THERAPEUTIC RATIONALE OF YAVA KSHARA WITH GOKSHURADI KASHAYA IN MUTRASHMARI: A COMPREHENSIVE REVIEW

Background: Mutrashmari is one of the most common disorders of the Mutravaha Srotas. Acharya Sushruta de-scribes it as a Daruna and Kastha Sadhya Vyadhi and grouped it under Ashtamahagada owing to its potential to disturb or hamper the structure and function of Mutravaha Srotas, it is termed as Antaka Pratima1 as it gives intol-erable pain and it may become fatal if left untreated timely. In contemporary medicine, it is correlated with uro-lithiasis. Its incidence varies with geography, age, and sex, affecting men more than women (3:1), most commonly between 30-50 years.2 In India, it is prevalent in the stone belt regions such as Gujarat, Maharashtra, and Raja-sthan.3 Conventional treatment of urolithiasis includes medical and surgical approaches that are costly, invasive, and asso-ciated with high recurrence rates. In Ayurveda various formulations have been described for the management of Mutrashmari, one of which is mentioned in Rasatarangini is Yavakshara with the Anupana of Gokshuradi Kashaya.4 They have unique properties like Lekhana, Bhedana, Chedana, Tridoshahara, Mootrala, Shothahara and Vedana Sthapana making it effective for the management of Mutrashmari. They also offer safe, cost-effective, and easily available conservative therapies with reduced recurrence. Objective: To review the therapeutic rationale of Yava Kshara with Gokshuradi Kashaya in the management of Mutrashmari based on Ayurvedic principles and available contemporary evidence. Materials and Methods: Relevant information was collected from classical Ayurvedic texts, published research articles, journals, and other scientific literature related to Mutrashmari, Yava Kshara, and Gokshuradi Kashaya. Results: Yava Kshara possesses Ksharana, Chedana, Bhedana, Lekhana, and Ashmaribhedana properties, which may facilitate the disintegration and expulsion of urinary calculi. Gokshuradi Kashaya exhibits Mutrala, Shoolaha-ra and Mutravirechaniya actions that may improve urinary flow and alleviate associated symptoms. The combined use of these formulations offers a multifaceted therapeutic approach targeting both calculi and symptom manage-ment. Conclusion: Yava Kshara with Gokshuradi Kashaya demonstrates considerable therapeutic potential in the man-agement of Mutrashmari. The classical Ayurvedic attributes and contemporary evidence collectively support its relevance as an effective approach for managing urinary calculi and associated symptoms.