Pittashmari is considered to arise from the imbalance of all three Doshas. The primary approach to its management emphasizes Yakrutottejana (stimulation of liver function), which promotes proper secretion and flow of Achha Pitta (pure bile), thereby aiding in the dissolution of the stone.
Based on the analysis of Nidan Panchaka and Samprapti Ghataka, it is understood that dietary and lifestyle factors that aggravate Pitta and Kapha lead to the accumulation of vitiated Pitta and Kapha in the Pittashaya (gallbladder region). This accumulation results in Srotorodha (obstruction of channels).
Due to this obstruction, the normal movement of Vata is hindered, leading to its aggravation. The aggravated Vata, owing to its Ruksha (dry) quality, causes drying and condensation of the accumulated Pitta and Kapha, ultimately resulting in the formation of Ashmari (stone).
The Ayurvedic management of Mutrashmari (renal calculi) focuses on balancing the Doshas and clearing the Srotas to dissolve stones and prevent recurrence. This is achieved through herbal medicines along with appropriate diet and lifestyle changes.
Herbs like Gokshura (Tribulus terrestris) help by increasing urine output and preventing stone formation, while Varuna (Crataeva nurvala) and Pashanabheda (Bergenia ligulata) support stone breakdown and expulsion due to their anti-urolithiatic and antioxidant properties.
Formulations such as Mutravardhak Vati act by correcting Vata and Pitta, improving Agni, and reducing Ama, thereby preventing crystallization in the urinary tract. This helps in dissolving existing stones and avoiding new ones.
Improved digestion and gut function also aid in toxin elimination, while medicines like Brahmi Vati and GIT stimulants help reduce stress, which in turn helps control Vata and supports overall balance.
Arogyavardhini Vati: Its contents, due to their cholagogue nature, help in the stimulation of the secretion of bile from the liver and also aid in washing out excessive bile from the body before being absorbed, and thus help in the prevention of liver, spleen, and gall bladder disorders.
Almost 50% of its content is Kutaki. Kutaki is bitter in taste, cooling, and removal of excessive fire energy from the body, best for the removal of excessive Pitta from the body via the colon.
Kutaki helps in the restoration of Liver functions by overcoming fatty liver changes. It also promotes liver regenerating activities by restoring cytochrome.
1. Punarnava Guggulu exhibits Shothahara and Mutrala properties, reducing edema and promoting urine flow, thereby facilitating expulsion of calculi. It also acts as Srotoshodhaka, clearing obstruction in Mutravaha Srotas and reducing Kapha accumulation responsible for stone formation [8,9].
2. Gokshura Guggulu acts as Mutrala and Ashmari-bhedana, promoting diuresis and aiding in the fragmentation and expulsion of urinary stones. It pacifies Vata and Kapha, relieving pain and dysuria associated with Ashmari [8,9].
3. Arogyavardhini Vati improves Agnideepana and Amapachana, correcting metabolic dysfunction and preventing further stone formation. It also performs Srotoshodhana, clearing obstruction and supporting proper metabolism [8,9].
4. Chandraprabha Vati acts as Mutrala, Shothahara, and Balya, improving urinary flow, reducing inflammation, and strengthening the urinary system. It helps in relieving symptoms like dysuria and frequency [8,9].
5.Pashanbheda + Punarnava + Gokshura
This combination has strong Ashmari-bhedana and Mutrala action.
Pashanbheda helps in breaking stones
Punarnava reduces inflammation and edema
Gokshura enhances urine flow
Together, they facilitate the disintegration and expulsion of calculi [8,9].
6. Panchasakar Churna acts as Mridu Rechaka and Vatanulomaka, promoting bowel evacuation and correcting Apana Vata. This helps reduce intra-abdominal pressure and supports proper urinary flow, indirectly aiding in Ashmari management [8].