1. Uttara Vasti in Male – A scientific approach
Dr.K.Siva Rama Prasad
Uttara Vasti, as Chakrapani
commented “Shrestanam” 1
“Shrestagunataya” 2, which means
the best and gives rise the best re-
sults. The Uttara Vasti is adminis-
tered through the mootra and yoni
marga. These two are of
uttramarga where as guda be-
comes “Adhra Marga” 3. Uttara
Vasti also has the Netra and
Putaka. The Uttara Vasti Netra is
called as “Pushpanetra” 4. The
pushpa refers to the “Artava” or
“Rajas” of female and to the
“Sukra” of the male. Thus the treat-
ment Uttara Vasti is used for the
Sukra and Artava diseases justifi-
able. It becomes a best treatment
in the Panchakarma.
The methods of administration
of medicament i.e. drug evolution,
drug sources and routes of drug
administration is necessary to discuss here. American Medical association (Ama) council defines
Drugs as “a comprehensive, convenient and authoritative reference book that includes informa-
tion on both old and new single entity drugs and mixtures”. This book of modern medicine refers
Charaka and Susruta as the fathers of medicine 5. The pharmacology book refers the various
routes of drug administrations. Out of those “Trans Urethral or Trans Uterine” routes are not
mentioned. They have the rest of routes and described “Trans rectal” as only enemata, but not
given any specified interest or identification to the Trans rectal route of administration of medi-
cine.
The Uttara Vasti as discussed will have an apparatus made of Uttara Vasti Netra and Putaka.
These are replaced now a day with rubber catheters such as Folley’s catheter or metallic cath-
eters.
Uttara Vasti Netra:
The types of Uttara Vasti Netra differ for male and female. The male Uttara Vasti can be
administered at any time but for female it is necessary to wait for the “Ritukala” i.e. menstruation,
as the Os is open at that time.
The sizes of Uttara Vasti Netra mentioned by Acharya is as under –
Size of the Netra Description
Male 12 cms (Anguli) resembling jasmine flower stalk,
tail of the cow,
hole equal to mustard seed (Charaka) 6
14 (Anguli) cms – (Susruta) 7
Female 10 cms (Anguli) comfortable size to pass the urethra,
hole equal to Green gram seed 8 , 9
for full grown nulli paras 4 (Anguli) cms
virgins 1 (Anguli) cm 10,11
Garbhashaya sodhana should not be performed in the virgins.
1
2. Uttara Vasti Putaka: 2. mootra Vyadhi
Putaka is a sac made up of sheep, goat 3. artava Dosha
or hog urinary bladder 12. If it is not available it 4. yonivyapat
is better to use the skin of eagle. Now a days 5. yoni shoola
for the sterile conditions to adopt we are using 6. Rajosrava (Adhika)
plastic bags. 13 7. Rajonasha
8. Akala rajopravritti
Eligible:, 14,15 9. vandhya
This is used for the people who have 10. garbhashaya Vyadhi
the following conditions; 11. placental retention
Male: Non eligible:
1. 13 varieties of mootra Dosha – Mutouksada, Prameha – as in prameha no balder is
Mutra jathara, Mutra krichra, Mutrotsanga, involved and have the “Prabhuta mutrata and
Mutra kshaya, Mutraateeta, Asteela, Avila mutrata” the uttra Vasti has no value in
Vtavasti, Ushnavata, Vtakundalika, this disease.
Raktagrandhi, Vidwighata, and Vasti Virgins – as garbhashaya shodhana
Kundalika
2. Mutra sharkara Administration time:
3. Ashmari Male: at any time after the evacuation of the
4. Vasti shoola bladder
5. Vankshana shoola Female: at the time of menstruation and at any
6. Shukra Dosha time in case of Asrigdhara and Yoni vyapat 16, 17
7. Sukraotseka Dravya:
8. Dhwajabhanga
9. Klaibya The quantity is differed as the size of
Female: urinary bladder and uterus differs. No classical
1. 13 varieties of mootra Dosha – Mutouksada, texts dealt this point better. But in practice it is
Mutra jathara, Mutra krichra, Mutrotsanga, seen approximately 2-tola i.e. 25ml of the liquid
Mutra kshaya, Mutraateeta, Asteela, is administered in to bladder and 10 to 12 ml in
Vtavasti, Ushnavata, Vtakundalika, to uterus. As snehika and Nirooha are the meth-
Raktagrandhi, Vidwighata, and Vasti ods used in regular Vasti of rectal root, in the
Kundalika same way the difference is noticed here also.
Table showing the quantities of Uttara Vasti dravya according to different Acharyas
Acharya Vasti Ashaya M/F/C Quantity Equal
measure in ml
Charaka Sneha Mutra M ½ Pala or 2-tola 25ml
Vagbhata Sneha Mutra F 1 Prakuncha 4-tola 50ml
Vagbhata Sneha Mutra C 1 Sukti or ½ pala 25ml
Susruta Sneha Mutra F hand full 25ml
Susruta Sneha (Sodhana) Mutra F double 50ml
Susruta Kwatha Mutra F 4times 100ml
Susruta Kwatha Mutra M 2 times of Female 200ml
Vagbhata Sneha Garbha F 1 pala 50ml
Vagbhata Sneha (Sodana) Garbha F 2 Pala 100ml
Vagbhata Kwatha Garbha F 2 pala 100ml
Vagbhata Kwatha (Sodana) Garbha F 4 Pala 200ml
The sodhana of the garbhashaya with Nirooha Uttara Vasti may disturb the internal
lining and also the ovaries with huge quantities. Thus for the delivered females 2 pala and
others 1 pala is administered. But if the block of the ovarian tubules is to be removed under
guided supervision the higher dose is recommended. Thus the Vagbhata promoted the
medium dose of 1 pala for every body.
2
3. Uttara Vasti according to Charaka consists of 2. glycosides
Ardhapala Sneha i.e. 2-tola (24ml) 18. This dose 3. oils fixed and volatile
is meant for the adult of the age 25 years. This 4. resins
seems to be the ultimate dose for the males. 5. oleoresins
Vagbhata mentioned one Prakuncha 6. gums
Sneha i.e. 1 pala (4-tola) is madhyama matra 19 7. tannins
in females for Uttara Vasti. Susruta also men- 8. antibacterial substances
tioned 4-tola for females and said the dose has
to be assessed by the physician by yukti 20. Alkaloids:
Other wise a hand full of the Sneha is adminis- Alkaloids are basic substances contain-
tered for the females as Uttara Vasti 21. When ing cyclic nitrogen, which are insoluble in water
the Uttara Vasti is done for the shodhana double but combine with acids to form well-defined,
the quantity is used 22. If the kwatha is used for water soluble salts e.g. morphine, atropine and
the Uttara Vasti it will be double to the Sneha emetine.
i.e. 2 prasruta (4-pala or 200ml) 23. Glycosides:
Charaka did not mention any differences These are ether-like combinations of
in Sneha quantity for male and females. It is as sugars with other organic structures. A glyco-
the same quantity of ½ pala (2-tola or 25ml). side does not form salts with acids but when
Vagbhata mentioned the Uttara Vasti pediatric heated with mineral acids it is hydrolysed to a
dose as shukti (1/2 pala or 2-tola or 25ml) 24. sugar and a nonsugar component called agly-
When the drug is discussed we have to cone or genin e.g. digoxigenin. A glycoside
understand the method of drug administration which yields glucose on acid hydrolysis is called
and its mode of action on the area where it is a glucoside e.g. strophanthin.
administered. Oils:
The drugs based on the source classi- Fixed oils:
fied as under – Fixed oils are glycerides of oleic, palm-
Mineral: itic and stearic acids. These are fats and many
Liquid paraffin, magnesium sulfate, have food value. Many fixed oils are edible and
magnesium trisilicate and kaolin. In Ayurveda are employed for cooking and as solvents, e.g.
we can consider the calyxes of metals and the peanut oil, coconut oil, olive oil. Castor oil has
compounds such as siddha Makaradhwaja. certain pharmacological actions and acts as a
Animal: purgative.
Insulin, thyroid extract, heparin, gona- Volatile oils:
dotrophins and antitoxic sera. In Ayurveda we Volatile oils are volatilised by head and
use animal products such as laksha, kapardhika possess aromas. They are also called essen-
bhasma etc. tial or flavouring oils, as aromas of plants and
Vegetable: flowers reside in the volatile oils present. Chemi-
Morphine, digosin, quinine, atropine and cally, they are not fats and are without any ca-
reserpine. Almost all the compounds we use are loric value. They contain the hydrocarbon ter-
of vegetable in origin either in the form of pene or some polymer of it, which serves as
Kwatha or Taila. diluent or a solvent for a more active compound
Synthetic: e.g. menthol in peppermint oil.
Aspirin, sulfonamides, procaine and cor- Volatile oils are used as -
ticosteroids. Synthetics are not practiced in Carminatives: for expulsion of gas from the
Ayurveda. stomach, e.g. oil of eucalyptus, asafoetida, gin-
Microorganisms: ger,
Bacteria and fungi, isolated from soil are Antiseptics: in mouthwash, pastes,
important sources of antibacterial substances Counterirritants e.g. oil of wintergreen, turpen-
(antibiotics) e.g. penicillin and bacitracin. Micro- tine oil,
organism groups also not practiced in Ayurveda. Flavouring agents e.g. oil of peppermint, and
Majorities of the drugs currently used in thera- as
peutics are synthetic in allopathic medicine. Pain relieving agents e.g. oil of clove in tooth-
Vegetable drugs: The pharmacologically ac- ache.
tive principles in vegetable drugs are
1. alkaloids,
3
4. We know the routes of administration of drugs Lipid or water solubility: High lipid solubility of
as – the non-ionised drug form favours its absorp-
1. Local tion from the gastrointestinal tract, in the same
2. Enemata (Trans rectal) (a) Evacuate enema way at the rectum and also in urinary bladder.
(b) Retention enema Concentration: Higher concentration favours
3. Oral or eternal route rapid absorption.
4. Sublingual Area of the absorbing surface and local cir-
5. Parental route culation: Drugs can be absorbed better from
a) Inhalations the small intestines than from the stomach be-
b) Injections cause of the larger surface area of the former.
1) Intra-dermal Reduction in the area of the absorbing surface,
2) Intra venous as in Uttara Vasti prolongs the absorption as it
3) Intra arterial retains for more time under sphincter control.
4) Intra thecal Physical state: Liquids are better absorbed
5) Intra peritonial than solids, and crystalloids are better absorbed
6) Intra medullary than colloids.
7) Intra articular Presence of other agents: Thus vitamin C
c) Iontophoresis (Amla varga) enhances the absorption of iron
d) Inunction or Intra dermal (Abhyanga) from the gastrointestinal tract, while phytates
Out of the above, discussed routes of ad- retard it.
ministration the Trans urethra and Trans uter- Ionization: It may be assumed for all practical
ine routes are not mentioned. There is trace evi- purposes that the mucosal lining of the bladder
dence that these routes are practiced in early is impermeable to the ionized form of a weak
days of Hippocrates. But recent researches over acid or a weak base. The weakly acidic and
the rectal route admit that these routes have basic drugs exist in two forms.
significance of their own. The unremembered A unionized component, predominantly lipid
and untouched area of the Uttara Vasti has tre- soluble, absorbed rapidly.
mendous practice in Ayurveda because of its An ionized and often water-soluble component
efficacy and stand still as milestone of Ayurvedic absorbed poorly.
knowledge. The unionized fraction can cross the cell
The different routes have advantages and membrane that contains lipid and the amount
also disadvantages. Some of the problems in of the drug, which crosses the gut wall, is de-
different routes of administrations are discussed termined by the gradient of concentration be-
as under – tween the lumen of the gut and the portal venous
GIT: Enzyme interaction blood. If the plasma concentration of a drug
Skin: Poor absorption present in a free non-ionized form is rapidly re-
Other routes: Inactivation and duced by binding with plasma proteins, the drug
non-bio suitability absorption from the gut lumen is enhanced e.g.
Trans rectal: the best route of drug salicylates.
administration and Acidic-drugs are rapidly absorbed from
accepted by Acharyas as the stomach. Basic drugs are not absorbed until
half of the treatment they reach the alkaline environment of the small
Trans urethral: activates and interfere intestine. The alkaline environment, in which the
C
ANP and CGMP major component of the drug exists in a union-
for urino genital problems ized form, facilitates their absorption.
Factors affecting drug absorption Formulation: Usually, substances like lactose,
Particle size: The particle size of sparingly sucrose, starch and calcium phosphate or lac-
soluble drugs can affect their absorption. Thus, tate are used as inert diluents in formulating
a compound that contains large aggregates of powders or tablets.
the active compound does not disintegrate eas- Absorption of a drug from various mu-
ily even on prolonged contact with mucosa cosae and its distribution within the cell is modi-
hence, is poorly absorbed. Small particle size fied by a series of membranes. The main bar-
is important for absorption. Thus, the dosage rier to the drug transport seems to reside in the
of the active drug can be reduced without los- cell membrane. Studies of the permeability of
ing efficacy simply by reducing the particle size. this membrane suggest that a lipid barrier is
4
5. present. Although the membrane also contains vation norepinephrine.
pores, only small water-soluble molecules can Drug action
pass through them. Absorption of drugs from It can be because of –
the gut occurs by -Simple diffusion: This is a Colour
bi-directional process where the rate of trans- Physical mass
fer across a membrane is proportionate to the Smell
concentration gradient. A water soluble drug of Taste
low molecular weight such as alcohol or urea Osmosis
and water (Kwatha) itself diffuse passively Adsorption
through aqueous pores of the membrane. Wa- Soothing demulcent
ter-soluble drugs with larger molecular weight Radioactivity
do not cross the membrane passively but need Radio-opacity
an active transport process for absorption. Reduction in surface tension
Drugs, which are lipid soluble (Sneha), however, Electrical charge
are mostly transferred by simple or passive dif- Acidity or alkalinity
fusion. Highly lipid soluble drugs can thus be Chelation (metals)
absorbed by this process regardless of the pH Metabolic activity
of the medium, provided the drug is able to dis- Retarding drug absorption
solve sufficiently in the intestinal fluid and reach 1) Reduction of vascularity of absorbing surface
the absorptive surface. 2) Reduction in the solubility of drug
Active transport: This is a specialized process 3) Administration of the drug in the oily solution
requiring energy and is independent of the Combination of drug with protein
physical properties of the membrane. Drugs with 4) Esterification –with weak organic acids (Amla
large molecular size need an active transport varga)
system to assist their absorption. A few synthetic 5) Implantation in non-absorbable surfaces or
drugs are absorbed by active transport because slow absorbable surfaces
of structural similarity to natural substance. 6) Inhibition of drug metabolism in liver
Drugs related to steroids, active processes that (Bhutagnipaka) by bypassing the route or MAO
are normally involved in the absorption of di- inhibitors introduction and making slow bio trans-
etary and endogenous substances might ab- formation
sorb glucose and aminoacids. Majorities of the 7) Slowing the renal excretion of the drug
drugs are not absorbed by active transport. 8) Increased protein binding of the drug in
Carrier transport is an active transport where a plasma
carrier molecule combines with a drug to be The drug administered in the Trans urethral
transported at one membrane surface and dis- route acts -
sociates from it at another surface. 1. Through nerve impulse or initiation
Pinocytosis: Another process which plays an 2. Reacting definitive concentrations in the cell
important role in unicellular organisms like Poorvakarma:
amoeba is pinocytosis, where the cell takes up The poorva karma is as that of Anuvasana
from its surroundings fluid or macromolecules Vasti karma 26. Initially Sneha Sweda has to be
but not particulate matter. The importance of performed. Then the patient asked to take bath
the phenomenon in multi cellular organisms, and food with milk 27. Then the patient will be
however, is doubtful. given Kangi with milk and
Drugs undergo a series of factors ghee 28.
such as oxidation, reduction, hydrolysis Pradhana karma:
and synthesis. Out of these the process of Patient initially instructed
oxidation has a mitochondrial enzyme to evacuate the bladder. Be-
monoamine oxidase (MAO), which causes fore initiating the Uttara
oxidative determination. Released dopam- Vasti ask the patient to lay
ine is recaptured via an active reuptake down and soft application of
mechanism and inactivated by MAO and Vata hara taila over the
COMT in a manner analogus to the inacti- genitalia 29. Because of this
procedure the penis stiffens
and easy penetrability of
Pushpa Netra (catheter) is
5
6. possible. This procedure is administered in sit- When the Sneha is inside the bladder
ting position for the males and in supine for fe- the Anuvasana Vasti vidhi (procedures) has to
males. In case of the females mutrashaya gata be performed.
Uttara Vasti either rubber catheter or Foley’s Vasti dravaya pratyagamanam:
catheter is used. Other wise for the The contents of the Vasti retain inside for more
Garbhashaya gata Uttara Vasti time if the quantity is less (25ml of Sneha) and
a standard dilatation of the os forcibly evacuated as the quantity increases to
and administration of the medi- the 200ml (Kwatha). The medicine introduced
cine is done. in to the uterus retains for much time and may
At this lecture the limita- dribble in to the vagina.
tion is for male Uttara Vasti. Complications
Thus now male Uttara Vasti is Common complications are –
dealt in detail. 1. Burning sensation and
Male urethra is approxi- 2. Bleeding.
mately 20 cms long. When the penis is stiff and If the Vasti dravya retains for more time as-
acceptable for the “Eshani” (probe) penetration, sociated with burning sensation –
in sitting position (Now a day’s supine position 1. Sodhana gana Uttara vasti
is also followed) slowly the probe is pushed in 2. Massage over the pubic region
to the urethra. 3. Introducing Eshani
The insertion of 4. Varti prayaogam through urethra or and rec-
probe is for the tum
patients those For the Vasti daha –
who have any 1. Ksheeri vriksha kashaya Uttara Vasti
obstruction or 2. Yastimadu kashaya Uttara Vasti
Mutra krichra 3. Ksheera Vasti
etc. lakshanas. Paschat karma:
Other wise for After the main procedure completed we
the treatment look for the symptoms of complications. When
Sukra or no complications are observed light meal with
klaibya, a direct either green gram or milk can be given 30. It is
catheter will preferred to give –
serve the pur- Mamsarasa in Vata Dosha
pose. When the Ksheera in Pitta Dosha
catheter passes Mudga Yusha in Kapha Dosha
deep in to the urethra it stuck at the vesico ure- As the dravya comes out on the same
thral junction. Then slowly introduce further in day 2, 3 or 4 such Uttara Vastis has to be prac-
to the urinary bladder. A small amount of the ticed 31. This procedure is followed for 3 days
residual urine is passed through the catheter subsequently 32. Give a gap of 3 days and start
and it conforms that the catheter is inside the the procedure for once again 33. The other
bladder. vyapats resembles the Anuvasana Vasti and to
be treated as the same 34.
Hypothesis of Uttara Vasti action
and conclusion
1) The urinary bladder, which is a prime ana-
tomical organ for the male Uttara Vasti, is a site
for the Apanavata and has the influence of
Swadhistana Chakra of shatchakra described
in Hatayaga Pradeepika. This Swadhistana
chakra has the 8 dala and its placement is 2nd
from the down. It lies in the linga i.e. penis. The
concurring of this chakra leads to rise the
Kundalini in the body. It is attributed to the sac-
ral plexus. This nural plexus has importance in
the Uttara Vasti.
6
7. place. And its action is over the CGMP, ANP,
BNP and CNP. The posterior wall of the blad-
der is a smooth triangular area (the Trigone of
the bladder) 38 has the capacity of absorption
and the rest of the area is placed by stretch-
able epithelia covered by thick musculature
outside.
Mechanism of bladder: -
In the region of the bladder neck at the urethro-
vesical junction, there is a complicated arrange-
ment of smooth muscle fiber slings, which en-
circle the bladder neck, and the upper part of
the urethra to form a smooth muscle sphincter.
These involuntary muscle fibers are relaxed
during micturition and the upper urethra be-
comes dilated by urine.
2) Anatomically the bladder lies in the anterio
inferior part of the pelvis. The Ureters and many
blood vessels to the bladder approaches from
posterior arised from the umbilical arteries. The
umbilical arteries have the connections to the
portal circulation 35. The lymphatics accompany
veins and drain in to lymph nodes along the in-
ternal iliac vessels 36. The micturition is under
the control of sympathetic, para sympathetic and
somatic nerve fibers. These nerve fibers de-
velop from sacral plexus as shown in figure 37.
These nural controls have specific pressure
actions and action over motor end plates of the
bladder musculature either by inhibiting or acti-
vating the Acetylcholine. Here in this process
of Uttara Vasti mainly the nural activation takes
Spirally arranged smooth muscle slings
whose function is similar to one surround the
urethra itself above.
The compressor urethrae is a voluntary
muscle situated in the layers of the triangular
ligament and its supposed function is to arrest
the passage of urine and to empty the urethra
at the end of micturition. This is sometimes
called the external sphincter as opposed to the
internal sphincter at the bladder neck. A similar
arrangement is seen in the anal canal. The
sphincteric action of this voluntary muscle is of
very small importance compared with the invol-
untary sphincter.
The anterior fibers of the pubo-rectalis
when contracted draw the vagina and urethra
forwards towards the symphysis and in this
way somewhat help to control micturition 39.
7
8. rise. Then the bladder relaxes, the pressure falls
and remains steady at a level slightly above its
previous value. In this way the bladder adjusts
its tone and prevents any considerable rise of
pressure. Since, adaptation requires a certain
length of time it is seen that if fluid is introduced
into the bladder very rapidly adaptation fails to
occur and micturition starts with a lesser filling
than normal. Experimentally, it is seen that up
to a filling of 400cc rise of tension is very slight
and tone adaptation is perfect. But beyond
400c.c pressure rises more sharply and adap-
tation fails.
This tone adaptation takes place through
the action of hypogastric nerves. Cortical cen-
ters exert a tonic inhibitory control over bladder
Mechanism of filling of bladder 40
by volitional effort hypogastric nerve may fur-
1. Introducing catheters in the bladder, con-
ther be stimulated, thus causing relaxation of
necting them with suitable manometers and
bladder. When the bladder is completely de-
studying the pressure changes. The effects
nervated it behaves exactly like an inert rubber
of rapid and slow filling of bladder can be
bg. It fails to show any power of tone adapta-
studied by introducing fluid from outside.
tion, and micturition starts much earlier than in
2. Normally, bladder becomes filled up with urine
a normal case.
coming from the two Ureters. Peristaltic waves
Intermittent rhythmic contractions of the
pass down the Ureters from the renal pelvis to
bladder wall take place during filling. As the blad-
the bladder. With each such wave a jet of urine
der is distended rhythmic contractions are set
enters the bladder. The waves travel at a speed
up reflexly.
of 20-25mm per second and with a frequency
Mechanism of impotency41
of 1-5 per minute. The higher figures are seen
In this age we began to compromise on
if the volume of urine be large (diuresis). Under
our sex life and on our relationships. Sex doesn’t
normal conditions the internal and external
come easy, it depends on health and it is not
sphincters remain tonically contracted. The
just intercourse, it is all about pleasure. Sex
opening of the Ureters also remain guarded by
achieved by keeping fit, having a good relation-
similar sphincters. These sphincters remain
ship, proper communication, eating well, fine
closed and open only when the peristaltic waves
stimulus, proper arousal perfect erection, good
arrive. In this way, bladder gradually fills up.
orgasm and timely ejaculation. Apart from all
When about 300-400cc of urine is collected
other causes of having a good sex, erection
(pressure-15-18 cm of water) the normal desire
plays an important role. The erection depends
for micturition is felt. By voluntary effort, the
upon physical, emotional and mental health.
onset of micturition can be delayed till a maxi-
Usually anxiety of fear leads to situational im-
mum of about 700-800cc of urine accumulates
potency. Therefore the major influence of stress
in the bladder (pressure about 100 cm of wa-
and depression and physical strain has to clear
ter). No further inhibition is possible beyond this
when a person is intended to have good sex. It
stage and micturition will automatically begin.
is being observed the erection is under the neuro
As the bladder fills up, two types of movements
vascular control as emotional control. Where
are seen in it. They are as follows -
chemicals are released and physically filling the
Adjustment of tone: Just like other hollow vis-
penis vessels and making hard with proper erec-
cera, bladder is capable of adjusting its tone in
tion. Erection flags when another enzyme called
such a way that, a large volume of urine may
phosphodiestreasetype type 5 (PDE5) neutral-
collect in it with relatively small increase of intra
izes the CGMP. The brain activates and releases
vesical pressure. It thus differs in its behavior
Nitric Oxide in the spongy tissues. It activates
from a rubber bag, in which the tension is di-
the enzyme Guanylate cyclase that produce
rectly proportional to the volume of its contents.
cyclic guanosine mono phosphate (CGMP). The
When a moderate quantity of fluid (50-
GMP relaxes the spongy tissues and increase
100c.c.) is introduced slowly into the bladder, C
the blood flow to the penis. The penis stiffens
the intra vesical pressure shows a temporary
8
9. as the arteries and the spongy tissues dilate 10 Charaka Siddhi 9/73-4
and squeeze the vein shunt. 11 Susruta Samhita Chikitsa 37/104-5
Osmotic overload 12 Ibid 37/107-108
The osmotic overload is witnessed due 13 Ibid 37/107-108
to the glomerular filling rate (GFR) and the tone 14 Ibid 37/125-126
and specific gravity of the medicine introduced 15 Charaka Samhita Siddhi 9/71
in to the bladder. This may disturb the Na+ and 16 Ibid 9/69
H+ concentrations in the urine. This effects the 17 Astanga Hridaya sutra 19/77-78
internal environment to alter there by the 18 Charaka Samhita Siddhi 9/59
“Anupravana bhava” of the Dosha takes place 19 Astanga Hridaya sutra 19/80
in to the bladder. The main absorption is either 20 Susruta Samhita Chikitsa 37/102
from the trigone area or the upward movement 21 Ibid 37/106
of the medicine in to the Ureters and pelvis of 22 Ibid 37/110
the Kidney. This is not certain but not to be ruled 23 Ibid 37/117
out. 24 Astanga Hridaya sutra 19/80
25 Satoskar, Kale, Bhandarkar, Pharmacology
Renal function: and Pharmacotherapeutics, 7 th edition,
The renal function and GFR is the key 1980, Popular Prakashan Pvt. Ltd., Bombay
to know the mechanism of the Uttara Vasti. In –34.pp 3-4
this the GFR has a relation to the ANP (atrial 26 Astanga Hridaya sutra 19/73
natriuretic peptide). Osmotic diuresis is pro- 27 Charaka Samhita Siddhi 9/60
duced by the administration of compounds such 28 Susruta Samhita Chikitsa 37/109
as polysaccharides that are filtered but not re- 29 Ibid 37/110
absorbed. The GFR as it is related to the ANP, 30 Ibid 37/113
BNP (brain natriuretic peptide) and CNP (third 31 Charaka Samhita Siddhi 9/64
natriuretic peptide in the brain) 42 which resemble 32 Astanga Hridaya sutra 19/81
ANP will enhance CGMP, which is a regulatory 33 Ibid 19/82
factor of the libido and erection. 34 Charaka Samhita Siddhi 9/68
Nerves contain polypeptides are found 35 W. Henry Hollinshed, Textbook of Anatomy,
on many blood vessels. The cholinergic nerves 2nd edition, 1975, Oxford & IBH publishing
also contain VIP, which produces vaso dilation. co. pp685
The increase in vaso dilation and rise of CGMP 36 Baily & Love’s, Short practice of surgery, 17th
will make a person through Uttara Vasti makes edition, 1980, ELBS., Pp 1195
them to rectify the Sukra gata Vyadhi and 37 Samson Wright, Applied Physiology, 9th edi-
klaibya. tion, 1993, pp 237
Even though we get the remarkable re- 38 G.J.Romanes, Cunnigham;s manual of
sults out of the uttra Vasti, studies are to be practical anatomy, 13th edition, pp228, 205
done under tracer techniques with radioactive 39 John Howkins, Shaw’s textbook of gynecol-
labels such as C14, H3 and S35. Then the efficacy ogy, 9th edition, 1971, pp 25
of the Uttara Vasti can be proved to the scien- 40 C.C.Chatterjee, Human Physiology, 2nd edi-
tific community. tion, 1952, pp397
41 K.S.R.Prasad, Impotency, Ayurmedline, Vol-
Reference: 2, pp 57
1 Charaka Siddhi 12/1 Chakrapani 42 William F Ganong, Review of Medical Physi-
2 Ibid 9/50 Chakrapani ology, pp 421, 543, 639, 643, 651, 653 and
3 Astanga Hridaya sutra 19/70 659
4 Charaka Siddhi 9/58
5 Satoskar, Kale, Bhandarkar, Pharmacology Female Uttara Vasti
and Pharmacotherapeutics, 7 th edition,
1980, Popular Prakashan Pvt. Ltd., Bombay
–34.pp 3
6 Charaka Siddhi 9/58
7 Susruta Samhita Chikitsa 37/101
8 Charaka Siddhi 9/72
9 Susruta Samhita Chikitsa 37/103
9