Rasnadi Ksheerapaka: for PID, abdominal pain, Menstrual Pain

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Ksheerapaka is an Ayurvedic dosage form to administer herbs in the medium of milk and water. In this, the milk processed with one or more medicinal herbs is given to combat specific conditions. 

One such preparation called Rasnadi Ksheerapaka has been explained in the context of Yoni Vyapad Chikitsa chapter of Charaka Chikitsa Sthana, chapter 30. This preparation is extremely useful to reduce uterine, vaginal and pelvic pain in women.

Rasnadi Ksheerapaka

Rasnadi Ksheerapaka is one of the best herbal recipes prepared in milk base which is effectively used in treating Yoni Shula.

The term Yoni actually means ‘vagina’ in true terms. But this term is used in broader terms to include the structures in and around the vagina. These structures include uterus (womb), fallopian tubes (uterine tubes), ovaries and pelvis.

Thus Rasnadi Ksheerapaka is an effective analgesic. It alleviates the pain associated with all the above mentioned structures.
Rasnadi Ksheerapaka is a simple formulation which can be prepared at home. Therefore it could be an effective home remedy. But it shall be prepared and tried only on medical recommendation.

Ksheerapaka
Ksheera = Milk
Paka = Cooking, processing

By meaning of root terms of the word Ksheerapaka, it is clear that it is a formulation which is prepared in milk base. The herb or herbs (in this preparation) are boiled in specified quantities of milk and water until only milk remains. By the time the water content of the preparation evaporates, the milk would be saturated with medicinal properties. The final milk recipe obtained after filtering off the herbs is called Ksheerapaka.

Ingredients

Ingredients of Rasnadi Ksheerapaka
In Rasnadi Ksheerapaka there are 3 herbs. They are Rasna (root), Gokshura (fruit) and Vasa (leaves).

Rasna Mula Churna – Small pieces or coarse powder of root (rhizome) of Rasna (Pluchea lanceolata, Alpinia galangal) – ½ pala quantity (24 grams approximately)

Gokshura Phala Churna – Small pieces or coarse powder of fruits of Gokshura (Tribulus terrestris) – ½ pala quantity (24 grams approximately)

Vasa Patra Churna – Small pieces or coarse powder of leaves of Vasa (Adhatoda vasica) – ½ pala quantity (24 grams approximately)

Aja Ksheera (milk of goat) / Go Ksheera (cow’s milk) – 1 ½ pala quantity (72 grams approximately)
Jala (water) – 6 pala (288 grams approximately), i.e. 4 times that of milk

Method of preparation

Method of preparation of Kutaja Ksheerapaka
The roots of Rasna, fruits of Gokshura and Leaves of Vasa should be individually taken in the above said quantities.

They should be pounded individually so as to obtain their coarse powder.

These powders of all 3 ingredients are put into a big vessel consisting of water in the above said quantity

The vessel is heated on moderate fire to prepare Chaturthamsha Avashishta Kashaya of Rasnadi herbs (all 3 herbs) i.e. until ¼ of water remains in the form of the decoction of Kutaja. The remaining liquid or filtrate will be 1 ½ pala i.e. 72 grams approximately (same as the quantity of milk taken).

This Kashaya or decoction is filtered so as to separate the solid ingredients (powder of bark). The filtrate is collected in another sterile vessel.

To this filtrate, the goat’s milk or cow’s milk is added in the mentioned quantity.

The combination of milk and decoction are once again heated on mild (moderate) flame of fire. The ingredients are heated until all the water evaporates and only milk is left over.

72 grams of milk and 72 grams of decoction of Rasna, Gokshura and Vasa are heated until 72ml of water (the part of decoction evaporates) leaving behind half of the total ingredients, i.e. until the milk is left over.
This processed milk is called Rasnadi Ksheerapaka.
It is served warm.

Dose

The final preparation of 72 ml shall be divided into 2 doses of equal volume and administered to the patient.

The medicine should not be carried over for long duration, neither stored, nor preserved. If it is done, the medicine may lose its medicinal property. The second dose should therefore be given within 2.5-3 hours of the first dose.

In conditions of severe pain and associated bleeding from vagina, the whole dose of medicine (ksheerapaka) shall be given in 1 or 2 servings within a short span of time.

Caution –  

• The ksheerapaka should be prepared fresh every time. Large quantity i.e. 72 grams of ksheerapaka is prepared at a time because if more doses is required the medicine cannot be prepared immediately. Since the preparation is time consuming process, it is better to prepare large volume of medicine at a time as a backup, in case it is required. This step can be taken seeing the severity of the condition.
• Rasnadi Ksheerapaka should neither be preserved nor be carried over to the next part of the day or next day. If some medicine remains, it shall be disposed.
• The medicine should not be re-processed or refrigerated. It would lose its properties by doing so.
• Generally 1 or 2 doses would be sufficient in a day. In chronic and stubborn cases, more doses shall be planned.

Benefits

Benefits of Rasnadi Ksheerapaka
Rasnadi Ksheerapaka is used in effective treatment of –

• Yoni Shula – Pain in vagina, uterus, ovaries, fallopian tubes (painful condition of female reproductive system)
• Vataja Shula – Vata type of pain i.e. pricking, gripping, squeezing type of pain in the abdomen and pelvis
• Kati Shula – Pelvic pain, Pelvic Inflammatory Disease (PID)
• Kashtartava – Dysmenorrhea and related pain
• Mutrakrichra – Urinary disorders, dysuria, difficulty in passing urine
• Vasti Shula – pain in urinary bladder

Mode of action

Probable mode of action of Rasnadi Ksheerapaka –
Rasna is the best analgesic and anti-inflammatory herb. It alleviates pain in the abdomen (tummy), pelvis and pelvic organs (uterus, fallopian tubes, ovaries, and vagina)

Gokshura is also a good anti-inflammatory herb. It is a good diuretic and reduces the fluid collection in the tissues. Therefore it reduces the edema associated with female reproductive system and pelvis. It also cleanses the urinary bladder and good for reproductive system.

Vasa is the best medicine in bleeding disorders. Therefore as a part of the combination, it helps in checking excess bleeding and associated pain in excessive vaginal bleeding, dysmenorrhea, dysfunctional uterine bleeding (DUB) and Pelvic Inflammatory Disease (PID)

Thus Rasnadi Ksheerapaka is a multifaceted medicine.

Since the medicine is prepared in the milk base, it also helps in nourishing, replenesihng and strengthening the reproductive system and also the pelvis. The combination as a whole has a disease modifying role and also boosts up the immunity of the pelvic organs.

Just before Finishing –
Pelvic pain, pain associated with excessive bleeding (painful periods) and inflammation of pelvic organs (as evident in PID) are very common problems which trouble many women on regular basis. Rasnadi Ksheerapaka is one good remedy for all these problems especially PID. Since the medicine is given in milk base, it is palatable and also nutritious. Moreover the medicine strengthens the system as a whole apart from alleviating the pain and inflammation of pelvic organs. Do not forget to take the opinion of your Ayurvedic doctor before trying this remedy.
Click to Consult Dr Raghuram Y.S. MD (Ayu)