Avabahuka chikitsa dr prashanth a s

1. SHAMANA CHIKITSA IN
AVABAHUKA
DR.PRASHANTH.A.S
Professor
Department of Post Graduate Studies
in Kayachikitsa
Ayurveda Maha Vidyalaya
Hubli, Karnataka – 580024
Telephone: 0836-2335575
Mob: +91-94481-35575
Mail: drprashanthas@gmail.com
© COPYRIGHT RESERVED, Dr.Prashanth.A.S, Professor, Dept. of PG studies in KC, AMV, Hubli, KA

2. INTRODUCTION
• Avabahuka - affects Amsa Sandhi.
• Avabahuka - not mentioned in the
Nanatmaja Vata Vyadhi.
• Acharya Susruta, Vagbhata - Avabahuka a
Vata Vyadhi.
• Madhava Nidana - Amsa Shosha and
Avabahuka.
• Amsa Shosha - preliminary stage -
Sleshaka Kapha Sosha in Amsa Sandhi.
• Avabahuka - Shleshaka Kapha Sosha +
Shoola during movement, restricted
movement etc.
• Madhukosha Teeka:
– Amsa Shosha - Dhatu Kshaya i.e., Sudha
Vata Janya
– Avabahuka - Vata Kapha Janya.

3. MODERN VIEW
• Aches and pains related to
musculo-skeletal system are
common and the incidence of such
illness increases with age.
• Avabahuka can be compared to
the musculo skeletal disorders of
the shoulder girdle and brachial
plexus neuropathy.
• In allied sciences the therapeutic
aspect of management of these
disorders still remain in infancy.

4. LITERARY REVIEW
• Charaka – Bahusirshagata Vata
• Sushruta – Avabahuka
• Vagbhata – Avabahuka
• Dalhana, Arunadatta, Hemadri – analyzed
Avabahuka in detail.
• Madhava Nidana, Yoga Ratnakara –
Avabahuka.
• Madhavakara is the first to differentiate it
from bahushosha.
• Bhavamishra, Sharangadhara etc. –
Rasoushadhis in this context.
• Vangasena – Chikitsa with different
Yogas.
• Gadanigraha, Brihat NighantuRatnakara,
Nidana Sara etc. – Avabahuka with its
management.

5. NIRUKTI AND PARIBHASHA
• Avabahuka comprises of two words
'ava' and 'bahuka'.
– Ava means ‘Viyoga’ or ‘Vikratou’
which means dysfunction or
separation.
– It can be taken as deterioration or
dysfunction.
– Bahuka - (at the end of a
compound) - bahu - the arm.
– Bahuka - Muscular gender.
• Thus Avabahuka can be defined as,
– Bahustambho Avabahuka
– Bad arm, stiffness in the arm joint

6. AMSA SANDHI VIVECHANA
• This is a major joint of upper limb.
• This is one type of chala and
Ulookhala sandhi.
• This is formed by the combination
of Pragandasthi, Akshakasthi and
Amsaphalakasthi.
• Pratanavati type of Snayu cover this
sandhi.
• Shleshaka Kapha present in this
joint acts as lubricant and helps in
protection and movement of the
Sandhi.

7. AMSA SANDHI & MARMA
• The Amsa Marma - head (Murdha), neck (Greeva) and the
arm (Bahu).
• Formed by the union of Amsa Peetha (glenoid) and the
Skanda (acromio clavicular joint).
• This is a Snayu Marma to a length of half finger's width (1
cm).
• Amsa Marma consists of Mamsa, Sira, Snayu, Sandhi and
Asthi. But it is a Snayu Marma.
• It is one of Vaikalyakara Marma, any trauma to this will
produce disability or deformity of the shoulder joint.

8. NIDANA
• Bahya Hetu – causing injury to the
Marma or the region surrounding
that.
• Abhyantara Hetu – indulging in
Vata Prakopaka Nidana leading to
vitiation of Vata in that region.
– This may be again of Bahya
Abhigataja (External cause)
which manifest Vyadhi or
disease first and the other is
Dosha Prakopajanya
(Samshraya) which in turn leads
to Karmahani of Bahu.

9. SAMANYA SAMPRAPTI
Nidana
Mithya Ahara Vihara Old Age
Provocation of Vyana Vata
Sthanasamsraya in Amsa Pradesa
Sleshaka Kapha Sosha Affliction of Sira, Snayu,
Mamsa, Asthi, Kandara
Bahu Cheshta Hara
Avabahuka

10. MARMABHIGHATA SAMPRAPTI
Abhyantara Marmabhighata Bahya Marmabhighata
Amsa Marmabhighata
Affliction of Mamsa, Sira, Snayu, Asthi, Kandara
Provocation of Vata
Bahu Chesta Hara
Avabahuka

11. SAMPRAPTI GHATAKA
Udbhavasthana Amapakwashaya
Sancharasthana Rasayanis
Adhisthana Amsa Pradesha
Vyaktastana Bahu Pradesha, Amsasandhi
Dosha Vata predominant : (Vyana and Prana)
Anubandha Dosha : Kapha (Sleshaka), Pitta
Dooshya Pradhanataha: Asthi, Majja, Rakta, Mamsa.
Upadhatu Sira, Snayu, Kandara.
Agni Jataragni and respective Dhatwagnis
Ama Jatraagni mandyajanya Ama and respective Dhatwagni
Mandyajanya Ama
Srotas Asthivaha, Majjavaha srotas
Srotodusti Prakara Sanga
Roga marga Madhyama
Roga Avastha Chirakari

12. DOSHA INVOLVEMENT
 Vata Vyana: Chalagunataha Kshaya.
Vyanavayu Ruksha Gunataha Kshaya.
Prana: Karmataha Kshaya.
 Kapha Sleshakha: Dravyataha Kshaya.
Avalambaka: Supports the srotas of the kapha by
virtue of its Ambukarma
Dravyataha kshaya.
 Pitta Pitha dushti because of Asraya-
Asrayi bhava of Rakta, due to Sira,
Snayu vishosha.

13. ROOPA
• Bahu Praspandida Hara
(impaired or loss of movement of
the upper limb)
• Amsa Bandhana Shosha
(Muscle waisting) (Sushruta)
• Shoola (Pain)

14. • Avabahuka: (A.H)
• Viswachi: (A.H)
• Manya Stambha: (C.S)
• Ekanga Vata: (C.S)
• Amsa Sosha: (S.S)
SAPEKSHA NIDANA

15. • Ashtanga Hrudaya – Avabahuka Chikitsa:
• Sushruta Samhita – Avabahuka Chikitsa:
• Charaka Samhita – Bahusirsha Gata Vata:
CHIKITSA SUTRA

16. SAMANYA CHIKITSA
• Vatavyadhi – Snehana, Swedana, Mrudusamshodhana, Vasti,
Sirovasti, Nasya, etc.
• Charaka – Sthana, Dushya - Specific therapies.
• Vagbhata - Jatroordhva Vatavikaras – Nasyakarma.
• Three major approaches are made in the management of
Vatavyadhi.
– Treatment of Kevala Vata
– Treatment of Samsrusta Vata
– Treatment of Avruta Vata

17. VISHESHA CHIKITSA
• Ashtanga Hrudaya - Nasya and
Uttarabhaktika Snehapana.
• Astanga Sangraha - Navana Nasya
and Sneha Pana.
• Sushruta - Vatavyadhi Chikitsa
except Siravyadha.
• Chikitsa Sara Sangraha - Nasya,
Uttara bhaktika Snehapana and
Sweda.
• Vagbhata - Brumhana Nasya.
• Chakradatta - Nasapana.

18. LINE OF TREATMENT
Samanya
• Nidana parivarjana
• Abhyanga
• Swedana
• Uttarabhaktika Snehapana
• Nasyakarma
• Nasaapaana
• Shamanoushadhi
Vishesha
• Marmabhighata Chikitsa
‘Samprapti Vighatanameva Chikitsa’

19. SHAMANA CHIKITSA SIDDHANTA
• Vata Hara Oushadha Sevana
• Uttara Bhaktika Sneha Sevana
• Marmabhighata Chikitsa
• Brumhana Nasya
• Lepa
• Abhyanga
• Sweda
• Seka

20. Mahatwa of Uttara Bhaktika Snehapana
• Acts on Vyana and Prana Vata
Shamana
• Acts as Brumhana
• Acts on Urdhwa Jatru Gata Roga
• Does Snehana effect on Sandhi
• Acts on Sleshaka Kapha
• Acts as Snehana on Shoshita Sira,
Snayu, Mamsa, Asthi, Kandara.

21. MARMABHIGHATA CHIKITSA
• When there is Marmabhighata of Amsa Marma leading to Avabahuka prime
importance is given for Marmabhighata Chikitsa.
• Lepa – Marma Gulika mixed with Murivenna.
• Lepa – Karuttha Gulika mixed with Murivenna.
• Gandha Taila 10-20 drops internally at bed time with Prasarinyadi Ksheera
Kashaya or with Ushna Ksheera Anupana.

22. BRUMHANA NASYA
• Same like Uttara Bhaktika Sneha
Pana
• Acts as Brumhana which is
Vatahara in nature
• Acts on Urdhwa Jatru Gata Roga
• Does Snehana effect on Sandhi
• Acts as Snehana on Shoshita Sira,
Snayu, Mamsa, Asthi, Kandara.

23. LEPA
• Vatahara Lepa which are having
Brumhana, Ushna can be used.
• Vruddhadarvadi Lepa – Vatahara,
Brumhana, Ushna.
• Dasamoola Ksheera Lepa –
Brumhana, Vatahara.

24. ABHYANGA
• Abhyanga with Various Taila
mentioned for Avabahuka like
• Mahamasha Taila
• Parinatakeriksheeradi Taila
• Karpasasthyadi Taila
• Prasarinyadi Taila
• does the action of Vatahara, Brumhana,
brings Snehana effect to the Sandhi

25. SWEDANA
• Various kind of Swedana like
• Jambeera Patrapinda Sweda
• Shastika Shali Pinda Sweda
• Kukudanda Sweda
• Dasamoola, Bala Kashaya Nadi Sweda
• acts as Vatahara, Rujahara, Brumhana
• Vasodilator, Improves the circulation.

26. SEKA
• Seka with various Vatahara
Kashaya and Taila are used
in Avabahuka.
• Acts as like Abhyanga.

27. Specific Shamanoushadhi
in Avabahuka

28. • Dasamoola Bala Masha Kwatha – Chakradatta
• Ashtavarga Kwatha – Sahasrayogam
• Maharasnadi Kwatha – Sahasrayogam
• Prasarinyadi Kwatha – Sahasrayogam
• Ekanga Veera Ras – Rasarajasundara
• Vata Gajankusha Ras – Bhai.Rat
• Prasarinyadi Taila – Ash.Hru
• Ketakyaadi Taila – Sahasrayogam
• Parinatakeri Ksheeraadi Taila – Sahasrayogam
• Kaarpaasasthyaadi Taila – Sahasrayogam
• Mahaakukkudamaamsa Taila – Bhai.Rat
• Bruhat Masha Taila – Chakradatta

29. Dasamoola Bala Masha Kwatha
• Chakradatta, Vatavyadhi.25
• -
• Indicated as Pana and Nasya.
• Indicated in Avabahuka, Viswachi.
• Acts as Brumhana, Vatahara, Balya.
• Adding Sneha / Ajya in it facilitates the action
of the Kwatha.

30. Maharasnadi Kwatha

31. Maharasnadi Kwatha
• Sahasrayoga, Kashaya Prakarana
• Anupana – Sunti Ch, Pippali Ch, Yogaraja
Guggulu, Ajamodadi Ch, Eranda Taila
• Indication – Sarvanga kampa, Kubja,
Pakshaghata, Avabahuka, Grudrasi, Amavata,
Sleepada, Apatanaka, Antravrudhi, Adhmana,
Janugatavata, Ardita, Sukramaya etc.
• Acts mainly as Vatahara, Soolahara,
Srotoshodhana.

32. Ashtavargam Kwatha
• Sahasrayoga, Kashaya prakarana
• -
• Vatahara, Ushna
• Can be given with Ksheerabala (101)
• Acts as Vaso-dilator

33. Prasarinyadi Kwatha
• Sahasrayoga, Vishista Kashaya prakarana
• -
• Vatahara, Ushna, Teekshna, Brumhana, Balya
• Has vaso-dilator property.

34. Ekangaveera Ras
• Rasarajasundara, P-458
• -
• Anupana – Ardraka swarasa
• Indication – Pakshaghata, Ardita, Apabahuka,
Viswachi, Gridrasi, Vata roga, Dhanurvata

35. Vatagajankusha Ras

36. Vatagajankusha Ras
• Bhaishajya Ratnavali, Vatavyadhi.488-492
• Anupana – Pippali Ch, Manjishta Kwatha
• Indication – Gridrasi, Kroshtukasirsha,
Avabahuka, Manyastambha, Urustambha,
Pakshaghata

37. Prasarinyadi Taila
• Ashtanga Hrudaya. Chi.21/65-66
• -
• Vatahara, Ushna, Teekshna, Brumhana, Balya
• Has vaso-dilator property.

38. Parinatakeri Ksheeraadi Taila
• Sahasrayoga, Taila Prakarana
• -
• Used for Abhyanga
• Vatahara, Ushna, Brumhana
• Indicated in Avabahuka.

39. Kaarpaasasthyaadi Taila
• Sahasrayoga, Taila Prakarana
• -
• Indicated for Pana, Nasya, Abhyanga
• Indicated in Avabahuka, Pakshaghata, Ardita
• Vatahara, Ushna, Teekshna, Balya
• Prabhava – Acts on Urdhwa Jatru Vikaras.

40. Ketakyaadi Taila
• Sahasrayoga, Taila Prakarana
• -
• Vatahara, Ushna
• Indicated in Asthigata Vata
• Useful in Marmabhighata Janya Avabahuka

41. Mahaakukkudamaamsa Taila
Ingredients Indications

42. Mahaakukkudamaamsa Taila
• Bhaishajya Ratnavali, Vatavyadhi.511-520
• Indicated in almost all Vatavyadhi
• Brumhana, Balya, Vatahara

43. Bruhat Masha Taila

44. Bruhat Masha Taila
• Chakradatta, Vatavyadhi.192-196
• Used as Vasti, Abhyanga, Nasya
• Indication – Hastakampa, Shirakampa,
Bahusosha, Avabahuka, Badirya, Karnanada,
Karnasula, Visvachi etc.
• Brumhana, Vatahara, Ushna
• Prabhava – Acts on Urdhva Jatrugata Roga

45. Shamanoushadhi’s in other
conditions

46. Chakradatta
• “Moolam balaayaastvatha paaribhadraat tathaa aatmaguptaa
swarasam pibed vaa Nasyantu yo maamsarasena kuryaan
maasadasou vajra samaana baahu” (Vatavyadhi.26)
• “Baahushoshe pibet sarpir bhuktvaa kalyaanakam mahat”
(Vatavyadhi.28)
• Trayodasanga Guggulu – Gridrasi baahu prishte hanu grahe...
(Vatavyadhi.69-73)
• Narayana Tailam – Hanusthambe Manyaasthambe...
(Vatavyadhi.120-130)
• Mahanarayana Tailam – Hanugraham... (Vatavyadhi.131-140)
• Swalpamaasha Tailam – Baahuseersha gata vata...
(Vatavyadhi.154-155)

47. Bhaishajya Ratnavali
• Balaadi Kashayam – Baahushosha... (Bha.Rat.26/67)
• Yogarajaguggulu Vati – Sarvaan Vataamayaan...
(Bha.Rat.26/102-113, Sarngadhara)
• Brihat Vaata Chintaamani Ras – Vaata Rogam...
(Bha.Rat.26/141-144)
• Vaata Vidwamsa Ras – Manyaa Sthambam...
(Bha.Rat.26/178-184, Rasendra Sara Sam)
• Maashabalaadi Tailam – Hanusthambham Manyaasthambam...
(Bha.Rat.26/551-556)
• Vishagarbha Tailam – Hanusthambham Manyaasthambham...
(Bha.Rat.26/560)
• Balarishtam – Sarva Vata Roga hara... (Bha.Rat.26/572-574)

48. Ekamoolika Prayoga

49. Guggulu
• Rasa : Katu, Tikta, Kashaya
• Guna : Laghu, Sara, Vashada
• Virya : Ushna
• Vipaka : Katu
• Karma : Balya, Rasayana,
Varnya, Vatakaphahara,
Bhagnasandhanakrut,Medoh
ara
• DOSE - 2- 4 g of the drug.

50. Rasna
• Rasa: Tikta
• Guna : Guru
• Virya : Ushna
• Vipaka : Katu
• Karma : Amapacana,
Kaphavatahara
• Dose : 25 - 50 g. (Decoction)

51. Lashuna
• Rasa: Madhura, Katu
• Guna: Guru, Picchila, Sara,
Snigdha, Teekshna
• Virya: Usha
• Vipaka: Katu
• Karma: Balya, Deepana,
Hrudya, Kaphavatahara,
Raktadoshahara,
Bhagnasandhanakara,
Rasayana, Asthimamsa
Sandhankara
• Dose: 3 g of drug

52. Prasarini
• Rasa: Tikta
• Guna: Guru, Sara
• Virya: Ushna
• Vipaka: Katu
• Karma: Vatahara, Vrushya,
Balakrut, Sandhanakrut
• Dose: 2 - 4 g of drug in
powder form

53. Ashwagandha
• Rasa: Tikta, Kashaya
• Guna: Laghu
• Virya: Usha
• Vipaka: Madhura
• Karma: Rasayana,
Vatakaphahara, Balya,
Vajikarana
• Dose: 3 - 6 g of the drug in
powder form

54. Bala
• Rasa: madhura
• Guna: laghu, snigdh, pichhil
• Virya: sita
• Vipaka: madhura
• Karma: balya
• Dose: 25 - 50 g (Decoction)

55. Other Shamanoushadhi’s

56. • Kwatha : Bhadradarvadi Kwatha (S.Y)
Dhanadanayanadi Kwatha (S.Y)
Mahamanjishtadi Kwatha (S.Y)
• Rasoushadhi : Ardhangavatari Ras (R.R.S)
Amruta Sanjeevani Rasayana (R.R.S.S)
Kalakandaka Ras (R.Y.S.S.)
Mallasindoora (R.T.S.)
Yogendra Ras (B.R.)
Rasaraja Ras (B.R.)

57. • Guggulu : Shadasheeti Guggulu (Y.R.)
Simhanada Guggulu (B.R.)
• Ghrita yoga : Brihat chagaladi ghrita (B.R.)
Indukanta ghrita (S.Y.)

58. • Taila Yoga : Triteeya Prasarani Taila (Ch.D.)
Niramisha Masha Taila (B.R.)
Bala Taila (B.R.)
Madhyama Narayana Taila (B.P.)
Maha Saindavadi Taila (B.P.)
Laghu Vishagarbha Taila (Y.R.)
Visha Tinduka Taila (R.T.)
Ksheerabala Taila (S.Y.)
Balaswagandhadi Taila (S.Y.)
Dharwantharam Taila (S.Y.)

59. PERSONAL DATA OF THE PATIENT
Name : Mr. shivaputrappa.gurappanavar
Age : 42 Yrs.
Sex : Male
Religion : Hindu
Occupation : farmer
Economic status : poor
Educational status : 10th
std
Marital status : Un Married
Habitat : Rural
Address : atpost yaraguppi tal kundagol
dist dharawad
OPD No. : 9862
Date : 23 – 11 - 09

60. PRADHANA VEDANA:
• Severe Pain in the right shoulder joint (Amsa Sandhi Shoola)
since – 3 months
• Pain radiating to RUL
• Difficulty in range of movements (Stambha)
• Numbness
• Unable to carry on his daily regimen (Karmakshayakari)
ANUBANDH VEDANA:
• Chest Pain
• Bilateral knee jts pain

61. ADYATANA VYADHI VRUTTANTA:
Patient was apparently normal 3 months ago. One fine day patient fell
down with outstretched hand when he went to procure water from the
well, he had an injury to rt shoulder joint, chest, both knees etc. he had
lacerations over knees and elbow. Initially pt was administered with
nsaids and his rt shoulder jt was immobilized with figure of 8 bandage
by a local vaidya . After 4 days the condition worsened and he developed
swelling of the affected part and above mentioned complaints for which
he consulted the same person. again he was immobilized in their own
method for 20 days by which he had minimal relief. But Since from last 20
days the symptoms aggravated and pt was unable to carry on his daily
regimen for which he came to our hospital.

62. VAYUKTIKA VRUTTANTA:
Aahara : Vegetarian
Rasa satmy : Katu, Tikta, Kashaya rasa pradhana
Vihara
Nidra :poorvakalina Prakruta ( 6 – 7 hrs)
now adhyatanakalina disturbed due to pain
Vyasana : occasional smoker
TREATMENT HISTORY:
NSAID’s
Immobilization
PURVA VYADHI VRUTTANTA:
h/o Fall.

63. SAMANYA PAREEKSHA:
Ashta Sthana Pareeksha;
Nadi : 80/min.
Mala : Malabaddata
Frequency: once a day, imcomplete evacuation
Characteristics: Hard, Dry
Mootra : Prakruta,
Frequency: day – 2-3 times, Night –1-2 times
Characteristics: Normal coloured, non turbid
Jihwa : Prakruta
Shabdha : Prakruta
Sparsha : Prakruta
Drik : Prakruta
Aakruti : Madhyama

64. Dashavidha Pariksha:
Prakruti : Vatapittaja
Vikruti : Vata pradhana kapha anubanda
Sara : Madhyama
Samahanana : Madhyama
Pramana : Madhyama ( Ht: 5’2” wt – 46 kg)
Satmya : Katu, tikta, Kashaya rasa satmya
Satwa : Madhyama
Ahara shakti : Avara
Vyayama shakti : Madhyama (Now reduced)
Vayaha : Madhyama (Parihani) (42 years)

65. Vitals Examination:
Temperature : 98o
F
Pulse : 80/min.
Respiration Rate : 18/min.
Blood Pressure : 140/90 mmHg
Height : 5’2”
Weight : 46 Kgs

66. II. Motor System :
Muscle Strength : Weak on right upper extremity
Bulk of muscles : Reduced in right upper extremity
Tone of muscles : Hypotonia (Decreased in rt upper
limb)
Gait : Normal
III. Sensory System:
Pain : Pricking type of pain present
Touch : No signs of Inflammation
Joint Position : Normal

67. 2. Respiratory system
O / I : Respiration Rate – 18/min.(Regular)
O / A : Normal vesicular Breath sounds
3. C.V.S.
O / I : Pulse–80 / min,BP – 140/90 mm Hg
O / A : S1 S2 heard
4. GIT
P / A
O / I : Normal Contour
O / A : Normal Bowel sounds heard
O / P : No Organomegaly

68. SROTAS PAREEKSHA:
• Pranavaha Srotas : Prakruta
• Udakavaha Srotas : Prakruta
• Annavaha Srotas : Prakruta
• Rasavaha Srotas : Karshya
• Raktavaha Srotas : Ruja, Karshya
• Mamsavaha srotas : Atiruja
• Medovaha srotas : Prakruta
• Asthivaha Srotas : Asthi Shoola
• Majjavaha Srotas : Ruja, Stabdata
• Mutravaha Srotas : Prakruta
• Purisavaha Srotas : Malabaddata
•Swedhavaha srotas : Prakruta

69. LOCAL EXAMINATION:
1. Tenderness
Rt. Shoulder : Present
Rt. Upper Ext : Present
Chest Region : Mild ( right side)
Cervical Region : Absent
2. Numbness
Rt. Upper Ext. : Present
3. Grip Strength : Reduced
4. ROM Rt shoulder jt : Painful Adduction &
Abduction
GM Readings : Flexion 60
Elevation 50
Hyperextension 40

70. ROGA PAREEKSHA:
•Nidana : Abhighata, Vatakara Ahara, Vihara
• Roopa : Karmahaani
Shoola
Stambha
Vedana in uraha, amsa, bahu
• Upashaya : Madhura amla lavana rasa yukta ahara
Alpa Vyayama.
• Anupshaya : Vata vardhaka ahara ( ruksha,
sheeta, laghu, katu, tikta, kashaya)
Vata vardhaka vihara (atijagarana, vyayama,
vegavidharana)

72. DIAGNOSIS:
Apabahuka
SADHYA-ASADHYA:
Kastha Sadhya
VYAVACHEDAKA NIDAN:
- Ekangavata (Monoplegia)
- Vishvachi (Radio Ulnar Neuritis)
- Apabahuka (Frozen shoulder)
- Amsa shosha

73. TREATMENT GIVEN:
Amapachana with Panchakola churna 10 gms twice daily with hot
water for 2 days
1) Jambeera pinda sweda
2) Nasapaana with dasamooli balamaasha kwath 7 Days
SHAMANA:
1) Yogaraja Guggulu 500mg, Thrice daily after food along with
2) Prasarinyadi Ksheera Kashaya 40ml as Anupana for 45 Days.

74. PATHYA:
• Abyanga, svedana, mardana
• Madhura amla, lavana, snigdha padartha
APATHYA:
• Vata vardhaka ahara vihara

75. RESULT:
• Patient felt 85% improvement after 7 days of
procedures.
Assessment
GM ROM readings
Right shoulder joint : BT AT
Adduction Painful Normal
Abduction Painful Normal
Flexion 60 180
Elevation 50 180
Hyperextension 40 90

78. Dr. PRASHANTH. A. S. M.D. (Ay), (Ph.D.),
PROFESSOR
DEPARTMENT OF POST GRADUATE STUDIES IN KAYACHIKITSA
AYURVEDA MAHAVIDYALAYA, HUBLI (KARNATAKA)
Cell: 09448135575 drprashanthas@gmail.com
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Ayurveda Mahavidyalaya, Hubli

79. Ayurveda Mahavidyalaya, Hubli
Ayurveda Mahavidyalaya, Hubli