E-ISSN:2456-3110

Case Report

Mutravirechaneeya Mahakashaya

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 3 MARCH
Publisherwww.maharshicharaka.in

A case study of Mutravirechaneeya Mahakashaya along with Erand Taila in the management of Mutrashmari w.s.r. to urolithiasis

Aklesh1*, Aruna O2, Rashmi D3, Aradhana K4
DOI:10.21760/jaims.10.3.68

1* Aklesh, Post Graduate Scholar, Department of Kayachikitsa, Shri NPA Govt Ayurveda College, Raipur, Chattisgarh, India.

2 Ojha Aruna, Professor and HOD, Department of Kayachikitsa, Shri NPA Govt Ayurveda College, Raipur, Chattisgarh, India.

3 Diwan Rashmi, Lecturer, Department of Kayachikitsa, Shri NPA Govt Ayurveda College, Raipur, Chattisgarh, India.

4 Kande Aradhana, Lecturer, Department of Rognidana Evum Vikriti Vigyan, Shri NPA Govt Ayurveda College, Raipur, Chhattisgarh, India.

According to Susruta Samhita, Ashmari is classified under Mutravaha Srotovikara and Ashtamahagada.[1] Urinary stone disease affects 3 to 5% of the general population and is becoming more common worldwide mostly as a result of metabolic disturbances and changes in the global climate. According to Acharya Charaka, oral drugs such as Mutravirechaneeya Mahakashaya which have qualities like Chedana, Lekhana, Bhedana, and Mutrala that aid in the dissolution of urinary stones, should be tried before undertaking surgical methods. On April 02, 2024, a 50-year-old female visited the Outpatient department (OPD) at Shri Khudadad Dungaji Government Ayurved Hospital, Raipur, C.G. She complained of burning during his micturition, pain in his right flank that spread to his groin, and orange-colored urine for two days. Urolithiasis was the diagnosis, and surgery was recommended. Mutravirechaneeya Mahakashaya[2] and Erand Taila[3] was given continuously for 90 days in three regimens. Clinical assessment criteria were used to evaluate the effects of treatments on 15 days. After treatment for 90 days, excellent level also reducing the symptoms and stone size. During the follow-up period, symptoms and stone size were changed. In conclusion, this Mutrashmari patient’s quality of life was improved by the treatment of Mutravirechaneeya Mahakashaya and Erand Taila.

Keywords: Mutravirechneeya Mahakasaya, Erand Taila

Corresponding Author How to Cite this Article To Browse
Aklesh, Post Graduate Scholar, Department of Kayachikitsa, Shri NPA Govt Ayurveda College, Raipur, Chattisgarh, India.
Email: 		Aklesh, Aruna O, Rashmi D, Aradhana K, A case study of Mutravirechaneeya Mahakashaya along with Erand Taila in the management of Mutrashmari w.s.r. to urolithiasis. J Ayu Int Med Sci. 2025;10(3):435-439.
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https://jaims.in/jaims/article/view/4186/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-02-13 2025-02-26 2025-03-06 2025-03-15 2025-03-26
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 10.54

© 2025 by Aklesh, Aruna O, Rashmi D, Aradhana K and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(3)435
Download PDFBack To ArticleIntroductionCase ReportObservations and ResultsDiscussionConclusionReferences
Aklesh et al. Management of Mutrashmari w.s.r. to urolithiasis

Introduction

Mutrashmari, or urolithiasis, is a condition where stones form in the urinary system. The word Mutrashmari comes from the Sanskrit words mutra, which means urine, and Ashmari, which means a structure resembling stone. In Ayurveda, Mutrashmari is caused by an imbalance of Ahara (diet) and Vihara (living habits), which leads to aggravated Kapha Dosha in the urinary system. Other factors that can contribute to Mutrashmari include sleeplessness, heavy consumption of fast food, and preserved foods. Symptoms of Mutrashmari include intermittent pain and burning micturition. The lifetime prevalence of symptomatic urolithiasis, or urinary stones, is about 10% in men and 5% in women. The prevalence of kidney stones is similar worldwide, at around 12%. In India. Urolithiasis is characterized by the formation of solid masses in the urinary system. It's a chronic and recurrent condition that has a significant impact on healthcare. Reducing discomfort while trying to improve and minimizing impairments in activities of daily living are goals of treatment. Analgesics and nonsteroidal anti-inflammatory medications (NSAIDs) are part of conventional pharmacological care of urolithiasis, yet their use does not effectively relieve pain. It is a persistent illness.

Case Report

A 50-year-old female patient presented to the outpatient department of Shri Khudad Dungaji Government Ayurveda College & Hospital at Raipur with a history of pain in the Left Iliac region and radiating pain loin to groin region since 15 days, sometimes burning micturition since 1 week, sleep disturbed and complaint of constipation since 1 week.

OPD: 08149
Start of Medication: 02/04/2024
Name: xxxx
Age: 50
Sex: Female
Address: Gudhyari, Raipur, C.G.
Religion: Hindu
Education: Middle school
Marital Status: Married
Socio-economic Status: Middle Class
Occupation: Housewife
Habitation: Semi Urban

Chief complaints with duration

Table 1

ComplaintsTime duration
Pain left Iliac region15 days
Radiating pain some time loin to groin15 Days
Sometime burning micturition1 week
Sometime constipation1 weak
Disturbed sleep1 week

History of present illness

According to patient she was asymptomatic for one month, after that on date of 10th March 2024 suddenly she had pain in left Iliac region radiating left loin to groin region. Along with sometimes burning micturition. She took some painkillers and antacids and got some temporary relief one week she also suffered from constipation. for someone's advice, she came to our hospital for treatment.

Table 2

Vedana (Renal pain)PresentSince 15 days
Sadah Mutrata (Burning micturition)PresentSince 1 weak
Mutrakrichta (Dysuria)PresentSince 1 weak

General Examination

Table 3

B.P120/70 mmhgP/R74/min
Height158 cmWeight58 kg

Ashtavidha Pariksha

Nadi (Pulse) - Pitta-Kaphaj
Mutra (Urine) - Dark yellowish
Mala (Stool) - Vibandha Some time
Jivha (Tounge) - Shwetabha Mild
Shabda(voice) - Prakrit
Sparsh (Skin) - Sheet
Drika (Eye) - Samanya
Akriti (General Appearance) - Madhyam

Dashavidha Pariksha

Prakriti - PK,
Vikriti - Dosha - VPK, Dushya - Rasa,Mutra
Sara - Madhyam
Samhanana - Madhyama
Pramana - Madhyama
Satmya - Madhyama
Satva - Pravara
Ahara Shakti - Madhyama
Vyayam Shakti - Avara
Vaya - Madhyam


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Aklesh et al. Management of Mutrashmari w.s.r. to urolithiasis

Family History: No H/O - DM/HTN/Urolithiasis

Assessment Criteria[7]

G0 - No Symptoms.
G1 - Mild Symptoms.
G2 - Moderate Symptoms sufficient to cause Distress/Difficulty in performing routine work.
G3 - Symptoms very severe/patient unable to perform routine work.

Pain:

SymptomGrading Score
No. Pain0
Occasional pain did not required treatment1
Occasional pain but, required treatment2
Constant dull ache pain, required treatment3
Severe constant pain, but did not show relief even after treatment4

Burning micturition:

SymptomGrading Score
No Occasional burning micturition0
Occasional burning micturition1
Occasional burning micturition, required treatment2
Constant burning micturition required treatment3
Constant severe burning micturition but did not show relief even after treatment4

Dysuria:

SymptomGrading Score
No Dysuria0
Occasional dysuria1
Occasional dysuria which requires treatment2
Constant dysuria which requires treatment3
Constant severe dysuria but did not show relief even after treatment4

No. of RBC’s Present in urine:

SymptomsGrading
No RBC/Hpf0
0-5 RBC/Hpf1
6-10 RBC/Hpf2
11-15 RBC/Hpf3
>16 RBC/Hpf4

No. of Pus Cells Present in urine:

No. of Pus CellsGrading
No pus cells/Hpf0
0-5 pus cells/Hpf1
6-10 pus cells/Hpf2
11-15 pus cells/Hpf3
>16 pus cells/Hpf4

Total number of calculus in both side kidney:

Total number of calculusGrading
No calculus0
1-2 calculus1
3-4 calculus2
5-6 calculus3
>6 calculus4

Size of calculus:

SizeGrading
No calculus0
0-3mm1
4-5mm2
6-8mm3
10mm or <10mm4

Therapeutic Procedure

1. Oral medication: Mutravirechaneeya Mahakashaya was given 50 ml before meal two times a day.

2. Erand Taila - 10 ml

Duration of Treatment: 90 days.

Ingredient of: Mutravirechaneeya Mahakashaya[8]

The presented compilation work helps towards proving its biological activities and pharmacology of its extracts which will contribute towards further exploration of this group of great clinical potential. However, further studies should be carried out to identify the mechanism of the pharmacological actions of these drugs. Ingredients are :-

VrikshadaniGokshuraPunarnavaApamarg
PasanbhedDarbhaKushKash
GundraEtkatmoola

Clinical Study

The patient was first administrated Sanjeevani Vati two tablets BD with lukewarm water and Eranda Taila 10 ml at night during sleep time with lukewarm water.

After seven days patient feels mild improvement in constipation and sleep disturbance.

First sitting (day 1-15):

A volume of 40 ml of Mutravirechaneeya Amahakashaya empty stomach morning and evening for 15 days.

Day 16-90 days - again same management.


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Aklesh et al. Management of Mutrashmari w.s.r. to urolithiasis

Observations and Results

SymptomsBeforeAfter
PainG3G0
Burning micturitionG2G0
DysuriaG2G0
Pus cells1-2 hpf0-1 hpf
Size of calculus6.2 mm00mm
Number of calculus0100
Weight58kg54kg
BMI23.23 kg/m221.63 kg/m2
BMR1256.90 K/Cal1219.91 K/Cal
USG
Whole abdomen and pelvis		Left kidney
A calculus of 6.2 mm at lower calyx		No stone
BL kidney

Discussion

Nowadays, the prevalence of renal disorders is rising quickly worldwide, and the current medical treatment options have unfavourable effects on people's health. In the ancient Ayurvedic medical science, plants of Mutravirechaniya Mahakashaya, which are referred to as the 35th Mahakashaya in the 4th chapter of Charaka Samhita, Purvardha are primarily known for their ability to induce urine or increase urinary flow in addition to their ability to defend the urinary system.

In traditional Indian medicine, formulations with these plants as the primary ingredients have been frequently prescribed for cases of fluid accumulation in the lower extremities, renal calculi, abdominal fluid collection, and other cases of fluid overload. Research supports the ability to increase urine flow and the active ingredient's ability to destroy urinary calculi. However, according to the description in Ayurvedic text, the signs, symptoms, and signs with a scoring system were noted to evaluate the severity. This assessment was done twice (i.e., in pre and post-treatment phases). The severity of symptoms and sign was categorized as follows: Mild, moderate, and severe. A statistically significant relief was observed in cardinal symptoms of Mutrashmari (urolithiasis) in the patient. This proves that the medication is effective in reducing the cardinal symptoms of Mutrashmari. The Mutravirechaneey Mahakashaya have Tridosha Shamak Guna pacifying due to their Ushna (digestive and metabolism stimulating) and Tikshna (penetrating) properties.

It would have acted on vitiated Vata and helped to relieve in pain. Burning sensation and calculus are produced due to presence of Dushita Pitta and Kapha Dosha. Drugs have Deepana (enhance digestive power) and Srotoshodhaka (remove obstruction of microchannels) properties, which reduces Kupita Pitta and Kapha.

Conclusion

Mutravirechaneeya Mahakashaya is an unexplored drug in management of Ashmari having Ashmarighna, Anulomana and Mutrala and Dahashamak property. Even though it is difficult to treat disease Ashmari, Mutravirechaneeya Mahakashaya along with Eranda Taila shown significant results in Ureteric stone and be simple to use and cost-effective management. Present article has tried to give an account of updated information on various pharmacological properties of classical diuretic group as much as possible. However, some drugs in Mutravirechaniya Mahakashaya are controversial like Pashanbheda as their scientific names are lacking in original texts. While some plants like Gundra and Itkatmula are rarely seen. They searched for available scientific studies with their Sanskrit names as well as botanical names derived from various concerned books. Classical books. mentioned in reference section are followed for such purposes.

jaims_4186_01.jpg
Before Treatment


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After Treatment

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