Kaphaj yonivyapad-nidananatmaka adhyayan : a critical review .

A healthy woman is a promise of a healthy family. The concept of healthy yoni has been asserted in various phases of a woman’s life, from puberty to menopause, the concept of healthy yoni has been mentioned in Ayurveda as well as in modern. Due to change in lifestyle, modern food habits of fast food, junk food she is unable to follow the rules of Dincharya, Rutucharya, Rajaswala, Rutumatiand Sutikaparicharya which are explained by Aacharyas for women’s health. Thus she is prone to various yonirogas, one of which is Yonigat Shewta-Picchilsrava, Yonikandu, Yonigata Alpavedana which are the features of Kaphajayonivyapada and is neglected by women as minor symptoms. Now a days, infection related to yoni is a burning problem irrespective of their age or socioeconomic status. Due to infection, there may be sign and symptoms like vaginal discharge, itching, coldness. In Ayurveda, these types of sign and symptoms are found in Kaphaja yoni vyapad and some of symptoms are similar with Non Specific Vulvovaginitis. Gynaecological disorders have found its immense importance in the field of medicine due to fact that women have a unique function of giving birth. In Ayurveda, women health care is related in separate section, where the term Yoni vyapad includes majority of gynaecological disorders. Before knowing the management, literature of the disease should be known. Therefore, in this study an effort has been put forth to make a literary study covering almost all the aspects of Kaphajayonivyapad as per Ayurveda and modern.

A healthy woman is a promise of a healthy family. The concept of healthy yoni has been asserted in various phases of a woman's life, from puberty to menopause, the concept of healthy yoni has been mentioned in Ayurveda as well as in modern. Due to change in lifestyle, modern food habits of fast food, junk food she is unable to follow the rules of Dincharya, Rutucharya, Rajaswala, Rutumatiand Sutikaparicharya which are explained by Aacharyas for women's health. Thus she is prone to various yonirogas, one of which is Yonigat Shewta-Picchilsrava, Yonikandu, Yonigata Alpavedana which are the features of Kaphajayonivyapada and is neglected by women as minor symptoms. Now a days, infection related to yoni is a burning problem irrespective of their age or socioeconomic status. Due to infection, there may be sign and symptoms like vaginal discharge, itching, coldness. In Ayurveda, these types of sign and symptoms are found in Kaphaja yoni vyapad and some of symptoms are similar with Non Specific Vulvovaginitis. Gynaecological disorders have found its immense importance in the field of medicine due to fact that women have a unique function of giving birth. In Ayurveda, women health care is related in separate section, where the term Yoni vyapad includes majority of gynaecological disorders. Before knowing the management, literature of the disease should be known. Therefore, in this study an effort has been put forth to make a literary study covering almost all the aspects of Kaphajayonivyapad as per Ayurveda and modern.
ayurvedic classics, which disrupts the women hood in various ways. Health care of woman is very important. Any disorders that hampers the general, mental as well as the reproductive health of woman should be considered with care and required medical attention. Female body is highly complex and delicate. Because of special reproductive role, women are at risk of some distinct female disorders. Kaphaja yoni vyapad is one of those diseases. Vaginal discharge means yoni strava is seen as a symptom in case of this disease. As the Stree is mula of reproduction, Stree is important part of our society and family. Being Daughter, wife, mother, carrier oriented women, she plays different roles and follows social and family responsibilities. Nature has given special role to Streeto become mother. (1) Along with that as today's women is carrier oriented she is becoming independent, making her own decision and thus making her own space in the society. Thus in this fast life she is subjected to all sorts of physical and mental hardship. Due to change in lifestyle, modern food habits of fast food, junk food she is unable to follow the rules of Dincharya, Rutucharya, Rajaswala The second most common infections among reproductive aged women with a single incidence of 75%, and two or more episodes in 45% of women. Candida albicans is responsible for 85% to 90% of the vaginal yeast infections. Vulvovaginitis, it is a situation in which the vagina gets sore and irritated.
It is a common occurrence in females. Though it is not a very serious disorder yet it can be a cause of severe discomfort and irritation. Common side effects that are prevalent in the case of vaginitis include either abnormal discharge or vulvovaginal irritation or both. The discharge may also tend to have an unpleasant odor. Candida albicans, a commensal dimorphic fungal organism of the gastrointestinal and reproductive tracts, is also the causative agent of vulvovaginal candidiasis (VVC). VVC affects an estimated 75% of all women in their reproductive years and another 5-10% have recurrent VVC (RVVC). Vaginitis involves infections of the vaginal lumen and often the vulva as well. Symptoms include burning, itching, soreness, an abnormal discharge, and dysparunia. Signs include vaginal and vulvar erythema and edema. Acute VVC has several known predisposing factors including antibiotic and high estrogen oral contraceptive usage, hormone replacement therapy, pregnancy, and uncontrolled diabetes mellitus. RVVC can be multifactorial in etiology, but is usually defined as idiopathic with no known predisposing factors. Instead, susceptibility to RVVC had been postulated to result from an adaptive immune dysfunction or deficiency. In women with RVVC, antifungal therapy is highly effective for individual symptomatic attacks with little evidence for drug resistance but does not prevent recurrence. In Ayurveda classics, the physiological and pathological aspects of This study is made after reviewing all the available Ayurvedic classics as well as modern books thoroughly.
Excessive consumption of foods and substances which cause oozing and serous effusion in the body and also other kapha aggravating foods and activities on regular basis by woman causes aggravation of kapha.
Kapha Dosha is composed of earth and water elements. It has coolness and heaviness as its basic qualities. Any diet or activity that causes increase of coolness and heaviness naturally increases Kapha Dosha. (11)  Candidal vulvovaginitis is caused by inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species, most commonly Candida albicans. Candida is part of the normal flora in many women and is often asymptomatic. Therefore, candidal vulvovaginitis requires both the presence of candida in the vagina/vulva as well as the symptoms of irritation, itching, dysuria, or inflammation. Candidal vulvovaginitis occurs when Candida species superficially penetrate the mucosal lining of the vagina and cause an inflammatory response. The dominant inflammatory cells are typically polymorphonuclear cells and macrophages.

Qualities of Kapha
Patients may present with discharge, which is typically thick and adherent, or with excoriations, "external" dysuria, vaginal itching, vaginal burning, dyspareunia, or swelling.
Due to estrogen deficiency and effect of other systemic illness like Diabetes mellitus, the alteration in vaginal defence leads to recurrent vaginal infections. The presence of foreign micro flora in the vagina, may lead to altered micro environmental changes due to alkaline vaginal pH resulting in decrease of doderline bacilli, which in turn leads to vulvovaginal candidiasis.
In the contemporary understanding of physiological vaginal discharge, it is non offensive, non irritant and non purulent. Physiologically the vaginal flora, doderline bacilli adhere to the epithelial wall of vagina and maintain the acidic pH and thus prevent the uropathogens from infecting vagina. The changes in the vaginal environment, such as an increase in glucogen production in pregnancy or altered estrogen and progesterone levels from the use of oral contraceptives, enhance the germination of fungus. Occasionally, the basis of information is a foreign body inserted into the vagina by the child. The accidental entry of sand or shreds of clothing, especially from woollen pants, is another possibility.

Clinical features:
The main symptom is a purulent discharge but the child may also complain of pain & soreness of the vulva. These interfere with walking & cause dysuria. In a young child often the parent notices her crying during urination or scratching herself. The vulva is reddened, sometimes edematous or excoriated, & bathed in discharge. If the discharge is blood stained the presence of a foreign body or some other conditions such as a cervical polyp should be suspected and excluded.
 Senile vaginitis (Atrophic Vaginitis) (Aetiology& pathology) This is caused by any of the common pyogenic organisms invading tissues which have lost their resistance. Senile endometritis or vulvitis is sometimes present as well. The vaginitis is often granular, that is, it appears as small multiple reddened areas which are mostly seen in the vault and around the Urethral orifice.

Allergy: Drug Sensitivity
A local reaction to chemicals is not uncommon & the patient presents with discharge, pruritus & a fiery-red vagina.
Antiseptics such as Arsenic, mercury, I2, picric acid, phenol preparations and gentian violet used to be common causes. Presently, toilet preparations such as soaps, deodorants & bath salts, contraceptives such as rubber or materials used in the preparation of synthetic devices, the powder in which they are packed & chemical spermicidal & nylon underwear are the common causes. Idiopathic There are some isolated cases of troublesome, chronic and resistant vaginal ulceration, sometimes multifocal, the causes of which are never discovered. These have been treated empirically by vitamins, Antihistamines, antiseptics, various fungicides & trichomonacides & in the case of postmenopausal women with oestrogen.

Bacterial vaginosis
Many cases of vaginitis are attributed to bacterial vaginosis (non specific vaginitis) also known as Gardenerella Vaginalis.

Pathology:
 Gardenerella vaginalis is the organism most commonly associated with Bacterial vaginosis. It is a small pleomorphic coccobacillus that may be gram variable when stained and is found attached to epithelial 'clue cell' in smears of vaginal exudates or discharge.  It is not sexually transmitted and has a variable incubation period. About 50% women are asymptomatic carriers of infection, but majority complain of vaginal discharge without itching. Bacterial vaginosis is termed as vaginosis rather than vaginitis, because it is alteration in the normal vaginal flora rather than due to any specific