To the Editor: 

I read with interest the newspaper coverage of the article “Validation of a Functional Pyelocalyceal Renal Model for the Evaluation of Renal Calculi Passage While Riding a Rollercoaster,” which was published in The Journal of the American Osteopathic Association (JAOA).¹ I then read the article in the JAOA but found that the historical aspect of this method was missing. Hence, I would like to place the details of this unique method of dislodging renal calculi for easy passage in the context of the Ayurvedic treatise, Ashtanga Hridaya. 

Ayurveda firmly considers exogenous or endogenous factors that affect normal equilibrium of health as Shalya. Renal calculi is a Shalya due to endogenous causes.² The sole treatment of any Shalya (renal calculi with regard to the JAOA article) is extraction from the body medicinally by certain maneuvers or by surgical procedure. Numerous lithotriptic plants and their formulations are mentioned in ancient Ayurvedic treatises, and alkali preparations are most preferred among them, resulting in significant lithotriptic activity.^3-8 

Ashtanga Hridaya proposes a unique method of extraction of renal or ureteric calculi, wherein the patient is made to ride a horse or vehicle after consuming lithotriptic herbal decoctions or medicinal wine.^9,10 This unusual method will increase Vata dosha (bodily humor), which propels the stone from its site. Lithotriptic decoctions aid in breaking and disintegrating the stone, while the ride on a horse ensures the passage from the urinary tract. This method has not been reported in scientific journals, to our knowledge. This letter is likely the first to describe this Ayurvedic method of dislodging renal calculi.