AAMJ / Vol. 2 / Issue 6 / November – December 2016

A A M J Anveshana Ayurveda Medical Journal

www.aamj.in ISSN: 2395-4159

Case Report

Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in

Manyāsthambha w.s.r to Cervical Spondylosis - A Case Study

Jadhav Bhagyashree 1 Bhagyalaxmi K S 2 Vinay kumar K N 3 Kiran M Goud 4

A b s t r a c t

Cervical spondylosis is a common degenerative condition of the cervical spine presenting

with the complaint of neck pain, stiffness, numbness, restricted neck movements, painful

neck movements and weakness. By considering the sign and symptoms of cervical

spondylosis it can be correlated with manyāsthambha. The incidence rate of Cervical

spondylosis is 83 per 1,00,000 population and prevalence rate ranging up to 3.3 cases

per 1000 population. The line of treatment of Manyāsthambha goes in the same line of

vāta vyādhi chikitsa. Bāhya Snehana and Svedana are the two modalities of Bahirpari-

mārjana chikitsa indicated for the ailments of vātavyādhi. Hence in the present study

Nirgunḍi patra pinḍa sveda and Mardana with Kukkutānḍa was adopted as line of treat-

ment. In the present case study the above treatment was adopted for 7 days. The result

was found significant in parameters like Neck pain, Neck stiffness, restricted neck move-

ments, painful neck movements.

Key words: Manyāsthambha, Cervical Spondylosis, Mardana, Kukkutānḍa, Nirgunḍi

Patrapinḍa Sveda

1 & 2 PG Scholar, 3 Reader, 4 Professor, Department of PG Studies in Panchakarma, SKAMCH &

RC, Bangalore.

CORRESPONDING AUTHOR

Dr. JADHAV BHAGYASHREE

PG Scholar,

Department of Panchakarma,

SKAMCH & RC,

Bangalore, Karnnataka, (India).

Email: jadhavbhagyashree5@gmail.com

Jadhav et.al : Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in Manyāsthambha w.s.r to Cervical Spondylosis - A Case study

AAMJ / Vol. 2 / Issue 6 / November – December 2016 1065

INTRODUCTION

oday is the era of modernization and fast life. In

this era, human being is prone for numerous de-

generative problems, because of unwholesome life

styles, food habits and professional strain, in associa-

tion with road and traffic situation.[i] The Cervical

Spondylosis is one of the commonest degenerative, neu-

rological condition by which the major population has

been affected. By considering the signs and symptoms

of Cervical Spondylosis, it can be correlated with

Manyāsthambha which is one among vātaja nānātmaja

vyādhi [ii], the symptoms of which includes Ruk and

stambha in manya pradeśa and associated asthi and

sandhi. Due to the nidāna, the vāta doṣa gets vitiated

and takes aśraya at manya pradeśa and causes

stambha and ruja of neck. Hence, pain at manya

pradeśa and stambha of manya occurs. The stambha is

the resultant spasticity of neck muscles, which stretches

and makes neck stiff. Bāhya Snehana and Svedana are

the two modalities of Bahirparimārjana chikitsa indi-

cated for the ailments of vātavyādhi.[iii] Svedana is iden-

tified as best to relieve shoola and stambha pradhāna

vāta vyādhis. As cervical spondylosis is vāta predomi-

nant disorders, nirgunḍi patrapinḍa sveda was selected

as a modality of treatment. Nirgunḍi has vedanāsthā-

pana, śothahara, dīpana, pāchana and rasāyana

properties which are helpful for this condition. In addi-

tion to svedana Mardana with Kukkutānḍa, ajaya,

saindhava lavaṇa as a bāhya snehana was adopted.

As described by Bhavprakash which may improve the

strength of fibrous tissue increases movement and flexi-

bility of the joints and relives the pain and stiffness.

Kukkutānḍa is Uṣṇa Singdha in guṇa so it is helpful to

decrease vitiated vāta doṣa. According to modern egg

yolk strengthens the muscles. Ayurvedic approach to the

disease Manyāsthambha is to retard the degeneration

and to strengthen the Dhātus for pacifying the vāta

doṣa.

CASE REPORT

A female patient aged 53 years with a moderate built

visited panchakarma O.P.D of SKAMCH & RC Benga-

luru. She was having following complaints, pain in the

neck, stiffness in neck and headache since 1 year, Tin-

gling sensation and weakness of arms, patient was hav-

ing giddiness sometimes. Onset of pain in neck was

gradual but since last 6 months pain had aggravated

and patient was having severe pain in the movement of

neck and at rest also. All other vitals were normal.

Investigation done:

Blood test CBC, ESR, RBS, X ray of cervical spine

antero-posterior and lateral view

Reports: CBC was normal, ESR was slightly in-

creased, X ray of cervical spine showed degenera-

tive changes.

The assessment was done based on symptoms.

TREATMENT APPROACH

Nirgunḍi patrapinḍa svedana followed by

Kukkutānḍa mardana with Kukkutānḍa drava,

ajjya, saindhava lavaṇa for 7 days.

Pūrva karma:

Pottali is prepared with the nirgunḍi patra .

Kukkutānḍa drava, ajjya, lavaṇa taken in a vessel

and kept in hot water bath and should be heated till

in attains thick consistency.

Pradhāna karma:

The patient was asked to lie comfortably in prone posi-

tion with the neck and head straight and well exposed

and arms keeping under head. Then sthānika nirgunḍi

patra pinḍa was given for 15 minutes on affected area.

Then Mardana was done with the Kukkutānḍa drava for

15 min maintaining the temperature. After mardna the

part was cleaned with cloth dipped in warm water.

Paśchāt karma:

Affected part should be cleaned with the cloth.

ASSESSMENT OF RESULT

Subjective parameter:

Parameter Before treatment After treatment

Neck pain 2 0

Neck stiffness 2 0

Tingling sensation 1 0

Headache Present Absent

Objective parameter:

Parameter Before

Treatment

After

Treatment

Tenderness 2 0

Mobility of

cervical

spine

Flexion 2 0

extension 2 0

Rt.lateral

rotation 2 1

Lt.lateral

rotation 2 1

T

Jadhav et.al : Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in Manyāsthambha w.s.r to Cervical Spondylosis - A Case study

AAMJ / Vol. 2 / Issue 6 / November – December 2016 1066

DISCUSSION

Manyāsthambha is described in all the samhitas. Vari-

ous āhāraja and vihāraja, mānsika and other

vātaprakopa nidāna are mentioned in samhitas which

causes vātavyādhi. Common line of treatment

vātavyādhi is snehana and svedana. Acharya

Bhavaprakasha mentioned in bhavaprakasa.

Kukkutānḍa with its contents is heated with saindhava &

ājya(ghrita) & applied to the grīva pradeśa and the

mardana is done to pacify manya stambha. Kukkutānḍa

has snigdha guṇa, kaphahara and vātahara properties

helps in reliving the pain and provides nourishment,

lavaṇa due to its sūkśma and tīkśna properties, it helps

to pass the drug molecules in systemic circulation.

Ghrita is having madhura guṇa and vāta kapha hara

property mainly acts on rūkśata and helps in the provid-

ing nourishment. Along with this nirgunḍi patra pinḍa

svedana was given which is snigdha sveda. Nirgunḍi

has vedanāsthāpana, śothahara properties. Local hy-

perthermia produced during svedana procedure has

very vital physiological and therapeutic effect and

proved very much effective in joint degenerative condi-

tions. It improves local blood and lymphatic circulation

and thereby improving local tissue metabolism. Hyper-

thermia relaxes local musculature by physical effect of

heat and thereby reduces stiffness and spasm of para-

vertebral muscles and reduces stiffness of neck muscles

reduces pain and helps in the restricted neck move-

ments. Because of this pressure gradient on cervical

spine get reduced. Thermal and pain signals are locat-

ed in skin parallel to each other. Among these two sen-

sations the stronger one is received, which is thermal

sensation and pain sensation ceases.

CONCLUSION

The result was assessed on the basis of symptomatic

improvement using VAS. Improvement was observed in

most of the symptoms due to reduction in inflammation

and spasm provided by nirgunḍi patra pinḍa sveda and

Kukkutānḍa mardana. Degenerative joint changes be-

ing progressive and irreversible treatment, is aimed at

the relief of the symptoms and to check the disease pro-

cess and to induce regeneration if possible.

^^^^

Gradings:

Neck pain

No neck pain 0

Mild neck pain 1

Moderate neck pain 2

Severe neck pain 3

Neck stiffness

No neck stiffness 0

Mild neck stiffness 1

Moderate neck stiffness 2

Severe neck stiffness 3

Radiation of pain

No Radiation 0

Radiation to one arm occasionally 1

Radiation to one arm continuously 2

Radiation to both arm occasionally 3

Radiation to both arm continuously 4

Painful neck movements

No painful neck movements 0

Mild painful neck movements 1

Moderate painful neck movements 2

Severe painful neck movements 3

Weakness of upper limb

No Weakness of upper limb 0

Mild Weakness of upper limb 1

Moderate Weakness of upper limb 2

Severe Weakness of upper limb 3

Giddiness

No Giddiness 0

Mild Giddiness 1

Moderate Giddiness 2

Severe Giddiness 3

Right lateral rotation

Normal i.e. able to make complete right lateral rotation 0

Rotation with mild difficulty 1

Rotation with moderate difficulty 2

No rotation 3

Left lateral rotation

No Restriction I.E. Able To Touch The Interclavicular Line 0

Up To 2 Cms Difference Between The Chin And Inter-

clavicular Line 1

2.1 – 4 Cms Difference Between The Chin And Interclavi-

cular Line 2

More Than 4 Cms Difference Between The Chin And In-

terclavicular Line 3

Normal i.e. able to make complete left lateral rotation 0

Rotation with mild difficulty 1

Rotation with moderate difficulty 2

No rotation 3

Extension

No Restriction I.E. Patient Is Able To Look Up To The Ceil-

ing 0

Up To 4 Cms Difference Between The Chin And Inter-

clavicular Line 1

3.9 – 2 Cms Difference Between The Chin And Interclavi-

cular Line 2

< 2 Cms Difference Between The Chin And Interclavicular

Line 3

Jadhav et.al : Role of Nirgunḍi Patra Pinḍa Sveda and Kukkutānḍa Mardana in Manyāsthambha w.s.r to Cervical Spondylosis - A Case study

AAMJ / Vol. 2 / Issue 6 / November – December 2016 1067

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Source of Support: Nil.

Conflict of Interest: None declared

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How to cite this article: Jadhav et.al : Role of Nirgunḍi

Patra Pinḍa Sveda and Kukkutānḍa Mardana in

Manyāsthambha w.s.r to Cervical Spondylosis - A Case

Study AAMJ 2016; 6:1064 – 1067