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Lajjalu treatment of uterine prolapse
Prakash Pharmaceuticals, D-149, 7sf Cross, Vidyanagar; SHIVAMOGGA-577203, Kamataka State, lndia
Mimosa pudica was found useful in cases of uterine prolapse with bleeding. consistent with my experience of working
with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has
been avoided up to this date, and is not now expected to be recommended.
Key words: Ayurveda, uterine prolapse, lajjalu, Mimosa pudica linn-
T, M. Shivanctndaiah, T. M. Indudhar,
P raka sh Cl in ic, Sh ivam ogg a -577 202.
e- m ail : indudhar tm@gmail. c om,'r 9 4 9 4 4 I I 5 4 4 3 6
e-mail: tmshiv@gmail.com, +91 99012 49108
INTBODUCTION
This atticle is a detailed report of a tecent Ayutvedic
herbal treatment of Utedne Ptolapse, which the senior
authot has successfully applied in hundteds of cases ovet
the past four decades. Utedne Ptolapse is a specific form
of the vatious kinds of genital ptolapse common among
the female popuJation today, paticulady those over 50.
Vhile undetlying causes may not be cleat, what is clear
is that physical weakness in that region is quite commorr.:
Biomedical treatment tends to be expensive. For stages
1 and 2, vatious outpatient treatments including vaginal
pessatisstlJ may be ptesctibed, while fot latet stages 3 and
4, sutgety is usually tecommended. Discussions of non-
sutgical altetnatiyes emphasize that little infotmation is
available.t2l National costs of this lack of altetnative are
high. In a2005 study of female hospitalization in the US,
!(hiteman et al, f<rund gynecological disotdets to account
fot 7oh of hospitalizations fot women aged 15 to 44,
and 1,4o/o fot those aged 45 to 54.t31 Of these, the genital
ptolapse rate was 7.0, a figute that had temained steady
fot 7 yeats.[3J
$(hile hystetectomy is the classic sutgical intetvention fot
utetine ptolapse, studies show that its application in eldetly
populations tequiting it ate not without tisk,lal patticulatly
when co-motbidity conditions common in the eldetly ate
Address for correspondence:
Dr. T M. Shivanandaiah, Prakash Clinic, D-149,
First Cross, Vidyanagar, Shivamogga - 577203,lndia.
E-mail: tmshiv@gmail.com
Receivedl 03-Apr-2O10
Revised: 2O-Apr-2O10
Acceptedl 25-Apr-2O10
DOI: 1 0.4 1 03/0975-9476.65090
Journal of Ayurveda & lntegrative Medicine I April 201O I Vol 1
present e.g. hlpettension, tespitatoty disease, CID ot DM.
Modetnaltetnatives include attempts to rebuild otgan walls
with porcine skin collagen implanttsJ ot polyptopllene,l6J
possibly supplemented by such devices as tension-ftee
vaginal tape.tr Mote tecent apptoaches favot minimally
invasiyel6] ot lapatoscopic methods of Jigament repait.iS,el
T,'helattet haye been subject to a recent systematic teview:t1o1
The coet of these methods, and the inevitable pain and tisks
involved, make the possibiJity of a putely hetbal altetnative
highly desitable, both fot the patient and the healthcate
system, The authot has used just such an apptoach ftom
Alurveda fot sevetal decades. Though not part of the
ancient Jitetatute, the herb employed, Lajjalru (Sanskrit)
(Pwdica Minzo.ia L) is well desctibed in mote tecent literature
dating from 400-500 yeats ago [Box 1], togethet with its
uses [Box 2].
The following recent case represents a gpical example.
CASE HIST0BY: LAJJAI-U USE F0R PROI-APSED UTERUS
A woman aged 44 years reported with a histoty of
vaginal bleeding accompanied by pain, which she said
had statted a year pteviously, and had been repeating
occasionally. She had been examined at the Medwin
Hospital, Ban1aru Hills, Andhta Ptadesh, on 1B'h June
2009, and advised to wear utedne dngs. She was also
given medicine to take. She chose not to weat the tings,
and only took the medicines.
In het second check on 14 October 2009, an ulttasonogram,
found that the condition had aggtavated. Subsequent
anasis found het Utetine Ptolapse to haye teached stage
3. Het Gynecologist advised hystetectomy, as the only
temedyavailable. The patient declined the operation, saying
I lssue 2 125
Shivanandaiah and lndudhar: Lajjalu treatment of uterine prolapse
Box 1: Lajjalu / namskari in ayurvedic literature
r. Ref: Bhavaprakasha Nighantu
Lajjalu sheetala tikta kashaya Kaphapittajitl
Raktapittamateesaram yonirogam vinashayayethl I
Lajjalu (Mimosa pudica L.):
Potency - cold;
Tastes - bitter and astringent;
Normalises vitiated Doshas - Pitta and Kapha;
Cures - bleeding disorders, diarrhoea and
diseases of female genitourinary tract
z. Ref: Kaiyyadevea Nighantu
Namaskari Himaatikta Kashayaa kapha pittahal
Yonirogam ateesara raktapittecha nashayeth
Namaskari (Mimosa pudica L.)
Potency - cold
Taste of drug - astringent and bitter
Can pacify vitiated Doshas - Kapha and Pitta
Cures: diseases offemale genito urinary tract,
diarrhoea and bleeding disorders.
Box 2: Mode of use
Ref: Sharma DP Vanoushadhi shataka (Hindi). P.rzz
Yonibhramshaha yonimargse kamal (Garbhashaya; Uterus) bahar
ajanepar Lajjalu ke patronka Ras (liquid from crushing)Ya OR mul
(Root) Ghiskar kamal par Lep (application) lagaave, aur haatonpar
lepkar upar chadave, Langot bhaandkarAaram karne se kamal rah
jaatahai, Naye rog me Laabh hota hai.
ln acute uterine prolapse (cervix or uterus is prolapsed through
vaginal orifice), application of paste of Lajjalu root and leaves on
the prolapsed region followed by a pplication of a tight bandage is
beneficial.
she was anemic, and consideted hetself too weak fot the
operation. Instead, she visited my cJinic in Shivamogga,
I{atnataka, to try A},urvedic treatment.
My diagnosis fot tteatment (as in Figutes 2 and 3):
complaints wete bleeding per vagina - quantity small with
bad odot; feeJing of a healy mass in the uto-genital passage;
occasional pain in the loins, back and thighs. Genetal
examination revealed het to be anemic & emaciated: debilitv
and apathy matked.
Treatment: On the basis of experience, infotmation in Box
3, and with patient's consent, Lajjalu was selected:
Kashalaw (Decoction) to be taken otally; and Swar"asa
(Jiquid/paste ftom ctushing) as external application.
Regime: i). 30m1. La11a/w Kashalaw (plant decoction)
given 3 times a day fot 10 days. The patient found slight
imptovement in condition; the pain decteased and the
bleeding also seemed to be less. ii). an aqueous extract
fot otal intake was continued along with the extetnal
application i.e. a thick paste of Lajjalu root was applied
over the Ptolapse inside the vagina and a tight diapet was
126
Box 3: Lajjalu / namskari = Mimosa pudica
linnaeus
Family; Mimosaceae. Botany: Mimosa pudica Linnaeus
Habitat; Native to tropicalAmerica; naturalized in tropical and
subtropical regions of lndia.
English names; Touch-me-not, Sensitive-plant, Humble-Plant.
Ayurvedic Names; Lajjalu, Lajavanti, Namas kari, Samanga, San ko-ch ini,
Shamipatra, Khadirka, Raktapadi. (Siddha/Tamil; hottalsurungi.)
Action; Leaf-astringent, alterative, anti-septic, styptic, blood purifi er.
Uses: diarrhoea, dysentery, hemophilic conditions, leucorrhoea,
morbid conditions of vagina, piles, fistula, hydrocele and glandular
swellings.
Root: gravel and urinary complaints Decoction : relief of asthma.
Biochemistry: contains mimosine and turgorin.
Leaf movements: due to derivatives of 4-O- (beta-D-glucopyranosyl-6'-
sulphate) Gallic acid.
Aerial parts: contain z"-O-rhamnosylorientin &
z"-Orhamnosylisoorientin, C-glycosylfl avones.
Dosage; Whole plant, root
- 10 - zo ml juice; 5o-roo ml decoction.
Central Council for Research in Ayurveda and Sidha (CCRAS).
Whole plant-ro-zoq for decoction. (APl, Vol. I l.)
Laiialu / Namskari in Avurvedic Literature
1 . 'oqrs: rftaor fitl $qrqr s$fqqfi( I
,ttfircftmt qllaitqra fiarniqrr' ('{rss-q..t)
2. qg.ft Ggrfro 6qrq 6q'ftra r
qifr''irrc erfrsR 16' fr+il T"riil nGq{qfua)
3. 'rucr{t {rc'icer (?Er €ii(cfi{r r
rqolq ri*ltqai urla gaa nqar rle(lt'
(+. lr )
4. 'rtaqr{t +E'rftm lq<rfksrtarfhdt r
dlnqr6Nrarqeq$gsqrqgq u' ( rr. fl{. )
W. I. VI, 382. Sloka 1'3 & 4 mentioned on
Page 750 Dravyaguna Vijnana
B. B. O., ii, 336 by priyavritSharma,
'Choukambha Bharti Academy
5. +furE{r qtft cT.i t errra lneflrq; qrfl"
3nqr+qr, irdrg t q#qr r+r qr
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frsql q'q-aqr dq a..Tr+ 3TR 6nnq-{ Aq-fr-r
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6q?r rdqrirT t, cq n iln drlr fr arar i rr
(q-ffi"rf,q'fiftt-src. tus <rfq-srEaci I
Figure 1: References from literature
put on, to tetain the paste in the contact position fot 2 to 3
houts (patients never report any reaction to, or discomfott
ftom, these treatments).
The patient was advised that thtee 40 day coutses of
treatment would be needed. The fitst course began on
11.11.09.
Journal of Ayurveda & lntegrative Medicine I April 2O1O I Vol 1 | lssue 2
Shivanandaiah and lndudhar: Lajjalu treatment of uterine prolapse
ftqri-qqs *,*,-,-* I
1": us6 i'igirrffin, ilffi
:: I l::,1;.:::_:",r;l': :':''".': ; ,l#
ln?ti rq* i rxilrfnza! rr,..,,.r:!r ii {{Hrl . I :.= jril ri ir ir+
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Figure 2: Diagnosis 1
Results 1: on 26.11 .09 aftt 1 5 days treatment, extetnal and
intetnal, I noted the following:
")
Bleeding almost stopped.
b) Pain vety slight and not continuous.
.) Etosion and ptolapse matkedly teduced; only giving
very slight inconvenience.
Results 2: on28 Decembet 2009,at the end of the fitst 40
day Ayutvedic treatment, the patient undetwent a second
Ulttasound Scan. Results were as follows:
Utetus: notmal in size, measutes 9.5 x 5.5 x 4.3 cm; showing
antetiot wall intta-utetal fibtoid with calcification within
it. Suggestive of degenetating of fibtoid measuting 1.0 x
0.8 cm.
As on genetal checkup on 10.10.2009 measutes notmal
white dischatge, mictutation, no dysutia (painful ot difficult
utination)
Ovaties: both ovaties now notmal in size: echotextute tight
2.4 x 2.3 cm; left 2.4 x 2.7 cr,.:r.
No evidence of ftee fluid in pouch of Douglas: no
tendetness in the patt.
Livet: eatliet mildly enlatged in size with incteased echo
textufe.
Now, size is notmal, and shows homogeneous echo textute.
Ulttasound Scan of pelvis aftet completion of 3td course
of tteatment : Repott Utetus is notmal in size and measutes
6.6x3.3 x 5.2 cm shows smallintramural fibtoid measuting
9.6mm in antetiot wall. Utetine endomettial echo (5.6 mm)
Journal of Ayurveda & lntegrative Medicine I April 2O1O I Vol 1 | lssue 2
is well visualised and appeats notmal. 2.6 x 1.8 x 2.7cm.
left ovaty 2.5 x 1.6 x 2.5 cm. both ovaties ate notmal in
size and echotecxtute. No evidences of ftee fluid in Pouch
of Douglas.
Clinical Conclusion: Patient's condition shows
imptovements in sevetal ateas.
Also, since the patient had been advised hystetectomy,
but being unwilling to undetgo surgery, had ptefetted
to try A),urvedic medicine, it suggests that het fitst 40
days Ayutvedic tteatment may be a step to avoiding
hystetectomy (as in findings ftom my ptevious treatments).
Dlscussl0N
I have tteated cases of Utetine Ptolapse of diffetent
degtees fot many years, during which I have ptesented a
few case reports fot the benefit of ptofessionals and the
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rnrir fir ?T{ tn, q}t ssft Frsa ftr irq ,f,dtuT,
t r drt# ft qrrq$il
#rr{tgr*crTffit cr"nr h ffr-"rdffifir sqFrtr Ec#r.
rrd c{taT,{qrqfucck fl{rgrP{ TsitTqlqfs r ctfit {cr ls{r gI
s*{i++nT r<"nqlfuflr. xsrtqraqi il' ( qf,tr{; ) r cfi{ tri ( cfl ) ft
+ fun #{ rcr{l $'t {flstilr trfr t-( t ) rlq, ild rifrr rr
(Oblcot of mltil Er!+!ic!6. ), rq-,q.lsll: strl rEf{{ ( qErcFd: ),
) rarm, fr rrrfr * qitr rtr + rm il ryr qfu t, * +qt t r s{r-tE
fqvrm cgrfw ryfu B q:rRt1' | ( rmrr+ i, ( q ) rFflq, ct{ qq *
+r rH'{ c{l-'til{{fir+fn arsf,Fr('r ( ilfigl{i: ) r ftm rnr< t qrrq
ri ri.r +q ih rqi c{ fr ril il rm a{ t clil r{fi nFr h*q't r
sc$ rl rql rt gfirE{l{ r$(q $tr qril t r !fr fl{s-il{ rnFr d E{q
Figure 3: Diagnosis 2
127
Shivanandaiah and lndudhar: Lajjalu treatment of uterine prolapse
genetal pubJic. Many patients come ftom diffetent parts
of the country, among them, cases of 2"d and 3'd degtee
ptolapse as diagnosed by Gynecologists. Many such utetine
ptolapse cases have come to me with scan reports and othet
details. This atticle reports a very recent case.
Fot the entitety of my 50 yeats medical ptactice, I have
onlyused Ay;tvedic dtugs to treat, usually fotmulated and
ptesented in capsule fotm fot incteased convenience over
chwrna fotm. Fot extetnal appJication on affected parts, I
glve Swarau exttact, which patients take fot lengthy petiods,
dosage depending on the degtee of ptolapse.
In addition to utetine ptolapse (Gar"bha Bhrawsha),Lajjaluis
used fot ptolapsed tectum (Gwda Bhrawsha), vaginal-utetine
disotdets (Yoni Vlapar), dysfunctional utetine bleeding
(Raktaynl, ptles (Arsha),anal fistula (Bh agandar"),extetnal &
intetnal bleeding & non-bleeding dysmenotthoea (Rqoh),
leucotthoea (Suet Pradar"a), & utinaty infections.
0vERAtt c0Nctusl0N
Miwosa Pwdica was found to be vety useful in this case
of utetine ptolapse with bleeding, consistent with my
expetience of wotking with the condition fot mote than
45 yeats, and tteating hundteds of such cases of thitd
degtee utetine ptolapse. Hystetectomy was avoided up to
this date, and is not now expected to be tecommended.
Editotial Comment: As a fitst single case study by the
authots, this was accepted because of its wide potential
intetest and implications. Today's high ptevalence of
Utetine Ptolapse, and the nature of biomedical treatments,
mean that the possibility of wide scale adoption of Lajjalu
treatment fot that and telated ptoblems metits futthet
evaluation.
REFERENCES
1. Hansom LA, Schulz JA, Flood CG, Cooley B, Tam F. Vaginal
pessaries in managing women with pelvic organ prolapse
and urinary incontinence: Patient characteristics and factors
contributing to success. lnt Urogynecol J Pelvic Floor
Dysfunct 2006;1 7:1 55-9.
Poma PA. Non-surgical management of genital prolapsed:
Review and recommendations. J Repro Med 2000;45:10-5.
Whiteman MK, Kuklina E, Jamieson DJ, Hillis SD, Marchbanks
PA. lnpatient hospitalization for gynecologic disorders in the
United States. Am J Obstet Gynecol 2010.1n press.
Piya-Anant M, Therasakvichya S, Leelaphatanadit C,
Techatrisak K. lntegrated health research program for the
Thai elderly: Prevalence of genital prolapse and effectiveness
of pelvic f loor exercise to prevent worsening of genital
prolapse in elderly women. J Med Assoc Thai 2003;86:509-
15.
David-Montefiore E, Barranger E, Dubernard G, Detchev R,
Nizard V, Darai E. Treatment of genital prolapse by hammock
using porcine skin collagen implant (Pelvicol). Urology
2005;66:1314-8.
Chibelean B. Minimally invasive surgical treatment of complex
genital prolapse in elderly women: lmpact on quality of life.
Eur Urol Suppl 2009;8:664.
de Tayrac R, Gervaise A, Cheauvaud-Lambling A, Fernandez
H. Combined genital prolapse repair reinforced with a
polypropylene mesh and tension-free vaginal tape in women
with genital prolapse and stress urinary incontinence: A
retrospective case-control study with short-term follow-up.
Acta Obstet Gynecol Scand 2004;83:950-4.
Schwartz M, Abbott KR, Glazerman L, Sobolewski C, Jarnagin
B, Ailawadi R, et al. Positive symptom improvement with
laparscopic uterosacral ligament repair for uterine or vaginal
vault prolapsed: lnterim results from an active multicenter
trial. J Minim lnvasive Gynecol 2OO7;14:570-6.
Uccella S, Ghezzi F, Bergamini V, Serati M, Cromi A, Franchi
M, et al. Laparscopic uterosacral ligaments plication for
the treatment of uterine prolapse. Arch Gynecol Obstet
2OO7;6:225-9.
Margulies RU, Rogers MA, Morgan DM. Outcomes of
transvaginal uterosacral ligament suspension: Systematic review
and metaanalysis. Am J Obstet Gynecol 2O1O;2O2:124-34.
Source of Support: Nil, Conflict of lnterest: None declared
2.
4.
5.
6.
7.
124 Journal of Ayurveda & lntegrative Medicine I April 2O1O I Vol 1 | lssue 2

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Mimosa pudica; Lajjalu treatment of uterine prolapse

  • 1. Lajjalu treatment of uterine prolapse Prakash Pharmaceuticals, D-149, 7sf Cross, Vidyanagar; SHIVAMOGGA-577203, Kamataka State, lndia Mimosa pudica was found useful in cases of uterine prolapse with bleeding. consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended. Key words: Ayurveda, uterine prolapse, lajjalu, Mimosa pudica linn- T, M. Shivanctndaiah, T. M. Indudhar, P raka sh Cl in ic, Sh ivam ogg a -577 202. e- m ail : indudhar tm@gmail. c om,'r 9 4 9 4 4 I I 5 4 4 3 6 e-mail: tmshiv@gmail.com, +91 99012 49108 INTBODUCTION This atticle is a detailed report of a tecent Ayutvedic herbal treatment of Utedne Ptolapse, which the senior authot has successfully applied in hundteds of cases ovet the past four decades. Utedne Ptolapse is a specific form of the vatious kinds of genital ptolapse common among the female popuJation today, paticulady those over 50. Vhile undetlying causes may not be cleat, what is clear is that physical weakness in that region is quite commorr.: Biomedical treatment tends to be expensive. For stages 1 and 2, vatious outpatient treatments including vaginal pessatisstlJ may be ptesctibed, while fot latet stages 3 and 4, sutgety is usually tecommended. Discussions of non- sutgical altetnatiyes emphasize that little infotmation is available.t2l National costs of this lack of altetnative are high. In a2005 study of female hospitalization in the US, !(hiteman et al, f<rund gynecological disotdets to account fot 7oh of hospitalizations fot women aged 15 to 44, and 1,4o/o fot those aged 45 to 54.t31 Of these, the genital ptolapse rate was 7.0, a figute that had temained steady fot 7 yeats.[3J $(hile hystetectomy is the classic sutgical intetvention fot utetine ptolapse, studies show that its application in eldetly populations tequiting it ate not without tisk,lal patticulatly when co-motbidity conditions common in the eldetly ate Address for correspondence: Dr. T M. Shivanandaiah, Prakash Clinic, D-149, First Cross, Vidyanagar, Shivamogga - 577203,lndia. E-mail: tmshiv@gmail.com Receivedl 03-Apr-2O10 Revised: 2O-Apr-2O10 Acceptedl 25-Apr-2O10 DOI: 1 0.4 1 03/0975-9476.65090 Journal of Ayurveda & lntegrative Medicine I April 201O I Vol 1 present e.g. hlpettension, tespitatoty disease, CID ot DM. Modetnaltetnatives include attempts to rebuild otgan walls with porcine skin collagen implanttsJ ot polyptopllene,l6J possibly supplemented by such devices as tension-ftee vaginal tape.tr Mote tecent apptoaches favot minimally invasiyel6] ot lapatoscopic methods of Jigament repait.iS,el T,'helattet haye been subject to a recent systematic teview:t1o1 The coet of these methods, and the inevitable pain and tisks involved, make the possibiJity of a putely hetbal altetnative highly desitable, both fot the patient and the healthcate system, The authot has used just such an apptoach ftom Alurveda fot sevetal decades. Though not part of the ancient Jitetatute, the herb employed, Lajjalru (Sanskrit) (Pwdica Minzo.ia L) is well desctibed in mote tecent literature dating from 400-500 yeats ago [Box 1], togethet with its uses [Box 2]. The following recent case represents a gpical example. CASE HIST0BY: LAJJAI-U USE F0R PROI-APSED UTERUS A woman aged 44 years reported with a histoty of vaginal bleeding accompanied by pain, which she said had statted a year pteviously, and had been repeating occasionally. She had been examined at the Medwin Hospital, Ban1aru Hills, Andhta Ptadesh, on 1B'h June 2009, and advised to wear utedne dngs. She was also given medicine to take. She chose not to weat the tings, and only took the medicines. In het second check on 14 October 2009, an ulttasonogram, found that the condition had aggtavated. Subsequent anasis found het Utetine Ptolapse to haye teached stage 3. Het Gynecologist advised hystetectomy, as the only temedyavailable. The patient declined the operation, saying I lssue 2 125
  • 2. Shivanandaiah and lndudhar: Lajjalu treatment of uterine prolapse Box 1: Lajjalu / namskari in ayurvedic literature r. Ref: Bhavaprakasha Nighantu Lajjalu sheetala tikta kashaya Kaphapittajitl Raktapittamateesaram yonirogam vinashayayethl I Lajjalu (Mimosa pudica L.): Potency - cold; Tastes - bitter and astringent; Normalises vitiated Doshas - Pitta and Kapha; Cures - bleeding disorders, diarrhoea and diseases of female genitourinary tract z. Ref: Kaiyyadevea Nighantu Namaskari Himaatikta Kashayaa kapha pittahal Yonirogam ateesara raktapittecha nashayeth Namaskari (Mimosa pudica L.) Potency - cold Taste of drug - astringent and bitter Can pacify vitiated Doshas - Kapha and Pitta Cures: diseases offemale genito urinary tract, diarrhoea and bleeding disorders. Box 2: Mode of use Ref: Sharma DP Vanoushadhi shataka (Hindi). P.rzz Yonibhramshaha yonimargse kamal (Garbhashaya; Uterus) bahar ajanepar Lajjalu ke patronka Ras (liquid from crushing)Ya OR mul (Root) Ghiskar kamal par Lep (application) lagaave, aur haatonpar lepkar upar chadave, Langot bhaandkarAaram karne se kamal rah jaatahai, Naye rog me Laabh hota hai. ln acute uterine prolapse (cervix or uterus is prolapsed through vaginal orifice), application of paste of Lajjalu root and leaves on the prolapsed region followed by a pplication of a tight bandage is beneficial. she was anemic, and consideted hetself too weak fot the operation. Instead, she visited my cJinic in Shivamogga, I{atnataka, to try A},urvedic treatment. My diagnosis fot tteatment (as in Figutes 2 and 3): complaints wete bleeding per vagina - quantity small with bad odot; feeJing of a healy mass in the uto-genital passage; occasional pain in the loins, back and thighs. Genetal examination revealed het to be anemic & emaciated: debilitv and apathy matked. Treatment: On the basis of experience, infotmation in Box 3, and with patient's consent, Lajjalu was selected: Kashalaw (Decoction) to be taken otally; and Swar"asa (Jiquid/paste ftom ctushing) as external application. Regime: i). 30m1. La11a/w Kashalaw (plant decoction) given 3 times a day fot 10 days. The patient found slight imptovement in condition; the pain decteased and the bleeding also seemed to be less. ii). an aqueous extract fot otal intake was continued along with the extetnal application i.e. a thick paste of Lajjalu root was applied over the Ptolapse inside the vagina and a tight diapet was 126 Box 3: Lajjalu / namskari = Mimosa pudica linnaeus Family; Mimosaceae. Botany: Mimosa pudica Linnaeus Habitat; Native to tropicalAmerica; naturalized in tropical and subtropical regions of lndia. English names; Touch-me-not, Sensitive-plant, Humble-Plant. Ayurvedic Names; Lajjalu, Lajavanti, Namas kari, Samanga, San ko-ch ini, Shamipatra, Khadirka, Raktapadi. (Siddha/Tamil; hottalsurungi.) Action; Leaf-astringent, alterative, anti-septic, styptic, blood purifi er. Uses: diarrhoea, dysentery, hemophilic conditions, leucorrhoea, morbid conditions of vagina, piles, fistula, hydrocele and glandular swellings. Root: gravel and urinary complaints Decoction : relief of asthma. Biochemistry: contains mimosine and turgorin. Leaf movements: due to derivatives of 4-O- (beta-D-glucopyranosyl-6'- sulphate) Gallic acid. Aerial parts: contain z"-O-rhamnosylorientin & z"-Orhamnosylisoorientin, C-glycosylfl avones. Dosage; Whole plant, root - 10 - zo ml juice; 5o-roo ml decoction. Central Council for Research in Ayurveda and Sidha (CCRAS). Whole plant-ro-zoq for decoction. (APl, Vol. I l.) Laiialu / Namskari in Avurvedic Literature 1 . 'oqrs: rftaor fitl $qrqr s$fqqfi( I ,ttfircftmt qllaitqra fiarniqrr' ('{rss-q..t) 2. qg.ft Ggrfro 6qrq 6q'ftra r qifr''irrc erfrsR 16' fr+il T"riil nGq{qfua) 3. 'rucr{t {rc'icer (?Er €ii(cfi{r r rqolq ri*ltqai urla gaa nqar rle(lt' (+. lr ) 4. 'rtaqr{t +E'rftm lq<rfksrtarfhdt r dlnqr6Nrarqeq$gsqrqgq u' ( rr. fl{. ) W. I. VI, 382. Sloka 1'3 & 4 mentioned on Page 750 Dravyaguna Vijnana B. B. O., ii, 336 by priyavritSharma, 'Choukambha Bharti Academy 5. +furE{r qtft cT.i t errra lneflrq; qrfl" 3nqr+qr, irdrg t q#qr r+r qr {a frsql q'q-aqr dq a..Tr+ 3TR 6nnq-{ Aq-fr-r 3q{ o-gr+, E-*nilrdrdr6.{ eTnrq 6-{++ 6q?r rdqrirT t, cq n iln drlr fr arar i rr (q-ffi"rf,q'fiftt-src. tus <rfq-srEaci I Figure 1: References from literature put on, to tetain the paste in the contact position fot 2 to 3 houts (patients never report any reaction to, or discomfott ftom, these treatments). The patient was advised that thtee 40 day coutses of treatment would be needed. The fitst course began on 11.11.09. Journal of Ayurveda & lntegrative Medicine I April 2O1O I Vol 1 | lssue 2
  • 3. Shivanandaiah and lndudhar: Lajjalu treatment of uterine prolapse ftqri-qqs *,*,-,-* I 1": us6 i'igirrffin, ilffi :: I l::,1;.:::_:",r;l': :':''".': ; ,l# ln?ti rq* i rxilrfnza! rr,..,,.r:!r ii {{Hrl . I :.= jril ri ir ir+ fi,n Fiir Fr n .r irn : : rn' litrjn l{r4F r,r rill l ;ri litr!!i i{.mri tr {ir {:,i i. hr ;, :in ' is id{:, ,. a {. . d .. ,,i-.. r.rq c, r:r i iqi tq, (q{ i, sn t. cdni:- tsfk:- mq , {tffi,- {n r- h{ :- ry nttn : qandFr:- {a :- (t**1 Figure 2: Diagnosis 1 Results 1: on 26.11 .09 aftt 1 5 days treatment, extetnal and intetnal, I noted the following: ") Bleeding almost stopped. b) Pain vety slight and not continuous. .) Etosion and ptolapse matkedly teduced; only giving very slight inconvenience. Results 2: on28 Decembet 2009,at the end of the fitst 40 day Ayutvedic treatment, the patient undetwent a second Ulttasound Scan. Results were as follows: Utetus: notmal in size, measutes 9.5 x 5.5 x 4.3 cm; showing antetiot wall intta-utetal fibtoid with calcification within it. Suggestive of degenetating of fibtoid measuting 1.0 x 0.8 cm. As on genetal checkup on 10.10.2009 measutes notmal white dischatge, mictutation, no dysutia (painful ot difficult utination) Ovaties: both ovaties now notmal in size: echotextute tight 2.4 x 2.3 cm; left 2.4 x 2.7 cr,.:r. No evidence of ftee fluid in pouch of Douglas: no tendetness in the patt. Livet: eatliet mildly enlatged in size with incteased echo textufe. Now, size is notmal, and shows homogeneous echo textute. Ulttasound Scan of pelvis aftet completion of 3td course of tteatment : Repott Utetus is notmal in size and measutes 6.6x3.3 x 5.2 cm shows smallintramural fibtoid measuting 9.6mm in antetiot wall. Utetine endomettial echo (5.6 mm) Journal of Ayurveda & lntegrative Medicine I April 2O1O I Vol 1 | lssue 2 is well visualised and appeats notmal. 2.6 x 1.8 x 2.7cm. left ovaty 2.5 x 1.6 x 2.5 cm. both ovaties ate notmal in size and echotecxtute. No evidences of ftee fluid in Pouch of Douglas. Clinical Conclusion: Patient's condition shows imptovements in sevetal ateas. Also, since the patient had been advised hystetectomy, but being unwilling to undetgo surgery, had ptefetted to try A),urvedic medicine, it suggests that het fitst 40 days Ayutvedic tteatment may be a step to avoiding hystetectomy (as in findings ftom my ptevious treatments). Dlscussl0N I have tteated cases of Utetine Ptolapse of diffetent degtees fot many years, during which I have ptesented a few case reports fot the benefit of ptofessionals and the ffid{+l fi d crq{{ flfi t (elr< raa g{tT trrr tftr qr rffi qr ct +ffr fu crmrrir d tqr frq rrq t' c{Ftlfi. rmi qr+ lf SPd+il rt, xfloTt t 'rrtq md ftlfti g[si, cqffi ftr Tit; 6 Tq1T xr grml+r ntit*rrsc( {qt sE rwr t ffit rfts{rlfrtmr 11 Ss{ n(t li {i< rg fltl qt qst fl qrts k{r fir t r frftqfiq rg sf mlr*, rtq ' gltlft r rD I (q)cqhq'cffqr( <uffu qflrr-rrfiqiu!, Et{, qE rrm * rqrq ) ( lrrr Fold Mtrho& of Inwstigaton ) ilf$It+ +ft{$t- l tq rk ( i ) rsq r rr *#t'r {r1fl ft m(e idTt-t t t irnrfs ilrc Tatimny),( r )Elsq{I}ircot 0tatrtim[ ( t ) lEE-{ ) St ( y ) gft ( Baron or [k!.rimt ) x tr u furrl-rrrot{frtt FIFt'f,( so-fi+ IfirGqt ftrt ffirr fit{ *Er{frn 'ffi tr cr !frfm fic *r Wlffirratgrlil rE fl rrt fun rl ? errmq Eqi eqqc] firfiriil il fts6 l-( I ) HE- rtr rqq il M wfi t dt tusn rftr m fr{Tr t r til trr cfi{ ltt t ' t t ) {fitt-flrrfi c il} svr rqt il f,srt rffr qt q qqtdt ilt n t frn t r tt 'rrnf q+{ {t Wtr t r wrtl rqgqq{{rrtqiti+ i rrnridd'rq, t qtr il( sfi( * qcr rErt (wrrqrr+'Hyrfi+ffifr{I. rllt .nc'arrwr )'{BE ril crt t r rg fi{ qtt sf,q rflfr fi rftr dt fr wil fl&c r rtla trd t qrttfrR {EHGflF{ cqcl ctfl'n{k lqal rr wd * na ftT+ tTfl flrr t it rrfifi'tqt t I rtgrrr (t irc qrq qldft*tt'*rr1 r*r * I Ir;rF[ f,il ( qut rrr ] u [tt t r s{qirqr{ ft nrmr t+qrcl{rrq: ffir rmmi q rflq{ p flld rnrir fir ?T{ tn, q}t ssft Frsa ftr irq ,f,dtuT, t r drt# ft qrrq$il #rr{tgr*crTffit cr"nr h ffr-"rdffifir sqFrtr Ec#r. rrd c{taT,{qrqfucck fl{rgrP{ TsitTqlqfs r ctfit {cr ls{r gI s*{i++nT r<"nqlfuflr. xsrtqraqi il' ( qf,tr{; ) r cfi{ tri ( cfl ) ft + fun #{ rcr{l $'t {flstilr trfr t-( t ) rlq, ild rifrr rr (Oblcot of mltil Er!+!ic!6. ), rq-,q.lsll: strl rEf{{ ( qErcFd: ), ) rarm, fr rrrfr * qitr rtr + rm il ryr qfu t, * +qt t r s{r-tE fqvrm cgrfw ryfu B q:rRt1' | ( rmrr+ i, ( q ) rFflq, ct{ qq * +r rH'{ c{l-'til{{fir+fn arsf,Fr('r ( ilfigl{i: ) r ftm rnr< t qrrq ri ri.r +q ih rqi c{ fr ril il rm a{ t clil r{fi nFr h*q't r sc$ rl rql rt gfirE{l{ r$(q $tr qril t r !fr fl{s-il{ rnFr d E{q Figure 3: Diagnosis 2 127
  • 4. Shivanandaiah and lndudhar: Lajjalu treatment of uterine prolapse genetal pubJic. Many patients come ftom diffetent parts of the country, among them, cases of 2"d and 3'd degtee ptolapse as diagnosed by Gynecologists. Many such utetine ptolapse cases have come to me with scan reports and othet details. This atticle reports a very recent case. Fot the entitety of my 50 yeats medical ptactice, I have onlyused Ay;tvedic dtugs to treat, usually fotmulated and ptesented in capsule fotm fot incteased convenience over chwrna fotm. Fot extetnal appJication on affected parts, I glve Swarau exttact, which patients take fot lengthy petiods, dosage depending on the degtee of ptolapse. In addition to utetine ptolapse (Gar"bha Bhrawsha),Lajjaluis used fot ptolapsed tectum (Gwda Bhrawsha), vaginal-utetine disotdets (Yoni Vlapar), dysfunctional utetine bleeding (Raktaynl, ptles (Arsha),anal fistula (Bh agandar"),extetnal & intetnal bleeding & non-bleeding dysmenotthoea (Rqoh), leucotthoea (Suet Pradar"a), & utinaty infections. 0vERAtt c0Nctusl0N Miwosa Pwdica was found to be vety useful in this case of utetine ptolapse with bleeding, consistent with my expetience of wotking with the condition fot mote than 45 yeats, and tteating hundteds of such cases of thitd degtee utetine ptolapse. Hystetectomy was avoided up to this date, and is not now expected to be tecommended. Editotial Comment: As a fitst single case study by the authots, this was accepted because of its wide potential intetest and implications. Today's high ptevalence of Utetine Ptolapse, and the nature of biomedical treatments, mean that the possibility of wide scale adoption of Lajjalu treatment fot that and telated ptoblems metits futthet evaluation. REFERENCES 1. Hansom LA, Schulz JA, Flood CG, Cooley B, Tam F. Vaginal pessaries in managing women with pelvic organ prolapse and urinary incontinence: Patient characteristics and factors contributing to success. lnt Urogynecol J Pelvic Floor Dysfunct 2006;1 7:1 55-9. Poma PA. Non-surgical management of genital prolapsed: Review and recommendations. J Repro Med 2000;45:10-5. Whiteman MK, Kuklina E, Jamieson DJ, Hillis SD, Marchbanks PA. lnpatient hospitalization for gynecologic disorders in the United States. Am J Obstet Gynecol 2010.1n press. Piya-Anant M, Therasakvichya S, Leelaphatanadit C, Techatrisak K. lntegrated health research program for the Thai elderly: Prevalence of genital prolapse and effectiveness of pelvic f loor exercise to prevent worsening of genital prolapse in elderly women. J Med Assoc Thai 2003;86:509- 15. David-Montefiore E, Barranger E, Dubernard G, Detchev R, Nizard V, Darai E. Treatment of genital prolapse by hammock using porcine skin collagen implant (Pelvicol). Urology 2005;66:1314-8. Chibelean B. Minimally invasive surgical treatment of complex genital prolapse in elderly women: lmpact on quality of life. Eur Urol Suppl 2009;8:664. de Tayrac R, Gervaise A, Cheauvaud-Lambling A, Fernandez H. Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: A retrospective case-control study with short-term follow-up. Acta Obstet Gynecol Scand 2004;83:950-4. Schwartz M, Abbott KR, Glazerman L, Sobolewski C, Jarnagin B, Ailawadi R, et al. Positive symptom improvement with laparscopic uterosacral ligament repair for uterine or vaginal vault prolapsed: lnterim results from an active multicenter trial. J Minim lnvasive Gynecol 2OO7;14:570-6. Uccella S, Ghezzi F, Bergamini V, Serati M, Cromi A, Franchi M, et al. Laparscopic uterosacral ligaments plication for the treatment of uterine prolapse. Arch Gynecol Obstet 2OO7;6:225-9. Margulies RU, Rogers MA, Morgan DM. Outcomes of transvaginal uterosacral ligament suspension: Systematic review and metaanalysis. Am J Obstet Gynecol 2O1O;2O2:124-34. Source of Support: Nil, Conflict of lnterest: None declared 2. 4. 5. 6. 7. 124 Journal of Ayurveda & lntegrative Medicine I April 2O1O I Vol 1 | lssue 2