A CASE STUDY OF AYURVEDIC MANAGEMENT OF VRUKKASHMARI WITH SPECIAL REFERENCE TO RENAL CALCULI.

About Author

Correspondence Address

DMM Ayurved College, Shivaji Nagar, Aarni Road, Yavatmal 445001
Contact No. : 9011361475, Email : dakhoreumesh2015@gmail.com

Date of Acceptance : 30 Jun 2026

Date of Publication : 30 Jun 2026

Article ID : SD-IJAY_188

How to cite this article : http://doi.org/10.55552/SDNJAY.2026.4215

Abstract

Vrukkashmari, described in Ayurveda as one of the Ashtamahagada, is a Kapha-pradhana Tridoshaja disorder characterized by the formation of urinary calculi. It can be correlated with renal calculi (urolithiasis) in contemporary medicine. A 57-year-old male patient presented with complaints of Sakashta Mutrapravrutti, Sadaha Mutrapravrutti, and dribbling micturition for two months. The patient was managed with Ayurvedic formulations including Gokshuradi Guggulu, Punarnava Guggulu, Arogyavardhini Vati, Chandraprabha Vati, Punarnava Mandura, Gandhaka Rasayana, a combination of Punarnava, Gokshura, Pashanbheda and Avipattikara Churna, along with Sukhavirechana Churna and dietary regulations. Assessment was performed through serial ultrasonography and clinical evaluation. Follow-up ultrasound reports revealed resolution of the ureteric stone, hydronephrosis, hydroureteronephrosis, and pelvicalyceal system dilatation. Although renal calculi persisted, significant symptomatic relief and improvement in urinary tract pathology were observed. The study suggests that Ayurvedic management may provide effective symptomatic relief and aid in preventing complications associated with renal calculi.

KEY WORDS:-  Vrukkashmari, Renal Calculi, Urolithiasis, Ashmari, Ayurvedic Management

Introduction

Vrukkashmari is a condition in which there is the formation of a substance like a stone. [1] It is one among the Ashtamahagada (eight fatal conditions).[2] It is considered difficult to cure because of its Marma Ashrayatwa due to involvement of Basti, which is one of the Tri Marma (three vital parts), being the Vyakta Sthana.[3] It is Kapha Pradhana Tridoshaja Vyadhi.[4]

तासां पूर्वरूपाणि-वस्तिपीडारोचकौ मूत्रकृच्छ्रं वस्तिशिरोमुष्कशेफसां वेदना ज्वरः कृच्छ्रावसादौ बस्तगन्धित्वं मूत्रस्येति ।।[5]

Acharya Sushruta have described symptoms of this condition, including Jwara (fever), Basti Peeda (discomfort and pain in the bladder), Aruchi (anorexia), Mutrakriccha (difficulty in micturition), Bastishira Vedana (pain in the urethra), Mushka Vedana (pain in the testicles) and Shepha Vedana (pain in the penis). Due to resemblance in clinical manifestations, Vrukkashmari is compared to Renal calculi.

Urolithiasis is a pathological condition of the urinary system where aggregation of urinary crystalloids takes place anywhere in the urinary tract, i.e., from the kidney to the urinary bladder.

Stone formation commonly occurs due to inadequate urinary drainage, foreign bodies in the urinary tract, microbial infections, diet with excess oxalates and calcium, vitamin A deficiency, excess vitamin D, and metabolic diseases like hyperthyroidism, cystinuria, gout, intestinal dysfunction, etc.[6]

There are 4 types of Ashmari described by Acharyas. Vataj Ashmari, Pittaj Ashmari, Kaphaj Ashmari and Shukraj Ashmari. Structure and symptoms are different. Vataj Ashmari symptoms resemble with Calcium Oxalate type Stone, Pittaj Ashmari symptoms resemble with Uric Acid type stone, Kaphaj Ashmari symptoms resemble with Oxalate/Phosphate type stone. Mostly Kaphaj pradhyanya dosh is involved in Ashmari.[7]

Discussion

Gokshuradi Guggulu - Gokshuradi Guggulu possesses Mutrala (diuretic), Ashmaribhedana (lithotriptic), and Shothahara (anti-inflammatory) properties. It promotes urine flow, reduces urinary stasis, helps in the disintegration and expulsion of urinary calculi, and alleviates pain and inflammation in the urinary tract.^[8]

Punarnava Guggulu - Punarnava Guggulu acts mainly as a Shothahara and Mutrala formulation. It reduces edema and inflammation, enhances renal function, facilitates the elimination of excess fluid and metabolic wastes through urine, and helps maintain normal urinary tract physiology.^[9]

Arogyavardhini Vati - Arogyavardhini Vati acts as Deepana, Pachana, Yakrit-Uttejaka, and Raktashodhaka. It improves digestion and metabolism, removes Ama, supports liver function, and purifies Rakta Dhatu. These actions help correct the underlying metabolic imbalance and enhance nourishment to hair follicles, thereby supporting hair growth in Indralupta.^[10]

Chandraprabha Vati - Chandraprabha Vati exerts Mutrala, Deepana-Pachana, and Rasayana actions. It improves urinary flow, relieves dysuria, reduces inflammation of the urinary tract, and supports the normal functioning of the kidneys and urinary system, thereby aiding in the management of urinary calculi.^[11]

Punarnava Mandura - Punarnava Mandura acts as Raktavardhaka, Shothahara, Deepana, and Rasayana. It improves hemoglobin levels, enhances tissue nutrition, reduces inflammation, and supports proper circulation. By improving Rakta Dhatu and overall nourishment, it promotes healthy hair follicle growth and aids in the management of Indralupta.^[12]

Gandhaka Rasayana - Gandhaka Rasayana functions as a Rasayana, antioxidant, and antimicrobial formulation. It enhances tissue regeneration, improves immunity, reduces oxidative stress and inflammation, and supports healing of the urinary tract, thereby contributing to overall recovery and prevention of recurrent urinary disorders.^[13]

FOLLOW UP

The patient was followed regularly through clinical examinations and serial ultrasonography from May 2024 to January 2026. During follow-up visits, the patient reported progressive reduction in dysuria, burning micturition, and dribbling of urine. No episodes of acute renal colic, urinary tract infection, or recurrence of ureteric obstruction were observed. The patient was advised to continue dietary regulation, maintain adequate hydration, and undergo periodic ultrasonographic evaluation to monitor the status of residual renal calculi and prevent recurrence.

LIMITATION OF STUDY 

This is a single-case study; therefore, the findings cannot be generalized to a larger population.

Absence of a control group limits comparison with other treatment modalities.

Conclusion

The present case study demonstrates that Ayurvedic management of Vrukkashmari can provide significant symptomatic relief and improvement in urinary tract pathology. The treatment successfully resolved ureteric obstruction, hydronephrosis, hydroureteronephrosis, and pelvicalyceal dilatation while improving urinary symptoms and quality of life. Although complete dissolution of renal calculi was not achieved, the overall clinical outcome suggests that Ayurvedic formulations possessing Mutrala, Ashmaribhedana, Shothahara, and Rasayana properties may play an important role in the conservative management of renal calculi and prevention of associated complications. Further studies with larger sample sizes and longer follow-up periods are required to establish the efficacy of this treatment approach.

References