Efficacy of traditional treatment regimen on Kati Shoola with special reference to lumbar spondylolisthesis
A 59-year-old woman, who attended the Outdoor Patients Department of Ayurvedic Teaching Hospital, Borella, for treatment of her lower back pain, was selected and admitted to the ward. She had a 9-month history of progressively increasing pain in left lower back and both buttocks, but no pain in both legs. She was an otherwise healthy farmer, capable of doing heavy work. She had no history of trauma and her symptoms have increased gradually.\nOn physical examination, prominence of the upper posterior border of the sacrum was observed on the lower back. Patient had little discomfort in buttocks on turning to the lateral side. Straight leg raising test was negative in both legs. She could flex the body forward up to 5°. Motor and sensory functions were normal in right and left legs and both deep and superficial reflexes were also normal.\nAll details of the patient including present history, past history, treatment history, dietary habits, lifestyle, and addictions were recorded before the treatment. Necessary examinations and X-rays in lumbo sacral region were done and findings were recorded. Patient was kept on a normal diet without any specific restrictions and was advised not to lift any weights. The patient was treated with four treatment regimens for 65 days. Details are as below.\nThe patient was treated for 10 days with 120 ml of decoction of Eranda Saptaka with Rasona Methi Abhaya and 30 ml of Punarnawasawaya twice a day before meals. She was also given two pills of Chandraprabha each weighing 250 mg with lukewarm water and 5 g of powder of Safufe Surinjan with honey twice a day after meals. Thirty milliliters of Nirgundi oil was applied on Kati Pradesha (lumbar region).\nDuring the next 10 days, the patient was treated internally with 120 ml of decoction of Madhu Yashtee Nisha Yugma, and 5 g each of paste of Nawarathna and Thripala Churna twice a day before meals.\nSiddhartha Taila Pichu was also carried out by soaking 20 g of cotton in 60 ml of Siddhartha Taila and keeping over Kati Pradesha for 60 minutes in the morning at 10.00 a.m. Then, in the afternoon at 2.00 p.m., 30 g of paste of Ankenda paste was applied on the lumbar region and kept on for 120 minutes.\nFor the third regimen of the treatment, patient was treated internally and externally as mentioned in the second treatment regimen. Additionally, 120 ml of decoction of Dashamula Wenivelgeta was given twice a day before meals from day 21 to day 40.\nFrom day 41 to 65, the patient was treated internally with 120 ml each of decoction of Dashamula Wenivelgeta and decoction of Punarnawashtaka twice a day before meals. Siddhartha Taila Pichu was performed as described in the second treatment regimen. Thirty grams of paste of Wellangiriya was applied on lumbar region in the afternoon at 2.00 p.m. and kept on for 120 minutes.\nAll medicines were prepared at the Pharmacy, Ayurveda Teaching Hospital, Borella, Sri Lanka, according to the Ayurvedic Pharmacopoeia, Department of Ayurveda, Sri Lanka. Decoction of Punarnawashtaka, Punarnawasawaya, pills of Chandraprabha, Thripala Churna, and Nirgundi oil were prepared according to the methods given in the classical text.[] Bhaishayja Ratnavali.\nPreparation of decoction of Dashamula Wenivelgeta\nFive grams each of roots of Dashamula, seeds of Coriandrum sativum (Dhanyaka) and stem of Coscinum fenestratum are boiled together in 1920 ml of water until the final volume is reduced to 240 ml.\nPreparation of decoction of Eranda Saptaka with Rasona Methi Abhaya\nSix grams of each of the ingredients of decoction of Eranda Sapthaka, pericarp of Terminalia chebula (Abhaya), seeds of Trigonella foenum (Methika), and bulb of Allium sativum (Rasona) are boiled together in 1920 ml of water until the final volume is reduced to 240 ml.\nPreparation of decoction of Madhu Yashtee Nisha Yugma\n8.5 g each of roots of Glycyrrhiza glabra (Madhuyashti) and Stereospermum suaveolens (Patala), stem of Coscinum fenestratum, rhizomes of Curcuma longa (Haridra), tubers of Cyperus rotandus (Mustaka), stem bark of Azadirachta indica (Nimba), and Cassia fistula (Vyadighata) are boiled together in 1920 ml of water until the final volume is reduced to 240 ml.\nPreparation of paste of Nawaratna\nFive grams of each of finely powdered seeds of Cumminum cyminum (Jeeraka), Nigella sativa (Krishna Jeeraka), Carum copticum (Ajamoda), Vernonia anthelmintica (Atavi jeeraka), Myristica fragrance (Jatiphala), fruits of Piper longum (Pippali), mace of the fruits of M. fragrance, calyx of Eugenia caryophyllus (Lavanga), stem of the G. glabra, roots of Piccorrhiza curroa (Tikta), rhizomes of Zingiber officinalis (Shunti), resins of Ferula foetida (Hingu), 130 g of finely powdered pericarp of T. chebula (Abhaya), and 65 g of finely powdered pericarp of Terminalia bellirica (Bibhitaka) are ground well, adding honey, till it becomes a fine paste.[]\nPreparation of powder of Safufe Surinjan\nForty-eight grams of roots of Colchicum luteum (Surinjan), 12 g each of seeds of C. cumminum, leaves of Cassia angustifolia (Swarnapatrika), Mentha viridis (Pudina), 36 g of pericarp of T. chebula, and 144 g of sugar candy are powdered together.\nPreparation of Safufe Surinjan\nFive hundred grams of each of the roots of Aegle marmelos (Bilva), Premna intergrifolia (Agnimantha), Oroxylum indicum (Shyonaka), Stereospermum suaveolens (Patala), Gmelina aborea (Kashmarya), Solonum melongena (Vruhathi), and Ricinus communis (Eranda), and entire plant of Alysicarpus Vaginalis (Bhumi Shalaparni), Aerava Lanata (Astmabayda), Solanum Xanthocarpum (Kantakari), Tribulus terrestris (Gokshura), and Sida cordifolia (Bala) are boiled in 92.16 l of water until the volume is reduced to 23.04 l and then filtered. 23.04 l each of extract of rhizomes of Asparagus racemosus (Shatawari), fresh cow's milk, and 5.76 l sesame oil are mixed with the above decoction and heated. Sixty grams of each of finely powdered seeds of Peucedanum graveolens (Shatapushpa), Eletteria cardamomum (Ela) and Carum copticum (Ajamoda); rock salt, stems of Santalum album (Shwetha Chandana), Pterocarpus santalinus (Rakta Chandana), and Coscinum fenestratum, roots of Withania somnifera (Vaji Gandha) and Nardostachys jatamansi (Jatamansi), rhizomes of Acorus calamus (Vacha), Alpinia galanga (Rasna), and Zingiber officinalis, entire plant of Rubia cordifolia (Manjishta), fruits of P. longum (Pippali) and Saussurea lappa (Kushta), purified Shilajatu, and rock alum (Sinhala name: Galmada) are added to the above solution. The whole mixture is heated while stirring continuously, and when it reaches “Samapaka” stage, the medicated oil is taken out from the fire, allowed to cool down, and filtered.[]\nPreparation of paste of Ankenda\nSixty milliliters of juice is extracted from leaves of Acronychia pedunculata (Ankota). Ten grams of finely powdered alum sulfate (Sphaticari) is added to it and heated until a semi-solid paste is obtained.\nPreparation of paste of Wellangiriya\nForty grams of leaves of Paramignya monophylla is ground with 5 g of rhizomes of Curcuma longa and 5 g of common salt (Samudra Lawana), till it becomes a fine paste.