Thursday, March 15, 2018

Ayurvedic diuretics - mutrajanan aushadhiyo


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Next topic for discussion: Ayurvedic diuretics - mutrajanan aushadhiyo
Dr. Vivek: as i know Gokhru is known as a good ayurvedic herb having diuretic property. Vd.
Vd. Anand R Dugal: : If the condition is stroto avarodh due to snigdh mrudu guna then gokshuru is useful. If condition is dueto ruksha guna then sheelajeet and tail preparation is useful
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Dr. Sreedevi N, V: Ayurvedic diuretic- goksura and punarnava best known,Kokilaksa also.
Dr. Chhaya Chaudhri: Pashanbhed ...??
Dr. P S. Desai: Pashanbhed have more lithotripsic effect
Dr. Siva Kumar: Neeri kft
Dr. Hiral Khakhar: Varuna
Vd Rameshwar Dhanaji: Yavakshar shwetparpati are also good diuretic
Dr. Suhel Dalal: So many classical medicine  like Chandra prabha vati, Punarnava kwath tb, Punarnava Mandoor, Swet parpati, Gokshrafi guggulu  etc
Kwath like  Gokaharu kadha, Trun panchamoola kwath, Punarnavadi kwath, Asmarihara kwth, Varunadi kwth Etc
Aasava like Punarnavasavam, Varunasavam, Chandanasavam Etc
Syp like  Syp. Ural of vasu, Syp. Neeri of amil & Syp. Neeri Kft , Syp. Cystone himalaya &, Syp. Renalka, Syp.. Alka 5 charak, Syp.  River /smash it of gufic etc are leading brands
Vd. Hardik bhatt: Sherdi no Ras... Nariyel Pani. Are also mitrajanan.... Trunpanchmul kwath...--- darbh, kasdo, sherdimul, sarkat, shali danger mul are good diuretics...
Ayulink: Sherdi no Ras = sugarcane juice,  Nariyel Pani = coconut water 
Trunpanchmul kwath- darbh, kasdo, sherdimul, sarkat, shali danger mul are good diuretics...
The basic question is how to decide which diuretic should be used in which condition? Is there any criteria to select specific diuretic herb? Thnx
Dr Jayesh Patel: In dang area a local name is "Kurdu na bij" is also a high diuretic.
Vd. Sachin Kadlag: two terms mutra-janana and mutra-virechana should have different shades??? Some medicines can be only mutra- janana , some can be mutra-virechana or some can be both...??
Dr. Piyush Dodiwadiya: What are the effect of any ayurvedic diuretics on electrolytes
Is anyone know that whether it can cause hyponatremia or hypokalemia?
Vd. Sachin Kadlag: Gokshur is most commonly used mutravirechaka medicine . Its thorns (kantaka- कण्टक) are mainly used  in texts whole plant (पंचांग ) also said to be used. Gokshur is content of Dashmool. So its moola i.e. root is to be used If we see Charaka mahakashaya Gokshur is in mutravirechaniya mahakashaya . It is also in Shothahara mahakashaya in shothahara mahakashaya all  10 contents are same as Dashmool . so as shothagha karma if root i.e . mool is supposed  to be used  then in market what do we get root or thorns  and what are we actually using ?? There must be different shades in  indication of Gokshur roots and Gokshur thorns  ???
 Could we say mutra-janana dravya to be used in mutra-kshaya and mutravirechana dravya in obstruction of flow of urine or say in aapaana dushti /aapana pratiloma /or marga avarodhajanya aapana vata prakopa .....??? Can we say ....mutra-janana dravya has action on pakwashaya while mutra-virechana dravya has action on  Basti ...??? like Narikela udaka is said to be as basti –shodhana. we need to compile and think  on different terms related to mutra showing physiological (prakruti) and pathological (vikruti) conditions and also related to actions 
for example    बद्धमूत्र (baddha-mutra)  , सृष्ट मूत्र (shrushtha mutra ) , प्रचुर /बहु मूत्र , अल्प मूत्र 
some actions like मूत्रल (mutrala ) what it could mean exactly mutra- janana or mutra- virechana or mutra-vruddhikar. I have also one question about Ikshu (sugarcaine ) ..In Charaka su 25/40 i.e. in agreya sangraha Sugarcane juice is said to be the best in mutra-janana ... but here also is root of sugarcaine is the best or its fruit or fruit juice is best ...??
Gary Yuen: I have also seen in Caraka Su 25 the mention of iksu, and am wondering why it works. Reading some studies, a decoction (unsure of what that means) does not work as a diuretic. According to others, chewing on the cane itself is traditionally used. Other sources also mention it might not be common sugar iksu (saccharum officinarum) but kāśa (saccharum spontaneum). SUGARCANE IN THERAPEUTICS Karthikeyan, J and S. Sankar Samipillai https://pdfs.semanticscholar.org/5de5/ae8fbf061815c9ca2aa73290ec74de980376.pdf
Phytochemical profile of sugarcane and its potential health aspects
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441162
I don't think there should be a problem if one follows a strict diet according to texts. For potassium, dal and green leafy vegetables are best, plus roots and tubers. For roots and tubers, maybe traditional ones such as yam are better, potato has some but perhaps lower amounts. 
I am not sure if it is easy to define correct potassium levels. Salt is easy to adjust. For potassium, following a diet of dal, traditional green vegetables (all the ones in caraka su 27 are better than spinach, and likely much higher in potassium, maybe measured by bitterness, a majority of vegetables in su 27 too are greens, maybe meaning greens are the most important), etc. I have found that it is easy to get even the higher RDA of 4700 mg of potassium in one meal + fruit and nuts. Adjusting amounts of grains (less rice, the normal amount of rice people eat I think is from the tradition of people being kshatriyas & shudras and needing large amounts of rice). For the general modern population, I think it is better to not have that much. Adjusting diet to include more greens and dal, and potassium should be easy to get.
Slovenia Anoop S. Anand: Brihatyadi kashayam is good diuretic
Ayulink: Yes, hypothetically it seems like this.
Dr. Aksht Sapare: i think Mutrajanan is Saman Vayu(as mutrotpatti takes space in Aantra) karm n Mutravirechan is apan vayu karm.
Dr. Piyush Dodiwadiya: And I have read somewhere that poonarnava does diuresis but doesn't lowers down the BP. Is it true?
Dr. V B. Maheshwari: When there is problem in urine formation then there should use mutra janana medicines, but if you find problem in urination then mutravirechna medicines should use. Teekshan mutra virechneeya drugs cause electrolyte dis-balance, as they are loop diuretics. Mutra janan drugs, never cause electrolyte dis-balance, until taken in appropriate quantity. That's why in texts aacharya clearly mention use of teekshan veerechniya drugs should be use with caution and take medicated water regularly.
Ayulink: It is seen that most ayurveda doctors prescribe any diuretic blindly. Patient complain abt shoth - inflammation, they give punarnava, gokshur etc. But please some one explain in details, when to prescrive which mutrajanan or mutra virechak. This diuretics concept comes from modern science.
Dr. V B. Maheshwari: Poonarnava is very good diuretic as it's name says. Punar means again
Nava means new.It acts on nephrons. If u use in CRF patients it gives wonderful results.That's why aacharya used poornava mandoor in rakta alpata.It also lowers blood pressure but it's function is on nephrons only.Yes every time they did same mistakes that's why they don't get good results in every patient.First rule out cause of shotha, then only decide for drug.
Gary Yuen: And why are we not first considering the cause that makes diuretics necessary? Even if I gain 5 kg from eating restaurant food, it is easy to repair when returning to a good diet. I have noticed too a strict diet is also highly diuretic.
Dr. V B. Maheshwari: What you are saying is AYURVEDA Prime duty. स्वस्थस्य स्वास्थ्य रक्षणम... But if there are dosha imbalance then we have to use medicine. If we follow Astaahar aayatan then maximum disease will not occur.
Gary Yuen: Many are also used to street and restaurant food that is heavily salted. And are used to it so cook at home in similar ways. I do not know how salt was used in ancient times. If considered salt as an herb, will strict reduction and even intervals of no salt perform better than herbs?
Dr. V B. Maheshwari: In ancient time they used Saindhav lavan more for cooking purpose. In present time we used salt which is chemically coated. As in market you can find low sodium salt. If you start using saindhav lavan in appropriate quantity then it will act as medicine . But aarachya clearly mention use of lavan in excess quantity create complications.
Dr Anshul Bahl: Which salt you're talking about?
Dr. Vivek D. Shah: Now a days Mutrajanan ausadh n mutravirechn ausadh doesent make the major differance in day to day practice...cause in our field ptnt mostly comes after taking so many alopath diuratics like lasix etc...and pt having multiple complication with complete investigations....at that time we must hv to gv our best ayurvedic diuratics for shoth...i personly gv only *punarnva mool with yasthimdhu kshir paak* for those patient rather than to gv any ras aushadhi/metalic preaparation like chandra prabha etc....its jst my views...
 Gary Yuen: About diet, we all understand it is important but may not realize how much has changed from ancient times. I study mainly diet and because much has changed, there's much I've had to guess about. Modern foods such as peas, green beans, okra, eggplant, potato, carrot, these are possibly not very diuretic compared to what people still eat in villages. Wheat in North India is possibly like urad, a heavy food that people started to use because they needed the energy for war. Of grains, possibly gavedukha (coix lacryma-jobi) is the most diuretic with yava being 2nd. There are also other habits such as cooking herbs or foods in lots of oil that might also not have been common in ancient times. If one considers all aspect of food and the patient is willing to change anything, I think it might even be more effective than herbs. Or we can likely guess that such considerations were taken into account in older times, or they did not have our modern diet and cooking methods so they were not written about.
Dr. Siva Kumar: Want to know Mutrajanan in context of hypertension. Barely also acts as murajanak,dts y given in garbhini to relive press over bladder
Dr. Shantanandkumar: In our area two types of Barley available.can you explain
Dr. Nehal Shah: When we think about diuretic drug we should consider patient's prakriti also. I have found good results of Guduchi Satva for water retention induced oedema. With less side effects..Right sir, " anna kleda nirvahanena mutra" only kleda is filtered and formed as mutra.  Kleda vardana food has important role in urine production. It's my personal experience.
Dr. Navneeth Krishnan: Almost all in mutra sangrahaneeya are kashaya rasa.
Gary Yuen: I am not sure. If you mean pearled barley, that is like white rice and not recommended. Domesticated barley is possibly different from ancient forms. There are common 2- & 6-row varieties. 6 has less starch and more protein, now generally used only to feed animals. That may mean it is better but more difficult to cook. I have not tried. Like other grains, it also comes on other colors like black.
Dr. R Prathiban: Kashaya rasa is stambana
Dr. Pritam Veer: Mutrajanan Aushadhi -  which increase production of urine.(Mutrasya kledvaahanam ). Role of Mutra - मूत्रस्य क्लेदवहनम।।। Sanchit kled is expelled out via urine. So helps to reduce dosh dushti , aam sanchiti in body. When there is more production of  kled say for example in prameh there is increased frequency of urine. Reason is that kled sanchiti is more. It's body's reaction to expell kled. So that person urinates more.
Also kled and kaf ashraya ashrayi bhav. So when Kafa increases kled also increased.
Dr. Mrugeshkumar Patel: mutra virechaniya,mutra janan is compere  with drug act on nefron / loop?
Dr. Pritam Veer: Now we have to see prakruti of that patient. If Pitt pradhan then you can go with gokshur madhur - madhur- shit.
Shail H. Bhavsar: मुत्रवहनां स्रोतसां बस्तिमुलं वंक्ष्ण  Root of mutra vaha srotas is basti(bladder) and vankshan(groin), Damage to srotas cause, excess, scanty, obstructed, frequent, painful Urination So mutra virechaniya drugs should work on basti
Dr. P S. Desai: I think mutra Janan drugs will induce diuresis from renal And mutra virechaniy causes easy passing of urine . Like Kushamnd relaxes the bladder neck round muscle and drain the urine easily, So mutra virechaniy drugs will help in disurea
Dr. Sanjeev Gupta: Why Kushamnd relaxes the bladder neck round muscle ?Please explain it .
Dr. Maheshbhai: Yes virechaniya helps to expel out
Vd. Jignesh Thakkar: My humble view  In charak dashemani there are 3 gan 1) mutra virajaniya (which gives proper  color  to urine ) 2) mutra virechaniya which produces urine and expelling both 3) mutra sangrahaniya Which dicreases urine production. There is no different concept of mutra Janan and virechaniya We have different drugs as sukrajanan and sukravirechan ut same is not for mutra . As mutra is a mal when it is produced it should be expelled that is why there is no different drug as mutra Janan and mutra virechan. That is why mutra sangrahaniya should not  be kept as  doing collection (sangrahaniya) but doing suppression
Dr. Siva Kumar: Why gokshur is added in receipes of prameha?
Dr. Maheshbhai: Sir If there is obstruction how will it be expelled though produced well
Vd. Sachin Kadlag: If you see Charaka has explained Mutrakruccha and Prameha both in Santarpana janya vyadhi .(reference Cha. Su. 23/6  and also see 23/23 ) here in first combination one content  is gokshur (shwadanshtra ) so I feel personally Gokshura is mainly for useful when hetu is santarpana . and again charaka mentions mutrakruccha  in चिरक्षीण  and krusha rugna and there 3 different yoga are mentiones   which do tarpana there charaka even uses the term mutra- anulomana ...
Ayulink: Do we use mutra viranjaniya in practice?
Vd. Jignesh Thakkar: Hardly we are using mutra virajaniya....these drugs are coolant and  they are exerted from mutra after their metabolism....that's why it provides color to urine and cooling to mutra vaha strotas. How it works ? Kindly see details of tab.pyridium200mg of modern science it is the same pharmacology mutra virajaniya works. After taking tab.pyridium imidiately patients get elief from dysurea and burning.Same way Ayurved works but we have no ready to dispense  medicine. For that avpidak prayog is prescribed
Dr. R Prathiban: For to differentiate effect of different mutrala drugs on different region of  nephron needs experimental animal studies, to differentiate action of mutravirechaniya and mutraviranjaniya drugs experimentally we can check quantity and quality of urine output, metabolite measurement in urine, body fluid volumes etc would give lead
Vd. Jignesh Thakkar: Also I have not used if a pharma company makes it available then and then it is possible 
Dr. Bhavesh Modh: મૂત્ર વિરંજનીય  એટલે મારી દ્રષ્ટિએ... મૂત્ર માં વ્યાધિ વિકાર ને લઇ ને જે વિવર્ણતા આવે છે એને સિમ્પટોમેટીક દૂર કરનાર ગણ... વિવર્ણતા  માં લાલમૂત્ર અશ્મરીજન્ય વ્રણ ના કારણે.. અથવા અધિક પિત્ત ના કારણે પીળો  અથવા ઇન્ફેકશન  ના કારણે દુધીયો પેશાબ આવેછે. મૂત્રવિરેજનીય ગણ માં પદ્મ ની વિવિધ જાતો નો સમાવેશ  છે... 1.પદ્મ = red lotus  2.ઉત્પલ = blue waterlily  3.નલીન = ? Lotus  4.કુમુદ  = nightflowering lotus  5.સૌગન્ધિક = fragrant lotus  6.પૌણ્ડરીક =  White lotus  7.શતપત્ર - centepetal lotus   સાતેય જાત ના કમળ આજે સરળતા થી ઉપલબ્ધ  નથી... પણ એમની શીતવિર્યતા  મૂત્ર માં ઉત્પન્ન  થતી વિવર્ણતા ના કારણો  ને દૂર કરવા સક્ષમ છે  તર્કબુદ્ધિ  થી સ્વિકાર્ય થાય છે. બાકી ના ત્રણ માં મધુક  = liquorice પ્રિયંગુ =  ઘાતકી પુષ્પ છે... એના ગુણકર્મ  પણ વિચારણીય છે... પ્રશ્ન  હતો કે  મૂત્રવિરંજનીય  ગણ ના ઔષધો  burning mituration  દૂર કરે છે... કેમ કે વિવર્ણતા  માટે ના જે મૂળ  નિદાનો  છે એજ burning mituration માટે જવાબદાર  છે...
Dr. P S. Desai: As in ancient time pathology diagnosed by urine colour And drugs which removes that pathology called mutra virajaniy Means those drugs gives normal colour to urine and those drugs were useful in particular pathological condition  May be they have antibiotic effect or urine alkalizer effect and diuresis
Dr. Devesh Kumar: Corn silk also known as mutrala. Bhashama of corn silk is used by some vaidya in  mutra krucha
Croatia Branko Markovic: We use it here for mutra ashmari
Gary Yuen: How does hibiscus compare? It's one of the common herbs that I think can be taken regularly and also lowers blood pressure.
Vd. Gurumahantesh: I feel it expels kleda in prameha.
Dr. Dayanand Bothre: According to y.go.joshi a Pune based practitioner has written in their book , they use goat badiwali (big) Vajadi soups (large intenstine) for CRF patient as concept of mutroupti occure in pakvashay  (samano saman vrudhi).
Vd.Avinash Chougule: Gokshur is best bastishodak, mutravirechaniya n deepan drug
Dr. Jaya Sambhus: It really works I experienced 
Dr. Bhavin Santiago Chavda: Can gokshur is also used as  basti shodhak and deepan?
Dr. Mrugeshkumar Patel: swarjika kshar is also diuretics
Dr. Jayesh Thakkar: Am wondering other aspect mutra is mala of body and basti is important marma...overuse or excess loss and its effect...can blind use of mutrananiya result prameha eg ikshu is nidaan of prameha....then when to use mutrajaniya medicine ...is it only during mutra kshaya..using sotha is it okay...esp mutra kshaya lakshana are
Croatia Branko Markovic: As Gokshur is best according to many why lot of people use chandraprabha instead golshuradi guggulu?
Dr. Pritam Veer: Chandraprabha kalp with shilajit acts on whole urinary system. Helps to eliminate kled via urine. So for me it's drug of choice. Also it's tridosh shamak. So can be used.
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Compiled by - Dr. Dhruti Kagrana
 


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