Disease and conditions

The Indian system of medicine, Ayurveda is the best available health care system. Ayurveda delineates there support of life Ahara, Nidra and bramhmacharya for maintenance of perfect health.
Now a day’s maximum people suf¬fer from common disease like Hyperten¬sion, Arthri-tis, Hearing and vision impair¬ment, Coronary artery diseases, Chronic lung diseases, Diabetes mellitus, Periph¬eral vascular disease, Cancer, Parkinson’s disease, Cerebro vascular disease, Depres¬sion and Mood disorders, Dementia etc
Hearing impairment or deafness is most commonly seen in almost all the age groups because of the noise pollution, drug abuses, bad dietary habits, stressful life many of the Neu-ropsychiatric problems are seen, Meniere’s disease being one of them.
Meniere’s disease is characterized by episodic vertigo, fluctuating sensor neu¬ral hear-ing loss, tinnitus and aural fullness.
This illness occurs at irregular and unpredictable intervals. Tinnitus and deaf¬ness may be absent during the initial phase of attack of vertigo but invariably these symptoms appear as the disease pro¬gresses. The annual incidence of Meniere’s disease is 5-7 / 10,000 and onset is most frequent in the 5th decade of life it may also occur in young adults rarely. The ex¬act cause of Meniere’s disease is unknown.
Meniere’s disease is explained in modern classics of medicine, neurology, psychiatry, and E.N.T disorders. This dis¬ease is also called as Endolymphatichydrops. It is a disorder of ear where the endolymphatic system is distended. Treatment in the modern sci¬ence for this is disease is conservative management only.
In the Ayurvedic text shrotrendriya (one of the jnanedriya) is seat of Vayu and Aka-shatatwa, and is nourished by Tarpakakapha. After going through the Patho-Physiology and signs and symptoms of Meniere’s disease it can be inferred that in this disease there is vatas-thanagatakaphavikruti in shravanedriya.
The presentations like Bhrama, Karnaskweda, Karnanada, Karnabadhirya can be compared with Meniere’s disease symptomatically. However it is not possi¬ble to exactly compare or co-relate Meniere’s diseases with the different clini¬cal entities explained in Ayur-veda.
There is an accumulation of Endolymph in the membranous labyrinth, thus in the modern pharmacology diuretics are recommended and salt restriction is advised. Hence in the management of Meniere’s disease shothaghna, mutraladravyaprayoga if given therapeuti¬cally and if vishyanda-karaka, kledajanakadravyas like samudralavana are restricted, clinical im-provement will be necessarily noticed. Amapachanachikitsa followed by prayoga of vatapitta-harabhrama-nashakaaushadhiyogas along with mutraladravyas is to be recom¬mended in the management of Meniere’s disease.
Snehapana with kalyanakaghrita in alpamatra followed by snigdhavirechana is the other step of treatment because the upakrama of vatadosha is to be done with snehana, swe-dana and then mruduvirechana. Urdwajatrugatavikaras are generally managed by Nasya karma. Laxmivilasataila mentioned in Bhaishajyaratnavalli (MastishkaRogadhikara 29-36) adminis¬tered through the nostrils is found to be effective in relieving some symptoms of Me-niere’s disease. The Bhramaharakashaya yoga comprising of vatapittaharadravya (Kalyana-kakashaya and Shothagnamahakashaya) which is ef¬fective manodoshaharaaushadhi yoga is found very effective in relieving some symptoms of Meniere’s disease according to the expert physicians of Ayurveda. BruhatSootashekara Rasa is an excellent vatapittahara, bhra-manashakanadiuttejakaaushadhi yoga. The chikitsasiddhanta is planned according to the ba-sic concepts of Kayachikitsa.
Here an attempt is made to under¬stand Meniere’s disease in light of Ayur¬veda and its management through the basic concepts of Kayachikitsa. This study is taken up to confirm and to highlight the scientific, therapeutic approach in relation to the shareerikadosha – vata and pitta, manasikadosha rajas and vatasthanagatakapha. Further it is also intended to assess the efficacy, potency of Ayurvedic formulations in this regard.
In any form of research a critical, analytical work, rational interpretation and useful discussion on the different aspects of the particular research work done is very essential. In the present study, various aspects of Meniere’s disease are dealt.
The rampage of Meniere’s disease in the modern era is such that Meniere’s disease has acquired the status of social-occupational disorder. The annual inci¬dence of this triode system disorder is 0.5-7.5 / 1000 and the onset is most frequent in the 5th decade of the life, it may also occur in young adults rarely.
Many of the times Meniere’s dis¬ease is produced due to complication of some psy-chosomatic disorder like anxiety neurosis etc, and also due to Meniere’s disease some com-plication occurs such as hypertension, tension headache, lack of restoration of intellectual ca-pacity etc. Though in the present clinical study, the complications are excluded, the severe clinical complications of the trial, which are excluded, stimulate to study further on them. Modern science considers Meniere’s dis¬ease as endolymphyatichydrops, a disorder of inner ear where the endolymphatic sys¬tem is distended. It is characterized by classic triad of verti-go, tinnitus and tempo¬rary sensori-neural hearing loss where as in Ayurveda, vertigo (Bhrama) is induced due to either rasa dhatudusti or kshaya of majjadhatu. Tinnitus (karnakweda or karna nada) and hearing loss (karnabadhirya) are induced due to dusti of asthi and maj-jadhatu. In these three symptoms all three doshas are involved specially subtype tarpakaka-pha, sadhaka pitta and prana and vyanavayu.

Discussion on review of Literature
1. Historical Review:
Vedic texts define Karna as sense organ and it is included in the urdwa-Jatru Pradesh of the body. Ayurvedic texts de¬fine symptoms like Bhrama, Karnaksweda, Karnabadhiya etc. in detail but not defined any disease that includes these symptoms.
In Modern science, Scientist Meniere defined the disease of trio but did not explain it in detail. Various theories are similar to ones presented in Ayurveda, However, this disease have been exten¬sively studied and documented by a battery of investigative procedures after 1900’s.
2. Disease Review:
We find similarities in the Ayurvedic as well as in the modern text with regards to the following aspects; Definitions, Etio-pathology, Physiological and Anatomical aspect, Clinical features, Complications and Management. Meniere’s disease is broadly described above as in modern aspect but in Ayur¬veda, we find many terms like Bhrama, Karnaksweda, Karnabad-hirya, Shirashoola etc. However, these symp¬toms would be safe to consider in correla¬tion to Meniere’s disease.
Ayurvrdic Review
Nidana:
    No Ayurvedic texts have mentioned specific nidanas of bhrama roga but ac¬cording to dosha, dhatu, mala involved, we can define the suspected nidanas as follows. Vata prakopaka nidanas like Ativyayama, prajagarana, langana ruksha shita ahara sevana. Atimaruta-atapa sevana etc.
    Pitta prakopaka ahara, atapa sevana, ati agni sannidyata, katu - lavana - amla gunatmaka ahara sevana etc. Rajoguna vardhaka cheshta i.e lobha, moha, kama etc, and aghatadi agantuja karana etc.
Samprapti Ghataka:

1. Dosha-Pitta, vayu
2. Dushya-Majja mainly
3. Agni-Jatharagni, majjadhatwagni
4. Ama--Koshtagnimandya janya
5. Srotas--majjavaha and manovaha       mainly
6. Sroto dusti  -Sanga,vimarga, gamana
7. Sanchar sthana    -Rasayani and vatavahini sira    
8. Adhisthana        -Sharira and Manas
9. Vyakta sthana    -Shiras
10. Sadhy -asadhyata    -Kashtasadhya

Chikitsa: (Treatment)
    Madhura, balya, brumhaniya, pitta vata shamaka chikitsa along with satwavajaya line of treatment    
•    Intake of kshira, which is processed with shatavari, bala and draksha.
•    Intake of the choorna of vatyalika bija with sita.
•    Intake of a duralabha kwatha with ghruta.
•    Triphala siddha kshira.

Important Yogas:
1.    Vasant kusumakara ras.
2.    Laxmivilasa ras.
3.    Prameha gajakeshari ras.
4.    Sootsekhara ras.
5.    Suvarna makshika bhasma.
6.    Abhraka bhasma.
7.    Loha bhasma.
8.    Mukta pishti.
9.    Saraswatarista.
10.    Chyavana prashavaleha.
Pathya-Apathya:
Pathya:
•    Madhura rasa pradhana ahara i.e sita, dugdha, ghruta etc.
•    Shiro abhyanga.
•    Mamsa rasa sevana, majja sevana.
Apathya:
    Katu, amla, lavana rasa pradhana ahara, ruksha, shita, bhojana, ativyayama, ativya-vaya, maruta- atapa sevana, prajagarana, krodha, chinta, etc.
Sadhya - Asadhyata:    Bhrama is Kashta sadhya vyadhi.

Discussion on review of Literature
1. Historical Review:
Vedic texts define Karna as sense organ and it is included in the urdwa-Jatru Pradesh of the body. Ayurvedic texts de¬fine symptoms like Bhrama, Karnaksweda, Karnabadhiya etc. in detail but not defined any disease that includes these symptoms.
In Modern science, Scientist Meniere defined the disease of trio but did not explain it in detail. Various theories are similar to ones presented in Ayurveda, However, this disease have been exten¬sively studied and documented by a battery of investigative procedures after 1900’s.
2. Disease Review:
We find similarities in the Ayurvedic as well as in the modern text with regards to the following aspects; Definitions, Etio-pathology, Physiological and Anatomical aspect, Clinical features, Complications and Management. Meniere’s disease is broadly described above as in modern aspect but in Ayur¬veda, we find many terms like Bhrama, Karnaksweda, Karnabad-hirya, Shirashoola etc. However, these symp¬toms would be safe to consider in correla¬tion to Meniere’s disease.
Ayurvrdic Review
Nidana:
    No Ayurvedic texts have mentioned specific nidanas of bhrama roga but ac¬cording to dosha, dhatu, mala involved, we can define the suspected nidanas as follows. Vata prakopaka nidanas like Ativyayama, prajagarana, langana ruksha shita ahara sevana. Atimaruta-atapa sevana etc.
    Pitta prakopaka ahara, atapa sevana, ati agni sannidyata, katu - lavana - amla gunatmaka ahara sevana etc. Rajoguna vardhaka cheshta i.e lobha, moha, kama etc, and aghatadi agantuja karana etc.
Samprapti Ghataka:
1. Dosha    -Pitta, vayu
2. Dushya    -Majja mainly
3. Agni    -Jatharagni, majjadhatwagni
4. Ama        -Koshtagnimandya janya
5. Srotas    -majjavaha and manovaha       mainly
6. Sroto dusti  -Sanga,vimarga, gamana
 7.    Sanchar sthana    -Rasayani and vatavahini sira    
 8. Adhisthana        -Sharira and Manas
 9. Vyakta sthana    -Shiras
 10. Sadhy -asadhyata    -Kashtasadhya
Chikitsa: (Treatment)
    Madhura, balya, brumhaniya, pitta vata shamaka chikitsa along with satwavajaya line of treatment    
•    Intake of kshira, which is processed with shatavari, bala and draksha.
•    Intake of the choorna of vatyalika bija with sita.
•    Intake of a duralabha kwatha with ghruta.
•    Triphala siddha kshira.

Important Yogas:
1.    Vasant kusumakara ras.
2.    Laxmivilasa ras.
3.    Prameha gajakeshari ras.
4.    Sootsekhara ras.
5.    Suvarna makshika bhasma.
6.    Abhraka bhasma.
7.    Loha bhasma.
8.    Mukta pishti.
9.    Saraswatarista.
10.    Chyavana prashavaleha.
Pathya-Apathya:
Pathya:
•    Madhura rasa pradhana ahara i.e sita, dugdha, ghruta etc.
•    Shiro abhyanga.
•    Mamsa rasa sevana, majja sevana.
Apathya:
    Katu, amla, lavana rasa pradhana ahara, ruksha, shita, bhojana, ativyayama, ativya-vaya, maruta- atapa sevana, prajagarana, krodha, chinta, etc.
Sadhya - Asadhyata:    Bhrama is Kashta sadhya vyadhi.
Disscussion on Materials and Methods:
Shad dharanachoorna was selected for purpose of Amapachana and Agni vardharna action. Kalyanakaghruta selected for snehana in avaramatra. GandharvaHaritakichoorna was preferred for its mruduvirechaka action (i.e. oil based soft laxative). Laxmivilastaila was selected for nasya because of its efficacy of sarvamastishikagatarogahara and karnarogaha-ra property. Bruhatsootashekharras and Bhramaharkashaya were selected as shamanou-shadhi based on their action on vata, pitta and kapha. A total of 13 subjects were studied in a single group. They had follow up period of 1 month after the treatment schedule.
Study Design: Clinical Trial
Materials
The following materials were utilized for the clinical trial
•    Shaddharana Churna for Amapachana.
•    Kalyanaka Ghruta for snehapana.
•    Gandharva Haritaki for Mrudu Virechana.
•    Laxmivilas Taila for Nasya.
•    Bruhat Soota Shekhara and Bhramahara kashaya as Shamanaushadhi.
Trial Group:        
•    Amapachana with Shaddharana choorna
•    Dosage – 5 gms thrice daily for 3-5 days. (till nirama lakshanas attained)
•    Snehapana with Kalyanaka ghruta
•    (Avara sneha schedule) for 1-3 days
o    First day    -    25 ml
o    Second day    -    50 ml
o    Third day -75 ml at morning time
o    Anupana - Luke warm water
•    Mrudu Virechana with Gandarva Haritaki
Dosage – 1 karsha to 1 tola (6 to 12 gms )
Anupana - Luke warm water
Shamanoushadhi:
•    Bruhat Soota Shekhar rasa
    Dosage:125mg twice daily with Madhu
    Anupana-Luke warm water
•    Bhramahara kashaya yoga
    Dosage: 30 - 45ml twice daily
    Anupana - Luke warm water
•    Nasya karma with Lakshmivilasa taila
•    (Nasya karma was be repeated once in every 30 days in pratimarsha schedule during the course of shamanoushadhi).
•    Dosage: 4 drops (2 ml each) into each nostril for 7 days.
•    Subjects of trial group were given Amapachana with Shaddharana Churna for 3 – 5 days.
•    Snehapana with Kalyanaka Ghruta in avara matra for 1 – 3 days.
•    Swedana for one day, mrudu virechana with Gandharva Haritaki for one day, sam-sarjana karma, vishranthi for 1 – 3 days.
•    Nasya karma with Lakshmi vilas Taila for 7 days.
•    Shamanaushadhi was given for 3 months.
•    Nasya karma was repeated once in every 30 days in pratimarsha schedule during the course of shamanaushadhi.
INCLUSION CRITERIA:
•    Subjects between the age of 20 to 65 years presenting with the clinical features of Meniere’s disease described in modern medical texts and fulfilling the diagnostic in-dex scoring system for suspected Meniere’s Disease.
•    Subjects of either sex between 20 to 65 years, who are fit for the Nasya therapy.
•    Subjects willing to receive Ayurvedic treatment.
Exclusion Criteria:
•    Subjects suffering from uncontrolled Diabetes mellitus, uncontrolled Hypertension etc.
•    Subjects with Cardiac abnormalities.
•    Subjects with vertibro bacillary syndrome.
•    Subjects who are unfit for Nasya therapy.
•    Subjects with Cerebellar ataxia, Focal fits (Epilepsy).
•    Subjects suffering from any infectious disorders.

Disscussion on Materials and Methods:
Shad dharanachoorna was selected for purpose of Amapachana and Agni vardharna action. Kalyanakaghruta selected for snehana in avaramatra. GandharvaHaritakichoorna was preferred for its mruduvirechaka action (i.e. oil based soft laxative). Laxmivilastaila was selected for nasya because of its efficacy of sarvamastishikagatarogahara and karnarogaha-ra property. Bruhatsootashekharras and Bhramaharkashaya were selected as shamanou-shadhi based on their action on vata, pitta and kapha. A total of 13 subjects were studied in a single group. They had follow up period of 1 month after the treatment schedule.
Study Design: Clinical Trial
Materials
The following materials were utilized for the clinical trial
•    Shaddharana Churna for Amapachana.
•    Kalyanaka Ghruta for snehapana.
•    Gandharva Haritaki for Mrudu Virechana.
•    Laxmivilas Taila for Nasya.
•    Bruhat Soota Shekhara and Bhramahara kashaya as Shamanaushadhi.
Trial Group:        
•    Amapachana with Shaddharana choorna
•    Dosage – 5 gms thrice daily for 3-5 days. (till nirama lakshanas attained)
•    Snehapana with Kalyanaka ghruta
•    (Avara sneha schedule) for 1-3 days
o    First day    -    25 ml
o    Second day    -    50 ml
o    Third day -75 ml at morning time
o    Anupana - Luke warm water
•    Mrudu Virechana with Gandarva Haritaki
Dosage – 1 karsha to 1 tola (6 to 12 gms )
Anupana - Luke warm water
Shamanoushadhi:
•    Bruhat Soota Shekhar rasa
    Dosage:125mg twice daily with Madhu
    Anupana-Luke warm water
•    Bhramahara kashaya yoga
    Dosage: 30 - 45ml twice daily
    Anupana - Luke warm water
•    Nasya karma with Lakshmivilasa taila
•    (Nasya karma was be repeated once in every 30 days in pratimarsha schedule during the course of shamanoushadhi).
•    Dosage: 4 drops (2 ml each) into each nostril for 7 days.
•    Subjects of trial group were given Amapachana with Shaddharana Churna for 3 – 5 days.
•    Snehapana with Kalyanaka Ghruta in avara matra for 1 – 3 days.
•    Swedana for one day, mrudu virechana with Gandharva Haritaki for one day, sam-sarjana karma, vishranthi for 1 – 3 days.
•    Nasya karma with Lakshmi vilas Taila for 7 days.
•    Shamanaushadhi was given for 3 months.
•    Nasya karma was repeated once in every 30 days in pratimarsha schedule during the course of shamanaushadhi.
INCLUSION CRITERIA:
•    Subjects between the age of 20 to 65 years presenting with the clinical features of Meniere’s disease described in modern medical texts and fulfilling the diagnostic in-dex scoring system for suspected Meniere’s Disease.
•    Subjects of either sex between 20 to 65 years, who are fit for the Nasya therapy.
•    Subjects willing to receive Ayurvedic treatment.
Exclusion Criteria:
•    Subjects suffering from uncontrolled Diabetes mellitus, uncontrolled Hypertension etc.
•    Subjects with Cardiac abnormalities.
•    Subjects with vertibro bacillary syndrome.
•    Subjects who are unfit for Nasya therapy.
•    Subjects with Cerebellar ataxia, Focal fits (Epilepsy).
•    Subjects suffering from any infectious disorders.

Disscussion on Materials and Methods:
Shad dharanachoorna was selected for purpose of Amapachana and Agni vardharna action. Kalyanakaghruta selected for snehana in avaramatra. GandharvaHaritakichoorna was preferred for its mruduvirechaka action (i.e. oil based soft laxative). Laxmivilastaila was selected for nasya because of its efficacy of sarvamastishikagatarogahara and karnarogaha-ra property. Bruhatsootashekharras and Bhramaharkashaya were selected as shamanou-shadhi based on their action on vata, pitta and kapha. A total of 13 subjects were studied in a single group. They had follow up period of 1 month after the treatment schedule.
Study Design: Clinical Trial
Materials
The following materials were utilized for the clinical trial
•    Shaddharana Churna for Amapachana.
•    Kalyanaka Ghruta for snehapana.
•    Gandharva Haritaki for Mrudu Virechana.
•    Laxmivilas Taila for Nasya.
•    Bruhat Soota Shekhara and Bhramahara kashaya as Shamanaushadhi.
Trial Group:        
•    Amapachana with Shaddharana choorna
•    Dosage – 5 gms thrice daily for 3-5 days. (till nirama lakshanas attained)
•    Snehapana with Kalyanaka ghruta
•    (Avara sneha schedule) for 1-3 days
o    First day    -    25 ml
o    Second day    -    50 ml
o    Third day -75 ml at morning time
o    Anupana - Luke warm water
•    Mrudu Virechana with Gandarva Haritaki
Dosage – 1 karsha to 1 tola (6 to 12 gms )
Anupana - Luke warm water
Shamanoushadhi:
•    Bruhat Soota Shekhar rasa
    Dosage:125mg twice daily with Madhu
    Anupana-Luke warm water
•    Bhramahara kashaya yoga
    Dosage: 30 - 45ml twice daily
    Anupana - Luke warm water
•    Nasya karma with Lakshmivilasa taila
•    (Nasya karma was be repeated once in every 30 days in pratimarsha schedule during the course of shamanoushadhi).
•    Dosage: 4 drops (2 ml each) into each nostril for 7 days.
•    Subjects of trial group were given Amapachana with Shaddharana Churna for 3 – 5 days.
•    Snehapana with Kalyanaka Ghruta in avara matra for 1 – 3 days.
•    Swedana for one day, mrudu virechana with Gandharva Haritaki for one day, sam-sarjana karma, vishranthi for 1 – 3 days.
•    Nasya karma with Lakshmi vilas Taila for 7 days.
•    Shamanaushadhi was given for 3 months.
•    Nasya karma was repeated once in every 30 days in pratimarsha schedule during the course of shamanaushadhi.
INCLUSION CRITERIA:
•    Subjects between the age of 20 to 65 years presenting with the clinical features of Meniere’s disease described in modern medical texts and fulfilling the diagnostic in-dex scoring system for suspected Meniere’s Disease.
•    Subjects of either sex between 20 to 65 years, who are fit for the Nasya therapy.
•    Subjects willing to receive Ayurvedic treatment.
Exclusion Criteria:
•    Subjects suffering from uncontrolled Diabetes mellitus, uncontrolled Hypertension etc.
•    Subjects with Cardiac abnormalities.
•    Subjects with vertibro bacillary syndrome.
•    Subjects who are unfit for Nasya therapy.
•    Subjects with Cerebellar ataxia, Focal fits (Epilepsy).
•    Subjects suffering from any infectious disorders.

Disscussion on Materials and Methods:
Shad dharanachoorna was selected for purpose of Amapachana and Agni vardharna action. Kalyanakaghruta selected for snehana in avaramatra. GandharvaHaritakichoorna was preferred for its mruduvirechaka action (i.e. oil based soft laxative). Laxmivilastaila was selected for nasya because of its efficacy of sarvamastishikagatarogahara and karnarogaha-ra property. Bruhatsootashekharras and Bhramaharkashaya were selected as shamanou-shadhi based on their action on vata, pitta and kapha. A total of 13 subjects were studied in a single group. They had follow up period of 1 month after the treatment schedule.
Study Design: Clinical Trial
Materials
The following materials were utilized for the clinical trial
•    Shaddharana Churna for Amapachana.
•    Kalyanaka Ghruta for snehapana.
•    Gandharva Haritaki for Mrudu Virechana.
•    Laxmivilas Taila for Nasya.
•    Bruhat Soota Shekhara and Bhramahara kashaya as Shamanaushadhi.
Trial Group:        
•    Amapachana with Shaddharana choorna
•    Dosage – 5 gms thrice daily for 3-5 days. (till nirama lakshanas attained)
•    Snehapana with Kalyanaka ghruta
•    (Avara sneha schedule) for 1-3 days
o    First day    -    25 ml
o    Second day    -    50 ml
o    Third day -75 ml at morning time
o    Anupana - Luke warm water
•    Mrudu Virechana with Gandarva Haritaki
Dosage – 1 karsha to 1 tola (6 to 12 gms )
Anupana - Luke warm water
Shamanoushadhi:
•    Bruhat Soota Shekhar rasa
    Dosage:125mg twice daily with Madhu
    Anupana-Luke warm water
•    Bhramahara kashaya yoga
    Dosage: 30 - 45ml twice daily
    Anupana - Luke warm water
•    Nasya karma with Lakshmivilasa taila
•    (Nasya karma was be repeated once in every 30 days in pratimarsha schedule during the course of shamanoushadhi).
•    Dosage: 4 drops (2 ml each) into each nostril for 7 days.
•    Subjects of trial group were given Amapachana with Shaddharana Churna for 3 – 5 days.
•    Snehapana with Kalyanaka Ghruta in avara matra for 1 – 3 days.
•    Swedana for one day, mrudu virechana with Gandharva Haritaki for one day, sam-sarjana karma, vishranthi for 1 – 3 days.
•    Nasya karma with Lakshmi vilas Taila for 7 days.
•    Shamanaushadhi was given for 3 months.
•    Nasya karma was repeated once in every 30 days in pratimarsha schedule during the course of shamanaushadhi.
INCLUSION CRITERIA:
•    Subjects between the age of 20 to 65 years presenting with the clinical features of Meniere’s disease described in modern medical texts and fulfilling the diagnostic in-dex scoring system for suspected Meniere’s Disease.
•    Subjects of either sex between 20 to 65 years, who are fit for the Nasya therapy.
•    Subjects willing to receive Ayurvedic treatment.
Exclusion Criteria:
•    Subjects suffering from uncontrolled Diabetes mellitus, uncontrolled Hypertension etc.
•    Subjects with Cardiac abnormalities.
•    Subjects with vertibro bacillary syndrome.
•    Subjects who are unfit for Nasya therapy.
•    Subjects with Cerebellar ataxia, Focal fits (Epilepsy).
•    Subjects suffering from any infectious disorders.

Disscussion on Materials and Methods:
Shad dharanachoorna was selected for purpose of Amapachana and Agni vardharna action. Kalyanakaghruta selected for snehana in avaramatra. GandharvaHaritakichoorna was preferred for its mruduvirechaka action (i.e. oil based soft laxative). Laxmivilastaila was selected for nasya because of its efficacy of sarvamastishikagatarogahara and karnarogaha-ra property. Bruhatsootashekharras and Bhramaharkashaya were selected as shamanou-shadhi based on their action on vata, pitta and kapha. A total of 13 subjects were studied in a single group. They had follow up period of 1 month after the treatment schedule.
Study Design: Clinical Trial
Materials
The following materials were utilized for the clinical trial
•    Shaddharana Churna for Amapachana.
•    Kalyanaka Ghruta for snehapana.
•    Gandharva Haritaki for Mrudu Virechana.
•    Laxmivilas Taila for Nasya.
•    Bruhat Soota Shekhara and Bhramahara kashaya as Shamanaushadhi.
Trial Group:        
•    Amapachana with Shaddharana choorna
•    Dosage – 5 gms thrice daily for 3-5 days. (till nirama lakshanas attained)
•    Snehapana with Kalyanaka ghruta
•    (Avara sneha schedule) for 1-3 days
o    First day    -    25 ml
o    Second day    -    50 ml
o    Third day -75 ml at morning time
o    Anupana - Luke warm water
•    Mrudu Virechana with Gandarva Haritaki
Dosage – 1 karsha to 1 tola (6 to 12 gms )
Anupana - Luke warm water
Shamanoushadhi:
•    Bruhat Soota Shekhar rasa

• Dosage:125mg twice daily with Madhu
• Anupana-Luke warm water

•    Bhramahara kashaya yoga
    Dosage: 30 - 45ml twice daily
    Anupana - Luke warm water
•    Nasya karma with Lakshmivilasa taila
•    (Nasya karma was be repeated once in every 30 days in pratimarsha schedule during the course of shamanoushadhi).
•    Dosage: 4 drops (2 ml each) into each nostril for 7 days.
•    Subjects of trial group were given Amapachana with Shaddharana Churna for 3 – 5 days.
•    Snehapana with Kalyanaka Ghruta in avara matra for 1 – 3 days.
•    Swedana for one day, mrudu virechana with Gandharva Haritaki for one day, sam-sarjana karma, vishranthi for 1 – 3 days.
•    Nasya karma with Lakshmi vilas Taila for 7 days.
•    Shamanaushadhi was given for 3 months.
•    Nasya karma was repeated once in every 30 days in pratimarsha schedule during the course of shamanaushadhi.
INCLUSION CRITERIA:
•    Subjects between the age of 20 to 65 years presenting with the clinical features of Meniere’s disease described in modern medical texts and fulfilling the diagnostic in-dex scoring system for suspected Meniere’s Disease.
•    Subjects of either sex between 20 to 65 years, who are fit for the Nasya therapy.
•    Subjects willing to receive Ayurvedic treatment.
Exclusion Criteria:
•    Subjects suffering from uncontrolled Diabetes mellitus, uncontrolled Hypertension etc.
•    Subjects with Cardiac abnormalities.
•    Subjects with vertibro bacillary syndrome.
•    Subjects who are unfit for Nasya therapy.
•    Subjects with Cerebellar ataxia, Focal fits (Epilepsy).
•    Subjects suffering from any infectious disorders.

Chikitsa: (Treatment)
    Madhura, balya, brumhaniya, pitta vata shamaka chikitsa along with satwavajaya line of treatment    
•    Intake of kshira, which is processed with shatavari, bala and draksha.
•    Intake of the choorna of vatyalika bija with sita.
•    Intake of a duralabha kwatha with ghruta.
•    Triphala siddha kshira.

Important Yogas:
1.    Vasant kusumakara ras.
2.    Laxmivilasa ras.
3.    Prameha gajakeshari ras.
4.    Sootsekhara ras.
5.    Suvarna makshika bhasma.
6.    Abhraka bhasma.
7.    Loha bhasma.
8.    Mukta pishti.
9.    Saraswatarista.
10.    Chyavana prashavaleha.
Pathya-Apathya:
Pathya:
•    Madhura rasa pradhana ahara i.e sita, dugdha, ghruta etc.
•    Shiro abhyanga.
•    Mamsa rasa sevana, majja sevana.
Apathya:
    Katu, amla, lavana rasa pradhana ahara, ruksha, shita, bhojana, ativyayama, ativya-vaya, maruta- atapa sevana, prajagarana, krodha, chinta, etc.
Sadhya - Asadhyata:    Bhrama is Kashta sadhya vyadhi.

CONCLUSION
•    Meniere’s disease is one of the chronic diseases, which is critically diagnosed and poorly treated with increasing incidences even in the Indian Society.
•    Symptoms mentioned in Ayurveda related with conditions like Karna nada, Badhirya, Karna kshweda, Bhrama roga resembles to Meniere’s disease in different degrees.
•    Vata pradhana tridosha and Rajo guna are the prime factors in the causation of Meniere’s disease. The Manas is also provoked by these factors.
•    Meniere’s disease is generally related to the middle-aged group and in the elderly popula-tion where it could be due to the normal physiological process of ageing and because of the predominance of vata dosha in this avastha.
•    Incidence of manifestation of Meniere’s disease is equal in both sexes.
•    Erratic life styles, unhealthy eating habits and lack of exercise could contribute towards developing Meniere’s disease.
•    Nasya and Shamanoushadhi provided highly significant relief on both the Objective and Subjective parameters of Meniere’s disease.
•    Nasya could exert its action on multiple levels of dosha, dhatu, srotas, manas indriyas, marma and Ajna chakra. It could also influence its action on the nervous system by pos-sibly being absorbed by the micro circulation in inner nose. The Gandhapaka vidhi of taila is probably necessary to treat vataja disorders as aromatic substances have a shamana effect on vata as well as on the manas.
•    Following Pathya Apathya and Counselling shows an important role in the management of Meniere’s disease.
To sum up, it can be said that, Meniere’s disease is a condition that needs to be as-sessed correctly and proper measures should be adopted in its management.  Symptomatic treatment is not the answer to these problems