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CASE REPORT
Year : 2021  |  Volume : 14  |  Issue : 1  |  Page : 94-96  

Management of Som Rog: A success story


Department of Kayachikitsa, Dhanwantri Government Autonomous Ayurvedic College, Ujjain, Madhya Pradesh, India

Date of Submission21-Feb-2020
Date of Decision25-Jun-2020
Date of Acceptance25-Jun-2020
Date of Web Publication22-Jan-2021

Correspondence Address:
Arti Jain
Dhanwantri Government Autonomous Ayurvedic College, Ujjain, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_308_19

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  Abstract 


Som rog is a very rare disease in female; it affects <1 in 2000. Water is present all over the body and this water being the sustainer of the body is called as som and the disease caused by the loss of this water is called Som rog. Som rog is correlated with diabetes insipidus (DI). DI is part of a group of hereditary or acquired polyuria and polydipsia disease. To assess the efficacy of Stambhan chikitsa in the management of Som rog with the use of drug Somnath ras, Praval bhasma, Guduchi satva, Chandraprabha vati, Lodhrasava, Ahara, and Vihara was advised and assessed before treatment and after treatment advised for follow-up. The treatment adopted is effective in the management of Som rog and to improve the quality of life.

Keywords: Chandraprabha vati, diabetes insipidus, Lodhrasava, Som rog, Somnath ras


How to cite this article:
Jain A, Jain N. Management of Som Rog: A success story. Med J DY Patil Vidyapeeth 2021;14:94-6

How to cite this URL:
Jain A, Jain N. Management of Som Rog: A success story. Med J DY Patil Vidyapeeth [serial online] 2021 [cited 2021 Mar 3];14:94-6. Available from: https://www.mjdrdypv.org/text.asp?2021/14/1/94/307676




  Introduction Top


In Ayurvedic literature, Som Rog was not described in Brahatri Samhita. It was first described in Bhavaprakash Samhita.[1] Som rog is specially occurring only in female, same as polyuria occur in men. In the case of Som Rog, clear, nondirty, cold, odorless, white, and painless water comes out from the women's urinary passage in excessive quantity and women are being unable to stand with the flow, because of this woman does not get comfort even a little. Som rog causes Kshaya of all Dhatu. In modern science, Som rog symptoms are almost same as in diabetes insipidus (DI) symptoms, so Som rog is correlated with DI. DI is an uncommon disorder that causes an imbalance of fluid in the body.[2] The body normally balances fluid intake with the excretion of fluid in urine. In DI the body loses too much fluid through urination, causing them to be excessively thirsty. Polyuria (>50 ml/kg), dilute urine (osmolality <300 mOsm/L), and increased thirst (water intake of up to 20 L/day) are characteristic of DI.[3] Major cause of DI are woman indulging in too much copulation, grief and fatigue, effect of sorcery (witch craft), homicidal poison (Bh.P.), and due to excessive metabolism and hard work.[4]

SAMPRAPTHI-All Body water begins to secrets from its place through the urinary passage. This water being the sustainer of the body is called as Som and the disease caused by the loss of this water is called Som rog.[5] In modern medical science, Som rog is correlated with DI. In its impairment of the synthesis of antidiuretic hormone by which urinary control is disturbed and incontinence occur.[6]

SYMPTOM[7]–Discharge – (1) Clear, nondirty, cold, odorless, white, large in quantity, painless water comes out and (2) Incontinence.

Dhatu kshyajanya lakshana – Head debilitation, weakness, dryness of mouth and palate, yawning, delirium and not satisfied by food, snacks, and drink.


  Case Report Top


Case presentation

The present case study was successfully done as Ayurvedic management of SOMA ROG. A 30 year old lady married, nonsmoker, nonalcoholic, residing in UJJAIN consulted at Kayachikitsa outpatient department (OPD) of Dhanwantari Ayurvedic Medical College and Hospital Ujjain (M. P.) with OPD registration no. 9464 on April 17, 2019, come with gradual onset of mildly clear, nondirty, cold, odorless, white, painless, and incontinence water comes out urinary passage in whole day since 6 months. But excessive quantity, clear, nondirty, cold, odorless, white, and painless water comes out urinary passage in whole day and she is being unable to stand with the flow since 2 months without pad, body ache (Angmarda) dryness of mouth and palate (mukhashosh), and laziness (alasya). Hence, she consulted a doctor nearby home. Her investigation regarding diabetes mellitus (DM) had normal study, so she had started taking treatment as per doctors' advice. Her complained was not resolve with above treatment so she consult for above complain in kayachikitsha OPD.

The patient had developed the above complaint before 6 months and for its management they visited the OPD of Kayachikitsa.

There was no history of hypertension, diabetes mellitus, tuberculosis, and other serious illness. No relevant history of dietary, congenital and surgical illness was found.

Menstrual cycle 4–5/28–30 days, amount 2–3 pads/day no associated symptom and G4P4A0D0 L4.

General condition – moderate, diet – vegetarian, appetite – excessive, micturation – incontinence, bowel habit – regular, addiction – non patient was come in OPD of Kayachikitsa UJJAIN for further clinical assessments and investigations.

The patient was conscious, afebrile and well oriented to time place and person. Her blood pressure was 110/70 mmHg, pulse rate 74/min, respiratory rate 20/min, and her height 156 cm and weight 51 kg.

On systemic examination – S1, S2 heart sound normal with no added sound, H.R. – 74/min, B/L clear, air entry adequate, no added sounds, on per abdomen examination soft, nontender, and no organomegaly detected. Genitourinary system – any deformity not detected.

Blood investigation

Before treatment April 18, 2019, Hb% – 9.7 g/dl, erythrocyte sedimentation rate (ESR) – 20 mm, and BSL®– 120 mg/dl.

Medication

  1. SOMANATH RAS – 250 mg bd or 15 days (Kajjali, LohaBhasma, tamalpatra, ela, haridra, daruharidra, jambuchhal, usher, gokshur, vidang, jeerrak, patha, amalaki, dadimchhal, shal, lodhra, shwetchandal, shudhtankan, guggulu, and swarnamakshik)


    • PRAVAL BHASMA – 125 mg bd for 15 days
    • GUDUCHI SATV – 250 mg bd for 15 days.


  2. CHANTRAPRABHA VATI – 1 TDS with Luke warm water* 15 days.[16],[17],[18]
  3. LODHRASAV – 4 TSF * BD with equal water * 15 days.


The follow-up was made on 16th day, 30th day, and 60th day. During this period, patient did not developed any other complaints. After 60th day, blood investigations are carried out it shows following results, i.e., ESR – 8 mm, Hb%–12.3 g%, and blood sugar 98 mg/dl. The patient reported gradual improvement in urine incontinence, excessive urinary discharge, weakness (Balakshya), dryness of mouth and palate (mukhashosh), and laziness (alasya). After treatment, the patient got significant relief.


  Discussion Top


MODE OF ACTION – Mode of action can be understood on the basis Samprapti (pathogenesis) of the disease and Gunakarma (properties) of the ingredients.

  1. Somnath ras[7] is very important drug of Som rog. Som rog leads to the degeneration of the dhatus mainly Rakta, Mamas, and Ojus which causes Pandu and Durablya, etc. In this condition, Somnath ras in content Loha Bhasma acts as Rasayana for all sapta dhatus. Loha Bhasma is mainly increased blood cells and flow which helps in restoration of body cells and systems in Som rog properties of Kajjali such as Rasayana, Jantughna (antimicrobial), Yogavahi (as catalyst), and sarvamayahara (corrects all disease).[8],[9] Hence, Kajjali play an important role in Som rog. Most of the ingredients contain Kshaya, Tikta rasa; Laghu, Ruksha Guna; and Sheeta veerya properties. Due to Kshaya, Tikta ras, it has Grahi action so it is indicated Som rog. Excessive watery discharge (ojus) in urinary passage is the cardinal symptom in Som rog. Excessive discharge is one lakshana of kapha vruddhi.[10] Laghu, Ruksha Guna decelerates the excessive kapha so it is beneficial in som.
  2. Praval bhasma[11],[12] has got properties such as cooling, Balya and soothing, so it is used to treat disorders such as Pitta aggravation and calcium deficiency. Because of calcium compounds, it can alkalize urine and help to fight urine infection.[13] Guduchi satva[14],[15] is having Tikta, Kshaya ras with Madhura vipaka, Snigdha Guna and is Tridoshashamaka, Dipaniya. These would support in the anti som loss activity and other associated symptoms along with Rejuvenation
  3. Chandraprabha vati[16] has properties of Rasayana, Balya, and Vrushya which revenue the property of stabilizing tissues and also prevent cell damage. The properties of Deepana, pachana, Amadosahara, Rakta prasadana, Lekhaniya, and Medogna will help decrease the Avila Muttra in urine
  4. Lodhra (Symplocos racemosa) is the main ingredient in Lodhrasava.[17],[18] Lodhra is having Tikta, Kshaya rasa, Laghu and Ruksha guna, Sheeta veerya, and katu vipaka. Because of its Tikta, Kshaya, and Sheeta property, it is Kapha-Pittashamaka and also highly effective astringent that was utilized in the treatment of Som rog. Moreover, this astringent action can be attributed to a Loturodine alkaloid present in Lodhra bark. Almost ingredients contain Kshaya, Tikta rasa; Sheeta veerya properties. Tikta ras has Grahi action it is because of its Kshaya so it is indicated in Som rog.



  Conclusion Top


When treated Som rog with Ayurvedic treatment schedule as described in Ayurveda according to the condition of patient and state of the disease and with apt application of Ayurveda principles, good result can be seen. In our study we apply Ayurvedic principles according to patient condition and state of disease. more studies were needed to substantiate the effect of Ayurveda treatment in Som rog.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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2.
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Kalra S, Zargar AH, Jain SM, Sethi B, Chowdhury S, Singh AK, et al. Diabetes insipidus: The other diabetes. Indian J Endocrinol Metab 2016;20:9-21.  Back to cited text no. 6
    
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Shankarlal SV, Jain J, Kirshnadas Prakashana KS, Streerogadikar. Kavivar shree Shaligram Vaisya edited with Vangsen. Pt. 2. 2nd ed. Bombay, 2003. p. 328.  Back to cited text no. 7
    
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Shah DP, Zala V, Damre A, Sathaye SS. Evaluation of bioavailability enhancement by Kajjali, an ayurvedic proprietary herbomineral product, Conference Paper in Drug Metabolism Reviews. 16th North American Regional International Society for the Study of Xenobiotics Meeting; October, 2009. Available from: http://www.issx.confex.com/issx/16na/webprogram/paper17724.html. [Last accessed on 2015 Jul 16].  Back to cited text no. 9
    
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Brahmanand Ttipathi, Charaka Samhita of Agnives, Prmeha Nidana)/6. Charaka – Chandrika Hindi Commentary. Vol. 1. Ch. 4.Varanasi: Chaukambha Surbharati; 2002. p. 613.  Back to cited text no. 10
    
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Kaviraj Shree Ambikadatta Shastri Ayurvedacharya edited with Bhaisajya Ratnavali. Ch. 86/24-27. Varanasi: Chaukambha Sanskrit Sansthan; 2002. p. 808.  Back to cited text no. 11
    
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Shastri K. Pranacharya Sri Sadananda Sharma, Rasa Tarangini, Sriharidatta Shastri's Prasadana Commentary. Ch. 23/139. New Delhi: Mothilal Banarasidasa Publishers; 2009. p. 529.  Back to cited text no. 12
    
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Sastri VL. Bhisagratna Brahmasankar Sastri edited with Yogaratnakara with vidyotini Hindi Commentary. Rajyakshma Chikitsa1. 11th ed. 7th, Varanasi: Chaukambha Sanskrit Sansthan; 1999. p. 118.  Back to cited text no. 14
    
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Ratnavali B. Vidyotini Hindi Commentary by Ambikadatta Shastri. 16th ed. 37/9. Varanasi: Choukhambha Sanskrit Sansthan; 2002. p. 118.  Back to cited text no. 15
    
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Murthy KR, editor. Sharangdhara Samhita of Sharangdhara. Madhyam Khand. 2nd ed., Ch. 40. Ver. 49. Varanasi: Chaukhambha Orientalia; 2012. p. 105.  Back to cited text no. 16
    
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Rasatantrasara VA. Siddaprayoga Samgraha, Part – 1, Krishna Gopala Ayurveda Bhavan (D.T.). Asavadiprakaran. Ajmer Rajasthan; 2012. p. 368.  Back to cited text no. 17
    
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Priyavart S. Charaka Samhita of Agnives, English Translation. Shloka Number 41,42,43,44. 6th ed., Vol. 2. Ch. 6. Varanasi: Chaukambha Orientalia; 2002. p. 121-2.  Back to cited text no. 18
    




 

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