AIAPGET Points
– Acharya Sushruta has explained the treatment of diseases of vagina i.e. YONIVYAPAT Pratisedha in chapter 38 of Uttara Tantra
– Causes of yoni vyapad – copulation with a man having PRAVRUDDHA LINGA, copulation with other men, woman is RUKSHA, DURBALA and BALA (and has excessive copulation).
– Four causes for manifestation of Yoni Vyapad – MITHYACHARA, ARTAVA PRADUSHTI, BIJA DOSHA & DAIVA.
– Five types of Vatala Yoni Vyapad – Udavarta, Vandhya, Vipluta, Paripluta and Vatala
– Five types of Pittala Yoni Vyapad – Rudhira (Rakta) Kshara Yoni, Vamini, Sramsini, Putragni and Pittala
– Five types of Kaphaja Yoni Vyapad – Atyananda, Karnini, Acharana, Aticharana and Sleshmala
– Five types of Tridoshaja Yoni Vyapad – Sandha, Phalini, Mahati, Sucivaktra and Sarvaja (Sannipataja)
Vataja Vaginal Disorders –
– Udavarta Yoni – discharge of frothy menstrual blood with difficulty
– Vandhya Yoni – no menstruation at all
– Vipluta Yoni – vaginal pain every day
– Paripluta Yoni – severe pain during copulation
– Vatala Yoni – vagina is rough, inactive, has pain and pricking
Pittaja Vaginal Disorders –
– Lohitaksara Yoni – menstrual blood is discharged in more quantity, has burning sensation
– Vamini Yoni – expulsion of BIJA (ovum) along with RAJAS – menstrual blood, accompanied with VATA (discharge of air / gas)
– Sramsini Yoni – excessive bleeding, weakness, difficulty in delivery of child (DUPRASUSCHA)
– Putraghni Yoni – STHITAM STHITAM HANTI GARBHAM – Retention of seed (embryo) for short period of time and is later killed due to excess bleeding
– Pittala Yoni – excessive DAHA, PAKA and presence of JWARA
Kaphaja Vaginal Disorders –
– Atyananda Yoni – NA SANTOSHAM GRAMYADHARMENA GACHCHATI – woman finds no pleasure from copulation
– Karnini Yoni – sprouts or growths produced by kapha and blood in the vagina
– Acarana Yoni – woman experiences orgasm earlier than man in copulation
– Aticarana Yoni – BIJAM NA VINDATI – woman copulates much but does not retain the bija (does not conceive)
– Slesmala Yoni – presence of very slimy vagina, itching and very cold feeling
Tridoshaja Vaginal Disorders
– Sandha Yoni – ANARTAVA – menstruation, ASTANA – absence of breasts, KHARA SPARSHA CHA MAITHUNE – woman experiences roughness or friction during copulation
– Aphalini Yoni – woman needs a man of big size for copulation and still does not conceive
– Maha Yoni – presence of a very wide vagina
– Sucivaktra Yoni – presence of very constricted vagina
– Tridoshaja Yoni – presence of features / symptoms of aggravation of all the three doshas
Treatment principles of Yoni Vyapad –
– PRATIDOSHAM TU SADHYASU Snehadi Krama, Uttara Basti.
– Treatment if vagina is rough, cold, rigid and insensitive during copulation – KUMBHI SWEDA, introduction of VESAVARA (douche) into the vagina, always wearing PICHU TAILA – diaper soaked in oil and YONI DHAVANA & PURANA with suitable liquids / decoctions etc.
Other Treatments
– SHITA VIDHI – in presence of osha chosha (Raktapitta Vidhi)
– YONI PURANA with PANCHAVALKALA or RAJAVRKSHA Churna – for Durgandha and Pichchilata
– YONI DHAVANA with Kashayas
– SHODHANA Dravya Kashayas added with GOMUTRA and SAINDHAVA – for YONI SHODHANA – in presence of PUYASRAVA from YONI
– Paste of the fruits of Brhati along with two kinds of Haridra should be used for filling in the vagina, if the vagina has itching and is insensitive. The vagina should also be fumigated with medicated smoke.
– Paste of BRHATI, HARIDRA & DARUHARIDRA – for Purana if vagina has itching and is insensitive. YONI DHUPANA is also desired.
– PICHU prepared with SHODHANA DRAVYAS – beneficial in Karnini Yoni.
– Snehana with GHRTA – in Prasramsini Yoni. This should be followed by Swedana with KSHIRA & MAMSARASA. After this, the Vagina should be pushed inside and bandage applied.
– SURA, ARISHTA or ASAVA should be administered appropriate to each dosha, every morning.
– MAMSARASA added with RASONA should be given for drinking. She should also be given food with more milk and meat-soup.
Treatment principles of – SHUKRA-ARTAVA DOSHA, STANA Roga, KLAIBYA, MUDHA-GARBHA & GARBHINI Prati-roga Chikitsa should be adopted in treating YONI VYAPAD.
The 37th chapter of Uttaratantra of Sushruta Samhita is named as Yonivyāpat Pratiṣedha Adhyaya. This chapter deals with the Treatment of Diseases of Vagina.
अथातो योनिव्यापत्प्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound Yoni vyāpatpratiṣedha – treatment of diseases of vagina and uterus; as revealed by the venerable Dhanvantari.
Vyāpat kārana – causes of diseases-
प्रवृद्धलिङ्गं पुरुषं याऽत्यर्थमुपसेवते |
रूक्षदुर्बलबाला या तस्या वायुः प्रकुप्यति ||३||
स दुष्टो योनिमासाद्य योनिरोगाय कल्पते |४|
Causative factors –
– woman copulating excessively with a man having big penis,
– woman copulating excessively with other men,
– woman who is dry (and has copulation in excess)
– woman who is debilitated (and has copulation in excess) or
– woman who is very young (and has copulation in excess)
Pathogenesis – Vata gets aggravated in the body of the woman due to the above said etiological factors. Later it gets localized in her vagina and gives rise to many diseases of the vagina.
त्रयाणामपि दोषाणां यथास्वं लक्षणेन तु ||४||
विंशतिर्व्यापदो योनेर्निर्दिष्टा रोगसङ्ग्रहे |
मिथ्याचारेण याः स्त्रीणां प्रदुष्टेनार्तवेन च ||५||
जायन्ते बीजदोषाच्च दैवाच्च शृणु ताः पृथक् |६|
The symptoms of each of the three doshas would manifest differently with their specific features. Earlier it was mentioned that such vaginal disorders are twenty in number. Now, listen to those diseases produced by indulgence in improper activities, disorders of menstrual fluid, abnormalities of seed (ovum in this context) and providence (act of God).
Roganama – names of diseases-
उदावर्ता तथा वन्ध्या विप्लुता च परिप्लुता ||६||
वातला चेति वातोत्थाः, पित्तोत्था रुधिरक्षरा |
वामिनी स्रंसिनी चापि पुत्रघ्नी पित्तला च या ||७||
अत्यानन्दा च या योनिः कर्णिनी चरणाद्वयम् |
श्लेष्मला च कफाज्ज्ञेया, षण्डाख्या फलिनी तथा ||८||
महती सूचिवक्त्रा च सर्वजेति त्रिदोषजा |९|
| Dosha Predominance in Diseases of Vagina | Name of the diseases caused |
| Vata | Udavarta Yoni,
Vandhya Yoni, Vipluta Yoni, Paripluta Yoni and Vatala Yoni |
| Pitta | Rudhira (Rakta) Ksara Yoni,
Vamini Yoni, Sramsini Yoni, Putraghni Yoni and Pittala Yoni |
| Kapha | Atyananda Yoni,
Karnini Yoni, Acarana, Aticarana and Slesmala Yoni |
| Sannipata – Tridoshas | Sandha Yoni,
Phalini Yoni, Mahati Yoni, Sucivaktra Yoni and Sarvaja (Sannipataja) Yoni |
Laksanas – features of each-
Types of Vataja Yoni Vyapat and their symptoms
सफेनिलमुदावर्ता रजः कृच्छ्रेण मुञ्चति ||९||
वन्ध्यां नष्टार्तवां विद्याद्विप्लुतां नित्यवेदनाम् |
परिप्लुतायां भवति ग्राम्यधर्मे रुजा भृशम् ||१०||
वातला कर्कशा स्तब्धा शूलनिस्तोदपीडिता |
चतसृष्वपि चाद्यासु भवन्त्यनिलवेदनाः ||११||
Vataja Vaginal Disorders –
| Name of Vaginal Disorder caused by Vata | Symptoms |
| Udavarta Yoni | Discharge of frothy menstrual blood with difficulty |
| Vandhya Yoni | No menstruation at all |
| Vipluta Yoni | Pain in vagina every day |
| Paripluta Yoni | Severe pain during copulation |
| Vatala Yoni | Vagina is rough, inactive, has pain and pricking |
In the first four diseases mentioned here, pain and other features of vata aggravation are present.
Types of Pittaja Yoni Vyapat and their symptoms
सदाहं प्रक्षरत्यस्रं यस्यां सा लोहितक्षरा |
सवातमुद्गिरेद्बीजं वामिनी रजसा युतम् ||१२||
प्रस्रंसिनी स्यन्दते तु क्षोभिता दुःप्रसूश्च या |
स्थितं स्थितं हन्ति गर्भं पुत्रघ्नी रक्तसंस्रवात् ||१३||
अत्यर्थं पित्तला योनिर्दाहपाकज्वरान्विता |
चतसृष्वपि चाद्यासु पित्तलिङ्गोच्छ्रयो भवेत् ||१४||
Pittaja Vaginal Disorders –
| Name of Vaginal Disorder caused by Pitta | Symptoms |
| Lohitaksara Yoni | Menstrual blood is discharged in more quantity, accompanied with burning sensation |
| Vamini Yoni | Expulsion of seed (ovum) along with menstrual blood accompanied with discharge of air / gas |
| Sramsini Yoni | Elimination of more blood,
Weakness and Difficulty in delivery of child |
| Putraghni Yoni | Retention of seed (embryo) for short period of time and is later killed due to excess bleeding |
| Pittala Yoni | Severe burning sensation and ulceration in the vagina
Fever |
In the first four of the above mentioned diseases, there will be features of aggravation of pitta.
Types of Kaphaja Yoni Vyapat and their symptoms
अत्यानन्दा न सन्तोषं ग्राम्यधर्मेण गच्छति |
कर्णिन्यां कर्णिका योनौ श्लेष्मासृग्भ्यं प्रजायते ||१५||
मैथुनेऽचरणा पूर्वं पुरुषादतिरिच्यते |
बहुशश्चातिचरणादन्या बीजं न विन्दति ||१६||
श्लेष्मला पिच्छिला योनिः कण्डूयुक्ताऽतिशीतला |
चतसृष्वपि चाद्यासु श्लेष्मलिङ्गोच्छ्रितिर्भवेत् ||१७||
Kaphaja Vaginal Disorders –
| Name of Vaginal Disorder caused by Kapha | Symptoms |
| Atyananda Yoni | No pleasure (in women) from copulation |
| Karnini Yoni | Sprouts or growths produced by kapha and blood in the vagina |
| Acarana Yoni | Woman gets orgasm earlier to man in copulation |
| Aticarana Yoni | Woman copulates much but does not retain the seed (does not conceive at all) |
| Slesmala Yoni | Woman has very slimy vagina
Itching and very cold feeling |
In the first four diseases mentioned above, there will be kapha aggravation symptoms.
Types of Tridoshaja Yoni Vyapat and their symptoms
अनार्तवस्तना षण्डी खरस्पर्शा च मैथुने |
अतिकायगृहीतायास्तरुण्याः फलिनी भवेत् ||१८||
विवृताऽतिमहायोनिः सूचीवक्त्राऽतिसंवृता |
सर्वलिङ्गसमुत्थाना सर्वदोषप्रकोपजा ||१९||
चतसृष्वपि चाद्यासु सर्वलिङ्गोच्छ्रितिर्भवेत् |
पञ्चासाध्या भवन्तीमा योनयः सर्वदोषजाः ||२०||
Tridoshaja Vaginal Disorders
| Name of Vaginal Disorder caused by Tridosha | Symptoms |
| Sandha Yoni | No menstruation,
Absence of breasts Woman experiences roughness / friction during copulation |
| Aphalini Yoni | Woman needs a man of big size for copulation and still
Does not conceive |
| Maha Yoni | Vagina is very wide |
| Sucivaktra Yoni | Vagina is very constricted |
| Tridoshaja Yoni | Features of aggravation of all the doshas will be present |
In the first four diseases mentioned above, symptoms of aggravation of all the doshas will be present. These five diseases produced by the three doshas are incurable.
Cikitsã – treatment
प्रतिदोषं तु साध्यासु स्नेहादिक्रम इष्यते |
दद्यादुत्तरबस्तींश्च विशेषेण यथोदितान् ||२१||
कर्कशां शीतलां स्तब्धामल्पस्पर्शां च मैथुने |
कुम्भीस्वेदैरुपचरेत् सानूपौदकसंयुतैः ||२२||
मधुरौषधसंयुक्तान् वेशवारांश्च योनिषु |
निक्षिपेद्धारयेच्चापि पिचुतैलमतन्द्रितः ||२३||
धावनानि च पथ्यानि कुर्वीतापूरणानि च |२४|
Administration of therapies like oleation etc. (and Pancakarma therapies as and when needed) are desirable for the diseases caused by each dosha separately and also those which are curable. Mainly, vaginal enema is very effective and should be administered.
Below mentioned treatments should be done if the vagina is rough, cold, inactive (rigid) and insensitive during copulation –
Kumbhi Sveda – Meat of animals living in marshy lands and those living in water should be boiled with water. The steam coming from it should be allowed to the vagina.
Vesavara i.e. meat soup cooked with herbs predominantly of sweet taste should be introduced into the vagina (douche).
The woman should always use / wear a diaper soaked in oil without laxity.
The vagina should be washed with suitable medicines (medicated decoction etc).
ओषचोषान्वितासूक्तं कुर्याच्छीतं विधिं भिषक् ||२४||
दुर्गन्धां पिच्छिलां चापि चूर्णैः पञ्चकषायजैः |
पूरयेद्राजवृक्षादिकषायैश्चापि धावनम् ||२५||
योन्यां तु पूयस्राविण्यां शोधनद्रव्यसम्भृतैः |
सगोमूत्रैः सलवणैः शोधनं हितमिष्यते ||२६||
Cold treatments described previously (in the context of bleeding diseases) should be administered if there is burning and sucking sensation.
Powder of five astringent herbs (Pancavalkala) or that of Rajavrksa should be used to fill in the vagina, when there is foul smell and sliminess in the vagina. The vagina should also be washed with herbal decoctions.
Decoction of purificatory herbs added with gomutra and saindhava lavana should be used for washing the vagina if the vagina is exuding pus.
बृहतीफलकल्कस्य द्विहरिद्रायुतस्य च |
कण्डूमतीमल्पस्पर्शां पूरयेद्धूपयेत्तथा ||२७||
वर्तिं प्रदद्यात् कर्णिन्यां शोधनद्रव्यसम्भृताम् |
प्रस्रंसिनीं घृताभ्यक्तां क्षीरस्विन्नां प्रवेशयेत् ||२८||
पिधाय वेशवारेण ततो बन्धं समाचरेत् |
प्रतिदोषं विदध्याच्च सुरारिष्टासवान् भिषक् ||२९||
प्रातः प्रातर्निषेवेत रसोनादुद्धृतं रसम् |
क्षीरमांसरसप्रायमाहारं विदधीत च ||३०||
Wicks prepared with purificatory herbs should be put into the vagina in Karnini Yoni.
In the case of Prasramsini Yoni, ghee should be used to anoint the vagina. Later, fomentation should be done with milk and meat soup. Following this, the vagina should be pushed inside and bandage applied.
Every morning, dura, arista or asava, appropriate to each dosha, should be administered by the physician. She should be given meat soup added with rasona – garlic for drinking. She should eat food with more milk and meat soup.
शुक्रार्तवादयो दोषाः स्तनरोगाश्च कीर्तिताः |
क्लैब्यस्थानानि मूढस्य गर्भस्य विधिरेव च ||३१||
गर्भिणीप्रतिरोगेषु चिकित्सा चाप्युदाहृता |
सर्वथा तां प्रयुञ्जीत योनिव्यापत्सु बुद्धिमान् |
अपप्रजातारोगांश्च चिकित्सेदुत्तराद्भिषक् ||३२||
Treatment of disorders of Sukra and Artava and of breasts, causes of klaibya – impotence, mudha garbha – foetal obstruction and treatment of pregnant women during each month have already been described.
In Yoni Vyapat i.e. vaginal diseases, the intelligent physician should adopt all those without any laxity. Diseases of premature delivery such as fevers etc. should be treated by the physician by referring to further chapters of Uttara Sthana.
इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कुमारतन्त्रे योनिव्यापत्प्रतिषेधो नाम (द्वादशोऽध्यायः, आदितोऽ) अष्टत्रिंशत्तमोऽध्यायः।।३८।।
Thus ends the thirty-eighth chapter by name Yoni vyāpat pratiședha in Uttara sthana of Suśrutasamhita.
Thus ends Kaumārabhrtya/Balacikitsa in Uttara sthana of Suśruta samhita.
