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Amavata is the most crippling of the joint diseases. It occurs throughout the world in all climates and all ethnic groups. Though all the Doshas take part in the causation of this disease, Ama and vitiated Vata play the dominant role. The clinical features of rheumatoid arthritis, such as pain, swelling, stiffness, fever, and general debility, are almost identical to that of Amavata. Treatment provides symptomatic relief, but the underlying pathology remains unchecked because of the absence of effective drugs. In the management of Amavata all the acharyas have described the sequential employment of Dipana, Amapachan, Shodhan, and Shaman therapies. For this study, 118 patients of Amavata were randomly divided into two groups. The patients in group A (50 patients) were given Matra Basti with Brihat Saindhavadi Taila along with Vatari Guggulu; the patients in group B (53 patients) were given only Vatari Guggulu. All the patients responded favorably to the treatment in both the groups; however, patients treated with Matra Basti had better relief in most of the cardinal signs and symptoms of the disease.

Amavata is a disease caused due to the vitiation or aggravation of Vayu associated with Ama. Vitiated Vayu circulates the Ama all over the body through Dhamanies, takes shelter in the Shleshma Sthana (Amashaya, Sandhi, etc.), producing symptoms such as stiffness, swelling, and tenderness in small and big joints, making a person lame. The symptoms of Amavata are identical to rheumatism, which include rheumatoid arthritis and rheumatic fever. It is observed that rheumatism is an autoimmune disorder, which is among the collagen disorders having strong and significant parlance with Amavata. Various drug trials were already carried out on Amavata, yet there is a lacuna in the management of Amavata. Hence, in the present clinical study, 28 patients were selected and kept on ‘Amrita Ghrita’. All the patients were investigated for complete blood count (CBC), rheumatoid arthritis (RA) titer, Antistreptolysin O (ASO) titer, C-reactive protein (CRP) titer, platelet count, urine routine, and microscopic, before and after treatment. The collected data was distributed according to age, sex, and prakruti, and a t-test was applied for the clinical assessment of the subjective and objective parameters of ‘Amrita Ghrita,’ and it has shown significant reduction in the positivity of the RA titer (t > 5.09, at the 0.001% level), ASO titer (t > 4.08, at the 0.001% level), and CRP titer (t > 4.82, at the 0.001% level), and weight gain (t > 5.12, at the 0.001% level), as also an increase in Hb% (t >9.22, at the 0.001% level), and platelet count (t> 5.90, at the 0.001% level), and decrease in ESR (t > 9.70, at the 0.001% level).

Diabetes mellitus is a common chronic metabolic disorder prevalent all over the world. Virechana is the Shodhana procedure that is specific for the elimination of vitiated Pitta and Kapha doshas. Thus, in the present study, the Virechana process has been selected prior to the administration of Shamana drug. Nyagrodhadi churna is mentioned in Chakradatta, which is modified into Ghana form for easy administration and dose maintenance. The present study was conducted in two groups: Group A, Nyogrodhadi Ghana vati (Shamana therapy) and Group B, Virechana and Nyogrodhadi Ghana vati (combined therapy). A total of 42 patients were registered for the present study, in which 34 patients completed the and eight patients were dropouts. After evaluating the total effect of the therapies, it was observed that the Virechana and Nyagrodhadi Ghanavati (combined therapy) provided better relief in the patients of Madhumeha in comparison with Nyagrodhadi Ghanavati (Shamana therapy) alone.

Amavata (Rheumatoid Arthritis) has been a challenging problem to the medical field. Various treatment protocols are applied in this disease with partial success. In present clinical study, 12 patients of clinically proven Amavata (Rheumatoid Arthritis) were treated with Panchamuladi Kaala Basti to evaluate its efficacy. All clinical Ayurvediya nidanadi parameters and American Rheumatism Association guidelines for Rheumatoid Arthritis were followed. Before treatment and after treatment, analysis was done and results were calculated statistically using paired ‘t’ test. Results obtained are encouraging and indicate the efficacy of Panchamuladi Kaala Basti over Amavata (Rheumatoid arthritis), exploring many aspects of this clinical entity.

Arsha (hemorrhoids) is engorgement of the hemorrhoidal venous plexus, characterized by bleeding per rectum, constipation, pain, prolapse and discharge. It is manifested due to improper diet, prolonged standing and faulty habits of defecation causing derangement of tridosha, mainly vata dosha. Vitiated dosha localizes in guda vali, pradhana dhamani and mansdhara kala and vitiates twak, mansa, meda and rakta, resulting in the annavaha sroto dushti. Modern management of arsha needs, mainly, a surgical approach, i.e. hemorrhoidectomy, wherein the result was found to be less satisfactory. In this regard, to determine a solution for satisfactory cure, the kshara sutra ligation method in arsha was studied in comparison with hemarrhoidectomy. Kshara sutra ligation in arsha was employed in 35 patients, and 26 patients were dealt with hemorrhoidectomy. The study revealed a better result of the kshara sutra ligation-treated group in comparison with hemorrhoidectomy. The observations revealed that maximum advantages like minimum hospital stay, no bleeding during or after operation, no post-operative anal stenosis, a low cost-effective and more acceptable to different categories of people, etc. were recorded in the kshara sutra-treated group. Statistically, kshara sutra ligation for arsha was found to be highly significant and effective management. No adverse effects were noted during the follow-up period.

The present study was aimed to assess the clinical effectiveness of Rasona Rasnadi Ghanavati and Simhanada Guggulu along with Rasona Rasnadi Lepa in Amavata, and to compare the effect of these two therapies in the treatment. Total 101 patients of Amavata were registered for the present study and were randomly divided into two groups. In group A- Rasona Rasnadi Ghanavati 2 Vati thrice/day was given for 3 months, while in group B- Simhanada Guggulu 2 Vati thrice a day for 3 months was adminstered. Along with this, Rasona Rasnadi Lepa was applied locally over affected joints twice daily in both groups. The effects of therapy in both groups were assessed by a specially prepared proforma. The results of the study showed that both the groups showed significant relief in symptoms; however, compared to Simhanada Guggulu, Rasona Rasnadi Ghanavati showed better result in the management of Amavata. Simhanada Guggulu or Rasona Rasnadi Ghanavati along with Rasona Rasnadi Lepa can be used as an effective ayurvedic intervention in the treatment for rheumatoid arthritis.

Sandhigata Vata is one among the 80 Nanatmaja Vata Vyadhies. Sandhigata Vata and Osteoarthritis have common symptoms, and hence, both are considered as similar entities by a majority of Ayurvedic scholars and same has been adopted here. Osteoarthritis is the most common joint disease among human beings today. In this study, a total of 116 patients were registered, out of them 101 patients had completed the full course of treatment, while 15 patients left against medical advice. The 101 patients of Sandhigata Vata were treated in two groups. Group A: In this group 50 patients of Sandhigata Vata were treated with Nirgundi Patra pinda sweda for 21 days and Ashwagandhadi Guggulu Yoga3 g/day for 45 days was given orally. Group B: In this group 51 patients of Sandhigata Vata were treated with only Ashwagandhadi Guggulu Yoga 3 g/day for 45 days. To assess the effect of the therapy objectively, all the signs and symptoms of Sandhigata Vata were given a score, depending upon their severity. Also functional tests like walking time, climbing stairs, and joint movement, were measured as a criteria for assessment. Both the groups showed good results, but Group B showed better results in comparison to group A

Amavata is described as a difficult to cure (Krichhrasadhya) disease in Ayurveda. Pain in joints with swelling is a cardinal feature of this disease. It can be correlated with rheumatoid arthritis described in modern medical science. In conventional medical science, steroids and some nonsteroidal anti-inflammatory drugs are used for its management, but they cause certain dangerous side effects in the patients. Ayurveda promises an excellent therapy for it. The present clinical trial was conducted with the same objective to provide a safe, economical and effective therapy to the patients of Amavata. The present study was conducted in 73 patients having classical symptoms of Amavata. The patients were given Vardhamana Pippali Rasayana for 15 days. Patients with any other acute or chronic systemic illness or infection were excluded from the study. The observations and results obtained were analyzed statistically applying the “t” test. All the patients experienced up to 50% relief from the signs and symptoms of Amavata after the therapy. The drug might have produced its beneficial effects in the patients of Amavata due to its Agnideepana, Amapachana, Vatashamaka and Rasayana effects in the body. A significant decrease in the erythrocyte sedimentation rate in all the patients was also noticed. All the results obtained were highly significant statistically. Thus, it can be implicated that the Vardhamana Pippali Rasayana has a lot of beneficial effects in the patients of Amavata.

‘Basti’ is compared with conventional enema due to its similarity in procedure of administration. But in effect enema is a simple evacuation technique, whereas ‘Basti’ is a therapeutic measure considered as ‘Ardha Chikitsa’ i.e half therapy in the disease management. Constitution of ‘Basti dravya’ formulation specifically ‘Aasthaapana Basti’ has a direct impact on the end result of ‘Basti’ therapy. A systematic stepwise procedure of preparation of ‘Aasthaapana Basti’ is described in Ayurvedic Classics. The present study evaluates the significance of this procedure through standardization of ‘Maadhutailika Basti’, a type and standard of ‘Aasthaapana Basti’. Four samples of ‘Aasthaapana Basti’ including the classical one were prepared for this study by replacement, exclusion and supplementation of honey in the formulation. A comparative study of physico-chemical characteristics of these samples was carried out. The stability of the constitution of ‘Maadhutailika Basti’ was also studied to assess the role of honey as a natural emulsifying agent. The study underlines the significance of the procedure described in the classics emphasizing the role of honey as a natural emulsifying agent in standardization of ‘Maadhutailika Basti’.

Grahani and Agni are having Adhara-Adheya-Sambandha. Grahani is described as an Agni Adhishthana by most of the acharyas. Mandagni is a root cause of Ama Dosha and it is the crucial factor for manifestation of most of the diseases. Among them, Grahani is the prime disease of gastro-intestinal tract and seen often in day-to-day practice. A total of 66 patients were randomly divided in three groups and treated with: A) Kalingadi Ghanavati, three vatis of 500 mg twice daily with takra, B) Tryushnadi Ghrita, 10 g twice daily before meal with lukewarm water and C) Combination of both the drugs for 14 days. An assessment was done on the basis of Rogabala, Dehabala, Agnibala, and Chetasabala. The study revealed that combination proved better results than those of individuals.

Study design:

A prospective study of 50 patients suffering from Bhagandara(Fistula in Ano) (age ranging from 18-54years) treated by Kshara sutra therapy

Place:

Kshara sutra unit, Central research Unit, Punjabi bagh, New Delhi

Duration:

January 2007 to July 2008.

Objectives:

To determine the incidence of low or high anal fistula, recurrence rate following Kshara sutra therapy and effect of Ksharasutra therapy on the Bhagandara. Material and methods: The fifty patients (50) were selected randomly in the Out Patient Department.

Study Design:

Uncontrolled open level Study.

Results:

Patients were followed to see the incidence of recurrence, effect of Kshara Sutra Therapy on incontinence. Overall recurrence rate was only 5.88 %. Minor incontinence was observed only following Kshara sutra Therapy for high variety for which no treatment was given. No such complication occurred in low variety.

Conclusion:

Bhagandara (Fistula in Ano) can be treated by Kshara Sutra Therapy with minimal loss of sphincter muscle and low reoccurrence rate.

The present study was carried out to evaluate the role of Uttar Basti in tubal blockage, in order to establish it as a safer and cost-effective Ayurvedic treatment modality. The criteria for selection of patients and assessment of results were unilateral or bilateral tubal blockage diagnosed in hysterosalpingography (HSG). A total of 16 patients in the reproductive age group were registered for the study, with 62.50% unilateral and 37.50% bilateral tubal blockage. Fifteen patients completed the course of treatment. The patients with an evidence of active infection or chronic diseases were excluded. Kumari Taila was selected for its Vata Kapha Shamaka and Lekhana properties. The dose of Uttar Basti was 5 ml with duration of two consecutive cycles (six days of Uttar Basti in each cycle with an interval of three days in between). Uttar Basti was administered, after cessation of menstruation, to the screened patients, through hematological, urinary, and serological (HIV, VDRL, HBsAg) investigations. The tubal blockage was removed in 80% of the patients, and 40% of the patients had conceived within the follow-up period of two months. The results suggest that Uttar Basti is a highly significant treatment modality for tubal blockage, with no apparent complications.

Gridhrasi can be equated with sciatica, where pain, weakness, numbness, and other discomforts along the path of the sciatic nerve often accompanies low back pain. It is a common affliction of adults, costing billions of dollars in healthcare and resulting in more lost days of work than any other illness but the common cold. A herniated disc, spinal stenosis, piriformis syndrome, etc., can all cause sciatica. The treatment available for sciatica in modern medicine is not very satisfactory.The role of research in Ayurveda is to elucidate the underlying principles and to explain them in modern parameters. The present study was aimed at establishing clinically the effect of Nirgundi (Vitex negundo) Ghan Vati (dried water extract) alone as well as in combination with Matra Basti in the management of Gridhrasi. A total of 119 patients were registered for the study, out of which 102 patients completed the treatment: 52 patients in group A (Nirgundi Ghan Vati) and 50 in group B (Nirgundi Ghan Vati + Matra Basti). The results show that both treatments had an effect on Gridhrasi, but there was better relief of the signs and symptoms in group B. Matra Basti and Nirgundi Ghan Vati might both contribute to different extents in the recovery of the patient.

Sushruta has mentioned different methods of management of diseases, such as Bheshaja karma, Kshara Karma, Agni karma, Shastrakarma and Raktamokshana. The approach of Agni karma has been mentioned in the context of diseases like Arsha, Arbuda, Bhagandar, Sira, Snayu, Asthi, Sandhigata Vata Vikaras and Gridhrasi. Gridhrasi is seen as a panic condition in the society as it is one of the burning problems, especially in the life of daily laborers. It is characterized by distinct pain starting from Sphik Pradesha (gluteal region) and goes down toward the Parshni Pratyanguli (foot region) of the affected side of leg. On the basis of symptomatology, Gridhrasi may be simulated with the disease sciatica in modern parlance. In modern medicine, the disease sciatica is managed only with potent analgesics or some sort of surgical interventions which have their own limitations and adverse effects, whereas in Ayurveda, various treatment modalities like Siravedha, Agni karma, Basti Chikitsa and palliative medicines are used successfully. Among these, Agni karma procedure seems to be more effective by providing timely relief. Shalakas for Agni karma, made up of different Dhatus like gold, silver, copper, iron, etc. for different stages of the disease conditions, have been proposed. In the present work, a comparative study of Agni karma by using iron, copper and previously studied Panchadhatu Shalaka in Gridhrashi has been conducted. A total of 22 patients were treated in three groups. Result of the entire study showed that Agni karma by Panchadhatu Shalaka provided better result in combating the symptoms, especially Ruka and Tandra, while Lauhadhatu Shalaka gave better results in combating symptoms of Spanadana and Gaurava. In the meantime, Tamradhatu Shalaka provided better effect in controlling symptoms like Toda, Stambha and Aruchi. Fifty percent patients in Panchadhatu Shalaka (Group A) were completely relieved. In Lauhadhatu Shalaka (Group B), the success rate was 00.00%, and in Tamradhatu Shalaka (Group C), the percentage of success rate was 14.28%. After analyzing the data, Tamradhatu Shalaka was found to be more effective than Lauha and Panchadhatu Shalakas.

A research trial was conducted at in-patient level to compare the efficacy of Sahacharadi taila with that of Nirgundi taila in Saisaveeyavata (Poliomyelitis). Forty cases were selected for the trial and grouped into two at random and treated with Sahacharadi taila and Nirgundi taila respectively. Results in both groups were highly encouraging and statistically significant. The study also revealed that 25% of patients had undergone Polio vaccination and it was not helpful to prevent the disease.

Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA), which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when intervention is started in its early stages. Niruha basthi with Balaguduchyadi yoga, combined by Shamana treatment with Rasnerandadi kwatha and Simhanada guggulu have been found effective in curbing its progression. This article presents a single case report in which these treatments achieved considerable success.

Fistula in ano is treated conventionally, by using the surgical techniques like fistulectomy or fistulotomy. In this practice of surgery there are many complications like delayed healing and stenosis or incontinence. The period of convalescence is also long. But after the advent of ‘Kshara Sutra’ for the treatment of fistula in ano, the complications he reduced to negligible level. It has become a boon to the patients of fistula in ano. But still the quest is continuing to improve the efficacy of Kshara sutra , to make it more acceptable, of late Kshara sutra  is being prepared in different ways of changing materials used for preparation, One such modification of Kshara sutra  is preparing it by the use of latex expressed form the tender fruit of papaya. The advantages of this thread are low corrosiveness, less pain and speed cutting besides easy availability.

Bhagandara (Fistula in Ano) at modern parlance is a common anorectal condition prevalent in the populations worldwide and its prevalence is second highest after Arsha (hemorrhoids). Kshara Sutra (K.S.) is one of the chief modality in the treatment of Bhagandara in Ayurvedic science. Exploration of the new plants for the preparation of Kshara as a better substitute to Apamarga Kshara is the need of the hour. To find out an effective alternative to Apamarga K.S. in view of easy processing, a Snuhi Ksheera Sutra without any Kshara and the Tilanala K.S. were opted for their clinical evaluation. Total 33 cases of Bhagandara were divided randomly into 3 groups, having 11 patients in each group. In Group A, Snuhi Ksheera Sutra; in Group B, Tilanala K.S. and in Group C, Apamarga K.S. were used. Assessment was done on objective (Unit Cutting Time - UCT) and subjective parameters. Statistically insignificant difference was observed in the efficacy of treatment by subjective parameters like pain, discharge, etc. between the three groups. It was found that Tilanala K.S. showed higher UCT (9.76 days) while lower in Snuhi Ksheera Sutra (7.42 days) as compared to Apamarga K.S. (8.82 days). Thus Tilanala K.S. can be used as a substitute for Apamarga K.S. and Snuhi Ksheera Sutra can be employed in the recurrent fibrosed cases of Bhagandara.

Traditional Medicine has its own importance for the treatment of various medical and surgical diseases irrespective of tremendous development of modern medicine. There are number of diseases were after repeated surgery. Fistula-in ano is one such condition which is prone to recurrence even after repeated surgery and can be effectively treated by Ayurvedic medicines. An extensive work has been done on the treatment of Bhagandara by Kshara sutra exploring various aspects of the problem and finding our the solution to them1. the present study is related to similar type of medicated thread known as Aragvadadi Sutra which has been mentioned by sushruta in Bhagandara. It consists of Aragvadha (Cassia fistula), Haridra (Curcuma longa), Agaru (Aquilaria agalocha), Madhu (Honey) and Ghrita (Ghee). This is the first non-caustic thread being tried on different types of Bhagandara. Especially it is a painless thread, non-irritant and very useful in sensitive patients like children, females and elders.

Authentic Ayurvedic texts mention eleven types of Shiro Roga (diseases in head). Kaphaja Shirsha Shoola, which occurs due to vitiation of Kapha and Vata Dosha, is one of them. Chronic sinusitis is a chronic inflammation of sinuses. It can be correlated with Kaphaja Shirsha Shoola. Decoction of Pitawakka Navaya consists of nine ingredients. They are Bhoomyamalaka, Haritaki, Bharangi, Chavya, Pippali, Salarka, Guduchi, Shunti and Maricha. These herbs, which pacify vitiated Vata Dosha and Kapha Dosha, are used by traditional physicians in Sri Lanka to treat Kaphaja Shirsha Shoola (chronic sinusitis). However, no scientific studies have been conducted to evaluate the efficacy of Pitawakka Navaya in treatment of Kaphaja Shirsha Shoola. Hence, this clinical study has been conducted to evaluate its efficacy.. Sixty patients suffering from Kaphaja Shirsha Shoola were selected and examined. These patients were randomly divided into two groups of thirty patients each. First group was treated with 120 ml of decoction of Pitawakka Navaya twice a day for fourteen days. The second group was treated with 120 ml of placebo twice a day for fourteen days. After treatment, most of the patients’ symptoms were completely or partially relieved. In less than 10% of patients, some symptoms were unchanged or aggravated. It is observed that traditional decoction Pitawakka Navaya is beneficial for Kaphaja Shirsha Shoola (chronic sinusitis).

A clinical trial was carried out on 30 patients of Amlapitta aged between 20 to 35 years with complaints of Avipaka, hrit-kanthadaha, tikta-amlodgara, utklesa, udarasula, adhmana and aruchi, who were registered from OPD and IPD of Gopabandhu Ayurveda Mahavidyalaya, Puri. They were equally divided into three groups Chincha kshara, Kadali kshara and placebo (who were administered with fresh wheat powder) for 30 days in a dose of 500 mg thrice daily with water. Investigations was done in order to exclude upper gastrointestinal tract ulcer, carcinoma in stomach, cholecystitis, carcinoma gall bladder, and heart diseases. The clinical assessments were carried out on the 30th day by subjective and objective parameters and it was inferred that both Chincha kshara and Kadali kshara were effective and reduced the symptoms of amlapitta. Chincha kshara was found to be more effective than Kadali kshara. The study shows the effect of Chincha and Kadali kshara which led to cure in 4(40%) and 3(30%) patients respectively, and maximum improvement in 4(40%) and 5(50%) patients affected with amlapitta disease, respectively. No untoward effect was noticed due to administration of ksharas during the clinical trial period.

In the context of Bhagna (fractures), Chikitsa sthana of Sushruta Samhita, a classical treatise of Ayurveda the entire protocol for management of different kinds of injuries is elaborated. Manjisthadi Lepa according to the mode of application either Ushna or Sita can facilitate the healing of soft tissue injury like Deep vein thrombosis, Cellutitis, Synovitis and Thrombophlebitis. It is proposed that symptomatic relief can be achieved with Sheeta Lepa in Acute conditions of Abhighata (injury)were Rakta and Pitta are mainly vitiated and UshnaLepa in Chronic conditions were Vata Kapha are vitiated.

Basti therapy is used widely for treatment of various diseases in the field of Ayurveda with several proven clinical applications, however; the exact mechanism through which the benefits are obtained are yet to be ascertained in the light of the contemporary developments in clinical science. It is also not clear that when administered Basti the active principles in the formulation gain entry in to the systemic circulation or not. The present study was planned to acquire some preliminary data with regards to the absorption of phytochemical constituents of the formulations when administered in the form of Basti. Gallic acid was used as marker compound and it's absorption in systemic circulation was assessed using high performance liquid chromatography. Gallic acid present in Lekhana Basti (Emaciating/ Desiccating Medicated Enema) was found to get absorbed in to systemic circulation. Maximum concentration in serum was seen in the animal which received Lekhana Basti with Prakshepa Dravya ( Catalytic Adjuvant) in comparison to animal which received Lekhana Basti without Prakshepa Dravya. Area under curve in chromatogram was also more in animal which received Lekhana Basti with Prakshepa Dravya. From primary evidence created by HPLC study it can be said that, phytochemicals of the Basti formulation do get absorbed in systemic circulation.

Osteoporosis is a systemic disorder that affects entire skeleton, which is a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of the skeleton, leading to enhanced bone fragility and a consequent increase in fracture risk. In Ayurveda, it can be correlated with Asthi-Majjakshaya. Basti (therapeutic enema) is the prime therapy for Asthi related diseases and Asthi Shrinkhala (Cissus quadrangularis) is the drug which is being used for strengthening of bone by traditional Vaidya since long. It has been selected for oral administration. In clinical trial, 12 patients treated with Majja Basti along with Asthi Shrinkhala pulp capsules and results are very encouraging.

Ayurvedic classics give importance to Shuddha Artava and mention that Artavadushti is one of the causative factors for infertility. Artavakshaya is not separately described as disease any where in Ayurvedic classics, of course, this doesn’t desecrate Artavakshaya. Because, Acharya Charaka has quoted in Charaka Nidana Sthana, first chapter, that symptoms of a disease themselves also constitute as a disease. But sometime, because of their subordinate nature they are only symptoms and not disease. This quotation substantiates the stand of taking ‘Artavakshaya’ as disease in the present studies. There are many processes and methods available in Ayurvedic classics to alleviate Artavakshya. But it is yet, the on going research to find out a method of treatment, which is nearer to procurance of permanent cure without side effects. It is well known that Ayurvedic classics emphasize on both Shodhana and Shamana therapy. Since Vata plays key role in Yoniroga, Uttarbasti, being Vata shamana, is a specific treatment in diseased condition of Yoni. As Shamana therapy Kwatha preparation choose to evaluate its efficacy. In the present study total 37 patients were registered, out of them 6 patients were discontinued. One group of patients was administered Arkapushpa Taila Uttarbasti and Krishna Tila Kwatha simultaneously. It gave more significant result. Krishna Tila Kwatha was administered orally in other group. Placebo wheat powder was administered orally in third group. Uttarbasti and Kwatha were found highly effective when administered simultaneously.