Nephrolithiasis is a common and recurrent disorder of the urinary system characterized by the formation of calculi within the urinary tract. The prevalence of urinary stone disease has increased remarkably in recent years due to changing lifestyle patterns, unhealthy dietary practices, sedentary habits, inadequate fluid intake, obesity, and metabolic abnormalities. The disease commonly affects individuals during the most productive years of life and is associated with high recurrence rates. Clinically, patients may present with severe flank pain radiating towards the groin, dysuria, haematuria, nausea, vomiting, and burning micturition. If neglected, the condition may further lead to urinary tract infection, obstruction, hydronephrosis, and progressive renal damage. In Ayurveda, a similar condition is described under the term Ashmari, which is considered one of the serious disorders of Mutravaha Srotasa. Sushruta has classified Ashmari among the Ashtamahagada due to its severe pain, difficult management, and recurrent nature. Ayurvedic classics explain that vitiation of Doshas, predominantly Kapha along with Vata, contributes to the formation of stone-like structures within the urinary system. The disease has been described in detail with respect to its Nidana, Samprapti, classification, symptomatology, and prognosis. Earlier diagnosis of Ashmari was mainly based on clinical features and physical examination; however, contemporary diagnostic modalities such as ultrasonography, X-ray, and computed tomography have improved the accuracy of diagnosis and assessment of urinary calculi. Despite advances in modern management, recurrence remains a major clinical challenge, highlighting the importance of preventive and holistic approaches. The present review article aims to critically analyze the Ayurvedic concept of Ashmari and establish its correlation with nephrolithiasis. The review also explores classical references, etiopathogenesis, clinical manifestations, diagnostic approaches, and the contemporary understanding of urinary stone disease from both Ayurvedic and modern perspectives.
Dr. Vinay Kumar*1, Dr. Mahesh S. Jayabhaye2, Dr. Monika Yadav3 (Wed,) studied this question.