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INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH

Correlation of Ayurvedic Doshik Features with Sonological, Radiological and

Urine Analysis Findings in Mutrashmari : An Observational Study

Dr. Krishna P.Thorat Kullolli.¹

Professor ,Department of Roga Nidan Evum Vikriti vigyana,Indian Institute Of Ayurved Research And Hospital

Rajkot,Gujrat.

1

Corresponding author: Dr. Krishna P.Thorat Kullolli

Article Info: Published on : 15/01/2026

Cite this article as: - Dr. Krishna P.Thorat Kullolli (2026) ; Correlation of Ayurvedic Doshik Features with Sonological,

Radiological and Urine Analysis Findings in Mutrashmari : An Observational Study;Inter .J. Dignostics and Research 3 (2) 92- 100,

DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 8 2 6 0 7 5 1

Abstract

Mutrashmari, recognized as one of the Ashtamahagada, continues to pose diagnostic and therapeutic challenges due

to its recurrent nature and complex pathogenesis.^[1]Ayurveda describes three clinically relevant types—Vataja,

Pittaja, and Kaphaja Ashmari—which correspond to urinary calculi, whereas Shukraja Ashmari represents

[2]

spermolith formation.

Although modern urology has advanced significantly with the development of

ultrasonography, radiology, and biochemical urine analysis, the precise etiology and recurrence of urolithiasis remain

incompletely understood^[3]. Classical Ayurvedic texts advocate early diagnosis and management during the

Purvarupa Avastha, yet dosha-specific identification at this stage is difficult because morphological stone

characteristics are not visible without imaging.This observational and analytical study aimed to bridge this diagnostic

gap by correlating Purvarupa and Rupa of Mutrashmari with findings from sonology, radiology, and urine analysis

in 60 patients. The study evaluated whether modern diagnostic parameters—such as stone size, site, radiodensity,

urine pH, turbidity, RBC count, and crystal presence—could assist in identifying the underlying doshik

predominance before stone expulsion. Results demonstrated a consistent association between imaging characteristics

and classical doshik features, suggesting that integrated assessment enhances early diagnosis and enables dosha-

specific intervention in the Purvarupa stage.This study highlights the potential of combining Ayurvedic clinical

understanding with contemporary diagnostic tools to improve accuracy, facilitate early treatment, and reduce

recurrence of Mutrashmari. The findings open avenues for a refined integrative approach to urinary stone disease.

Keywords – Mutrashmari, Ashmari, urolithiasis, sonology, radiology, urine analysis, Purvarupa, doshik assessment,

Ayurveda.

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Introduction :

tools can aid in identifying the doshik type of

Mutrashmari,

one

of

the

Ashtamahagada,

Ashmari in its early (Purvarupa) stage. This article

summarizes the conceptual background, study

methodology, observations, results, discussion, and

conclusions, supported by classical Ayurvedic

references and modern diagnostic correlations.

continues to trouble mankind due to its recurrent

and complex nature^[4]. Ayurveda describes Vataja,

Pittaja, and Kaphaja Ashmari comparable to

urinary calculi, while Shukraja Ashmari resembles

spermolith. ^[5,6]

Aims And Objective :

Despite major advances, urolithiasis remains a

clinical challenge even today because its exact

pathophysiology is still unclear. Modern imaging

techniques—USG, radiology, and advanced urine

analysis—now allow detection of stones before

expulsion and even before renal damage occurs in

obstructive cases. Yet, recurrence remains a major

concern^[7]. Ayurvedic diagnosis of doshik types

relies primarily on Rupa (manifest features) and

Bheda (complications), which appear only after

stone expulsion^[8]. Acharyas, however, emphasized

treating Ashmari in its Purvarupa Avastha, before

full manifestation. In the contemporary era,

assessing doshic involvement in Purvarupa is

difficult because the morphology of the stone

cannot be visualized without imaging.

Mutrashmari because of its dreadful complications

and high recurrence rates as high as 50% with in

five years has become troublesome diseaes for the

urologist and the mankind.Treatment in the

purvarupa avastha of the ashmari can be possible

by the usage of sonological,radiological and urine

analysis to avoid the recurrence.So this study was

taken up with the following aim and objectives:

Aim: An Observational and Analytical Study of

mutrashmari

with

the help

of sonological,

Radiological and Urinary findings.

Objectives:

1. To make use of the sonological, radiological and

urinary investigation findings to draw a

conclusion to compair types of stones with the

types of mutrashmari to enable ayurvedic

Imaging tools help bridge this diagnostic gap by

allowing in-vivo appreciation of a stone’s size,

shape, density, and location, which may reflect

underlying doshik pathology. Integrating classical

Purvarupa with modern imaging findings may

physicians

to

apply

specific

of

dosha

and

at

vyadhipratyanika

chikitsa

ashmari

purvarupawastha^[9,10]

.

2. To analyse thesonological, Radiological and

urinary investigation findings for the early

detection of mutrashmari before its passage in

the urine and becomes evident for the naked

eyes i.e in purvarupawastha . ^[11]

enable

early

detection

and

dosha-specific

management, thereby preventing recurrence by

correcting samprapti at the root level.

With

this

perspective,

the

present

study—

3. To evaluate the type of mutrashmari with the

help of purvarupa as well as rupa of various

type of doshaj mutrrashamri as described in

“An Observational and Analytical Study of

Mutrashmari with the Help of Sonology, Radiology

and Urine Analysis”—was carried out on 60

patients to evaluate whether modern diagnostic

samhita ^[12]

.

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Materials & Methods :

1. Study Overview:

Item

6. Scoring Parameters :

Parameter

Score Basis

Details

Pain / Mutrakrichra /

Study Type

Sample Size

Duration

Observational

60

0–3

Dahan

Normal 0, Acidic 1,

Alkaline 2

Urine pH

Turbidity

Hematuria

5 days

0–3

2. Inclusion and Exclusion Criteria :

RBC/HPF: 0 / 5–10 /

10–20 / >20

0 / 0–5 / 5–10 / >10

mm

Inclusion Criteria

• Age 18–60

Exclusion Criteria

Stone Size

• Shukrashmari

Albumin

Pus Cells

Trace–+++ (0–3)

0–5 / 5–15 / 15–30 / >30

8–10 / 10–20 / 20–30

/ >30

• ARF/CRF/BPH/DM

• Both sexes

/TB

• Vataja / Pittaja /

Kaphaja

Epithelial Cells

• UTI complications

Ashmari

7. Doshik Features (Comparison) :

• Purvarupa

• Malignancy/Trauma

present

Feature

Vataja

Pittaja

Kaphaja

• Congenital

Pain

Urine

Stone

Severe

Scanty

Rough

Burning

Reddish

Yellow/black Smooth/white

Mild

Avila

anomalies

3. Methodology :

Test

Purpose

USG

KUB X-ray

Urine Exam

Site, size, radiolucent stones

Radiopaque stones

pH, RBC, Albumin, Pus cells

Observation & Results :

Study sample: 60 patients with Mutrashmari;

diagnosis confirmed by urine analysis, KUB

radiograph and abdominal-pelvic USG. Most

patients were young to middle-aged males,

predominantly vatakaphaja in constitution, from

middle socioeconomic background, and presenting

within six months. Clinically, todavat (vata-type)

pain and mutrakṛcchra were major symptoms.

Calcium-oxalate stones were the most common,

mostly >10 mm and located in the kidney, with

4. Investigations:

Phase

Components

Diagnostic

Investigation

Assessment

Purvarupa + Rupa

USG, KUB X-ray, Urine exam

Correlation of findings

5. Grading (0–3)

Grade

Meaning

0

1

2

3

Nil

Mild

Moderate

Severe

radio-opacity

in

the

majority.

Urine

was

predominantly acidic with minimal proteinuria.

This profile strongly reflects a vata-kapha dominant

pathogenesis correlating with modern Ca-oxalate

stone formation^[13,14]

.

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Demographic Table :

Stone Characteristics Table :

No. of

Patients

Sr.

No.

Stone

Parameter

No. /

Patients

Sr. No.

Parameter

Percentage

1

2

Male

Female

Age 21–40

yrs

Married

Vatakaphaja

Prakriti

Kaphapittaja

Prakriti

41

19

68.33%

31.67%

1

Vataja Ashmari

Kaphaja

Ashmari

Pittaja Ashmari

Tridosha

29

48.33%

25%

2

15

3

4

5

40

52

32

66.67%

86.67%

53.34%

3

4

11

5

18.33%

8.33%

Calcium

Oxalate

Phosphate

Stones

Uric Acid

5

6

7

29

15

11

48.33%

25%

6

7

8

26

45

50

43.33%

75%

Middle income

group

18.33%

Stones

Sādhāraṇa

Deśa

Family

history

present

8

9

10

Mixed Stones

Stones >10 mm

Stones 0–5 mm

Kidney

Location

Ureter Location

Bladder

Location

Single Stone

Multiple Stones

Unilateral

5

31

26

8.33%

41.89%

35.14%

83.33%

9

53

88.33%

11

12

13

53

19

12

66.67%

31.67%

20%

Lifestyle & Diet Table :

Sr.

No. of

Patients

Parameter

No.

Percentage

14

15

16

17

18

19

34

26

43

7

10

49

56.67%

43.33%

71.67%

11.66%

16.67%

81.67%

1

2

3

4

5

6

7

Non-vegetarian

Vegetarian

Tea habit

Coffee

Tobacco/Gutkha

Smoking

Alcohol

Both alcohol &

smoking

Madhura Rasa

preference

Katu Rasa

preference

38

22

16

10

15

5

63.33%

36.67%

26.67%

16.67%

25%

Bilateral

Vesical Calculi

Radio-opaque

8.33%

13.33%

8

Urine Analysis Table :

8

9

6

10%

48.33%

40%

Sr.

No.

Urine Finding

No. of

Patients

Percentage

29

24

1

2

3

4

5

6

7

Acidic pH

Alkaline

49

11

42

38

36

21

13

81.67%

18.33%

70%

63.33%

60%

10

Protein Nil

RBC 0–10 /hpf

Pus cells 0–5

Crystals absent

Ca-oxalate

crystals

Amorphous

urates

Ca-phosphate

crystals

Clinical Features Table :

35%

21.66%

Sr.

No.

No. of

Patients

Clinical Finding

Percentage

1

2

3

4

5

6

7

Todavat Vedana

Manda Vedana

Daha Vedana

Mixed Vedana

Mutrakr̥ cchra

Hematuria

28

13

11

8

50

25

26

46.67%

21.67%

18.33%

13.33%

83.33%

41.67%

43.33%

8

9

7

5

11.66%

8.33%

Sadahamutrata

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Discussion :

that basis already the contemporary science has

So after considering all the observations and results

the doshik type of the ashmari can be diagnosed in

the purvarupa avastha and even in the earliar stage

established that the calcium oxalate stones present

with irregular border and rough surface were as

phosphate stones present with regular border and

smooth surface. On this bases the features of vataja

ashmari simulate with calcium oxalate,cystine and

struvite stag-horn stone where as kaphaja ashmari

simulate with the phosphate stones^[19]. Hence all the

three investigations clubbed with the subjective

parameters of the classical purva rupa and rupa can

only give the clear picture of the ashmari to treat

with definitive results.

of

the

rupa

avastha

with

the

help

of

sonology,radiology and urine analysis together. But

Using either of the three investigations alone it may

not be possible to conclude the doshik type of the

ashmari because non radio-opaque stones cannot be

appreciated with their morphological features by

the KUB radiograph^[15], such stones are Xanthine

and indinavir with tannish yellow and tannish red in

colour respectively, can be made on USG and

urinary findings. These stones along with uric acid

stones can be the close comparison with the pittaja

ashmari^[16]. Even though USG abdomen and pelvis

can detect both radio-opaque and radiolucent stones

but fails to appreciate the surface of the stone and

to detect the stone in the middle part of the ureters

and membranous and panile part of urethra in such

situations the KUB radiograph along with urine

analysis can be handy^[17]. The analysis of the

crystals and PH of the urine can be helpful to asess

the doshik vitiation by correlating the sadaha

Conclusion :

On the basis of the review of literature and

observations made by this clinical study, which was

conducted on the selected 60 patients, the following

conclusions can be drawn.

1. The nidana and samprapti that are mentioned

for ashmari, remain same till today with little

bit of modification like bike riding and distant

travelling in place of prishtayana (ashwayana)

and functional dysuria for mutrakrrichra etc.^[20]

2. Ashmari in its purvarupa avastha requires help

of the sonology,radiology and urine analysis to

confirm the presence of stone in vitro in the

present days.

mutrata

in

reduced

PH

with

the

burning

micturation which is common in the concentrated

urine with urethritis secondary to infection may be

due to urine obstruction dependent on the stone size

irrespective of the composition of the stone. Hence

sadaha mutrata can be a secondary manifestation

with the vataja as well as kaphaja ashmari i.e with

the calcium and phosphate stones. It can be primary

manifestation in the uric acid, Xanthine and

indinavir stones which can be compared with

pittaja ashmari^[18]. The KUB radiograph helps to

make out the outline of the radio-opaque stones on

3. KUB radiograph can diagnose calcium oxalate

and phosphate stones that are comparable to

vataj and kaphaja ashmari respectively. USG

abdomen and pelvis can diagnose even the

radiolucent stones along with radio-opaque

stones which can be assessed about their doshik

composition in accordance with the classical

purvarupa,rupa and the findings of the urine

examination. RBC in urine or gross haematuria

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is correlated to sarudhira mutrata seen in

pittaja ashmari can be confirmed with the help

the ashmari in accordance with classical

purvarupa and rupa.

of the other to investigation i.e KUB and USG.

4. Most of the time Calcium oxalate stone happen

to be vataja ashmari; phosphate stones are

7. The treatment of the ashmari will become

definite, economical,

invasive and ultimate

non surgical, non-

when treated in

kaphaja

ashmari,

whereas

and

uric

purvarupa avastha with the early diagnosis by

the help of conjugation of purvarupa & Rupa

with sonology, radiology and urine analysis.

8. The classical Purvarupa & The modern

diagnostic aids like sonology, Radiology &

Urine analysis are incomplete without each

other to have final doshik composition of the

ashmari in the present days.

acid,urate,cystine,xanthine

indinavire

stones happen to be pittaja ashmari but cannot

be the same all the time as subjective

complaints of the purvarupa and rupa may

vary from the findings of KUB,USG and Urine

examination with respect to doshik vitiation i.e,

in

rare

condition

like

haematuria

(sarudhiramutrata) which is the classical sign

of pittaja ashmari may also be seen in the

calcium oxalate stones due to the injury to renal

system by sharp projections of the calculi

compared to vataja ashmari. The stag-horn

calculi composed of phosphate acquires the

shape of renal pelvis and calyces as it grows,

which contradicts it from kukkutanda shape

(smooth oval shape) which is the hallmark of

kaphaja ashmari. And sometimes uric acid

stones may contain calcium oxalate crystals to

become radio-opaque. ^{[21,22,23,24,25,26]}

References :

1. Sushruta; Sushruta Samhita; with Nibandha

Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

Prakashana Varanasi; reprint 1994; Sutra

Sthana 33/4; pp

2. Agnivesha; Caraka samhita; with Ayurveda

Dipika commentary by Chakrapanidatta

edited

by

Vaidya

Yadavaji

Trikamji

5. Majority of the sufferers happen to be middle

aged; married; non-vegetarian; males and of

middle income group.

Acharya;

chaukhamba

Surabharati

Prakashana Varanasi; reprint 2000; Vimana

Sthana 5/8; pp

6. The plain KUB radiograph can detect 80% of

the urinary calculi which are radio-opaque.

USG abdomen and pelvis is helpful in both

radiopaque and radiolucent stones except in the

stones of middle part of ureter, membranous

and penile part of urethra. Urine examination

can assist the KUB and USG findings in

drawing the final conclusion about the type of

3. Jack.W. McAninch & Tom.F.Lue;Smith &

Tanagho’s General Urology;Mc Graw Hill

Lang, London, 18 edition.

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4. Sushruta; Sushruta Samhita; with Nibandha

Sangraha commentary of Sri

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

Prakashana Varanasi; reprint 2000; Vimana

Sthana 5/8; pp

10. Vagbhata; Ashtangasangraha; with Hindi

commentary by Kaviraj Atrideva Gupta;

Prakashana Varanasi; reprint 1994; Shareera

Sthana 9/12; pp

Krishnadasa

Academy;

reprint

1993;

Shareer Sthana 6/18; pp

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Dipika commentary by Chakrapanidatta

11. Sushruta; Sushruta Samhita; with Nibandha

Sangraha commentary of Sri

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

edited

by

Vaidya

Yadavaji

Trikamji

Acharya;

chaukhamba

Surabharati

Prakashana Varanasi; reprint 2000; Vimana

Sthana 5/8; pp

Prakashana Varanasi; reprint 1994; Shareera

Sthana 9/12; pp

6. Vagbhata; Ashtangasangraha; with Hindi

commentary by Kaviraj Atrideva Gupta;

12. Sushruta; Sushruta Samhita; with Nibandha

Krishnadasa

Academy;

reprint

1993;

Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

Shareer Sthana 6/18; pp

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with hindi commentory by Bhishagratna

Prakashana Varanasi; reprint 1994; Shareera

Sthana 9/12; pp

Pandit Sri Brahma Sahankara Mishra; Part

II; Chaukhambha Sanskrit Sansthan; 7^th

edition 2000; Purvardha 9/172; pp

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Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

8. Sushruta; Sushruta Samhita; with Nibandha

Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

Prakashana Varanasi; reprint 1994; Shareera

Sthana 9/12; pp

Prakashana Varanasi; reprint 1994; Shareera

Sthana 9/12; pp

14. Jack.W. McAninch & Tom.F.Lue;Smith &

Tanagho’s General Urology;Mc Graw Hill

Lang, London, 18 edition.

9. Agnivesha; Caraka samhita; with Ayurveda

Dipika commentary by Chakrapanidatta

15. Jack.W. McAninch & Tom.F.Lue;Smith &

Tanagho’s General Urology;Mc Graw Hill

Lang, London, 18 edition

edited

by

Vaidya

Yadavaji

Trikamji

Acharya; chaukhamba Surabharati

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16. Vagbhata; Ashtangasangraha; with Hindi

commentary by Kaviraj Atrideva Gupta;

Krishnadasa Academy; reprint 1993;

Shareer Sthana 6/18; pp

Krishnadasa

Academy;

reprint

1993;

Shareer Sthana 3/12; pp

23.Bhavamishra; Bhavaprakasha; Vidyotini

with hindi commentory by Bhishagratna

17. Jack.W. McAninch & Tom.F.Lue;Smith &

Tanagho’s General Urology;Mc Graw Hill

Lang, London, 18 edition

Pandit Sri Brahma Sahankara Mishra; Part

II; Chaukhambha Sanskrit Sansthan; 7^th

edition 2000; Purvardha 9/172; pp

24. Sushruta; Sushruta Samhita; with Nibandha

18. Sushruta; Sushruta Samhita; with Nibandha

Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

Prakashana Varanasi; reprint 1994; Nidana

sthana 3/4; pp

Prakashana Varanasi; reprint 1994; shareera

Sthana 4/31; pp

25. B.D.Chaurasia; Human Anatomy; CBS

Publications & distributors;2^ndedition 1991.

19. Jack.W. McAninch & Tom.F.Lue;Smith &

Tanagho’s General Urology;Mc Graw Hill

Lang, London, 18 edition

26.Jack.W. McAninch & Tom.F.Lue;Smith &

20. Sushruta; Sushruta Samhita; with Nibandha

Tanagho’s General Urology;Mc Graw Hill

Sangraha

Dalhanacharya, edited by Yadavji Trikumji

Acharya; Chaukhamba Surabharati

commentary

of

Sri

Lang, London, 18 edition.

Declaration :

Conflict of Interest : None

Prakashana Varanasi; reprint 1994; Nidana

sthana 9/18 Dalhan;

21. Agnivesha; Caraka samhita; with Ayurveda

Dipika commentary by Chakrapanidatta

edited

by

Vaidya

Yadavaji

Trikamji

Acharya;

chaukhamba

Surabharati

Prakashana Varanasi; reprint 2000; Shareera

Sthana 7/7; pp

22. Vagbhata; Ashtangasangraha; with Hindi

commentary by Kaviraj Atrideva Gupta;

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ISSN: 2584-2757

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Copyright @ : - Dr.Krishna P.Thorat Kullolli Inter. J.Digno. and Research IJDRMSID00101 |ISSN :2584-2757

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