A m/72 was suffering from pain & bilateral pedal edema from last few weeks. The Pt had a h/o bleeding piles for long 3 months. O/e- hb%-6.8, ESR- 65, CRP +, ASO TITRE - VE. Refereed for transfusion of 2 unit whole blood with medication. After 5 days Hb raised to 9.2, ESR 15, CRP + with rt sided pedal edema ++. Opinions solicitated.

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1) Mahalakshmi Vilas Ras Swarn 1 tab Rasmanikya50 mg GandhakRasayan 1 tab Kamdudha Ras Moti 1 tab 2) Kankayan vati 1 Bolbaddh Ras 1 b.d 3) Punarnavarishta 1 tsf Lohasava 1 tsf b.d.p.c. 4) Kasisadi tail locally 5) Proctosedyl H oint Pilex oint before and after defecation. Dear Dr Supratim Bir Sir I congratulate you for your cost conscious attitude.

Thanks you
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@Dr. Supratim Bir sir how you are managing this case? Are you planning for Kshar Sutra for arsha?

Now the chief complain of the Pt is swelling over rt leg. Piles issue sorted out. Blood parameters are also coming down. But the edema is not meeting my calculations, for why I posted the case. Pain is also under control.
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To improvement in Hb should be stable after 3 month also..

Raktsthaban bruhan upakram.. Arshkuthar rash 2bd Arshogni vati 2bd Aarogyavardhani tab 2bd Lohasav 10ml with medicine with Luke warm water.. Laghu dipan pachan diet.. Cow ghee milk old rise green gram

First do lipid profile., Rft ,CBC ,electrolyte See for DVT
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Cordiac reports should done,, RX deepana pachana drs,,p mandoor tab bid with draksharista , arjunin tab, present piles condition should be check,

Shodhari loham C.p.vati Punarnava Dashamoola kwath

Bvc is costly but it is very useful in old age as in old age all symptoms r related to vaat vruddhi and bvc ras is sanjivani and act like miracle so dnt think its cost and after all life is precious than every coin of money Jaan hai to jahan hai bhai

Arshkuthar ras chitrakadi vati Gokshuradi guggul in proper dose will do

Punarnavashtak quath Arjunarishta Brihat vaat chitamani ras Hridayarnav ras Raktajeevan avaleh Chandraprabha vati

Sir why BVCRas plz justify. Pt is on Punarnabadi kwath already. As I consciously prescribe against costly preparations I wish to know ur opinion for this BVCRas plz.
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Dr. Hemant Adhikari sir please comment.

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