Importance of hetu and nidan parivarjan in chikitsa of akala palita-a case study

Akala palita is a common burning problem particularly in youth resulting in cosmetic , mental and social issues. The incidence of premature aging along with akalapalita is on increase particularly in tropical and developing countries. Many factors are responsible for akalapalita like stress, improper dietary habits, not following healthy lifestyle, packed food etc. apart from these, many new hetu have to be considered and treated because treatment cannot be completed without nidan parivarjan. This case deals with a young boy of age 12 years having premature graying of hairs, since 6 months. Intensity increased over last 2 months and patient came for consultation. This case was managed successfully with nidanparivarjan, shaman nasya and bruhan snehapan for 2 months on opd basis.


Introduction-
Premature graying of hair is a burning problem, as large percentage of population especially young men and women are affected. Around the world, men spend about one million dollars yearly for caring of hair, whereas women spend 500 billion dollars, without having awareness about the role of improper diet in causation of grey hair.
Even though heredity is one of the causes of premature graying of hair, Ahara and regimens also cause, which includes

Aims and objective-
To study the Nidanas of Akala Palitya and their role in manifestation of disease, as mentioned in Ayurvedic Samhitas in view of present scenario.

Case history-
This case deals with a young boy of age 12 years having premature graying of hairs, since 6 months. Intensity increased over last 2 months and patient came for consultation.
 No history of any major medical or surgical illness.
 Personal history-football player (used to take ORS and packed fruit juices very often, daily.) After taking detailed history it was come to know that patient was having so much intake of ORS and packed juices to combat increased thirst since last 2 months also being a football player he had lots of stress, exertion, competitive nature and anger produced from that so all these factors were involved in pittavriddhi.

Result-
From the assessment of symptoms before and after treatment , it can be concluded that nidanparivarjan, shaman nasya with ksheeradi taila for one month and bruhan sneha with goghruta for one month proved significant in relation with akala palita .
Similarly it can be said that nidanparivarjan was important part of this treatment as recurrence of symptoms was not occurred after 6 months of treatment also.

Discussion-
The increased heat or Ushanatwa of the body reaches to the Shiropradesha or scalp area by certain psychosomatic causes like grief, fatigue, anger etc, and gets mixed with vitiated Pitta Doshas and further afflicts the hair and ripens the hairs and causes Palitya (gray colour of the hair) 4 . Although for the disease of Palitya, no specific Nidana are mentioned, but still on basis of Samprapti, Pitta Prakopaka Nidana 5 , Rasadushti 6

Contemporary views on etiopathogenesis-
The pigmentation of hair follicles is due to melanin. Melanin is two types: eumelanin and pheomelanin. The colour of human hair depends on melanogenesis, the process of synthesis of melanin and its subsequent distribution from the melanocyte to keratinocyte. The biological process of gray hair appears to be associated with the progressive loss of pigment producing cells. Depletion of melanocytes leads to premature graying of hair . 12

Discussion on drug selection-
The treatment given in this case was chosen after the complete examination of patient and disease.
First and foremost important part is nidanparivarjan which was long term use of ORS and packed fruit juices, in this case. It lead to lavan rasa atiyog lakshan resulting in palitya. And in addition to this stress, anger ,competitive nature were also contributing to pitta and vata vruddhi.
Then ksheeradi taila shaman nasya given for about a month with 7 days nasya then 7 days gap in this pattern with dose of 6,8,10 bindu. Nasa is the dwar to shiras so ksheeradi taila 13 was useful in pacifying shirogata pitta dosha and helped in sampraptibhanga.
After shaman nasyam, bruhan ghrut pan was given to patient with goghruta in dose of 10-20 ml. It helped in generalized vata pitta shaman and saravan dhatu nirmiti also balya to asthi dhatu , as kesh is considered as mala of asthi.
No sufficient treatment modalities are helpful for palitya inspite of so many are described in samhitas, probably the main cause behind this is hetu satatya. We do all type of shodhan , shaman chikitsa but as nidanparivarjan not done properly by identifying pin point hetu that's why chances of recurrence are more in case of akala palita.
So this case emphasizes on importance of finding proper hetu and nidanparivarjan for complete and shuddha chikitsa.