Siddhars Thought On Renal Calculai

Renal Calculai
Renal Calculai
Kidney Stone
A kidney stone, 8 millimeters (0.31 in) in diameter
History
Aravindh Herbal Labs
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Renal Calculai
The existence of kidney stones was first recorded thousands of years ago, and lithotomy for
the removal of stones is one of the earliest known surgical procedures.
In 1901, a stone discovered in the pelvis of an ancient Egyptian mummy was dated to
4,800 BC.
Medical texts from ancient Mesopotamia, India, China, Persia, Greece, and Rome all
mentioned calculous disease.
Part of the Hippocratic Oath suggests there were practicing surgeons in ancient Greece to
whom physicians were to defer for lithotomies.
The Roman medical treatise De Medicina by Aulus Cornelius Celsus contained a description
of lithotomy, and this work served as the basis for this procedure until the 18th century.
Famous people who were kidney stone formers include Napoleon I, Napoleon III, Peter the
Great, Louis XIV, George IV, Oliver Cromwell, Lyndon B. Johnson, Benjamin Franklin,
Michel de Montaigne, Francis Bacon, Isaac Newton, Samuel Pepys, William Harvey,
Herman Boerhaave, and Antonio Scarpa.
New techniques in lithotomy began to emerge starting in 1520, but the operation remained
risky.
After Henry Jacob Bigelow popularized the technique of litholapaxy in 1878, the mortality
rate dropped from about 24% to 2.4%.
However, other treatment techniques continued to produce a high level of mortality,
especially among inexperienced urologists.
In 1980, Dornier MedTech introduced extracorporeal shock wave lithotripsy for breaking up
stones via acoustical pulses, and this technique has since come into widespread use.
Introduction to the Urinary Tract

The urinary tract, or system, consists of the kidneys, ureters, bladder, and urethra.
The kidneys are two bean-shaped organs located below the ribs toward the middle of the
back, one on each side of the spine.
The kidneys remove extra water and wastes from the blood, producing urine.
They also keep a stable balance of salts and other substances in the blood.
The kidneys produce hormones that help build strong bones and form red blood cells.
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The urinary tract.

Narrow tubes called ureters carry urine from the kidneys to the bladder, an oval-shaped
chamber in the lower abdomen.
Like a balloon, the bladder's elastic walls stretch and expand to store urine. They flatten
together when urine is emptied through the urethra to outside the body.
Definition And Explanation

A kidney stone, also known as a renal calculus (from the Latin ren, "kidney" and calculus,
"pebble") is a solid concretion or crystal aggregation formed in the kidneys from dietary
minerals in the urine.
The kidneys are the master chemists of your body, primarily responsible for filtering
metabolites and minerals from the blood circulation. These secretions are then passed to the
bladder and then out of the body as urine through the urethra.
The urine has all the ingredients that form the stone, but all these ideally pass through without
our knowledge. When there is an imbalance in any of these substances, the crystals cluster
together into stones. In medical terminology these deposits are known as Renal Calculi.
Kidney stones are clumps developed from solidified crystals in the kidney or urinary tract.
The size of stone can be as small as a grain of sand to one as large as the size of a golf ball.
Kidney stones are the commonest complaint and one of the most painful of the urological
disorders. Kidney stones may modify the victim's behaviour with great fear of intense pain
and threaten with failure of the kidney.
People who have already had more than one kidney stone are prone to develop more stones.
A family history of kidney stones is also a risk factor for the development of kidney stones.
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Urinary stones are typically classified by their location in the kidney (nephrolithiasis), ureter
(ureterolithiasis), or bladder (cystolithiasis), or by their chemical composition (calciumcontaining, struvite, uric acid, or other compounds).
About 80% of those with kidney stones are men. Men most commonly experience their first
episode between 30 and 40 years of age, while for women the age at first presentation is
somewhat later.
One in every twenty people develops a kidney stone at some point in their life. Recurrence
rates are very high around 50% over a 5-10 year period and 75% over 20 years.
Men are affected approximately 4 times more often than women. The prevalance of kidney
stones begins to rise when men reach their 40s, and it continues to climb into their 70s.
Kidney stones typically leave the body by passage in the urine stream, and many stones are
formed and passed without causing symptoms. If stones grow to sufficient size (usually at
least 3 millimeters (0.12 in)) they can cause obstruction of the ureter.
Ureteral obstruction causes postrenal azotemia and hydronephrosis (distension and dilation of
the renal pelvis and calyces), as well as spasm of the ureter. This leads to pain, most
commonly felt in the flank (the area between the ribs and hip), lower abdomen, and groin (a
condition called renal colic).
Renal colic can be associated with nausea, vomiting, fever, blood in the urine, pus in the
urine, and painful urination. Renal colic typically comes in waves lasting 20 to 60 minutes,
beginning in the flank or lower back and often radiating to the groin or genitals.
The diagnosis of kidney stones is made on the basis of information obtained from the history,
physical examination, urinalysis, and radiographic studies. Ultrasound examination and blood
tests may also aid in the diagnosis.
Classification
Kidney stones are typically classified by their ;
1. location and
2. chemical composition.
Classification Based on Chemical composition
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Scanning electron micrograph of the surface of a kidney stone showing tetragonal

crystals of Weddellite (calcium oxalate dihydrate) emerging from the amorphous
central part of the stone (the horizontal length of the picture represents 0.5 mm of the
figured original)
Multiple kidney stones composed of uric acid and a small amount of calcium oxalate
Calcium-containing stones
By far, the most common type of kidney stones worldwide contains calcium.
For example, calcium-containing stones represent about 80% of all cases in the United States;
these typically contain calcium oxalate either alone or in combination with calcium phosphate
in the form of apatite or brushite.
Factors that promote the precipitation of oxalate crystals in the urine, such as primary
hyperoxaluria, are associated with the development of calcium oxalate stones.
The formation of calcium phosphate stones is associated with conditions such as
hyperparathyroidism and renal tubular acidosis.
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Calcium Oxalate Kidney Stone

The calcium oxalate kidney stone variety is the most common making up 80%-90% of all kidney
stone formations. The problem develops when calcium in the body is not disposed of efficiently and
builds up in the urine. As the calcium passes through the kidneys it binds itself to other nutrients such
as oxalate or phosphate.
Oxalate, or oxalic acid, gets its name from the biological process of incomplete oxidation of
carbohydrates.
It occurs naturally in
rhubarb (especially leaves),
black pepper,
buckwheat,
kiwi fruit,
star fruit,
chocolate,
nuts,
cocoa,
spinach,
beets,
chard,
berries and
beans.
Tea leaves also contain a high concentration of oxalate.
So if you are prone to the development of calcium oxalate kidney stones, stay away from the
foods and beverages listed above.
Research has shown that low calcium diets have actually led to a higher risk of developing
kidney stones. As ones intake of calcium decreases, the amount of oxalate in the bloodstream
increases, thus increasing the amount of oxalate in the kidneys that eventually binds with the
calcium forming stones.
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Upshot...moderate intake of calcium is advised. Don't be afraid of calcium. Potassium Citrate
and Magnesium Citrate have proven effective in reducing calcium oxalate stones as discussed
at Duke University.
Struvite stones
Struvite was first described from medieval sewer systems in Hamburg Germany in 1845 and
named for geographer and geologist Heinrich Christian Gottfried von Struve (1772-1851).
Struvite is occasionally found in canned seafood, where its appearance is that of small glass
slivers, objectionable to consumers for aesthetic reasons but of no health consequence.
Use of struvite as an agricultural fertilizer was in fact first described in 1857.
Struvite (magnesium ammonium phosphate) is a phosphate mineral with formula:

NH4MgPO46H2O.
Struvite crystallizes in the orthorhombic system as white to yellowish or brownish-white
pyramidal crystals or in platey mica-like forms.
It is a soft mineral with Mohs hardness of 1.5 to 2 and has a low specific gravity of 1.7.
It is sparingly soluble in neutral and alkaline conditions, but readily soluble in acid.
Struvite urinary stones and crystals form readily in the urine of animals and humans that are
infected with ammonia-producing organisms.
They are potentiated by alkaline urine and high magnesium excretion (high magnesium/plantbased diets).
They also are potentiated by a specific urinary protein, in domestic cats.
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About 1015% of urinary calculi are composed of struvite .
Struvite stones (also known as "infection stones", urease or triple-phosphate stones), form
most often in the presence of infection by urea-splitting bacteria.
Using the enzyme urease, these organisms metabolize urea into ammonia and carbon
dioxide.
This alkalinizes the urine, resulting in favorable conditions for the formation of struvite
stones.
Infection stones can grow rapidly, forming large calyceal staghorn (antler-shaped) calculi.
Proteus mirabilis, Proteus vulgaris, and Morganella morganii are the most common
organisms isolated.
Less common organisms include Ureaplasma urealyticum, and some species of Providencia,
Klebsiella, Serratia, and Enterobacter.
These infection stones are commonly observed in people who have factors that predispose
them to urinary tract infections, such as those with spinal cord injury and other forms of
neurogenic bladder, ileal conduit urinary diversion, vesicoureteral reflux, and obstructive
uropathies.
Even in the absence of infection, accumulation of struvite crystals in the urinary bladder is a
problem frequently seen in housecats, with symptoms including difficulty urinating (which
may be mistaken for constipation) or blood in the urine (hematuria).
The protein cauxin, a protein excreted in large amounts in cat urine that acts to produce a
feline pheromone, has recently been found to cause nucleation of struvite crystals in a model
system containing the ions necessary to form struvite.
This may explain some of the excess struvite production in domestic cats. In the past, surgery
has been required to remove struvite uroliths in cats; today, special acidifying low magnesium
diets may be used to dissolve sterile struvite stones.
Upper urinary tract stones that involve the renal pelvis and extend into at least 2 calyces are
classified as staghorn calculi. Although all types of urinary stones can potentially form
staghorn calculi, approximately 75% are composed of a struvite-carbonate-apatite matrix.
They are also commonly seen in people with underlying metabolic disorders, such as
idiopathic hypercalciuria, hyperparathyroidism, and gout.
Uric acid stones

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Uric acid was first isolated from kidney stones in 1776 by Scheele.
As far as laboratory synthesis is concerned, in 1882, Horbaczewski claimed to have prepared
uric acid by melting urea hydrogen peroxide with glycine, trichlorolactic acid, and its amide.
Soon after, repetition by Eduard Hoffmann shows that this preparation with glycine gives no
trace of uric acid, but trichlorolactimide produces some uric acid. Thus, Hoffmann was the
first to synthesize uric acid.
About 510% of all stones are formed from uric acid.

Uric acid is a heterocyclic compound of carbon, nitrogen, oxygen, and hydrogen with the
formula C5H4N4O3. It forms ions and salts known as urates and acid urates such as
ammonium acid urate.
Uric acid is a product of the metabolic breakdown of purine nucleotides.
High blood concentrations of uric acid can lead to a type of arthritis known as gout. The
chemical is associated with other medical conditions including diabetes and the formation of
ammonium acid urate kidney stones.
People with certain metabolic abnormalities, including obesity, may produce uric acid stones.
Uric acid is a diprotic acid with pKa1=5.4 and pKa2=10.3. Thus in strong alkali at high pH, it
forms the dually charged full urate ion, but at biological pH or in the presence of carbonic
acid or carbonate ions, it forms the singly charged hydrogen or acid urate ion as its pKa1 is
lower than the pKa1 of carbonic acid.
As its second ionization is so weak, the full urate salts tend to hydrolyze back to hydrogen
urate salts and free base at pH values around neutral.
It is aromatic because of the purine functional group.
As a bicyclic, heterocyclic purine derivative, uric acid does not protonate like carboxylic
acids.
X-Ray diffraction studies on the hydrogen urate ion in crystals of ammomium hydrogen
urate, formed in vivo as gouty deposits, reveal the keto-oxygen in the 2 position of a tautomer
of the purine structure exists as a hydroxyl group and the two flanking nitrogen atoms at the 1
and 3 positions share the ionic charge in the six membered pi-resonance-stabilized ring.[2]
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Thus, while most organic acids are deprotonated by the ionization of a polar hydrogen-tooxygen bond, usually accompanied by some form of resonance stabilization (resulting in a
carboxylate ion), uric acid is deprotonated at a nitrogen atom and uses a tautomeric
keto/hydroxy group as an electron-withdrawing group to increase the pK1 value.
The five membered ring also possesses a keto group (in the 8 position), flanked by two
secondary amino groups (in the 7 and 9 positions), and deprotonation of one of these at high
pH could explain the pK2 and behavior as a diprotic acid.
Similar tautomeric rearrangement and pi-resonance stabilization would then give the ion
some degree of stability. (On the structure shown at the upper right, the NH at the upper right
on the six membered ring is "1", counting clockwise around the six membered ring to "6" for
the keto carbon at the top of the six membered ring.
The upper most NH on the five membered ring is "7", counting counter clockwise around this
ring to the lower NH, which is "9".)
Uric acid stones (see image below) are the most common cause of radiolucent kidney stones
in children.
Several products of purine metabolism are relatively insoluble and can precipitate when
urinary pH is low.
These include 2- or 8-dihydroxyadenine, adenine, xanthine, and uric acid.
The crystals of uric acid may initiate calcium oxylate precipitation in metastable urine
concentrates .
Uric acid stones.
The terms gouty nephropathy, urate nephropathy, and uric acid nephropathy are used to
describe renal insufficiency due to uric acid precipitation within the renal tubules.
Uric acid urolithiasis or uric acid kidney stones refer to development of a stone or calculus
composed of significant amounts of urate in the renal pelvis, ureter, or bladder.
They also may form in association with conditions that cause hyperuricosuria (an excessive
amount of uric acid in the urine) with or without hyperuricemia (an excessive amount of uric
acid in the serum).
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They may also form in association with disorders of acid/base metabolism where the urine is
excessively acidic (low pH), resulting in precipitation of uric acid crystals.
Certain medical conditions may further trigger uric acid kidney stone formation. These
include:Diabetes too may lead to uric acid kidney stones. Research reveals that people with type 2
diabetes have highly acidic urine, which may lead to uric acid stones.
Insulin Resistance.
Genetic factors.
Chronic diarrhea.
Binge Drinking.
Some rare types of anemia.
Blood cancers.
Lead poisoning.
Not eating for long periods of time.
Genetic Factors.
Hypocitraturia, a low amount of citrate in the urine
A diagnosis of uric acid urolithiasis is supported by the presence of a radiolucent stone in the
face of persistent urine acidity, in conjunction with the finding of uric acid crystals in fresh
urine samples.
Cystine Kidney Stones
Cystinuria (siss-tin-NYUR-Ree-Uh), and the chemical cystine (SISS-teen) were discovered in

1812 by Dr. William Hyde Wollaston (1766-1828), originally of Norfolk, England.
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Wollaston ( a partially blind man), working with his colleague, Dr. Humphrey Davy,
discovered a chemical in a stone found in the bladder which Wollaston named "cystic oxide."
Another doctor, Berzelius, recognized that this discovery was not an oxide, and he changed
the name to cystine.
In the old school of writing, it was spelled "cystin". The name cystine has nothing to do with
its chemical composition, but rather, for the place of its discovery. It was so named because
of its location in the bladder ( cyst= bladder) (Note: the bladder is named "cyst" in reference
to cyst, a pouch or closure, as the bladder takes the appearance of a pouch). Therefore, it was
mistakenly thought that cystine stones originated only in the bladder.
Cystine was the first amino acid to be discovered thru medical research.
Dr. Wollaston says upon his finding of the unusual stone: "A new species of urinary calculus
had been taken [by Dr. Reeve] from his brother when he was five years old. These calculi
have a yellowish semi-transparency; and they have also a peculiar glistening luster. I am
inclined to consider it as an oxide; and it may be convenient to give it the name of cystic
oxide."
In 1908, Sir Archibald Garrod first introduced the concept of inborn metabolic errors.
Garrod proposed the 4 original conditions to be Albinism, Alkaptonuria, Pentosuria, and
Cystinuria.
Cystine stones are a rare type of kidney stone.
Cystine cells are in the shape of a hexagon (the Italian word sistino means "six".) Oftentimes,
the stones themselves will be in the shape of a hexagon.
Cystine stones are the hardest of all kidney stones in composition, so this means they are the
hardest to dissolve and break up. But consider the source~like we mentioned, cystine makes
up the hardness of human nails and of rhino horn.
Cystinuria (also called cystine stone disease) is a rare, internal disorder of the function of the
necessary amino acids cystine, methionine, arginine, orthinine, and lysine, that results in
chronic and erratic cystine kidney stone production.
It is a "recessive" disorder; recessiveness can only be expressed when the genes are
"homozygous", or have a special, corresponding arrangement on the chromosomes. A
recessive trait is more rare than a dominant one.
At first glance, it may seem that the culprit is a "overproduction" of cystine, but this is not the
whole picture.And it's NOT a disorder of the kidney, per se.
Actually, the body is secreting too much cystine in the urine, not producing too much in the
first place. And this is where the problem lies.
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The internal kidney network of a Cystinuric has an impaired ability to reabsorb the excess
cystine during the kidney's filtration process, as in healthy individuals.
With no where else to go in the body, the cystine becomes a part of the kidney's product :
urine.
With an extreme concentration of cystine-a crystalline-("a substance composed of rock
crystals") the ever-thickening urine begins to form tiny, even microscopic crystals, which
quickly bond and clump together to form larger stones.
They are then ready to lodge in their warm hiding place for many days, weeks, months, or
even years, or will be passed in the same day.
The other aminos (COLA), are more soluble in urine than cystine, and have an alternate
transport system of filtration. While problems can arise from their presence, they do not
appear as part of the stone's make-up.
Cystinuria is referred to as a childhood disease because it is present from birth, but persist
thru adulthood. And cystine secretion can begin as early as the womb.
Fortunately, for a lot for people, major stone formation does not start til young adulthood,
oftentimes between the ages of 9-20. Roughly 22% of persons will begin stone formation in
childhood.
For a normal person, cystine output in urine is 40-80 milligrams daily. But for a cystine
patient, a daily output of 300-600+ mg is the normal.
Cystine stones, formed from too much amino acid called cystine, make up between 1 to 3
percent of all kinds of kidney stones.
Those who suffer from cystine stones are likely to also suffer from a genetic condition called
cystinuria.
Cystinuria occurs when the body doesn't process cystine properly and the chemical builds up
in urine.
The cystine crystallizes instead of being excreted, and forms a mass called a cystine stone.
Cystinuria, like cystine kidney stones, is a rare condition, affecting only one of out 10,000
people.
Epidemology
Cystinuria is an EXTREMELY rare disease, striking over 10,000 sufferers (1%) in the United
States alone. This rounds out to roughly 1,300 men and 700 women.
Given the numbers, that would make Cystinuria an "orphan disease".
An orphan disease is one that affects less than 200,000 people. And the world estimate is not
that much larger. 6-8% of pediatric cystine stones fall under this, and 1% adult.
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Cystine are the most common type of stones in children.
Unfortunately, it's most common in whites, such as light, blond, or red haired people of
European ancestry (ie:Celtic peoples). And for some reason, it's somewhat common in
Libyan Jews, with 1 in 2,500 being affected.
Other findings show 1 in 4,000 people in Australia, 1 in 1,900 in Spain, 1 in 2,000 in the UK,
1 in 2,500 in Israel, i in 5,600 in the Czech peoples, 1 in 18,000 in Japan, 1 in 17,286 in New
South Wales, and 1 in 100,000 in Sweden.
It appears that it is common in English blood, so if you have English ancestry, this would be a
good thing to consider.
In fact, many of our stoned friends are presently living in Canada, Aussie, and The UK. Other
numbers show cystine patients in Ireland and Scotland, and U.S. states that the English
are/were once prevelant in, such as Massachusetts.
But remember! Many of these diagnosed individuals will never PRODUCE stones!, due to
the various levels of cystine concentration in the urine .
Symptoms
The symptoms of a cystine kidney stone are the same as other types of urinary tract stones.
Small stones that pass on their own may not cause any symptoms at all.
Larger stones can cause you to have back and stomach cramps, and possibly nausea and
vomiting.
The pain may progress to your side and groin area if the stone is in the process of passing out
of your body.
Burning upon urination and blood in the urine can also be signs that you are suffering from a
kidney stone.
Cystine stones account for 1-2% of all renal stones and 6-8% of calculi in children.
Unlike most stones, they are caused by a genetic mutation and are inherited. This condition is
called cystinuria and individuals can inherit one gene (heterozygous) or two genes
(homozygous).
There is no sexual predilection and patients may present at any age.
The primary symptom of having cystinuria is the formation of urinary calculi. Stones may be
present in single, multiple, or large staghorn configurations.
Pure cystine stones are not easily visible on plain x-rays due to their sulfur content.
Physiology of cystine stones
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Cystinuria is caused by a genetic mutation that results in abnormal (decreased) small bowel
absorption and kidney reabsorption of cystine and three other amino acids: ornithine, lysine,
and arginine.
Three types of genetic mutations can lead to cystinuria.
Urinary levels of cystine are elevated in patients with cystinuria despite decreased bowel
absorption because of the kidney abnormalities allow cystine to leak into the urine.
The primary source for urinary cystine is due to the bodys breakdown of its precursor,
methionine, an amino acid present in many foods.
Diagnosis of cystine stones
A strong family history of kidney stones, development at a young age, or recurrent stone
disease are suggestive of the diagnosis.
Hexagonal stop sign crystals discovered during microscopic examination of urinary
sediment are highly indicative of having the disease, but are found in only 17-26% of patients
with homozygous cystinuria.
Cystine stones are amber in color. Stone analysis will confirm the diagnosis.
The limited solubility of cystine is responsible for spontaneous crystallization and subsequent
stone formation when it is present in high concentrations. Urinary pH, or the acidity, does
have a profound effect on cystine solubility, however, and manipulating the pH is one of the
mainstays of therapy to dissolve and preventive cystine stones.
Other types
People with certain rare inborn errors of metabolism have a propensity to accumulate crystalforming substances in their urine.
For example, those with cystinuria, cystinosis, and Fanconi syndrome may form stones
composed of cystine.
People afflicted with xanthinuria often produce stones composed of xanthine.
People afflicted with adenine phosphoribosyltransferase deficiency may produce 2,8dihydroxyadenine stones, alkaptonurics produce homogentisic acid stones, and
iminoglycinurics produce stones of glycine, proline and hydroxyproline.
Classification Based On Location

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Kidney stones are one of the most common disorders of the urinary system. Although these
crystals are small, they can create intense pain as they move along the urinary tract.
Kidney stones are found in three main locations in the urinary system.
They are:
1. Stones in kidney
2. Stones in ureter
3. Stones in bladder
Common Sites Where Kidney Stones Are Located
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Stones in Kidneys
Kidney stones are most commonly found in the kidneys. The kidneys are two small organs
located behind the ribs; they are mainly responsible for removing water and wastes from the
blood and producing urine.
Calyceal calculi refers to aggregations in either the minor or major calyx.
Nephrolithiasis (from the Greek (nephros, "kidney") and (lithos, "stone")) refers to the
presence of such calculi in the kidneys.
In kidneys stones are located in :
renal calyxes
renal pelvis
pelvi ureteric junction
Stones in Ureter
Kidney stones may also be located in the ureter, which are small tubes that carry urine from
the kidneys to the bladder.
The condition is called ureterolithiasis when a calculus is located in the ureter.
In ureter stones are located in:
Distal part of ureter

Proximal part of ureter
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Mid part of ureter
The intense pain associated with kidney stones typically occurs when the stone is traveling
through the ureter.
Stones in Bladder
The kidney stones will occasionally travel all the way through the ureter to the bladder. The
bladder is responsible for storing urine before it is excreted from the body.
Stones may also form or pass into the bladder, a condition referred to as cystolithiasis
In bladder stones are located in:
Vesico ureteric junction

Vesicular pouch
Vesico uretheric junction
Once the kidney stones reach this location, their next step is to be excreted with the urine.
This radiograph shows a large staghorn calculus involving the major calyces and renal
pelvis in a person with severe scoliosis.
The CT scan, below, shows a stone in each kidney (red arrowheads).
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Causes
There are many potential causes of kidney stone formation. In general they are the result of a
superconcentration of chemicals in the urine which further cause crystals.
They are:
A disorder in metabolism,
dietary habit,
dehydration,
recurrent urinary tract infection,
blockage of the urinary tract could alter your urine concentration
The main reasons are:

1. A positive family history (genetic tendency) also makes a person prone to kidney
stone formation. Hereditory factors also play a strong role. Hypercalciuria (where there
is excess of calcium excreted in urine) is also a genetically acquired factor which leads
to frequent development of kidney stones.
2. Metabolism : Metabolic disorder is one of the main cause of kidney or renal stones. In
this body is not able to assimilate the minerals and salts such as calcium, uric acid or
other salts in the blood. Metabolism is commonly impaired in endocrine disorders such
as hyperparathyroidism, certain diseases like ulcerative colitis and regional entritis. In
gouty arthritis the high level of uric acid in the urine can act as a breeding ground for
calcium oxalate stones. On the whole the formation of kidney or renal stones is a
complex process.
3. Dietary habits : Diet contributes a part in the formation of renal or kidney stones and
is considered a major maintaining cause. Clinically it is observed that too much of a
particular food promotes kidney or renal stones. A pregnant woman was advised to
take plenty of 'greens' to raise iron in the blood, and she developed renal or kidney
stones which came into light because of an acute renal colic (pain). Similary a patient
who had an abnormal craving for 'tomatoes' is now on the treatment for renal calculus
or kidney stones. Habits like 'betel chewing' with lime should also be considered.
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4.
5.
6.
7.
8.
Certain foods that increase the risk for kidney or renal stones in susceptible individuals
include spinach, strawberries, tomatoes, grapefruit juice, apple juice, soda, and all
types of teas and berries.
An imbalance of vitamins and minerals can increase the amount of calcium oxalate in
the urine; when the levels become too high, the calcium oxalate does not dissolve, and
crystal may begin to form.
Inadequate intake of fluids : Some people do not take sufficient water and fluids. In
some living in high temperature areas cause sweating and loss of fluid. The above may
lead to long-term dehydration resulting in concentration of urine which further leads to
over concentration of metabolic byproducts in the urine.
Infection : Chronic urinary tract infection (UTI) may predispose to stone formation.
The slough and the crusts which results following an infection, would combine with
high level minerals and salts to form stones. This is considerably noted in the
formation of vesical calculus after chronic cystitis.
Urinary obstruction : Urinary bloackage as in prostate enlargement, stricture urethra
and limited activity for several weeks will predispose to stone formation by making
sedimentation. Prostatic enlargement invariably causes stones in many patients.
Patients with inflammatory bowel disease or who have had an intestinal bypass or
ostomy surgery are also more likely to develop kidney stones.
Some medications also raise the risk of kidney stones which include diuretics, calcium
containing antacids and crixivan, a drug used to treat HIV infection.
Dietary factors that increase the risk of stone formation include :

A.
B.
Low fluid intake

High dietary intake of
animal protein,
sodium,
refined sugars,
fructose
high fructose corn syrup,
oxalate,
grapefruit juice,
apple juice,
cola drinks.
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X-ray with bilateral kidney stones
Calcium
Calcium is one component of the most common type of human kidney stones, calcium
oxalate.
Some studies suggest people who take supplemental calcium have a higher risk of
developing kidney stones, and these findings have been used as the basis for setting the
recommended daily intake for calcium in adults.
In the Women's Health Initiative, postmenopausal women who consumed 1000 mg of
supplemental calcium and 400 international units of vitamin D per day for seven years had a
17% higher risk of developing kidney stones than subjects taking a placebo.
The Nurses' Health Study also showed an association between supplemental calcium intake
and kidney stone formation.
Unlike supplemental calcium, high intakes of dietary calcium do not appear to cause kidney
stones and may actually protect against their development.
This is perhaps related to the role of calcium in binding ingested oxalate in the
gastrointestinal tract.
As the amount of calcium intake decreases, the amount of oxalate available for absorption
into the bloodstream increases; this oxalate is then excreted in greater amounts into the urine
by the kidneys.
In the urine, oxalate is a very strong promoter of calcium oxalate precipitation, about 15
times stronger than calcium.
In fact, current evidence suggests the consumption of diets low in calcium is associated with
a higher overall risk for the development of kidney stones.
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Renal Calculai
For most individuals, however, other risk factors for kidney stones, such as high intakes of
dietary oxalates and low fluid intake, probably play a greater role than calcium intake.
Other electrolytes
Aside from calcium, other electrolytes appear to influence the formation of kidney stones.
For example, by increasing urinary calcium excretion, high dietary sodium may increase the
risk of stone formation.
Fluoridation of drinking water may increase the risk of kidney stone formation by a similar
mechanism, though further epidemiologic studies are warranted to determine whether
fluoride in drinking water is associated with an increased incidence of kidney stones.
On the other hand, high dietary intake of potassium appears to reduce the risk of stone
formation because potassium promotes the urinary excretion of citrate, an inhibitor of urinary
crystal formation.
High dietary intake of magnesium also appears to reduce the risk of stone formation
somewhat, because like citrate, magnesium is also an inhibitor of urinary crystal formation.
Animal protein
Diets in Western nations typically contain more animal protein than the body needs. Urinary
excretion of excess sulfurous amino acids (e.g., cysteine and methionine), uric acid and other
acidic metabolites from animal protein acidifies the urine, which promotes the formation of
kidney stones.
The body often balances this acidic urinary pH by leaching calcium from the bones, which
further promotes the formation of kidney stones.
Low urinary citrate excretion is also commonly found in those with a high dietary intake of
animal protein, whereas vegetarians tend to have higher levels of citrate excretion.
Vitamins
Despite a widely held belief in the medical community that ingestion of vitamin C
supplements is associated with an increased incidence of kidney stones, the evidence for a
causal relationship between vitamin C supplements and kidney stones is inconclusive.
While excess dietary intake of vitamin C might increase the risk of calcium oxalate stone
formation, in practice this is rarely encountered.
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Renal Calculai
The link between vitamin D intake and kidney stones is also tenuous. Excessive vitamin D
supplementation may increase the risk of stone formation by increasing the intestinal
absorption of calcium, but there is no evidence that correction of vitamin D deficiency
increases the risk of stone formation.
Other
There are no conclusive data demonstrating a cause-and-effect relationship between alcohol
consumption and kidney stones.
However, some have theorized that certain behaviors associated with frequent and binge
drinking can lead to systemic dehydration, which can in turn lead to the development of
kidney stones.
The American Urological Association has projected that increasing global temperatures will
lead to an increased incidence of kidney stones in the United States by expanding the "kidney
stone belt" of the southern United States.
Signs and symptoms
Diagram showing the typical location of renal colic, below the rib cage to just above the
pelvis
A stone may quietly grow for years together and may remain silent for many years.
Very often it is an incidental finding in routine for other illness.
A kidney stone can cause problems in 2 ways :
when it moves or
when it grows so large that it begins to disupt kidney function and cause damage
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Renal Calculai
After keeping silent for sometime, the stone may start to move downwards drawn by the
urine and gravity. When the stone makes its run for freedom, it hurts the patient with severe
abdominal pain with or without nausea and vomitting causing :
Colicky pain : The pain is 'loin to groin'. The pain may be felt over back or side,
radiates to the groin, scrotum in men and the labia in women. It is often described as
'the worst pain' ever experienced, even more painful than gunshot, surgery, fractured
bones and so on.
Hematuria : Blood in the urine which may look as pink or orange.
Pyuria : Pus in the urine. Cloudy or foul-smelling urine.
Dysuria : Buring pain on urination; more typical with associated infection.
Oligouria : Reduced urinary volume caused by obstruction of bladder or urethra by

stone.
Frequent urge to urinate.
Abdominal distension.
Nausea or vomiting.
Fever and chills.
Profuse sweating
The hallmark of stones that obstruct the ureter or renal pelvis is excruciating, intermittent
pain that radiates from the flank to the groin or to the genital area and inner thigh.
This particular type of pain, known as renal colic, is often described as one of the strongest
pain sensations known.
Renal colic caused by kidney stones is commonly accompanied by :
urinary urgency,
restlessness,
hematuria,
sweating,
nausea,
vomiting.
It typically comes in waves lasting 20 to 60 minutes caused by peristaltic contractions of the

ureter as it attempts to expel the stone.
The embryological link between the urinary tract, the genital system, and the gastrointestinal
tract is the basis of the radiation of pain to the gonads, as well as the nausea and vomiting that
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Renal Calculai
are also common in urolithiasis. Postrenal azotemia and hydronephrosis can be observed
following the obstruction of urine flow through one or both ureters.
Pathophysiology
Supersaturation of urine
When the urine becomes supersaturated (when the urine solvent contains more solutes than it
can hold in solution) with one or more calculogenic (crystal-forming) substances, a seed
crystal may form through the process of nucleation.
Heterogeneous nucleation (where there is a solid surface present on which a crystal can grow)
proceeds more rapidly than homogeneous nucleation (where a crystal must grow in liquid
medium with no such surface), because it requires less energy.
Adhering to cells on the surface of a renal papilla, a seed crystal can grow and aggregate into
an organized mass.
Depending on the chemical composition of the crystal, the stone-forming process may
proceed more rapidly when the urine pH is unusually high or low.
Supersaturation of the urine with respect to a calculogenic compound is pH-dependent.
For example, at a pH of 7.0, the solubility of uric acid in urine is 158 mg/100 ml. Reducing
the pH to 5.0 decreases the solubility of uric acid to less than 8 mg/100 ml.
The formation of uric acid stones requires a combination of hyperuricosuria (high urine uric
acid levels) and low urine pH; hyperuricosuria alone is not associated with uric acid stone
formation if the urine pH is alkaline.
Supersaturation of the urine is a necessary, but not a sufficient, condition for the development
of any urinary calculus.
Supersaturation is likely the underlying cause of uric acid and cystine stones, but calciumbased stones (especially calcium oxalate stones) may have a more complex etiology.
Inhibitors of stone formation

Normal urine contains chelating agents, such as citrate, that inhibit the nucleation, growth,
and aggregation of calcium-containing crystals.
Other endogenous inhibitors include
calgranulin (an S-100 calcium binding protein),

Tamm-Horsfall protein,
glycosaminoglycans,
uropontin (a form of osteopontin),
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Renal Calculai
nephrocalcin (an acidic glycoprotein),

prothrombin F1 peptide,
bikunin (uronic acid-rich protein).
The biochemical mechanisms of action of these substances have not yet been thoroughly
elucidated. However, when these substances fall below their normal proportions, stones can
form from an aggregation of crystals.
Kidney stones often result from a combination of factors, rather than a single, well-defined
cause. Stones are more common in people whose diet is very high in animal protein or who
do not consume enough water or calcium.
They can result from an underlying metabolic condition, such as
distal renal tubular acidosis,

Dent's disease,
hyperparathyroidism,
primary hyperoxaluria,
medullary sponge kidney.
In fact, studies show about 3% to 20% of people who form kidney stones have medullary
sponge kidney.
Kidney stones are also more common in people with Crohn's disease.
People with recurrent kidney stones are often screened for these disorders. This is typically
done with a 24-hour urine collection that is chemically analyzed for deficiencies and excesses
that promote stone formation.
Diagnosis
Bilateral kidney stones can be seen on this KUB radiograph. Note the presence of
phleboliths in the pelvis, which can be misinterpreted as bladder stones.
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Renal Calculai
Axial CT scan of abdomen without contrast, showing a 3-mm stone (marked by an

arrow) in the left proximal ureter
A stone at the uteral vesicular junction

Diagnosis of kidney stones is made on the basis of information obtained from:
the history,
physical examination,
urinalysis,
radiographic studies.
Clinical diagnosis is usually made on the basis of the location and severity of the pain, which
is typically colicky in nature (comes and goes in spasmodic waves).
1. Pain in the back occurs when calculi produce an obstruction in the kidney.
2. Physical examination may reveal fever and tenderness at the costovertebral angle on
the affected side.
Imaging studies
Calcium-containing stones are relatively radiodense, and they can often be detected by a
traditional radiograph of the abdomen that includes the kidneys, ureters, and bladder (KUB
film).
Some 60% of all renal stones are radiopaque.
In general, calcium phosphate stones have the greatest density, followed by calcium oxalate
and magnesium ammonium phosphate stones.
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Renal Calculai
Cystine calculi are only faintly radiodense, while uric acid stones are usually entirely
radiolucent.
Where available, a noncontrast helical CT scan with 5 millimeters (0.20 in) sections is the
diagnostic modality of choice in the radiographic evaluation of suspected nephrolithiasis.
All stones are detectable on CT scans except very rare stones composed of certain drug
residues in the urine, such as from indinavir.
Where a CT scan is unavailable, an intravenous pyelogram may be performed to help confirm
the diagnosis of urolithiasis. This involves intravenous injection of a contrast agent followed
by a KUB film. Uroliths present in the kidneys, ureters or bladder may be better defined by
the use of this contrast agent.
Stones can also be detected by a retrograde pyelogram, where a similar contrast agent is
injected directly into the distal ostium of the ureter (where the ureter terminates as it enters
the bladder).
Ultrasound imaging of the kidneys can sometimes be useful, as it gives details about the
presence of hydronephrosis, suggesting the stone is blocking the outflow of urine.
Radiolucent stones, which do not appear on CT scans, may show up on ultrasound imaging
studies.
Other advantages of renal ultrasonography include its low cost and absence of radiation
exposure.
Ultrasound imaging is useful for detecting stones in situations where X-rays or CT scans are
discouraged, such as in children or pregnant women.
Despite these advantages, renal ultrasonography is not currently considered a substitute for
noncontrast helical CT scan in the initial diagnostic evaluation of urolithiasis. The main
reason for this is that compared with CT, renal ultrasonography more often fails to detect
small stones (especially ureteral stones), as well as other serious disorders that could be
causing the symptoms.
Laboratory examination
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Renal Calculai
Struvite crystals found on microscopic examination of the urine
Laboratory investigations typically carried out include:
microscopic examination of the urine, which may show red blood cells, bacteria,
leukocytes, urinary casts and crystals;
urine culture to identify any infecting organisms present in the urinary tract and
sensitivity to determine the susceptibility of these organisms to specific antibiotics;
complete blood count, looking for neutrophilia (increased neutrophil granulocyte

count) suggestive of bacterial infection, as seen in the setting of struvite stones;
renal function tests to look for abnormally high blood calcium blood levels
(hypercalcemia);
24 hour urine collection to measure total daily urinary volume, magnesium, sodium,
uric acid, calcium, citrate, oxalate and phosphate;
collection of stones (by urinating through a StoneScreen kidney stone collection cup
or a simple tea strainer) is useful. Chemical analysis of collected stones can establish
their composition, which in turn can help to guide future preventive and therapeutic
management.
Prevention
Dietary measures
Specific therapy should be tailored to the type of stones involved. Diet can have a profound
influence on the development of kidney stones.
Preventive strategies include some combination of dietary modifications and medications
with the goal of reducing the excretory load of calculogenic compounds on the kidneys.
Current dietary recommendations to minimize the formation of kidney stones include:
Increasing fluid intake of citrate-rich foods (especially citrate-rich fluids such as

lemonade and orange juice), with the objective of increasing urine output to more than
two liters per day
Attempt to maintain a calcium (Ca) intake of 1000 1200 mg per day
Limiting sodium (Na) intake to less than 2300 mg per day
Limiting vitamin C intake to less than 1000 mg per day
Limiting animal protein intake to no more than two meals daily, with less than 170
230 g per day (A positive association between animal protein consumption and
recurrence of kidney stones has been shown in men, but not yet in women.)
Limiting consumption of foods containing high amounts of oxalate (such as spinach,

strawberries, nuts, rhubarb, wheat germ, dark chocolate, cocoa, brewed tea)
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Renal Calculai
Maintenance of dilute urine by means of vigorous fluid therapy is beneficial in all forms of
nephrolithiasis, so increasing urine volume is a key principle for the prevention of kidney
stones.
Fluid intake should be sufficient to maintain a urine output of at least 2 l (68 US fl oz) per
day.
A high fluid intake has been associated with a 40% reduction in recurrence risk.
Calcium binds with available oxalate in the gastrointestinal tract, thereby preventing its
absorption into the bloodstream, and reducing oxalate absorption decreases kidney stone risk
in susceptible people.
Because of this, some nephrologists and urologists recommend chewing calcium tablets
during meals containing oxalate foods.
Calcium citrate supplements can be taken with meals if dietary calcium cannot be increased
by other means.
The preferred calcium supplement for people at risk of stone formation is calcium citrate
because it helps to increase urinary citrate excretion. Aside from vigorous oral hydration and
consumption of more dietary calcium, other prevention strategies include avoidance of large
doses of supplemental vitamin C and restriction of oxalate-rich foods such as leaf vegetables,
rhubarb, soy products and chocolate.
However, no randomized, controlled trial of oxalate restriction has yet been performed to test
the hypothesis that oxalate restriction reduces the incidence of stone formation. Some
evidence indicates magnesium intake decreases the risk of symptomatic nephrolithiasis.
Epidemiology
Urolithiasis is a significant source of morbidity, affecting all geographical, cultural, and racial
groups.
The lifetime risk is about 10 to 15% in the developed world, but can be as high as 20 to 25%
in the Middle East.
The increased risk of dehydration in hot climates, coupled with a diet 50% lower in calcium
and 250% higher in oxalates compared to Western diets, accounts for the higher net risk in
the Middle East.
Although one might expect more calcium oxalate stones, uric acid stones are actually more
common in the Middle East than calcium-containing stones.
In North America and Europe, the annual incidence (number of new cases per year) of kidney
stones is roughly 0.5%.
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Renal Calculai
In the United States, the prevalence (frequency in the population) of urolithiasis has increased
from 3.2% to 5.2% from the mid-1970s to the mid-1990s.
The total cost for treating urolithiasis was US$2 billion in 2003.
About 80% of those with kidney stones are men; most stones in women are due to either
metabolic defects (such as cystinuria) or infection.
Men most commonly experience their first episode between 30 and 40 years of age, whereas
for women, the age at first presentation is somewhat later.
The age of onset shows a bimodal distribution in women, with episodes peaking at 35 and 55
years. Recurrence rates are estimated at 50% over a 10-year and 75% over 20-year period,
with some people experiencing ten or more episodes over the course of a lifetime.
Research directions
Crystallization of calcium oxalate appears to be inhibited by certain substances in the urine
that retard the formation, growth, aggregation, and adherence of crystals to renal cells.
By purifying urine using salt precipitation, isoelectric focusing, and size-exclusion
chromatography, some researchers have found that calgranulin, a protein formed in the
kidney, is a potent inhibitor of the in vivo formation of calcium oxalate crystals.
Considering its extremely high levels of inhibition of growth and aggregation of calcium
oxalate crystals, calgranulin might be an important intrinsic factor in the prevention of
nephrolithiasis.
Urinary system Pathology Urologic disease / Uropathy

Abdomi
nal
NonMinimal change Focal

proliferat
segmental Membranous
ive
Glomerulopathy Primar
Mesangial proliferative
/
ily
Nephropat
glomerulitis/ nephro Proliferat Endocapillary proliferative
hy/
ive
Membranoproliferative/mesangio
(glomerulonephr tic
(nephritis+
capillary
itis+
nephrosis)
glomerulonephr
By
osis)
Diabetic Amyloidosis
condition
Primar
Type I
Goodpasture's syndrome
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Renal Calculai
RPG/Type II
hypersensitivity
ily
Type II
Post-streptococcal Lupus
nephrit RPG/Type III
(DPN) IgA/Berger's
ic, hypersensitivity
RPG
Type III
Wegener's granulomatosis
RPG/PauciMicroscopic polyangiitis
immune
Proximal RTA (RTA 2) Fanconi syndrome
Thick
Bartter syndrome
ascending
Distal
Gitelman syndrome
convoluted
Tubulopathy/
tubulitis
Collecting Liddle's syndrome RTA (RTA 1)

duct
Diabetes insipidus (Nephrogenic)
Renal
papilla
Renal papillary necrosis
Major Hydronephrosis Pyonephrosis Reflux

calyx/pelvisnephropathy
Any/all Acute tubular necrosis
Interstitium
Interstitial nephritis (Pyelonephritis, Danubian

endemic familial nephropathy)
Renal failure (Acute renal failure,
General
Chronic renal failure) Uremic
syndromes
pericarditis Uremia
Any/all
Renal artery stenosis Renal Ischemia

Hypertensive nephropathy
Vascular
Renovascular hypertension Renal
Cortical Necrosis
Other
Analgesic nephropathy Renal

osteodystrophy Nephroptosis
Abderhalden-Kaufmann-Lignac
syndrome
Ureter Ureteritis Ureterocele Megaureter

Page 32
Renal Calculai
Pelvic
Cystitis (Interstitial cystitis, Hunner's ulcer, Trigonitis, Hemorrhagic

Bladdercystitis) Neurogenic bladder Bladder sphincter dyssynergia
Vesicointestinal fistula Vesicoureteral reflux
Urethra
Urethritis (Non-gonococcal urethritis) Urethral syndrome Urethral

stricture/Meatal stenosis Urethral caruncle
Obstructive uropathy Urinary tract infection Retroperitoneal fibrosis

Any/all Urolithiasis (Bladder stone, Kidney stone, Renal colic) Malacoplakia Urinary
incontinence (Stress, Urge, Overflow)
Uric Acid
Brushite
Silica (Canine)
Struvite
Calcium Oxalate
Stuvite with staple Monohydrate with
superficial Dihydrate
Calcium Oxalate
Carbonate Apatite
Monohydrate
deposited over Silica
Uric Acid
Calcium Oxalate
Monohydrate
Calcium Oxalate
Monohydrate
Calcium Oxalate
Dihydrate
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Renal Calculai
Calcium Oxalate
Monohydrate (coated
with Triamterene)
Tricalcium
Phosphate &
Apatites
Xanthine
Brushite
Calcium Carbonate Uric Acid Dihydrate
Struvite (Ferret)
Struvite (Feline)
Calcium Oxalate
Monohydrate
deposited over
Apatite
Calcium Oxalate
Monohydrate
partially encrusted
w/ Dihydrate
Struvite
Carbonate Apatite
Calcium Oxalate
Monohydrate
Cholesterol (Biliary)
Cystine
Struvite
Page 34
Renal Calculai
Renal calculai Siddhars Thought

Siddha System Of Medicine
The siddha system of medicine is the oldest medical system in the world.
There are extensive references to this system in the Thirukural and the Tamil grammar work
Tholkappiam which are pointers to its period of origin.
Siddha medicine is practised in Southern India.
The origin of the Tamil language is attributed to the sage Agasthya and the origin of Siddha
medicine is also attributed to him.
Before the Aryan occupation of the Sind region and the Gangetic plain there existed in the
southern India, on the banks of the river Kavery, and Tamirapani, a civilization which was
highly organised
It is an ancient, traditional system of Indian medicine, developed by 18 Siddhars who
glorified human beings as the highest form of birth.
They believed that it was essential to preserve the human body to achieve eternal bliss.
They proved through their own lives that it was possible to achieve longevity without
becoming senile, by leading simple lives and following the laws of nature.
The Siddha system has not only made valuable contributions in the field of medicine but has
also provided knowledge of eternity, alchemy and yogic living.
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Renal Calculai
Like Ayurveda, the Siddha system also believes that everything in the world is made up of the
panchabhoothas panjeekarnam
Siddhars developed among other branches of a vast knowledge system, known as siddha
medicine; practised mainly in Tamil nadu.
The unique aspect of this system is that, this form of medicine aims at the immortality of both
soul and the body.
Basic principles of Siddha medicine

The universe consists of two essential entities, matter and energy.
The Siddhas call them Siva (male) and Shakti (female, creation).
Matter cannot exist without energy inherent in it and vice versa.
The two co-exist and are inseparable.
They are the primordial elements Bhutas, not to be confused with modern chemistry.
Their names are:
1. Munn(solid),
2. Neer (fluid),
3. Thee (radiance),
4. Vayu (gas) and
5. Aakasam (ether).
These five elements (Bhutas) are present in every substance, but in different proportions.
Earth, water , fire , air and akasam are manifestations of these 5 elements .
The human anatomy and physiology, causative factor of diseases, the materials for the
treatment and cure of the diseases, the foods for the sustenance of the body, all fall within the
five elemental categories (3) .
Siddha Science considers nature and man as essential one.
Nature is man and man is nature.
Man is said to be the microcosm and universe is the macrocosm because what exists in the
world, exists in man.
Man is nothing but a miniature world containing the 5 elements of the various principles,
which constitute the herbo minerals, herbals and animal kingdom.
A close relationship is found to exist between the external world and the internal system of
man. Siddhars maintains that the structure of the human body is miniature world in itself man
consumes water and food and breathes air, and thus maintain the heat in the body.
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Renal Calculai
The life force is given by ether.
The earth is the first element which gives fine shape, to the body including bones, tissues,
muscles, skin, hair, etc.
Water is the second element representing blood. Secretions of glands, vital fluid etc.
Fire is the 3rd element that gives motion, vigor, vitality to the body, it also helps digestion,
circulation, and stimulation besides respiration, and the nervous system.
Above all the three is the characteristics of mans mental and spiritual faculities.
Siddha system of medicine is based on Saiva Siddhantha.
Siddha is a tamil word that is derived from its roots siddh, which means perfection in life or
Heavenly Bless.
The fundamental principles of siddha methodology are:
Vatham (alchemy)
Vaithiyam (medicine)
Yogam (yoga)
Gnanam (or) Thathuvam (philosophy)
Siddhars Spiritual Scientists of tamil nadu explored and explained the reality of nature and its
relationship to man by the yogic awareness and experimental findings.
They postulated the concept of spiritualism for self improvement and the practise propounded
by them can to be known as the SIDDHA SYSTEM.
Tridoshas according to Siddha Medicine

The three doshas may be compared to three pillars that support a structure.
From the charts below it can be seen the Tridoshas are involved in all functions of the body,
physical, emotional and mental.
The bodily activities, voluntary and involuntary are linked to Vatham. Pitham is linked to
bodily changes involving destruction/metabolism.
All constructive processes are performed by Kapam.
They function dependent on each other.
They permeate every single structure in the body.
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Renal Calculai
The maintenance of the equilibrium is health, disturbance is disease.
Vatham
Pitham
characteristic is
dryness, lightness, heat, mover of the nervous
coldness &
force of the body
motility
Formed by
Aakasam and
Vayu, controls the
nervous action that
constitute
movement,
activity,
sensation,etc.
Vatham
predominates in
the bone.
Vatham
predominates in
first one third of
life when activity,
growth ,sharpness
of functionof
sense,are greater
Kapam
smoothness,
firmness, viscidity,
heaviness
Formed by munn
Formed by Thee, controls the and Neer,controls
metabolic activity of the
the stability of the
body, digestion,warmth,
body such as
lustre,
strength, potency,
intellect,assimilation,etc.
smooth working of
Pitham predominates in the
joints. Karpam
tissue blood.
predominates in
other tissues
Pitham predominates in the

second one third of life
Location-pervades Location-in alimentary canal

the body (refer to from cardiac end of stomach
Vayu chart)
to end of small intestine
Karpam
predominates in
the last one third of
life. Diminishing
activity of various
organs and limbs
Location-in chest
,throat, head and
joints
-acts as thermostat
to the body
Saptha Thathus
The seven tissues (dhatus) one of the three doshas predominate as shown in chart above in
third column.
The seven dhatus are:
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Renal Calculai
1. Rasa (lymph),
2. Kurudhi(blood),
3. Tasai(muscle),
4. Kozhuppu (adipose tissue),
5. Elumbu(bone),
6. Majjai (marrow) and
7. Sukkilam and Artavam (male and female hormones)
Diagnosis in siddha system:

There are 8 methods of diagnosis in the Siddha system.
The most primary of these methods is the pulse diagnosis.
Apart from this, diagnosis is also based on the examination of the tongue, complexion,
speech, eyes, palpitation, urine and stool.
A unique feature of the urine examination is the oil test or neikuri.
Vayu
Vatham is considered to be the primary dosha because it activates the other two doshas.
Vatham is the outcome of the Akasa and Vayu of the Panchamaha Bhutas.
The location and functions of the Vayu is not much different from that of Ayurveda.
Prana
Apana
Samana
located in
mouth and
nostrils
(inhaled)
- aids
ingestion
located at anal
extremity
equalizer,
(expelled)
aids
-elimination, digestion
expulsion
Vyana
Udana
functions in
circulation of
upper
blood and
respiratory
nutrients
passages
Kalladaipu
Aecording to siddhars Renal calculai is named as kalladaippu (or) achmari
Page 39
Renal Calculai
Definition:
It is a disease characterised by pain in the tip of the genitalia, improper flow of
urine during micturition, low back pain, pain in loin and groin and urine mixed with small
sand like stones.
Causes:
1. Drinking water which is stagnated in a place for long period (pond water, lake
water)
2. Eating high carbohydrate rich diet frequently.
3. Intake of foods that increases vatha dosha
4. controlling the seminating reflex.
Types:
On the basis of Doshas it is grouped into 4 types.
They are:
1.vatham kalladiappu
2.pitham kalladaippu
3.kapham kalladaippu
4.mukkutram kalladaippu
Pothu kurikunagal:
Burning micturition
Intermitted flow of urine
Nausea
Vomitting
Fever
Pain in lowback radiating to loin and groin upto the tip of the genitalia
Pain and severe burning sensation in the tip of the genitalia
Sometimes haemeturia
Sometimes diarrhea
Headache
Mukutra verupadu:
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Renal Calculai
According to yukimuni the Thee butha increases from its level. Due to its elevation it dries
out the body fluids,thereby the amount of urine formation gets reduced and hence there
occurs the salt retention and deposition in the urinary tract. It also reduces the action of
Abana vayu,which intermits with the flow of urine during micturition and results in the
disease.
Method of Treatment :
The treatment for the imbalance of the Tridoshas are made up of the five elements.
The drugs are made up of the five elements.
By substituting a drug of the same constituents (guna) the equilibrium is restored. The
correction of the imbalance is made by substituting the drug which is predominately of the
opposite nature.
An example is of Vatham imbalance is cold, dry thus the treatment will be oily and warmth.
For inactivity of limbs, massage and activity, are prescribed.
If Pitham dosha is increased, warmth is produced; to decrease Pitham , sandalwood is
administered, internally or externally because of its cold characteristics .
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Renal Calculai
Aravindh Herbals Treatment For Renal Calculai

In Aravindh Herbals there are many naturally formulated capsules which are particularly
specified and yield good result in the treatment of renal calculai in clinical trials and regular
practice.
Among them we can see leading 3 capsules.
They are:
1. Capsule Musa-P
2. Capsule Tribulus-T
3. Capsule Aerva-L
Contents Of The Capsules:

1. Capsule Musa-P:
t contains Valai thandu powder-500mg
2. Capsule Tribulus-T:
It contains Nerunchil powder-500mg
3. Capsule Aerva-L:
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Renal Calculai
It contains Sirukan pelai powder-500mg
A detailed explanation of the contents of the above mentioned capsules are given in the
following pages.
Musa paradisica
Scientificclassification
Kingdom
Plantae Plants
Subkingdom
Tracheobionta Vascular plants
Superdivision
Spermatophyta Seed plants
Division
Magnoliophyta Flowering plants
Class
Liliopsida Monocotyledons
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Renal Calculai
Subclass
Zingiberidae
Order
Zingiberales
Family
Musaceae Banana family
Genus
Musa L. banana
Species
Musa paradisiaca L. (pro sp.) [acuminata balbisiana]

French plantain
Common name:
English:Banana
Hindi: Kela
Manipuri: Laphoo tharo
Tamil: Vaazha
Malayalam: Vaazha
Distribution
Original home of banana is believed to be India and Malaya.
In the mythological ages in Europe it was called the 'apple of paradise'. The Greek and
Arabian writers referred to it as a wonderful fruit of India.
The banana, a plant originating in South Africa, is considered to have been the first fruit to
appear on the Earth, having been mentioned in writings that date back to the beginning of
mankind.
The Malayan soldiers probably took them to Madagascar about the fifth century AD and from
there it spread to east coast and mainland of Africa.
Later, it was introduced in Western countries and other parts of the world.
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In India, there are three important banana producing areas South India, Western India and
Eastern India from Bihar to Assam.
It is one of the oldest cultivated plants.
They are native to tropical South and Southeast Asia, and are likely to have been first
domesticated in Papua New Guinea.
[1] Today, they are cultivated throughout the tropics.
[2] They are grown in at least 107 countries,
[3] primarily for their fruit, and to a lesser extent to make fiber, banana wine and as
ornamental plants
Morphology
The banana plant is a herbaceous plant, which because of its size and structure, is on many
occasions confused with a tree.
It has large leaves of which the overlapping bases form the so-called false trunk.
The plant produces two stems at the same time: a bigger one for the immediate obtaining of
the fruit, and a smaller one, which produces the fruit 6-8 months later.
The lifespan of a banana plant plantation is at least 25 years.
Fully grown, the stem reaches a height of 10 - to 30 feet.
From the center of the crown spring the flowers.
Each pseudostem normally produces a single inflorescence, also known as the banana heart.
More are sometimes produced; an exceptional plant in the Philippines produced five .
The inflorescence contains many bracts (sometimes incorrectly called petals) between rows
of flowers.
The female flowers (which can develop into fruit) appear in rows further up the stem from the
rows of male flowers.
Only female flowers develop into a banana fruit that vary in length from about 4 - 12 inches.
The ovary is inferior, meaning that the tiny petals and other flower parts appear at the tip of
the ovary.
The banana fruits develop from the banana heart, in a large hanging cluster, made up of tiers
(called hands), with up to 20 fruit to a tier.
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The hanging cluster is known as a bunch, comprising 320 tiers, or commercially as a
"banana stem", and can weigh from 3050 kilograms (66110 lb).
In common usage, bunch applies to part of a tier containing 310 adjacent fruits.
Individual banana fruits (commonly known as a banana or 'finger') average 125 grams
(0.28 lb), of which approximately 75% is water and 25% dry matter.
There is a protective outer layer (a peel or skin) with numerous long, thin strings (the phloem
bundles), which run lengthwise between the skin and the edible inner portion.
The inner part of the common yellow dessert variety splits easily lengthwise into three
sections that correspond to the inner portions of the three carpels.
The fruit has been described as a "leathery berry".
In cultivated varieties, the seeds are diminished nearly to non-existence; their remnants are
tiny black specks in the interior of the fruit.
The average weight of a bunch is about 25 lbs.
Each banana plant bears fruit only once.
The propagation is through shoots from the rhizomes, since most of the seeds species are
sterile.
Chemical constituents
A new bicyclic diarylheptanoid,
rel-(3S,4aR,10bR)-8-hydroxy-3-(4-hydroxyphenyl)-9-methoxy-4a,5,6,10btetrahydro-3H-naphtho[2,1-b]pyran (1),
as well as four known compounds,
1. 1,2-dihydro-1,2,3-trihydroxy-9-(4-methoxyphenyl)phenalene (2),
2. hydroxyanigorufone (3),
3. 2-(4-hydroxyphenyl)naphthalic anhydride (4),
4. 1,7-bis(4-hydroxyphenyl)hepta-4(E),6(E)-dien-3-one (5),
were isolated from an ethyl acetate-soluble fraction of the methanol extract of the fruits of
Musa paradisiaca cultivar, using a bioassay based on the induction of quinone reductase
(QR) in cultured Hepa1c1c7 mouse hepatoma cells to monitor chromatographic fractionation.
The structure and relative stereochemistry of compound 1 were elucidated unambiguously by
one- and two-dimensional NMR experiments (1H NMR, 13C NMR, DEPT, COSY, HMQC,
HMBC, and NOESY) and single-crystal X-ray diffraction analysis.
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Isolates 15 were evaluated for their potential cancer chemopreventive properties utilizing an
in vitro assay to determine quinone reductase induction and a mouse mammary organ culture
assay.
Banana stem contains Tannins, eugenol, tyramine.
High tannin content in the plant and unripe fruits has antibiotic activity.
Serotonin, levarterenol, and dopamine are available in the ripe fruit and peel.
Other chemical constituents are alkaloids, steroidal lactones, and iron .
Medicinal Uses
Bananas are true sources of energy.
A banana contains potassium, proteins, fibers, carbohydrates and an association of vitamins:
A, B, B6, C and E; it is rich in calcium, magnesium, iron, zinc and folic acid.
These facts being taken into consideration, the banana is one of the healthiest fruits.
It also contains serotonin or the substance of happiness, having an anti-stress role.
Other properties of bananas: especially helpful in anti-fat treatments, being very dense, it
offers a sensation of satisfaction.
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Being rich in iron, the bananas stimulate the production of hemoglobin in the blood, thus
helping in cases of anemia.
Because of its high potassium, but low salt content, it is indicated for those having problems
with arterial pressure.
Being an aliment that is rich in fibers, the banana helps with constipation, through the
regaining of the intestines' normal activity.
Containing a type of protein, which the body transforms into serotonin, the fruit is indicated
in treatments against depression, leading to an improved affective state.
The banana is also indicated for calming of nerves, being used in treatments for the regulating
of intestinal traffic.
Having a fine and soft texture, it is also used in treating ulcer.
The fruit has the power of growing concentration capacity.
The potassium contained in bananas helps regulating heartbeats, brings oxygen to the brain
and maintains the water quantity in the body at a constant level.
At moments of stress, the metabolism is accelerated and the level of potassium decreases, a
situation in which the consumption of bananas is recommended.
The fruit is also useful against smoking, helping the body regenerate after the effects of lack
of nicotine.
Many cultures see the banana as a refreshing fruit, which can decrease the physical and
emotional temperature of pregnant women.
Against hangovers, a milkshake can be prepared, sweetened with honey. The banana calms
the body and rebuilds the sugar level in the body, while the milk calms and hydrates the body.
Mosquito bites can be treated if the affected area is rubbed with the interior part of a banana
peal.
Bananas are used in cosmetics for treating dried complexions, limp skin and itches.
In cases of solar burns or numbness from cold, a crushed banana can be applied on the face to
calm pain and reduce inflammations.
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It is recommended that bananas be consumed when they have only a few spots of brownish
color because that is when it is richest in minerals and vitamins.
In the moment of the fruit's consumption, its color has to be taken into account. It shouldnt
be eaten while it is of a pale yellow or green color because at such a time it contains starch,
which is hard to digest.
Being rich in calories, it is recommended that those who are holding anti-fat treatments and
who suffer from diabetes consume it moderately.
It is not indicated for use in a severe anti-cholesterol diet.
Bananas do not bear temperatures lower than 12 degrees and they should never be kept in
refrigerators.
Cosmetic tips:
1. Creams based on bananas, used in cosmetics for treating dried complexions, are
prepared from crushed bananas, a teaspoon of liquid honey is added and the mixture
is stirred well.
It is applied on the face under the form of a mask.
It is kept that way for 15 minutes, and then washed away with mineral water.
2. Another mask against itching is prepared of a crushed banana mixed with yogurt. It is
applied on the face and kept for ten minutes before washing it away.
3. Facial lotion, for dried complexions is obtained like this: a very ripe banana is taken,
crushed in the mixer, added to a glass of milk and a teaspoon of olive or sweet almond
oil.
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Bananas are naturally slightly radioactive, more so than most other fruits, because of their
potassium content and the small amounts of the isotope potassium-40 found in naturally
occurring potassium.
Proponents of nuclear power sometimes refer to the banana equivalent dose of radiation to
support their arguments.
History of banana
Southeast Asian farmers first domesticated bananas.
Recent archaeological and palaeoenvironmental evidence at Kuk Swamp in the Western
Highlands Province of Papua New Guinea suggests that banana cultivation there goes back to
at least 5000 BCE, and possibly to 8000 BCE.
It is likely that other species were later and independently domesticated elsewhere in
southeast Asia.
Southeast Asia is the region of primary diversity of the banana.
Areas of secondary diversity are found in Africa, indicating a long history of banana
cultivation in the region.
Actual and probable diffusion of bananas during Islamic times (7001500 CE)
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Phytolith discoveries in Cameroon dating to the first millennium BCE triggered an as yet
unresolved debate about the date of first cultivation in Africa.
There is linguistic evidence that bananas were known in Madagascar around that time.
The earliest prior evidence indicates that cultivation dates to no earlier than late 6th century
CE.
It is likely, however, that bananas were brought at least to Madagascar if not to the East
African coast during the phase of Malagasy colonization of the island from South East Asia c.
400 CE.
The banana may have been present in isolated locations of the Middle East on the eve of
Islam.
There is some textual evidence that Muhammad was familiar with bananas.
The spread of Islam was followed by far-reaching diffusion.
There are numerous references to it in Islamic texts (such as poems and hadiths) beginning in
the 9th century.
By the 10th century the banana appears in texts from Palestine and Egypt.
From there it diffused into north Africa and Muslim Iberia.
During the medieval ages, bananas from Granada were considered among the best in the Arab
world. In 650, Islamic conquerors brought the banana to Palestine.
Today, banana consumption increases significantly in Islamic countries during Ramadan, the
month of daylight fasting.
Bananas were introduced to the Americas by Portuguese sailors who brought the fruits from
West Africa in the 16th century.
The word banana is of West African origin, from the Wolof language, and passed into English
via Spanish or Portuguese.
Many wild banana species as well as cultivars exist in extraordinary diversity in New Guinea,
Malaysia, Indonesia, China, and the Philippines.
There are fuzzy bananas whose skins are bubblegum pink; green-and-white striped bananas
with pulp the color of orange sherbet; bananas that, when cooked, taste like strawberries.
The Double Mahoi plant can produce two bunches at once.
The Chinese name of the aromatic Go San Heong banana means 'You can smell it from the
next mountain.'
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The fingers on one banana plant grow fused; another produces bunches of a thousand fingers,
each only an inch long.
Flower
Kilawin banana inflorescence (heart, flower), a Filipino favorite dish.

Banana hearts are used as a vegetablein South Asian and Southeast Asian cuisine, either raw
or steamed with dips or cooked in soups, curries and fried foods.
The flavor resembles that of artichoke. As with artichokes, both the fleshy part of the bracts
and the heart are edible.
The flowers are astringent and are used to treat leucorrhoea,metroghia,menorrhea.
The flowers are used to treat urinary tract infections in both sexes.
Leaves
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Banana leaves are large, flexible, and waterproof.
They are often used as ecologically friendly disposable food containers or as "plates" in
South Asia and several Southeast Asian countries.
Especially in the South Indian states of Tamil Nadu, Karnataka, Andhra Pradesh and Kerala
in every occasion the food must be served in a banana leaf and as a part of the food a banana
is served.
Steamed with dishes they impart a subtle sweet flavor.
They often serve as a wrapping for grilling food.
The leaves contain the juices, protect food from burning and add a subtle flavor. I
n Tamil Nadu (India) leaves are fully dried and used as packing material for food stuffs and
also making cups to hold liquid foods.
In Central American countries, banana leaves are often used as wrappers for tamales.
Trunk
The tender core of the banana plant's trunk is also used in South Asian and Southeast Asian
cuisine, and notably in the Burmese dish mohinga.
Other uses
Banana sap from the pseudostem, peelings or flesh may be sufficiently sticky for
adhesive uses.
In regions where bananas are grown, the large leaves may be used as umbrellas when
the pseudostems are tied together to form a floatation device.
Banana peel may have capability to extract heavy metal contamination from river
water, similar to other purification materials.
Uses of Plantain Stems:

The stem of a plantain or banana plant contain fibers rich in medicinal qualities.
It can be used to make tea, though the taste is bitter.
They are also prepared in foods such as salads and cooked into recipes.
The medicinal value of plantain stems includes :
antifungal,
antibacterial and
digestive aiding properties.
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Natural Diuretic
As a natural diuretic, plantain stem fiber helps the urinary tract and the overall digestive
system function.
This plant will stimulate the kidneys, according to Active Liquid Wellness, and help them to
filter toxins from the body.
Well functioning kidneys is the key to uric acid filtration, lower cholesterol levels and blood
coagulation.
The gastrointestinal benefits of plantain stem are numerous as well;
Purdue University says that the peel, stem and roots of the Musa plant are used to treat
digestion problems such as diarrhea, stomach lesions and dysentery.
Trauma associated with chemotherapy treatment causes stomach problems; plantain stem
fiber helps to protect the stomach lining from such trauma and the resulting nausea.
According to Dr. John Z of Wellshere, plantain fiber may help to treat Crohn's disease.
Crohn's disease causes chronic intestinal inflammation, bleeding and diarrhea.
The disease also weakens a person's ability to fight off invading bacteria in the intestinal
tract.
In person's with Crohn's disease, the level of E. coli bacteria in the stomach is higher than
normal and can become dangerous.
Plantain fiber carries antibacterial and gastrointestinal healing properties, both of
which are useful in combating the symptoms of Crohn's disease.
The stem and pulp of bananas have antifungal and antibiotic powers.
The ancient Aztecs used plantain stem to treat tuberculosis and asthma attacks.
In addition to attacking the bacteria that causes tuberculosis, the plantain fiber eases
symptoms such as congestion and mucus production.
According to Herbs2000, plantain fiber is helpful in removing congestion and infection of the
middle ear.
Over all use of Banana stem
Plantain juice is used as an antidote for snakebite
Arthritis and Gout :- Bananas are useful in the treatment of arthritis and gout. A diet of
bananas only for three or four days is advised in these conditions. The patient can be given to
eat eight or nine bananas daily during this period and nothing else.
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Anemia :- Being high in iron content, bananas are beneficial in the treatment of anemia. They
stimulate the production of haemoglobin in the blood.
Allergies:- The fruit is very useful for those who are allergic to certain foods and who suffer
in consequence from skin rashes or digestive disorders or asthma. Unlike other protein foods,
many of which contain an aminoacid which these persons cannot tolerate and which causes
allergy. Bananas contain only benign amino-acids which in most cases ate not allergic. The
fruit, however, does cause allergic reactions in certain sensitive persons and they should
avoid it.
Kidney Disorders :- Bananas are valuable in kidney disorder because of their low protein
and salt content and high carbohydrate content. They are useful in uraemia, a toxic condition
of the blood due to kidney congestion and dysfunction. In such cases, a diet of bananas
should only be taken for three to four days, consuming eight to nine bananas a day. This diet
is suitable for all kidney troubles, including nephritis.
Tuberculosis :- Bananas are considered useful in the treatment of tuberculosis. According to
Dr. J. Montelvz of Brazil, South America, the juice of the plantain or the ordinary cooked
bananas works miracles in the cure of tuberculosis.
He claims to have cured patients with advanced stage of tuberculosis with frequent cough,
abundant expectoration or phlegm and high fever in two months by this treatment.
Urinary Disorders :- Juice from Banana stem is a well known remedy for urinary disorders.
It improves the functional efficiency of kidney and liver thereby alleviating the discomforts
and diseased condition in them.
It dears the excrettonory organs in the abdominal region of toxins and helps to eliminate them
in the form of urine. It has been found to be of great help in the treatment for the removal of
stones in the kidney, gall bladder, and prostate.
It is advisable to mix this juice whenever possible with the juice of ash pumpkin.
Over weight :- A diet consisting of bananas and skimmed milk is considered an effective
remedy for weight reduction. In prescribed course of diet treatment, the daily diet is restricted
to six bananas and four glasses of skimmed milk or buttermilk made from skimmed milk for
a period of 10 to 15 days.
Thereafter green vegetables may be introduced gradually, reducing the intake of bananas
from six to four. This regimen of prescribed course of diet treatment can be continued till the
desired results are achieved.
Bananas are suitable for overweight people as they contain practically no sodium.
Menstrual Disorders :- Cooked banana flower eaten with curd is considered an effective
medicine for menstrual disorders like painful menstruation and excessive bleeding.
Banana flower helps increase progesterone hormone which reduces the bleeding.
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Bums and Wounds :- A plaster is prepared by beating a ripe banana into a fine paste. It can
be spread over burns and wounds and supported by a cloth bandage.
It gives immediate relief. The young tender leaves of banana tree form a cool dressing for
inflammations and blisters.
Prooved pharmacological action

The leaves have been studied as treatment for bronchitis and cold.
Studies in rats demonstrate effectiveness for stone lysis.
Plantain juice was used as an antidote for snakebite in the East.
In animal studies, the extract of Musa paradisiaca green fruits reduced hyperglycemia in
normal and diabetic mice and protected the gastric mucosa from aspirin-induced erosion
stimulating gastric and colonic mucosa and had direct vasodilation effect and nonspecific
relaxing and inhibiting effect on aortic and portal smooth muscles.
There was evidence in vivo antimicrobial activity of Musa paradisiaca root extract .
Bananas are an excellent source of vitamin B, soluble fiber, and contain moderate amounts of
vitamin C, manganese and potassium.
Along with other fruits and vegetables, consumption of bananas may be associated with a
reduced risk of colorectal cancer and in women, breast cancer and renal cell carcinoma.
Banana ingestion may affect dopamine production in people deficient in the amino acid
tyrosine, a dopamine precursor present in bananas.
Individuals with a latex allergy may experience a reaction to bananas.
Banana peel has displayed antioxidant activity in vitro, especially from unripe extracts.
Norepinephrine, dopamine and serotonin are also found in plantain fibers; these chemicals
smooth stomach muscles, stimulate intestines and inhibit intestinal secretion.
Musa paradisiaca L.commonly known as plantain, is a very popular food plant all over
theworld and is grown in all tropical regions of the world.
It has been used for the treatment of inflammation , rheumatism,renal calculai, diabetes and
hypertension traditional medicine.
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The root and stem juice have been used in traditional medicine recipes for the treatment of
diabetes and renal calculai is justified in this research studies.
Banana, raw, edible parts Nutritional value per

100 g:(3.5 oz)
The banana is of great nutritional value. It has a rare combination of energy value, tissue
building elements, protein, vitamins and minerals. It is a good source of calories being richer
in solids and lower in water content than any other fresh fruit.
A large banana supplies more than 100 calories.
It contains a large amount of easily assimilate sugar, making it a good source of quick energy
and an excellent means of recovery from fatigue.
Banana
Food Value
Minerals and Vitamins
Moisture - 70.1%
Calcium - 17 mg
Protein - 1.2%
Phosphorus - 36 mg
Fat - 0.3%
Iron - 0.9 mg
Minerals - 0.8%
Vitamin C - 7 mg
Carbohydrates - 27.2%
Small amount of Vitamin B Complex
Fibre - 0.4%
* Values per 100 gm's edible portion
** International Unit
Calorific Value - 116
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Renal Calculai
The banana constitutes almost a complete balanced diet in combination with milk. It contains
a high grade protein, which includes three of the essential amino acids.
Banana and milk supplement each other in an ideal manner and provide all the needed
nutrients to the body.
BANANA RAW PARTS NUTRITIONAL VALUES

Energy 371 kJ (89 kcal)
Carbohydrates 22.84 g
Sugars 12.23 g
Dietary fiber 2.6 g
Fat 0.33 g
Protein 1.09 g
Vitamin A equiv. 3 g (0%)
Thiamine (vit. B1) 0.031 mg (3%)
Riboflavin (vit. B2) 0.073 mg (6%)
Niacin (vit. B3) 0.665 mg (4%)
Pantothenic acid (B5) 0.334 mg (7%)
Vitamin B6 0.4 mg (31%)
Folate (vit. B9) 20 g (5%)
Choline 9.8 mg (2%)
Vitamin C 8.7 mg (10%)
Calcium 5 mg (1%)
Iron 0.26 mg (2%)
Magnesium 27 mg (8%)
Manganese 0.3 mg (14%)
Phosphorus 22 mg (3%)
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Potassium 358 mg (8%)
Zinc 0.15 mg (2%)
Valathandu Juice or Banana Stem Juice Nature's remedy for kidney stones
Banana stem or valathandu has many medicinal properties, but it is believed that it is the
excellent natural remedy for kidney stones and this does not mean only people with kidney
stone problem should eat it, anyone can take it.
Valathandu when taken raw is more beneficial than cooked.
Here is a simple recipe to prepare valathandu juice
#1: Remove the outer stem from the banana stem.
#2: Cut the inner stem into small pieces.
#3: Grind the pieces along with water and filter it. Now the juice is ready.
Note: Can even add sugar to this juice. Banana stem of about 10 to 15 cms is enough for this
juice. Drink this juice once in a month.
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Tribulus
terrestris
Scientific classification
Kingdom:
Plantae
Division:
Angiosperms
Class:
Eudicots
Subclass:
Rosids
Order:
Zygophyllales
Family:
Zygophyllaceae
Genus:
Tribulus
Species:
T. terrestris
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Common Name:
Hindi Gokharu
English Land-calotrops
Latin Tribulus Terrestris Linn
Sanskrit - Goshurah, shuuadamshtra, swadukantaka, trikantaka
Tamil Nerinci, Palleru-mullu ,Neranjal
Kannada - Negalu
Telugu
- Palleru
Malayalam- Nerinnil, Nerinill
Marathi - Sarapte, Dhakte Gokharu
Bengali:
Goxuri, Chhote gokhuri
Distribution
Tribulus terrestris is a flowering plant in the family Zygophyllaceae, native to warm
temperate and tropical regions of the Old World in southern Europe, southern Asia,
throughout Africa, and Australia.
It can thrive even in desert climates and poor soil.
It is commonly found throughout India, up to an altitude of 5,400 m.
Morphology
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T.terrestris is a variable, prostrate annual.

It is a taprooted herbaceous perennial plant that grows as a summer annual in colder climates.
The roots are slender and cylindrical, light brown and faintly aromatic.
The stems radiate from the crown to a diameter of about 10 cm to over 1 m, often branching.
They are usually prostrate, forming flat patches, though they may grow more upwards in
shade or among taller plants.
The leaves are pinnately compound with leaflets less than 6 mm (a quarter-inch) long,the
leaflets, 5-8 pairs, subequal, oblong to linear-oblong.
The flowers are leaf-opposed, solitary, 410 mm wide, with five pale-yellow to yellow; the
fruits, globose, consisting of 5-12 woody cocci, each with 2 pairs of hard, sharp, divaricate
spines, one pair longer than the other.
A week after each flower blooms, it is followed by a fruit that easily falls apart into four or
five single-seeded nutlets.
The fruits, globose, consisting of 5-12 woody cocci, each with 2 pairs of hard, sharp,
divaricate spines, one pair longer than the other.
The nutlets or "seeds" are hard and bear two to three sharp spines, 10 mm long and 46 mm
broad point-to-point.
These nutlets strikingly resemble goats' or bulls' heads; the "horns" are sharp enough to
puncture bicycle tires and to cause painful injury to bare feet.
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History
Tribulus terrestris a Far East herb also known as Gokshura`in Ayurveda` and Bai Ji Li in
China which traditionally has`been used for sexual and kidney dysfunctions as well as colic
pains,`hypertension and hypercholesterolemia.
It has a long standing use of` being a revitalizer and energizer (increases energy).`
In Greek history, it is widely used to treat ailments such as headache, nervous disruption,
constipation, and sexual dysfunction.
In China and India, Tribulus Terrestris is used as the remedy for liver, kidney, urinary and
cardiovascular.
Chemical Constituents
Two alkaloids are the beta-carboline alkaloids harman (harmane) and norharman
(norharmane).
The alkaloid content of dried foliage is about 44 mg/kg.
Principal Constituents is Harmine.
The fruit contains 5% of a semidrying oil, peroxidase, traces of glycoside resin, proteins and
inorganic matter1.
Steroidal saponins mainly furostanol glycosides have been isolated2.
Large quantities of potassium and nitrates are present too6
Medicinal Uses
T. terrestris is a well - known aphrodisiac plant useful in low libido and erectile dysfunction.
It improves energy, vitality , and builds muscle strength.
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It is also useful in urolithiasis, dysuria, and kidney dysfunction.
In Ayurvedic system of medicine Gokhru is indicated for the treatment of
urinary disorders,
kidney diseases,
diseases of the genito-urinary system,
calculus affections and impotence.
It is used for regulation of heart functions, reduction of inflammation, indigestion, chronic
cough and` asthma also.
In Ayurveda it is considered that Gokhru helps to improve vitality and vigor.
The fruits of Gokhru are used in Ayurveda in the treatment of
kidney stones,
painful urination and
other genito- urinary disorders,
mainly in the form of an infusion.
They are also prescribed for the treatment of breathing difficulties, diabetes, rheumatism,
piles, dropsy, heart diseases, impotence and Bright`s disease.
The leaves of this medicinal plant of India are considered to possess stomachic properties,
and a paste prepared from them is used in the treatment of bladder stones.
Athletes used the extract of Tribulus Terrestris dietary supplement to increase energy,
provide healthy hormone function, enhance muscle movement and provide energy for the
athletes during the training session.
The main use of Tribulus Terristris is to increase Male and Female Libido and a Fitness
Supplement
Tribulus terrestris benefits identified in various human and animal studies are :
*. Improves muscle growth and body strength.
* Reported to enhance libido sexualis and erectile function.
*. Reported to increase the number and motility of spermatozoa.
* Increases LH levels by 72% and testosterone levels by 41% in only five days.
*. Helps in alleviating some symptoms associated with male menopause.
*. Reduction in cholesterol.
*. Reductions in high blood pressure.
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*. Inhibition of stress-induced clumping of blood platelets.
* Increases in strength of contraction of the heart muscle.
*. Reductions in sodium and fluid retention.
*. Anti-urolithiatic (urinary/kidney stone preventing) and litholytic (dissolving) activities.
*. Improvement of the profile of red and white blood cells and stimulation of the humoral
immune system.
*. Anti-bacterial, anti-malarial and anti-fungal properties, anti-inflammatory activity.
*. Analgesic effects.
*. No adverse effects.
*. No toxicity and side effects.
`* Most Common and very Effective in problems connected with Urination
*. Used for disurea, kidney stone and uncomfortable urination.
*. Used in to cure headache, eye problem as hives, conjunctivitis, weak eyesight and anxiety.
*. It is used to cure high blood pressure and flank pain.
*. For athletic performance, muscle mass enhancement, and as a testosterone booster.
*. It suitable for premenstrual syndrome and menopausal syndrome.
Prooved Pharmacological Actions

Some body builders use T. terrestris as post cycle therapy or "PCT".After they have
completed an anabolic-steroid cycle, they use it under the assumption that it will restore the
body's natural testosterone levels.
The extract is claimed to increase the body's natural testosterone levels and thereby improve
male sexual performance and help build muscle. I
ts purported muscle-building potential was popularized by American IFBB bodybuilding
champion Jeffrey Petermann in the early 1970s. It has demonstrated the anabolic steroid
effects of Tribulus terrestris .
Some users report an upset stomach, which can usually be counteracted by taking it with food
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Renal Calculai
Research in animals
T. terrestris has been shown to enhance sexual behavior in an animal model.
It appears to do so by stimulating androgen receptors in the brain.
T. terrestris is now being promoted as a booster for the purpose of increasing sex drive.
Its use for this purpose which found effects on free testosterone and luteinizing hormone in
men belonging to infertile couples.
A research review conducted in 2000 stated that the lack of data outside of this study prevents
generalizing to healthy individuals .
Animal studies in rats, rabbits and primates have demonstrated that administration of
Tribulus terrestris extract can produce statistically significant increases in levels of
testosterone, dihydrotestosterone and dehydroepiandrosterone, and produces effects
suggestive of aphrodisiac activity.
On the other hand, one recent study found that T. terrestris caused no increase in testosterone
or LH in young men, and another found that a commercial supplement containing
androstenedione and herbal extracts, including T. terrestris, was no more effective at raising
testosterone levels than androstenedione alone.
The active chemical in T. terrestris is likely to be protodioscin (PTN).
In a study with mice, T. terrestris was shown to enhance mounting activity and erection better
than testosterone cypionate; however, testosterone cypionate is a synthetic ester of
testosterone engineered for its longer activity, rather than an immediate effect.
The proerectile aphrodisiac properties were concluded to likely be due to the release of nitric
oxide from the nerve endings innervating the corpus cavernosum penis.
Also, T. terrestris was shown to have strong inhibitory activity on COX-2.
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Renal Calculai
Tribulus terrestris is also a good osmotic diuretic in human and useful in
AKD (Acute Kidney Diseases )
CKD (Chronic Kidney Diseases AND
RENAL CALCULAI
The effects of T. terrestris alcoholic extract have been studied;
the alkaloids seem responsible for a slight increase in blood pressure, and increase in renal
perfusion3.
The litholytic action of the fruit is attributed to the aspartic and glutamic acid content.
Aerva lanata
Scientific classification
Kingdom: Plantae
Division: Angiosperms
Class: Eudicots
Subclass: Core eudicots
Order: Caryophyllales
Family: Amaranthaceae
Subfamily: Amaranthoideae
Genus: Aerva
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Renal Calculai
Species: A. lanata
Botanical name Aerva lanata
Distribuion
Aerva lanata is a woody, prostrate or succulent, perennial herb flowers in the first year.
Aerva lanata is a common weed which grows wild everywhere in plains of India.
A. lanata prefers damper sites than A. javanica and can be found in open forests on mountain
slopes, on waste and disturbed ground, deserted cultivation and coastal scrub and at altitudes
from sea level to 900 metres (3,000 ft).
Native to Afrotropic:
Northeast Tropical Africa: Ethiopia, Somalia
East Tropical Africa: Kenya, Tanzania, Uganda
West-Central Tropical Africa: Cameroon, Rwanda, Zaire
West Tropical Africa: Cte d'Ivoire, Ghana, Liberia, Nigeria, Sierra Leone, Togo
South Tropical Africa: Malawi, Mozambique, Zimbabwe
Southern Africa: South Africa - Natal, Transvaal
Western Indian Ocean: Madagascar
Arabian Peninsula: Saudi Arabia
Indomalaya:
Indian Subcontinent: India, Sri Lanka
Malesia: Indonesia, Malaysia, Papua New Guinea, Philippines
Australasia: Queensland[1]
Common names
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Renal Calculai
Hindi:Gorakhbuti or Kapuri jadi.

Kannada: Bilesuli.
Malayalam: Cherula.
Marathi: Kapuri-madhura.
Sanskrit: Astmabayda
Tamil: Sirru -pulay -vayr.
Telugu: Pinde-conda, Pindi-chetter.
Morphology
Aerva lanata is an erect, prostrate undershrub and occurs throughout India as a common
weed in fields and waste places
Herb, erect or prostrate with a long tap-root, branched from near the base; branches many,
pubescent or wolly- tomentose, striate.
Leaves alternate, 2-2 x 1-1.6 cm on the main stem, 6-10 x 5-6 mm on the branches, elliptic or
obovate, or subotbicular, obtuse or acute, entire, pubescent above, more or less white with
cottony hairs beneath; petioles 3-6 mm long, often obscure.
Flowers greenish white, very small, sessile, often bisexual, in small dense subsessile axillary
heads or spikes 6-13 mm long, often closely crowded and forming globose clusters;
bracteoles 1.25 mm, long, membranous, broadly ovate, concave, apiculate.
Perianth 1.5-1.25 mm long; sepals oblong, obtuse, sometimes apiculate, silky-hairy on the
back.
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Renal Calculai
Utricle broadly ovoid, acute; stigmas two, seed 0.85 mm in diameter, smooth and polished,
black.
Chemical constituents
Alkaloids:
Plant contains biological active canthin-6-one alkaloids such as 10-methoxy-canthin-6-one,
10-hydroxy-canthin-6-one, 10-O--D-glucopyranosyloxycanthin-6-one, 10-hydroxycanthin6-one (ervine), 10-methoxycanthine-6-one (methylervine), 10--Dglucopyranosyloxycanthin-6-one (ervoside), aervine (10-hydroxycanthin-6-one),
methylaervine (10-methoxycanthin-6-one) and aervoside (10--D-glucopyranosyloxycanthin6-one). Plant also contains alkaloids like -carboline-1 -propionic acid, 6-methoxy-
carboline-1-propionic acid, 6-methoxy--carbolin-l-ylpropionic acid (ervolanine), and
aervolanine (3-(6-methyoxy--carbolin-1-yl) propionic acid).
Flavanoids
Aerva lanata is a rich source of flavanoids such as kaempferol, quercetin, isorhamnetin,
isorhamnetin 3-O--[4-p-coumaroyl--rhamnosyl(16) galactoside and flavanone glucoside
persinol, persinosides A and B, 5, 4'-hydroxy-3, 6, 7-trimethoxyflavone, 5-hydroxy-3, 6, 7, 4tetramethoxyflavone, 5-hydroxy 2', 3,5', 6, 7-pentamethoxyl flavone, 3,3', 5, 7-trihydroxy-4'methoxyflavone, apigenin 7-O--D- glucoside and 7-O--D-glucopyranoside.
Miscellaneous phytoconstituents
Aerva lanata also contains methyl grevillate, lupeol, lupeol acetate benzoic acid, -sitosteryl
acetate and tannic acid.
Nutritive content
Leaves of Aerva lanata were found to be high in carbohydrate (26.6 g/100g), crude protein
(22.6 g/100g) and ash (31.2 g/100g).
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Renal Calculai
Mineral composition (mg/100g) revealed that the leaves were high in PO 4 (187), and
moderately high in other minerals such as K (47.9), K (Poatssium) (39.4), Ca (Calcium)
(51.7), Mg (Magnesium) (41.5), Zn (Zinc) (44.7), Fe (Ferrous) (11.0) and low in Mn
(Manganese) (1.04)
Medicinal Uses
The plant is said to be diuretic and demulcent used in lithiasis.
Its diuretic action is said to be very effective in the treatment of urethral discharges and
gonorrhoea and is of value in cases of lithiasis and as an anthelmintic.
The root has a camphor like aroma.
The dried flowers which look like soft spikes, are sold under the commercial name as
Buikallan or Boor.
Decoction of the flowers is said to cure stones in any part of the stomach and that of the
root is diuretic and cure for kidney stones.
The root is demulcent, diuretic, useful in strangury (slow to be and painful discharge of
urine).
The roots are used in the treatment of headache.
The plant is regarded as a vermifuge for children.
It is given orally the juice of the roots to patients of liver congestion, jaundice, biliousness
and dyspepsia.
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Renal Calculai
It is also given as decoction of the whole plant to cure pneumonia, typhoid and other
prolonged fevers.
Decoction of the root is given as tonic to pregnant women.
Also used for the treatment of gonorrhea and kidney disorders, cutaneous affections and
sugar in urine.
This herb is described as "one of the best known remedies for bladder and kidney stones."
Ayurvedic practitioners recommend a decoction of the plant to be taken internally for a few
days to dissolves the stone and to clear the urinary path.
Leaves
A leaf-decoction is prepared as a gargle for treating sore-throat and used in various complex
treatments against guinea-worm.
To wash Babies that have become unconscious during an attack of malaria or of some other
disease are washed with a leaf decoction at the same time smoke from the burning plant is
inhaled.
The leaf-sap is also used for eye-complaints.
An infusion is given to cure diarrhoea and in an unspecified manner at childbirth, and on
sores.
Root
The root is used in snake-bite treatment.
Flowers
For pains in the lower part of the back leaves and flowers are reduced to ash which is rubbed
into cuts on the back.
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Renal Calculai
Prooved pharmacological actions

Aerva lanata has been ethnomedicinally used as a therapeutic agent for a variety of diseases.
Moreover, numerous research works have proven its uses beyond the ethnomedicinal ones in
experimental animals.
Alkaloids and flavonoids which were isolated from this plant may be responsible for its
pharmacological activities.
The road ahead is to establish specific bioactive molecules, which might be responsible for
these actions.
Therefore the cultivation, collection, and further pharmacological exploration of Aerva
lanata are essential.
Antimicrobial
Aerva lanata whole plant ethyl acetate and methanol extracts showed interesting
antimicrobial activities against Bacillus subtilis, Bacillus cereus, Staphylococcus aureus,
Escherichia coli, Shigella dysenteriae, Shigella shiga, Shigella sonnei, Shigella flexneriae,
Shigella boydii, Klebsiella, Aspergillus fumigatus, Aspergillus niger, Candida albicans,
Hensinela californica and Rhizopus oligosporum and petroleum ether, ethyl acetate and
methanol extracts showed significant cytotoxic properties.
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Renal Calculai
Antiparasitic
The antiparasitic activity of the seed and leaf extracts of Aerva lanata were tested against a
tapeworm and an earthworm, particularly the ethanolic extract proved to be better against
tapeworms and earthworms than the Albendazole, which is used for treating parasite
infections.
Diuretic and anti-urolithiasis
The alcoholic extract of Aerva lanata was tested for diuretic activity.
The study indicated that the alcoholic extract at a dose of 800 mg/kg acted as a diuretic, with
respect to control.
Aerva lanata aqueous suspension (2 g/kg body wt/dose/day for 28 days) to CaO 2 urolithic
rats had reduced the oxalate-synthesizing enzymes, and diminished the markers of crystal
deposition in the kidney.
The results of the study confirmed that Aerva lanata can be used as a curative agent for
urolithiasis.
Acute renal failure
The ethanol extract of the entire plant of Aerva lanata was studied for its nephroprotective
activity in cisplatin- and gentamicin-induced acute renal injury in albino rats of either sex.
In the curative regimen, the extract at dose levels of 75, 150 and 300 mg/kg showed dosedependent reduction in the elevated blood urea and serum creatinine and normalized the
histopathological changes.
In the gentamicin model the rats in the preventive regimen also showed good response to the
ethanol extract at 300 mg/kg.
The findings suggest that the ethanol extract of Aerva lanata possesses marked
nephroprotective activity with minimal toxicity and could offer a promising role in the
treatment of acute renal injury caused by nephrotoxins like cisplatin and gentamicin.
Antiasthmatic
The ethanolic extract of the aerial parts of Aerva lanata showed antiasthematic at 100 g/ml
in the isolated goat tracheal chain preparation.
When administered orally 30 and 60 mg/kg of extract demonstrated antiastmatic activity
against clonidine -induced catalepsy and it also inhibits mast cell degranulation in mice.
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Renal Calculai
Antifertility activity
The ethanolic extract of the aerial parts of Aerva lanata were evaluated for antifertility
activity using anti-implantation, abortificient, and motility of rat spermatozoa (in vitro)
models.
The anti-implantation effect seems to be dependent on the dose as well as the initiation of
treatment on specific days of pregnancy.
Aerva lanata has shown pre-implantation loss of 20% and 30% against control at the dose of
200 and 400 mg/kg b/w, respectively.
Percentage pregnancy failure among the treated groups was 30% and 40% at the dose of 200
and 400 mg/kg b/w, respectively.
Aerva lanata at a concentration of 10% showed no motility of rat spermatozoa within 60 sec.
Anti-hyperglycemic and anti-diabetic
In the oral glucose tolerance test, Aerva lanata (400 mg/kg) increased the glucose threshold at
60 min after the administration of glucose.
The alcoholic extract of Aerva lanata was found to reduce the increased blood sugar level of
alloxan-induced diabetic rats (42% at 375 mg/kg and 48% at 500 mg/kg body weight).
Aerva lanata (400 mg/kg) treatment prevented a diabetic mice weight loss in.
In the subacute study, repeated administration (once a day for 28 days) of glyburide and
Aerva lanata caused a significant reduction in the serum glucose level as compared to the
vehicle-treated group.
Hypolipidemic
The hypolipidemic activity of Aerva lanata was assessed on ethylene glycol-induced calcium
oxalate urolithic rats.
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Renal Calculai
Total lipids, total cholesterol and triglyceride levels were significantly increased in the serum,
liver and kidney of calcium oxalate urolithic rats.
Besides, phospholipids (PL), high-density lipoproteins (HDL), low-density lipoproteins
(LDL) and very low-density lipoproteins (VLDL) levels were altered in calcium oxalate
urolithic rats.
On supplementation of Aerva lanata aqueous suspension, the above changes were reverted to
near normal.
These results indicate that the Aerva lanata aqueous suspension acts as a hypolipidemic agent
in calcium oxalate urolithiasis.
Hepatoprotective
Petroleum ether extractable fraction of the whole plant Aerva lanata was evaluated for the
protective effect against liver damage induced by carbon tetra chloride (CCl 4 ) in Sprague
Dawley rats.
Aerva lanata administration significantly reversed the histopathological changes, reduced
hepatic lipid peroxidation and increased the serum total protein and albumin/globulin (A/G)
ratio.
Immunomodulatory and antitumor

Petroleum ether extract of Aerva lanata showed significant cytotoxicity against Daltons
lymphoma ascites (DLA) tumor cell lines in vitro and stimulated lymphocyte proliferation in
in vitro and in vivo conditions.
DLA-bearing animals when treated with A. lanata showed increase in lifespan compared to
control animals.
Partially purified fraction was also found to be hepatoprotective as evidenced from the
normal levels of liver marker enzymes compared to the elevated levels of these enzymes in
DLA alone inoculated animals.
The partially thin layer chromatography-purified fraction of the petroleum ether extract of
Aerva lanata proved to be cytotoxic to DLA, Ehrlich ascites (EA) and B16F10 cell lines in
vitro.
Since partially TLC-purified fraction was found to be more cytotoxic to DLA cell lines, it
was used to study the pharmacological effect and its potential to reduce solid tumor induced
by DLA cell lines in mice.
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Renal Calculai
Anti-diarrheal
Ethanolic and aqueous extracts of Aerva lanata and A. javanica were screened for antidiarrheal activity.
All the extracts showed significant anti-diarrheal activity in charcoal meal test. reduction of
the intestinal transit is suggested as mechanism of action.
Over all view of capsules action:

Capsule Musa-p acts as a best coolent,demulcent and diuretic.
So it acts on the urinary tract and washes away the extra deposits in the tract and thereby
reduces the stone size and facilitate it to go away from the body.
Capsule Tribulus-T is a good general tonic,aphrodisiac and diuretic agent.
It aiso have anti spasmodic and analgesic and anti bacterial effect,
so it controls the infection and inflammation caused due to the calculai in the urinary tract.
It has another best action of preventing the lowering of semen count due to the action of
diuretics .
Capsule Aerva-L containing sirukanpeelai is named in tamil literature as kalkaraichi.
So its name itself indicates its power of lithotropic action.
It also have anti microbial,anti pyretic, analgesic and diuretic action.
So it helps to reduce the stone size ,controls infection.
It also reduces renal colic to a little extend .
Conclusion
Like all the traditional Indian medicines, siddha is based on the concept of man as a part of
the universe and therefore on the harmony that exists between the two.
The therapies are based on body humours .
Siddhars have developed longevity discipline called kayakalpa.
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Renal Calculai
Siddha system advocate for logevity, are controlling the breathing and diet are methods
suggested in this system.
Meditation and yoga are also significant aspect of siddha system.
Siddha describes 96 main constituents of human beings. These are manifestations of the 4
basic components of an individual - physical, psychological, moral and intellectual.
Of the 96 principles, Mukkutram, the psychological unit (consisting of vali or pain, azhal or
crying and iyam or giving) is very important.
It has to be in equilibrium for the body to be healthy. Any slight deviation causes diseases.
Siddha system of medicine is an integrated part of indian system, which is very potent and
unique system when compared with other traditional systems in existence siddha medicine
being one of the worlds most complex and intricate forms of medicine, is on the verge of
being lost due to change.
Many chronic diseases like Renal calculai,Diabetes,Hypertension,Bronchial asthma
considered incurable in western medicine, can be treated successfully with siddha medicine.
The unique aspect of this system is that, this form of medicine aims at the immortality of both
soul and the body.
Accordingly to the Hindu Philosophy there are 2 modes of salvation for humans one is the
salvation of the metaphysical self and the others is the physical salvation within the body
rendered immortal.
The latter is called Jeeva Mukthi and siddhars aimed at these also.
The immortality of the perishable body new sound strange to a rational mind, but the aim had
the effect of setting very light standards of medicine.
.
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Renal Calculai

A kidney stone, 8 millimeters (0.31 in) in diameter

Introduction to the Urinary Tract

Aravindh Herbal Labs

The urinary tract.

Definition And Explanation

Aravindh Herbal Labs

Classification Based on Chemical composition

Aravindh Herbal Labs

Scanning electron micrograph of the surface of a kidney stone showing tetragonal

Aravindh Herbal Labs

Calcium Oxalate Kidney Stone

Aravindh Herbal Labs

Struvite (magnesium ammonium phosphate) is a phosphate mineral with formula:

Aravindh Herbal Labs

Uric acid stones

About 510% of all stones are formed from uric acid.

Uric acid stones.

Cystine Kidney Stones

Cystinuria (siss-tin-NYUR-Ree-Uh), and the chemical cystine (SISS-teen) were discovered in

Aravindh Herbal Labs

Aravindh Herbal Labs

Classification Based On Location

Common Sites Where Kidney Stones Are Located

Aravindh Herbal Labs

pelvi ureteric junction

Distal part of ureter

Aravindh Herbal Labs

Mid part of ureter

Vesico ureteric junction

Vesico uretheric junction

Aravindh Herbal Labs

The main reasons are:

Dietary factors that increase the risk of stone formation include :

Low fluid intake

Aravindh Herbal Labs

X-ray with bilateral kidney stones

Aravindh Herbal Labs

Aravindh Herbal Labs

Signs and symptoms

Aravindh Herbal Labs

Pyuria : Pus in the urine. Cloudy or foul-smelling urine.

Dysuria : Buring pain on urination; more typical with associated infection.

Oligouria : Reduced urinary volume caused by obstruction of bladder or urethra by

Frequent urge to urinate.

Fever and chills.

It typically comes in waves lasting 20 to 60 minutes caused by peristaltic contractions of the

Aravindh Herbal Labs

Inhibitors of stone formation

calgranulin (an S-100 calcium binding protein),

Aravindh Herbal Labs

nephrocalcin (an acidic glycoprotein),

distal renal tubular acidosis,

Aravindh Herbal Labs

Axial CT scan of abdomen without contrast, showing a 3-mm stone (marked by an

A stone at the uteral vesicular junction

Aravindh Herbal Labs

Aravindh Herbal Labs

complete blood count, looking for neutrophilia (increased neutrophil granulocyte

Increasing fluid intake of citrate-rich foods (especially citrate-rich fluids such as

Limiting sodium (Na) intake to less than 2300 mg per day

Limiting vitamin C intake to less than 1000 mg per day

Limiting consumption of foods containing high amounts of oxalate (such as spinach,