed the clinical trial were considered for assessing
the results. The above patients were divided into two groups, Group A and Group B
consisting 20 patients in each group. The cardinal signs and symptoms were
statistically analyzed before and after the trial.
In the present study it is observed that Jatamamsi Choorna along with
suitable Pathya Ahara and Vihara effectively reduced the signs and symptoms of
Essential HTN in comparison with the other group which was kept only on pathya
ahara and vihara.
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DISCUSSION 2012
Cardinal Symptoms:
Headache:
There was statistically Highly Significant change in Group A compared to
Group B with ‘p’ value 0.004 (Table no.59).
Clinically Group A patients showed better response with clinical outcome
of 75% than Group B (25%). The grade of improvement was better i.e 50% in Group
A than in Group B.
Better clinical outcome of Group A treated with Jatamamsi Choorna may
be due to its Madhura rasa, Snigdha guna and also because of its Vatahara and
Pittahara property.
Dizziness:
Group B with ‘p’ value 0.001 (Table no. 60).
of 70% than Group B (20%). The grade of improvement was better i.e. 50% in Group
A than in Group B.
be due to its Tikta, Madhura rasa, Sheeta veerya and Pittahara property.
Palpitation:
There was statistically insignificant change in Group A after the treatment
compared to Group B with ‘p’ value 1.000 (Table no. 61).
of 45% than in Group B (5%). The grade of improvement was better i.e. 40% in
Group A than in Group B.
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DISCUSSION 2012
be due to its Hridya and Balya properties.
Easy Fatigue:
Group B with ‘p’ value <0.001 (Table no. 62).
of 80% than in Group B (25%). The grade of improvement was better i.e. 55% in
Group A than in Group B.
be due to its Balya property.
Cardinal Signs:
Systolic B.P.:
There was Statistically Highly Significant change in Systolic BP in Group
A after trial compared to Group B with ‘t’ value 9.974 and ‘p’ value <0.001 (Table
no. 63).
be due to its Medhya, Tridoshhara and Rakta Doshahara and Hridya Properties; and
also its prabhava on arterial B.P.
Diastolic B.P.:
There was Statistically Highly Significant change in Diastolic BP in Group
A after trial compared to Group B with ‘t’ value 6.026 and ‘p’ value <0.001 (Table
no. 64).
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DISCUSSION 2012
be due to its Medhya, Tridoshhara and Rakta Doshahara and Hridya Properties; and
also its prabhava on arterial B.P.
Overall effect of the therapy:
When data obtained in patients of Group A was statistically compared with the data of
patients of Group B, response in patients of Group A i.e. with Jatamamsi Choorna
along with Pathya Ahara and Vihara is found to be more effective (Moderate/Marked
response: 100%, p<0.001) than in patients of Group B (30%) i.e. with only Pathya
Ahara and Vihara (Table no. 65).
Role of Jatamamsi Choorna in Samprapti Vighatana of Shonita Dushti:
Dosha:
Vata: Snigdha guna and Madhura rasa helps in Vata Shamana.
Pitta: Sheeta veerya and tikta - madhura rasa helps in Pitta Shamana.
Kapha: Tikta - kashaya rasa and katu vipaka helps in Kapha shamana.
Dushya: Tikta rasa and sheeta veerya helps in pacifying Rakta dosha.
On Manas: Through prabhava it helps in pacifying manasa dosha namely Rajas.
On Srotas: Through prabhava it modulates Sanjnavaha Srotas.
Agni: Jatamamsi Choorna causes Deepana, Pachana and Anulomana since it consists
of katu rasa and katu vipaka. This helps in improving the Jatharagni and Dhatwagni
and helps in bringing the vitiated doshas to normal form.
The schematic representation of Samprapthi and Samprapthi Vighatana of
Shonita Dushti which has shown in the Flow Chart no. 3 shows that the nidanas of
Shonita Dushti namely Aaharaja, Vihaaraja, Manasika and Anya nidanas causes
123
DISCUSSION 2012
Jatharagni and Dhatwagni mandya. It results in the Vata Pradhana Tridosha Prakopa
Rajo Guna Bahulata and Dushta Shonita affecting Sanjnavaha Srotas.
The Jatamamsi choorna because of its Katu Rasa, Katu vipaka, Laghu-
deepana-pachana-anulomaka gunas ameliorates agnimandya.
Because of Sheeta veerya and tikta - madhura rasa it pacifies Pitta
Prakopa. Because of Snigdha guna it pacifies Vata Prakopa. Through Tikta - kashaya
rasa and katu vipaka it pacifies Kapha Prakopa. Through prabhava it pacifies manasa
dosha namely Rajas and modulates Sanjnavaha Srotas. There by further prognosis of
disease process stops. Through Tikta rasa, Sheeta veerya and Rakta doshahara
property it pacifies Shonita Dushti. Thus Jatamamsi Choorna helps in the amelioration
of Shonita Dushti in terms of cardinal signs and the symptoms.
124
DISCUSSION 2012
Flow Chart No. 3: Schematic Representation of Samprapti and Samprapti

Vighatana of Shonita Dushti w.s.r. to Essential Hypertension by Jatamamsi
Choorna
NIDANA
SAMPRAPTI
VIGHATANA
AHARAJA VIHARAJA MANASIKA ANYA

KATU RASA, KATU
VIPAKA, LAGHU
GUNA, DEEPANA-
PACHANA-
AGNIDEEPANA ANULOMAKA-
JATHARAGNI & DHATWAGNI MANDYA GUNA OF
JATAMAMSI
CHOORNA
PITTA PRADHANA TRIDOSHA PRAKOPA, PACIFIES TIKTA–MADHURA RASA,

RAJO GUNA BAHULATA, DUSHTA SNIGDHAGUNA, SHEETA
VEERYA, TRIDOSHAHARA
SHONITA AFFECTING SANJNAVAHA MANASA DOSHAHARA,
SROTAS SANJNA STHAPANA,
PITTASARAKA, BALYA,
MEDHYA GUNA OF
JATAMAMSI CHOORNA
SARVA SHAREERA SANCHARA
SANGA & VIMARGA GAMANA FURTHER PROGNOSIS

OF DISEASE PROCESS
STOPS WITH THE USE
OF JATAMAMSI
CHOORNA
ADHISTANA IN SHIRAS
PACIFIES TIKTA RASA, SHEETA VEERYA

SHONITA DUSHTI AND RAKTA DOSHAHARA
PROPERTY OF JATAMAMSI
(ESSENTIAL HYPERTENSION)
CHOORNA
ROGA
UPASHAMANA
125
CONCLUSION
CONCLUSION 2012
CONCLUSION
The scientific study starts with propositions and suppositions and progress
to theory and dogmas as the problems at hand becomes clearer. Clarity is gained as
more and more trials are carried out and a comprehensive picture of the disease and
the effect of the dravya emerge.
In the present study 40 patients have been listed out divided them into 2
groups - Group A and Group B. Patients in Group A-Trial group were administered
with Jatamamsi Choorna along with pathya aahara and vihaara and patients in
Group B-Control group were kept on only pathya aahara and vihaara.
The data recorded on the observations and results:-
 It can be concluded that the highest incidence of Shonita Dushti is seen among
the male patients of 41-50yrs, most of them on mixed diet and from nuclear
family.
the patients consuming Katu rasa as dominant rasa.
the patients indulged in Akala Bhojana and Adhyashana.
the patients with Disturbed Sleep Habit.
 It can also be concluded that stress is an important causative factor in causing
Shonita Dushti since 97.5% of the patients were under Mental Stress.
the patients indulged in Less Exercise and Sedentary Life Style.
126
CONCLUSION 2012
the patients addicted to Tea, followed by Cigarette Smoking, Alcohol Intake,
Coffee and Tobacco Chewing.
 And also it can be concluded that maximum incidence of Shonita Dushti is
seen among the patients with tension and anxiety as emotional makeup.
the patients whose occupation involved with Manual Work, followed by
Sedentary Work.
the patients with Inadequate Rest during work time.
 It can also be concluded that highest incidence of Shonita Dushti is seen
among the patients with Vata Pittaja and Pitta Kaphaja prakruti.
 It can be concluded that highest incidence of Shonita Dushti is seen among the
patients with Vishama Agni.
patients with Krura Koshta.
 Again it can also be concluded that Shonita Dushti is seen in the patients with
the maximum salt intake.
patients indulged in Daihika Shrama.
patients indulged in Chinta, followed by Krodha.
 It can be concluded that highest incidence of Shonita Dushti is seen among
the patients having Ajeerna.
127
CONCLUSION 2012
patients with the lakshanas like Krodha Prachurata, Anidra and Ati Sveda;
followed by Shiroruk, Klama, Bhrama, Atidourbalya, Tamasaatidarshana and
Akshiraga.
 It can be concluded the Vata Pradhana Tridosha along with Rajo Guna
Bahulata is involved in the pathogenesis of Shonita Dushti.
patients with the Family History of HTN.
 It can also be concluded that highest incidence of Shonita Dushti is seen
among the patients with the main complaint of Easy Fatigue; followed by
Headache, Dizziness and Palpitation.
 From the signs and symptoms recorded in the present study, Shonita Dushti
can be favorably compared with Essential HTN.
 Statistical analysis of the data obtained leads to the conclusion that Jatamamsi
Choorna along with pathya aahara and vihaara is highly effective in
Samprapti vighatana of Shonita Dushti.
 It can also be concluded that Pathya aahara and vihaara (Group-B) alone
doesn’t produce results comparable to Pathya aahara vihaara along with
Jatamamsi Choorna (Group-A).
 It can therefore be concluded that ‘Jatamamsi Choorna along with Pathya
Aahara and vihaara has a significant role to play in the Samprapti vighatana
of Shonita Dushti’.
 The study has to be done on a larger sample for further exploration.
128
SUMMARY
SUMMARY 2012
SUMMARY
This dissertation work entitled “A study on Naidanika Samprapti of Shonita
Dushti w.s.r. to Essential Hypertension and its Samprapti Vighatana using Jatamamsi
Choorna” consists of 8 chapters namely Introduction, Objectives, Review of
Literature, Methodology, Observations and Results, Discussion, conclusion and
Summary.
 1st Chapter – Deals with introduction where in brief account of need and
scope for the study and the rationality behind selecting the disease.
 2nd Chapter – Deals with the 4 main Objectives of the study.
 3rd Chapter – is subdivided into 3 sub chapters namely Historical Review,
Disease Review and Drug Review.
• Historical Review – Description of blood circulation mentioned both
in Ayurvedic and modern perspectives were dealt in brief here.
• Disease Review – Description of Etymological Derivation, Nidana,
Samprapti, Rupa, Chikitsa, Pathya-Apathya and Sadhya-Asadhyata of
Shonita Dushti in both Ayurvedic as well as modern perspectives are
dealt here.
• Drug Review – In this part Botanical name, family, synonyms, habitat,
habit, chemical composition, history, useful part, dose, Guna
Panchakas, karma and other uses of the drug Jatamamsi are explained.
 4th Chapter – Deals with the methodology, the study design, source of data
and parameters for assessment.
129
SUMMARY 2012
 5th Chapter - The clinical study, observations made on study, the results of
the data drawn after the study are expressed in tables and charts and the
comparison between the groups are made statistically.
 6th Chapter - Discussion on the study topic, study design, assessment and
objectives of the study are discussed in detail here along with the observations
made during the study and the probable mode of action of the drug is
discussed.
 7th Chapter - The conclusion drawn out of the clinical study is dealt here.
 8th Chapter – The summary of the whole study is dealt here. It can therefore
be concluded that Jatamamsi Choorna along with Pathya Ahara and Vihara
forms an excellent means of Samprapti Vighatana of Shonita Dushti.
130
BIBLIOGRAPHY
&
REFERENCES
BIBLIOGRAPHIY & REFERENCES 2012
BIBLIOGRAPHY & REFERENCES
1. Harrison’s Principles of Internal Medicine. Vol. II, Naomi D.L. Fisher, Gordon
H.Williams, 16th edition, pp.2607 page no.1463
2. Davidson.Davidson’s Principles & Practice of Medicine. Edited by Nicholas A.
Boon, Nicki R. Colledge, Brian R. Walker, John A.A. Hunter. Published by
Churchill Livingstone Elsevier, 20th edition, Reprint 2006, page no-608
3. Clinical study on the effect of Takradhara in the essential hypertension :
Dr Rajshekara sanapeti.
4. Charaka samhita by Agnivesha, revised by Charaka and Dridhabala with Dipika
commentary of Chakrapanidatta, edited by Vaidya Jadavaji Trikamaji Acharya,
Chaukhamba publications, 5th edition 2001 pp. 738, page no 124
8. Vaidya Baghel MS.Research in Ayurveda-2nd edition Jamnagar:Mridu Ayurvedic
Publication and Sales;2005.pp381, page no 43, sl no 942
12. Atharvaveda, Atharva Samhita, Mantranukramya Samhita, Edition 1994,
Naga Prakashak, 10.8.43
131
13. Rigveda, Rigveda Samhita, Mandala1-10, Edited by K.L Joshi, Chaukhambha

Orientalia. 1.52.7 .
17. Charaka samhita by Agnivesha, revised by Charaka and Dridhabala with
Dipika commentary of Chakrapanidatta, edited by Vaidya Jadavaji Trikamaji
Acharya, Chaukhamba publications, 5th edition 2001 pp. 738, page no 184
21.Sushrutha, Sushrutha samhita,Nibandhasamgraha commentary of Daldanacharya
and Nyayachandrika Panchika commentary of Gayadasa, edited by Yadavji
Trikamji Acharya, Sutrasthana 21st chapter, 9 th edition, Krishnadas Achademy,
Varanasi, pp.824, Pg no: 101, Shloka no: 10
22. Bhava Mishra. Bhava prakasha commentary by Dr. K.C. Chunekar, Edited by Dr.
G.S. Pandey, published by choukhamba Bharati Academy.Reprint 2006.
khanda, karpooradi varga, 89th shloka, P.No.-240
23. Dravyagun a Vijnana Vol.II (vegetable drug), Prof. P.V. Sharma, published by
choukhamba Bharati Academy, Varanasi. Reprint 1998. Page no. 32
24. Dravyaguna Vijnana Vol.II (vegetable drug), Prof. P.V. Sharma, published by
25. Shabdakalpadruma, Raja radhakanta deva, Nag publications, New Delhi,1988.
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26. Sir monier Williams.

Acharya, Chaukhamba publications, 5th edition 2001 pp. 738, page no 124 Shloka
no 5
no 5
no 15
no 8
H. Williams, 16th edition, pp.2607 page no.1466
no 9
no 10
no 10
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37. Astanga Hridayam, by Vagbhata with commentaries of Arunadatta and
Hemadri, edited by Bhishagacharya Hari sadashiva shastri Paradakara vaidya ,
Chaukhamba publications, 9th edition, 2002 pp.956, page no.12
38. Sushrutha, Sushrutha samhita, Nibandhasamgraha commentary of
Daldanacharya and Nyayachandrika Panchika commentary of Gayadasa, edited by
Yadavji Trikamji Acharya, 9 th edition, Krishnadas Achademy, Varanasi, Pp.824,
Pg no: 103, Shloka no: 17
39. Dr. K. Nishteswar and Prof. R. H. Singh. Ayurvedic treatment for Hypertension
(High blood pressure), Krishnadas Academy Varanasi publication, 1st edition
2002, pp.87, page no 8
2002, pp.87, page no 8
2002, pp.87, page no 9,10
42. Robbins Basic Pathology. Edited by Kumar, Abbas, Fausto, Mitchel. Published by
Elsevier. 8th edition 2007, pp.946, page no 355
2002, pp.87, page no 9
44. Robbins Basic Pathology. Edited by Kumar, Abbas, Fausto, Mitchel. Published
by Elsevier. 8th edition 2007, pp.946, page no 355
no 16
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no 12
no 11
no 14
no 13
Yadavji Trikamji Acharya, Sutrasthana 21st chapter, 9 th edition, Krishnadas
Achademy, Varanasi, pp.824, Pg no: 83, Shloka no: 7
no 14
135

no 9
no 14
no 14
no 15
no 12
136

no 30
no 31
no 32
no 26
no 17
no 17
no 17
137

Acharya, Chaukhamba publications , 5th edition 2001 pp. 738, page no 127 Shloka
no 57
Acharya, Chaukhamba publications, 5th edition 2001 pp. 738, page no.386 Shloka
no 54
74. Yogaratnakara with vaidya prabha hindi commemtory,edited by Dr Indradev
Tripati, Krishnadas ayu series Varanasi, 1st edition, 1998, pp 89, p.no 375
75. Bhaishajya ratnavali ,Govinda dasji, edited by bhaishajya ratnashri Mishra , vol
2, 2009, Chaukhamba publications pp. 799 page no.76
76. Yogaratnakara with vaidya prabha hindi commemtory, edited by Dr Indradev
Tripati, Krishnadas ayu series Varanasi, 1st edition, 1998, pp 894, p.no 376
78. Bhava Mishra. Bhava prakasha commentary by Dr. K.C. Chunekar, Edited by
Dr. G.S. Pandey, published by choukhamba Bharati Academy.Reprint 2006.
Madhyama khanda, karpooradi varga, 89th shloka, P.No.-240
79. R.B. Arora, Nardostachys jatamansi – a chemical, pharmacological and clinical
appraisal, I.C.M.R., 1975, special report series no. 51
80. Mishra D, Chaturvedi RV, Tripathi SC. The fungitoxic effect of the essential oil
of the herb Nardostachys jatamansi DC. Trop Agric. 1995; 72:48-52
G.S. Pandey, published by choukhamba Bharati Academy. Reprint 2006.
138

Madhyama khanda, karpooradi varga, 89th shloka, P.No. 240
139
ANNEXURE
ANNEXURE 2012
PROFORMA FOR M.D. (AYU.) RESEARCH WORK

DEPARTMENT OF P.G. STUDIES IN ROGA NIDANA
GOVT AYURVEDA MEDICAL COLLEGE BANGALORE
Title: “A study on naidanika samprapti of Shonita Dushti w.s.r to
Essential Hypertension and its samprapti vighatana using Jatamamsi
choorna”
Guide: Dr. R.K.Hibare Scholar: Dr. Radhika T.P

Date:
Patient name: Serial no.:
Age: OPD/IPD NO.:
Sex: M/F Bed no.:
Religion: H/M/C/O DOA:
Education: UE/P/HS/PU/Gr/PG DOD:
Marital Status: M/UM/W/D Diagnosis:
Occupation:
Socio Economic Status: P/LM/M/UM/U
Family: Nuclear / Joint
Habitat: Rural / Urban / Slum
Address:
Pin:
Phone no.:
140
ANNEXURE 2012
Main Complaint (Pradhana Vedana):
Symptoms Duration
Shiroruk
Krodha Prachurata
Tamasaatidarshana
Bhrama
Atidourbalya
Akshiraga
Anidra
Klama
Buddhi Sammoha
Ati Sveda
Associated Complaints (Anubandhi vedana ):
History of Present Illness (Adyatana vyadhi vrittanta):
History of Past Illness (Poorva vyadhi vrittanta):
Treatment History (Chikitsa vrittanta):
Family History (Koutumbika vrittanta):

Members HTN DM IHD Others
Father
Mother
Brother
Sister
Others
Personal History (Vaiyuktika vrittanta):

• Diet (Ahara): Veg/Mixed
141
ANNEXURE 2012
• Dominant Rasa: M/A/L/Kt/T/Ks

• Diet Habit: Akala bhojana/Kalabhojana/Abhojana/Samashana/Adhyashana/
Vishamashana/Anashana
• Appetite: Poor/Moderate/Good
• Bowel: Regular/Irregular/Constipated …….. times/24hrs
Consistency: Hard/Semisolid/watery
• Micturition: Frequency………..times/day………times/night
Associated- Pain/Burning
• Sleep: Sound/Disturbed/Delayed
Day-………...hrs
Night-…………hrs
If disturbed: Mental strain – Present/Absent
Awakening: Yes/No
Other:
• Exercise: Less/Adequate/Excess
Regular/Irregular
Nature of exercise: Walking/Running/Yoga/Others
• Addiction: Tea/Coffee/Alcohol/Cigarette smoking/Tobacco
Chewing/Snuffing/Tranquilizers/Others
Duration- ……….yrs
Quantity-
Frequency-
• Emotional make up: Anxiety/Tension/Depression/Jolly/Sentimental/

Phobic/Normal
Occupational History:
• Nature of work- Manual/Sedentary/Labor/Sitting/Travelling/Walking/
Studying/Mental
• Hours of work- ……………./day
142
ANNEXURE 2012
……………/night
• Rest- Adequate/Inadequate/Excessive (………….hrs)
Gynaecological Hitory:
1) Menstrual History:
• Menarche-………yrs
• Menstrual Cycle- ………… days.
• Period of flow-…………days
• Other details- Regular/Irregular/Scanty/Painful/Menorrhagia/Metrorrhagia/
Dismenorrhoea/ Leucorrhoea
• Menopause-……….yrs
2) Obstetric History:
• Married life - ………….yrs
• No. of delivery –
• No. of LSCS –
• No. of abortion –
General Examination:
Built- Well/Moderate/Poor Pulse-……../min
Nourishment- Well/Moderate/Poor B.P-…………..mm of Hg
Respiratory Rate-………/min Clubbing- P/A
Tongue- Coated/Clear Height-……….cms
Nails- Pink/Pallor/Bluish Weight-………kgs
Conjunctiva- Pink/Pallor/Bluish Lymph nodes- Palpable/Not
palpable
Oedema- Foot/ankle/leg/sacral/hands/face- Pitting/Non pitting
Cyanosis- Extremities: Upper/Lower, buccal mucosa, Lips, conjunctiva
Dasha Vidha Pareeksha:

Prakruti- V/P/K/VP/PK/VK/Sama Satva - P/M/A
Vikruti - Dosha: V/P/K Satmya - P/M/A
143
ANNEXURE 2012
Dhatu: Samhanana - P/M/A
Mala: Pramana - P/M/A
Vaya – Bala/Madhyama/Vriddha
Sara - Twak/Rakta/Mamsa/Meda/Asthi/Majja/Shukra/Sarva
Vyayama Shakti-Purva kaleena: P/M/A
Adyatana: P/M/A
Aharashakti- Abhyavaharana: Purva kaleena - P/M/A
Adyatana – P/M/A
Jarana: Purva Kaleena - P/M/A
Adyatana – P/M/A
Dosha Pareeksha:
Vata:
Pitta:
Kapha:
Ashta Sthana Pareeksha:
Nadi- Mutra- Shabda-

Drik-
Mala- Jihwa- Sparsha-

Akruti-
Sroto Pareeksha:
Pranavaha srotas:
Annavaha srotas:
Udakavaha srotas:
Rasavaha srotas:
Raktavaha srotas:
Mamsavaha srotas:
Medavaha srotas:
Asthivaha srotas:
144
ANNEXURE 2012
Majjavaha srotas:
Shukravaha srotas:
Artavavaha srotas:
Pureeshavaha srotas:
Mutravaha srotas:
Swedavaha srotas:
Agni Pareeksha : Sama/Vishama/Teekshna/Manda

Koshta Pareeksha: Mridu/Madyama/Krura
Systemic Examination:
1. Cardio Vascular System:
Inspection:
• Shape of the chest – Normal/Kyphosis/Scoliosis/Others

• Apical thurst – Visible/Invisible
• J.V.Pulse – Visible/Engorged/Invisible
• J.V.Pressure – Raised/Normal
• Carotid Pulsation – Visible/Diminished/Invisible
Palpation:
• Pulse – 1) Rate – ………/min

2) Rhythm – Regular/Irregular
3) Volume – Full/Weak
4) Force –
• Apex Beat – Palpable/Not palpable

Force:
Character:
Thrill: Systolic/Diastolic/Continuous
• Carotid Pulsation – Palpable/Not palpable

Presence of thrill
Percussion:
Auscultation:
145
ANNEXURE 2012
• Heart Rate – ………/min

• Rhythm –
• Extra sounds – Split: First Heart Sound
Second Heart Sound
Murmur:
Site Intensity Character

Systolic murmur
Diastolic murmur
2. Respiratory System:
Inspection:
Palpation:
Percussion:
Auscultation:
3. Gastro Intestinal Tract:

Inspection:
Palpation:
Percussion:
Auscultation:
Nidana Panchaka:
Nidana:
Ahara Vihara Manas Other

Ati lavana Ati adana Chinta Ajeerna
Ati Kshara Bhuktva Diva Krodha Chardi vega
Ahara Praswapanam Pratighata
Ati Katu Ati atapa
Ati amla Santaapa
Ati Kulatha Shrama
Ati Masha Abhighaata
Ati Tila Adhyashana
taila
Ati Pindalu Sharat kala
Ati
Moolaka
146
ANNEXURE 2012
Ati
Nishpaava
Ati Dadhi
Ati
Teekshna,
Ushna
madya
Ati Jalaja
Mamsa
Sevana
Ati Aanupa
Mamsa
Sevana
Purva Rupa:
Rupa/Lakshana:
Rupa Duration
Shiroruk
Krodha Prachurata
Tamasaatidarshana
Bhrama
Atidourbalya
Akshiraga
Anidra
Klama
Buddhi Sammoha
Ati Sveda
Upashaya:
Anupashaya:
Samprapti Ghataka:
147
ANNEXURE 2012
• Dosha -
Vata Pitta Kapha

Shiroruk Akshiraaga Guru Gaatrata
Bhrama Krodha Prachurata
Kampa Ati Sweda
Moorcha
Tikta Amla Udgaara
• Dushya -
Rasa Rakta Asthi Majja

Ati Dourbalya Tamasaatidarshana Vaivarnya Bhrama
Guru Gaatrata Akshiraaga Moorcha
Tandra Shiroruk Tamo darshana
Dourbalya
Klama
Krodha Prachurata
• Srotas -
• Srotodushti -
• Agni -
• Udbhava Sthana -
• Sanchara Sthana -
• Adhishtana -
• Vyakta Sthana-
Assessment criteria:
• Subjective Parameters:
Parameters BT
Head ache
Dizziness
Palpitation
Fatigue
• Objective Parameters:
Parameters BT
148
ANNEXURE 2012
Blood Systolic
Pressure Diastolic
Investigations:
Parameters B. T A.T Normal value
Blood Routine Hb%
T.C
D.C N
L
E
M
B
E.S.R
R.B.S
Urine Routine Micro
Albumin
Sugar
ECG: B.T-
A.T-
Samprapti Vighatana:
1. Group A Trial Group-Jatamamsi Choorna & pathya ahara and vihara
2. Group B Control Group-Pathya Ahara & Vihara
Group A
Drug: Jatamamsi choorna Time of administration:
Dose: 1gm t.i.d Duration: 30 days
Anupana: Water Follow up:
Pathya ahara:
• Shooka varga: Shaali, Puraana Yava, Godhuma.

• Shimbi varga: Mudga, Chanaka.
• Kritaanna varga: Mudga Yusha, Laghu Anna.
• Dugdha varga: Go Dugdha.
• Shaakha varga: Kushmanda, Patola, Tanduleeyaka, Upodika, Vastuka.
149
ANNEXURE 2012
• Phala varga: Dadima, Amalaki, Draksha, Narikela.
Pathya vihara: Adequate rest, Timely intake of food.
Apathy ahara: Katu, Amla ahara, Ati lavana sevana, Dadhi, Masha, Kulatha,
Nishpava, Guru abhishyandakara ahara, Teekshna madya, Jalaja & Anupa mamsa,
Tamboola.
Apathya vihara: Divaswapna, Ati atapa sevana, Ati Shrama, Abhighata, Chardi vega
dharana, Mutra-Pureesha vega dharana.
Group B
Duration: 30 days
Pathya ahara: Same as above
Pathya vihara: Same as above
Apathya ahara: Same as above
Apathya vihara: Same as above
Observation:
Subjective parameter AT
Head Ache
Dizziness
Palpitation
Fatigue
Objective parameter BT AT
Blood Pressure Systolic
Diastolic
Pulse Rate
Signature of the PG scholar Signature of the guide
150

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“A STUDY ON NAIDANIKA SAMPRAPTI OF SHONITA DUSHTI W.S.R.

Dissertation submitted to the Rajiv Gandhi University of Health Sciences,

DEPARTMENT OF POST GRADUATE STUDIES IN ROGANIDANA

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation entitled “A STUDY ON NAIDANIKA

SAMPRAPTI OF SHONITA DUSHTI W.S.R. TO ESSENTIAL

HYPERTENSION AND ITS SAMPRAPTI VIGHATANA USING

JATAMAMSI CHOORNA” is a bonafide research work carried out by me under

of PG studies in Roganidana, Govt. Ayurvedic Medical College, Bangalore.

Date: Signature of the candidate

DEPARTMENT OF POST GRADUATE STUDIES IN ROGA NIDANA

This is to certify that the Dissertation entitled “A STUDY ON NAIDANIKA

SAMPRAPTI OF SHONITA DUSHTI W.S.R. TO ESSENTIAL

HYPERTENSION AND ITS SAMPRAPTI VIGHATANA USING

JATAMAMSI CHOORNA” is a bonafide research work done by Dr. RADHIKA

T.P. in partial fulfillment for the degree of Ayurveda Vachaspathi, Doctor of

Medicine (Ayurveda) in Roga nidana of the Rajiv Gandhi University of Health

Assessment and approval.

Date: Signature of the Guide

Place: Dr. R.K. HIBARE M.D. (Ayu)

Professor and HOD

DEPARTMENT OF POST GRADUATE STUDIES IN ROGA NIDANA

ENDORSEMENT BY THE HOD and PRINCIPAL

This is to certify that the dissertation entitled “A STUDY ON NAIDANIKA

SAMPRAPTI OF SHONITA DUSHTI W.S.R. TO ESSENTIAL

HYPERTENSION AND ITS SAMPRAPTI VIGHATANA USING

JATAMAMSI CHOORNA” is a bonafide research work done by Dr. Radhika

graduate studies in Roganidana, Government Ayurvedic Medical College, Bangalore.

Signature of the HOD Signature of the Principal

DEPARTMENT OF POST GRADUATE STUDIES IN ROGA NIDANA

DECLARATION BY THE CANDIDATE

I hereby declare that the Rajiv Gandhi University of Health Science,

in print or electronic format for academic/ research purpose.

Date: Signature of the candidate

Place: Dr. Radhika T.P.

© Rajiv Gandhi University of Health Sciences, Karnataka

By grace of Lord Mahalingeshwara and

could be accomplished smoothly and timely.

Place: Bangalore Dr. Radhika T.P.

1. A.C.E. : Angiotensin Converting Enzyme

Hypertension is the term used to describe high blood pressure. Blood

hypertension having no definable cause is designated as essential hypertension. It is

suffers from hypertension, and majority of them have essential hypertension.

The present study entitled “A Study on naidanika samprapti of Shonita

Choorna” is an attempt to evaluate the role of Jatamamsi Choorna in the Samprapti

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The present study is carried out with the following objectives:-

 To study the Naidanika Samprapti of Shonita Dushti.

 To evaluate the efficacy of Jatamamsi Choorna as a means of Samprapti

Vighatana in patients suffering from Essential Hypertension.

 To study the effect of Pathya Aahara and Vihara in Samprapti Vighatana of

Hospital of G.A.M.C.), Bangalore.

ages of 30 to 60 years were selected for the study.

Present study comprised of 40 patients divided into 2 groups, Group A

Present History, Family History, and Personal History.

Patients in Group A-were administered 1gm t.i.d. of Jatamamsi Choorna

Subjective parameters: Headache, Dizziness, Palpitation and Easy Fatigue.

Objective parameters: Systolic and Diastolic Blood Pressure.

square/Fisher Exact Test.

SL. NO. CONTENTS PAGE NO.

i. Historical Review 7-11

ii. Disease Review:

iii. Drug Review 41-44