This case is presented by the author in the departmental seminar on 04-02-2006

Name of the patient: Lakshmi.

Age: 23 years.

Gender: female.

Occupation: House wife.

Chief complaints:

1. Bleeding through nose two to three times a day.
2. Burning sensation and pain in nasal cavity.
3. Burning sensation in head.
4. Amla aasyata (Acidic taste)
5. Loss of appetite.
6. Burning sensation in ears.
7. Anidra.(insomnia)
8. Aasya paaka (Inflammation of oral cavity)

Duration:

For the past one year.

History of present illness:

Patient was asymptomatic one year back. Bleeding was observed in the form of drop by drop, once in a day in initial stages. Gradually symptoms like Burning sensation and pain in nasal cavity, Burning sensation in head, Amla Aasyata (Acidic taste), Loss of appetite, Burning sensation in ears, Anidra, Aasya Paaka (Inflammation of oral cavity) were developed.

Personal history: 

Patient usually shows more affinity towards amla and lavana rasa (acidic and salty tastes) dominant food items. She is a hard worker in the fields, regularly exposed to smoke while cooking with fire wood and regular exposure to sun and dust.

Family history:

There are no similar complaints from any of the family members.

Menstrual history:

Regular cycles with little pain in supra pubic region.

Treatment history:

She has undergone several treatments during every attack of bleeding, for the past one year and disappointed due to the recurrence. Then she sought Ayurvedic treatment. 

Examination of the patient:

Sroto dusti:

Involved srotas:

1. Prana vaha (Vyakti Sthana)
2. Rakta vaha (Srotovikruti)
3. Annavaha (Udbhava Sthana)

Type of involvement:

1. Vimarga Gamana. of Rakta

Dosha:

Pitta and Rakta.

Diagnosis:

 Nasagata Rakta Pitta.

Prognosis:

Saadhya

Treatment procedures:

1. Samshodhana.
2. Samshamana.

Details of the Treatment:

1. Virechana (Keeping in view of the Madhyama Bala of the patient, Mrudu Virechana is administered  with following medicines for three days.)
1. Gandharwa hastaadi taila 10ml daily once at bed time.        
2. Draakshaadi kashaya 10ml daily once at bed time with equal quantity of water.
2. Avapeedana Nasya with Doorwaa Swarasa (six drops in each nostril) for seven days.
3. Chandanaadi Taila is used for Abhyanga as Poorva Karma throughout the duration of the treatment.
4. Shiro Abhyanga with Chandanadi taila twice daily as regular usage.
5. Avipattikara churna 500 mg. daily once at bed time for thirty days.
6. Godanti Bhasma 125mg tid from first day of treatment.

Ahaara:           

Pathya Ahaara for pitta and rakta doshas.

Results:

1.       Nasa Asrik Sraava (epistaxis) stopped in first week itself.

2.       Associated complaints like burning sensation and pain in nose as well as in head are reduced after second week.

3.       Case is followed once in every fifteen days.

4.       No recurrence is noticed up to two months.

5.       Recurrence of bleeding in ninth month may be due to apathya and over excertation.

6.       Due to the recurrence Kamadhudha rasa 250mg bid and Useeraasava 15 ml tid are prescribed in ninth month.

7.       From tenth month no recurrence is observed.