PUTRAGNI YONIVYAPAD

🔺 CASE STUDY NO: PUTRAGNI YONIVYAPAD (पुत्रग्नि योनिव्यापद्)

(A Pitta-dominant Yonivyapad characterized by excessive heat in the yoni and habitual abortion.)

🔺 NIDANAM (ETIOLOGY / CAUSATIVE FACTORS)

• Āhārāja Hetu:

  • Teekshṇa, Ushṇa, Amla, Lāvaṇa, Kaṭu Ahāra (spicy, hot, sour, salty foods)

• Vihārāja Hetu:

  • Excessive coitus

  • Suppression of natural urges (vegadhāraṇa)

• Mānasika Hetu:

  • Mental stress, anger, emotional imbalance

• Specific to Putragni:

  • Frequent intake of Pitta-vardhaka āhāra-vihāra

  • Overuse of agni-vardhaka dravyas

Classical References:

• Charaka Saṃhitā – Cikitsā Sthāna 30/25-26

• Aṣṭāṅga Hṛdaya – Uttara Tantra 38

• Sushruta Saṃhitā – Cikitsā Sthāna

🔺 PURVAROOPAM (PREMONITORY SYMPTOMS)

• Slight burning or irritation in the yoni

• Abnormal vaginal discharge

• Discomfort during sexual intercourse

(Note: Specific purvarūpas not described; general signs considered from Yonivyapad)

🔺 LAKSHANA (SYMPTOMS / CLINICAL FEATURES)

• Yoni feels excessively hot (as if on fire)

• Burning sensation during coitus

• Repeated miscarriages or fetal loss after conception

• Painful intercourse

• Inflammation of vaginal tract

• Yellowish, foul-smelling discharge

• Pitta-related signs: burning, heat, discoloration

References:

• Charaka Saṃhitā Cikitsā 30/25–26

• Aṣṭāṅga Hṛdaya Uttara 38

🔺 GENERAL & SYSTEMIC EXAMINATION

• General Examination:

  • Pallor (due to chronic blood loss or anemia)

  • Fatigue, weight loss

  • Weakness, anxiety, irritability

• Systemic Examination:

  • Per abdomen: Lower abdominal tenderness

  • Pelvic examination:

    • Burning sensation, heat, redness

    • Vaginal ulceration or erosion

    • Vaginal inflammation and discharge

🔺 LABORATORY INVESTIGATIONS

• CBC: Check for anemia, infection

• ESR / CRP: Chronic inflammation

• Blood sugar (FBS/PPBS): Rule out diabetes

• Urinalysis: Rule out UTI

• Vaginal swab: Culture & sensitivity – rule out infections

• Pap smear: Rule out cervical lesions or malignancy

• Hormonal Profile: Estrogen, progesterone

• Thyroid Profile: T3, T4, TSH

🔺 DIFFERENTIAL DIAGNOSIS

• Pelvic Inflammatory Disease (PID)

• Cervicitis

• Vaginitis

• Endometritis

• Bacterial vaginosis

• Trichomoniasis

• Gonorrhea / Chlamydia

• Cervical erosion

• Chronic endocervicitis

• Uterine fibroids with infection

🔺 SAMPRAPTI (PATHOGENESIS)

• Due to nidana sevana → Pitta prakopa

• Pitta localizes in yoni with its teekshṇa & ushṇa gunas

• Burns the shukra/artava and uterine lining

• Embryo cannot survive → recurrent miscarriage or infertility

Samprapti Ghataka:

• Dosha: Pitta

• Dushya: Artava, Shukra, Rasa

• Srotas: Artavavaha, Yonivaha

• Adhisthāna: Yoni (reproductive organs)

• Roga Mārga: Ābhyantara

🔺 SAMANYA CHIKITSA (GENERAL MANAGEMENT)

• Pitta-shamana chikitsa: Cooling and soothing therapies

• Avoid:

  • Snehana

  • Swedana

  • Ushṇa-tīkṣṇa dravyas

• Useful Rasa Dravyas:

  • Madhura, Tikta, Kaṣāya rasa

🔺 UPASHAYA (PALLIATION / RELIEVING FACTORS)

• Use of sheetala (cooling) herbs and dravyas

• Application of ghṛita, milk, or ghee locally

• Cool baths, douches

• Abstinence from sexual activity during Pitta times

🔺 ANUPASHAYA (AGGRAVATING FACTORS)

• Hot, spicy, sour foods

• Sexual intercourse in midday/summer

• Stress, anger, anxiety

• Use of Pitta-vardhaka medicines or Panchakarma inappropriately

🔺 VISHISHTA CHIKITSA (SPECIFIC TREATMENT)

• Internal Pitta-shamana Dravyas:

  • Shatavari

  • Ashoka

  • Lodhra

  • Musta

  • Chandana

  • Ushīra

• Uttara Basti:

  • Kṣīra (milk) or ghṛita processed with Pitta-shāmaka dravyas

• Oral Medications:

  • Drākṣādi Kaṣāya

  • Chandanasava

  • Usheera-Sārivā Chūrṇa

• Local Treatments:

  • Yoni Prakṣālana: Decoctions of Triphalā, Yastimadhu, Guduchi

  • Shatadhauta Ghṛita: External application

• Pathya Āhāra-Vihāra:

  • Cold milk, ghṛita

  • Shādanga Pānīya

  • Avoid spicy, sour foods

  • Avoid heat, sun, anger