JOA-XII-October - December-2018-4f4ay9OBo6ShtirVV PDF

Journal of Ayurveda
A Peer Reviewed Journal

Vol.XII No 4 Oct-Dec 2018
Contents
Editorial
Editorial- Academic integrity and curbing Plagiarism 03
Prof. Sanjeev Sharma
Clinical Studies
Efficacy of Kampavatari Rasa In Kampavata W.S.R. To Parkinson’s Disease 04
Dr. Ram Chandra Singh, Dr. Mahendra Prasad, Prof. Om Prakash Dadhich
A Comparative Study on The Effect of Avasadahara Yoga (Kalpit) 11
and Psychotherapy in The Management of Depression
Dr. Pankaj Kumar Jain, Prof. Hemraj Meena
Efficacy of an Ayurveda Compound in the Management of Iron Deficiency 19
Anaemia: A Randomized Controlled Trial
Dr. Rashmi Pareek, Dr. Nisha Kumari Ojha
Clinical Evaluation of Efficacy of Madhura Aushadha Siddhataila Matravasti 28
And Yonipichu In Sukhaprasava
Dr. B. Pushpalatha, Dr. Priyanka Kasyap, Prof. K. Bharathi , Dr. Hetal Dave
Clinical Study on The Effect of Shatahvadi Dhumapana with or without 41
Pippali Rasayana in Peenasa With Special Reference to Chronic Simple Rhinitis
Dr. P. Narayanan, Prof. Shamsa Fiaz
A Comparative Study of two samples of Kushmand Khand in Amlapitta: 48
A prospective randomized control trial
Dr. Sangeeta Pareek, Dr. Jagriti Sharma, Dr. Mohar Pal Meena, Dr. Rajendra Prasad Sharma
Clinical Study on the Effect of An Ayurveda Formulation In The Management 56
of Medodushti W.S.R. To Dyslipidaemia
Dr. Shashi Choudhary, Dr. Udai Raj Saroj, Dr. Harish Bhakuni
A Clinical Study On The Efficacy Of Ardhanarishvara Rasa Nasya and 66
Nimbadi Guggulu In The Management Of Kaphaja Shiroroga W.S.R. To Sinusitis
Dr. Mansi, Dr. Aparna Sharma
A Study of Vyanghara Karma of Laksha obtained 73

from different host plants
Dr. Satyendra Singh, Dr. Swati Singh, Prof. Mohan Lal Jaiswal, Prof. A.R. Murthy
Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 1

Experimental Studies
Anti-Microbial Study On Different Samples of Lavangadi Vati 85
Dr. Amitabh Mazumder, Dr. Parween Bano, Prof. K. Shankar Rao
In-Vitro Evaluation of Anti-Microbial Effect of Herbal Formulation 92
Dr. Goyal Arun, Dr. Rath Sudipt, Prof. Kotecha Mita
An in-vivo study of toxicological effects of Shudha Dhatura Beej and its 98

therapeutic efficacy w.s.r. to Jwar.
Dr. Ramnivas Berval, Dr. R.K. Sharma (Chulet), Prof. Anita Sharma
Conceptual Studies
A Study of Asthi Sharir In Context of Various Types of Asthi 105

Described In Ayurvedic Samhitas
Dr. Gaurav Soni, Dr. Sandeep Lahange, Dr Vikas Bhatnagar,
Dr Shailja Kumari Bhatnagar, Dr. Isha Herswani
Comprehensive approach of Lifestyle Modification in Diabetes Mellitus 113

w.s.r. Prameha - Dr Anju K Bhardwaj, Dr G Prabhakara Rao
Conceptual study on Aartavakshaya 120
Dr. Bhingardive Kamini, Dr. O.P. Sharma, Dr. Santosh Kumar Bhatted
Analytical Study
An Analytical Study on Tamra Patra Sthita Jala 129
Dr. Chandra Chud Mishra, Dr. Sarvesh Kumar Agrawal, Prof. Kamalesh Kumar Sharma
Case Studies
Ayurvedic Management of Obstructive Uropathy with 133
Vesico-Ureteral Reflux : A Case Study
Dr Nidhi Sharma, Dr Asit K Panja
Functional Outcome of Basti Karma in Avascular Necrosis of 137

Femoral Head – A Case Report
Dr. Gopesh Mangal, Dr. Pravesh Srivastava

EDITORIAL
Clinical Practice on Ayurvedic principles….

Academic integrity and curbing Plagiarism
Publication or presentation of one’s work on public platforms is the need of the day. Good research or
conceptual work should be published for the benefit of the society in general and for the science in particular.
Publication of the work also adds credits to one’s bio-data which may be beneficial for his personal career growth.
Due to this reason the inflow of new research journals and publications of articles in those journals is increasing
day by day. This definitely has indented the academic honesty to more or less extent. Researchers or academicians
at so many times are crossing the lines of sanctity and are publishing or presenting other’s work as a whole or
part of that as their own works without acknowledging the original workers or contributors. This mounts to be
an academic dishonesty and plagiarism.
Academic integrity as defined in UGC regulations, 2018 is the “Intellectual honesty in proposing,
performing and reporting any activity, which leads to creation of intellectual property”. “Plagiarism” means
the practice of taking someone else’s work or idea and passing them as one’s own (UGC regulations, 2018,
Promotion of Academic Integrity and Prevention of Plagiarism in Higher Educational Institutions). In the
same regulations UGC also recommends that “And whereas, assessment of academic and research work done
leading to the partial fulfilment for the award of degrees at Masters and Research level, by a student or a
faculty or a researcher or a staff, in the form of thesis, dissertation and publication of research papers,
chapters in books, full-fledged books and any other similar work, reflects the extent to which elements of
academic integrity and originality are observed in various relevant processes adopted by Higher Educational
Institutions (HEIs)”. Here it is pertinent to mention that in Ayurvedic institutions also the real picture is not
so good and the issue of plagiarism is there. So many times students and faculty use others work full or part
and present as their own knowingly or unknowingly.
It is of utmost importance that academic honesty or integrity must be maintained in the educational
institutions. Every effort should be made to curb the menace of plagiarism. Although the UGC has notified
the regulations in the Gazette of India on 23rd of July, 2018 yet every institute should adopt the policy to
maintain the academic integrity and check the plagiarism. In National Institute of Ayurveda we have notified
the policy under the heading “Plagiarism Policy of National Institute of Ayurveda”. It is expected from every
researcher, student and faculty that this policy should be applied while presenting or proposing their work
in the form of synopsis, research proposals/projects, thesis, dissertations, research articles, case reports,
and review articles, chapters in the books or full books.
Prof. Sanjeev Sharma

Director

http:// journalofayurveda.in
ISSN No:2321-0435
ORIGINAL ARTICLE
Efficacy of Kampavatari Rasa In Kampavata
W.S.R. To Parkinson’s Disease
*Dr. Ram Chandra Singh, **Dr. Mahendra Prasad ***Prof. Om Prakash Dadhich
*Assistant Prof., Dept. of Sharira Kriya, Motherhood Ayurveda Medical College, Roorkee, Haridwar, Uttarakhand
** Assistant Prof., *** Professor, H.O.D.& Dean Academic
P. G. Department of Sharira Kriya, N.I.A. Jaipur
ABSTRACT
Kampavata (Parkinson’s disease) is a slow progressive disorder of late adult life It is a burning
problem among society in all countries around the world. The average age of onset is about 60 years, and
fewer than 5% of patients present under the age of 40.
25 Patients of Kampavata were randomly selected and assessed on the basis of Webster scale as
subjective criteria. Handgrip power, picking of pins with hands, walking time, butting time and chest expansion
were used as Objective parameters.
Kampavatari Rasa was given in dose of 125 mg twice daily with lukewarm water for 30 days. After
duration of treatment we compared base line data with data after treatment statistically. We have found
Significant result in Bradykinesia, Tremor, Upper extremity swing, Gait, Self-care and Walking time.
Key Words: Kampavata, Parkinson’s disease, Kampa, Kampavatari Rasa
How to cite this article : Singh R.C.

Quick Response Code:
Prasad M, Dadhich OP, Efficacy of Kampavatari
Rasa in Kampavata W.S.R. to parkison’s Disease,
JOA, XII-4, 2018); 4-10
Introduction
Ayurveda is a monumental contribution of

India to the world. As the name implies, it is an
Website:- journalofayurveda.in organized body having knowledge of healthy living.
Address of correspondence: It represents a well codified human care system and
Dr. Ram Chandra Singh speaks of the art and science of health and healing.
Assistant Prof., Dept. of Sharira Kriya, Ayurveda stands on three basic biological
Motherhood Ayurveda Medical College, humours, named as Vata, Pitta and Kapha. Every
Roorkee, Haridwar, Uttarakhand humours has its aggravating and pacifying factors.
Email:- [email protected] Vata is most prominent and regulatory over others.
Contact No:- 8004640010, 9462939261 Different Humours are prominent in different ages

Singh RC, Prasad M, Dadhich OP, Efficacy of Kampavatari Rasa in Kampavata W.S.R. to parkison’s Disease, JOA, XII-4, 2018;
4-10
like Kapha in childhood, Pitta in Young and Vata in humours of the body. Gati and Gandhana are the two
old age. principal functions of Vata i.e., all the motor and
sensory functions in the body are governed by Vata.
Parkinson’s disease has an annual incidence
Kampavata as one of Vataja disorder which has
of about 18/100000 in the UK and a prevalence of
cardinal sign of Kampa.
about 180/100000. Age has a critical influence on
incidence and prevalence, the latter rising to 300– Parkinson’s disease is characterized by
500/100000 after 80 years of age. Average age of abnormalities of motor function. It interferes with
onset is about 60 years, and fewer than 5% of activities of daily routine activities of life such as
patients present under the age of 40. grooming, bathing, dressing, feeding etc. Taking all
these into consideration this study was planned to
The etiological factors of Vata Vyadhi in
evaluate the efficacy of Kampvatari Rasa in
general have been explained in our classics, but
Kampvata.
separate Nidana for Kampavata are not explained.
Kampavata is one of the Vata Vyadhi and it is also Materials And Methods
told that, Na Kampo Vayuna Vina1 i.e. without Vata,
Ø Source of data: Patients were selected from
there is no manifestation of Kampa.
OPD of Arogyashala N.I.A. Jaipur and SSBH
Acharya Charaka mentionedVepathu under Jaipur. Patients were selected randomly
Nanatmaja disorder of Vata2. Many other references irrespective of age, sex, religion, education, socio
regarding the Kampa are available in the name of economic status & occupation.
Vepathu, Vepana, Pravepana etc. Kampa as one of
Ø Study design: Open random type
the symptom of many other diseases like Vataja
Jwara3, Vataja Apasmara4, Anantavata 5, Vishama Ø Sample size: 25 clinically diagnosed patients of
Sannipataja Jwara6, Vatika Kustha7, Vatika Pandu8 Kampavata.
and Urustambha9 have been mentioned. Acharya
Ø Drug: Kampvatari Ras was prepared in the
Sushruta described that Vata Vyadhi kills the patient
Pharmacy of National Institute of Ayurveda,
when accompanied with complications such as
Jaipur and packed in form of capsule to enhance
Kampa10 . Acharya Vagbhatt mentioned Kampaas
its palatability for easy administration.
one of the symptom of Vata Prakopa. Acharya
Kashyapa has listed Vepathu under the Vata Ø Dose- 125 mg twice daily with luke warm water.
Nanatmaja disorders11.
Ø Time period of Clinical trial- Internal
A more detailed diagnostic approach for the administration of Kampvatari Rasa for 30 days.
first time was provided by Basav Raj explaining the
Ø Follow up- Duration of follow up was 15 days.
symptoms of Kampavata viz. “Karapada Tale
Kampa” (tremors in hands and legs), Ethical Clearance- Clinical study was
“Dehabhramana” (postural instability), approved by Institutional Ethics Committee, by
“Matiksheena” (dementia), and “Nidrabhanga” Order No-F10(5)/EC/2014/7223 on Date 07/11/
(sleeplessness) and thus he definitely provided some 2014.
new ideas in understanding of the disease.
Inclusion Criteria
The word Kampa is derived from the root
1 . Patients with clinical signs & symptoms of
“Kapi Chalne” and suffixed by “Ghan” which gives the
Kampvata in comparison with Parkinson’s
meaning ‘to move’ or ‘to shake’. “Gatradi Chalanam”,
disease were selected.
that which produces shaking or movements in the
body. The word Kampa conveys the meaning of 2. Patients of either sex were selected.
shaking or tremor. The term Vata is derived from the
3. Patients above 30 years of age.
root “Va” and suffixed by “Kth”. “Va-
Gatigandhanayoh” 12 Vata is one of the three

4-10
4. Those who were ready to sign the consent form Withdrawal Criteria
and follow the instructions as advised. 1 . Patients developing any threatening
Exclusion Criteria complication during this trial. If any adverse
effects will be found then it will be withdrawn
Patients with other systemic disorder which from the study and informed to near by
interfere with the treatment were excluded such as- Pharmacovigilance cell.
1 . Alzheimer’s disease 2. Patient not willing to continue treatment.
2. Drug induced 3. Any other acute illness.
3. Trauma Criterias For Assessment
4. Epilepsy
(1) Subjective Criteria
5. Ataxia
Most of the signs and symptoms of
6. Hyperthyroidism Kampavata are subjective in nature, to give the
7 . Wilson’s disease etc. results and for statistical analysis “webster scale”13
for parkinson’s disease have been adopted.
Table No- I Subjective Criteria With Grading
PARAMETERS FINDING POINTS
Bradykinesia of No involvement 0
Hands Detectable slowing of the supination-pronation rate; beginning 1

difficulty in handling tools buttoning clothes and with handwriting
Moderate slowing of the supination-pronation rate in one or both 2

sides; moderate impairment of hand function; handwriting is
greatly impaired micrographia present
Severe slowing of the supination-pronation rate; unable to write or 3

button clothes; marked difficulty in handling utensils
Rigidity Non-detectable 0
Detectable rigidity in neck and shoulders; activation phenomenon is 1

present; one or both arms show mild negative resting rigidity
Moderate rigidity in neck and shoulders; resting rigidity is present 2

if patient is not on medications
Severe rigidity in neck and shoulders; resting rigidity cannot 3

be reversed by medication
Posture Normal posture; head flexed forward less than 4 inches 0
Beginning poker spine; head flexed forward more than 5 inches 1
Beginning arm flexion; head flexed forward up to 6 inches; one or both 2

arms raised but still below waist
Onset of simian posture; head flexed forward more than 6 inches; one 3
or both hands elevated above the waist; sharp flexion of hands
beginning inter-phalangeal extension; beginning flexion of knees

4-10
Upper Swings both arms well 0
Extremity One arm definitely decreased in amount of swing 1
Swing One arm fails to swing 2
Both arms fail to swing 3
Gait Steps out well with 18-30 inch stride; turns about effortlessly 0
Gait shortened to 12-18 inch stride; beginning to strike one heel; 1

turnaround time slowing; requires several steps
Stride moderately shortened to 6-12 inches; both heels beginning 2

to strike floor forcefully
Onset of shuffling gait; steps less than 3 inches; occasional stuttering- 3

type or blocking gait; walks on toes; turns around very slowly
Tremor No detectable tremor found 0
Less than 1 inch of peak-to-peak tremor movement observed in limbs 1

or head at rest or in either hand while walking or
during the finger-to-nose testing.
Maximum tremor envelope fails to exceed 4 inches; tremor is severe 2

but not constant and patient retains some control of hands
Tremor envelope exceeds 4 inches; tremor is constant and severe; 3

patient cannot get free of tremor while awake unless it is a pure
cerebellar type; writing and feeding self are impossible
Facies Normal; full animation; no stare 0
Detectable immobility; mouth remains closed; beginning features 1

of anxiety or depression
Moderate immobility; emotion breaks through at markedly increased 2

threshold; lips parted some of the time; moderate appearance of
anxiety or depression; drooling may be present
Frozen facies; mouth opens >= 0.25 inches; drooling may be severe 3
Seborrhea None 0
Increased perspiration secretions remain thin 1
Obvious oiliness present and secretion much thicker 2
Marked seborrhea; entire face and head covered by thick secretion 3
Speech Clear loud resonant easily understood 0

Beginning of hoarseness with loss of inflection and resonance; good 1
volume and still easily understood
Moderate hoarseness and weakness; constant monotone unvaried pitch; 2
beginning of dysarthria hesitance stuttering difficult to understand.

4-10
Marked harshness and weakness; very difficult to hear and to 3

understand
Self-Care No impairment 0
Still provides full self-care but rate of dressing definitely impeded; able 1
to live alone and may be employable
Requires help in certain critical areas; very slow in performing most 2

activities but manages by taking much time
Continuously disabled; unable to dress feed self or walk alone 3
Interpretation:
3. Picking of pins with hands:
l Minimum score: 0
The patients were asked to pick up the head
l Maximum score: 30 of 20 pins one by one and keep away until all the
20 pins get collected. The time taken by the patient
l The higher the score the greater the disease for this job was noted.
severity and disability.
4. Walking time:
Table No- II Interpretation The walking time was measured by asking

the patient to walk a distance of 20 feet in straight
Scale Disability line. The patients were told to walk with maximum
possible speed and the time was noted down in
1 – 10 early illness
second with the help of a stopwatch.
11 - 20 moderate
5. Buttoning time:
21 – 30 severe or advanced
Patient was requested to fix five buttons.
Average time taken for buttoning was noted in
(2) Objective Criteria
seconds.
1. Hand grip power: -
Observations And Results
For this purpose the cuff of B.P apparatus
After completion of the therapy of
folded, tied and inflated to such an extent so that the
Kampavatari Rasa for one month, its effect on the
manometer recorded 20 mm of Hg constantly. The
clinical features was observed as presented in table.
patient was asked to press the cuff with maximum
Various observations made and results obtained
power gripping the cuff in his hand. The record of
were computed statistically using Graph Pad Instat.
the maximum grip was noted down. To avoid the
Software Version 3.10 to find out the significance of
errors 3 consecutive readings were taken giving a
the values obtained and various conclusions were
sufficient rest to the arm and the mean value of it
drawn accordingly. For nonparametric data
was considered.
Wilcoxon matched-pairs signed ranks test was
2. Chest expansion: used. While for Parametric data Paired ‘t’ Test was
used and results were Calculated.
The degree of expansion of chest was
measured by placing the measuring tape. Just below
the nipples with its zero mark at the middle of
sternum. Patients were instructed to take the deep
breath in and out. The difference of expansions
between inspiration and expiration was noted.

4-10
Table No- III Effect Of Kampavatari Rasa On Subjective Parameters
Symptoms N Mean Diff. % Of SD SE W P Result

BT AT Change
Bradykinesia 25 1.72 1.28 0.44 25.58% 0.82 0.16 99 0.0304 S
Rigidity 25 1.96 1.64 0.32 16.32% 0.90 0.18 76 0.1336 NS
Posture 25 1.64 1.40 0.24 14.63% 1.09 0.21 35 0.3303 NS
Upper extremity 25 2.00 1.52 0.48 24% 0.87 0.17 103 0.0237 S
swing
Gait 25 2.32 1.76 0.56 24.13% 1.08 0.21 110 0.0258 S
Tremor 25 2.16 1.64 0.52 24.07% 1.12 0.22 88 0.0348 S
Facies 25 1.80 1.60 0.20 11.11% 0.86 0.17 40 0.3225 NS
Seborrhea 25 1.80 1.52 0.28 15.55% 0.84 0.16 43 0.1465 NS
Speech 25 1.72 1.40 0.32 18.60% 1.03 0.20 71 0.1564 NS
Self-Care 25 2.08 1.52 0.56 26.92% 0.96 0.19 108 0.0159 S
Table No- IV Effect Of Kampavatari Rasa On Objective Parameters
Criteria N Mean Diff. % Of SD SE t P Result

BT AT Change
Hand grip power 25 30.28 31.20 -0.92 -3% 2.97 0.59 1.54 0.1346 NS
Chest expansion 25 0.54 0.60 -0.05 -12% 0.14 0.02 1.93 0.0646 NS
Picking of pins 25 60.08 59.64 0.44 0.73% 3.11 0.62 0.70 0.4862 NS
with hands
Walking time 25 68.72 67.48 1.2 1.74% 2.63 0.52 2.35 0.0271 S
Buttoning time 25 68.4 67.36 1.04 1.52% 2.80 0.56 1.85 0.0762 NS
Tikta, Kashaya Rasa and Madhura Vipaka. Katuka

Discussion
having Tikta Rasa, Sheeta Virya and Katu Vipaka.
Indication of Kampavatari rasa is said for Since we know that Madhura, Amla, Lavana helps
Kampavata in Rasa Raj Sundar. Kampavatari Rasa in Decreasing Vata Dosha properties and Katu, Tikta
has mainly 3 ingredients, Parada, Tamra Bhasma and Kashaya helps in increasing the Vata Dosha
and Kutaki Swarasa Bawana. Parada is having properties. Some Dravya works with its Rasa, some
Shadarasa, Snigdha Guna, Ushna Virya, Madhura with Virya, some with Guna, some with Vipaka and
Vipaka and Tridoshahara properties. Parada is also some with their Prabhava. So along with Yogavahi
Sarvrogahara and having Yogavahi Guna. Parada property of Parada and Prabhava may helped in
may helped in normalizing the Vata Dosha properties modifying the Kampavata parameters.
mainly Chala Guna, which are disturbed in
However, it was the success of the therapy
Kampavata. Tamra Bhasma having Madhura, Amla,
that improvement was noticed in the patients.
4-10
Parkinson’s disease is a chronic, progressive, 4. Pandey Pt. Kashinath, Chaturvedi dr. Gorakhnath,
incurable type of Vataja disorder. Kampavatari Rasa Charaka Samhita part-2, Varanasi, Chaukhambha
Bharti academy, 2009, p-330
was found good enough for treatment for
Kampavata. 5. Pandey Pt. Kashinath, Chaturvedi dr. Gorakhnath,
Charaka Samhita part-2, Varanasi, Chaukhambha
Conclusion Bharti academy, 2009, p-325
Ø There are so many etioligical factors like Ahara, 6. Pandey Pt. Kashinath, Chaturvedi dr. Gorakhnath,
Vihara, Prakriti, inheritance etc. for Kampavata, Charaka Samhita part-2, Varanasi, Chaukhambha
but the key point is that any factor, which Bharti academy, 2009, p-120
vitiates Vata, can lead to Kampavata. 7. Pandey Pt. Kashinath, Chaturvedi dr. Gorakhnath,
Ø Trial drug (Kampavatari Rasa) has significant Bharti academy, 2008, p-647
result in Brady kinesia, Tremor, Upper extremity
8. Pandey Pt. Kashinath, Chaturvedi dr. Gorakhnath,
swing, Gait and Self care. It has insignificant
result in Rigidity, Posture, Facies, Seborrhea and
Speech.
Ø Trial drug (Kampavatari Rasa) has significant Charaka Samhita part-2, Varanasi, Chaukhambha
result in Walking time. It has insignificant result Bharti academy, 2009, p-767
in Hand grip power, Chest expansion, Picking of
1 0 . Shastri Kaviraj Dr. Ambikadutt, Sushrut Samhita part-
pins with hands and Buttoning time. 1, Varanasi, Chaukhambha Sanskrit Sansthan, 2010,
p-163
References:
1 1 . Bhisagacharya Sri Satyapala, Kashyapa Samhita,
1. Deva Raja Radha kant, Shabda Kalpadrum, Varanasi,
Varanasi, Chaukhambha Sanskrit Sansthan, 2015, p-
chowkhambha Sanskrit Series Office, 1967, p-28
6 1
1 2 . Shastri Kaviraj Dr. Ambikadutt, Sushrut Samhita part-
1, Varanasi, Chaukhambha Sanskrit Sansthan, 2010,
p-112
1 3 . Webster DD. Critical analysis of the disability in
Parkinson’s disease. Modern Treatme t. 1968 (March);
pp-279-281.
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ISSN No:2321-0435
ORIGINAL ARTICLE
A Comparative Study on The Effect of
Avasadahara Yoga (Kalpit) and Psychotherapy in The
Management of Depression
*Dr. Pankaj Kumar Jain, **Prof. Hemraj Meena
*Lecturer, Deptt. of Sharir Kriya, J.P. Government Ayurved College, Bhavnagar, Gujarat
**Ex. Prof., P.G. Department of Sharira Kriya, N.I.A. Jaipur
ABSTRACT
Regarding mental illness, psychological temperament and emotions, Ayurveda has been written in
detail. If the medical knowledge of the mental diseases described in Ayurveda is found in the context of
depression, two main medical methods are revealed - non-materialistic treatment and medicinal therapy.
The physio-pathological studies of Mansa Dosha and the clinical study of 60 patients of depression, has
been presented in the research paper.
The patients were divided into three groups in present study. Patients of group ‘A’ were given the
hypothetical combination of drugs in the form of an Arishta (traditional fermented formulation) and group
of ‘B’ patients were given psychotherapy. Meditation, chanting, praying and interviewing were used in
psychotherapy. Both methods were used in the group ‘C’. The results of the use of both methods were found
to be more effective.
Key Words: Avsad, Depression, Manas Doshas, Avasadahara Yoga, Psychotherapy, Meditation, Counseling.
Quick Response Code: How to cite this article : Jain PK,

Meena H, A Comparative Study on The Effect of
Avasadahara Yoga (Kalpit) and Psychotherapy
in The Management of Depression JOA XII-4,
2018; 11-18
Introduction
Mental disorder and psychological

Website:- journalofayurveda.in temperament are broadly described in Ayurveda
Address of correspondence: texts. In today’s materialistic society, human life has
Dr. Pankaj Kumar Jain become speedy, mechanized, less affections and
H-401, Vaidahi-2 Residency Near Vavol more centered, which contribute to more production
Hp Petrol Pump, K- Road, Gandhinagar, of Kama (Desire), Krodha (anger), Lobha (greed),
Gujarat-382016 Bhaya (fear), Shoka (Grief), Chinta (Worry) and
Email:- [email protected] Irshya (envy) etc. like Manasa Vikaras. In this way,
Contact No:- 9558345511 accurate knowledge of Manasa is necessary to

Jain PK, Meena H, A Comparative Study on The Effect of Avasadahara Yoga (Kalpit) and Psychotherapy in The
Management of Depression JOA XII-4, 2018; 11-18
understand about nature of life and health1. dementia, Schizophrenia, Obsessive compulsive
disorders were not selected.
Raja and Tama are the Doshas pertaining to
the mind and the types of morbidity caused by them, ii) Patients having fully diagnosed chronic disease
are Kama, Krodha, Moha, Lobha, Mada, Bhaya etc. like Malignancies, Hypothyroidism, Asthma,
Acharya Charaka has advised to suppress these chronic renal Failure, cirrhosis of liver and other
factors, because they tend to elevate Raja and Tama similar disorders were not selected.
Gunas, which cause Mano-dushti. These obnoxious
iii) Patients with acute illnesses like myocardial
states of Mana produce Mano-vikara with
infarction (M.I.), Cerebral-vascular Accident
involvement of Sangyavaha or Manovaha Srotasa2.
(C.V.A.), Congestive Heart Failure (C.H.F.),
That means depression is a state in which Chronic obstructive pulmonary disease
retardation of body and mind functions3 seen i.e. (C.O.P.D.), meningitis.
psychomotor retardation.
iv) Patient suffering from drug induced Depressive
Chakrapani has explained the term illness.
depression as incapability of mind as well as the
[C] Discontinuation Criteria -
body to work 4 i.e. cannot think or guess properly
or inability to respond properly by mind body and Patients were discontinued from the clinical
speech. trial; if they did not report for regular follow-up
during clinical trial due to any reason. During trial
According to Commentary of Dalhan, patient
period, if any other acute disease overlapped with
not doing any work due to fear of failure is called
classical manifestation of depression then also those
Vishad5.
patients were discontinued.
This study was design for evaluate the
Drug content
important of psychotherapy and Ayrvedic medicine.
Bramhi, Satavari, Vidharika, Ushir, Abhaya,
Aims and Objectives
Adrakh (Sunthi), Misi, honey, Sugar, Dhatki, Renuka,
This study has been carried out clinical Trivrat, Pippali, Lawanga, Kusth, Aswagandha,
evaluation of Avasadahara Yoga and Psychotherapy Vibhitak, Guduchi, Aila, Vidang, Tvak and Vacha.
in the management of depression on various
Psychotherapy:
scientific parameters
Psychological counseling between the
Materials & Methods:
physician and the patient is undertaken (Prashna) 6.
Selection of Cases - Prashna have important role to start the counseling
of a patient and questionnaires are also type of
The patients of Depression fulfilling criteria
Prashna Pariksha.
for selection were registered from O.P.D., N.I.A.,
Jaipur. Acharya Shushrut has mentioned treatment
of mental diseases (Manasa Roga) by counseling of
[A] Inclusion Criteria -
patients (Shukhavaha Shabda) 7.
The diagnosis of patients of depression was
Acharya charak mentioned Adrvayabhoot
confirmed on the basis of detailed history, thorough
Chikitsa in form of Upayo8.
clinical examination and scoring the Beck Depression
Inventory II. Acharya Charak has mentioned about
Sadvrat Palan9 and Chikitsa Sthan cheptor 1 (part 4)
[B] Exclusion Criteria -
about Achar Rasayan10 . These are the techniques of
i) Patients superimposed with major psychiatric privation of mental disease. So it may also include
illness like Mania, Alzheimer’s disease, Senile in psychotherapy.

The term Satwavajaya 11. implies the Group C (Combined Group)

therapeutics for mental (emotional stresses)
Both therapy given in group A & group B as
disturbances. As like the meaning of this word-
mentioned above (Psychotherapy and Avasadahara
victory of Mind, it is secured best by restraining the
Yoga).
mind from desire for unwholesome objects and the
cultivation of Gyana (knowledge), Vigyana Criteria of Assessment
(understanding), Dharya (courage), Smriti (recalling
During the trial and follow-up study the
memory power) and Samadhi (concentration). The
patients were assessed on the following parameters-
techniques of Satwavajaya Chikitsa include all
technique of modern psychotherapy. a) Subjective improvement.
Acharya Vagbhatta mentioned in Sutra b) Clinical improvement.

Sthan that the treatment of Mano dosha (Raja and
a) Subjective Improvement -
Tama) use of Dhee, Dharya and Atmadi Vigyana12.
All the patients registered for the trial were
So in addition to the above, Ayurveda
specifically asked for any changes in their clinical
envisages other method of treatment viz. –
manifestations and growing feeling of well being
Meditation, Shirodhara, Shirobasti, Abhyanga,
produced by the drug under trial.
Yoga, Counselling etc.
b) Clinical Improvement -
In counseling, counselor hears any type of
problem of patient and suggests solution as much as For the assessment of clinical improvement,
possible. Many patients feel loneliness, so counselors the incidence of presenting features was worked out
suggest for use of pleasure techniques. and the severity of symptoms was rated in each case.
For this purpose the following “Beck Depression
3. Grouping & Administration of Drug:
Inventory (BDI)” was used.
Selected patients of depression were divided
The numerical system was used to rate or to
into three groups on random basis for the drug
report value on some measured dimension, for
administration as follows -
example, a scale ranging from 0 to 3, with 0 meaning
Group A (Avasadahara Yoga Group): strongly disagree and 3 strongly agree. In the scale
various symptoms are graded into different grade as
Drug : Patients of this group were given
shown below -
Avasadahara Yoga
Absent 0
Dose : 15 ml twice in a day
Mild 1
Duration : 30 Days
Moderate 2
Anupana : With equal amount of water (lukewarm)
Severe 3
Time : After meal
Group B (Psychotherapy Group) : • Total BDI score can range from 0 to 63
Drug : Psychotherapy including counselling, 0-9 - Normal Non-depressed state

Mantra Jap, prayer and Meditation.
10-18 - Mild Depression
Duration : 30 Days
19-29 - Moderate Depression
Time : Meditation with Mantra Jap done for
30-63 - Severe Depression
15-30 min. daily and given counselling
4 times in the period of 30 days.

Duration of Clinical Trial And Followup having Tamasika Manasika prakriti.

Studies -
The present study shows that maximum
All the patients of three groups were numbers of the patients 58.33% were having
regularly followed up 2 times i.e. on 15 th day and Madhyama Sara, 71.67% were having Madhyama
30 th day to evaluate the therapeutic effect of Samhanana, 68.33% were having Madhyama
treatment given. The patients were asked to fill up Pramana, 46.67% were having Madhyama Satmya
the Beck Depression Inventory for diagnosis before and 68.33% were having Avara Satva.
and after the treatment.
The present study reveals that maximum
Observations numbers of patients i.e. 41.67% were having
Madhyama Abhyavaharana Shakti, 40.00% were
The data of the present study depicts that the
having Avara Jarana Shakti, 60.71% were having
maximum number of patients i.e. 65 % were male
Avara Vyayama Shakti, 90.00% were from
and 80% of the patients were Hindus.
Madhyama Vaya and 66.67% belonged to Jangala
The study reveals that majority of the Desha.
patients i.e. 45% were reported in the age group of
Results:
21 – 30 years and maximum 30% of the patients
were having higher secondary education level and Effect Of Avasadahara Yoga (Group A) :
maximum numbers of patients i.e. 48.33% were from
The present study denotes that statistically
middle class and maximum 33.33% of the patients
highly significant result was found in Pessimism
were in service.
(70.97%), in Sadness (66.67%), in Loss of pleasure
The data of the present study depicts that the (64.52%), in Irritability (55.88%) and in Tiredness or
majority of the patients i.e. 55% were married and Fatigue (54.70%),
most of the patients (78.33%) were belonging to
Statistically significant result was found in
urban habitat and 40.00% patients were having
Agitation (49.26%), Changes in sleeping patterns
family history.
(48.78%), Loss of energy (48.65%), Indecisiveness
The present study mentions that dietary (47.50%), and Self Dislike (43.97%)
habit of most of the patients’ i.e.55% was Niramisha
Statistically not significant result was found
(vegetarian), majorities i.e. 33.33% of the patients
in Crying (40.30%), Suicidal Thoughts or wishes
were having Mandagni and 55.00% were having
(35.00%), Self criticalness (34.21%), Changes in
Madhyama Koshtha.
Appetite (32.24%), Punishment feelings (27.50%),
In the present study, the available data Guilty feelings (25.00%), Past failure (21.88%), in
depicts that maximum number of patients i.e. 53.33% worthlessness (19.12%) and Loss of Interest in Sex
were taking tea/coffee, however 18.33% of the (16.07%)
patients were having addiction of sleeping pills, while
The initial mean score were 29.85, 15.75
15.00% were having habit of chewing pan/tobacco
reduction with 42.24% decrease of BDI Score was
and 06.67% each were smoking and use alcohol. No
noted, which was statistically highly significant
patients were addicted of snuffing or drugs.
(P<0.01).
The data of clinical study represents, 60.00%
Effect of Psychotherapy (Group B) :
patients were having disturbed sleep and 25.00%
patients were having irregular Mala Pravritti, The present study denotes that statistically
whereas 26.67% patients had constipation. highly significant result was found in Sadness
(65.38%), in Self Dislike (64.29%), in Self criticalness
The present study shows that maximum
(61.54%), in Loss of pleasure (56.25%), in Suicidal
numbers of the patients i.e. 40.00% were having
Thoughts or wishes (56.25%), in Pessimism (51.85%),
Vata-kapha Sharirika Prakriti and 51.67% were

Guilty feelings (50.00%), in Agitation (50.00%), in pleasure (58.54%), Loss of energy (56.76%),
Past failure (46.43%). Irritability(55.88%), Past failure (55.56%),
Concentration difficulty (51.61%), Loss of Interest in
Statistically significant result was found in
Sex (47.37%), in changes in appetite (47.06%), in
Indecisiveness (45.77%), Changes in sleeping
Worthlessness (45.00%) and in Crying (44.44%).
patterns (45.71%), in Irritability (45.45%), in Crying
(42.86%), in Punishment feelings (42.42%), in The initial mean score was 32.6 which was
Tiredness or Fatigue (40.30%), Loss of Interest in Sex reduced to 12.0 with 63.19% decrease of BDI Score,
(38.86%), Loss of energy (37.84%). which was statistically highly significant (P<0.001).
Statistically not significant result was found Discussion:

in Changes in Appetite (30.85%) and in Worthlessness
In this study we choose the two distinct
(27.83%).
therapies (Adravyabhut & Dravyabhut) and
47.86% decrease of BDI Score were observed evaluated its efficacy on the current disease
which was highly significant (P<0.001). Depression.
Effect Of combine therapy (Group C) : A very minor mistake of the physician may
drop the patient into dark and become life
Statistically highly significant results were
threatening for him.
found in Guilty feelings (87.50%) and in Self Dislike
79.41%, whereas statistically significant result was So we start our therapy in the both of
observed in Self criticalness 76.67%, Changes in dimension i.e. Satva to Sharir and Sharir to Satva
sleeping patterns (75.61%), punishment feelings
It is observed from our clinical study that
(72.73%), Sadness (70.14%), followed by significant
the drugs having an aphrodisiacal effect, show a
result in Pessimism(63.16%), Suicidal Thoughts or
great role in mitigating the mental diseases specially
wishes (61.54%), Indecisiveness (60.71%), Loss of
those are depressive in nature.
interest (59.38%), Agitation (58.62%), Loss of
Comparison of effect of Therapies:
Symptom Avasadahara Yoga Psychotherapy Combine Therapy

(Group A) (Group B) (Group C)
Sadness 66.67 % 65.38 % 70.45 %

Pessimism 70.97 % 51.85 % 63.16 %
Past failure 21.88 % 46.43 % 55.56 %
Loss of pleasure 64.52 % 56.25 % 58.54 %
Guilty feelings 25.00 % 50.00 % 87.50 %
punishment feelings 27.50 % 42.42 % 72.73 %
Self Dislike 43.97 % 64.29 % 79.41 %
Self criticalness 34.21 % 61.54 % 76.67 %
Suicidal Thoughts or wishes 35.00 % 56.25 % 61.54 %
Crying 40.30 % 42.86 % 44.44 %
Agitation 49.26 % 50.00 % 58.62 %
Loss of interest 45.77 % 43.33 % 59.38 %

Indecisiveness 47.50 % 45.77 % 60.71 %

Worthlessness 19.12 % 27.83 % 45.00 %
Loss of energy 48.65 % 37.84 % 56.76 %
Changes in sleeping patterns 48.78 % 45.71 % 75.61 %
Irritability 55.88 % 45.45 % 55.88 %
Changes in Appetite 32.24 % 30.85 % 47.06 %
Concentration difficulty 44.52 % 39.13 % 51.61 %
Tiredness or Fatigue 54.70 % 40.30 % 70.00 %
Loss of Interest in Sex 16.07 % 38.86 % 47.37 %

Effect On Total BDI Score All the drugs of Avasadahara yoga have
Rasayana property, which replenishes the vital fluids
Combined therapy (Group C) 63.19%
in the body. That nourishes the body, sense, mind &
provided better relief in BDI score followed by
intellect successively. But apart from Rasayana
Psychotherapy (Group B) 47.86% and Avasadahara
property some of the drugs have Vrishya & Medhya
Yoga (Group A) 42.24 %.
Guna also.
Overall Effect Of Therapies
As a result it acts over the target organ
Complete remission was seen in Avasadahara instantly. It is a big question that there any relation
Yoga (Group A) in 05.00% patients and in combined between hypogonadism and Depression. It is seen
therapy (Group C) in 15.00% patients. that impotent, frigid or infertile (male & female)
person are depressive. That is seems to be due to
75.00% patients got markedly improvement
their fruitless work.
by combined therapy and 55.00% by Psychotherapy
and followed by 50.00% by Avasadahara Yoga. Conclusion:
Moderately improved patients were noted Physical and psychological ailments affect
45.00% each in Avasadahara Yoga (Group A) and each other. Mana plays an important role to
Psychotherapy (Group B) and 10.00% in combined controlling normal physiology and Manas Doshas
therapy. (Raja and Tama) strongly afflict in every process and
every step of life. It is seen that Kaphaja Unmad may
Comparison Of The Effects
be correlated with disease depression to some extent.
On the basis of the comparison of the effects
Though mental diseases are chronic in nature
of all three groups on individual symptoms, total
but it may be fatal. Short therapy is not sufficient to
B.D.I. Score and overall effect discussed earlier, it
break down this complex phenomenon and so long
was found that combined therapy provided better
term therapy is very essential.
relief in the most of symptom which were having
significant relief than other two therapies. The counseling is the life saving tool for
depressive patients. Not only to the patient but it is
So it can be concluded that combined
applicable to the close relatives of patients too.
therapy proved better than Psychotherapy or
Behavior of counselor should be like a friend for
Avasadahara Yoga administered therapy alone.
open conversation and lighting to problems specific.
Probable Mode of Action of Psychotherapy:
Combined therapy proved better than
Though clinically efficacy of Psychotherapy individual psychotherapy as well as Avasadahara
is proved, the nature of its action is very complex. Yoga administered therapy.
Therefore, to understand the mode of action of
Need large clinical study for explain
Psychotherapy is a difficult task. Meditation
the mood of action as modern parameters Further
processes enhance & the Sattva quality and
study should plan with some modern parameter.
Counseling itself seems to produce a relaxation
response. Reference
Probable Mode of Action of Avasadahara 1. Agnivesha: Charka Samhita, Ayurveda Deepika,

Yoga: commentary by Chakrapanidutta; Ed. Pt.Y T
Acharya; Chaukhamba Surbharati Prakasham
After considering the above description, it Varansi, 2016; Sutra Sthan Chapter no.1 verse
seems that all the drugs of Avasadahara Yoga no55, Page no.15.
having some action at psycho-neurological level and 2 . Agnivesha: Charka Samhita, Ayurveda Deepika,
the combination of these drugs might be able to commentary by Chakrapanidutta; Ed.Pt.Y T
break the pathogenesis of depression at different Acharya; Rastriya Sanskrit Sanstha, 2006;Sutra
levels.
Sthan Chapter no.24 verse no.25 Page no.125. tattvasandipika, Hindi commentary by Kaviraj
Ambikadutta Shastri, Chaukhamba Sanskrit
3. Sushuruta, Sushurut Samhita, Nibandhasangraha
Sansthan Varansi 2006; Sutra Sthahan Chapter no.
commentary by Sri Dalhanacharya; Ed. Pt. Y T
1 Verse no. 46 page no. 8
Varansi,2018; Kalp sthahan Chapter no. 3 Verse no 8. Agnivesha: Charka Samhita, Ayurveda Deepika,
21 page no. 569. commentary by Chakrapanidutta;Ed. Pt.Y T
3. Agnivesha: Charka Samhita, Ayurveda Deepika,
Varansi, 2016;viman Sthan Chapter no 8. verse no
commentary by Chakrapanidutta; Ed. Pt.Y T
8,. Page no.275
Varansi, 2016; Sutra Sthan Chapter no.3 verse no.36 9. Agnivesha: Charka Samhita, Ayurveda Deepika,
Page no.401. commentary by Chakrapanidutta;Ed. Pt.Y T
Varansi, 2016; Sutra Sthan Chapter no.8 verse no18-
29. Page no.58-61.
Varansi, 2018; Sutra sthahan Chapter no. 1 Verse 1 0 . Agnivesha: Charka Samhita, Charak Chandrika
no.24 page no. 596 commentary by Drdhabala Ed. Tripathi
Brahamanand; Chaukhamba Surbharati Prakasham
Varansi, 2001; chikitsa Sthan Chapter no. ¼, verse
no30-35. Page no.388.
Varansi, 2018; sutra sthahan Chapter no. 1 Verse no. 1 1 . Agnivesha: Charka Samhita, Ayurveda Deepika,
33 page no. 9. commentary by Chakrapanidutta;Ed. Sharma R. K.
Dash Bhagwan; chokhamba sanskrit series, Reprint
6. Vagbhat,Astang Hridya, with Sarvangsundra
edition-2005;Sutra Sthan Chapter no. 11 verse no.54
commentary by Hemadri, Introduction by Prof.
Page no.77.
P.V.Sharma, Chaukhamba Orientalia, Varanasi,
sutra sthan,chapter 1, verse 22, page no. 14. 1 2 . Vagbhat, Astang Hridya, with Sarvangsundra
commentary by Hemadri, Introduction by
7. Sushuruta, Sushurut Samhita, Edited with Ayurveda
Prof.P.V.Sharma, Chaukhamba Orientalia, Varanasi,
Sutrasthan, chapter 1, verse 26, page no. 16.
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ISSN No:2321-0435
ORIGINAL ARTICLE
Efficacy of an Ayurveda Compound in the Management of
Iron Deficiency Anaemia: A Randomized Controlled Trial
*Dr. Rashmi Pareek, **Dr. Nisha Kumari Ojha
*Ph.D. Scholar, **Assistant Professor
P.G. Department of Kaumarbhritya, National Institute of Ayurveda, Jaipur
ABSTRACT
Background and objectives: Iron deficiency is the most common cause of nutritional anaemia in
the world. Adolescent girls are at high risk of iron deficiency anaemia due to accelerated increase in
requirements for iron. All allopathic oral iron preparations are gastric irritant and common side effects.
Therefore present study was done to evaluate the safety and efficacy of an Ayurveda compound Vajra Vatak
Mandoor in iron deficiency anaemia. Design: randomized control trial Participants: adolescent girls (12-
15 years) Methods: 100 patients were selected from OPD and IPD of National Institute of Ayurveda, Jaipur
and local school in Jaipur. That were satisfied the inclusion and exclusion criteria. They were randomly
divided in two groups. In Group A administered Vajra Vatak Mandoor and in group B Iron and Folic Acid
tablets for three month of duration with follow up at every forth night. Results: Non significant improvement
in intergroup comparison, extremely significant improvement in most of clinical feature of and in laboratory
parameters. Conclusion:The trial drug “Vajra Vatak Mandoor” is effective , safe and palatable in reduce
incidence of the symptoms of Pandu.
Key Words: -Pandu, Iron deficiency anaemia, Vajra Vatak Mandoor
Quick Response Code: How to cite this article : Pareek R,

Ojha NK, Efficacy of an Ayurveda Compound in
the Management of Iron Deficiency Anaemia: A
Randomized Controlled Trial, JOA XII-4, 2018;
19-27
Introduction
Globally, anaemia affects 1.62 billion people

(95% CI: 1.50-1.75 billion) ,the population group
Website:- journalofayurveda.in with the greatest number of individuals affected is
Address of correspondence: non-pregnant women. (468.4 million, 95% CI: 446.2-
Dr. Rashmi Pareek 490.6) 1 Approximately one third of the world
P.G. Department of Kaumarbhritya, National population is suffering from it. Iron deficiency is the
Institute of Ayurveda, Jaipur most common cause of nutritional anaemia in the
Email:- [email protected] world. Nutritional iron deficiency is the commonest
Contact No:- 7891832811 cause of anaemia in India.2 56% adolescent girls and

Pareek R, Ojha NK, Efficacy of an Ayurveda Compound in the Management of Iron Deficiency Anaemia: A Randomized
Controlled Trial, JOA XII-4, 2018; 19-27
30% adolescent boys in India are affected by gastric irritant and common side effects of oral iron
Anaemia according to the third National Family include nausea, abdominal pain and either
Health Survey. Adolescents (age 10-19 years), constipation or diarrhoea. Ferrous sulphate usually
especially girls, are at high risk of iron deficiency and causes severe gastrointestinal side effects like
anaemia due to accelerated increase in requirements gastritis, constipation/diarrhoea. Parenteral iron
for iron, poor dietary intake of iron, malaria and therapy may be required if iron cannot be absorbed
worm infestation. from intestine and patient experiences intolerable gut
symptoms. 3
According to the Ayurveda classics the
nearest correlation of iron deficiency anaemia can be The present clinical study entitled “Study of
made with Pandu Roga, because predominance of Prevalence of Iron Deficiency Anaemia in Adolescent
Panduta or pallor in the whole body is termed as Girls and Efficacy of Vajra Vatak Mandoor in Its
Pandu Roga. Pandu Roga is Pitta Pradhana Management” has been carried out successfully and
Tridoshaja Vyadhi. The decreased level of rasa and has been presented with the broad headings of
rakta which have the prime functions of nourishment Introduction, Literature Review, Review of Trial
and providing support to the vital function give rise Drug, Demographic study, Clinical study (Materials
to the symptoms.Pandu is divided into five types; and Methods, Observations and results) and
vatika, paittika, kaphaja, tridoshaja, mrid- Discussion.
bhakshanajanya pandu. The chikitsa comprises of
Trial Drug - Vajra Vatak Mandoor. The
Pittashamaka, Deepana-Pachana, Rasayana,
compound has been rationally modified to make it
Strotoshodhaka, Rakta Vardhak and Agni Vardhaka
in tablet form for easy administration.
medications. All allopathic oral iron preparations are
Table no. I- Showing ingredients of Vajra Vatak Mandoor4
S.No. Drugs Botanical Name Part used
1. Pippali Piper longum fruit
2. Pippali mool Piper longum root
3. Chavya Piper chaba fruit
4. Chitrak mool Plumbago zeylanicum root
5. Shunthi Zingiber officinale rhizome
6. Maricha Piper nigrum fruit
7. Devdaru Cedrus deodara Heartwood
8. Haritaki Terminalia chebula fruit
9. Vibhitak Terminalia bellarica fruit
10. Aamalki Emblica officinalis fruit
11. Vidanga Embelia ribes fruit
12. Mustaka Cyperus rotundus rhizome
13. Mandoor Fe2O3

Aims And Objectives Timelines
1) To study its co-relation with the socio-economic Total trial period: 8 weeks
status of the family.
Washout/Preparatory Period: 4 weeks (if required)
2) To evaluate the safety and efficacy of an
Follow up period: 4 weeks
Ayurveda compound Vajra Vatak Mandoor in
iron deficiency anaemia. Statistical Analysis: 8 weeks
Methods Selection of Cases
Study type: The clinical study was Subjects attended the O.P.D. and I.P.D. of
conducted in the form of an interventional, Kaumarbhritya Department of National Institute of
randomized control trial, open label, grouped (group Ayurveda, Jaipur.
A & group B).
Age Group: Girls of 12-15 years of age were
End point: Safety and Efficacy selected for the study.
Number of patients to be completed in the Number of Cases: 100 cases (50 in each
clinical trial (sample size): 100 group)
Table no.II- Showing grouping of cases.
Group A (n=50) Group B (n=50)
Trial drug (Vajra Vatak Mandoor) Control drug (Iron Folic Acid tablets)
Dose 500mg in two divided doses 100 mg elemental iron and 500 mcg
folic acid
Dosage form tablet tablet
Route Oral (After meals) Oral (After meals)
Anupan Butter milk Water
Duration 8 weeks 8 weeks
Criteria For Selection Of Patients dysfunction (defined as Aspartate amino-

transferase and/or alanine aminotransferase >3
Inclusion Criteria
times of the upper normal limit) or renal
1) Adolescent girls aged between 12-15 years. dysfunction (defined as S. creatinine > 1.2mg/dl)
uncontrolled pulmonary dysfunction (asthmatic
2) Adolescent girls with iron deficiency anaemia (Hb
and Chronic obstructive pulmonary disease
8 gm-12 gm %).
patients)
3) Adolescent whose parents were willing to give
4) Co-morbidity like Tuberculosis, Urinary tract
consent for clinical trial.
infection and bleeding disorders etc.
Exclusion criteria
5) H/o hypersensitivity to any of the trial drug or
1) Adolescent girls suffering from major systemic their ingredients.
illness necessitating long term treatment.
6) Adolescent girls who have completed
2) Adolescent girls with evidence of malignancy. participation in any other clinical trial during the
past six months.
3) Adolescent girls with concurrent serious hepatic

Withdrawal Criteria Objective: Laboratory findings were
assessed before and after treatment. Hb%, Complete
The participant may be withdrawn from the
Blood Count, Peripheral Blood Smear, Stool routine
trial if there is:
and microscopic.
1 . Any major ailment necessitating the institution
Adverse effects: To rule out the possible
of new modalities of treatment.
adverse effects of the trial drug record of information
OR maintained on every follow-up i.e. gastric irritation,
2. Non-compliance of the treatment regimen gastric upset, constipation diarrhoea, teeth
(minimum 80% compliance is essential to discoloration, other untoward effect if any.
continue in the study).
National Institute of Ayurveda, Jaipur.
Assessment Criteria Institutional Ethics committee’s approval was taken
to conduct the clinical trial. Study was approved by
For assessment of the efficacy of the trial
IEC order no.-F10 (5)/EC/2014/7220. A voluntary
therapy, following parameters were adopted-
signed, witnessed informed consent was obtained
Subjective: Based on clinical features of from the participant/ parents/ guardians prior to the
anaemia according to both modern and Ayurvedic start of clinical trial.
parameters on the basis of presenting features on
Observations And Results
four point scale.
Table no. III-Showing common observations of clinical study
S. Factor Classification Group A Group B Total

No. (n=50) (n=50)
No. % No. % No. %
1 Severity of Anaemia Mild (Hb<12-10%) 36 72 38 76 74 74
Moderate (Hb <10-8%) 09 18 08 16 17 17
Severe (Hb<8%) 05 10 04 08 09 09
2 Age Group (in years) 12 to <13 13 26 15 30 28 28
13 to <14 18 36 17 34 35 35
14 to <15 19 38 18 36 37 37
3 Menarche Achieved 32 64 28 56 60 60
Not achieved 18 36 22 44 40 40
4 Relegion Hindu 22 44 30 60 52 52
Muslim 28 56 20 40 48 48
Others 00 00 00 00 00 00
5 Economic status Higher 00 00 01 01 01 01
Upper Middle 10 20 07 14 17 17
Lower Middle 26 52 31 62 57 57
Lower 14 28 11 22 25 25

6 Habitat Urban Area 44 88 48 96 92 92
Rural Area 06 12 02 04 08 08
7 Immunization Status No immunization 11 22 14 28 25 25
Incomplete 08 16 06 12 14 14
Complete 10 20 07 14 17 17
Unknown 21 42 23 46 44 44
8 Diet Vegetarian 20 40 22 44 42 42
Mixed 30 60 28 56 58 58
9 Weight Average 32 64 30 60 62 62
Under weight 18 36 19 38 37 37
Over weight 00 00 01 02 01 01
10 Hygienic Condition Good 14 28 09 18 23 23
Moderate 30 60 27 54 57 57
Poor 06 12 14 28 20 20
11 Sleep Sound 32 64 26 52 58 58
Disturbed 22 44 20 40 42 42
12 Agni Mandagni 30 60 31 62 61 61
Visamagni 13 26 09 18 22 22
Tikshnagni 00 00 01 02 01 01
Samagni 07 14 09 18 16 16
13 Koshtha Krura 08 16 10 20 18 18
Mridu 02 04 00 00 02 02
Madhyam 40 80 40 80 80 80
14 Appetite Poor 35 70 42 84 77 77
Good 15 30 06 12 21 21
Excessive 00 00 02 04 02 02
15 Prakriti Vata-Paittaja 04 08 05 10 09 09
Vata-Kaphaja 25 50 23 46 48 48
Pitta-Kaphaja 21 42 22 44 43 43

Table No.VI – Showing Incidence of Causative Factors (Nidana) in the Patients of Pandu
Roga at the Time of Registration (n=100)
Sr Specific Nidana No. of patients %
No. Group A Group B Total

(n=50) (n=50)
1 Food insufficient in quality 23 25 48 48
2 Food insufficient in quantity 16 13 29 29
3 Excess intake of Amla, Lavana, Katu 20 18 38 38
4 Excess intake of Ushna, Tikshna, Ruksha 16 20 36 36
5 Faulty diet habit 32 39 71 71
6 Excess intake of Viruddhahar 18 19 37 37
7 Diwaswapna (Day Sleep) 29 34 63 63
8 Ratri Jagarana 07 11 18 18
9 Exercise during digestion 02 03 05 05
10 Nidanarthkararogas- Grahani 10 12 22 22
11 Nidanarthkararogas- Krimi 20 22 42 42
12 Nidanarthkararogas- Pratishyaya 15 21 36 36
Table no. V- Showing Clinical Recovery in Cases of IDA Treated with Vajra Vatak Mandoor
in Group A and Iron Folic Acid Tablets in Group B (Wilcoxon Matched pairs test)
Sr Features Group Mean % SD SE P Value Ipt

No. BT AT Diff. gain
1 Palpitation A 1.980 1.200 0.7800 39.39 0.6788 0.0960 <0.0001 ES
B 1.640 1.020 0.6200 37.80 0.6966 0.0985 <0.0001 ES
2 Dyspnoea A 1.918 1.240 0.6531 34.05 0.8552 0.1222 <0.0001 ES
B 1.860 1.260 0.6000 32.25 0.7284 0.1030 <0.0001 ES

3 Fatigue A 1.840 1.180 0.6600 35.86 0.7453 0.1054 <0.0001 ES
B 1.900 1.220 0.6800 35.78 0.7126 0.1008 <0.0001 ES
4 Vertigo A 1.860 1.320 0.5400 29.03 0.7060 0.0998 <0.0001 ES
B 1.840 1.260 0.5800 31.52 0.6728 0.0951 <0.0001 ES

5 Weakness A 1.760 1.160 0.7000 39.77 0.7825 0.1107 <0.0001 ES
B 1.820 1.120 0.7000 38.4 0.7354 0.1040 <0.0001 ES
6 Pallor A 1.940 1.180 0.7600 39.17 0.6565 0.0928 <0.0001 ES
B 1.900 1.200 0.7000 36.84 0.7071 0.1000 <0.0001 ES

7 Brittle Nails A 0.160 0.100 0.0600 37.50 0.2399 0.0339 0.2500 NS
B 0.220 0.180 0.0400 18.18 0.1979 0.0279 0.500 NS
8 Ankle A 0.180 0.060 0.1200 66.66 0.3283 0.0464 0.0313 NS
Oedema B 0.140 0.060 0.0800 57.14 0.2740 0.0387 0.1250 NS
9 Smooth A 0.320 0.300 0.0200 06.25 0.1414 0.0200 >0.9999 NS
Tongue B 0.420 0.220 0.2000 47.61 0.4041 0.0571 0.0020 VS
10 Loss of A 2.100 1.300 0.8000 38.09 0.6061 0.0857 <0.0001 ES
Appetite B 1.840 1.160 0.6800 36.95 0.7407 0.1047 <0.0001 ES
11 Irritability A 1.440 1.460 0.0200 1.38 3.087 0.4366 0.0019 VS
1.360 1.020 0.3400 25 0.5194 0.0734 0.0002 ES
Both the trial and control showed extremely significant result over subjective parameters. Trial drug
Vajra Vatak Mandoor on group A was found more effective over the subjective parameters -weakness,
palpitation, pallor and loss of appetite with % gain of 39.77%, 39.39%, 39.17%, 38.09% respectively
Table no. VI -Showing pattern of Hematological Changes in Cases of Iron Deficiency

Anaemia in Group A and in Group B (Paired ‘t’ test)
Sr Features Group Mean % SD SE P Value Ipt

No. BT AT Diff. gain
1 Hemoglobin A 11.04 12.14 1.094 9.90 0.6520 0.9220 <0.0001 ES
B 10.11 11.25 1.114 11.31 0.5159 0.0729 <0.0001 ES
2 RBC A 4.277 4.657 0.379 8.87 1.158 0.1638 0.0248 S
B 4.033 4.517 0.484 12.01 0.2953 0.0417 <0.0001 ES
3 PCV A 27.50 37.28 9.788 35.59 2.013 0.2847 <0.0001 ES
B 27.83 36.88 9.050 32.51 2.951 0.4174 <0.0001 ES
4 MCV A 68.57 78.09 9.516 13.87 3.337 0.4719 <0.0001 ES
B 66.38 75.95 9.564 14.40 3.538 0.5003 <0.0001 ES
5 MCH A 25.53 28.23 2.700 10.57 1.243 0.1758 <0.0001 ES
B 24.61 27.60 2.988 12.13 1.278 0.1807 <0.0001 ES
6 MCHC A 32.56 34.87 2.308 7.08 1.983 0.2804 <0.0001 ES
B 32.59 34.15 1.552 04.76 1.368 0.1934 <0.0001 ES

In present study, Aruchi (Loss of appetite), normal level and Dhatunirman process gets toned up
Avipaka (Improper digestion), Pandutva (Paleness) which results ultimately to Dhatupushti and Dhatu
were commonly observed premonitory symptoms, Prasadana so due to these properties it is helpful in
while Shirnaloma (Falling of hairs), Pada Sada Pandu Roga.
(Weakness in feet), Nirutsaha/ Shaithilendriya
Srotoshodhak effect- Maximum number
(Apathetic) were most commonly observed
of drugs possess Laghu, Ruksha Guna and Tikta
symptoms. While in demographic study fatigue was
Rasa. So the drug also possess Srotosodhak
most prevalent symptom which was observed during
property and help in clearing the Srotas.
the survey.
Krimihara effect- Mustaka7 and vidanga8
Statistical calculation between before and
are having anti helminthic properties. Krimi is also
after treatment findings of objective parameters all
most prevalent cause of anaemia in children because
results were found extremely significant (P<0.0001)
of poor sanitation and outside foods.
in both groups except RBC count in group A which
was significant with P value 0.0248. Pandu includes various types of anaemias,
kapha dominant variety of Pandu has more
On intergroup comparison on subjective
resemblance with iron deficiency anaemia.In
parameters, all results were found non-significant
Ayurveda, more emphasis has been given for the
except smooth tongue which was very significant
correction of metabolism as well as supplementation
with P value 0.0043.
of iron in treatment of Pandu.
Probable Mode Of Action
As the study was planned aiming adolescent
Doshahara effect- ‘Vajravataka Mandoor’ girls; tablet form was preferred due to its higher
has contents of Triphala having Tridoshahara acceptance, palatability and easy dose fixation.Trial
properties. Lauha Bhasm is having Kaphapitta drug Vajravataka Mandoor showed almost equal and
Shamak property and Pandu is Pitta Pradhan extremely significant improvement as compared to
Tridoshaja Vyadhi so, due to these properties it is control drug IFA tablets. However Vajravataka
helpful in treating Pandu. Mandoor showed better results on all cardinal
features except vertigo and irritability. Trial drug
Rasayana effect- It contains well known
Vajra vatak Mandoor was found more effective over
Rasayana drugs like Amalaki, 5 Pippali 6 ,Mandoor
the subjective parameters-weakness, palpitation,
Bhasm. Mandoor Bhasma is mentioned as a best
pallor and loss of appetite, which were the most
drug for Pandu Roga. Amalaki is a proved drug for
common complaints of girls with anaemia.
Pandu, moreover the presence of vitamin-C and
ascorbic acid helps in absorption of iron. All results were found extremely significant
in both groups, however group A showed significant
Agnivardhak and Dhatuposhan effect-
gain in Red Blood Cells count. After treatment
When we analyze the formulations mentioned in the
maximum % gain was observed in Packed Cell
context of Pandu, it is evident that they contain
Volume among all objective parameters in both
herbal ingredients like Panchkola, Maricha etc. that
groups A and B. In intergroup comparison all
are known correctors of the metabolism and
subjective and objective parameters showed non-
enhancers of bioavailability of nutrients. 102
significant result.
formulations are mentioned in the treatment of
Pandu in Ayurvedic formulary of India among which Study reveals that all the drugs used in
72 does not contain metallic iron. All these indicate Vajravataka Mandoor are effective in all the
that more emphasis was given in the text books of conditions described in the pathogenesis of Pandu
Ayurveda for factors affecting metabolism. Trikatu Roga. Thus it can be considered as a useful drug.
is present in Vajravataka Mandoor, so the drug
increases the Jatharagni and Dhathavagni up to

Conclusion 2. Medical Physiology by A.K. Das, Vol. II, Books and Allied
(p) Ltd., Calcutta- 9.
Nutritional anaemia is a major public health
3. Clinical Pharmacology by Bennett and Brown, 19 th
problem in India and is primarily due to iron
edition, 2005, Published by Elsevier, New Delhi,
deficiency especially in girls where they are exposed 110024.
to risk of onset of menarche. Trial drug Vajra vatak
4. Bhaishjya Ratnavali, pandurogadhikar Vidhyotini
Mandoor showed almost equal and extremely
Hindi Commentry by Kaviraj Ambikadutt
significant improvement as compared to control
Shastri,chaukhamba Sanskrit sansthan, edition 2004,
drug Iron Folic Acid tablets. However Vajra vatak page no. 722.
Mandoor showed better results on all cardinal
5. Charmi S. Mehta and Vimal R. Joshi, “Anti ageing
features except vertigo and irritability. All results
drugs in Ayurveda” International Journal of Green
were found extremely significant in both groups;
and Herbal Chemistry, 2012, Vol.1.No.1, 61-74.
however group A showed significant gain in Red
Blood Cells count. In intergroup comparison all 6. Natarajan KS, Narasimhan M, Shanmugasundaram
KR, and Shanmugasundaram ER, Antioxidant activity
subjective and objective parameters showed non-
of a salt-spice-herbal mixture against free radical
significant result. No adverse effects were reported induction, J Ethnopharmacol, 105(1-2), 2006,76-83.
during entire period of study by any of the patients
7. Padma Venkatasubramanian., Ashwini Godbole.,
in trial group created with Vajra vatak Mandoor.
Vidyashankar R and Gina R Kuruvilla. Evaluation of
References traditional anthelmintic herbs as substitutes for the
endangered Embelia ribes, using Caenorhabditis elegans
1. de Benoist B et al.,eds.Worldwide prevalence of anaemia model. Current Science, 105(11):1593-1598, (2013)
1993-2005.WHO Global Database on Anaemia
Geneva,World Health Organisation,2008. 8. Chemistry & Pharmacology of Ayurvedic Medicinal
Plants, Vd. Mukund Sabnis, 1st edition,Chaukhamba
Amarabharati Prakashan, Varanasi, Vol-I,2006;p.
no.185,186,187
‚Ê¢⁄Ê≥Ê—-
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∑§Ë 100 Á∑§≥ÊÙÁ⁄ÿÙ ∑§Ê R§◊ ⁄Á„Ã Ã⁄Ë∑§ ‚ ⁄ÊC˛Ëÿ •ÊÿÈfl¸º ‚¢SÕÊŸ ∑§ ’Á„⁄¢ª ∞fl¢ •ãÃ⁄¢ª ß∑§Êß¸ ’Ê‹⁄Ùª •ÊÒ⁄ SÕÊŸËÿ ÁfllÊ‹ÿ
‚ øÿŸ ∑§⁄ ºÙ ‚◊Í„ ◊¥ ’Ê¢≈ ÁºÿÊ– ∞∑§ ‚◊Í„-• ∑§Ù fl¡˝ fl≈∑§ ◊ã«ÍU⁄ •ÊÒ⁄ ‚◊Í„-’ ◊¥ •Êÿ⁄Ÿ ∑§Ë ªÙÁ‹ÿÊ ∑§Ù 2 ◊Ê„
Ã∑§ ‹ªÊÃÊ⁄ ‚flŸ ∑§⁄flÊÿÊ ªÿÊ– Inter group ◊ non-significant ¬Á⁄UáÊÊ◊ Á◊‹, ¬⁄ improvement ‚◊Í„-• ◊¥ •Áœ∑§
Á◊‹Ê– ß‚Ë ¬˝∑§Ê⁄ ‚◊Í„-• ∑§ ⁄ÙÁªÿÙ¥ ◊¥ ¬Êá«ÈU ∑§ ‹ª÷ª ‚÷Ë ‹ˇÊáÊÙ ◊¥ ÷Ë extremely significant ¬Á⁄UáÊÊ◊ Á◊‹–
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ISSN No:2321-0435
ORIGINAL ARTICLE
Clinical Evaluation of Efficacy of Madhura Aushadha
Siddhataila Matravasti And Yonipichu In Sukhaprasava
*Dr. B. Pushpalatha, **Dr. Priyanka Kasyap, ***Prof. K. Bharathi , ****Dr. Hetal Dave
*Associate professor, Deptt of Prasuti and Striroga, NIA, Jaipur
** Ayurveda Medical officer, Indrana, District Jabalpur, Madhya Pradesh
*** Professor and H.O.D, **** Assistant Professor, Deptt. of Prasuti-Stree Roga, NIA, Jaipur
ABSTRACT
Despite of advanced health care in the field of Obstetrics, a high number of women continue to die
during childbirth, due to any cause, related to or aggravated by the pregnancy or during management of
labour. Woman’s health has been neglected since many decades due to gender inequality, poverty, illiteracy;
working for the survival of mother is human rights imperative. Keeping in view the above facts and direct
emergency of saving the mother, women’s health is incorporated in the Millennium Development Goals. There
have been substantial achievements from 1990 (baseline year for the MDGs) to date; but globally maternal
deaths are 50% only decreased. But the situation is not very much normal, even now every year 289 000
maternal deaths are occurring worldwide, most are from preventable causes. To achieve these unmet goals
of MDG 5, now there is consensus on evidence-based, cost-effective investments and interventions.
At this juncture, the pro-poor and cost effective interventions of Ayurveda are the best suitable
methods for antenatal, intranatal as well as post natal care. A comprehensive antenatal care starting from
conception to delivery is described under the heading Garbhini paricharya in Ayurveda. This antenatal care
also incorporates the regimen to facilitate Eutocia (Sukhaprasava); Vasti is the procedure advocated for the
same purpose.
The present clinical study is taken up to
Quick Response Code: evaluate the efficacy of Madhura aushadha siddha
taila in the form of Vasti (Biopurificatory enema) and
Yonipichu (Vaginal tampon) in the management of
labour.
Key words: Pregnancy, Labour, Yonipichu,

Sukha prasava, Madhura Aushada siddha taila
Matra vasti
Website:- journalofayurveda.in
Address of correspondence: How to cite this article : Pushpalatha
Dr. Priyanka Kasyap B, Kasyap P, Bharathi K, Dave H, Clinical
Ayurveda Medical officer, Indrana, evaluation of Efficacy of Madhura Aushadha
District Jabal pur, madhyapradesh Siddhataila Matravasti And Yonipichu In
Email:- [email protected] Sukhaprasava, JOA XII-4, 2018; 28-40
Contact No:- 9413206790

Pushpalatha B, Kasyap P, Bharathi K, Dave H, Clinical evaluation of Efficacy of Madhura Aushadha Siddhataila
Matravasti And Yonipichu In Sukhaprasava, JOA XII-4, 2018; 28-40
Introduction and Pichu particularly in affliction of Vayu .5

Pregnancy is one of the most important Rationality of selection of trial drugs:
events in the life of every woman. Child bearing and
Madhuraushadha Sidda Taila: Madhura
delivery are such physiological entities which are
aushadha siddha taila Matravasti described to use
always ready to convert into pathological entities, if
during ninth month of pregnancy. Eight drugs
uncared. So, here Prakriti Sthapanam is essential to
Ashwagandha, Shatavari, Vidarikanda,
prevent the pathology, and is the main motto of
Yastimadhu, Mudgaparni, Mashaparni, Jivanti and
antenatal care.
Bala were selected from Madhura skandha described
To prevent the pathological changes that in Charaka Vimanasthana-8 6 ; these drugs were
occur during labour proper antenatal care is selected due to their availability and expected high
essential. The life of an unborn child is dependent degree of clinical effects. Murchana of Tila taila done
on the mother. According to Acharya Charaka, the according to the reference of Bhaishajyaratnavali-
woman is root of offspring.1 Jwararogadhikar Adhyaya. 7 After murchana,
The present study is taken up to evaluate the Madhura aushadha siddha Taila was prepared as per
clinical efficacy of ninth month regimen of Garbhini the Tailapaka vidhi by adding eight drugs to
mentioned by Charaka on Prasava (labour), that is murchita Tilataila. The oil was prepared in
use of Madhura Aushadha Siddha taila Matravasti Pharmacy of National Institute of Ayurveda, Jaipur.
and Yonipichu for the purpose of Sukha and Aims & Objectives
Nirupadrava Prasava.
1 . To evaluate the efficacy of Madhura aushadha
2
The Prasava’ is defined as Prakruta if it siddha taila Matravasti along with Yonipichu
fulfills the following criteria- Swabhava -spontaneous after completion of 32 weeks of pregnancy on
in onset, Upasthita kala – onsets at term, process of labour.
Avakshira-cephalic presentation, Swabhawika kala-
2. To study ninth month Garbhini Paricharya of
without undue prolongation.
Acharya Charaka
At the onset of labour the foetus gets turned
3. To reduce the complications of intra-natal
and comes forward due to action of Prasooti Maruta
period, especially third stage complications.
and then expelled out through Apatyapatha this is
termed as normal labour. Pregnancy especially 4. To evaluate the effect of procedure on early
during course of labour is the most critical stage. As puerperium.
Acharya Kashyapa has described labour as a critical
Materials And Methods
phase of women’s life 3 Facilitating Prasava to
culminate into Sukhaprasava is one of the aims of Selection of patients:
Masanumasika Garbhiniparicharya. It is the unique
All Primi pregnant women were recruited
stage where maternal adaptation occurs easily to
from OPD/IPD of PG Department of Prasutitantra
provide a favorable outcome for both mother and
and Striroga, National Institute of Ayurveda, Jaipur.
foetus.
All subjects were thoroughly examined and selected
As per Ayurveda the ‘Apana Vayu’ plays an strictly as per the criteria of inclusion. The patients
important role in the foetal expulsion. 4 Vayu is were randomly allocated into two different groups
essential for contraction and retraction of and trial drug were given after taking written
mayometrium and to expel the foetus. To keep this informed consent of the patients. Total 35 patients
Vayu in balanced state, Acharya have advised the were registered for the present study, 17 patients
administration of Anuvasana Vasti and Yonipichu. under Group-A (Matravasti and Yonipichu), among
Vayu is most likely to be vitiated during pregnancy, them 02 patients were dropped out. Under Group-B
and it is described that there is no other remedy total 18 patients were registered, among them 03
more beneficial than administration of “Matravasti patients were dropped out.

This work is approved by Institutional Ethical l Pregnancy associated with any systemic diseases
Committee vide letter No. F1O(5)EC/2014 dated 07/
l Pregnancy associated with malignancy of genital
11/2014
tract
Trial Groups: Two
l History of Bad obstetric history
Group-A
l Polyhydraminos
Madhura aushadha siddha taila
l Pre-eclamsia/Eclamsia
Matravasti - The trial drug were administered after
completion of 32 weeks of gestational age, once in a l Intra Uterine Growth Retardation
week up to 36 weeks of gestational age; after
l Mal -presentation
completion of 36 weeks of gestation, twice in a week
till delivery. l History of Ante-Partum Haemorrhage
Matra vasti dose- 60 ml l Contracted pelvis
Madhura aushadha siddha taila l Vaginal obstruction (adhesion & stenosis)

Yonipichu - given once in a week after completion
l Pregnancy associated with placental
of 32 to 36 weeks then continued daily till delivery.
abnormalities
Group-B
l Pregnancy associated with reproductive tract
Under this group patients were registered as abnormalities/pathology.
control, no drug was administered.
Criteria for Withdrawal:
1. Study type: Interventional
1 . On development of any complications patient will
2. Study design: Randomized controlled trial be withdrawn from trial
3. Allocation: Randomized 2. 100% non-compliance of trial
Randomization method: Randomization is done Laboratory investigations:

through simple random method
l Blood – Complete Blood picture, ABO Rh,
4. Masking: Open label Bleeding Time, Clotting time, HIV, HBsAg, VDRL,
Fasting Blood sugar, LFT, RFT
5. Purpose: Treatment
l Urine-Routine & microscopic
6. Sample size: 30 (15 in each group)
l TSH
7 . End point: Efficacy
l Ultrasonography for Fetal well being
Criteria of Inclusion:
l Other investigations like ECG, Serum Blood Urea,
l Pregnant woman between the ages of 20-30
Serum Creatinine, will be advised in suspected
years.
cases to rule out the other specific diseases
l Primipara with single intrauterine fetus after
Criteria of Assessment
completed 32 weeks of gestational age.
Clinical result were assessed on the basis of
l Normal fetal position at term. duration and events of stages of labor and nature of
Criteria of Exclusion: delivery and accordingly grades were given to the
patients:
l Age less than 20 years and more than 30 years
Grade-0
l Multipara, multiple pregnancy
Onset of labor - Spontaneous
Partogram - Before alert line Grade-III
Uterine contractions - Normal pattern Onset of labour - Spontaneous/Induced

Partogram - After alert line
Type of delivery - Spontaneous vaginal delivery
without episiotomy. Uterine contractions - Irregular pattern
Type of delivery - Caesarian section
Grade-I
Statistical Analysis:
Onset of Labour - Spontaneous
The data collected on the basis of
Partogram - Before alert line/ between alert line
observations were analyzed using appropriate
& action line
statistical test (Paired ‘t’ test was used for parametric
Uterine contractions - Normal pattern data and Wilcoxan rank sign test for non-parametric
Type of delivery - Spontaneous vaginal delivery with data and ANOVA for comparative analysis) to
episiotomy. evaluate the significances at different levels i.e. at
0.05, 0.01 and 0.001 levels.
Grade-II
The obtained results were interpreted as
Onset of Labour - Induced
follows-
Partogram - Before alert line/ between alert line & l Insignificant or Not significant - p>0.05
action line (NS or NQS)
Uterine contractions - Normal /Irregular pattern l Significant (S) - p<0.05
Type of delivery - Spontaneous vaginal delivery with l More or very Significant - p<0.01
or without episiotomy. l Highly or Extremely Significant - p<0.001
Observations:
Table -I Incidence of Age
S. No. Age Number of Patients Total Percentage
Group -A Group –B
1.. 20-23 6 9 15 50.00
2 24 -27 7 4 11 36.67
3. 28 -30 2 2 4 13.33
Total 15 15 30 100.0
Table -II - Incidence of occupation
S. No. Occupation Number of patients Total Percentage
Group - A Group – B
1. Labour 00 00 00 0.00
2. Housewife 11 13 24 80.00
3. Service 4 2 6 20.00
4 Business 00 00 00 0.00
Total 15 15 30 100.0

Table -III Incidence of Height
S.No. Height Number of patients Total Percentage
Group - A Group –B
1. 4’10’’ - 4’11’’ 01 03 04 13.33
2. 5.0’’- 5’2’’ 09 11 20 66.67
3. 5’3” –5’5” 05 01 06 20.00
4 >5’5” 00 00 00 0.00
Total 15 15 30 100.0
Table -IV Incidence of Gravidity
S. No. Gravidity Number of patients Total Percentage
Group - A Group – B patients

1. Primi Gravida 15 11 26 86.67
2. Second Gravida 00 04 04 13.33
3. Multi Gravida 00 00 00 0.00
Total 15 15 30 100.0
Table - V Incidence of vasti pratyagamana kala
S. No. Vasti pratyagamana kala Group A Total patients Percentage

1. 1-3 hrs 00 00 0.00
2. 4-6 hrs 5 5 33.33
3. >6hrs 10 10 66.67
Total 15 15 100.0
This table indicates that maximum number of patients i.e. 66.67% had Vasti pratyagamana in > 6
hrs and 33.33% patients had 4-6 hrs (Table -V).
RESULTS
Table - VI Incidence of Prasava kala
S. No. Gestational period Patients Total %

in week Group A Group B patients
No % No %
1. <37 wks 1 6.66 1 6.66 2 6.66
2. 38-39 wks 10 66.66 8 53.33 18 60.00
3. 40-41 wks 4 26.66 6 40 10 33.33
Total 15 100 15 100 30 100.0

Table -VII Effect of Therapy on Contractions
S.No. Contractions Group-A Group-B Total %
No % No %
1. Good 9 60 5 33.33 14 46.67
2. Fair 5 33.33 7 46.66 12 40.00
3. Poor 1 6.66 3 20 4 13.33
Total 15 100 15 100 30 100.0
Table - VIII Incidence of Rupture of Membrane
S. No. Rupture of Number of Patients Total %
Membranes Group A Group B
No % No %
1. Pre labour 03 20.00 07 46.66 10 33.33
2. At labour Early 06 40.00 06 40.00 12 40.00
3. At labour Late 06 40.00 02 13.33 08 26.67
Total 15 100 15 100 30 100.00
Table - IX Grade of labor wise distribution
S. No. Grade of Number of Patients Total %
labor Group A Group B
No % No %
1. 0 00 00.00 01 06.66 01 03.33
2. 1 12 80.00 06 40.00 18 60.00
3. 2 02 13.33 05 33.33 07 23.33
4. 3 01 06.66 03 20.00 04 13.33
Total 15 100 15 100 30 100.00

Table -X Showing effect of therapy on different symptoms in Group -A (Wilcoxon Signed
Rank Test)
Group-A Mean Mean No. S.D. S.E. +ve -ve Sum of P Signi-
B.T. A.T. Dif. % rank rank all rank ficance
Vibandha 1.40 0.33 1.07 76.19% 13 1.28 0.33 79.5 11.5 68 0.035 S.
Udarashoola 1.20 0.27 0.93 77.78% 12 0.59 0.15 78 0 78 0.01 S.
Katishoola 1.60 0.67 0 . 9 3 58.33% 13 0.46 0.12 91 0 91 0.007 S.
Daurbalyata 2.13 0.80 1.33 62.50% 15 0.49 0.13 120 0 120 0.004 H.S.
Kshudha- 1.53 0.73 0.80 52.17% 10 0.68 0.17 55 0 55 0.02 S.

vaishmya
Nidravaishmya 1.33 0.67 0 . 6 7 50.00% 9 0.62 0.16 45 0 45 0.028 S.
Swetasrava 1.40 0.60 0.80 57.14% 9 0.77 0.20 45 0 45 0.028 S.
Yonikandu 0.93 0.20 0.73 78.57% 10 0.59 0.15 55 0 55 0.02 S.
Table -XI Effect of therapy on different symptoms in Group-B
Group-B Mean Mean No. S.D. S.E. +ve -ve Sum of P Signi-
B.T. A.T. Dif. % rank rank all rank ficance
Vibandha 1.47 1 . 4 7 0.00 0.00% 0 0.00 0.00 0 0 0 N.D. N.D.
Udarashoola 1.40 1.40 0.00 0.00% 0 0.00 0.00 0 0 0 N.D. N.D.
Katishoola 1.60 1.60 0.00 0.00% 0 0.00 0.00 0 0 0 N.D. N.D.
Daurbalyata 2.00 2.00 0.00 0.00% 0 0.00 0.00 0 0 0 N.D. N.D.
Kshudha- 1.53 1.47 0.07 4.35% 1 0.26 0 . 0 7 1 0 1 N.D. N.D.

vaishmya
Nidravaishmya 1.00 0.93 0 . 0 7 6.67% 0 0.26 0 . 0 7 0 0 0 N.D. N.D.
Swetasrava 1.33 1.33 0.00 0.00% 0 0.00 0.00 0 0 0 N.D. N.D.
Yonikandu 1.00 1.00 0.00 0.00% 0 0.00 0.00 0 0 0 N.D. N.D.
N.D.= Not define

Table -XII Inter Group Comparison of effect of therapy on different symptoms
(Comparison between the groups by Mann-Whitney Test)
Symptoms U1 U2 U’ Z P Value Significance

Vibandha 45 180 45 2.799 0.005 H.S.
Udarashoola 22.5 202.5 22.5 3.73 0.0001 H.S.
Katishoola 15 210.0 15 4.04 0.00005 H.S.
Daurbalyata 0 225 0 4.666 0.00001 H.S.
Kshudhavaishma 44 181 44 2.84 0.0049 H.S.
Nidravaishma 52 173 52 2.5 0.012 S.
Swetasrava 45 180 45 2.799 0.005 H.S.
Yonikandu 37.5 187.5 37.5 3.11 0.001 H.S.
Table -XIII Showing effect of therapy on the duration of stages of labour in Group-A
(Paired t-test).
Stages Mean Mean Mean Mean No. S.D. S.E. t P Signi-

B.T. A.T. Dif. % ficance
1st stage 12 7.07 4.93 41.11% 15 1.98 0.51 9.65 <0.001 H.S
2nd stage 120 32.00 88.00 73.33% 15 13.73 3.55 24.82 < 0.001 H.S.
3rd stage 30 6.67 23.33 77.78% 15 3.09 0.80 29.28 < 0.001 H.S.
Table -XIV Showing effect of therapy on the duration of stages of labour in Group-B
(Paired t-test)
Stages Mean Mean Mean Mean No. S.D. S.E. t P Signi-

B.T. A.T. Dif. % ficance
1st stage 12 09.93 02.07 17.22% 15 1.44 0.37 5.57 < 0.001 H.S
2nd stage- 120 43.20 76.80 64.00% 15 27.95 7.22 10.64 < 0.001 H.S.
3rd stage- 30 11.00 19.00 63.33% 15 6.32 1.63 11.64 < 0.001 H.S.
Table no XVI - Incidence of Effect of therapy on early purperium
S.No. Symptoms Patients Total %

Group A Group B
number % number %
1. PPH 1 6.66 1 6.66 2 10.00
2. Jwara 1 6.66 4 26.67 5 16.66
3. Kampa 0 0 0 0 0 00
4. Pipasa 0 0 0 0 0 00

5. Atisara 0 0 0 0 0 00
6. Yonibhedan 0 0 0 0 0 00
Discussion patients in group A i.e. 60% had good contractions,

in 33.33% patients had fair contractions and 6.66%
Acharya Charaka mentioned use of
had poor contractions. Group B 46.66% had fair
Anuvasana vasti and Yonipichu in ninth month of
contractions in 33.33% patients had good
Garbhini paricharya for the purpose of facilitating
contractions and 20% had poor contractions (Table
normal labour, get healthy offspring as well as to
VII).
reduce the post partum complications.8 The present
study is carried out to evaluate the same therapy Group A above table reveals 40 % patients
clinically in Garbhini women. Study carried out had rupture of membrane at early labour and 40%
under two groups, Group-A (trial group) and Group- patients had late labor, while 20% had ROM at pre
B (control group). Trial group subjects were given labor.
Madhuraushadha siddha taila Matravasti and
Group B reveals 46.66% patients had rupture
Yonipichu with the same oil on 30 patients, i.e. 15
under each group. of membrane at pre labour and 40% patients had
early labor, while 13.33% patient had ROM at late
Discussion on observation of Clinical Study: labor (Table VIII). The above table deciphers that in
Group A 80% patient achieved grade 1, 13.33%
Most of the patients i.e. 50.00% in the study
achieved grade 2, 6.66% patient undergone LSCS. i.e.
were found in the age group of 20-23, followed by
Grade 3. In Group B 40% achieved Grade 1, 33.33%
36.67% patients in the age group of 24-27 yrs (Table-
patient achieved Grade 2 and 20% patient undergone
I). On observation of occupation it is found that
LSCS. (Table IX)
maximum number of patients i.e. 80.00% patients
were housewives and 20.00% patients were in Above table shows that in group A 76.19 %
service (Table-II). Observation of height reveals that relief was observed in Vibandh, 77.78% in
maximum number of patients i.e. 66.67% were Udarashoola, 58.33% in Katishoola, 62.50% in
between 5’to 5’2’’ in height followed by 5’3’’-5’55” i.e. Daurabalya, 52.17% in Kshudhavaishamya, 50% in
20% (Table-III). Maximum patients were Primi Nidravaishamya, 57.14% in Shwetasrava, and
gravida i.e. 86.67% and 13.33% were second gravida 78.57% relief observed in Yonikandu. There is H.S.
(Table-IV). As per as Vasti Pratyagamana Kala is result in Daurabalya and S. result in other symptoms
concerned, 66.67 % patients had Vasti (Table X) In group B Not Define result in any
Pratyagamana Kala more than 6 hrs, 33.33% symptoms (Table -XI).
patients had 4-6 hrs. As the Jirna Kala of Matravasti
This table deciphers that in Vibandh in group
is 6 hours and maximum number of patients retained
the drug up to the specific time period. A 76.19 %, in group B 0% relief was observed.
Results In group A77.78% relief was observed in

Udarashoola and in group B 0% relief was observed.
Above table depicts that maximum number
of patients of group A i.e. 66.66% had delivered at In group A 58.33% relief was observed in
38-39wks of gestational period, followed by 26.66% Katishoola and in group B 0% relief was observed.
patients had onset of labor at 40-41wks. In group A 62.50% relief was observed in
Group B 53.33 % of patients delivered at 38- Daurabalya and in group B 0% relief was observed.
39wks of gestational period, followed by 40% patients In group A 52.17% relief was observed in
had onset of labor at 40-41wks (Table VI) Kshudhavaishamya and in group B 4.35%% relief was
This table indicates that maximum number of observed.

In group A 50% relief was observed in for parturition and in the present study also
Nidravaishamya and in group B 6.67% relief was maximum number of patients was delivered in this
observed. In group A 57.14% relief was observed in time period. This shows that if Apana Vayu and
Shwetasrava and in group B 0% relief was observed. Vyana Vayu are stayed in Samavastha, they will
In group A 78.57% relief was observed in Yonikandu initiate the labour at proper time with regular
and in group B 0% relief was observed (Table XII). uterine contractions. Administration of Matravasti
keeps these Vayu in Samavastha.
Above table reveals that the mean duration
st
of I stage of labour was 12 hrs and actual time Contractions: This table indicates that
taken was 7.07 hrs showing highly significant effect. maximum number of patients i.e. 46.67% had good
The mean duration second stage was 120 min and contractions, 40.00% had fair contractions and
actual time taken was 32 min, which shows highly 13.33% patients had poor contractions. Vasti
significant effect. maintains Apanavayu in samavastha and causes
regular uterine contractions in coordinated manner.
The mean duration third stage was 30 min
The present study shows that power required for
and actual time taken was 6.67 min which shows
normal labour was sufficient in maximum patients.
highly significant effect. Above table reveals that the
mean duration of first stage of labour was 12 hrs and Rupture of membranes (ROM):
actual time taken was 9.93 hrs showing highly Maximum number of patient’s i.e. 40.00% had
significant effect. rupture of membranes during early stage of labour,
while 33.33% had rupture at pre-labour and 26.67%
The mean duration second stage was 120 min
had during later time of labour. Rupture of
and actual time taken was 43.20 min, which shows
membranes itself can initiate and enhance the labour
highly significant effect. The mean duration third
pains and shorten the duration of labour. ROM is
stage was 30 min and actual time taken was 11 min
caused by infections sometimes, but in the present
which shows highly significant effect (Table XIV).
study none of the cases had history of premature
On first Stage- In Group A and Group B shows rupture of membranes. The krimighna property of
statistically highly significant difference i.e. Group A Madhura Aushadha Siddha Taila prevented the
was better than Group B. premature ROM, while on the other hand proper
uterine contractions caused ROM during labour.
On second Stage- Group A and Group B
shows significant difference i.e. Group A was better Mode of delivery: In Group-A Matravasti
than Group B. On third Stage- Group A and Group and Yonipichu were given. Vasti regulates and
B shows significant difference i.e. Group A was better maintains Apana Vayu in samavastha and also helps
than Group B. in increasing the laxity of birth canal. Maximum
patients of this group were delivered normal
Above table reveals that 10% patient had
vaginally with episiotomy. One patient had history
PPH and Jwara occurred in 16.66% of patients
of leaking before the onset of labor, so that patient
Kamp, Pipasa, Atisaar and Yonibhedan was not
had undergone Caesarean section. In Group B, 3
observed in any patient.
patients were undergone Caesarean section due to
Group A 6.66 % patients had observed PPH non-progress of labour and fetal distress.
and 6.66% patients had observed Jwara. Group B
Grade of labour: In Group-A, 80% patients
6.66 % patients had observed PPH, 26.67% patients
achieved Grade 1, 13.33% achieved Grade 2, 6.66%
had observed Jwara (Table XVI)
patients undergone Caesarean section i.e. Grade 3. In
Discussion on Effect of Therapy: Group-B 40% achieved Grade 1, 33.33% patients
achieved Grade 2 and 20% patient undergone
Prasavakala: Maximum number of patients
Caesarean section. Grading was done on the basis of
i.e. 60% was delivered between 38 - 39 weeks of
pre-planned history sheet that depend on the
gestation. This is the natural period of gestational age

partogram, as in Group A Matra Vasti and Pichu expulsion of foetus.
might have helped in softening and relaxing the
Probable Mode of Action of Madhura
ligaments and fibrous tissues. So, time taken for
Aushadha Siddha Taila:
labour was less, and hence patients were delivered
under Grade 1. One Patient undergone LSCS, due to From a number of drugs, only eight drugs
non-progress of labour and premature rupture of were selected from Madhura Skandha for present
membranes. study. These drugs were selected due to their easy
availability and expected high degree of clinical
Effects of therapy on different Lakshanas:
effects. In this trial drugs were selected for the
In Group A 76.19% relief was observed in preparation of Madhura Aushadha Sidhha Taila.
Vibandh, 77.78% in Udarashoola, 58.33% in
The contents of Madhura Aushadha Siddha Taila
Katishoola, 62.50% in Daurbalyata, 52.17% in
are-
Kshudhavaishamya, 50% in Nidravaishmya,
57.14%% relief was observed in Shwetasrava and Ø As, the ingredients of Taila are Balya,
78.57% relief in Yonikandu. Brimhaneeya, Snehana, Garbhaposhaka, and
Rasayana properties provides strength to the
In Group B, 4.35% relief was observed in
Manspeshi of Garbhasaya and Yoni.
Kshudhavaishamya, 6.67% relief was observed in
Nidravaishamya and not defined any relief in other Ø Being Shoolhara and Vedanasthapana property
symptoms like Vibandha, Udarashoola, Katishoola, of Satavari9 and Ashwagandha10 plays important
Daurbalyata, Shwetasrava and Yonikandu. role in relieving backache and lower abdominal
pain.
Effect of therapy on the duration of stages of
labour: Ø Tila oil as a main ingredient maintains normal
vaginal flora physiology. It relieves in painful
In general the mean duration of first stage of
conditions of vagina. It controls the vaginal yeast
labour is 12 hours, whereas in the present trial, in
infection.
Group A, actual time taken was 7.07 hours, this
shows the highly significant effect of trial drugs. The Ø As the Moorcchita Tila Taila also has the
mean duration of second stage is 120 minutes, and properties of Moorcchana Dravyas-Manjistha,
actual time taken was 32 min, which shows Amalaki, Haritaki, Bibhitaka, Haridra, Lodhra,
statistically highly significant effect. The mean Twaka, Ketaka, Vata, Mustaka, so Madhura
duration of third stage is 30 minutes and an actual Aushdha Siddha Taila has the properties of
time taken was 6.67 min which shows highly Vedanasthapana, Deepana, Mutrala, Rasayana,
significant effect. Anulomana, Krimighna, Shothahara.
In Group B the mean duration of first stage Ø Hence when Madhura Aushadha Siddha Taila (a
of labour is 12 hours and actual time taken was 9.93 combination of all mentioned drugs) is used on
hours showing highly significant effect. The mean patient in the form of Anuvasana Vasti and Pichu
duration of second stage is 120 minutes and actual then that results in the combined effect of all
time taken was 43 minutes, which shows statistically these together.
highly significant effect. The mean duration of third
Ø The administration of Madhura Aushadha
stage is 32 minutes and actual time taken was 11
Siddha Taila Matra Vasti improves Snigdha
minutes which shows highly significant effect.
property in the mother’s body parts like
In Group A, Vasti by its nature caused abdomen, flanks, and sacrum and genital organs.
Vatanulomana and promoted Prasootimaruta to It also promotes the natural functioning of
expel the foetus in time without undue prolongation, Vyana-Vayu and prasutimarut and helps in
as the birth canal also become soft and smooth due Sukhaprasava.
to Vasti and Pichu helped in easily and timely

Probable Mode of Action of drug according to Department of Prasutitantra and Striroga, National
modern science: Institute of Ayurveda, Jaipur.
Uterine muscles are involuntary muscles. The

act of contraction and relaxation of uterus occurs in Reference
particular period only. In pregnant uterus, these 1 Charak samhita Vidyotini vyakhya, Kashinath
actions can be seen at the time of labour. pandey And Gorakhnath Chaturvedi, part –II, chikitsa
sthan 30/5, Reprint 2009 Chaukambha Bharati
Ø Colonic irrigation reduces the chance of Acadamy varanasi, Pp. 841
infections and allows labour in time without
2. Charak samhita Vidyotini vyakhya, Kashinath
premature rupture of membranes as infection is
pandey And Gorakhnath Chaturvedi, part –I, sharir
main cause of PROM. sthan 6/24, Reprint 2009 Chaukambha Bharati
Acadamy varanasi Pp. 906
Ø Pichu with Madhura Aushadha Siddha Taila
maintains the natural vaginal flora prevents from 3. Kashyapa samhita, with The Vidyotini hindi
infections the use of Pichu also helps in cervical cpmmentary and Hindi translation of Sanskrit
ripening by altering the cervical matrix releasing introduction, Srisatyapala Bhishagacharya, Ka.sa.khi
11/5, reprint 2013, Chaukhambha Sanskrit
prostaglandins which facilitates normal labour.
prakashan, varanasi Pp. 304
Ø The wholesome effect of Vasti act on nervous 4. Charak samhita Vidyotini vyakhya, Kashinath
system which helps to release natural oxytocin pandey And Gorakhnath Chaturvedi part –II ,chikitsa
from posterior pituitary as well as help in sthan 28/11, Reprint 2009 Chaukambha Bharati
increasing the oxytocin receptors. Acadamy varanasi, Pp. 778.
Prostaglandins are local hormone. 5. Bhaisajya Ratnavali by Kaviraj govindnath sen

Siddiprada hindi commentary, Prof.Siddhi Nandan
Prostaglandin helps in the process of parturition also
Mishra, Garbhinirogadhikar 68/57 Reprint 2011
effect on inflammation and immunity. Thus helps in Chaukambha Surbharti Prakashan varanasi, Pp.
easy labour, as prostaglandins facilitates labour here 1057.
this drug increases the permeability of membranes
makes cervix soft. All the components of drug also
pandey And Gorakhnath Chaturvedi, part –I, viman
improves the neurological functions which may help sthan 8/139, Reprint 2009 Chaukambha Bharati
to release oxytocin from pituitary so overall Acadamy varanasi, Pp. 789.
contributes in Sukhaprasava. During and after the
7. Bhaisajya Ratnavali by Kaviraj govindnath sen
trial no adverse event or side effects were occurred.
Siddiprada hindi commentary, Prof.Siddhi Nandan
Mishra, jwarrogadhikar 5/1268 Reprint 2011
Conclusion
Chaukambha Surbharti Prakashan varanasi, Pp. 206..
Ø This clinical trial shortened the first and second
stages of labour by having good effect on pandey And Gorakhnath Chaturvedi, part –I, sharir
ripening of cervix and stretching and relaxing of sthan 8/32, Reprint 2009 Chaukambha Bharati
vaginal canal and perineum in Group-A. Acadamy Varanasi, Pp. 939.
Ø In Group A one patient undergone Caesarian 9. Database of medicinal plants used in ayurveda,
Volume I, Edition 2007, Central Council for Research
section while in group B 3 patients were
in Ayurveda & Siddha, Deptt. Of ISM & H, Ministry of
undergone Caesarian.
Health & Family Welfare, Govt. Of India, Pp. 419
Acknowledgements: 1 0 . Database of medicinal plants used in ayurveda,
Volume III, Edition 2007, Central Council for Research
Authors are grateful to Dr. Ajay Sharma, the
in Ayurveda & Siddha, Deptt. Of ISM & H, Ministry of
then Director, National Institute of Ayurveda for his Health & Family Welfare, Govt. Of India, Pp.
encouragement and financial support. Thanks are
also due to Dr. Sushila Sharma, Head, P.G.

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ISSN No:2321-0435
ORIGINAL ARTICLE
Clinical Study on The Effect of Shatahvadi Dhumapana
with or without Pippali Rasayana in Peenasa With Special
Reference to Chronic Simple Rhinitis
*Dr. P. Narayanan, **Prof. Shamsa Fiaz
*Resident Medical Officer Govt. Ayurveda Medical College and Hospital, Kottar, Nagercoil-629002
**Prof. & HOD, PG Department of Shalakya Tantra, NIA, Jaipur
ABSTRACT
Chronic simple rhinitis, though not life threatening, is much troublesome and irritating disease
reducing the quality of life of an individual in day to day activity. Management of chronic simple rhinitis in
Allopathy is through antibiotics, nasal decongestants and nasal irrigations with alkaline solutions, which
provides symptomatic relief. Peenasa, mostly said to be synonymous to Pratishyaya, is more aptly the
chronic stage of Dushtapeenasa and can be correlated to chronic simple rhinitis. Ayurveda provides better
management of this disease.
In present study, 30 patients of Peenasa, (chronic simple rhinitis) were studied into two groups. In
group-I, patients were advised Shatahvadi Dhumapana and in group-II, patients were advised Shatahvadi
Dhumapana and Pippali Rasaayana orally. Better relief was observed in group II which received combined
treatment than group I which received only Shatahvadi Dhumapana therapy.
Key Words - Peenasa, chronic simple rhinitis,, Shatahvadi Dhumapana, Pippali Rasaayana.
How to cite this article : Narayanan P,

Fiaz S, Clinical Study on The Effect of Shatahvadi
Dhumapana With or Without Pippalirasayana
In Peenasa With Special Reference To Chronic
Simple Rhinitis, JOA XII-4, 2018; 41-47
Introduction
Peenasa is a Nasagataroga, i.e. a nasal

disorder explained by almost all Acharyas in
Website:- journalofayurveda.in Ayurveda. Though the term is more commonly taken
Address of correspondence: to be synonymous to Pratishyaya, 1 it is more
Dr. P. Narayanan specifically used to mean the advanced stage of
Resident medical officer Govt. Ayurveda Medical Pratishyaya. This differentiation is clear from the
College and Hospital, Kottar, Nagercoil-629002 explanation by Acharya Sushruta2 and also from the
Email:- [email protected] etymological meaning of the word (Peenam
Contact No:- 9442177150 Sthoolam Api naram syati nashayati iti). The main
symptoms of Peenasa are Nasarodha (nasal
Narayanan P, Fiaz S, Clinical Study on The Effect of Shatahvadi Dhumapana With or Without Pippalirasayana In
Peenasa With Special Reference To Chronic Simple Rhinitis, JOA XII-4, 2018; 41-47
obstruction), Nasashopha (swollen turbinates), coincidence can be found out from the planetary
Nasasrava (nasal discharge), Shirahshoola positions of the patients presenting with the
(headache) and Kaphotklesha (Post-nasal complaints of peenasa. Any coincidence, if proved,
3,4
discharge) These correlate with the symptoms of would help to advice the patients that are liable for
chronic simple rhinitis.5 the disease to take precautionary measures to avoid
serious affliction of the same.
Though this condition is not fatal, it is a
much disturbing and debilitating disease and it affects Aims And Objectives:
the quality of life to a great extent. Management of
l To clinically evaluate the efficacy of Shatahvadi
chronic simple rhinitis in Allopathy is through
Dhumapana in peenasa with special reference to
antibiotics, nasal decongestants and nasal irrigations
Chronic Simple Rhinitis.
with alkaline solutions, which provides symptomatic
relief. The symptoms generally reappear on the l To clinically evaluate the efficacy of combined
withdrawal of the drugs. Moreover, antibiotics are not effect of Shatahvadi Dhumapana and Pippali
recommended for prolonged usage which causes Rasayana in peenasa with special reference to
undesirable side effects. Nasal decongestants should Chronic Simple Rhinitis.
not be taken for more than five days and in case of
l To compare the results to suggest whether
continuous usage, may cause a condition called
Shatahvadi Dhumapana alone will be more
rhinitis medicamentosa, Therefore an alternative
effective in the control of chronic simple rhinitis
solution in Ayurveda is sought for, which provides
or the combination of Shatahvadi Dhumapana
relief from all the symptoms of the disease and also
and Pippali Rasayana is more effective in the
improve immunity thereby reducing the recurrent
above case.
attacks.
l To find out if any planetary or astrological
Dhumapana is a simple but much efficacious
correlation to the occurrence of peenasa as
treatment for Peenasa. Shatahvadi Dhuma is an
described in Veerasimhavaloka can practically
important and effective formulation mentioned in
be found and to suggest any preventive step
Ashtanga Hridaya for the management of Peenasa.6
based on the result.
So also, Rasayana is an important line of treatment
of Peenasa and the line of treatment of Dushta Material And Methods:
Peenasa is mentioned to be on the line of treatment
In the present study, 33 patients who were
of Rajayakshma.7 Pippali Rasayana is an important
attending the OPD and IPD of NIA, Jaipur with
Rasayana prescribed for Kapha predominant
clinical signs and symptoms of Peenasa with special
diseases in general and Peenasa in particular. 8
reference to chronic simple rhinitis were selected for
Therefore the effect of Shatahvadi Dhumapana alone
the study. This study was cleared by institutional
and the combined effect of Shatahvadi Dhumapana
ethics committee with letter no.F10(5)/EC/2014/
and Pippali Rasayana are studied and compared in
7224 dated 7-11-2014.
this trial.
Inclusion criteria:
In ancient times, Ayurveda was practised in
Patients suffering from three or more of the
consonance with other occult sciences like Jyotisha
following symptoms for more than three months
and Mantravada. Textual references of astrological
were selected for study.
integration is also found in many diseases. A book
named Veerasimhavaloka, which describes the 1 . Nasal obstruction
planetary correlation with occurrence of diseases 2. Nasal discharge
and their astrological management, is available in 3. Headache
print. Planetary coincidence for the occurrence of
peenasa is also described therein.9 An attempt was 4. Swollen turbinate
also be made to find out whether any such 5. Post-nasal discharge
The exact date, time and place of birth of the a day after meal with honey for 30 days
patients are also obtained if reliable data can be
Follow up study
presented by the patient.
Patients were asked to attend the O.P.D for
Exclusion criteria
one month for the follow up study
1 . Patients below 12 years and above 80 years
Criteria Of Assessment:
2. Pregnant women.
Both subjective and objective parameters
3. Patients with history of congenital disorders of were employed for the assessment of the effect of the
nose. treatment.
4. Patients suffering from gross deviation of nasal Subjective criteria include –

septum and associated with other nasal
1) Headache
pathology like nasal polyps, etc.
2) Post-Nasal Drip
5. Patients with uncontrolled systemic diseases like
3) Swollen Turbinates
diabetes mellitus and hypertension.
4) Nasal Obstruction
6. Rhinitis associated with hyperthyroidism,
exanthemas, adenoidal hyperplasia, choanal 5) Nasal Discharge
atresia and nasal tumors. Radiological and laboratory criteria include
7 . For the purpose of astrological assessment, the 1) TLC, DLC, ESR, TEC
patients who have no reliable data on the exact
2) X-Ray PNS Water’s view
date, time and place of birth were excluded.
Statistical Analysis
Withdrawal criteria:
The information regarding demographic data
The patients developed any side effect or
was given in percentage. The scoring of criteria of
could not follow the instructions given, were
assessment was analyzed statistically in terms of
withdrawn from the trial.
mean values of B.T. (Before Treatment), A.T. (After
Grouping of patients: treatment), S.D. (Standard Deviation) and S.E.
(Standard Error). The results obtained were
i) Group-I: 16 patients of Peenasa (Chronic
considered Significant for p value <0.01 and
Simple Rhinitis) were advised Shatahvadi
insignificant for p value>0.05.
Dhumapana alone. 15 patients completed the course
of treatment and one patient left against medical In individual I and II group – Wilcoxon
advice. matched pairs signed ranks test were performed for
nonparametric data.
ii) Group 2: 17 patients of Peenasa
In intergroup comparison between I and II
(Chronic Simple Rhinitis) were advised Shatahvadi
group - Mann Whitney test for nonparametric data.
Dhumapana once a day and Pippali Rasayana
(orally). 15 patients completed the course of Observation And Results:
treatment and 2 patients left against medical advice. Total 33 patients were registered in clinical
Drugs and posology: study; amongst them 30 patients completed the
treatment and 3 patients discontinued the treatment.
i) Shatahvadi Dhumapana: Three puffs So some important observation of 33 patients and
each in each nostril, three times continuously with results of 30 patients are given below-
two sittings of 7 days with interval of 7 days
Observation:
ii) Pippali Rasayana:: 5gms. Three times
l Maximum number of patients were in the of age
group of 32-41 years (27.27%), females (54.55%), l Majority of patients had perenniel of disease
married (69.7%), Hindu (69.7%), educated up to (42.43%)
secondary (39.4%) belonged to middle class
l DNS was present in 36.36% patients, tenderness
(69.7%), vegetarians (78.79%), housewives
of sinuses in 97.97% patients ,and haziness over
(39.4%) and urban (90.91%) Majority of patients
maxillary sinus area in X-Ray of PNS in 90.91%,
had Vata-Kaphaja (33.3%), and Rajasa Prakriti
(63.64%). l All had haziness over any part of the sinuses in
varying orders, 93.94% had nasal discharge,
l Majority of patients had Vishama Dietetic habits
75.76% had nasal obstruction, 69.7% had
(66.67%), addictions like smoking and alcohol
headache and 36.36% each had nasal obstruction
(78.79%), medium appetite (54.55%) and sound
and swollen turbinates.
sleep (65.90%).
l Regarding astrological data, only 4 patients had
l Maximum number of patients showed
their exact date and time of birth readily
Madhyama Vikrti, Sara, Samhanana, Pramana,
available with them. Therefore further studies on
Sattva, Satmya i.e. respectively 60.61%, 72.73%,
the same could not be carried out with such a
63.64%, 72.73%, 72.73%% and 75.76%
meager data.
respectively.
Results:
Table No. I: Showing effect of therapy in subjective parameters in Group-I (Wilcoxon

matched paired single ranked test)
Sl. Symptoms Mean Dif. % of SD SEM W p Results

No B.T. A.T. Change value
1. Headache 1.330 0.600 0.73 54.89 0.704 0.182 45 0.0039 S
2. Post-Nasal Drip 0.733 0.267 0.467 63.71 0.516 0.133 28 0.0156 S
3. Swollen Turbinates 0.667 0.400 0.267 40.02 0.458 0.118 10 0.1250 NS
4. Nasal Obstruction 1.333 0.333 1.000 75.18 0.756 0.195 66 0.001 S
5. Nasal Discharge 1.533 0.333 1.200 78.28 0.676 0.174 91 0.0002 S
SD: Standard deviation, SEM: Standard error of mean, W: Wilcoxan Sign, S: Significance, NS: Non Significance
Table No. II Effect of Therapy In radiological and Laboratory Parameters in Group-I

(Student’s Paired ‘t’ test)
Sl. Investigation Mean Dif. % of SD SEM t p Res-

No. Parameter B.T. A.T. Change Value value ults
1. Haziness in X-Ray 5.4 3.2 2.2 40.74 0.941 0.243 9.054 <0.0001 S
2. ESR 21.667 12.533 9.134 42.16 10.12 2.613 3.495 0.0036 S
3. TLC 7106.7 6820 286.7 4.02 1523.6 393.38 0.729 0.4782 NS
4. Eosinophil % 3.6 3.267 0.333 9.25 3.374 0 . 1 3 7 0.3827 0 . 7 0 7 7 NS
5. TEC 264.8 218.67 46.13 17.42 0.51 0.114 0.7283 0.4784 NS

Table No. III: Effect of Therapy in Subjective Parameters in Group-II (Wilcoxon matched
paired single ranked test)
Sl. Symptoms Mean Dif. % of SD SEM W p Results

No B.T. A.T. Change value
1. Headache 1.533 0.467 1.066 69.6 0.704 0.182 78 0.0005 S
2. Post-Nasal Drip 0.6 0.2 0.4 66.67 0 . 5 0 7 0.131 21 0.0313 S
3. Swollen Turbinates 0.4 0.133 0.267 66.67 0.594 0.153 6 0.25 NS
4. Nasal Obstruction 1.0 0.2 0.8 80.0 0.715 0.2 45 0.0039 S
5. Nasal Discharge 1.733 0.133 1.6 92.33 0.507 0.131 120 <0.0001 S
Table No. IV: Effect of Therapy in Radiological and Laboratory Parameters in Group-II
(Student Paired ‘t’ test)
Sl. Investigation Mean Dif. % of SD SEM t p Res-

No. Parameter B.T. A.T. Change Value value ults
1 Haziness in X-Ray 6.267 1.533 4.734 75.54 1.751 0.452 10.468 <0.0001 S
2 ESR 11.933 11.333 0.6 5.02 10.568 2.729 0.2199 0.8291 NS
3 TLC 6313.3 5753.3 560 8.87 743.35 191.93 2.918 0.0112 S
4 Eosinophils % 4.133 3.2 0.933 22.57 1.751 0.452 2.064 0.0580 NS
5 TEC 271.53 195.93 75.6 27.84 121.60 31.397 2.408 0.0304 S
Table No. V: Intergroup comparison of subjective parameter of Peenasa

(Mann-whithey U test)
Sl. Symptoms Mean of Grp. SD of Grp. SEM of Grp. U p Res-
No A B A B A B value ults
1 Headache 0.733 1 . 0 6 7 0.704 0.704 0.182 0.182 141 2.054 NS
2 Post-Nasal Drip 0.467 0.4 0.516 0.507 0.133 0.131 120 0.7353 NS
3 Swollen Turbinates 0.267 0.267 0.458 0.594 0.118 0.153 118 0.7782 NS
4 Nasal Obstruction 1.0 0.8 0.756 0 . 7 7 5 0.195 0.2 134.5 0.4768 NS
5 Nasal Discharge 1.2 1.6 0.676 0 . 5 0 7 0.175 0.131 148.5 0.0992 NS
SD: Standard deviation, SEM: Standard error of mean, S: Significance, NS: Non Significance

Table No. VI: Intergroup Comparison of X-Ray and Laboratory Parameters of Peenasa
S Parameter Mean of Grp. SD of Grp. SEM of Grp. t p Res-
No A B A B A B Value value ults
1. Haziness in X-Ray 2.2 4.733 0.941 1.751 0.243 0.452 4.935 < 0.0001 S
2. ESR 9.133 0.6 10.12 10.568 2.613 2.729 2.259 0.0322 S
3. TLC 286.67 560 1523.6 743.35 393.38 191.93 0.6245 0.5394 NS
4. Eosinophils 0.333 0.933 3.374 1.751 0.871 0.452 0.6114 0.5475 NS
5 TEC 46.133 75.6 245.33 121.6 63.343 31.397 0.4168 0.6813 NS
SD: Standard deviation, SEM: Standard error of mean, S: Significance, NS: Non Significance
Table No. VII: % wise Improvement of Signs and Symptoms in Both Groups
S.N. Cardinal Symptoms Result In Percentage
Group-I Group-Ii
1 Headache 54.89 S 69.6 S
2 Post-Nasal Drip 63.71 S 66.67 S
3 Swollen Turbinates 40.02 NS 66.67 NS
4 Nasal Obstruction 75.18 S 80.0 S
5 Nasal Discharge 78.28 S 92.33 S
S: Significance, NS: Non Significance

Conclusion:
Discussion:
l The disease Peenasa which is described in
Effect of Therapy on Assessment Criteria: Ayurvedic classics can be correlated to chronic
simple rhinitis.
Statistically significant relief was found in
nasal discharge in both groups. The relief in nasal l Chronic stage of non-specific rhinitis is known as
obstruction was significant in Group-I and Group- chronic simple rhinitis and if the condition is left
II. Headache showed statistically significant relief in untreated it may lead to several health hazards.
Group-I and Group-II. The relief in post-nasal drip
l The term Peenasa is mostly used in the context
was statistically significant in both the groups, but
of advanced stage of Dushta Pratishyaya.
there was insignificant relief in swollen turbinates in
both the groups. l Dhumapana is an important treatment modality
indicated for all types of Urdhvajatrugata
Inter Group Comparison:
Rogas, especially in Peenasa.
In comparative study over criteria of
l Shatahvadi Dhumavarti is an important and
assessment, statistically insignificant difference was
efficacious formulation for Dhumapana.
observed between two therapies in all assessment
criteria. l Rasayana is an important treatment

recommended in all debilitating diseases. It is References:

also highly beneficial in Peenasa as it gives not
1. Amarasimha. Amarakosha. Guruprasad Shastri Sri
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Samskritha Samsthan; 2013, Uttara Tantra. 24, 16-
discharge in both groups. The relief in nasal
17:652.
obstruction was extremely significant in Group-
I and Group-II. Headache showed statistically 3. Ibid. Uttara Tantra. 24, 10-11: 651
significant relief in Group-I and Group-II. The 4. Vriddha Jivaka. Kashyapa Samhita with Vidyodini
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Chikitsadhyaya, 6 :130-132
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6. Acharya Vagbhata, Ashtanga Hridaya with Sarvanga
than Shatahvadi Dhumapana alone.
Sundara and Ayurveda Rasayana Commentaries Ed.
l The symptoms like headache and nasal discharge Hari Sadashiva Shastri; 2002. Chowkhamba
Surabhatrati Prakashan, Uttara Sthana.20,9-10: 844
had better improvement with the combined
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Thus it can be concluded that this combined 8. Acharya Charaka, Charaka Samhita with Ayurveda
Deepika and Jalpakalpataru Commentaries Charaka,
treatment is effective in management of Peenasa
ed. Kaviraj Shree Narendranath Sengupta and Kaviraj
with special reference to chronic simple rhinitis
Shri Balaichandra Sengupta, Edn. 3rd; 2009,
Chowkhamba Orientalia, Chikitsasthana 1(iii)/33-35:
231
9. Raja Veerasimha Tomara, Veerasimhavaloka, Sri

Radhakrishna Parashara, Krishnadas Academy,
Chowkhamba, 2nd Edition : 51
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ISSN No:2321-0435
ORIGINAL ARTICLE
A Comparative Study of two samples of Kushmand Khand in
Amlapitta: A prospective randomized control trial
*Dr. Sangeeta Pareek, **Dr. Jagriti Sharma, ***Dr. Mohar Pal Meena, **** Dr. Rajendra Prasad Sharma
*Medical officer NHM, Barmer Rajasthan.
**Ph.D. Scholar, ***Asst. Professor, ****Assot. Professor
Dept of Rasa Shastra & Bhaishajya Kalpana, NIA, Jaipur
ABSTRACT
From stone-age to space age food pattern of people has undergone numerous changes.These changes
have been always for the better aspect of life. Most of the vikara are deeply rooted in underprivileged dietary
habits like Ajirne Bhojana, Akale Bhojana, Akale Anshana, Virudha Bhojana, Atimatrasy Amla, lavana, Katu
Rasa Sevanam etc; improper life style like Vegvidharana, Divaswapa, Ratri Jagrana etc; and Mansik Bhavas
like Chinta, shoka, bhaya, krodha etc. and amlapitta is one of them. Keeping this in mind it was decided to
carry out clinical trial on 30 patients presenting classical signs and symptoms of Amlapitta. The patients
were selected irrespective of their age, sex, religion etc. Selected patients were divided into Group A and
Group B respectively and treated by Kushmanda Khanda prepared using ghrita (KKG) and Kushmanda
Khanda prepared without using Ghrita (KKW). In group A and B there were 15 patients in each. The results
were analyzed on the basis of improvement in cardinal, associated signs and symptoms. Statistically analysis
between Group A and Group B for the observation parameters Avipaka, Aruchi, Utkelesh, Tikta-Amlodgara,
Gaurava, Klama, Chhardi and Shirhshula found no significant changes and it showed that the relief % of
both Groups were closely similar. But in observation parameter of Daha the difference value of group A is
higher than group B. It shows that group A has higher relief as compare to group B.
Keywords: Khushmanda Khanda, Acidity, Avalehya, Bhaishajya kalpana
Quick Response Code: How to cite this article : Pareek S, Sharma

J, Meena MP, Sharma R P, A Comparative Study of
two samples of Kushmand Khand in Amlapitta: A
prospective randomized control trial, JOA, XII-4,
2018; 48-55
Introduction
In the present era stress has taken a toll on

Website:- journalofayurveda.in human life. Amlapitta is a common disease which
Address of correspondence: has its root cause in hurry, worry and curry. It is
Dr. Sangeeta Pareek, Shri Ram pareek Bhawan one such worldwide disease born as a result of
Street no 2, Gandhi Nagar, Barmer 344001 (Raj) various ups and downs during human’s life span.
Email:- [email protected]
Contact No:- 9414564382 Amlapitta is not considered as a separate
disease in Bruhatatrai but is mentioned as a symptom
Pareek S, Sharma J, Meena MP, Sharma R P, A Comparative Study of two samples of Kushmand Khand in Amlapitta:
A prospective randomized control trial, JOA, XII-4, 2018; 48-55
in number of places by Acharya Charaka. Acharya Ø Study Type : Interventional

Kashyapa was the first to give a detailed description
Ø No. of Group : Two
of the disease 1 and analyzed it on Doshika basis,
whereas Acharya Madhavakara has described the Ø No. of patient : 30
disease in detail and classified it on the basis of Gati2
Ø Treatment period : 30 days
i.e. Urdhvaga Amlapitta and Adhoga amlapitta.
Amlapitta can be correlated with acid reflux Ø Follow-up period : 15 day
syndrome which comprises of various types of
Inclusion criteria
gastro-oesophageal reflux diseases like gastritis,
dyspepsia, heartburn, hyperacidity, hypoacidity etc. 1 . Patients between the age group of 16 to 60 years.
described in modern sciences.
Now a day’s heart burn, reflexes of food 2. Patients having the classical signs and symptoms
taken, loss of appetite, abdominal pain sour belching, of Amlapitta like Avipaka, Klama, Utklesha,
nausea etc. has become very common complain to Tikta amlodgara, Daha, Chardhi, Shirah shula,
visit hospital. By taking antacids the person Gaurava, Aruchi etc.
neutralizes acid which is the first line of immunity
Exclusion criteria
and becomes more prone to various infections.
While in Ayurveda we concentrate more on Agni 1 . Patients below 16 yrs. of age and above 60 yrs.
Vraddhi and Aam pachana by various mean. of age.
The drug selected under the study 2. Patients suffering from Amlapitta along with
Kushmanda Khanda is described in Bhavaprakash other diseases like diabetes, Tuberculosis, heart
Uttarardh Madhyam Khanda Amlapitta Shleshmpitt diseases etc.
Adhikara3 and Raktapitt Adhikara 4 with ingredients
3. Patients suffering from Amlapitta for more than
Kushmanda Swarasa, Amalaki Churna, Sugar,
5 years.
Godugdha and Goghrita. Clinical efficacy is the
ultimate expectation from drug, hence present study 4. Patients suffering from Annadravashula and
was planned to evaluate the comparative efficacy of Parinama shula.
Kushmanda Khanda prepared by two different
classical references. Drug intervention
Aims and objectives - Dose : 12gm.
1 . To assess the efficacy of Kushmanda Khanda in Dosage form : Granules

the management of Amlapitta. Route of Administration : Oral
2. To compare the relative efficacy of Kushmanda Time of Administration : Twice daily
Khanda prepared with using Ghrita (sample KKG)
and without using Goghrita (Sample KKW) in the Anupana : Luke warm water
management of Amlapitta. Duration of therapy : 30 Days
Materials & Methods- Division in groups
Selection of patients Group A-15 patients : Sample KKG
Thirty patients irrespective of their sex, Group B -15 patients : Sample KKW
occupation, religion, socio economic status etc. were
selected from the O.P.D. and I.P.D. of National Note: Patients were guided regarding Pathya/
Institute of Ayurveda, Jaipur (Rajasthan). Apathya regimen by the Investigator.
Design of study Assessment Criteria-

During the Trial and Follow up, patients were to Amlapitta like Avipaka, Daha, Utklesha etc.
assessed in accordance with the following
Laboratory Investigations-
parameters-
All feasible investigations namely R.B.S.,
Subjective Parameters-
C.B.C., E.S.R.; and Urine-routine and microscopic
Improvement was observed according to the examination were done before the administration of
specially designed criteria’s that were made related the medicine to rule out other diseases.
Scoring pattern
Table No. I Grading for Amlapitta
S.No. Features Grading Score
1 Avipaka G0-No Avipaka 0
G1- Avipaka for a small time and feeling proper hunger 1
G2-Avipaka for a small time but not feeling hunger 2
G3-Feeling of heaviness and indigestion throughout the 3

day and symptoms occurring daily.
2 Aruchi G0-Normal appetite 0
G1-Unwelling to take food but eat 1
G2-Intake of food decreases 2
G3-No interest to intake food 3
3 Utklesh G0-Absent 0
G1-Feeling nausea occasionally 1
G2- Feeling nausea regular after taking meal 2
G3- always present and come gastric content in mouth 3
4 Tikta Amlodgara G0- Absent 0
G1- occasionally present after lunch or dinner 1
G2- present most of the time after taking lunch or 2

dinner and after digestion/vaman shanty
G3- always present 3
5 Daha G0- Absent 0
G1-Mild daha present 1
G2-Madhyam daha which mitigated by vamana or 2

intake of milk
G3- .Severe daha which cannot mitigated by vamana 3

6 Chhardi G0-Absent 0
G1-.Feeling nausea 1
G2-Occasionally present 2
G3- Regular vamana 3
7 Shirshshula G0-Absent 0
G1- occasionally present 1
G2- present most of the time 2
G3-Always present 3
8 Gaurava G0-Absent 0
G1-Feeling heaviness but less than 6 hrs. 1
G2- Feeling heaviness for more than 6 hrs. 2
G3- Feeling always heaviness 3
9 Klama G0- Absent 0
G1-Without any hard work in day time feeling fatigue at 1

evening time
G2- Without any hardwork in whole day and night feeling 2

fatigue in morning
G3-Every time feeling fatigue and no any desire of work 3
Statistical Analysis patients.

Analysis between Group A and Group B on Distribution based on Aaharaja nidana
objective parameter for inter group had been done
by Student T Test (paired) and non parametric data Maximum number of patient’s i.e.56.66%
by Mann-Whitney test with the help of Graph Pad had Virudhashana followed by Adhyasana and Guru
Prism 6 software. For intra group comparisons, for Bhojana i.e. 13.33% and 10%.
the nonparametric variables wilcoxon paired test Distribution based on Viharaja nidana
was used for statistical analysis.
Maximum number of patients i.e. 63.33%
Non-significant : P >0.05 were had Vega Dharana Viharaj Nidana followed by
Significant : P <0.05 Buktwa Divasvapna andUpavasa i.e.23.33% and
13.33% of total patients.
Highly significant : P < 0.01
Distribution based on Maanasik Bhava Janya
Observations and Results: Nidana
Main symptom wise distribution Maximum number of patients i.e. 50% had
In the present study, Tikta amlodgara, Chinta Manasik Nidan followed by Krodha and
Utklesh, Avipaka and Gaurava was observed in all Shoka Manasik Nidan i.e. 23.33% and 13.33% of total
the patients. Shira Shoola was found in 60 % patients patients.
and klama and Daha was observed in 86.67 %
Results of therapies
Statistical Analysis of Group A
Table NoII: Showing statistical Analysis
Group A BT AT Diff Relief % S.D S.E.M P Value Sig.
Avipaka 2.13 1.13 1.00 46.94 0.9258 0.3651 0.0054 S(**)
Aruchi 1.80 1.00 0.80 44.44 0.6761 0.3073 0.0019 S(**)
Utklesh 1.87 0.87 1.00 53.47 0.7559 0.3333 0.0074 S(**)
Tikta Amlodgar 1.93 0.73 1.20 62.17 0.8619 0.2582 0.0015 S(**)
Daha 1.80 1.00 0.80 44.44 0.6761 0.2582 0.0037 S(**)
Chhardi 0.00 0.00 0.00 0.00 0.0000 0.0000 ———
Shirhshula 0.53 0.33 0.20 37.73 0.4140 0.2108 0.5361 N.S.
Gaurava 1.47 0.80 0.67 45.57 0 . 7 2 3 7 0.2582 0.0306 S(*)
Klama 1.07 0.53 0.53 49.53 0.8338 0.3416 0.0234 S(*)
Significant **More Significant

This table depicts the effect of the research drug KKG had been observed on the patients of Group A.
It shows that its effect was significant on Avipak (P value = 0.0054), Aruchi (P value = 0.0019), Utklesh (P
value = 0.0074), Tikta amlodgar (P value =0.0015), Daha (P value = 0.0037), Gaurava (P value =0.0306),
Klama (P value = 00234) and effect on Chhardi, Shirhshula were found not significant.
Statistical Analysis of Group B
Table No III Showing statistical analysis
Group B BT AT Diff Relief % S.D S.E.M P Value Sig.
Avipaka 2.20 1.13 1.07 48.48 0 . 7 0 3 7 0.1817 0.0035 S(**)
Aruchi 2.07 1.13 0.93 45.16 0.8837 0.2282 0.0026 S(**)
Utklesh 1.87 0.93 0.93 50.00 0.8837 0.2282 0.0079 S(**)
Tikta Amlodgar 1.87 0.87 1.00 53.57 1.0000 0.2582 0.0046 S(**)
Daha 1.00 0.80 0.20 20.00 0.4140 0.1069 0.0039 S(**)
Chhardi 0.00 0.00 0.00 0.00 0.0000 0.0000 ———
Shirhshula 1.20 0.87 0.33 27.78 0.6172 0.1594 0.6076 N.S
Gaurava 1.73 0.87 0.87 50.00 0.9904 0.2557 0.0143 S(*)
Klama 1.33 0.73 0.60 45.00 0.8281 0.2138 0.0359 S(*)
This table depicts the effect of the research drug (KKW) had been observed on the patients of Group
B. It shows that its effect was significant on Avipaka (P value = 0.0035), Aruchi (P value= 0.0026), Utklesh
(P=value 0.0079), Tikta amlodgar (P value=0.0046), Daha (P value= 0.0039), Gaurav (P value=0.0143),
Klama (P value = 0.00359) and effect on Shirhshula was found non -significant.

Table No VI Inter group comparison between Group A and Group B
S. No. Group A vs. Group B Group A Group B P Value Sig.
1 Avipaka 1.00 1.07 0.7449 N.S
2 Aruchi 0.80 0.93 0.8131 N.S
3 Utklesh 1.00 0.93 0.7727 N.S
4 Tikta Amlodgar 1.20 1.00 0.5087 N.S
5 Daha 0.80 0.20 0.0157 S
6 Chhardi 0.00 0.00 —- —-
7 Shirhshula 0.20 0.33 0.4270 N.S
8 Gaurava 0.67 0.87 0.7606 N.S
9 Klama 0.53 0.60 0.3594 N.S
This table show the inter group comparison between Group A and Group B. Observation parameters
Avipaka(p value=0.7449), Aruchi(p value=0.8131), Utklesh(p value=0.7727), Tikta amlodgara(p
value=0.5087), Shirhshula (p value=0.4270), Gaurava (p value=0.7606), Klama(p value=0.3594) shows
non-significant changes. No significant changes denote that both Groups have closely similar relief.
Daha observation parameter is statistically significant (p value=0.0157).It shows that Group A shows
better relief in Daha than Group B.
overall effect of drug on patients compare to their

Overall Effect of Therapy: before treatment observation parameters score.
The grading percentage has been defined as Complete Relief - 76-100%

the ratio of difference % of individual patient of Moderate Relief - 51-75%
before treatment to after treatment observations
Mild Relief - 26-50%
multiply by hundred. This grading confirms the
No Relief - 0-25%
l In Group A 68% of patients had relief. Out of Probable mode of action of Kushmanda
which 30% of patients had mild relief, 8% had Khanda
moderate relief and 30% of patient had complete
Some contents of Kushmanda Khanda are
relief.
laghu and Ruksha in property. There is increase of
l In Group B 58.66 % of patients had relief. Out of Drava Guna in Amlapitta. Kledaka Kapha and
which 18% of patients had mild relief, 14% had Pachaka Pitta are drava in dominancy. So laghu-
moderate relief and 26.66% of patients have Ruksha Guna performs the function of Dravansha -
complete relief. Shoshana. Other functions of laghu – Ruksha Guna
are lekhana, Stambhana and Ropana. Kashaya Rasa
Discussion
tones up the tissues and hastens healing of ulcers.
Formulation was in the form of Avaleha but Amalaki being of Kashaya rasa might be rapidly
we prepare granules with following reasons: healing the ulcers and toning up the gastric and
duodenal mucosa making them more resistant
l To make more palatable.
against the action of acid. This procedure might be
l To enhance the self-life of drug. responsible for normalization of the acid output and
increase of mucin levels in the gastric juice. Besides
l To make much attractive.
giving relief from symptoms the drug had also
l To decide proper dose imparted Rasayana effects. Whether this
phenomenon is due to correction of the pathology
Lukewarm water had been chosen for
or due to the claimed Rasayana effects of the drug
Anupana because lukewarm water enhances the
as described in Ayurvedic texts is not certain, but
dissolution and disintegrations of drug and Acharya
the effect is there. Probably both the factors may be
Charaka indicates pacification of Amlapitta in
operating. Amalaki has been considered as one of the
Dugdha gunas5. It is believed that milk is capable of
fore most Rasayana drugs imparting a long healthy
providing a soothing and protective layer in the
life. Properties of Kushmanda i.e. Sheeta Virya,
stomach and esophagus, protecting sensitive tissue
Guru, Snigdha and Madhura Rasa are opposite to
from the harmful acid reflux. But, the fatty part of
Gunas of Pitta so act as Pitta Shamaka.
the milk is capable of creating further acidity which
is why non-fat milk is the preferred method when Conclusion
trying to combat the acidity of the stomach6 .
The pharmaceutical processing of
Statistically analysis between Group A and Kushmanda Khanda is easy and economic. Sample
Group B for the observation parameters Avipaka, KKG have good antacid capacity than sample KKW
Aruchi, Utkelesh, Tikta-Amlodgara, Gaurava, which was confirmed in clinical trial. In
Klama, Chhardi and Shirhshula were found not observational parameters i.e. Avipaka, Aruchi,
significant changes. It show that the relief % of both Tikta-Amlodgara, Utkelesh, Daha, Gaurava and
Groups were closely similar and in observation Klama, both samples had shown statistically
parameter Daha the difference value of group A is significant changes at various stages of trial i.e. before
higher than group B. It show that group A have treatment, at fifteen days follow up and after
higher relief % on Daha as compare to group B. treatment. The results comprise that KKG
Difference in the relief percentage of group A and B formulation is better than KKW due to addition of
may be due to variation in the ingredients of sample Ghrita having Pitta Shamaka property. Above study
KKG and KKW mentioned in the Bhava prakash concludes that Kushmanda Khanda can be easily
Uttrardha Madhayam Khanda in reference of utilized as an effective medicine for the treatment of
treatment of Amlapitta. Amlapitta.

References-
1. Pt. Hemraja Sharma, Vidyotini Hindi commentary,
Kashyapa Samhita, Chaukhamba Sanskrit Sasthan,
Varanasi (2010),Kash.Kh.16,pg.no.335
2. Madhavanidanam, Madhavacharya, ‘Madhukosha’

Vyakhya by Acharya Yadunandana Upadhya,
Chaukhamba Pakashan, Varanasi (2004), part 2,51/
1,page no.170
3. Bhavaprakasha, ‘Vidyotini’ commentary by Bramha

Shankar Mishra, Chaukhamba Sanskrit
Academy(2002), B. P.vol-2, Cha.10/20-22

Shankar Mishra, Chaukhamba Sanskrit
Academy(2002), B. P.vol-2, Cha.9/72-74

Shankar Mishra, Chaukhamba Sanskrit Academy
(2002), B. P.vol-2, Cha.9/72-74

Shankar Mishra, Chaukhamba Sanskrit Academy
(2002), B. P.vol-2, Cha.10/20-22
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ISSN No:2321-0435
ORIGINAL ARTICLE
Clinical Study on the Effect of An Ayurveda Formulation In
The Management of Medodushti W.S.R. To Dyslipidaemia
*Dr. Shashi Choudhary, **Dr. Udai Raj Saroj, ***Dr. Harish Bhakuni
*Ayurveda Medical Officer, Govt. Ayurveda Hospital, Chomu, Jaipur, ** Associate Professor, *** Assistant Professor
P. G. Department of Kayachikitsa, NIA, Jaipur
ABSTRACT
Purpose: The World Health Organization estimates that Dyslipidaemia is associated with more than
half of global cases of ischemic heart disease and more than 4 million deaths per year. World Health
Organization (WHO) in 2002 reported that high cholesterol level is one of the main non-communicable disease-
related risk factors in India. As described in Ayurveda, Medodushtijanya sign & symptoms shows strikingly
resemblance with Dyslipidaemia explained in modern text. While treating the Medodushti, selection of Dravya
should have criteria that help in Lekhana of excessive Meda-Kapha without Vayu-Prakopa & normalising
the Agni both at the level of Jatharagni & Dhatwagni. Method: In this clinical study, 50 clinically diagnosed
patients were registered and divided into two groups with 25 patients in each group. In group A, patients
were administered Ayurveda formulation in dose of 2 tab. (500 mg each) twice in a day (2gm/day) with
lukewarm water for 60 days. In group B, 25 patients were administered Capsule Shuddha Guggulu (extract)
in dose of 1 capsule twice in a day (500 mg/day) for 60 days with lukewarm water. Result: The results
were highly significant (p value < 0.001) in both subjective parameters i.e. Pipasadhikya, Daurbalya,
Swedadhikya, Kshudrashwasa, Angasadaa as well as objective parameters i.e. body weight, B.M.I., Waist-
hip Ratio, Waist-height Ratio & Lipid profile in both groups. On intergroup comparison statistically non-
significant difference was found in all subjective & objective parameters of both groups, except Body weight
where in Group A was quite significant than Group B
Quick Response Code: (p value < 0.05). So, both the therapies have almost
similar effect on all the parameters assessed.
Conclusion: From the observation & result, it can
be concluded that Ayurveda formulation can be used
effectively in the management of Dyslipidaemia & its
results are comparable and even better with that of
Shuddha Guggulu.
Website:- journalofayurveda.in Key Words: Medodushti, Dyslipidaemia,

Address of correspondence: Ayurvedic formulation, Shuddha Guggulu.
Dr. Shashi Chaudhary
Ayurveda Medical Officer How to cite this article : Choudhary S,
Govt. Ayurveda Hospital, Chomu, Jaipur, Saroj U R, Bhakuni H, Clinical Study on the Effect
Email- [email protected] of An Ayurveda Formulation In The Management
Mobile : 759700240 of Medodushti W.S.R. To Dyslipidaemia, JOA XII-
4 2018; 56-65

Choudhary S, Saroj U R, Bhakuni H, Clinical Study on the Effect of An Ayurveda Formulation In The Management
of Medodushti W.S.R. To Dyslipidaemia, JOA XII-4 2018; 56-65
Introduction: Dyslipidaemia in India is one of the main causes for

Coronary Artery Disease (CAD) mortality.The
During last centuries, life style alteration has
management of Dyslipidaemia is directed at the
been characterised by increased calories, fat intake
identification of those at high risk of cardiovascular
& reduction in physical activities along with a
disease and the primary prevention and secondary
dramatic increase in non communicable diseases
prevention of cardiovascular disease by the
(NCDs). Cardiovascular diseases account for most
management of all risk factors, including smoking,
NCD death of 17.5 million people annually. Raised
hypertension, diabetes and obesity.
Blood Pressure, increased Blood Glucose, elevated
Blood Lipids and Obesity are ‘intermediate risk As described in Ayurveda, Medodushtijanya
factors’ which can lead to Cardiovascular disease, a Sign & Symptoms shows strikingly resemblance with
NCDs. The epidemiology and economics of Dyslipidaemia explained in modern text. According
Dyslipidaemia is extensive and it is closely linked to to Ayurveda, Nidana for Medo Dhatu Dushti is
the pathophysiology of CVD and a key independent excessive intake of Shleshma Vardhak Ahara-
modifiable risk factor for Cardiovascular disease. Vihara and reduced exercise causes Agnidushti
Dyslipidaemia is a disorder of lipoprotein resulting in excessive formation of Sama Meda. Thus
metabolism, which can include overproduction or it presents as “Medovriddhi and Medodushti”.
deficiency of lipoproteins or both. The disorder can
Medodushti involvement have been seen in
manifest as an elevation of plasma cholesterol,
pathogenesis of various disease for e.g. in Prameha,
Triglycerides, or both, or alow high density
there is ‘Bahu Abaddha Meda Dhatu’ and in obesity
lipoprotein level or all three together that contributes
there is Sthoola Rupa of Meda Dhatu Dushti/Vriddhi.
to the development of atherosclerosis. High-density-
That can be considered as Baddha of Medo Dhatu.
lipoprotein (HDL) cholesterol however confers
Meda Dushti mentioned in Prameha & Sthaulya in
protection. Generally the risk of CHD rises as the
Ayurveda, can be considered as Dyslipidaemia. It
ratio of total cholesterol to HDL-cholesterol
should be treated on the lines of management of
(TC:HDL-C) rises. Dyslipidaemia may be related to the
Medoroga and Prameha.
other diseases (Secondary Dyslipidaemia) or to the
interaction between genetic predisposition and Materials & Methods
environmental factors.
A) Aims & objectives:
In India, there has been an alarming increase
The present clinical trial has been
in the prevalence of CVD over the past two decades
undertaken with the following three
so much accounting for 24% of all deaths among
objectives:
adults aged 25–69 years. 1 The World Health
Organization estimates that Dyslipidaemia is Ø Conceptual & clinical studies on Medodushti &
associated with more than half of global cases of Dyslipidaemia.
ischemic heart disease and more than 4 million
Ø To evaluate clinical efficacy of Ayurvedic
deaths per year.2 World Health Organization (WHO)
formulation made up of Daruharidra, Devdaru,
in 2002 reported that high cholesterol level is one
Musta, Amalaki, Haritaki, Vibihitaka in the
of the main non-communicable disease-related risk
patients of Dyslipidaemia (Medodushti).
factors in India.3 Almost one third of the population
of developed countries is detected to be having Ø To compare the efficacy of selected Ayurvedic
Dyslipidaemia; however, prevalence varies formulation and Capsule Shuddha Guggulu in
depending on ethnic group studied. There is a wide Dyslipidaemia (Medodushti).
variation in the prevalence of Dyslipidaemia in India
B) Selection of cases:
depending on habitat, socioeconomic stratum and
lifestyle practices. South Asians are facing growing The study was conducted on 50 clinically
“epidemics” of Obesity and Dyslipidaemia. Diabetic diagnosed & confirmed patients of Medodushti

(Dyslipidaemia) on the basis of subjective & objective stroke within 3 months of Study, Uncontrolled
parameters. Patients were randomly selected from Hypertension (Diastolic Blood Pressure > 100
OPD & IPD of Aarogyashala, P.G. Department of mmHg), Uncontrolled Diabetes Mellitus,
Kayachikitsa NIA Hospital, Jaipur. A regular record Impaired Renal function( Creatinine ≥ 2 mg/dl),
of assessment of all patients was maintained Hypothyroidism, Jaundice, Hepatitis, Chronic
according to Performa prepared for the study. infections & other serious diseases.
C) Inclusion criteria: ii. Pregnancy, Lactation and patients having

Dyslipidaemia due to drugs e.g. Glucocorticoids,
i. Patients between the age group of 20-60 years
Diuretics etc.
in either sex.
E) Study Design:
ii. Diagnosed & confirmed cases of Dyslipidaemia
(Medodushti) on the basis of criteria given by Randomized, Control & Open level, Clinical
NCEP-ATPIII (Serum Cholesterol ? 200 mg/dl, study.
Serum Triglycerides ? 150mg/dl, LDL Cholesterol
F) Grouping and Administration of Drug:
? 130mg/dl, HDL Cholesterol < 40mg/dl ) and
patients having alterations in any one or more Registered 50 patients were randomly
component of the lipid profile as follows were divided into 2 Groups of 25 patients in each as below:
included in present study.
Group A - 25 patients were administered
iii. Patients willing to sign the consent form. Trial Drug ‘Tablet Medonorm’ in dose of 2 tab. (1
tab = 500mg) twice in a day (2gm/day) with
D) Exclusion criteria:
lukewarm water for 60 days.
i. Patients having medical history of Unstable
angina, Myocardial Infarction, Heart failure,
Table I: Contents of Ayurveda formulation
Name of drug Latin name Proportion Part used
Daru haridra Berberis aristata 1part Stem
Devdaru Cedrus deodara 1 part Stem
Musta Cyperus rotandus 1 part Rhizome
Bibhitaka Terminalia belerica 1 part Fruit
Haritaki Terminalia chebula 1 part Fruit
Aamlaki Emblica officinalis 1 part Fruit
Group B - 25 patients were administered

l Laboratory investigations were repeated after
Capsule Shuddha Guggulu (Extract) in dose of 1
completion of the treatment i.e. after 60 days.
capsule twice in a day (500mg/day) for 60 days with
lukewarm water. F) Criteria For Assessment:
Follow-Up Study: Both subjective & objective parameters were

employed for assessment of the impact of the
l Follow up of the patient was done fortnightly for
treatment.
a period of 60 days.
a.) Subjective Criteria
l Improvement in the symptoms, if any & other
effects were noted down. Ayurveda is a subjective science. To give
results, objectively and for statistical analysis, 2 = Moderate (Symptom is bothering but tolerable)
following signs and symptoms of Medodushti was
3 = Severe (Symptom is not tolerable and needs
adopted :
medication)
i. Kshudra Shwasa (Breathlessness on exertion)
b) Objective Criteria:
ii. Angasada (sluggishness of body)
It was assessed mainly on the basis of
iii. Kshudhadhikya (excessive hunger) Biochemical investigations as Lipid Profile and along
with Anthropometric assessment before starting the
iv. Pipasadhikya (excessive thirst)
treatment and after completion of treatment in terms
v. Swedadhikya (excessive sweating) of percentage relief and statistical evaluations. For
the better assessment of clinical significance of
vi. Atinidra (excessive sleep)
changes in lipid profile & Anthropometric
vii. Daurbalya (weakness) assessment, a grading system was developed & used
in present trial.
viii. Kricchavyavayata (difficulty in sexual
intercourse) 1) Anthropometric Assessment:
ix. Krathana (snoring ) The following Anthropometric assessments

were done before & after the treatment using
Score was given according to the severity of
weighing machine & measurement tape:
symptoms. The details of the score adopted for the
main signs and symptoms in present study were as l Weight of the Patient ( in Kg )
follows:
l B.M.I.
0 = None (Symptom is not present at all)
B.M.I. = Weight of the patient (in Kg) ÷ [Height of
1 = Mild (Symptom is present but not bothering) the patient (in metre)]2
Classification of adults according to BMI4 :-
BMI CLASSIFICATION GRADE
< 18.5 Underweight 0
18.5-24.99 Normal 1
25.0-29.99 Overweight 2
>30 Obese 3
l Waist - Height Ratio: Ratio between the waist circumference & height of the patient was calculated.
Waist- Height Ratio Classification5:-
Waist-Height Ratio Health Risk Grade
0.4 Ok 0
0.5 Consider Action 1
0.6 Take a action 2
l Waist - Hip Ratio:
Ratio between the waist & hip circumference of the patient was calculated.
Waist-Hip Ratio Classification6 :-
Male Female Risk Category Grade
< 60 yr. >60 yr. < 60 yr. >60 yr.
<0.90 <0.95 <0.80 <0.85 Low 0
0.90-0.95 0.95-1.03 0.80-0.86 0.85-0.90 Moderate 1
>0.95 >1.03 >0.86 >0.90 High 2
2) Biochemical Parameter Assessment:
Following Biochemical parameters were done before the commencement & after completion of the
treatment
l Routine Blood Investigation-: Haemoglobin (Hb gm%) ,Total Leucocytes Count (TLC) ,Differential
Leucocytes Count (DLC), ESR (mm/hr)
l Lipid profile-: Serum Total Cholesterol (Sr.TC), Serum Triglycerides (Sr.TG), Serum Low Density
Lipoprotein (Sr.LDL), Serum Very Low Density Lipoprotein (Sr.VLDL), Serum High Density Lipoprotein
(Sr. HDL)
l Fasting Blood sugar ( FBS )
l RFT ( Renal Function Test )-: Blood Urea, Serum Creatinine
ATP III Classification of LDL, Total and HDL Cholesterol and Triglycerides7 :
Lipoprotein Concentration (mg/dl) Interpretation Grade
TC <200 Desirable 0
200-239 Borderline high 1
>240 High 2
LDL-c <100 Optimal 0
100-129 Near/above optimal 1
160-189 High 3
>190 Very high 4
HDL-c <40 Low 0
>60 High 1
TGs <150 Normal 0
200-499 High 2
>500 Very high 3

Observations: sleeping. Daytime sleeping leading to Doshaprakopa

especially formation of Ama which further causes
20 patients in age group 41-50 & 19 patients
Apakva-Ama Rasa & further impairs Dhatuposhana.
in age group 51-60 were found; it shows overall 78%
62% patients showed Madhyama Vyayama Shakti.
patients belong to 4th to 6th decade of life. According
Imparied Anna Rasa leading to impaired nutrition of
to sex, i.e.60% was female & 40% were male. 66%
further Dhatu, thus whatever the Dhatu are formed,
patients belonged to Hindu community. 96 % patients
they have Shaithilya Guna. 8 patients gave a history
were married. Maximum 40% patients were
of being tensed for one or other cause, 2 patients
housewives followed by 38% service class. About
showed depressed mood & 3 patients were having
72% patients belonged to Middle class. Max. 60 %
features of Anxiety. All these emotional conflict are
Patients had Vata-Kaphaj Prakriti & 28 % Pitta
important etiological factors for Medodushti. Higher
Kaphaj Prakriti, which is highly associated with the
incidence of various Nidana like 66% patients with
development of Dyslipidaemia. 50% patients were
Guru Sevena, 64% patients with Madhura Sevena,
belonging to Rajasik Manasa Prakriti. 72% patients
66% had history of Snigdha Sevena, 70% patients
were of Madhyama Sara. 70% were having
with Kshirad Sevena, 14% Swapnasukha, 56 % with
Madhyama Samhanana. But they were having
Avyayama, 34% with Diwaswapna etc. were found
complaint of Fatigueness, due to Mamsashaithiya &
to be etiological factors in Medodushti. Max 56%
Abaddha Meda leading to lethargy. 72 % patients
patients showed no habit of exercise. About 08 %
showed Madhyama Satva followed by 18% patients
patients, in the study showed history of Diabetes
with Avara Satva. 84% patients showed Madhyama
mellitus, 14 % were having history of Hypertension
Abhyavaharan Shakti. While 82% patients showed
& Osteoarthritis each. 54 % patients had shown BMI
Madhyama Jarana Shakti followed by 14% patients
between 25- 29.99 and 20 % had BMI > 30. 64 %
had Avara Jarana Shakti. 46 % patients each showed
patients had Total serum cholesterol in Borderline
Madhyam & Krura nature of Koshtha. It is due to
high range i.e. 200-239 mg/dl & 13% had high range
Samana Vayu Prakopa in there diseased individuals.
i.e. above 240 mg/dl. 46% patients had LDL
42% patient showed Vishamagni, followed by 40%
cholesterol in near optimal range i.e. 100-129, while
patients of Mandagni. 62% were found to have
HDL cholesterol was found to be within normal range
Madhura Rasa dominant diet followed by 60%
in nearly all the patients. In 58% patients Borderline
patients of Lavana Rasa dominant diet. 46% patients
high i.e. 150-199 mg/dl Triglycerides level was found
were dominantly having Adhyashana in their Dietary
and 28% of patients had high level i.e. 200-499 mg/
Habits, followed by 32% patients with Vishmashana.
dl of triglycerides.
36% patients showed Day time sleeping but
maximum 70% patients showed about 8 hrs of Results:
Table No II -: Showing effect of Therapy in Subjective Parameters. (Wilcoxon matched-pairs

signed ranks test)
Variable Group Mean Mean % SD SE± P S
BT AT Diff. Relief ± ±
Kshudhadhikya Gr. A 0.44 0.12 0.32 72.73% 0.56 0.11 <0.05 S
Gr. B 0.36 0.12 0.24 66.66% 0.44 0.09 <0.05 S
Pipasadhikya Gr. A 0.84 0.28 0.56 66.66% 0.58 0.12 <0.0001 HS
Gr. B 0.68 0.16 0.52 76.47% 0.52 0.10 <0.0001 HS
Daurbalya Gr. A 1.08 0.20 0.88 81.48% 0.60 0.12 <0.0001 HS
Gr. B 0.96 0.08 0.88 91.66% 0.67 0.13 <0.0001 HS

Swedadhikya Gr. A 0.96 0.44 0.52 54.16% 0.65 0.13 <0.001 HS
Gr. B 0.60 0.20 0.40 66.66% 0.58 0.11 <0.01 HS
Atinidra Gr. A 0.32 0.12 0.20 62.50% 0.41 0.08 >0.05 NS
Gr. B 0.16 0.04 0.12 75.00% 0.33 0.66 >0.05 NS
Kshudrashwasa Gr. A 0.88 0.36 0.52 59.09% 0.59 0.12 <0.001 HS
Gr. B 0.64 0.28 0.36 56.25% 0.49 0.1 <0.01 HS
Angasada Gr. A 0.68 0.08 0.60 88.23% 0.76 0.15 < 0.01 HS
Gr. B 0.92 0.12 0.80 86.95% 0.87 0.17 <0.001 HS
Krucchvyavayata Gr. A 0.13 0.1 0.03 25% 0.18 0.03 >0.05 NS
Gr. B 1.66 0.10 0.06 40% 0.2537 0.04 >0.05 NS
Krathana Gr. A 1.04 0.44 0.60 57.69% 0.65 0.12 <0.001 HS
Gr. B 0.96 0.52 0.44 45.83% 0.51 0.10 < 0.001 HS
(Note - HS: Highly Significant S: Significant NS: Non Significant)
Table No III -:Showing effect of Therapy in Anthropometric Parameters (Paired‘t’ Test &
Wilcoxon matched-pairs signed ranks test)
Parameters Group Mean Mean % SD SE± t P S
Body Weight (kg) A 68.76 66.12 2.64 04% 1.19 0.24 11.13 <0.0001 HS
B 71.08 69.12 1.96 2.75 1.17 0.23 8.36 <0.0001 HS
B.M.I. Value A 28.04 27.00 1.03 3.70 0.68 0.13 7.632 <0.0001 HS
(Kg/m2) B 2 7 . 1 1 26.38 0.72 2.67 0.38 0.77 9.415 <0.0001 HS
Grade A 1.92 1.68 0.24 12.5 0.43 0.09 - <0.05 * S
B 2 1.72 0.28 14 0.46 0.09 - <0.05 * S
Waist-Height Value A 0.61 0.57 0.04 6.5 0.05 0.009 3.674 <0.01 HS
ratio B 0.59 0.55 0.04 7.2 0.05 0.009 3.674 <0.01 HS
Grade A 1.84 1.64 0.20 10.87 0.41 0.08 - >0.05 * NS
B 1.64 1.44 0.20 12.19 0.41 0.08 - >0.05 * NS
Waist-Hip Value A 0.95 0.93 0.022 2.10 0.03 0.005 4.43 <0.001 HS
Ratio B 0.952 0.934 0.018 1.89 0.02 0.004 4.28 <0.001 HS
Grade A 1.92 1.76 0.16 8.33 0.37 0.075 - >0.05 * NS
B 1.84 1.56 0.28 15.21 0.46 0.092 - <0.05 * S
(Note - * - Wilcoxon matched-pairs signed ranks test)

Table No IV -: Showing effect of Therapy on Lipid Profile (Paired‘t’ Test & Wilcoxon
matched-pairs signed ranks test)
Variable Group Mean Mean % SD SE± t P S
Sr.TC (mg/dl) Value Gr. A 225.24 195.68 29.56 13.12 14.74 2.95 10.02 <0.0001 HS
Gr. B 220.04 1 8 6 . 5 6 33.48 15.21 20.03 4.01 8.36 <0.0001 HS
Grade Gr. A 1.240 0.44 0.80 64.51 0.50 0.10 - <0.0001* HS
Gr. B 1.08 0.32 0.76 70.37 0.52 0.10 - <0.0001* HS
Sr.TG(mg/dl) Value Gr. A 181.48 148.80 32.68 18.00 19.81 3.96 8.25 <0.0001 HS
Gr. B 177.84 152.28 25.56 14.37 46.02 9.20 2.78 <0.01 HS
Grade Gr. A 1.2 0.44 0.76 63.33 0.60 0.11 - <0.01* HS
Gr. B 1.12 0.56 0.56 50 1.08 0.22 - <0.05* S
Sr.LDL(mg/dl) Value Gr. A 138.36 113.04 25.32 18.3 17.08 3.42 7.411 <0.0001 HS
Gr. B 132.88 104.68 28.2 21.22 17.71 3.543 7.959 <0.0001 HS
Grade Gr. A 1.84 0.96 0.88 47.82 0.73 0.14 - <0.0001* HS
Gr. B 1.64 0.72 0.92 56.09 0.64 0.12 - <0.0001* HS
Sr.VLDL ( % ) Gr. A 36.36 29.72 6.64 18.26 3.97 0.79 8.368 <0.0001 HS
Gr. B 35.56 30.04 5.52 15.52 9.435 1.887 2.925 <0.01 HS
Sr.HDL(mg/dl) Gr. A 50.40 51.12 -0.72 1.43 3.13 0.62 1.15 >0.05 NS
Gr. B 51.72 50.2 1.52 2.93 4.89 0.99 1.55 >0.05 NS
FBS ( mg /dl) Gr. A 88.44 86.28 2.16 2.44 8.68 1.73 1.24 >0.05 NS
Gr. B 95.48 89.56 5.92 6.24 11.16 2.23 2.65 <0.05 S
(Note - Sr.TC-Serum Total Cholesterol; Sr.TG-Serum Triglycerides; Sr. LDL-Serum Low Density Lipoproteins;
Sr. VLDL- Serum Very Low Density Lipoproteins; Sr. HDL-Serum High Density Lipoproteins; FBS-Fasting Blood Sugar;
HS: Highly Significant; S: Significant; NS: Non Significant * - Wilcoxon matched-pairs signed ranks test)
On intergroup comparison in all subjective & objective parameters of both group, there were no
statistically significant difference was found except Body weight where Group A was quite significant than
Group B (p value <0.05). So, both the therapy have similar efficacy on all the parameters assessed.

Discussion- l It was observed that Dyslipidaemia is most

common in patients of 4th to 6th decades of life,
Ayurveda formulation containing drugs-
& is commonly found in individuals having
Devdaru, Musta, Daruharidra, Aamlaki, Vibhitaki
sedentary lifestyle, faulty dietary habits.
and Haritaki is indicated as a Kwatha preparation in
Prameha Chikitsa.8 Abaddha Meda Dushti mentioned l In this clinical study, the therapeutic results in
in Prameha in Ayurveda, can be considered as patients of group A, treated with Ayurveda
Dyslipidaemia so this formulation was selected to formulation (Tab. Medonorm) and in patients of
treat Medodushti. Trial drug in tablet form was a group B, treated with Shuddha Guggulu (Extract)
modified form of Kwath by Ghansattva method. It were almost equal in all subjective parameters.
pacifies the vitiated Kapha Dosha which is dominant
l Thus, Ayurveda formulation (Tab. Medonorm)
in the pathogenesis of Dyslipidaemia as well as
can be used effectively in the management of
depletes the excessively produced Rasa, Mamsa,
Dyslipidaemia & its result are comparable and
Meda, Vasa, Sweda and Kleda which are all similar
even better with that of Shuddha Guggulu.
in attributes to Kapha Dosha. Drugs like Musta,
Triphala, Daruharidra digest the Ama Dosha present References
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Chikitsasthana, Pramehachikitsa Adhyaya, 6/26,
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ISSN No:2321-0435
ORIGINAL ARTICLE
A Clinical Study On The Efficacy Of Ardhanarishvara Rasa
Nasya and Nimbadi Guggulu In The Management Of
Kaphaja Shiroroga W.S.R. To Sinusitis
*Dr. Mansi, **Dr. Aparna Sharma
*Ph.D. Scholar, Department of Shalakya Tantra, NIA, Jaipur
**Assistant Professor, Department of Shalakya Tantra, NIA, Jaipur
ABSTRACT
Kaphaja Shiroroga is one among the 11 types of Shiroroga mentioned by Aacharya Sushruta. In
modern science, it can be correlated to sinusitis. Sinusitis is a major problem in the society due to its
recurrent exacerbations and complications. Drugs selected for present study Ardhanarishvara rasa and
Nimbadi Guggulu are having Kaphavatahara, Lekhaniya, Srotoshodhana and Shothahara properties which
helps in break down of the pathogenesis of sinusitis. The chief procedure to remove Doshas from Shiras is
Shodhana Nasya. Therefore Nasya with Ardhanarishvara Rasa due to its medicinal properties helps in
removing the vitiated Kapha accumulated in Shiras. In present study 30 patients of Kaphaja Shiroroga
(sinusitis) were selected and randomly divided into two groups of 15 patients each. Group A was treated
with Ardhanarishvara Rasa Nasya and Group B was Ardhanarishvara Rasa Nasya and Nimbadi Guggulu
orally. Their individual and comparative effects were revealed in the study. A significant relief was found in
most of the symptoms and signs of Kaphaja Shiroroga (Sinusitis) after the trial.
Key words: Kaphaja Shiroroga, Sinusitis, Nasya, Nimbadi Guggulu
Quick Response Code: How to cite this article : Mansi, Sharma

A, A Clinical Study On The Efficacy of
Ardhanarishvara Rasa Nasya and Nimbadi
Guggulu In The Management of Kaphaja
Shiroroga W.S.R. To Sinusitis, JOA XII-4 2018;
66-72
Introduction
Website:- journalofayurveda.in Acharaya Sushruta has mentioned 11 types
Address of correspondence: of Shiro-Roga 1 in Uttar Tantra and Kaphaja
Dr. Mansi Shiroroga is one of them. The clinical features of
Ph.D. Scholar, Deptt. of Shalakya Tantra, Kaphaja Shiroroga described by Aacharya Sushruta
NIA, Jaipur are - Guru Pratistabdham (Heaviness and fullness of
Email.com: [email protected] head), Himam (Coldness in head), Shuna Akshikoota
Contact No. 8742093146 Vadanam (Swelling of face especially around the

Mansi, Sharma A, A Clinical Study On The Efficacy of Ardhanarishvara Rasa Nasya and Nimbadi Guggulu In The
Management of Kaphaja Shiroroga W.S.R. To Sinusitis, JOA XII-4 2018; 66-72
eyes), Shirobhitapa (Headache), Shirogalam to remove Doshas (infectious material) from Shiras
Kaphopdigdham (Feeling of having a coating of as it is quoted that “Nasa hi Shiraso Dwaram”.9 In
phlegm inside the head and throat) 2 . Sinusitis is Kaphaja Shiroroga treatment Shirovirechana
defined as inflammation of paranasal sinuses. Signs (Shodhana) Nasya is recommended. The term
and symptoms of sinusitis are headache, pain and “Shirovirechana” itself denotes the process of
swelling of affected sinus, heaviness in head, nasal cleansing of head. Hence Avapeeda Nasya (comes
discharge, nasal obstruction, post nasal drip, low under Shirovirechana type) with Ardhanarishvara
grade fever, halitosis, anorexia, periorbital swelling, Rasa due to its medicinal properties helps in
lassitude etc. On the basis of these clinical features, removing the vitiated Kapha there by clearing the
Kaphaja Shiroroga can be correlated to sinusitis in Srotas (sinuses) situated in Shiras (skull and face).
modern science.
Therefore the present study entitled “A
Sinusitis is a major problem in the society Clinical Study on the Efficacy of Ardhanarishvara
due to its recurrent exacerbations and Rasa Nasya and Nimbadi Guggulu in the
complications. Due to increased environment Management of Kaphaja Shiroroga w.s.r. to Sinusitis”
pollution and busy life style in present era, incidence had been designed to analyze and evaluate the
of rhinitis is increasing which leads to sinusitis if not complete concept and etiopathogenesis of sinusitis
properly treated. It is the fifth most common vis-à-vis Kaphaja Shiroroga based on clinical study,
diagnosis for which antibiotics are prescribed.3 In as a whole in light of Ayurvedic and modern concepts
India chronic sinusitis affects nearly 134 million
Aims and Objectives
people, making it the country with the second largest
number of sufferers in the world.4 Sinusitis itself is 1 . Aetiopathogenesis and clinical study of Kaphaja
rarely life threatening, but if the infection extends Shiroroga with special reference to sinusitis.
into surrounding deep tissues it can lead to serious
2. To evaluate the efficacy of Nasya with
complications like: orbital cellulitis, subperiosteal
Ardhanarishvara Rasa in the management of
abscess, orbital abscess, frontal and maxillary
Kaphaja Shiroroga (Sinusitis).
osteomyelitis, subdural abscess, meningitis, brain
abscess.5 3. To evaluate the efficacy of Nasya with
Ardhanarishvara Rasa and Nimbadi Guggulu
In modern science, only symptomatic relief
orally in patients suffering from Kaphaja
is achieved with antibiotics, decongestants,
Shirahshoola (Sinusitis).
analgesics etc., but the rate of recurrence is very
high. In advanced cases, surgical procedures are 4. To compare the efficacy of trial drugs in Kaphaja
advised which are expensive, and invite Shiroroga.
complications.
Material and Methods
In Kaphaja Shiroroga, vitiated Kapha Dosha
I. Study Design: The present study is an
accumulates in Shiras causing obstruction in Srotas
interventional, randomized, open label, and parallel
of head. Aacharya Vagbhatta has mentioned that the
group trial.
drugs used for the treatment of Kaphaja Shiroroga
should have Katu, Ruksha, Ushna and Teekshna II. Selection of Patients
properties,6 for removal of Kapha and Shodhana of
Source: Patients attending the O.P.D. and
Srotas. The contents of drugs Ardhanarishvara
I.P.D. of Shalakya Tantra of National Institute of
Rasa 7 and Nimbadi Guggulu8 selected for present
Ayurveda, Jaipur were screened for the present
study have these properties along with analgesic,
study. Freely given informed written consent was
antibiotic and anti-inflammatory effect and thus help
obtained from every subject prior to research
in breakdown of the pathogenesis of sinusitis.
participation. A research proforma was prepared to
In Ayurveda, Nasya is the chief procedure study all the conditions of patients.

Ethical clearance: Institutional Ethics ii) Nimbadi Guggulu
Committee (IEC) approval was taken prior to
l Dose: 2 tablets of 500 mg twice daily orally with
initiation of research workvide letter number F10(5)/
luke warm water
EC/2014/7224 dated 7-11-2014.
l Duration : 1 month
Inclusion Criteria
V. Investigations: X-Ray PNS, Hb%, TLC,
1 . Patients fulfilling the diagnostic criteria which
DLC, ESR, Absolute eosinophil count
were based on the signs and symptoms of
KaphajaShirorogaexplained in Ayurvedic VI. Follow up: A follow-up was done for
classics and sinusitis as per modern science. one and half month after completion of the treatment
at fortnight intervals to check status of the patients.
2. Patients between the age group of 8 to 80 years.
Assessment Criteria
Exclusion criteria
For assessment of the efficacy of the trial
1 . Patients not willing for the trial were excluded.
therapy, following subjective and objective
2. Pregnant women. parameters were adopted:
3. Patients with chronic debilitating infectious Subjective criteria:

diseases.
1) Shiroabhitapa (Headache)
4. Patients suffering from pain and facial swelling
2) Shiroguruta (Heaviness in head)
due to alveolar abscess, cellulitis of cheek,
furuncle, angioneuroticoedema, trigeminal 3) Galam Kaphaupadigdham (Post nasal drip)
neuralgia, temporal arteritis.
4) Shunakshikootavadanam (Periorbital and facial
5. Patients with malignancies of sinuses. oedema)
III. Grouping of patients: 5) Nasal obstruction
In the present study 34 clinically diagnosed 6) Nasal discharge

patients of Kaphaja Shiroroga (Sinusitis) were
7 ) Tenderness over sinuses
selected and randomly divided into two groups.
Randomization was done on the basis of random Objective criteria:
number table. Out of these 34 patients 30 patients
1) Haziness in sinuses in X-ray
completed the trial.
Statistical Analysis
Group A: 15 patients of Kaphaja Shiroroga
(Sinusitis) were given Nasya with Ardhanarishvara Various observations made and results
Rasa. obtained were computed statistically using Graph
Pad Instat 3 software. Individual A and B group:
Group B: 15 patients of Kaphaja Shiroroga
Wilcoxon matched pairs signed ranks test for
(Sinusitis) were given Ardhanarishvara Rasa for
nonparametric data. Intergroup comparison between
Nasya and Nimbadi Guggulu orally.
A and B group: Mann Whitney test for nonparametric
IV. Administration of Drugs: data. The obtained results were interpreted as:
i) Ardhanarishvara Rasa l Not significant p > 0.05
l Dose : 4 drops per nostril l Significant p ≤ 0.05
l Duration: Two sittings of 7 days with interval l Very significant p ≤ 0.01

of 7 days
l Extremely significant p ≤ 0.001

Observation and Results Maximum patients had mild headache (70%), thick
(muco-purulent) nasal discharge (40%), 46.66%
In the present trial total 34 patients were
patients had right and left frontal sinus tenderness
registered at the beginning but 4 patients
on palpation and maximum patients 93.33% had left
discontinued the trial before its completion and
maxillary sinus opacity followed by 83.33% with
therefore had to be excluded out of the trial. So
right maxillary sinus opacity in X-Ray PNS.
observation and results of 30 patients are given
below: Among 30 patients, headache was found in
93.33% patients, Shiroguruta in 90% patients, 50%
Observations:
patients had Kaphaupadigdham Galam(post nasal
In present study, maximum numbers of discharge), 23.33% patients were with complaint of
patients were in the age group of 21-30 years Periorbital or Facial edema (Shuna
(33.33%), male and female were equal. Majority of Akshikootavadanam), 86.66% patients had nasal
patients had chronic type of sinusitis (80%) and obstruction and nasal discharge was found in 66.66%
73.33% had seasonal attacks of the disease. patients.
Results:
Table I. Effect of therapy on subjective parameters in Group A

(Wilcoxon matched paired single ranked test)
S. Symptoms Mean Dif. % of SD SE W P Res-

No. BT AT Change ults
1 Shiroabhitapa 1.86 0.66 1.20 64.27 0.86 0.22 78 0.0005 ES

(Headache) p<0.001
2 Shiroguruta 1.33 0.33 1.00 75.01 0.65 0.16 78 0.0005 ES

(Heaviness in head) p<0.001
3 Kaphaupadigdham 0.93 0.46 0.46 50.02 0.63 0.16 21 0.0313 S

Galam p<0.05
(Post nasal drip)
4 Shunakshikoot- 0.26 0.06 0.20 74.99 0.41 0.10 6 0.2500 NS

avadanam p>0.05
(Periorbital and
Facial edema)
5 Nasal obstruction 1.86 0.86 1.00 53.56 0.65 0.16 91 0.0002 ES

p<0.001
6 Nasal discharge 1.20 0.46 0.73 61.10 0.70 0.18 45 0.0039 VS

p<0.01
7 Tenderness over 2.40 0.66 1.73 72.20 1.98 0.51 36 0.0078 VS

sinuses p<0.01

Table II. Effect of therapy on subjective parameters in Group B
(Wilcoxon matched paired single ranked test)
S. Symptoms Mean Dif. % of SD SE W P Res-

No. BT AT Change ults
1 Shiroabhitapa 1.86 0.60 1.26 67.86 1.10 0.28 66 P=0.001 ES

(Headache)
2 Shiroguruta 1.93 0.66 1.26 65.54 0.70 0.18 91 0.0002 ES

(Heaviness in head) p<0.001
3 Kaphaupadigdham 1.13 0.46 0.66 58.84 0.61 0.15 45 0.0039 VS

Galam p<0.01
(Post nasal drip)
4 Shunakshikootava- 0.20 0.06 0.13 66.65 0.35 0.09 3 0.5000 NS

danam (Periorbital p>0.05
and Facial edema)
5 Nasal obstruction 1.40 0.53 0.86 61.90 0.63 0.16 66 P=0.001 ES
6 Nasal discharge 1.13 0.26 0.86 76.49 0.83 0.21 45 0.0039 VS

p<0.01
7 Tenderness 3.40 0.86 2.53 74.50 3.33 0.86 36 0.0078 VS

over sinuses p<0.01
Table III. Intergroup comparison of subjective parameters of Kaphaja Shiroroga

(Mann Whitney test)
S. Symptoms Mean SD SE U P Res-
No. GA GB GA GB GA GB ults
1 Shiroabhitapa 1.20 1.26 0.86 1.10 0.22 0.28 113.50 >0.05 NS

(Headache)
2 Shiroguruta 1.00 1.26 0.65 0.70 0.16 0.18 136.50 >0.05 NS
3 Kaphaupadigdam 0.46 0.66 0.63 0.61 0.16 0.15 133.50 >0.05 NS

Galam
(Post nasal drip)
4 Shunakshikoota- 0.20 0.13 0.41 0.35 0.10 0.09 120 >0.05 NS

vadanam (Periorbital
and Facial edema)
5 Nasal obstruction 1.00 0.86 0.65 0.63 0.16 0.16 121 >0.05 NS
6 Nasal discharge 0.73 0.86 0.70 0.83 0.18 0.21 121.50 >0.05 NS
7 Tenderness over 1.73 2.53 1.98 3.33 0.51 0.86 122 >0.05 NS
sinuses

Discussion Duhsaha (unbearable) Shiroruja of Vata-
Kaphaorigin, a combination of Nimba, Triphala,
Statistically extremely significant results
Patola Vasa and Guggulu, have proven Shothahara
were found in Headache, Heaviness in head, Nasal
(anti-inflammatory), Vednahara (analgesic),
obstruction and Haziness in sinuses and very
antimicrobial and immune modulatory effects. Thus
significant results were found in nasal discharge and
it helped in reduction of inflammation and infection
tenderness over sinuses in both group.The
and thereby sinuses get proper drainage and
symptomatic improvement was considerable in all
ventilation and hence relief in the symptoms of
the subjective parameters. But the overall percentage
Kaphaja Shiroroga.
change was less in haziness in sinuses in X ray PNS.
Conclusion
Intergroup comparison of efficacy of two
therapies on subjective and objective parameters of Shiras (head) is one of the most vital organs
KaphajaShiroroga/sinusitis shows that all the of body and forms the root of body where the entire
parameters have p value >0.05 which is statistically special sense organs - eyes, ears, nose, and tongue
not significant. This shows that there is no statistical are situated. Therefore paranasal sinuses which are
difference in efficacy of both treatments. air filled spaces in the bones of skull are one among
the structures of Shiras. In management of Kaphaja
But on comparing symptomatic
Shiroroga, main concentration is given to the Dosha
improvement in both groups it was found that
Apkarshana from Urdhvajatru Pradesha and the
average percentage of relief was higher in ‘Group B’
main treatment which can drain the retained
i.e. 63.27%, followed by ‘Group A’ i.e. 59.07%. It
discharge (vitiated Kapha) from the sinuses is
shows that effect of therapy was a little more in
Shodhana Nasya. In the present study, Nasya with
Group B in comparison to Group A.
Ardhanarishvararasa which is a Teekshna Avapeeda
It is clear from the above description that in Nasya showed considerable relief in both groups.
both the group statistically extremely significant Combined use of Nimbadi Guggulu and Ardhana-
relief was observed in symptoms like headache, rishwara Rasa Nasyais more effective for controlling
heaviness in head and nasal obstruction and very the disease Kaphaja Shiroroga (Sinusitis). Study
significant results in nasal discharge and tenderness should be carried out on large sample to ascertain
over sinuses. It could be attributed to Avapeeda the effect of drug.
Nasya which is a Shodhana Nasya. Here
Purvakarma i.e. Abhyanga helped in Dosha
Mardavkaran, steam inhalation helped in Kapha References
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ISSN No:2321-0435
ORIGINAL ARTICLE
A Study of Vyanghara Karma of Laksha obtained
from different host plants
*Dr. Satyendra Singh, **Dr. Swati Singh, ***Prof. Mohan Lal Jaiswal, ****Prof. A.R. Murthy
*Assistant Professor, Dept.of Dravya Guna, Govt (Auto) Ayurved college Burhanpur, (M.P.)
**Assistant Professor Dept. of Samhita Siddhant, Govt (Auto) Ayurved college Burhanpur (M.P.),
***, ****Professor, P.G.department of Dravyaguna, NIA, Jaipur
ABSTRACT
Introduction - Vyanga is a common disorder generally affecting the face area and can be an
embarrassing condition. Vyanga is considered as a Kshudra roga. Laksha is described as Vyanganashan
dravyas in Ayurvedic classics. Laksha is an excellent remedy for skin diseases. Laksha is well known medicine
for its Vyanganahan,Varnya, Kusthaghna and Krimighna activity. Objective- To evaluate the Vyanghar
Karma of Laksha (Laccifer lacca Kerr.) which has been mentioned by various Acharya. To compare the
Vyanghar Karma of Laksha obtained from Different host plants. Material and Method- (i) Design – Open,
two armed, randomized and comparative clinical trial. (ii) Settings – OPD registered patients, Participants
– 30 patients of either sex. Intervention– 3 groups, Group A- 10 volunteers have been given Laksha powder
of Ashwattha plant. Group B- 10 volunteers have been given Laksha powder of Palash plant. Group C - 10
volunteers have been given Laksha powder of Koshamra plant. Intervention Period - 60 Days, Outcome
measures – Photography. Result- All the three groups are observed on the basis of classical reference
and size & Colour of patches. Statistically significant result was observed in group B and group A as compared
to group C. Conclusion- The present study supports the use of Laksha of Palash and Ashwattha in treating
Vyanga. With good acceptance by all treated patients.
Key word- Vyanga, Laksha, Varnya.
Quick Response Code: How to cite this Article: Singh S,

Singh S, Jaiswal ML, Murthy AR, A Study of
Vyanghara Karma of Laksha obtained from
different host plants JOA XII-4, 2018; 73-84
Introduction
Vyanga is a common disorder affecting the

face area and can be an embarrassing condition. It
may affect the self-confidence of certain individual.
Address of correspondence:
It is personality damaging disease which affect on
Dr Satyendra Singh
both psychic as well as somatic health. Vyanga is
Assistant Professor, Dept.of Dravya Guna
considered as a Kshudra roga by almost all Acharya,
Govt (Auto)Ayurved college Burhanpur, (M.P.)
Maharshi Sushruta1 and Charaka2 considered, it also
Contact - 9887506313
as Raktaja Roga. Concise description is available in
E-mail:[email protected]
classical text about Kshudra Rogas it is

Singh S, Singh S, Jaiswal ML, Murthy AR, A Study of Vyanghara Karma of Laksha obtained from different host
plants JOA XII-4, 2018; 73-84
characterized by Shyava Varna (Hyper- 3. To provide a natural, economic, safe and easily
pigmentation), Niruja (Painless), Tanu (Thin), available herb for anti- melasma of skin without
Mandal (Circular) etc. 3 it can be correlated to any side effects.
Melasma of modern medical science. Maharshi
Material & Methods
Sushruta 4 and Vagbhatta 5 have narrated some
specific etiology and Samprapti. This disease is Collection of Drug
menifested by due to disturbed Vata and Pitta Doshas
The exudates of Laccifer lacca Kerr of
and Rasa-Rakta Dushya. The causative factors
Ashwattha (Ficus religiosa Linn.) plant was
described in modern texts are useful to support
collected from its natural habitat i.e. O.P.D. Garden
above fact. All the causative factors like sun
of National Institute of Ayurveda, Jaipur. The
exposure, drug intake, hormonal changes at
exudate was collected in the month of June in
particular stages, vitamin deficiency, diet deficient in
morning time. The identification and authentication
animal fat, green vegetables and fruits etc.6 can be
of plant material collected for study was done at
included under the broad heading of Mithya Ahara
Herbarium, Botany Department, Rajasthan
and Vihara. Vyanga (Melasma) is a disease has been
University, Jaipur. Registration no. for Laksha of
around for centuries despite several treatment
Ashwattha plant is RUBL211469. Other two sample
options. However, these agents have certain
viz Palash & Koshamra were collected from the
limitations, either due to poor efficacies or due to
Indian Institute of Natural Resins and Gums, (IINRG)
compliance issues. Hence in this study we tried to
Ranchi Jharkhand.
overcome this problem by holistic system of
Ayurveda, through local and internal use of drug. Method
For the treatment of the Vyanga (Melasma), Preparation of the drug

so many drugs are mentioned in Ayurvedic classics
For the present study after the collection the
which are having Vyangahar action. Laksha is
drug was purified and dried in sun exposure by the
having classical references as Varnya and
7
scholar after that the drug was grinded and passed
Vyanganashan dravyas .
through fine piece of cloth to have uniform particle
In Charaka Samhita Laksha is mentioned in size. Powder of drug was prepared in the Dravya
Kushtha chikitsa adhyaya for the treatment of guna laboratory of the National Institute of
Kushtha8 and Shivtra chikitsa4. In Sushruta Samhita Ayurveda, Jaipur.
1st time a group is mentioned of the title of Lakshadi
Drug- Laksha (Laccifer lacca Kerr.)
gana. Lakshadi gana having Kushthanashak,
Kriminashak and Dushtavran vishodhak property.10 Dose – Churna-1-2 gm. (twice daily) with milk for
Regarding the properties of Laksha most of the internal use, for external application paste of Laksha
classics has given it as Kashaya and Tikta Rasa, Sheet in milk was prescribed according to affected area.
Veerya, Laghu and Snigdha Guna, Katu Vipaka
Duration –Two months.
dravya. Laksha is declared as Kapha-Pitta
Shamaka12 in most of the texts this may be due to Groups:
its kashaya and tikta rasa and sheet veerya.
All the volunteers were divided into three
Aims And Objectives groups to compare the efficacy of the trial drug:
1 . To evaluate Pharmacognostical and Phyto- Group A- 10 volunteers will be given Laksha

chemical study of Laccifer lacca Kerr. powder of Ashwattha plant.
2. To evaluate the clinical efficacy of Laccifer lacca Group B- 10 volunteers will be given Laksha
Kerr. w.s.r to its effect on Melasma. powder of Palash plant.
Group C -10 volunteers will be given Laksha

powder of Koshamra plant.
Consent of Volunteers: Discontinuation Criteria:
All the volunteers selected for the trial were l Any sort of allergy caused by drug.
explained the nature of study and their consent was
l Unable to follow the trial schedule.
obtained on the Proforma before inclusion in the
study. Criteria of assessment
Inclusion Criteria / Exclusion Criteria Objective Assessment: The difference in

the size of the affected area will be noted. The change
Inclusion Criteria
in complexion will be recorded by using digital
l Volunteers willing to participate in the trial. camera in daylight.
l Patients presenting with the signs and symptoms Subjective Assessment: The
of Vyanga will be selected. improvement by the therapy was assessed on the
basis of the following signs & symptoms. All the
l Patients of either sex with the age group between
features were assigned score depending upon their
10- 50 years will be selected.
severity to assess the effect of the drug. The detail
Exclusion Criteria of which is shown below.
l Age <10 yrs and > 50 yrs Scoring Criteria: - For subjective
parameter on the basis of classical reference
l Hyperpigmentation caused since birth like Nevus
of Ota. 1. Shyavata (Darkening of the skin)
l Hyperpigmentation caused by tumor like 0 - Normal

malignant melanoma.
1 - Mild
l Patients with secondary systemic involvement 2 - Moderate
l Vyanga along with Kushtha roga to be excluded. 3 - Severe
l Patients suffering with other systemic disorders 2. Parush-sparsh (Dryness)
like renal failure, hepatic disorders and endocrine
0 - Normal
system related disorders.
1 - Mild dryness (not seen but felt by touch)
l Associated with any other systemic and
metabolic disorders are excluded because, they 2 - Moderate dryness (stretching of the skin
may alter the results of observation. that person feels)
3 - Severe dryness (visible dryness and
l Pregnant women’s are excluded because even
hardness of skin)
though the drug composition is herbal and safe
still may be placental barrier and affect the 3. Daha (Burning sensation)
foetus.
0 - No Burning sensation
l Lactating mothers are excluded because even
1 - Mild Burning sensation
though the drug composition is herbal and safe
still may have effect over food (milk) of infant. 2 - Moderate Burning sensation
l Women’s using oral contraceptives are excluded 3 - Severe Burning sensation
because it may alter the results of observation.
4. Kandu (Itching)
l Hyper pigmentation caused since birth is
excluded because, the prognosis is very bad in 0 - No itching
these conditions. 1 - Mild itching

2 - Moderate itching 6. On the basis of colour of patches:-
3 - Severe itching 0 - Normal colour
Scoring Criteria: - For subjective parameter on the 1 - Light brown

basis of size and colour 2 - Brown
5. On the basis of size of patches:- 3 - Dark brown
1 - 0 -1cm - 1 4 - Black
2 – 1-3 cm - 2 Observation And Result-
3 - 3-6 cm - 3 Assessment Of Therapy
4 - > 6 cm - 4 Effect of therapy on Subjective Parameters on

the basis of Classical reference -
Table No. I
Effect of Laksha of Ashwattha plant in Group A
Parameter BT 15 30 45 60 Diff Diff SD SE P Sig.

days days days days % value
Shyavata 2.4 2.4 1.8 1.1 1.2 1.2 50 0.78 0.24 0.0039 S
Parush Sparsha 1.7 1.7 1.1 0.9 0.9 0.8 47.0 0.78 0.24 0.0156 S
Daha 0.8 0.8 0.7 0.3 0.3 0.5 62.5 0.52 0.16 0.0313 S
Kandu 0.6 0.6 0.4 0.2 0.2 0.4 66.6 0.51 0.16 0.0625 NS
Effect of Laksha of Ashwattha plant was found significant on Shyavata, Parush sparsh, Daha and
only one parameter Kandu was found non-significant.
Table No. II
Effect of Laksha of Palash plant in Group B

Shyavata 1.7 1.7 0.9 0.9 0.9 0.8 47.0 0.63 0.2 0.0011 S
Parush Sparsha 1 1 0.7 0.4 0.4 0.6 60 0.51 0.16 0.0119 S
Daha 0.8 0.8 0.6 0.1 0.1 0.7 87.5 0 . 6 7 0.21 0.0207 S
Kandu 0.9 0.9 0.8 0.5 0.5 0.4 44.4 0.51 0.16 0.254 NS
Effect of Laksha of Palash plant was found significant on Shyavata, Parush sparsh, Daha and only
one parameter Kandu was found non-significant.

Table No. III
Effect of Laksha of Koshamra plant in Group C

Shyavata 2.3 2.3 1.9 1.5 1.5 0.8 34.78 0.63 0.2 0.1038 NS
Parush Sparsha 1.4 1.4 1.2 0.7 0.7 0.7 50 0.48 0.15 0.0595 NS
Daha 0.7 0.7 0.5 0.4 0.4 0.3 42.85 0.48 0.15 0.4584 NS
Kandu 0.7 0.7 0.5 0.4 0.4 0.3 42.85 0.48 0.15 0.9141 NS
Effect of Laksha of Koshamra plant was found non-significant on all subjective parameter.
Table No. IV
Effect of Therapy by Inter group Comparison test on the basis of Classical reference
between all three groups
Parameter Ashwattha Palash Koshamra P Sig.
Shyavata 1.2 0.8 0.8 0.3467 NS
ParushSparsha 0.8 0.6 0.7 0.8499 NS
Daha 0.5 0.7 0.3 0.3398 NS
Kandu 0.4 0.4 0.3 0.8704 NS
After this statistical analysis of inter group comparison for subjective parameters (Shyavata, Parush-
sparsh, Daha and Kandu) shown non-significant results.
Table No. V
Comparison of Effect of Therapy on the basis of Classical reference between all three groups
S. N. Sign & symptoms Relief in percentage
Group A Group B Group C
1 Shyavata 50 47.05 34.78
2 ParushSparsha 47.05 60.00 50.00
3 Daha 62.50 87.5 42.85
4 Kandu 66.66 44.44 42.85
On comparing the results of all three groups on the basis of all classical subjective parameters it was
observed that Laksha of Palash (Group B) plant gave more relief as compared to Laksha of Ashwattha (Group
A) followed by Laksha of Koshamra (Group C) plant.

Effect of therapy on Subjective Parameters on the basis of Size and Colour of patches-
Table No. VI
Effect of Laksha of Ashwattha plant in Group A

Size 2.1 2.1 2.1 1.1 1.1 1 47.6 0.66 0.21 0.0039 S
Colour 2.5 2.5 2.1 1.2 1.2 1.3 52 0.94 0.30 0.0039 S
Effect of Laksha of Ashwattha plant was found significant on Size of patches and Colour of patches.
Table No. VII

Size 1.8 1.8 1.5 0.9 0.9 0.9 50 0.73 0.23 0.0151 S
Colour 2 2 1.6 1 1 1 50 0.81 0.25 0.0002 HS
Effect of Laksha of Palash plant was found highly significant on Colour of patches & significant on Size of
patches.
Table No. VIII
Effect of Laksha of Koshamra plant in Group C

Size 2.1 2.1 1.6 1.3 1.3 0.8 38.0 0.42 0.13 0.0758 NS
Colour 2.5 2.5 2.1 1.6 1.6 0.9 36 0.56 0.17 0.1572 NS
Effect of Laksha of Koshamra plant was found non-significant on Size of patches & Colour of patches.
Table No. IX
Effect of Therapy by Inter group Comparison test on the basis of Size and Colour of
patches between all three groups
Parameter Ashwattha Palash Koshamra P Sig.
Size 1 0.9 0.8 0.7909 NS
Colour 1.3 1 0.9 0.5783 NS
After this statistical analysis of inter group comparison in Size & Colour of patches shown non-significant
results.

Table No. X
Comparison of Effect of Therapy on the basis of Size and Colour between all three groups
S. N. Sign & symptoms Relief in percentage
Group A Group B Group C
1 Size 47.61 50 38.09
2 Colour 52 50 36
On comparing the results of all the three groups on the basis of Size and Colour of patches. It was
observed that Laksha of Palash (Group B) plant and Laksha of Ashwattha (Group A) plant were given almost
equal relief whereas least improvement was seen in Laksha of Koshamra (Group C) plant.
Discussion- Shyavata by 47.058% which was statistically

significant (p<0.001).
Effect Of Therapy On Subjective Parameters
On The Basis Of Classical Reference- Effect of Laksha of Palash plant on
Parusha sparash: Laksha of Palash plant had
Effect of Laksha of Ashwattha plant in Group
reduced Parusha sparasha by 60% which was
A
statistically significant (p<0.011).
By applying Wilcoxan Signed Rank (‘α’ value)
Effect of Laksha of Palash plant on
test following results were obtained
Daha: Laksha of Palash plant had reduced Daha
Effect of Laksha of Ashwattha plant on by 87.5% which was statistically significant
Shyavata: Laksha of Ashwattha plant had reduced (p<0.0207).
the Shyavata by 50.00% which was statistically
Kandu: Laksha of Palash plant had reduced Kandu
Effect of Laksha of Ashwattha plant on by 44.44 % which was statistically non-significant
Parush Sparsh: Laksha of Ashwattha plant had (p<0.254).
reduced Parush Sparsh by 47.05% which was
Effect of Laksha of Koshamra plant in Group
statistically significant (p<0.0156).
C
Effect of Laksha of Ashwattha plant on By applying Wilcoxan Signed Rank (‘α’ value)
Daha: Laksha of Ashwattha plant had reduced test following results were obtained
Daha by 62.50% which was statistically significant
Effect of Laksha of Koshamra plant on
(p<0.0313).
Shyavata: Laksha of Koshamra plant had reduced
Effect of Laksha of Ashwattha plant on the Shyavata by 34.782% which was statistically
Kandu: Laksha of Ashwattha plant had reduced non-significant (p<0.1038).
Kandu by 66.66 % which was statistically non-
Parusha sparash: Laksha of Koshamra plant had
Effect of Laksha of Palash plant in Group B reduced Parusha sparasha by 50% which was
statistically non-significant (p<0.0595).
By applying Wilcoxan Signed Rank (‘α’ value)
test following results were obtained Effect of Laksha of Koshamra plant on
Daha: Laksha of Koshamra plant had reduced
Daha by 42.857% which was statistically non-
Shyavata: Laksha of Palash plant had reduced the

Effect of Laksha of Koshamra plant on reduced the size of patches by 38.09% which was
Kandu: Laksha of Koshamra plant had reduced statistically non-significant (p<0.0758).
Kandu by 42.857% which was statistically non-
Colour of patches: Laksha of Koshamra plant had
Laksha of Palash plant (Group B) was found reduced the colour of patches by 36% which was
to be more effective in subjective parameter like, statistically non-significant (p<0.1572).
Parush-Sparsh and Daha as compare to Laksha of
Laksha of Palash (Group B) and Laksha of
Ashwattha (Group A) and Laksha of Koshamra
Ashwattha (Group A) plant was found to be more
(Group C) plant. Laksha of Ashwattha plant (Group
effective in subjective parameter like Size and Colour
A) was found to be more effective in subjective
of patches, compare than Laksha of Koshamra
parameter like, Shyavata and Kandu as compare to
(Group C) plant.
Laksha of Palash (Group B) and Laksha of the
Koshamra (Group C) plant. Mode Of Action Of Mukhalepa:
Effect Of Therapy On Subjective Parameters The classical therapeutic management of

On The Basis Of Size And Colour Of Patches Vyanga is described as Shodhana and Shamana
Thearapy. For the management of Vyanga Roga
Effect of Laksha of Ashwattha plant in Group
Shodhan therapy like Vaman, Virechana, Nasya,
A
Raktamokshana has been recommended. For the
By applying Wilcoxan Signed Rank (‘α’ Shaman therapy purpose many single or compound
value) test following results were obtained formulations are advocated either internally or
externally or both ways. The Ayurvedic
Effect of Laksha of Ashwattha plant on
pathogeneisis involves vitiation of Dosha starting at
Size of patches: Laksha of Ashwattha plant had
the Koshtha level and subsequent at Srotas level.
reduced size of patches by 47.61% which was
Pitta is said to be a Varn Prakashak and therefore
statistically highly significant (p<0.0039)
vatiation of Pitta leads to discoloration of skin but
Effect of Laksha of Ashwattha plant on this is an associated etiological factor in Vyanga
Colour of patches: Laksha of Ashwattha plant had whereas Vata is the predominant dosha in the
reduced the colour of affected area by 52 % which etiology of Vyanga. Ruksha guna of Vata dosha is
was statistically highly significant (p<0.0039). the principal causative factor for disease process of
Vyanga. The Ruksha guna of Vata dosha is
manifested as Rukshta in skin. Therefore application
By applying Wilcoxan Signed Rank (‘α’ value) of Snigdha dravyas (Laksha) as Lepa is postulated
test following results were obtained to reduce Rukshata.Vata and Pitta was pacified by
the Sheeta Veerya of the drug used for Lepa.
Effect of Laksha of Palash plant on Size
of patches: Laksha of Palash plant had reduced the Probable Mode Of Action Of Drug:
size of patches by 50% which was statistically
Vyanga is occur due to vitiation of Vata and
Pitta dosha. The Rasa of drug is Kashaya, Tikta.
Effect of Laksha of Palash plant on Vitiated Vata and Pitta get localized on the face and
Colour of patches: Laksha of Palash plant had gives rise to a patch on the skin, which is painless,
reduced the colour of patches by 50% which was thin and brown-black in colour. So Kashaya and
statistically highly significant (p<0.0002). Tikta Rasa subdues the Pitta which is the main cause
of the disease. The Guna of drug is Laghu-Snigdha.
Effect of Laksha of Koshamra plant in Group
Due to Snigdha Guna it alleviates the Vata. It breaks
B
the etiology of Vyanga by subsiding Pitta & Vata.
Size of patches: Laksha of Koshamra plant had l Tikta Rasa acts as Agnideepaka, Krimighna,

Kandughna, pacifies vitiated Pitta and is Laghu for internal use and for local application paste of
in property. Due to tikta rasa, and sheeta veerya Laksha in milk was prescribed according to
it act as Pittahara. affected area), reduced the colour and size of
patches in a statistically significant manner.
l The drug has Sheet Veerya, which is beneficial
Laksha of Koshamra (Group C) plant, (when
for skin disorder like Vyanga, due to its
given in powder form 1-2 gm. b.d. for 60 days
Pittashamak property. Sheet veerya is
for internal use and for local application paste of
Prasadana, Kledana and Jeevaniya as it
Laksha in milk was prescribed according to
promotes tissue firmness.
affected area) reduced the colour and size of
l Laksha has been mentioned in Bhava Prakasha patches but statistically non-significant manner.
nighantu as Varnya. Shyavata being the classical
l Laksha of Palash and Ashwattha plant reduced
symptom of Vyanga, occurs due to Vata and
the color and size of patches more than Laksha
Pitta Dosha. This symptom is treated by Laksha
of Koshamra plant.
due to its snigdha guna and tikta rasa.
l Therefore it is concluded that Laksha of Palash
l Parush sparsh in Vyanga is due to Abhyanga
and Ashwattha when used in Vyanga patient it
dvesha and other Vata vitiating Nidanas which
clear the affected area and is a safe and effective
causes roughness of face. Parush sparsh is
drug for treating Vyanga.
pacified by Snigdha guna of Laksha.
l Laksha of Ashwattha, Palash and Koshamra
l The Kandu was found in some volunteers in the
plant does not produce any ADRs in the
study. Which occurs due to Kapha dominant
prescribed dose and duration.
dosha dushti. Laksha have kapha shamaka due
to its kashaya, tikta rasa and katu vipak. l The study reaffirms Laksha as a low cost, safe,
effective, easily available and traditionally
l Aggravation of Piita dosha causes daha in
acceptable drug for the reducing Vyanga of the
vyanga, Laksha does Pitta shaman owing to its
affected population.
tikta rasa and sheeta veerya.
Referances-
l Laksha has been used as Balya drug due to its
Snigdha guna and sheeta veerya. It pacifies vata 1. Shushrut, Sushrut Samhita with Nibandhsamgraha
and pitta dosha, thus providing nourishment to commentary of Dalhanacharya , Edited by Vaidya
Yadavji Trikamji, Chaukhambha Surbharti
the tissue and especially skin, causing restoration
Prakashan, Varanasi, Edition 2017, Sutra Sthana 24/
of skin lustre. 9, Page. No. 116
l The drug has Laghu guna, thus acting as 2. Agnivesh, Charaka Samhita with Ayurvedadipika
Srotoshodhaka, and Agnidipaka. Commentary of Chakrapanidatta, Edited by Vaidya
Yadavji Trikamji, Chaukhambha Surbharati
l According to ayurvedic text Laksha is Prakashan, Edition 2014, Sutra Sthana 28/11-12, Page
Vishaghna, Krimighna, Vranaropak, no. 179
Vranshodhak, Shothhar and Dahahar.
3. Shushrut, Sushrut Samhita with Nibandhsamgraha
l In modern aspect Laksha has cooling, astringent, commentary of Dalhanacharya , Edited by Vaidya
haemostatic, anti-inflammatory, and anti-oxidant
Prakashan, Varanasi, Edition 2017, Nidana Sthana
effect. So the drug Laksha is useful for skin
13/45-46, pg. no. 324
diseases externally as well as internally.
4. Shushrut, Sushrut Samhita with Nibandhsamgraha
Conclusion: commentary of Dalhanacharya , Edited by Vaidya
l The trial drug Laksha of Palash (Group B) and Prakashan Varanasi, Edition 2017, Nidana Sthana 13/
Laksha of Ashwattha (Group A) plant, (when 45-46, pg. no. 324
given in powder form 1-2 gm. b.d. for 60 days

5. Vagabhatta, Ashtanga Hridayam with the 9. Agnivesh, Charaka Samhita, with Ayurvedadipika
Sarvangasundara commentary of Arunadatta and commentary of Chakrapanidaa, Edited by Vaidya
Ayurvedarasayana commentary of Hemadri, edited Yadavji Trikamji, Chaukhambha Surbharati
by Pt. Hari Sadashiv Shastri Paradakara, Prakashan, Edition 2014, Chikitsa Sthana 7/171, Page
Chaukhambha Surabharati Prakashana Varansi, no. 458
Edition 2016, Uttara Sthana 32/26, Page. No. 892
10. Shushrut, Sushrut Samhita with Nibandh Samgraha
6. http://emedicine.medscape.com/article/1068640- commentary of Dalhanacharya , Edited by Vaidya
overview#a010 Yadavji Trikamji, Chaukhambha Surbharti
Prakashan Varanasi, Edition 2017, Sutra Sthana 38/
7. Bhavamishra, Bhavaprakasha Nighantu with
64, Page. No. 169
commentary of Prof. K. C. Chunekara, Chaukhambha
Bharti Academy, Varanasi, Edition 2013, Haritakyadi 1 1 . Bhavamishra, Bhavaprakasha Nighantu with
varga. 194-195, page no. 110 commentary of Prof. K. C. Chunekara, Chaukhambha
Bharti Academy, Varanasi, Edition 2013, Haritakyadi
8. Agnivesh, Charaka Samhita, with Ayurvedadipika
varga. 194-195, page no. 110
commentary of Chakrapanidaa, Edited by Vaidya
Yadavji Trikamji, Chaukhambha Surbharati 1 2 . Priya Vrat Sharma, Priya Nighantu, Chaukhmbha
Prakashan, Edition 2014, Chikitsa Sthana 7/125, Surbharti Prakashan, Varanasi, Edition 1995,
page no. 456 Kasturyaadi Varga, Verse no. 4, Page no. 1434
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Group A
Before After
Before After
Before After

Group B
Before After
Before After
Before After

ISSN No:2321-0435
ORIGINAL ARTICLE
Anti-Microbial Study on Different Samples
of Lavangadi Vati
*Dr. Amitabh Mazumder **Dr. Parween Bano ***Prof. K.Shankar Rao
* Medical Officer (Ayu), RNB, Dist., Civil Hospital, Kokrajhar, Assam
**Ph.D Scholars, ***Professor & H.O.D., Deptt. of Rasashastra & Bhaishajya Kalpana, NIA, Jaipur.
ABSTRACT
Infectious diseases are a great challenge to human existence and the leading cause of death world-
wide. Haemophilus influenzae is a small (1.0 × 0.3µm), gram-negative, non motile, non-sporing bacillus,
exhibiting considerable pleomorphism. H. influenza is an exclusively human pathogen. Diseases caused by
H. influenza may be categorized into two groups; they are- Invasive and Non-Invasive. In Non-invasive group,
the bacillus spread by local invasion along mucosal surfaces and causes secondary or superadded infections,
usually of the respiratory tract. Cough is the symptom which arises in Respiratory tract during this non-
invasive infection. Lavangadi vati is the solid dosage form, comes under the Vati kalpana which is used in
the treatment of cough. Because of its quick action in the treatment of cough, the object of the study is to
evaluate the antimicrobial activity of 3 different formulation of Lavangadi vati against the H. Influenza.
Antimicrobial susceptibility test was performed by well diffusion methods.
The result shows that in comparison with S1, S2 and S3; S2 formulation at \100mg/ml shows the
best result against H. influenza i.e. 30mm ZOI comparative to 10 mg/ml Streptomycin.
Key Words:- Antimicrobial activity, Haemophilus influenza, Lavangadi vati.
Quick Response Code: How to cite this article : Mazumder A,

Bano P, Rao K S, Anti-Microbial Study on Different
Samples of Lavangadi Vati, JOA XII-4, 2018; 85-
91
Introduction
Infectious diseases account for

approximately one-half of all death in tropical
Website:- journalofayurveda.in countries. Infectious diseases are enchanted by
Address of correspondence: factors such as inadequate sanitation, poor hygiene
Dr.Amitabh Mazumder and overcrowding conditions. Ayurveda includes all
Medical Officer (Ayu), RNB, Dist., type of diseases, for example indigestion-oriented
Civil Hospital, Kokrajhar, Assam (Ajeernaja), immune-compromised (Oja-kshayaja)
Email: [email protected] and infectious diseases (Aupsargaja).
Contact No:- 9859018790 The term Aupasargaja Vyadhi is used for
infectious and contagious diseases.1 Krimi and Bhoota

Mazumder A, Bano P, Rao K S, Anti-Microbial Study on Different Samples of Lavangadi Vati, JOA XII-4, 2018; 85-91
are terms that may be co-related to microbes. From v The First sample (S1) was prepared as per
Krimi, Raktaja Krimi seems to be nearer to microbes specific reference of Vaidya jivanam written by
because these are invisible and live in blood vessels. Loliambaraj 6 with three times Bhavana of
Bhoota are invisible, so they may be microbes. Babbul Twaka kwatha.
Haemophilus influenzae is a small (1.0 × v The second sample (S2) was prepared with
0.3µm), gram-negative, non motile, non-sporing modified method of Vaidya Jivanam. Here
bacillus, exhibiting considerable pleomorphism. In Bhavana was given with khadir Sara kwatha,
sputum, it usually occurs as clusters of instead of Babbul Twaka kwatha. Babbula
coccobacillary forms. H. influenza is an exclusively Twaka Churna was mixed with the other
human pathogen. Diseases caused by H. influenza ingredients. All the materials were the same as
may be categorized into two groups; they are- mentioned in Vaidya Jivanam.
Invasive and Non-Invasive. In Non-invasive group,
v The third sample (S3) was prepared same as per
the bacillus spread by local invasion along mucosal
S1 only difference in seven times Bhavana of
surfaces and causes secondary or superadded
Babbul Twaka kwatha instead of three times.
infections, usually of the respiratory tract. These
include otitis media, sinusitis and exacerbations of v The antimicrobial susceptibility test performed
chronic bronchitis and bronchiectesis. These are by Well diffusion method on Muller Hinton (MH)
usually seen in adult and are often caused by the agar7 using 3 different samples of Lavangadi vati
non-capsulated strains. Cough is the symptom which formulations against Haemophilus influenza.
arises in respiratory tract during this non-invasive
Number of Bhavana:-
infection2.
In the SOP of Lavangadi vati, the number of
Now a days using antibiotics to subside
Bhavana is not mentioned in the Vaidya jivanam.
infection produces adverse toxicity to host organs,
So, the numbers of bhavana adopted here with were
tissues and cells3. Herbal molecules are safe, will
as general principle/average classical preparation.
overcome the resistance produced by the pathogens
since they are in combined form or in pooled form Three numbers of Bhavana – No
of more than one molecule in the protoplasm of reference for giving three numbers of Bhavana was
plant cell 4 . Some herbs have antibacterial and found in the classics in the preparation of Lavangadi
antifungal properties which will be useful to clinical vati. However, in the SOPs of various formulations
use.5 Lavangadi Vati is a most popular and effective like Ajirnahara vati, Amritprabha vati, Agnikumar
medicine in the treatment of cough. It is an Rasa, Agnisandipan Rasa, Umasambhu Rasa,
Ayurvedic solid dosage form prescribed for curative Khadiradi Gutika 8 etc. three number of Bhavana has
measure in all types of cough. One of the causative been carried out. Considering the above point of
factor of cough is due to various infections in the view, in the present research work, 3 number of
upper and lower respiratory tract. As per Ayurvedic Bhavana was done in the 2 batches of Lavangadi
classics it may due to Krimi. Therefore the objective vati (S1 & S2).
of the study is to evaluate the antimicrobial activity
Seven numbers of Bhavana9 - Vaidyaka
of this preparation against the pathogenic bacteria
Paribhasa Pradipa clearly mentioned the procedure
Haemophilus influenza.
for seven times of Bhavana, where no such reference
Materials and Method:- of number of Bhavana is available for a particular
formulation. Considering this reference the seven
v The raw material used for the preparation of
times of Bhavana was given in one batch of
Lavangadi vati was procured from Pharmacy,
Lavangadi vati (S3) in the present research work.
NIA, Jaipur. All the raw material was
authenticated and screened in Rasasashtra and
Bhaishajya kalpana department, NIA before
formulation development.
Preparation of Babbula Twaka kwatha (Ref.- Rasatarangini 2/50-51)
In the preparation of Babbul Twaka kwatha (Decoction) for Bhavana process, fresh kwatha was
prepared by using coarse powder boiled with distilled water in the ratio of 1:8 times10 each time for each
Bhavana. Showing of ingredient proportion of Drava Dravya in Table I.
Table No.1- Showing Ingredient and proportion of Drava dravya
S. No. Name Part used Quantity Proportion
1 Babbul Bark 300 grams 1:8
2 Distilled Water ——- 2400 ml.
Procedure: - using gas stove at the temperature in between 760c

to 78 0c. The quantity was then reduced to 1/8 th
Before starting the process all equipments (300ml) part of the initial (2400ml). This was then
were cleaned. Coarse powder of Babbul Twaka was filtered through a clean cotton cloth and stored in a
soaked with Distilled water in a medium size stainless glass beaker for Bhavana process. Various
steel vessel and kept it for overnight. Next morning observations during the preparation of Babbul
the soaking mixture in vessel was put on mild fire Twaka kwatha are shown in the following table.
Table No.II- Showing various observations during and after the

preparation of Babbul Twak Kwatha
Kwatha (Kw) Kw 1 Kw2 Kw3 Kw4 Kw5 Kw6 Kw7 Kw8 Kw9 Kw10
sample
Time spent 2.45 2.45 2.56 2.54 2.50 2.45 2.45 2.50 2.55 2.45
for preparation
of kwatha
(in hour )
Amount of 300 300 300 300 300 300 300 300 300 300
Kwatha (in ml)
Residue 1/8th 1/8th 1/8th 1/8th 1/8th 1/8th 1/8th 1/8th 1/8th 1/8th
Colour Dark Dark Dark Dark Dark Dark Dark Dark Dark Dark
Brown Brown Brown Brown Brown Brown Brown Brown Brown Brown
Odour Plea- Plea- Plea- Plea- Plea- Plea- Plea- Plea- Plea- Plea-
sant sant sant sant sant sant sant sant sant sant
Taste Astring Astring Astring Astring Astring Astring Astring Astring Astring Astring
-ent -ent -ent -ent -ent -ent -ent -ent -ent -ent
PH 3.7 3.7 3.8 3.7 3.7 3.7 3.8 3.7 3.7 3.7
Refractive Index 1.344 1.344 1.345 1.344 1.344 1.344 1.345 1.344 1.344 1.344
Bricks value 7 7 8 7 7 7 8 7 7 7
Specific gravity 1.028 1.028 1.026 1.028 1.028 1.028 1.026 1.028 1.028 1.028

Preparation of Khadir Sara solution for in distilled water and converts it to liquid form to
Bhavana process: - perform easy and comfort trituration (Bhavana).
Freshly prepared Khadir Sara kwatha was made
As the second sample of the study was a
each time for each Bhavana. In preparation of
modified one, here Bhavana was given by Khadir
Khadir Sara kwatha the ratio of water and ingredient
Sara kwatha instead of Babbul Twaka kwatha. In
was the same as in case of preparation of Babbul
this preparation, Khadir Sara powder was dissolved
Twaka kwatha.
Table No.III- Showing the ingredient and proportion of Drava Dravya
S. No. Name Part used Quantity Proportion
1 Khadir Sara 50 grams 1:8
2 Distilled Water —— 400 ml
Procedure: - dissolved completely in water. When Khadir Sara

Before starting the process all equipments was completely dissolved, the solution kept in
were cleaned. Khadir Sara powders were kept first beaker. This method was adopted three times for
in a small size stainless steel vessel and then add making three preparation of khadir Sara kwatha for
distilled water into vessel with khadir Sara. Stir the three times Bhavana in second sample.Various
whole mixer of vessel slowly until the khadir Sara organoleptic and physiochemical observation found
in Khadir Sara kwatha shown in Table no-IV.
Table No.IV- Showing various observations during and after the preparation
of Khadir Sara kwatha
Khadir Sara kwatha (Kh) Kh 1 Kh 2 Kh 3
Colour Pink Pink Pink
Odour Odorless Odorless Odorless
Taste Astringent Astringent Astringent
PH 5.7 5.7 5.7
Refractive Index 1.412 1.412 1.412
Bricks value 46 46 46
Specific gravity 1.00769 1.00769 1.00769
Preparation of Lavangadi Vati sample- Preparation of Lavangadi vati sample S1-
Three samples of Lavangadi Vati were 50 gram of fine powder of each ingredient
labeled as S1, S2 and S3 respectively. In all the 3 (Lavang, Maricha and Bibhitaka) were weighed and
samples the quantity of chief ingredients Lavanga, kept separately. Equal to the total quantity of above
Maricha, Bibhitaka and Khadir Sara were the same. drugs i.e. 150 grams of khadir Sara were weighed and
But Babbul Twaka was used as kwatha form in S1 kept separately. All the powder of ingredients was
and S3. Whereas Babbula Twaka was used in fine then mixed thoroughly and makes a homogenous
powder form in S2 sample. Prepared each handmade mixture in a steel tray. Then this homogenous
Vati weighed~ 1gm dose according to AFI11. mixture was shifted into a medium size Khalva

Yantra and three times Bhavana was given with times Bhavana was given with Babbul Twaka
Babbul Twak kwatha. It requires 170ml, 106ml and kwatha. It requires 170ml, 110ml, 100ml, 100ml,
100ml of Babbul Twak kwatha for first, second and 100ml, 90ml, 90ml of Babbula Twaka kwatha for
third Bhavana respectively. 1st, 2nd, 3rd, 4th, 5th, 6th and 7th Bhavana respectively.
Preparation of Lavangadi Vati sample S2- Anti-microbial susceptibility test:
50 grams of fine powder of each ingredient The anti-haemophilus activity of different

Lavanga, Maricha and Bibhitaka were weighed and formulations of Lavangadi vati was performed. H.
kept separately. Equal to the total quantity of above influenze was used for testing in-vitro antimicrobial
drug i.e.150 grams of Babbul Twaka churna were activity. Identification of microbial strain was based
weighed and kept separately. All the above on morphological, cultural and biochemical tests. In
mentioned powder of the ingredients was then mixed vitro anti-haemophilus activity was performed by
thoroughly to make a homogenous mixer in a well diffusion method on bacteria seeded Muller
stainless steel tray. The mixer of the powder was Hinton agar, wells of 6 mm were made on seeded
then shifted to a medium size khalva Yantra and agar by using pre-sterilized cork borer. Aliquot of
three times Bhavana was given with khadir Sara 60µl of each formulation S1, S2 and S3 (1, 10 and
solution. Each Bhavana was given with 400 ml of 100 mg/ml in DMSO) and standard antibiotic
khadir Sara kwatha. Streptomycin (10 mg/ml) was added into labeled
wells on seeded medium and allowed to stand for 1
Preparation of Lavangadi Vati sample S3-
hour on the bench for proper diffusion thereafter
50 gram of fine powder of each ingredient incubate for 37±2°C for 24 hour. The resulted
(Lavanga, Maricha and Bibhitaka) were weighed and inhibition zones were measured in millimeters (mm).
kept separately. Equal as total quantity of above Negative control of 60 µl of DMSO was also run in a
drugs i.e. 150 grams of khadir Sara were weighed and same manner and parallel to the treatments. Zone of
kept separately. All the powder of ingredients was inhibition of samples were compared with
mixed thoroughly and makes a homogenous mixture corresponding concentration of standard drug.
in a steel tray. Then this homogenous mixture was
Results:-
shifted into a medium size khalva Yantra and seven
Table No.V- Showing the Antimicrobial susceptibility test result of the 3 samples of
Lavangadi Vati against Haemophilus influenza.
S. No. Sample Standard and Sample ZOI Result

Dilution Inject
1 Lavangadi Vati S1 Standard (10mg/ml) 60 µl 28mm
1mg/ml 60 µl 17mm
10mg/ml 60 µl 19mm
100mg/ml 60 µl 25mm
1mg/ml 60 µl 17mm
10mg/ml 60 µl 22mm

1mg/ml 60 µl 13mm
10mg/ml 60 µl 22mm
Figure No.- 1, Showing the Antimicrobial activity of Lavangadi vati against the bacteria Haemophilus
influenza. at 100 mg per ml constraction.
Discussion:- 2. Ananthanarayan and Paniker’s, Textbook of

Microbiology, 9 th Edition, Universities Press (India)
Three different formulations of Lavangadi Private Limited.
Vati (S1, S2 and S3) were prepared using classical
3. Lin W.S. and X.Z. Song, 1989. Clinical and
and modified method to check their in-vitro anti- experimental research on a kidney tonyfying
haemophilus activity (shown in table no V). The prescription in preventing and treating children’s
antimicrobial susceptibility test performed for M.H. hearing loss induced by aminoglycoside antibiotic
agar using different concentration of Lavangadi Vati ototoxicity. Zhong Xi Yi Jie He Za Zhi (Chinese article),
formulations (Figure shown study plates in Figure 9:402-4, 388.
no.1). In comparison with S1, S2 and S3; S2 4. Sengupta A, Ghosh S and Bhattacharjee S, Abstract-
formulation at 100 mg/ml shows the best result Allium vegetables in cancer prevention Asian Pac. J.
against H. Influenza i.e. 30mm Zone of Inhibition Cancer Prev. 2004 Jul - Sep; 5(3):237-45.
comparative to 34 mm of Streptomycin (10 mg/ml). 5. Kalemba D. and Kunicka A, Abstract- Antibacterial

This results confirm that sample drug possess 88% and antifungal properties of essential oils, Curr Med
of activity comparative to standard antibiotic at Chem. 2003 May; 10(10):813-29.
specific concentration. S2 formulation shows higher 6. Loliambaraja, Vaidyajivanam, with vidyotini-Hindi
susceptibility against H. Influenza, possibly Khadir commentary by Dr. Indradeva Tripathi, vilash3/7,
Sara trituration may synergistically improve the Chaukhamba Orientalia, Varanasi, First Edition,
antimicrobial property of other ingredients of reprint 1978, pg37.
Lavangadi vati. 7. Perez, C., M. Paul and P, An Antibiotic assay by the agar
well-diffusion method, Acta Biol, Med.Exp., 15: 113-
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ßãç‹È∞¢¡Ê ∑§ ÁflL§h ⁄ÙªÊáÊÈ ¬˝ÁÃ⁄ÙœË ¬˝ÁÃÁR§ÿÊ ∑§Ê ◊ÍÀÿÊ¢∑§Ÿ Á∑§ÿÊ ªÿÊ– ⁄ÙªÊáÊÈ¬˝ÁÃ⁄ÙœË ‚¢flºŸ≥ÊË‹ÃÊ ∑§Ë ¬⁄ËˇÊÊ fl‹ «UË»È§¡Ÿ
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ÁflL§h ‚’‚ •ë¿UÊ •ÕÊ¸Ã ZOI 30mm ⁄„Ê–

ISSN No:2321-0435
ORIGINAL ARTICLE
In-Vitro Evaluation of Anti-Microbial Effect of Herbal
Formulation
*Dr. Goyal Arun, **Dr. Rath Sudipt, ***Prof. Kotecha Mita
*Senior Consultant (Ayurveda), NPCDCS-AYUSH Integration Project, CCRAS, 61-65 Institutional Area, Opp. D- Block, Janak Puri,
New Delhi-110058. **Assistant Professor, ***Professor & H.O.D., Deptt. of Dravyaguna, National Institute of Ayurveda, Jaipur
ABSTRACT
Surgical infection, particularly surgical site infection (SSI), is a major concern of surgery. Micro-
organisms contaminate these wounds and delays wound healing, Use of anti-microbial agents are very
important for prevention of sepsis. The aim of this study was to investigate the anti-microbial potential of
different extracts of flowers of Hibiscus rosa sinensis Linn., leaves of Melia azedarach Linn. and leaves and
stem of Jatropha curcas Linn. in combination in a suitable formulation (ointment) against S. aureus, E. coli.
Klebsiella sp. and P.aeruginosa. Majorly responsible for surgical wound infection, using agar well diffusion
technique. Aqueous and alcoholic extracts of Hibiscus rosa-sinensis Linn. showed antimicrobial activity
against Klebsiella sp and P. aeruginosa, while the alcoholic extracts of Melia azedarach and Jatropha curcas
showed activity with different microorganisms individually. In ointment form, the combination did not exhibit
significant activity. This is indicative of fact that the combination might nullify each other’s effect resulting
in loss of effectiveness. Thus, the ointment prepared from combination of test substances does not possess
anti-microbial activity.
Keywords:- Anti-microbial, Herbal, Ayurveda, Hibiscus, Melia azedarach, Jatropha curcas
Quick Response Code: How to cite this article : Goyal A,

Rath S, Kotecha M, In-Vitro Evaluation of Anti-
Microbial Effect of Herbal Formulation, JOA XII-
4, 2018; 92-97
Introduction
Ayurveda is a holistic system of medicine

nurturing human lives since ancient times. Drugs in
Website:- journalofayurveda.in Ayurveda plays important role not only as dietetics
Address of correspondence: but also in treatment of various diseases and
Dr. Goyal Arun disorders by being an integral part of Chikitsa
Senior Consultant (Ayurveda), NPCDCS-AYUSH Chatushpada. 1 According to Ayurveda, diseases
Integration Project, CCRAS, 61-65 Institutional develop due to imbalance of Tridosha. Apart from
Area, Opp. D- Block, Janak Puri, New Delhi- this, concept of micro-organism affecting the human
110058 Email:- [email protected], being is also present in Ayurveda texts as is evident
Contact No: - 8003898213 in Charak samhita.2 Dalahana in his commentary on

Goyal A, Rath S, Kotecha M, In-Vitro Evaluation of Anti-Microbial Effect of Herbal Formulation, JOA XII-4, 2018;
92-97
Sushruta samhita indicated towards the infectious explore the anti-microbial activity of their parts.
diseases. 3 There is abundant material available These parts can be used to produce effects on both
regarding Krimi in Vedic literature like Atharvaveda systemic and topical use. P Ruban et al reported
and Rigveda. Krimi are mentioned in Ayurveda antibacterial activity of hibiscus flowers against the
literature as Sukshma krimi, Rakshash, Bhoot, human pathogens such as E. coli, B. subtillis, P.
Adrashta, Durnama etc. Along with Vata, Pitta and aeruginosa, S. aureus, Streptococcus sp. Salmonella
Kapha, Krimi plays an important role in pathogenesis sp. 4 while Sen et al reported activity of Ethanol,
of various infective diseases. Methanol, Petroleum ether and aqueous extracts of
M. azedarach against the locally isolated human
Infections have long been a major health
pathogens like Escherichia coli, Staphylococcus
concern to entire human population, more so in
aureus, Bacillus cereus, and Pseudomonas
under developed & developing countries of the world 5
aeruginosa. Stem bark of Jatropha curcas shows
like India, especially the infection of post-operative
effective anti-bacterial activity in its methanolic
wounds. In surgical procedures, break in the
extract against different pathogenic bacteria.6
continuity of skin occur leading to formation of
surgical wound. As it is an unavoidable part of Material and methods:-
surgery, surgical wounds needs to be taken care of,
Collection and preparation of plant parts:
from any infections for proper healing. This creates
space for the development of suitable herbal anti- Fresh flowers of Hibiscus rosa sinensis Linn.
microbial formulation to be used topically for (Japa), Leaves of Melia azedarach Linn.
prevention of wound infections. (Mahanimba), leaves and stem of Jatroha curcas
Linn. (Vyaghra eranda) were collected from the field
In Ayuveda, many drugs have been
area of NIA, Jaipur, Rajasthan. Their identities were
mentioned having krimighna activity i.e. these
confirmed with the available literature and
plants kill or inhibit the growth of harmful
authenticated by the Department of the Botany,
microorganisms. Various researches done on Japa,
Rajasthan University.
Mahnimba and Vyaghra eranda in modern science
Table No. I:-
Sr. No. Plant Name Herbarium Account No.
I. Hibiscus rosa-sinensis Linn. RUBL211533
II. Melia azedarach Linn. RUBL211534
III. Jatropha curcas Linn. RUBL211535
The plants parts were cleaned, air-dried at solvent, evaporate 25 ml of the filtrate to dryness in
room temperature (28 ± 2 °C), blended to powder a tarred flat bottomed shallow dish and dry at 100
and stored at room temperature in sterile bottles ºC, to constant weight and weigh. This was followed
prior to use. by the dilution of the crude extract with mother
solvent to produce a stock solution of 300mg/ml;
Preparation of Plant Extract:
from which a series of dilutions were made to obtain
Macerate 10 g of the air dried drug, coarsely solutions of 20, 50, 100 and 200mg/ml
powdered, with 100 ml each of distilled water and concentrations.
alcohol separately, the specified strength in a closed
Culture and Maintenance of microorganisms:
flask for twenty-four hours, kept on a rotatory
shaker at 190-220 rpm shaking frequently during six Pure cultures of all experimental bacteria
hours and allowing standing for eighteen hours. were obtained from the Microbial Type Culture
Filter rapidly, taking precautions against loss of Collection and Gene Bank (MTCC), Institute of

92-97
Microbial Technology (IMTECH), Chandigarh. The maintained by sub culturing regularly on the same
pure bacterial cultures were maintained on nutrient medium and stored at 4oC before use in experiments.
agar medium. Each bacterial culture was further
Table No. II:-
Sr. No. Bacterial strains MTCC NO.
I. Exsherichia coli 10239
II. Pseudomonas aeruginosa 1034
III. Klebsiella Subsp. Pneumonia (aerogenes) 39
IV. Staphylococcus aureus 6908
Antibacterial activity:
Povidone Iodine solution at a concentration of 5%w/
The antibacterial activity of the crude v solution.
extracts was determined in accordance with the agar-
Ethical clearance:-
well diffusion method described by Perez et al.
(1990).7 The bacterial isolates were first grown in a Ethical clearance was not required in this
nutrient broth for 18 h before use. Standardized cell work as this research work was done in-vitro on
suspensions were spread on a Mueller-Hinton agar micro-organisms and does not involve any human or
(Oxoid). Wells were then bored into the agar using a animal trial.
sterile 5 mm diameter cork borer. Approximately 20
Observation and result:
ìl of the crude extract at concentration of 20, 50,
100, 200 and 300 mg/ml-1 were introduced into the In the present investigation, the inhibitory
wells as single samples and in concentration of 100, effect of different extracts (viz. Methanol, Aqueous)
200 and 300 mg/gm as mixture of alcoholic and of flowers of Japa, Mahanimba and Vyaghra eranda
aqueous extracts of all four samples in liquid extract were evaluated against bacterial strains individually
and in ointment form, then allowed to stand at room and in combination in ointment form. The
temperature for about 2 h and then incubated at antimicrobial activity was determined using agar well
37°C. Controls were set up in parallel using the diffusion method summarized in Table III- IX. The
solvents that were used to reconstitute the extract. activity was quantitatively assessed on the basis of
The plates were observed for zones of inhibition after inhibition zone.
24-48 h. The effects were compared with standard
Table No. III: Table showing ZOI of test drugs in different extracts of Japa:-
Extracts (w/v) Zone of inhibition (in mm)

S.aureus E. coli P.aeruginosa Klebsiella sp.
Aqueous 10% 0 0 6 6
Alcohol 10% 7 7 6 9
Aqueous 20% 0 7 11 9
Alcohol 20% 6 0 6 14
Aqueous 30% 8 8 14 20
Alcohol 30% 6 7 7 21

92-97
Table No. IV: Table showing ZOI of test drugs in different extracts of Mahanimba:-
Aqueous 10% 7 0 0 7
Alcohol 10% 0 6 0 7
Aqueous 20% 0 0 6 9
Alcohol 20% 0 8 6 10
Aqueous 30% 0 0 0 17
Alcohol 30% 7 8 16 20
Table No. V: Table showing ZOI of test drugs in different extracts of Vyaghra eranda Leaf
Aqueous 10% 0 6 0 8
Alcohol 10% 0 7 0 10
Aqueous 20% 0 8 0 11
Alcohol 20% 0 0 10 13
Aqueous 30% 0 9 6 12
Alcohol 30% 7 10 0 22
Table No. VI: Table showing ZOI of test drugs in different extracts of Vyaghra eranda Stem
Aqueous 10% 7 0 6 8
Alcohol 10% 6 6 6 9
Aqueous 20% 0 6 6 8
Alcohol 20% 6 8 7 13
Aqueous 30% 8 6 7 0
Alcohol 30% 6 0 0 21

92-97
Table No. VII: Table showing ZOI in different concentration of Mixture
Conc. (w/v) Zone of inhibition (in mm)

Mixture 10% 0 0 6 6
Mixture 20% 0 0 7 6
Mixture 30% 6 7 7 6
Table No. VIII: Table showing ZOI in different concentration of Ointment
Conc. (w/v) Zone of inhibition (in mm)

Ointment 10% 0 0 0 0
Ointment 20% 6 6 0 0
Ointment30% 0 0 0 6
Table No. IX: Table showing ZOI in Standard Povidone iodine (+ve control), Water, Alcohol
and Ointment base (-ve control)
Controls (w/v) Zone of inhibition (in mm)

Povidone Iodine 5% 13 0 0 28
Water (Aqueous) 0 0 0 0
Alcohol (99.5%) 0 0 0 6
Ointment Base 0 0 0 0
Discussion:- remaining two organisms.
In case of Japa, both Aqueous as well as In case of Vyaghra eranda leaf, Alcoholic
Alcoholic extracts were found highly effective in extract is much effective in all its conc. of 30%, 20%
30% conc. against Klebsiella sp. with ZOI of 20mm and 10% with 22mm, 13mm and 10mm of ZOI
and 21mm respectively but was less as compared to respectively while Aqueous extract shows
Standard Povidone Iodine of 28mm. For effectiveness of 12mm and 11mm in 30% and 20%
P.aeruginosa, aqueous extract was found effective in conc. for Klebsiella sp. Alcoholic extract of 30%
30% with 14mm and in 20% conc. with 11mm ZOI conc. shows activity of 10mm against E.coli and in
while they show mild response against E.coli and 20% conc. with 10mm ZOI against P.aeruginosa.
Staphylococcus aureus. In case of Vyaghra eranda stem, only
In case of Mahanimba, Alcohol extract Alcoholic extract shows good activity of 21mm and
shows highest activity in 30% conc. as 20 mm and 13mm in 30% and 20% conc. respectively against
in 20% conc, as 10mm while Aqueous extract shows Klebsiella sp.
ZOI of 17 mm in 30% conc. against Klebsiella sp. Different extracts of Japa, Mahanimba and
Alcoholic extract was found effective with 16 mm ZOI Vyaghra eranda exhibited various degree of zone of
against P.eruginosa in 305 w/v conc., while both the inhibition against different bacteria (Gram positive as
extract were not much effective against the well as Gram negative), they were taken as mixture

92-97
to test in liquid and ointment form to test their 1981. p. 61-62

collective efficacy. 2. Agnivesa. Sutrasthana, Jwarachikitsa adhyaya, 3/
115. In: Vd. Jadavaji Trikamji Acharya, editor. The
Mixture in both liquid and ointment forms in
Charaka Samhita with the Ayurveda Dipika
all the concentrations were found ineffective to show Commentary of Chakrapanidattta. 4th ed. Bombay:
considerable zone of inhibition. Munshiram Manoharlal Publishers Pvt Ltd.; 1981. p.
407-408
This shows that although individual drugs
have satisfactory effect in certain bacteria but when 3. Susruta. Sutrasthana, Vyadhisamuddeshiya adhyaya
used together, they fail to elicit this effect. The 24/7. In: Vd. Jadavji Trikamji Acharya, editor.
Sushruta Samhita with the Nibandhsangraha
hypothesis of individual effect will lead to summative
commentary of Sri Dalhanacharya. 6th ed. Varanasi
total effect does not hold good for these test : Chaukhamba Orientalia; 1997. p.114-115
substances.
4. Ruban P, Gajalakshmi K. In vitro antibacterial
The individual components might be activity of Hibiscus rosa-sinensis flower extract against
negating the effects of each other (due to Prabhava) human pathogens. Asian Pac J Trop Biomed
or the lowering of effective concentration of the [Internet].2012 May; 2(5): 399–403. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/
effective substance might be another reason for less
PMC3609315/ DOI: 10.1016/S2221-1691(12)60064-
effect. 1
Conclusion:- 5. Sen A, Batra A. Evaluation of Antimicrobial Activity of

Different Solvent Extracts of Medicinal Plant: Melia
Japa, Mahanimba and Vyaghra eranda
Azedarach L. International Journal of Current
individually possess variable degree of anti- Pharmaceutical Research [Internet]. 2012 March;
microbial activity against different strains of bacteria 04(2): 67-73. Available from: https://
but the herbal formulation i.e. ointment prepared innovareacademics.in/journal/ijcpr/Issues/
from the combination of test substances does not Vol4Issue2/488.pdf
exhibit anti-microbial activity against targeted 6. Igbinosa OO, Igbinosa EO, Aiyegoro OA. Antimicrobial
micro-organisms. activity and phytochemical screening of stem bark
extracts from Jatropha curcas (Linn). African Journal
References:- of Pharmacy and Pharmacology [Internet]. 2009
February; 3(2): 058-062. Available from: http://
1. Agnivesa. Sutrasthana, Khuddakchatushpada
c i t e s e e r x . i s t . p s u . e d u / v i e w d o c /
Adhyaya, 9/3. In: Vd. Jadavaji Trikamji Acharya,
download?doi=10.1.1.561.1288&rep=rep1&type=pdf
editor. The Charaka Samhita with the Ayurveda
Dipika Commentary of Chakrapanidattta. 4th ed. 7. Perez C., Paul M., Bazerque P. Antibiotic assay by agar
Bombay: Munshiram Manoharlal Publishers Pvt Ltd.; well diffusion method. Acta Biol Med Exp. 1990; 15:
113-115.
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∑§◊¸ Á∑§ ˇÊ◊ÃÊ ∑§Ë ¡Ê°ø ∞‚.•ÊÒÁ⁄ÿ‚, ß.∑§Ù‹Êß, ¬Ë.∞L§Á¡ŸÙ‚Ê ÃÕÊ Ä‹’Á‚∞‹Ê ÁS¬., ¡Ù Á∑§ ≥ÊÀÿ SÕÊŸªÃ fl˝áÊ ∑§ ‚¢R§◊áÊ
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ÁflÁ÷ÛÊ ‚Èˇ◊ ¡ËflÙ ¬⁄ √ÿÁQ§≥Ê— ¬˝÷ÊflË ‚ÊÁ’Ã „È∞– ©¬⁄ÙQ§ Œ˝√ÿÙ ∑§ ‚àflÙ ‚ ÁŸÁ◊¸Ã ◊‹„◊ ∑§À¬ŸÊ ÁR§Á◊ÉŸ ∑§◊¸ ◊¥
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ISSN No:2321-0435
ORIGINAL ARTICLE
An in-vivo study of toxicological effects of Shudha Dhatura
Beej and its therapeutic efficacy w.s.r. to Jwar.
*Dr. Ramnivas Berval, ** Dr. R.K. Sharma (Chulet), ***Prof, Anita Sharma
*P.G.Scholar, **Ex. Professor, ***Professor & H.O.D
P.G. Department of Agadtantra, National Institute of Ayurveda, Jaipur.
ABSTRACT
Upvishas are gaun vishas, one among them is Datura Metal which is unanimously accepted as
Jwarhara by all Nighantus of medieval and modern era. On the other hand, in toxicological text of modern
era it is said to be causing dry hot skin. So we have selected it as test drug and Jwar as disease & expect
there will be a plenty of experience which will make us enable to know whether it is higher doses or impurities
which causes contrary effects or it is Shodhana process which deprive Dhatura of its serious toxic properties.
Though, Jwar is most common & having high mortality rate in its different varieties. In Ayurveda it
has been considered such a disease which supposes to be present at the time of birth and death. Therefore,
it has been termed as kings of disease, Vikar-Raj Punarvasu Atreya also supported this thought or observation
of Acharya Shushruta and stated that:-
‚fl¸¬˝ÊáÊ÷ÎÃ—‚Öfl⁄Ê∞fl¡ÊÿãÃ‚Öfl⁄Ê∞flÁ◊˝ÿãÃ– (ø.ÁŸ. 1/35)

And started to write diagnostic and treatment chapters in Samhita, Nidana and Chikitsa keeping Jwar
at no.1. Doubtlessly, it is common and most important disease.
Key words: Upvisha, dhatura metal.
Quick Response Code: How to cite this article : Berval R,

Sharma RK, Sharma A, An in-vivo study of
toxicological effects of Shudha Dhatura beej and
its therapeutic efficacy w.s.r. to jwar, JOA XII-4
2018; 98-104
Introduction
Dhatura is included in the group of Upvisha.1
There are differences in the number of upvisha in
Dr.Ramnivas Berval,
ayurvedic books but Dhatura has been considered
PG Scholar, Deptt. of Agad Tantra,
upvisha by all ayurvedic authors of medieval era and
National Institute of Ayurveda, Jaipur
also in modern era. It is also considered by almost
all authors that every visha has 10 gunas in different
Contact No:- 9309405760
quantity and ratio which makes them special & more

Berval R, Sharma RK, Sharma A, An in-vivo study of toxicological effects of Shudha Dhatura beej and its therapeutic
efficacy w.s.r. to jwar, JOA XII-4 2018; 98-104
effective and dangerous some time, depending on tarangini 24/346-347, So that we can assess impact
different factors, dose & time of intake, method of of Shodhana on toxicity.
use, preparation of use, physical condition of user
Because it is not advised by Agad Tantra to
etc.
take poison in their original form in which they occur
For the purpose of identification of Rasa, in nature as these are mixed with a lot of toxic
Guna, virya, vipaka etc. of dhatura, we have impurities which are toxic for our body. Various pre-
surveyed about nine Ayurvedic Nigantu. In almost pharmaceutical processes have been described in the
21 major diseases, they have mentioned use of Ayurveda or especially in Rasagranthas to render
dhatura, the Jwar is only one where its utility, them useful to incorporate in medicines. They also
usability has been accepted or indicated by all nine suggested various methods of administration and
Nigantu. Therefore we have decided to study its do’s and don’ts. When followed all these as suggested
Jwarahara effect only where all Nigantu were having then there will be no scope for such symptoms to
same opinion about its usability in fever.2 develop.
On the other hand, it is described as poison Aims & objectives:

(in Parikh’s textbook of medical jurisprudence,
ü The aim of the present research work is to
forensic medicine and toxicology) which causes 9D’s
evaluate the antipyretic effect of powder of
symptoms, among which one is dry hot skin or
Shodhit Dhatura seeds in different doses and
pyrexia which is contrary to its so called therapeutic
compare of these effects with the effect of
use in ayurvedic texts/Nigantu as anti-pyretic.
antipyretic drug paracetamol.
But it is also very interesting to know that
ü To Study the acute toxicity of Shodhit Dhatura
there are some visha and upvisha which are creating
seeds after shodhana and to evaluate effect of
or producing a disease if they are taken in ashodhita
shodhana on the toxicity of Dhatura beej.
form. That same visha or upvisha can even treat or
eradicate the very same disease if taken in proper ü To find out the antipyretic efficacy of Datura
dose and if it is used in shodhit form. Dhatura metel seeds in Brewer’s yeast induced pyrexia in
represent the upvisha varga which can cause fever lab animals in different doses.
as its toxic effect if taken in ashodhita form.3 And it
ü To evaluate effect of shodhit and ashodhita
can also subside or reduce the body temperature if
dhatura beej on the temperature. It may be
it is taken after subjection of shodhana. The other
taken as model to create this.
one is Hartala, which can cause Kushtha disease by
its toxic effect if taken in ashodhita form and also ü To calculate average weight of seed of dhatura.
can treat it, if taken in shodhit form4.
ü To calculate average fatal dose given in text in
It created lot of curiosity in mind. Therefore, term of weight.
we have selected Dhatura beej for this study and
ü To compare the effects of Shodhit & Ashodhita
Jwar as disease where its effect can be assessed and
dhatura on weight of rats.
also to find out some possibilities to create a new
experimental model to produce high temperature in Materials & methods:
lab animal as an Ayurveda model. Because up to this
Ø Materials
time no Ayurveda model is available by which one
can produce fever in lab animal in controlled These articles/items have been included in
scientific conditions. the study as materials-
We also decided to perform toxicity study in Seeds of Dhatura metel, Apparatus for
ashodhita form dhatura seeds as well as its toxicity shodhana & liquid media to be used, Laboratory
after its shodhana by Godugdha in dola-yantra utensil, Trial equipment, Consumable items,
according to the purification method given in rasa Chemical reagents and drugs, Gadgets & software, Rat

animals, Food materials and water for rats. Detail of (i) Doses of brewer’s yeast solutions to all groups at
these items are given below- 0:0 hr.
Ø Seeds of Dhatura metel: We had used (ii) Liquid doses of different item mentioned as per
powder of Shodhit dhatura metel for toxicity study plan in antipyretic study at 18:00 hr.
& antipyretic study while toxicity study with - Procedure of recording of per hour temperature
Ashodhita dhatura was also performed. For this we
- Method used in Presentation of result
had collected 4 different samples and mixed them all.
One Sample of which was fresh ripped fruits of - Method of Statistical analysis
Dhatura metel were collected on November 3, 2014
Ø Inclusive criteria
and were dried in sunlight for 4 days to separate the
seeds while 3 other samples were collected from l The animals having 38ºC rectal temperatures will
Jaipur market. The detail of which has been only be included as a subject for this study.
described later in method used for calculation of
Ø Exclusive criteria
fatal dose.
l Animal which are having temperature less than
Ø Methods: These following methods has been
38ºC will not be included.
adopted for an easy and smooth transaction of
work regarding to the topic of research- Ø Method adopted for calculation of fatal dose;
- Methods of preparation of Shodhit and Ashodhita the fatal dose of datura metel is 100-125
dhatura beej powder seeds for human being.
- Method Adopted for shodhana of seeds of Total weight of seeds= 4 gm. or 4000 mg.
Dhatura metel in present study
Total number of seeds= 350
- Method adopted for Preliminary phytochemical
So weight of one seed= total weight of seeds/
screening
no. of seeds= 4000 mg/350= 11.43 mg.So we can
- Methods for preparations of stock solutions to be put the fatal dose given in term of no. of seeds into
used further, in experimental study the fatal dose in term of weight as follow-
- Method adopted for calculation of fatal dose in Fatal dose (in mg) = fatal dose (in term of seeds) X
unit of mg. or gm. instead of no. of seeds weight of 1 seed.
- Method for formation of Doses for acute toxicity Fatal dose (in mg) = (100-125 seeds) X 11.43 mg =
studies 1143-1429 mg.
(i) Doses formation for acute toxicity study with Ø Calculation of fatal doses for rats-
Shodhit dhatura beej powder
We have calculated fatal doses for rats by
(ii) Doses formation for acute toxicity study with multiplying fatal doses for human being to the
Ashodhita dhatura beej powder conversion factor for rat which is .018 for rat
- Evaluation method in toxicity study weighing 200 gm.
- Laboratory methods: fixation, tissue processing, So fatal dose for a rat weighing 200 gm. = fatal dose
section cutting and staining for human being X .018
- Method of setting three different Test Doses level And fatal dose (in mg/kg) = fatal dose for 200 gm.
for human being and its conversion into the rat X 5
doses (in mg) for Experimental Albino Rats
- Methods for liquid doses formation for
antipyretic study
Ø Method for formation of Doses for acute OBSERVATION & RESULTS

toxicity studies-
Observation on experimental study:
Acute single dose toxicity of dhatura beej
1. Observation on Shodhan of Dhatura
powder according to OECD guidelines-423, was
Seeds:
carried out-
It was observed that after compeletion of
Ashodhit (non-purified) & Shodhit (purified)
shodhan process the colour of Godugdha (cow’s
Dhatura seed churna was administered orally in
milk) was changed from white to Brownish.
single dose of 50 mg/kg body weight; 300 mg/kg
body weight and 2000 mg/kg body weight to 6 2. Observation on Acute Toxicity Studies:
groups of Albino Rats for both toxicity study. For
Observation on toxic effects & behavioural
this the rats were randomly selected in 7 groups with
changes:
3 rats in each group. The first 3 groups were given
Shodhit Dhatura seed churna in the dose of 50 mg/ In observation of toxic effect and behavioural
kg body weight, 300 mg/kg body weight and 2000 change in group given shodhit dhatura beej powder
mg/kg body weight respectively while the other three inhibition in salivary secretion, dryness of eyes,
groups were given same doses of Ashodhit Dhatura mucous membranes and dilation of pupil and tremor
seed churna and last group was placed as control were observed, in which most of these sign&
group and only given distil water. Dose of particular symptoms were in generally present in first 24 hr.
rat was calculated according to its body weight and of administration of test drug doses and then
then dissolved in 1% CMC solution to make drug automatically disappeared but more higher doses
suspended. made the rats more lethargy and more drowsy for a
long period which was even up to 14th day in 2000
Ø Protocol for antipyretic study:
mg/ kg dose.
The animals were fevered by injection of
In other groups which were administrated
10 ml/kg Brewer’s yeast suspension subcutaneously
Ashodhita dhatura beej powder, with these signs &
in the back, below the nape of the neck and the site
symptoms there were many other severe toxicity
of injection was massaged in order to spread the
signs & symptoms were observed such as;
suspension beneath the skin. The room temperature
inflammation and redness of eyes, dysphagia,
was kept at 22-240C. Immediately after injection, the
drunken gait, urine retention, severe dryness of
food was withdrawn but allowed free access to
mouth, skin, eyes and mucous membrane. These
drinking water. 18hr post challenge, the rectal
effects were followed by increase in temperature,
temperature was recorded using digital clinical
convulsion and even mortality in the end. These
thermometer. Only animals with a rectal temperature
signs & symptoms not only occurred early but also
at least 380 C (100.4 0F) were taken into the test and
persist for a long time at higher doses of ashodhita
split into five subgroups (N=8); placebo control,
dhatura beej.
standard control, test group-A, test group-B and test
group-C marked the rats as given in plan of study. Observation on mortality:
We have recorded and presented Rectal In toxicity study of Ashodhit dhatura seeds
temperature of rats in different groups at 0, 60, 120, 1 out of 3 rats in 300 mg/kg body weight group and
180, 240,300, 360 (at 18:00, 19:00, 20:00, 21:00, 2 out 3 rats in 2000 mg/kg body weight group were
22:00, 23:00 and 24:00 hr. of commencement of observed dead in 24 hr. after administration of test
study) minute after administrating distil water to drug.
placebo control group, paracetamol to standard
Analysis of change in weight:-
control group and test drug to 3 test groups as per
plan at 18:00 after yeast administration. In control group and in groups administrated
50 mg/ kg body weight of test drug, the % increase
in body weight was 2.7%, 4.97% and 2.79 % Analysis of histopathological study:
respectively for control, shodhit and ashodhita drug.
The pathological data indicated that the
Which means the shodhit dhatura is more effective
plant constituent (s) affected mainly in brain, kidneys
in increasing body weight.
and liver causing hepatocellular fatty vacuolation,
Analysis of haematological Parameters: fatty change and dilatation and alteration of
glomeruli of kidney and cerebral neuronal
In rats given ashodhita dhatura beej powder,
vacuolation and lymphocytic infiltration. This
in toxicity study, the increase of lymphocytes and
toxicity of Datura metel seeds might be related to
decrease in neutrophils were both very significant in
the compounds in Datura metel seeds.
comparison to those same doses, in rats given
shodhit dhatura beej powder. Which also indicate 1. Observation on Antipyretic study:
and proves about the inflammation happened and its
fever causing ability.
Table showing temperature (°F) presented as MEAN±SEM at 18-19-20-21-22-23 & 24th

hours after inducing yeast at 0 hr. to all groups & different item as per plan in different
group i.e. placebo-pcm-test drug in different doses in different group.
GROUP 18 HR 19 HR 20 HR 21 HR 22 HR 23 HR 24 HR
Placebo control 1 0 0 . 7 9 ± . 1 2 1 0 0 . 9 1 ± . 2 1 100.89±.25 1 0 0 . 8 9 ± . 1 9 1 0 0 . 8 8 ± . 2 1 100.85±.19 100.84±.18

group
Standard control 100.82±.15 99.78±.14 99.21±.13 99.00±.15 98.90±.16 98.70±.15 98.58±.12

group
Test group-A 100.80±.22 100.59±.22 100.40±.23 1 0 0 . 1 9 ± . 2 0 100.08±.20 99.99±21 99.96±.22
Test group-B 100.64±.19 100.38±.13 100.34±.14 100.18±.16 99.99±.09 99.82±.09 9 9 . 7 9 ± . 1 1
Test group-C 100.74±.19 100.34±.18 99.89±.16 99.68±.16 99.55±.13 99.30±.14 99.25±.18
Discussion: deprived (although attenuation of severity is

significant in term of mortality causing effect and the
Our study shows that Shodhana of dhatura
time they remain present) by shodhana. This is
has tremendous effects on depriving Dhatura of its
exactly what Nighantus say; which mentions it
some of serious toxic properties which looks
antipyretic unanimously and also mentioned some of
prominent given the fact that even 2000 mg/ kg
its toxic effects like Bharma etc.5
dose or 22.22 gm. human dose of Shudha Dhatura
(17.5 times of average textual fatal dose, as given in All three test doses (4.22, 5.625 & 7.03 mg/
Parikh’s text book of medical jurisprudence, forensic kg body weight of Shodhit Dhatura) although,
medicine and toxicology i.e. 100-125 seeds) didn’t continually reduce the increased body temperature
cause any fatality while Ashudha Dhatura causes 1 but the effectiveness has been changed with time. In
Mortality (33.33%) even at 300mg/kg or at 3.33 gm. first 3 hour of treatment pcm did extremely well by
human dose (2.6 times of textual fatal dose for reducing 1.05 °F, 0.56 °F and 0.21 °F of increased
human being), which is 1/8.5 times of maximum dose body temperature. In 1 st, 2 nd and 3rd hr., Temp
given of Shudha dhatura in this study. In 2000 mg/ reduction in test groups A, B, C were [-0.21 (20%), -
kg of Ashodhita Dhatura the mortalities are 66.66%. 0.19 (33.93%), -0.21 (100%)], [-0.26 (24.76%), -0.04
(7.14%), -0.16 (76.19%)], [-0.40 (38.10%), -0.45
However, beside effect on temperature some
(80.35%), -0.21 (100%)] respectively, in comparison
of other signs & symptoms of toxicity are not fully
to pcm. But in 4 th and 5 th hr. of treatment, temp
reduction in pcm group are 0.10 °F and 0.20°F but changed with time. In first 3 hour of treatment
in comparison to test drug A [-0.11 (110%), -0.09 pcm did extremely well by reducing 1.05 °F,
(45%)], B [-0.19 (190%), -0.16 (80%)] and C [-0.12 0.56 °F and 0.21 °F of increased body
(120%), -0.25 (125%)] it is less by-en-large. temperature. In 1 st , 2 nd and 3rd hr., Temp
reduction in test groups A, B, C were [-0.21
Which means mathematically, test drug-C
(20%), -0.19 (33.93%), -0.21 (100%)], [-0.26
reduced temp equal or more effectively than pcm
(24.76%), -0.04 (7.14%), -0.16 (76.19%)], [-0.40
during 4th and 5th hr. of treatment.
(38.10%), -0.45 (80.35%), -0.21 (100%)]
Statistically, effect of pcm is found significant respectively, in comparison to pcm. But in 4th
in comparison to effects of test dose 4.22 & 5.625 and 5th hr. of treatment, temp reduction in pcm
mg/kg body weight but it is insignificant or Ns in group are 0.10 °F and 0.20 °F but in comparison
comparison to test dose 7.03 mg/kg body weight. to test drug A [-0.11 (110%), -0.09 (45%)], B [-
0.19 (190%), -0.16 (80%)] and C [-0.12 (120%), -
Conclusion:
0.25 (125%)] it is less by-en-large.
1 . Shodhana has tremendous effects on depriving
Which means mathematically, test drug-C
Dhatura of its serious toxic properties which
reduced temp equal or more effectively than
looks prominent given the fact that even 2000
pcm during 4 th and 5 th hr. of treatment.
mg/ kg dose or 22.22 gm. human dose of Shudha
Statistically, effect of pcm is found significant in
Dhatura (17.5 times of average textual fatal dose,
comparison to effects of test dose 4.22 & 5.625
as given in Parikh’s text book of medical
mg/kg body weight (p<0.01) but it is insignificant
jurisprudence, forensic medicine and toxicology
or Ns in comparison to test dose 7.03 mg/kg
i.e. 100-125 seeds) didn’t cause any fatality while
body weight.
Ashudha Dhatura causes 1 Mortality (33.33%)
even at 300mg/kg or at 3.33 gm. human dose 6. Temperature in placebo control remained almost
(2.6 times of textual fatal dose for human being), stable when we have calculated average change
which is 1/8.5times of maximum dose given of of temperature in whole period of study but
Shudha dhatura in this study. In 2000 mg/ kg there was considerable decrease in increased
of Ashodhita Dhatura the mortalities are 66.66%. temperature by all three test doses in
comparison to placebo control.
2. Toxicity study shows that higher doses of Shudha
Dhatura also made rats drowsier and lethargy & Statistically, test dose-A, test dose-B, and test
it increases with increased doses, thus it also has dose-C are Ns, significant and significant (Ns,
toxic effect at much higher doses. p<0.05 and p<0.01) respectively in comparison
to placebo control. It means middle and higher
3. All three doses of Ashudha Dhatura (i.e. 50,
doses are effective in reducing pyrexia.
300, 2000 mg/kg body weight) have
considerable pyrogenic effect 7 . As per our study, average weight of one seed of
Datura metel, which is calculated through 4
4. In toxicity study of Ashudha Dhatura,
different samples collected randomly, is 11.43 mg
percentage increase in body temperature
and one gram of weight contains 87.5 seeds. As
according to different doses given, isn’t
per Parikh’s text book of medical jurisprudence,
considerably different, so even low doses can be
forensic medicine and toxicology 100 seeds
used to create pyrexia in lab animal (Model) as
weigh about 1 gram.
these doses don’t have mortality effect.
8. Fatal dose which is being calculated on the basis
5. All three test doses (4.22, 5.625 & 7.03 mg/kg
of number of seeds (i.e. 100-125 seeds for human
body weight of Shodhit Dhatura) although,
being), is 1143 mg- 1429 mg when expressed in
continually reduce the increased body
unit of weight but as per conclusion of our study
temperature but the effectiveness has been
22.22 gm. (2000mg/kg for rat) of shudha Refrences:
Dhatura has no fatal effect. Even though this dose
1. Sharma Priyavrat Dhanvantri Nighantu, first edition
is higher than mentioned in text. 1982 published by Chaukhambha Orientalia, Varansi,
India verse 5 page 171
9. Shudha form of dhatura has Brhana effect and
can be used as weight gainer. 2. Sharma Priyavrat Dhanvantri Nighantu, first edition
1982 published by Chaukhambha Orientalia, Varansi,
India. verse 6 page 171
3. Sharma Priyavrat Dravya Guna Vigyana, vol. II & III

(reprint 2001), Chaukhamba Bharati Academy,
Varanasi page 500.
4. K.R.Srikantha Murthy, Asthang Sangraha

Chaukhambha Orientala, published-1999,
Uttartantra Adhaya 40 verse 103 page 349-50.
5. K.R.Srikantha Murthy, Asthang Sangraha

Chaukhambha Orientala, published-1999,
Uttartantra Adhaya 40 verse 103 page 349-50.
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ISSN No:2321-0435
ORIGINAL ARTICLE
A Study of Asthi Sharir In Context of Various Types of Asthi
Described In Ayurvedic Samhitas
*Dr. Gaurav Soni, **Dr. Sandeep Lahange ***Dr Vikas Bhatnagar ****Dr Shailja Kumari Bhatnagar,
*****Dr. Isha Herswani
*Lecturer Dept of Sharir Rachana North Eastern Institute of Ayurveda & Homeopathy Shilong
**Assistant Professor, ***Associate Professor , ***** Ph.D scholar P.G. deptt. of Sharir Rachana , N.I.A. Jaipur, **** Assistant Professor,
P.G. Deptt. of Maulik Siddhant & Samhita, N.I.A., Jaipur
ABSTRACT
Ancient seers of Ayurveda have classified the elements of the body under three fundamental
components- Dosha, Dhatu and Mala. According to Acharya Sushruta the pioneer of Ayurveda, Asthi is
last part of body to be destroyed. Knowledge of Asthi can be traced back from Vedas passing chronologically
down to Samhitas. Asthi plays the role of kernel of body on which whole system depends. Profound
description is illustrated in classical texts about nomenclature, enumeration, types, Bhagna and its treatment.
Especially types and nomenclature are to be discussed in light of modern and classical grammar. Here main
aims are Analytical discussion about Sankhya and nomenclature of Asthi, Asthi Prakaras and grammatical
validation. As knowledge about Asthi dates from Pre-Vedic period concepts, believes, methods, usefulness
etc have changed from time being. The nomenclature of Asthi and Bhagna and Prakar is also same as in the
contemporary knowledge and profoundly described.
Keywords: Asthi Bhagna, Asthi Sankhya, Asthi Prakara
How to cite this article : Soni G,

Lahange S, Bhatnagar V, Bhatnagar S, Hershwani
I, A Study of Asthi Sharir In Context of Various
Types of Asthi Described In Ayurvedic Samhitas,
JOA, XII-4, 2018; 105-112
Introduction
It is very clearly apparent from the

admonitions of Galen how great is the usefulness of
a knowledge of the bones, since the bones are the
Website:- journalofayurveda.in foundation of the rest of the parts of the body and
Address of correspondence: all the members rest upon them and are supported,
Dr. Gaurav Soni as proceeding from a primary base. Thus if anyone
Lecturer, Dept of Sharir Rachana North Eastern is ignorant of the structure of the bones it follows
Institute of Ayurveda & Homeopathy Shilong necessarily that he will be ignorant of very many
Email:- [email protected] other things along with them.”
Contact No: - 9414818056
Niccolo Massa, 1559.
Soni G, Lahange S, Bhatnagar V, Bhatnagar S, Hershwani I, A Study of Asthi Sharir In Context of Various Types of
Asthi Described In Ayurvedic Samhitas, JOA, XII-4, 2018; 105-112
Being an eternal science, ‘Ayurveda’, the bones of human body.

science of human life deals with physical,
It is a hard substance which remains even
psychological as well as spiritual well being of an
after most part of body has been decayed. According
individual. It covers all the spheres of human life. As
to Susrutha1 it is substance which remains even after
we all know that, this entire world can be divided
else very part like flesh, muscles etc. are shattered
into two types of material i.e. soft and hard. Soft and
even after burying the body after death. It remains
hard though are antonyms yet are equally important
as last identity of person even after demise.
for sustainability. This division is also evident in
According to Shabdastomkara- it is part of body
human body. Here several parts are soft organs and
which remains till long period even after death of
rest hard. Hard part of body is skeleton system which
body. “Hada” is synonym of Asthi.2
provides support and shape. Thus, parts which
provide support, shape, helps in locomotion, Though every substance is made of all five
protection to soft organs are hard parts forming Mahabhutas (Akasha, Vayu, Agni, Jala and
nutshell of human body, comprising bones, teeth etc. Prithivi), but Asthi has predominance of Prithivi and
Vayu Mahabhuta.3 The Asthi Karmas are as follows
According to Acharya Susruta the pioneer of
Deha Dharan., Majja Pushti and supporting the
Ayurveda explained, the organs of the body destroy
Mamsa, Sira and Snayu.4 The numbers of Asthi in
after death except the Asthi. Asthi is the last to be
the Sharira according to different Samhitas are as
destroyed, even after death when body is buried or
follows-
burnt the remnants left are bones. Knowledge of
Asthi can be traced back from Vedas passing Table No.I:
5,6,7
chronologically down to Samhitas. Considering its Showing the Numbers of Asthi
history of description and importance many methods
S.No Text books Numbers
and thought can be visualized in classical texts. Each
explains their own way of enumeration and 1. Charaka Samhita 360
nomenclature.
2. Susruta Samhita 300
Literal Review
3. Astanga Hrudaya 360
In Atharva Veda, Narayana is author of
4. Astanga Sangraha 360
the Atharva hymn which takes us back to that period
of prehistoric or semi-mythical age of the medicine 5. Bhavaprakasha 300
men who combined the functions of priest and
6. Kashyapa Samhita 360
physician. Narayana is representative of this Indian
medicinal tradition. He is also author of famous 7. Bhela Samhita 360
“Purusha Sukta” (RV.X.90=AV.XIX.6), which
contains many anatomical references. The hymn Depending upon size, shape, position 8 of
X.2.1-8 is reported to show how Artharva mentioned Asthi in the body total Asthi is divided into five
types. These are tabulated below
Table No II: Showing the Types of Asthi
S.No Types Su.S As.S As.H. B.P

1 Kapala + + + +
2 Ruchaka + + + +
3 Taruna + + + +
4 Valaya + + + +
5 Nalaka + + + +
Kapala-Asthi9- These are flat in nature. The According to modern anatomy, there are
above and below layer is separated and hollowed about 206 bones in the adult human skeleton. The
parts are made. Red Majja is filled in it. Asthi’s early Indian anatomist, on the other hand, count
present in the Janu, Nitamba, Amsa, Ganda, Talu, either 360 (Aterya) or 300 (Susrutha) bones. This
Shankha, Vankshana and Madhyashira are known large excess is principally due to the fact that
as Kapalasthi. (besides including the teeth, nails, and cartilages)
they counted prominent parts of bones, such as are
Valaya-Asthi10 - These are round in shape.
now known as ‘processes’ or ‘protuberances’, as if
The ribs of the chest are of this type. Asthi in Ura,
they were separate bones. Their reasons for counting
Parshva and Prustha are Valayasthi.
in this manner were mainly three.
Taruna-Ashthi11- These are soft in nature.12
l Sometimes processes or protuberances of bones
They are mainly in between joint of vertebrae, two
were popularly known by special names, and
vertebrae there is a circle of Tarun Asthi. Hence, any
regarded as special bones. Examples are the
jolt to the body, till it reaches the brain becomes
malleoli, or ankle bones and the styloid processes
mild. Asthi’s present in the Ghrana, Karna, Greeva
or wrist-bones.
and Akshikuta are called as Tarunasthi.
l In other cases the separate enumeration of
Ruchaka-Asthi13 - the bones which help in
process or protuberances was due to an
taste or which are to enjoy food with taste. The
exaggerated regard for the homological principle.
Dashanas are known as Ruchak Asthi. These are 28
For example the right and left halves of the
or 32 in all. It is also considered as Updhatu of Asthi
skeleton were regarded as homologous.
by Sharangdhar.
l Sometimes, again it was a fancy for artificial
Nalika-Asthi 14- These are long like tubes
symmetry which led to the multiplication of
and hollow from within. They are stuffed with Majja.
bones. This can be cause of assumption of the
Till the age of 20 years, the color of this is red, and
existence of a third joint in the thumb and great
then it turns yellow. These types of bones are in the
toe, and of twelve costal tubercles instead of ten.
hands and legs. Asthi which remains from above
description are listed in this type. We can trace this variation in nearly all Asthi
Sankhya but major variations can be traced in
Discussion-
enumeration of ribs, vertebraes, phalanges etc. Like
Enumeration i.e. Sanhkya of human parts is while enumerating ribs Charaka states that there are
as important as the knowledge particular organ as 24 Parsvaka or ribs, 24 Sthalaka, sockets, and 24
stated by Acharya Charaka. According to Arbuda (tubercles) and of course as indicated by
Chakrapani – knowledge of enumeration of parts Susrutha manner of counting, it is to be understood
(Avayavaas) of human body is important in Clinical that there are 12 of such kind, that is, altogether
practice as it is prime source of evidence. Acharya thirty six, on each side.
states that Prayogan of Adhayaya Sharir Sankhya
As in Greeva Charaka makes the number of
Shariram is simply to know the whole body Sankhya
neck-bones to be fifteen. The Susrutha makes it to
Pramana. Limitation of Pramana of Avayavaas is
be only nine, while the list of Vagbhata makes it to
Sankhya Pramana. Importance of knowledge of
be thirteen. As a matter of fact, the number of the
Sharir Sankhya is given very efficiently in end of
cervical vertebrae is seven. Susrutha counts nine
seventh chapter of Sharir Shtana15. It illustrates – the
neck-bones, each of the six upper vertebrae as single
Clinician who has knowledge about human body with
bone; but the seventh he treated in the same way as
its all parts with their enumeration never gets
he treated the thoracic vertebrae, that is to say, he
distracted as the distraction faced by Clinician who
counted it as consisting of three bones; viz. a body
doesn’t have Tatwapurna (analytical) knowledge
plus spine and two transverse processes. He thus
about Sharir Sankhya.
obtained 6+3=9, bones.
Charaka obtained his total of fifteen bones by the enumeration was varied but each one satisfied
treating the cervical column somewhat similarly to their own principle and thus no major controversy
the vertebral column. As regards the count of can be drawn.
Vagbhata, his total of thirteen bones probably
Now talking about types or Prakara as per
represents, as usual, a compromise between the
Samhita, we can see that division was basically on
systems of Charaka and Susrutha.
the terms of Shalya Tantra and is uniformly pentad
Likewise several other Asthi and their type. Asthi can be divided in these five divisions as
Sankhya can be discussed and it can be seen though follows-
Table No. III Presenting division of Asthi as per their type (Susruta)
S.No Asthi Prakara Number Names
1 Tarunasthi 14 l Ghrana-3
l Karna-2
l Griva-9
l Aksikosa
2 Valayaasthi 110 l Parsva-72
l Prstha-30
l Uras-8
3 Nalakaasthi 125 l Padanguli (3x5)-15x2=30
}
l Padatala
l Padakurcha 20
l Gulpha
l Parsni-2
l Jangha-4
l Uru-2
l Hastanguli(3x5)-15x2=30
l Hastatala
l Hastakurcha
l Manika
l Karpurasthi-2
} 20
l Prakosthasthi-4
l Bahunalaka-2
l Trikasrita-1
l Amsaphalaka-2
l Kanthanadi-4
l Hanwasthi-2
4 Kapalasthi 19 l Janu-2
l Nitamba-4
l Amsa-2
l Ganda-2
l Talu-1
l Sankha-2
l Sira-6
5 Ruchakasthi 32 l Danta-32
Total 300 300
On using Tarka and Pramana we can which can sense or know the taste of food during
understand that the particular five types defined are chewing process.
just symbol for major division. In fact these merely So, total types can be summarized in five
are not just types but these are basically five ways group’s like-
of divisions of bones on different basis.
1. Tarunaasthi (undeveloped) and Pakvaasthi or
First division can be on the basis of hardness Ghanasthi (fully ossified)
or completion of ossification. On the basis of
hardness this is first type of Asthi, thus other can be 2. Kapalaasthi-(great surface area) and
its antonym that is Asthi or Pakva-Asthi (normal or Akapalaasthi (less surface area).
hard) or Jirna-Asthi (fully developed or hard). Next 3. Vartulakara (Valayasthi elastic and round) and
division is on basis of surface area. (Kapala-Asthi)- Avartulakara (not round in shape).
This is based on surface of bone. Kapala as described
is flat or which has more area than thickness. Other 4. Nalakaasthi (long and for movement) and
bones mainly are slender or cylindrical here surface Analakaasthi. (other than cylindrical)
area is comparatively less (Nalaka-Asthi). Next
5. Ruchaka (with sense power) and Kharasthi
division is on basis of specific shape (Vartulakara).
(normal bone).
This type bones are for specific functions of
providing support as well as helping in inspiration The bones sustain trauma in different ways.
and expiration i.e. providing elasticity as well as Acharya Susruta has paid due attention to this fact
support for specific function. Thus, this can be basis and observed that all the bones do not show similar
for division into two groups i.e. bones with round type of effect due to trauma. As we already know
shape and others without it i.e. Avartulakara. that Acharya have particularly described the types
of fractures occurring in each type of bone 16
Next division is on basis of length and end
mentioned as below-
points (Nalaka-Asthi). Main function of these is to
help in locomotion as these bones are mainly found 1) Tarunasthi - Namayante
in extremities. Thus, bones can be called as
2) Nalkasthi - Bhajayante
functioning in locomotion can be separated from
others with function of protection mainly like Kapala 3) Kapalasthi - Vibhidhyante
or Valaya-Asthi or Analakakara. Next division is
4) Ruchkasthi - Sphutayante
really interesting type as sense organ (Ruchaka-
Asthi)- Acharya Susrutha have divided next variety 5) Valayasthi – Sphutayante
specially on power of teeth as ‘Ruchaka’, i.e. one
On profound analysis on literal basis of the specific type of bone. Firstly let us dissect word on
words denoted as fracture types a clear picture can basis of Dhatu Pada and its meaning as per Panini
be drawn on relation of specific fracture with the Vayakarana in Ganakaastadhyayi. Results can be
tabulated as-
Tables No. IV showing Asthi Prakara; it’s Dhatu Pada and their meanings.
Type of Defination17 Type of Sandhi Dhatupada Meaning of English

bone Bhagna Dhatupada meaning
Taruna ÿÊÁŸ ÉÊŸÃÊ Ÿ ŸêÿãÃ Ÿ◊ •ãÃ Ÿ◊˜ ŸÊ◊ ¬˝ÁÃflàfl To bow , to
¬˝ÊåŸÈflÊÁãÃ ÃÊÁŸ ≥Êéº øÊ bend, curve,
ÃL§áÊÊÁSÕÁŸ bow down,
sink
Kapala ∑¢§ ŸÊ◊ Á≥Ê⁄— Ã¢ ÁflÁ÷äÿãÃ ÁflÁ÷Áº Áflœ˜, Á÷º˜ Áflœ˜ ÁflœÊŸÊ, Perforating,
¬Ê‹ÿÁÃ ßÁÃ •ãÃ Á÷Áº⁄˜ fissure, gap,
∑§¬Ê‹ ÁflºÊ⁄áÊ, cleaving
πá«U≥ÊÙ
Á÷œãÃ (øãŒ˝≈U)
Valaya flÃÈ¸‹Ê∑§Ê⁄ÊÁáÊ flÃÈ¸‹ S»È§≈ÿÁãÃ S»È§≈ S»È§≈˜, S»È§≈ Áfl∑§Ê‚Ÿ Brust, split,
•œ¸flÃÈ¸‹ ‚ºÎ≥ÊÊÁŸ •ãÃ S»È§≈ ÷ºŸ cracked
Nalaka Ÿ‹ ßfl ¬˝ÁÃ≥ÊÁÃ— ÷ÖÿãÃ ÷Á¡ ÷Ü¡˜ ÷TÙ •Ê◊º¸Ÿ Shatter,

Ÿ‹∑¢§ •ãÃ ÷È¡˜ ÷È¡˜ ∑§ıÁ≈Àÿ break to
Ÿ‹Ê∑§Ê⁄∑§ÁSÕÁflœÿÃ pieces
ßÁÃ
Table No. V showing comparison of word meanings of Asthi Bhagna; and type of fractures.
Asthi Bhagna 18 Meaning of Bone example Common Word meaning/

prakara Bhagna as per modern fracture19 meaning of
fracture
Taruna Namayante To bow, to Cartilaginous or Green Stick bone bends

bend, curve. bones of child Fracture and breaks
(which are not
fully ossified)
Valaya Sphutayante Burst, split, Ribs break in the Separation,

cracked. rib (detach) cracking
Kapala Vibhidhyante Fissure, gap, Flatbones like Linear, widen the suture,
cleaving. Skull bones, hip Depressed, displaced inward,
bone, scapula Diastatic, transverse break in
Basilar the full thickness
of the skull
Nalaka Bhajayante Shatter, break to Various Long Transverse, Perpendicular to

pieces. Bones like Oblique, the long axis, at an
Femur, Spiral, angle, bone
Humerus etc. Comminuted. fragments scatter
By these tables it is clearly visualized that Kapalasthi-19; as per Acharya Susrutha. Type of
our Acharaya had given principle of Asthi Bhagna bone and type of fracture in it, are in accordance
and Asthi Prakara on clinical basis as is proved here with its modern counterpart as proved by literal
merely by meanings of root word. This knowledge grammatical study of Dhatupada and their Artha.
can be used in vice a versa way that the particular
Reference
type of fracture occurs in particular type of bone as.
which means bones which tend to bend or curve can 1. Ambika Dutta Shastri, Sushutra Samhita with
be a type of Tarunaasthi, bones in which linear Elaborated Ayurveda Tatva Sandipika Hindi
Commentary, Reprint. Varanasi: Choukhambha
fractures or fissure is commonest type of fracture
Sanskrit Sansthan, Sharir Sthan 5/24, 2011; Pg60
can be a type of Kapalasthi, bones which commonly
breaks into pieces or detaches (having semi circular 2. Shabdkalpadrum; by Raja Radha Kanta Deva;
shape) from its attachment can be a type of chowkhamba Sanskrit Series; Varanasi; Vol (1-5) Pg no
7 2
Valayaasthi and bones in which fracture are mainly
perpendicular to axis, transverse to axis or at angle 3. Bhavprakash, Bhav Mishra5th ed. Vidyotini
can be a type of Nalakaasthi. Commentary by Brahma Shankar Shastri,
Chaukhamba Sanskrit Series, Varanasi, 1969. Pg no
Conclusion 125
As knowledge about Asthi dates from Pre- 4. Ambika Dutta Shastri, Sushutra Samhita with
Vedic period concepts, believes, methods, usefulness Elaborated Ayurveda Tatva Sandipika Hindi
etc. have changed over time. As per basic definition
Sanskrit Sansthan, Sharir Sthan 5/25, 2011; Pg60
of Asthi according to Susruta “it is substance which
remains as the last identity of person even after 5. Charaka Samhita with Vidyotini Hindi commentary
by Pt. Kashinath Shastri & Dr. Gorakhanatha
demise.” Whereas in modern science it is simply
Chaturvedi, Part-1&2, Published by Chaukhambha
defined as connective tissue i.e. hard in texture and
Bharti Academy Varanasi, 22nd Edition 1996, viman
characterized by the presence of Haversian system. sthan8/117,pg779.
Thus, a major difference arises as per definition so
6. Sushutra, Ambika Dutta Shastri, Sushutra Samhita
is the differences are seen in enumeration, types and
with Elaborated Ayurveda Tatva Sandipika Hindi
function. Commentary, Reprint. Varanasi: Choukhambha
Sanskrit Sansthan, Sharir Sthana 5/25,pg61.
The pentad division of Asthi Prakara was
given mainly in accordance with Shalya Tantra 7. Vagbhatt, Kaviraj Atridev Gupt, Ashtang Hridayam
especially for dislocation and fracture of bones. Vidyotini Hindi Commentary, Reprint. Varanasi:
Basically this pentad division is not the types of bone, Choukhambha Prakashan,2012,sharir sthana 3/28,
pg142.
but actually these are principles for division which
can be further elaborated like as Tarunasthi and 8. Sushutra, Ambika Dutta Shastri, Sushutra Samhita
Ghanasthi, Vartulakara and Avartulakar etc. This with Elaborated Ayurveda Tatva Sandipika Hindi
proves that classification of bones based on shape,
Sanskrit Sansthan, Sharir Sthan 5/28,pg 62.
size and texture was given firstly in Samhita not in
modern text as per popular belief. 9. Shabdkalpadrum; Vol (1-5) by Raja Radha Kanta Deva;
chowkhamba Sanskrit Series; Varanasi.
Leaving Rucaka, as a type especially for
1 0 . Shabdkalpadrum; Vol (1-5) by Raja Radha Kanta Deva;
Danta, rest can be classified under rest four as
Tarunasthi-14, Valayasthi-110, Nalakasthi-125 and
1 1 . Shabdkalpadrum; Vol (1-5) by Raja Radha Kanta Deva; 1 6 . Susruta Samhita: with commentaries
chowkhamba Sanskrit Series; Varanasi. Nibandhasamgraha by Dalhana and Nyayacandrika
by Gayadasa : Chaukhamba Orientalia, Varanasi : 5 th
1 2 Vagbhata: Astanga Samgraha: with commentaries of
Ed. (reprint 1992), Nidana Sthana16/17,pg89.
Sasileksa commentary by Indu and Chaukhambha
Orientalia, Varanasi, Sharira Sthana 5/65, pg126. 1 7 . Shabdkalpadrum; Vol (1-5) by Raja Radha Kanta Deva;
chowkhamba Sanskrit Series; Varanasi
chowkhamba Sanskrit Series; Varanasi. 1 8 . Susruta Samhita: with commentaries
Nibandhasamgraha by Dalhana and Nyayacandrika
by Gayadasa : Chaukhamba Orientalia, Varanasi : 5 th
Ed. (reprint 1992), Nidana Sthana 15/17,pg90
1 5 . Agnivesa: Caraka Samhita:Rev. by Caraka and
1 9 . Essential Orthopaediccs; by J. Maheshwari; published
Dradhabala with commentary by Cakrapanidatta:
by Jaypee Brothers Medical Publishers; New Delhi ;
Chaukhamba Sanskrit 1msthana: Varanasi, Sharira
edition 3 revised; 7 th reprint(2011).
Sthana 1/20,pg 67
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ÁR§ÿÊ≥ÊË‹ „ÙŸ ◊¥ ∑§Ê⁄áÊ „ÙÃ „Ò¥– •ÊøÊÿ¸ ‚ÈüÊÈÃ ∑§ •ŸÈ‚Ê⁄ •ÁSÕ „Ë ≥Ê⁄Ë⁄ ∑§Ê fl„ ÷Êª „Ò ¡Ù ‚’ ∑È§¿U ŸC „ÙŸ ∑§ ’Êº
÷Ë ’øÊ ⁄„ÃÊ „Ò– •ÁSÕ ∑§Ê fláÊ¸Ÿ flºÙ¥ ‚ „Ë Á◊‹ÃÊ „Ò ¡Ù ∑§Ë ‚¢Á„ÃÊÿÙ ◊¥ •ÊÒ⁄ ÷Ë S¬C „ÙÃÊ „Ò– •ÁSÕ ≥Ê⁄Ë⁄ ∑§Ê •ÊœÊ⁄
∑§Ê⁄áÊ „Ò– Á¡‚∑§ ¬Í⁄ ≥Ê⁄Ë⁄ ∑§ •ãÿ •flÿfl •ÊœÊÁ⁄Ã ⁄„Ã „Ò– ‚¢Á„ÃÊ•Ù¥ ◊¥ •ÁSÕ ∑§ ŸÊ◊∑§⁄áÊ, ‚¢ÅÿÊ, ¬˝∑§Ê⁄,÷ªA ∞fl¢
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•äÿÿŸ •Êfl‡ÿ∑§ „Ò ¬˝SÃÈÃ ‹π ◊¥ •ÁSÕ ∑§ ŸÊ◊∑§⁄áÊ, ‚¢ÅÿÊ ∞fl¢ ¬˝∑§Ê⁄ ¬⁄ ¬˝ÊøËŸ ∞fl¢ •flÊ¸øËŸ ◊ÃÊŸÈ‚Ê⁄ fl √ÿÊ∑§⁄áÊ
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ISSN No:2321-0435
ORIGINAL ARTICLE
Comprehensive approach of Lifestyle Modification in
Diabetes Mellitus w.s.r. Prameha
*Dr Anju K Bhardwaj **Dr G Prabhakara Rao
* Ayurveda Physician Employee State Insurance Corporation Medical College & Hospital Faridabad
**Deputy Medical Commissioner Employee State Insurance Corporation Headquarter New Delhi
ABSTRACT
Diabetes mellitus (DM) is a progressive chronic metabolic disorder characterized by hyperglycemia
associated with long-term micro vascular complications like retinopathy, nephropathy, neuropathy and macro
vascular (cardiovascular) complications. Pharmacological interventions i.e. medicines are not always
necessary to control diabetes, but emphasis should also be given to non-pharmacological management.
Prameha explained in Ayurveda texts bears resemblance to Diabetes.
There is detailed explanation in ayurveda texts regarding dietary modification and physical activities
for prevention and management of Prameha. This article is compiled with an aim to commemorate various
references of lifestyle modification in Ayurveda texts and researches supporting them. Principles of
Dinacharya, Aahara, Vihara, Sadvritta, Rasayana when applied in daily routine plays major role in
prevention as well as better management of Diabetes.
Keywords- Diabetes, Microvascular complications, Prameha, Lifestyle Modification.
How to cite this article : Bhardwaj AK,

Rao GP, Comprehensive approach of Lifestyle
Modification in Diabetes Mellitus w.s.r. Prameha,
JOA XII-4, 2018; 113-119
Introduction
Diabetes mellitus (DM) is a progressive,

chronic metabolic condition characterized by
hyperglycemia associated with long-term micro
vascular complications like retinopathy,
Website:- journalofayurveda.in nephropathy, neuropathy and macro vascular
Address of correspondence: (cardiovascular) complications. Premeha is a
Dr Anju K Bhardwaj syndrome which includes all those clinical conditions
MD (Ayu), Ayurveda Physician Employee State which are characterized by increased quantity of
Insurance Corporation Medical College & urine associated with or without the increased
Hospital, Faridabad frequency of micturition. Poly urea and Turbidity of
Email:- [email protected] the urine are the cardinal presenting features of this
Contact No:- 7065952747 diseased state.1
Bhardwaj AK, Rao GP, Comprehensive approach of Lifestyle Modification in Diabetes Mellitus w.s.r. Prameha, JOA
XII-4, 2018; 113-119
It is one of the common problems facing our Prakriti (Body Constitution), Saatmaya
modern era, resulting in numerous complications, (Accustomisation of food habits ), working nature
which can be effectively managed by simple i.e. Occupation etc. Patient preferences, values,
measures, such as lifestyle modifications. objectives, and priorities should be respected, and
Pharmacological interventions i.e. medicines are not these should then guide the shared clinical decision-
always necessary to control diabetes, but emphasis making process. This is the patient-centered
should also be given to non-pharmacological approach to DM management that is advocated by
management. Evidence has clearly shown that the American Diabetes Association and European
lifestyle variables are highly associated in Association for the Study of Diabetes.4 It encourages
determining the relative risk of diabetes mellitus. the individuals to own their lifestyle goals and action
Lifestyle variables include meal habits, exercise plans.
state, drinking state and smoking state. Modification
Dietary Modification
in these factors would result in improved compliance
towards hypoglycemic agents.2 Diet plays an important role in causation of
T2DM. Ayurveda says excessive consumption of
Need of Study
sweet, heavy food like milk, curds, sugarcane, meat
There are several factors that increase the of Anoopa Desha animals leads to increase in Kapha
risk of developing T2DM (Type 2 Diabetes Mellitus), Dosha and eventually causes Prameha or Diabetes.
some of which include Obesity, Family history of DM The key principles include calorie restriction, low-fat
in a first-degree relative, Increasing age, Polycystic diet, portion control, and increasing fruit, vegetable,
ovarian syndrome, Physical inactivity, Low-fiber, and fiber intake. Dietary habits of patient should be
high-fat, energy-dense diet, Urbanization. 3 The modified to encourage regular meal times and
management of T2DM is multifactorial, taking into healthy eating habits. Asthahaaravidhi
account other major modifiable risk factors, like Visheshayatana explained in Vimaana Sthaana of
obesity, physical inactivity, smoking, blood pressure Charaka Samhita.5
(BP) and dyslipidemia. Therefore preventive aspect
These are 8 specific factors of method of
of Ayurveda explained as Dinacharya, Aahara
dietetics which are discussed in detail further more
Visheshaayatana, Sadvritta, Rasayana etc needs to
and are summarized briefly below.
implemented in practice to prevent and manage
Diabetes. 1 . Prakriti/ Swabhava- Nature of food/ Qualitative
characteristics of food.
Literature Review
2. Karana – Processing of food.
Ayurvedic classical texts ie. Bruhatrayee and
others were screened for various references that can 3. Samyoga – Combination/mixing of different food
be directly or indirectly understood to frame items.
lifestyle guidelines in Diabetes. Various Research
4. Rashi – Quantity of food.
paper published in peer reviewed journals were
studied and screened for role of lifestyle modification 5. Desha – Habitat of food i/e. place of origin.
in terms of diet and exercise in Diabetes.
6. Kaala – Time and seasonal variation.
Comprehensive management of diabetes includes
multifactorial approach as there is no single 7 . Upayoga Samstha – Rules for dietetics.
etiological factor involved instead there is cluster of
8. Upayokta – The person who consumes the food.
factor responsible in causation of DM.
Prakriti/ Nature of food
Ayurveda suggests individualised approach
in preventive and curative medicine. In case of Major cause of Prameha si Kapha
individuals who are at risk of T2DM or suffering from aggravating diet that is Guru, Snigdha Guna Aahara
it, lifestyle modification has to be as per their hence diet advised should be Laghu, Rooksha in case
XII-4, 2018; 113-119
of Kaphaja Prameha which in general can be taken has reduced Kleda as compared to meat curries. 9
as Type 2 Diabetes Mellitus associated with obesity. Even through proper washing grains like rice prior
to cooking and removing the supernatant water also
One should opt food items that are mainly of
increase their digestibility. Green gram soaked in
Kledahara guna (which reduces the kleda) like Yava
Triphala Kashaya to prepare Daals or soup also has
(Hordeolum vulgare) Sarodaka, Chanaka (Green
more suitability to diabetic patient. In case of Vata
gram), Kulattha (Horsegram). One year aged grains
dominant Prameha where Nidaana is Apatarpana
like wheat, barley are to be preferred over newly
(Nutritional deficiency), nourishing diet is advised.
harvested . Yava is rich in fibre content and has very
So oils like Atasi Taila, Sarshapa Taila, Kharjoor are
low glycemic index too. Diabetic patients should eat
also indicated in Prameha.10
in moderation and at regular time intervals. Drinks
like Sarodaka (Acacia cathechu 12 gms boiled with Samyoga (combination/ mixing) -
approx 700 ml water to be taken for drinking Samyoga (combination) is aggregation of two or
throughout the day), Kushodaka, Madoodaka more substance. This exhibits peculiarities which are
(Honey with warm water) are advisable for not seen in case of individual substances. 11
diabetics.6 Combinations like fish with milk, hot pizzas with cold
drinks etc is Viruddhaahara as per Ayurveda and is
Substitution of energy-dense foods with foods
contraindicated for diabetics also. 12
rich in fiber, like fruits, vegetables, and whole grains,
and with low-glycemic index is appropriate. Rashi/ Quantity of food
Diabetics should go for calorie restriction to upto
Quantity to be taken depends on individuals
1,500 kcal/day and saturated fat intake should be
Agni (Appetite). It may vary depending upon time
minimised. Vegetables of tikta rasa are to be
and season even in same person. So one must assess
preferred. Fruits like pomegranate, Amla, Kharjura
it and eat accordingly. Ayurveda advocates
(dates), Kalingaka (Watermelon) can be taken. 7
Langhana (Fasting) in Kaphaja disorders. It means
Spices like pepper, fennel seeds, asafoetida are of
either fasting or reducing the quantity of food intake
great importance as they increase the digestive fire
so that there is Kapha Kshaya. Individual should eat
and thus improves metabolism. Ginger neutralizes
optimum quantity at proper time. One should eat
the heavy quality of the food thus adding ginger will
cautiously and avoid overeating.
convert the property of heavy food into a lighter
state. Desha (Habitat)
Karana/Processing Methods Desha denotes place relating to growth as

well as distribution of the substances and also the
Various method involved in cooking like
suitability in respect of place. It is a geographic
soaking, boiling, steaming, deep frying, marinating
region. Food substances differs in quality due to
etc bestows different properties to the food item
difference in soil and climate. Foods grown in
being cooked. So only there are various cooking
Anoopa Pradesh i.e. cold, rainy places are heavy to
methods that are highlighted in classical Ayurvedic
digest and not to be preferred for Diabetics whereas
texts that change the original nature of the food
food grown in Jaangala Pradesh (Region of dryness,
items. Keeping grains for a period of one year
less rainfall, Vata predominant) are Laghu and
increases Laghutva i.e. makes them easily digestible.
Rooksha, hence more suitable to Diabetics.
Yava (Barley) when overnight soaked in Triphala
Kashaya is comparatively more Rooksha in nature Kaala (Time and Seasonal variation)
and easy to digest. 8 Similarly when grains are dry
To maintain proper health in both healthy
roasted before use they become more easy to digest.
and diseased condition the seasonal regiment must
Roasted Bengal gram is very good choice for
be followed. Kala is eternally moving (time) as well
diabetics. Meat cooked in tandoor that is Shooli
as conditional. Ritucharya mentioned in Vasanta and
Mamsa (explained in Ayurvedic text) is more
Varsha Ritu has strong resemblance to the Pathya
beneficial for Diabetic patient, probably because it
XII-4, 2018; 113-119
Apathy mentioned in Prameha.13 should be done to certain limit by each individual

mentioned as Ardhashakti in Ayurveda that is till
Upayoga samstha (Classical rules of dieting)
the appearance of sweat on forehead, axilla and
It denotes the rules for dieting. This depends increased breathing rate. Basically there is Dhatu
on the digested food. One should eat light, warm, at Shaithilyata in Prameha, Samhanana of body is
proper time and in a calm environment. Heavy diet reduced so one should not go for vigorous exercise
at night time is to avoided by Diabetics. Frequent instead Yoga is very beneficial .Yoga postures like
small meals can be taken where fluctuations in Paschimottanasana, Halaasana, Vajraasana,
glucose level is more. Shalabhaasana, Vakraasana are effective in reducing
the blood glucose levels in patients with T2DM.16
Upayokta (The person who takes the food/user)
The beneficial effect of yoga in T2DM has
Upayokta is that who consumes the food.
been attributed to increased insulin sensitivity at
Dietary regimens cannot be same for individuals of
target tissues which decreases insulin resistance and
different Prakruti. For eg Preparation of Yava in
consequently increases peripheral utilization of
form of chapati and pancakes will be preferred to
glucose.17 It has also been postulated that yoga can
Kapha & Vata Prakriti respectively. So physician
rejuvenate or regenerate beta cells of pancreas.18 In
needs different approach in each individual. Here
addition, yoga has positive effect on general well-
Role of Saatmaya (Accustomisation to certain food)
being and stress.19
is very important. Before withdrawing any particular
food habit and introducing any new habit, one should Samyaka Nidra (Adequate Sleep)
take time and try with modifications of existing diet
Due to proper and adequate sleep body
first. Drastic changes are not accepted well, may lead
tissues and Doshas remain in balanced state of health
to Asatmaya Janya Vyadhis.
both physically and mentally. Ayurveda states that,
Daily Regimens happiness and sorrow, obesity and emaciation,
strength and weakness, virility and impotence,
Dinacharya regimens which are of immense
knowledge and ignorance, life and death are all
importance to diabetics are Brahma Muhurata
depends on adequate and inadequate sleep. 20
Jaagrana (Early Rising), Udvartana, Utsadana,
Repeated disruption of Circadian System, Pineal
Snaana, Vyayama etc. Udvartana is dry powder
Gland, Melatonin suppression by exposure to light.
massage all over body in opposite direction of body
Sleep deprivation causes impairment of the immune
hairs. It reduces Kapha and Kleda. Udvartanam with
system plus metabolic changes favouring obesity.
Tvaka (Cinnamomum zeylanicum), Ushira (Vetiveria
Poor sleep can be an important indicator of
zizanioides), Ela (Cinnamomum zeylanicum) , Agaru
emotional stress. On the one hand, emotional stress
(Aquilaria agallocha), Rakta chandan (Pterocarpus
can easily affect different aspects of sleep, such as
santalinus) along with takra all over body followed
initiation of sleep, sleep duration, and sleep quality.21
by bath in Vijaysara Sadhita Jala (decoction of
Conversely, sleeping problems may not only be a
Pterocarpus marsupium).14
consequence of emotional stress, but are often
Udvartana is especially indicated for Kapha experienced as a significant source of stress. Studies
Prakruti as it reduces weight and peripheral fat. In reveals that habitual sleep disturbances were
case of Vata Prakruti Diabetic patients can be associated with a higher incidence of type 2
advised to do massage of exteremities with supti diabetes. 22
tailam or pinda tailam on daily basis before taking
Diabetics should wake up early so that
bath. Vyayama leads to Kapha & Meda Kshaya. It
hormonal flow is regular. Sleeping early at night
creates sthairya in Dhatus (Compactness in Tissues)
reduces mental stress and restores energy too. One
of body.15
should strictly avoid Day sleep as it viciates Kapha
Exercise helps in weight control. Vyayama and Pitta Dosha. Day sleep decreases Agni and causes
XII-4, 2018; 113-119
deranged metabolism that may cause increase in More than 400 years ago, the famous English
weight. In case of individuals working during night, physician Thomas Willis noted that diabetes often
they are advised to sleep during day time upto half appeared among persons who had experienced
of their normal duration at night time. Also one must significant life stresses, sadness, or long sorrow.25
take care not to sleep just after having food. Chronic stress can also initiate changes in immune
system activity. There is experimental and clinical
Sadvritta / Behavioural Modification
evidence that a rise in the concentration of pro-
According to Ayurveda, to maintain a inflammatory cytokines and glucocorticoids,
healthy and disease free life everyone should follow particularly cortisol, in response to chronic stress
Sadvritta mentioned in Ayurveda texts. Sadvritta and often in depression, both contribute to the
plays key role in the maintenance of health and behavioral changes associated with depression.26 In
prevention of disease. Sadvritta are regarded as one addition, activation of the immune system can
of the measures to prevent various types of diseases. provoke neuroendocrine and neurotransmitter
It also plays important role in personal cleanness of changes that are similar to those provoked by
body and mind. Continues practicing these principles physical or psychological stressors. Sleep
gives balance and peace to the mind. This is code of disturbance and depression were also associated to
conduct for keeping good and balanced condition of hypercytokinemia and activated innate immunity. 27
body and mind. By following these, the person can
Rasayana (Rejuvenating herbs & Minerals)
achieve two aims together such as Arogya (health)
and Indriya Vijaya (control over the sense organs).23 The Ayurvedic texts describe Shilajatu as a
Naimittika Rasayana for Prameha and hence it is
One should not indulge in any activity
advisable to use Shilajatu in prediabetics or in
without proper examination and should not postpone
diabetic management as an adjuvant therapy for
the things to be done at the proper time. One should
promotive and preventive measure. Classically
not feel excessively exhilarated in achievements and
Shilajatu is well known for its Naimittika Rasayana
depressed in loss. Should always remember normal
effect, Ojovardhaka and Pramehaghna property.
modes of events happening since the cause of all
Dalhana’s commentary on Sushruta considered
things are definite and their effects are also definite.
Shilajatu as the best Naimittika Rasayana (Adjuvant
These all modifications helps in better management
therapy) for Prameha28 Nisha Aamalaki prayoga is
of stress.24 Stress has long been suspected as having
highly beneficial for diabetics.
important effects on the development of diabetes.
Table I- Showing Behavioural measures & Diet advised in T2DM
Behavioural Daily Dietary Advisable Oils

Modification/ Regimens/ Modification Vegetables
Sadvritta Dinacharya Cereals & Pulses & Fruits
Should control the Brahma Purana Yava(Barley) Patola(Parvala) Mustard

urges of Bhaya muhurta Bajra(Millet) Vastuka(Bathua) oil
(Fear), Chintan Jagarana Purana Godhuma Moringa
(excessive thinking), Vyayama (Wheat) Giloya(Tinospora
Krodha Shastika Shaali cardifolia)
(Anger) etc (Paddy ripened in Karela(Momordica)
60 days)
One should not Udvartana Mudga(Green gram) Pomegranate Flax seed

control urges of urine, Snaana Aadhaki(Pigeon pea) Amla, Kapitha oil
faeces, hunger, thirst, Samyaka Nidra Chanaka(Chick pea) Jambu
sleep etc. Kulattha(Horsegram) Kharjoora
XII-4, 2018; 113-119
Conclusion Rasa Vimaana Adhyaaya 1/21 Pp 554.
Lifestyle strategies are cost effective, at least 6. Harisha chandra kushwaha Charaka Samhita
Chaukhambha orientalia;Edition 2009 Chikitsa
in delaying the onset of DM. Lifestyle strategies,
Sthaana Prameha Chikitsa Adhyaaya Verse 6/46 Pp
unlike pharmacotherapy, are not limited by side 191.
effects and tolerability. In contrast to medications,
7. Siddhi Nandan Mishra Siddhi Prada Vyakhya of
which typically address only one risk factor, lifestyle
Bhaishjya Ratnavali Chaukhambha orientalia;Edition
modification simultaneously addresses obesity,
2013; Prameha Rogaadhikara 37/241,Pp 719.
glycemic control, BP, and lipid abnormalities.
Furthermore, behavioral strategies, such as stress 8. Harisha chandra kushwaha Charaka Samhita
Chaukhambha orientalia;Edition 2009 Chikitsa
management and self-monitoring of food and exercise
Sthaana Prameha Chikitsa Adhyaaya Verse 6/50 Pp
can be instituted.
192.
Ayurvedic dietary and behavioural 9. Harisha chandra kushwaha Charaka Samhita

modification needs to be incorporated so that Chaukhambha orientalia;Edition 2009 Chikitsa
Prediabetics and Diabetics can be effectively Sthaana Prameha Chikitsa Adhyaaya Verse 6/47 Pp
managed. Diabetes is a complex condition so all 191.
aspects of its management need to be brought 1 0 . Harish chandra kushwaha Charaka Samhita
together in a complementary fashion incorporating Chaukhambha orientalia;Edition 2009 Chikitsa
treatment of acute complications while preventing Sthaana 6 th Chapter Prameha Chikitsa Adhyaaya
long-term complications. Verse 6/46 Pp 191.
1 1 . Prof. Priyavrata Sharma Charak samhita volume 1

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ISSN No:2321-0435
ORIGINAL ARTICLE
Conceptual study on Aartavakshaya
*Dr. Bhingardive Kamini, **Dr. O.P. Sharma, ***Dr. Santosh Kumar Bhatted
*Medical officer, Ministry of Health& family Welfare GOI, New Delhi.
**Ex. Asso. Prof., Dept. of Panchakarma, NIA, Jaipur.
***Asso. Prof. & HOD, Dept. of Panchakarma, AIIA, New Delhi
ABSTRACT
In the modern world the sedentary life style associated with stress increased menstrual disorders.
Among menstrual disorders oligomenorrhea or hypomenorrhea is the most common gynaecological
problems. Ratio of menstrual disorder is rising in gynaecological practice which is a precursor of infertility
associated with various metabolic disorders, so it requires more attention. Menstrual disorder affects mental
state of women. Modern medical science gives Hormonal therapy for menstrual disorders which have many
side effects if continued for long time. So, in contemporary era it is very important to provide a particular
etiopathology and treatment for “Aartavakshaya”. Present article aims at elaborating details of
Aartavakshaya mentioned in Ayurveda classics.
Keywords: Aartava, Aartavakshaya, Hypomenorrhea, Menstrual disorders, Oligomenorrhea.
Introduction
How to cite this article : Kamini B,
Sharma OP, Bhatted SK, Conceptual study on Mother is the most blessed and beautiful
Aartavakshaya, JOA XII-4 2018; 120-128 word in the world; in this universe only females have
been bestowed the power of creation next to the
enormous God. This is why women are considered
Quick Response Code: as reflection of the God in this world. But the root of
the importance of women lies in their capacity of
creation. This is the reason why the question of
fertility is most important for women. In
AyurvedaAartavadushti is one of the cause behind
it.The word Aartava denotes two meanings one of
them is Antah Pushpa and another one is Bahir
Pushpa. Both Antah and Bahir Pushpa are
interrelated. Bahir Pushpa is outward manifestation
Website:- journalofayurveda.in of appropriate work of Antah Pushpa which is
necessary for conception. Here, the present studies
Dr. Bhingardive Kamini
deal with Bahir Pushpa that is Menstrual Blood.
Medical officer, Ministry of Health
& family Welfare GOI, New Delhi. Aim and Objectives: -
1. To review and compare literary data
Contact No:- 7877736643
available on Aartavakshaya in different Ayurvedic
Kamini B, Sharma OP, Bhatted SK, Conceptual study on Aartavakshaya, JOA XII-4 2018; 120-128
and modern classical texts. from the uterus. Thus, both words ‘Aartava’ and
‘Menstruation’ convey same meaning i.e. belonging
Materials & Methods:
or confirming to seasons or periods of time.
Only literary material from available
Synonyms:
Ayurvedic classical texts and commentaries were
reviewed, compared and analysed on classical Our ancient Acharyas have described certain
background to find similarities, dissimilarities and words for menstrual blood.
clinical approach in accordance to modern science.
(1) Aartava (2) Shonita (3) Asrik (4) Raja (5)
Literary Review:- Rakta (6) Lohita (7) Rudhir (8) Pushpa
There are no direct references regarding These words are used to indicate menstrual
‘Aartavakshaya’ in Veda. Shri Keshava Dutta Shastri, blood as well as ovum.
the author of ‘Atharvediya Karmaja Vyadhi
It is therefore necessary to consider
Nirodha’ has mentioned the etiopathogenesis of
reference to context before interpreting them
Anartava and its management. In ‘Vandhya
exactly for menstrual blood or ovum or even ovarian
Kalpadruma’ the author has mentioned the
hormones.
etiopathogenesis of ‘Nyunartava’ and its
management. In modern texts, period, menses or
catamenical flow are the words used as synonyms of
Here, in Nyunartava word ‘Nyun’ means less
menstrual blood.
quantity. In ‘Aartavakshaya’ word ‘Kshaya’ means
less quantity. Properties of Aartava:
Acharya Sushruta described Lakshanas and First we have to consider physiology of

Chikitsa of ‘Aartavakshaya’ in brief. 1 While Aartava before coming to conclusion of
describing the ‘Aartavadosha’ he has mentioned ‘Aartavakshaya’.
‘Kshinartava’. Kshinartava is one of the symptom of
Physiology of Aartava is described in
‘Aartavakshaya’ 2
Ayurvedic classics under the heading of ‘Shuddha
In both Vagabhata – I, II, The word Aartava Swarupa’.
‘Aartavakshaya’ is not clearly used but the word
(1) Varna
‘Kshinartava’ has been used which is actually a
synonym of ‘Aartavakshaya.’ 3 According to Acharya Charaka normal
colour of menstrual blood is like Gunjaphala, Lal
Bhel – Acharya Bhel has described
Kamala (Red lotus flower), Indragopa (An Insect)
‘Alpartava’ and ‘Vikritaartava’ but here also they are
and Alaktaka.6
synonymous of ‘Aartava-kshaya’.
Acharya Sushruta explained that the colour
Sharangadhara – He has mentioned
of Shuddhartava should resembles with the Shasha
‘Kshinartava’ as synonyms of ‘Aartavakshaya.’4
Asrik (Rabbit blood) and Laksha Rasa.7
Defination of Aartava:
According to modern text menstrual blood is
Ruturbhavamaartavam… 5 bright red in colour.
Aartava means monthly vaginal bleeding. (2) Gandha

Here word ‘Rutubhavam’ indicates the particular
Menstrual blood has specific odour.
time. That is monthly menstrual blood flow.
According to Madhukosha Vyakya; Aartava is
The word ‘Menstruation’ has its origin from Madhu Gandhi.
the Greek word ‘men’ meaning month. It’s literally
meaning is the periodic discharge of a bloody fluid
Acharya Sushruta says ‘Rakta’ has Vistrata Dhamanis, injury to these produces infertility,
(Amagandhitva) due to Prithvi Mahabhuta same can dyspareunia and amenorrhoea. Acharyas have
be consider for Aartava. 8 different opinion regarding modern concept of
‘Aartava Vaha Srotas’. Pandit Gangadhar Shastri
The menstrual blood has a characteristic
denotes Aartava Vahi Srotas as Uterine mucosa.
odour caused partly by bacterial action
degeneration; partly by the accompanying secretion Acharya Ghanekarji cite uterine arteries as,
of sebaceous and apocrine gland on vulva. “Aartava Vaha Srotasa”
(3) Matra Aartavakshaya as Disease:
Acharya Vagabhata denotes Aartava Acharya Sushruta quoted Aartavakshaya as

Pramana measuring to four Anjali. a disease as it is known that disease is a combination
of sign and symptoms.
According to modern medical science
measurement of Menstrual blood loss is also varies 1) Yathochit Kale Adarshanam
from individual to individual. The amount of blood
2) Yoni Vedana.
loss is estimated to be 20ml to 80 ml with an average
of 50ml. 3) Alpata
(4) Aartava Srava Kala 1) Yathochit Kale Adarshana: It means increase or

decrease menstrual cycle or dysfunctional
Aartava Srava Kala means duration of
uterine bleeding.
menstrual bleeding. Aartava Srava Kala varies with
individuals. Ayurvedic classics have different opinion 2) Yoni Vedana: pain during menstruation /
regarding duration of menstruation. It describes dysmenorrhea.
three (Vagbhata & Bhavamishra) to five (Charaka)
3) Alpata: It may be hypomenorrhea or
days and rarely up to seven (Harita&Bhela) days.
oligomenorrhra.
(5) Aartavapravritti Chakra Kala
Hypomenorrhea means scanty menses in
Aartava Pravritti Chakra Kala means normal menstrual cycle (25 to 35 days)
interval between two menstrual cycles.
Oligomenorrhea means increased menstrual
According to modern science, once the cycle ≥ 35 days to 6 month.
menstruation starts, it continues cyclically at
The word Aartava denotes two meanings one
intervals of 21 to 35 days with a mean of 28 days
of them is Antah Pushpa and another one is Bahir
(Text book of gynecology by D.C. Dutta)
Pushpa. Both Antah and Bahir Pushpa are
If inter menstrual period is exceed up 35 interrelated. Bahir Pushpa is outward manifestation
days, it is known oligomenorrhea. of appropriate work of Antah Pushpa which is
necessary for conception. Here, the present studies
Aartava Vaha Srotas:
deal with Bahir Pushpa that is menstrual blood.
Aartavavahasrotasa is one of the part of the
Aartavakshaya is more related to internal
Anatomy of female genital tract and since
genital organs. To evaluate the disease
Aartavakshayais also connected with Aartava Vaha
Aartavakshaya genital organs are very important. To
Srotas, it is very important to discuss about
understand the pathology of internal genital organ,
Aartavavahasrotas.
anatomy of this organ must be understood. Normal
“Aartavavahedwetayormulam Garbhashaya ’’9 menstrual pattern depend upon ovulation so it is
necessary to understand ovum according to
Aartava Vaha Srotas are two in number,
Ayurveda as Antah Pushpa term frequently used in
having roots in Garbhashaya and Aartava Vahi
the context of ovum in Ayurveda.
Beejagranthi:- ovum is monthly14 so, this reference can be true for

the meanings of Aartava. The term Rutukala is
Ø While describing Viddhalakshana of
defined as period most suitable for achievement of
Aartavavaha Srotas, Acharya Sushruta has
conception. The Rutukala in which, the seeds
enlightened the functions of ovary.
deposited are likely to bear fruits. This directly refers
Ø Tatraviddhaya Vandhyatva Maithunasahishnuta to the period of ovulation wherein the chances of
Aartavanashash10 conception are most. Acharya Kashyapa has also
explained Rutu Kala as the Beeja Kala.15
Means, any trauma to the Aartavavaha
Srotas may leads to Vandhyatva, Maithunaasahatva Aartavakshaya Chikitsa:
and Aartavanasha. However, he has not given any
Chikitsa is nothing but ‘Samprapti
description about The Anatomy Of Ovary.
Vighatana’ Chikitsa mainly divided into two
Beeja Nirmana:- segments.
Aaharais the most important entity for 1 . Shamana or Abhyantra

survival. The Aahara, composition of
2. Samshodhana or Sthanika
Panchamahabhuta, is acted upon by Jatharagni,
Bhutagni and Dhatvagni and the resultant nutritious Acharya Sushruta said ‘Aartavakshaya’
material is made available up to cellular level. In this should be treated by the use of purifying measures
course, Ayurvedic texts mentioned the formation of (Samshodhana) and Agneya substance. Dalhana says
Dhatus, Upadhatus, Malas, and Doshasetc. that for purification, only emetics should be used not
the purgatives, because purgation reduces Pitta,
The formation of the factor responsible for
which in turn decreases ‘Aartava’ while emesis
Garbhadharana occurs from Rasadhatu. The Aahara
removes Saumya substances, resulting into relative
Rasa derived from the consumed Aahara by the
increase in Agneya constituents of the body
action of Jatharagni is subjected to Rasa Dhatvagni
consequently ‘Aartava’ also increase.
to produce the Aartava. The process of Pravartana
of Aartava is governed by Apana vayu as Commentator Chakrapani says that by use of
mentioned by Acharyas in the Prakrita Karma of purifying measures Srotas are cleared. Emesis and
Apana vata.11 purgation clear upward and downward direct Srotas
respectively, thus both should be used, giving due
Swarupa of Beeja:
consideration to the dosages of drugs used for
The Swarupaas described by Acharyas in purification and fitness of the woman.
various contexts are:
Acharya Kashyapa says Aartavakshaya is
Rakta Lakshanam Aartavam Garbhakruttacha…|12 Anuvasana Sadhya Vyadhi.16
Aartavam Agneyam| 13 Acharya Vagabhata –I – II, recommend

Pitta Vriddhi Kara and Rakta Vriddhi Kara Chikitsa
Aartava is Agneya, has characteristics of
Rakta, forms Garbhaand also essential for creation
of life.
Kala of Beeja Nirmana:
The Aartava becomes Vyakta in a female

body from the age of twelve years and persists up
to fifty. Thus it is physiologically absent before
twelve years and after fifty years. The Aartava is
manifested from Rasa in the female body within a
month. The production of both menstruation and
Abhyantara Chikitsa
No. Name of Name of Yoga Reference

Preparation
1 Kwatha Tila, Karvi, Guda, in Form of Decoction Bha. Pra. Chi 70/22-24.
Krishna Tila Kwath with Guda Mishreya
Methikamuli, Garjara, Shatpushpa Etc. in Yog Ratna. Yoni Vyapada
Form Decoction Chikitsha Adhyaya
Harihar Samhita
2 Churna Shatpushpa Kashatpushpa-

shatavariKal.
3 Vati Rajah Pravartini Vati Rituvari Vati Bhai. Rat. 67/58-60.
Kanyalohadi Vati Rasoddhara Tantra
Boladivati Rasoddhara Tantra
Nastapushpantaka Rasa Rasoddhara Tantra
Bhai-Rat. 67/51-59.
4 Modaka etc. Aswathamuladi Modaka Agashti Bhel. Chi – 4
HaritakiModaka H.S. Sutrsthana – 9/63-66.
5 Ghrita Phala Ghrita Bha.Pra. Chi 70./54-56,
Brihata Shatavari Ghrita 58,
Kumar Kalyana Ghrita Shitakalyana Ghrita 81
Maha Kalyanaka Ghrita Yog.Rat.Yo. Vya. Chi -2
Ch.chi 30-36-64,
A.S. Utt 39/55
A.H. Utt 34/36-39
Bhai Rat 67/92-108
Yog Rat Prada chi-2
A.S.Utt – 9/19
A.S.Utt – 9/20
Sthanika Chikitsa
No. Name of Name of Yoga Reference

Preparation
1 Basti Anuvasana Basti Ch.si 12/18
Shatavaryadi Uttar Basti Ch.chi 30/102
Taila of Jivaniyadigana
Dravya Ka.Kalpa-shatpushpa
Shatpushpa Taila Shatarvari Kalpa.
Arkapushpa Tail Bha.bhai.rat-4
Uttarbasti
2 Varti Ikswaku-Bija, Bha.Pra.chi 70/22-24
Danti, Chapala, Yog. Rat.Yo.Vya. chi
Madana Phala, Guda, Surabija, Yavashuka, –2
Snuhikshira in Form of Varti
(Abbrevations: Kshinartava is described in Ashtartava Dusti. Here,

Bha. Pra. Chi: Bhavprakash Samhita chikitsasthan Aartavakshaya is synonyms of Kshinartava, so we
can take it.
YogRatna: Yog Ratnakar
Sushruta says that Kunapa-gandhi, Granthi-
Ka: Kashyap Samhita bhuta, Putipuya, Kshina and Mutrapurishagandhi
Bhai. Rat.:Bhaishajya Ratnavali disorder are incurable17
Bhel. Chi :Bhel Samhita Chikitsasthan Vagabhata – I, corroborating Sushruta has

accepted Kshinartava Dusti as curable one.18
H.S. Sutrsthana :Harita Samhita Sutrasthana
Physiological Consideration Of Aartava:
Yog.Rat.: Yogratnakar
Each and every process of human body
Ch.chi: charaka Chikitsasthan depends upon rhythmic phenomenon. Some
A.S. Utt: Ashtang Sangrahauttersthan processes of rhythmic phenomenon of human body
are heart rate and menstrual bleeding. These
A.H. Utt: Ashtang Hridyamuttersthan phenomena are most rhythmic because it is noticed
Ch.si: charaksiddhisthan externally. Here our subject is related to
menstruation. Menstruation depends on the cyclic
Ch.chi:Charakchikitsasthan
release of the steroid hormones estrogen and
Ka.Kalpa: Kashyap Samhita Kalpasthan progesterone. If this cyclic phenomenon is normal
then everything goes normally. It is therefore very
Bha.bhai.rat: Bharat Bhaishajyaratnakar)
essential to know physiology of menstruation to
Sadhyasadhyata (Prognosis) diagnose abnormality of menstrual disorder.19
In Ayurvedic classics, there is no description For understanding of menstrual disorder

about prognosis of Aartavakshaya but prognosis of
according to Ayurveda it is necessary to understand The rise in LH is accompanied by a smaller increase

normal menstrual pattern. in the level of plasma FSH, the physiologic
significance of which is unclear. The plasma
The Normal Menstrual Cycle
progesterone level also begins to rise just prior to
The menstrual cycle is divided into a midcycle and facilitates the positive feedback action
follicular or proliferative phase and a luteal, or of estradiol on LH secretion. At the onset of the
secretory, phase. The secretion of FSH and LH is luteal phase, plasma gonadotropins decrease and
fundamentally under negative feedback control by plasma progesterone increases. A secondary rise in
ovarian steroids (particularly estradiol) and by estrogens causes further gonadotropin suppression.
inhibin (which selectively suppresses FSH), but the Near the end of the luteal phase, progesterone and
response of gonadotropins to different levels of estrogen levels fall, and FSH levels begin to rise to
estradiol varies. FSH secretion is inhibited initiate the development of the next follicle (usually
progressively as estrogen levels increase—typical in the contralateral ovary) and the next menstrual
negative feedback. In contrast, LH secretion is cycle. Inhibin A levels are low in the follicular phase
suppressed maximally by sustained low levels of but reach a peak in the luteal phase. Inhibin B levels,
estrogen and is enhanced by a rising level of in contrast, are increased in the follicular phase and
estradiol—positive feedback. Feedback of estrogen low in the luteal phase. The endometrium lining the
involves both the hypothalamus and pituitary. uterine cavity undergoes marked alterations in
Negative feedback suppresses GnRH and inhibits response to the changing plasma levels of ovarian
gonadotropin production. Positive feedback is hormones. Concurrent with the decrease in plasma
associated with an increased frequency of GnRH estrogen and progesterone and the decline of corpus
secretion and enhanced pituitary sensitivity to luteum function in the late luteal phase, intense
GnRH. The length of the menstrual cycle is defined vasospasm occurs in the spiral arterioles supplying
as the time from the onset of one menstrual bleeding blood to the endometrium, causing ischemic
episode to onset of the next. In women of necrosis, endometrial desquamation, and bleeding.
reproductive age, the cycle averages 28 - 30 days This vasospasm is caused by locally synthesized
and the mean duration of flow is 4 -2 days. Longer prostaglandins. The onset of bleeding marks the first
menstrual cycles (usually characterized by day of the menstrual cycle. By the fourth to fifth day,
anovulation) occur at menarche and near the onset the endometrium is thin. During the proliferative
of menopause. At the end of a cycle, plasma levels phase, glandular growth of the endometrium is
of estrogen and progesterone fall and circulating mediated by estrogen. After ovulation, increased
levels of FSH increase. Under the influence of FSH, progesterone levels lead to further thickening of the
follicular recruitment results in development of the endometrium, but the rapid growth slows. The
follicle that will be dominant during the next cycle. endometrium then enters the secretory phase,
After the onset of menses, follicular development characterized by tortuosity of the glands, curling of
continues, but FSH levels decrease. the spiral arterioles, and glandular secretion. As
corpus luteum function begins to wane in the absence
Approximately 8 to 10 days prior to the
of conception, the sequence of events leading to
midcycle LH surge, plasma estradiol levels begin to
menstruation is again set into action.20
rise as the result of estradiol formation by the
granulosa cells of the dominant follicle. During the Discussion:
second half of the follicular phase, LH levels also
Aartavakshaya is one of the important
begin to rise (owing to positive feedback). Just
diseases pertaining to Aartava. It is explained in
before ovulation, estradiol secretion reaches a peak
Brihatrayee i.e Sushruta, Charaka, Vagbhata & in
and then falls. Immediately thereafter, a further rise
Laghutrayee like Bhavaprakasha,Sharangadhara. It
in the plasma level of LH mediates the final
is characterised by delayed, scanty menstruation
maturation of the follicle, followed by follicular
associated with pain along reproductive tract.
rupture and ovulation 16 to 23 h after the LH peak.
Ayurvedic literature, advocates Shodhana & Agneya 6. Carak, Caraksamhita of Agnivesh, edited with Vaidya
Dravya Upayoga. Aartavakshaya described as the Manoramahindi commentary by Acharya
S.Vidyadhara and prof.T.RaviDutt,forwarded by
most common menstrual disorders have become a
Acharya S.PriyaVrat, Chaukhamba Sanskrit
challenging problem may cause functional Prakashan, Delhi, reprint 2010,chikitsasthan 30/
disturbance associated with complaint of infertility 226.p.no.780.
and other metabolic disorder etc. Aartava is related
7. Sushruta, SushrutaSamhita, edited by Acharya
to reproductive life of woman as well as it helps to
S.PriyaVrat., Chaukhambha Surabharati, Varanasi
restore the normal rhythmic pattern of body. In 2009, Sharirsthan 2/19,p.no.16
modern medical science it is treated with hormone
8. Sushrut, Sushrutsamhita, sushrutvimarshinihindi
replacement therapy (HRT), having long terms use
vyakhya by S.Anantram edited by Acharya Priyavrat
and produces many side-effects. But Ayurveda
Sharma, ChaukhambaSurbhartiPrakashan, Varansi,
describes various treatment modalities and drugs to reprint 2009;sutrasthan 14/9,p.no.101.
treat Aartavakshaya with better responses and
9. Sushruta, SushrutaSamhita, edited by Acharya
without causing any side-effects.
Conclusion: 2009, Sharirsthan9/12,p.no.348
1 0 . Sushruta, SushrutaSamhita, edited by Acharya

Ayurveda has given various aspects of
S.Priya Vrat., Chaukhambha Surabharati, Varanasi
physiology of menstruation in microlevel than that
2009,. Sharirsthan 9/12,p.no.348
of modern science which are helpful to aware of
menstruation. In Ayurveda all menstrual 1 1 . Carak, Caraksamhita of Agnivesh, edited with Vaidya
Manoramahindi commentary by Acharya
irregularities associated with decrease menstrual flow
S.Vidyadhara and prof.T.Ravi Dutt, forwarded by
comes under broad heading of Aartavakshaya.As Acharya S.PriyaVrat, Chaukhamba Sanskrit
menstruation is goverened by Doshas their Prakashan, Delhi, reprint 2010,chikitsasthan 28/
imbalance causes abnormality. Therefore, it is 11.p.no.78
necessary to have balance state of Dosha, Dushya,
Dhatu and Mala. S.Priya Vrat., Chaukhambha Surabharati, Varanasi
2009,. Sutrasthan 15/5,p.no.56
Reference:
1. Sushrut, Sushrutsamhita, sushrutvimarsh in hindi
Sharma, ChaukhambaSurbhartiPrakashan, Varansi,
reprint 2009;sutrasthan 15/16,p.no.120. 1 4 . Sharangdhara, Sharangdhara Samhita, Gudhartha
Dipika & Dipika commentary by Kashirama &
2. Sushrut,Sushrutsamhita, sushrutvimarshinihindi
Adhamalla, Edited by P.S.Vidhyasagar, Chaukhamba
Surbharti Prakashan, Varansi, 1st edition, 2006,
Sharma, Chaukhamba SurbhartiPrakashan, Varansi,
Poorva khanda- 6/15
reprint 2010;sharir sthan 2/1,p.no.13.
1 5 . Ibidem, Ka.Sha.-5/5 Kashyapa Samhita;
3. Vagbhat,AshtangHridyam,edited with Nirmala hindi
Vrddhajivakiya Tantra, revised by Pandit S.Hemraja
commentary by.Dr.T.Brahmanand, Chaukhamba
with vidyotinihindi Commentary, Chaukhamba
Sanskrit Prakashan, Delhi,reprint 2009,Sharirsthan
Sanskrit Prakashan, Varanasi, reprint 2009,
1/10.p.no.339.
sharirasthan p.no.80
4. Sharangdhara, SharangdharaSamhita, Dipikahindi
1 6 . Kashyapa Samhita; Vrddhajivakiya Tantra, revised
commentary by Dr. T. Brahmanand , Chaukhamba
by Pandit S.Hemraja with vidyotinihindi
Surbharti Prakashan, Varansi, reprint 2010,Poorva
Commentary, Chaukhamba Sanskrit Prakashan,
khanda- 7/175.
Varanasi, reprint 2009,chikitsasthan 7
5. Vagbhat, Ashtang Hridyam,edited with Nirmala
1 7 . Sushruta, Sushruta Samhita, edited by Acharya
hindi commentary by Dr.T.Brahmanand,
S.Priya Vrat., Chaukhambha Surabharati, Varanasi
Chaukhamba Sanskrit Prakashan ,Delhi,reprint 2009,
Sharirsthan 1/1.p.no.5.
1 8 . Vagbhat, Ashtang Hridyam, edited with Nirmala

hindi commentary by.Dr.T.Brahmanand,
Chaukhamba Sanskrit Prakashan ,Delhi,reprint 2009,
Sharirsthan 1/25.p.no.339.
1 9 . Kamayni Shukla et al, A comparative study of Uttar

Basti of Yava-ksharaTaila and Kumari Taila in Tubal
Blockage, 2010.
2 0 . Kasper et.al, editors. Harrison‘s principles of internal

medicine. New York:McGraw-Hill , 16 th ed. Vol. 1,
Chapt. 326,p.2199
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ISSN No:2321-0435
ORIGINAL ARTICLE
An Analytical Study on Tamra Patra Sthita Jala
*Dr. Chandra Chud Mishra, **Dr. Sarvesh Kumar Agrawal, ***Prof. Kamalesh Kumar Sharma
*Assistant Professor, Department of Swasthvritta and Yoga, Mahaveer Ayurvedic Medical College, Meerut
**Assistant Prof., ***Professor & H.O.D., P.G. Dept of Swasthvritta and Yoga, National Institute of Ayurveda, Jaipur
ABSTRACT
The World Health Organization (2006) estimates that 88% of diarrhoeal disease is attributed to un
safe drinking water. Therefore, it becomes necessary to treat water before consumption. Household-level
methods of drinking water treatment are commonly referred as PoU (Point of Use). There are many PoU
available in market which is effective but they have some shortcoming like expensive maintenance, need
electricity etc.
Ayurveda recommends many methods of water storage and purification like boiling; filtration sun
light etc. Use of Tamra Patra for storage of drinking water is recommended in different Ayurvedic treaties.
The aim of present study was to explore the facts behind the traditional use of Tamra Patra for storage of
water and its use as a PoU. A complete analytical study of effect of copper in purification of drinking water
was done in this study.
Keywords: Copper, Copper treated water, PoU, Tamra Patra, Unsafe water, Water purification.
How to cite this article : Mishra CC,

Agrawal SK, Sharma KK, An Analytical Study on
Tamra Patra Sthita Jala JOA XII-4, 2018; 129-
132
Introduction
Water is fundamental to better health and

community development. According to the United
Nations, over 1.1 billion people lack access to safe
Website:- journalofayurveda.in drinking water, of which nearly two thirds live in
Address of correspondence: Asia. The intermittent and infrequent supply of water
Dr. Chandra Chud Mishra also results in need for storage of water at homes for
Assistant Professor, drinking Storage practices of water in various
Department of Swasthvritta and Yoga, containers that are not properly covered, inadequate
Mahaveer Ayurvedic Medical College, Meerut cleaning of storage containers, unhygienic storage
Email:- [email protected] conditions that lead to biofilm formation and
Contact No:- 8505080456 unhygienic handling and dispensing activities
Mishra CC, Agrawal SK, Sharma KK, An Analytical Study on Tamra Patra Sthita Jala JOA XII-4, 2018,; 129-132
contribute to contamination of water. Therefore, it three times with water filling it each time about 1/3
becomes necessary to further treat water at point of full. These samples were collected from a tap which
consumption or at the household level. In Ayurveda, was in regular use and tap was left open for two
procedures of Jalshodhana (purification of water) minutes. Before collection of samples tap was cleaned
are boiling, sun exposure, quenching the hot earthen properly and flamed to avoid any contamination.
ball in water, sieving, use of Katak, Sphatika, pearl, While collection of sample bottle was held near the
gems etc. Metals such as copper, silver and gold are vase with one hand and stopper and paper cover
used for making utensils to keep drinking water; they were held in other hand. The stream was gentle to
are also used traditionally in India. Use of Tamra avoid splashing. Then bottles were filled with water
Patra for storage of drinking water is not only and stoppers were tied with a cloth over it. Copper
recommended in different Ayurvedic treaties but pots of 3 L capacity with a surface area of
also practiced for generations. approximately 750 cm 2 were purchased from a
kitchenware shop. These vessels were non-reactive
Material and Method:
utensils made up of copper and used to store water
The aim of present study was to explore the for overnight before transferring to lab.The pots
facts behind the traditional use of Tamra Patra for were cleaned each time before use with citric acid
storage of water and to evaluate its role in changing to get a clean shiny surface and rinsed thoroughly
the quality of drinking water. To fulfil this target with water. This was then autoclaved and used for
water was assessed on physical, chemical and the study. All reagents and equipment as per Indian
biological parameters according to IS standards. standard guidelines was used to analyse different
Sample collection bottles of glass were used to collect parameters.
samples from source of supply for chemical and
Observation and Result:
physical analysis. Each bottle was of two liter
capacity. Sterile sample collection bottles were used The analytical study has been conducted in
to collect the samples for microbiological analysis standard government lab. The sample was analysed
and transfer of samples to lab after experiment. on test protocols as per India Standards. The
Before collecting samples bottles were rinsed well observations are comprehended in Table No. I.
Table No.I: observed values of different parameters before and after the experiment
Sr. Test Observed Values Specific values

No. Before After
1 Colour hazen units Colourless Colourless 5 max
2 Odour Objectionable Aggreable Aggreable
3 Turbidity (NTU) 2.6 1.2 1 max
4 pH 7.79 8.04 6.5 to 8.5
5 Total dissolved 2918 2948 500 max

solids, mg/l
6 Copper (asCu ), mg/l <.01 1.42 .05 max
7 Total Coliform Present Absent Absent

per 100 ml
In this study significant changes have been observed in copper, turbidity, pH, TDS value
Discussion: intensity of sunlight, etc. to operate or maintain it.

It also reduces recontamination due to handling. It
The water quality monitoring results
is simply a passive storage of water. In this study
obtained during 1995 to 2011 1 indicate that the
significant change has been observed in following
organic and bacterial contamination are continued to
parameters.
be critical in water bodies. This is mainly due to
discharge of domestic wastewater mostly in 1. pH values:
untreated form from the urban centers of the
In this study pH values has been analyzed as
country. Although community water supplies
per I.S. (Indian Standard) protocol. The pH was
providing safe drinking water after disinfection, they
within normal permissible limits and increased after
may be prone to contamination during transport or
storage in copper pot.
handling2. Approximately 72.2% of rural populations
consume untreated water owing to various reasons 2. Turbidity:
including taste (in the case of chlorine) or cost 3.
A significant decrease in turbidity was
Many studies have demonstrated that PoU water
observed. The change in turbidity might be due to
purification methods significantly improve the
formation of sediments. Further study is required to
physiochemical and microbial quality of water. Many
find the effect of copper on turbidity of water.
simple methods are recommended in Ayurveda for
enhancing the quality of drinking water. 3. Copper:
Water purification in Ayurveda: WHO (World Health Organization) (1996)

estimated that average copper requirements are 12.5
Several methods of water purification are
ìg/kg of body weight per day for adults and about
explained in Ayurveda classics. During Samhita
50 ìg/kg of body weight per day for infants. The IOM
period water was not as polluted as at present due
(Institute of Occupational Medicine) recommended
to lack of industrialization and less population. Hence
10 mg/day as a tolerable upper intake level for adults
we can classify the methods in three categories as we
from foods and supplements. In most foods, copper
explained earlier in Ayurveda review. When water is
is present bound to macromolecules rather than as
not much polluted and contain only physical
a free ion.Food and water are the primary sources
impurities at lesser extent it may be purified with
of copper exposure in developed countries. In
simple filtration (Garh Vastra Parisrav). Water with
general, dietary copper intakes for adults range from
physical impurities with lesser extent of biological
1 to 3 mg/day. Drinking water contributes 0.1–1 mg/
impurities could be made potable with moderate
day in most situations. Thus, daily copper intakes for
application of heat (Nirvapan). When water is highly
adults usually range from 1 to 5 mg/day.
impure and contains all kind of impurities physical
Concentration of copper increased after storage in
as well as biological it could be made potable with
copper pot. Although these values are within limits
boiling process (Agni Kwathan). So it is proved that
as per WHO guideline. Probable cause of this leaching
methods explained in classics are sufficient to fulfil
might be due to cuprosolvency. Further clinical
the purification requirements of that period.
study on effect of continuous use copper containing
Potential of Copper device as a low-cost water water is needed to know the effect of water stored in
purifier: copper pots. Study to evaluate the effect of copper
containing water in humans is required, in both long
This study has demonstrated that the copper
as well as short duration.
pot not only changed the physical chemical
properties of water but also inactivate bacteria, thus 4. Total dissolved solids:
demonstrating its potential as a PoU water purifier.
TDS (Total dissolved solids) value have
Copper pots for treating one liter of water would cost
increased due to storage in copper pot, but this
INR.500 - 600/- for a life time. Its functioning is not
increase was not very significant.
dependent on fuel, electricity, replaceable filters,
5. Total coliform bacteria: References:
Coliform bacteria was not recovered after 1. http://cpcb.nic.in/water.php/11/8/2015,18:16:57.

storage in copper pot. The antimicrobial activity of 2. Banda. K., Sarkar, R., Gopal, S., Govindarajan, J.,
copper is well established. Copper exhibits Harijan, B.B., Jeyakumar, M.B., Mitta, P., Sadanala,
antibacterial activity against a range of Gram positive M.E., Selwyn, T., Suresh, C.R., Thomas, V.A.,
and Gram negative bacteria, including spores. Devadason, P., Kumar, R., Selvapandian, D., Kang, G.,
Balraj, V. (2007). Water handling, sanitation and
Conclusion: defecation practices in rural southern India: a knowledge,
attitudes and practices study.Trans R Soc Trop Med Hyg.
l Copper leaching occur in water stored in coper 1124-30.
pot in significant levels.
3. Banda. K., Sarkar, R., Gopal, S., Govindarajan, J.,
l Odour of water improved after storage in copper Harijan, B.B., Jeyakumar, M.B., Mitta, P., Sadanala,
pots. M.E., Selwyn, T., Suresh, C.R., Thomas, V.A.,
Devadason, P., Kumar, R., Selvapandian, D., Kang, G.,
l pH changes occur in water after storage in Balraj, V. (2007). Water handling, sanitation and
copper pots. defecation practices in rural southern India: a knowledge,
attitudes and practices study.Trans R Soc Trop Med Hyg.
l Quality of water improves. 1124-30.
l Microbial contamination reduced as an effect of

copper on water.
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ISSN No:2321-0435
ORIGINAL ARTICLE
Ayurvedic Management of Obstructive Uropathy with Vesico-
Ureteral Reflux : A Case Study
*Dr Nidhi Sharma, **Dr Asit K Panja
*Ph.D. scholar, **Associate Professor. Deptt. of Maulik Siddhanta and Samhita
National Institute of Ayurvda, Jaipur
ABSTRACT
Ayurveda offers a different approach for the diagnosis and treatment of obstructive uropathy. In
present case study, a male patient, 17 years old with symptoms like painful micturition, pain in lower
abdomen, anorexia, weakness etc. Diagnosed with obstructive uropathy with vesico-ureteral reflux by
contemporary medical science and Mutraghata according to Ayurveda. The Ayurveda treatment included
Mutravirechaneeya drugs, vatanuloman and Virechan and symptomatic treatment. The patient showed
remarkable relief clinically and laboratory parameters also significantly came close to normal.
Key words: Obstructive uropathy, vesico- ureteral reflux, Ayurveda
Introduction
How to cite this article : Sharma N,
Obstructive uropathy is functional and
Panja AK, Ayurvedic Management of Obstructive
structural hindrance of normal urine flow, sometimes
Uropathy with Vesico-Ureteral Reflux : A Case
leading to renal dysfunction (obstructive
Study, JOA, XII-4, 2018,; 133-136
nephropathy)1. This condition in some cases results
in vesico-ureteral reflux. Obstructive uropathy in
Quick Response Code: Ayurveda is mentioned under Mutraghata which
encompasses thirteen different conditions. 2 The
present case is of bladder outlet obstruction for
which treatment given by contemporary medical
science was indwelling catheter for long term but no
absolute treatment was recommended. Ayurveda
suggest the drug therapy for the condition which act
on the disturbed equilibrium of Dosha and affected
srotas and Dushy.
Address of correspondence: Case History:
Dr. Asit K Panja
A patient male, 17 admitted to the IPD of
Associate Professor, Dept. of Maulik Siddhanta
Maulik Siddhanta Dept of National Institute of
and Samhita, National Institute of Ayurvda,
Ayurveda, Jaipur. He was experiencing painful
JaipurEmail: [email protected]
micturition, scanty urine, pus in urine, pain in both
Contact No:- 9982082832
the flanks (Katigrah), pain in lower abdomen, fever
Sharma N, Panja AK, Ayurvedic Management of Obstructive Uropathy with Vesico-Ureteral Reflux : A Case Study,
JOA, XII-4, 2018,; 133-136
(Jvar), anorexia (Aruchi), weakness (Daurbalya), investigation history is as follows

constipation (Vibandh) since 2 months.
USG (26/07/2018)
Past History: The patient, since childhood
Hydrouretero nephrosis, tortuous dilated
didn’t have proper sensation for micturition. He only
uterus, paper thin renal parenchyma
experienced urge for maturation when he felt
heaviness in the lower abdomen and used to take Pre-voiding urine volume: 700ml
longer time in maturation. Patient was in the habit
Post void residual urine volume: 650 ml
of taking very spicy food and 3 to 4 glasses of tea
daily. Two months back, the patient experienced pain NCCT KUB (27/07/2018)
in both the flanks (Katishula), fever (Jvar), painful
Both kidney enlarged, dilatation of bilateral
maturation, oligoanuria, anorexia, and weakness.
pelvicalyceal system, thinned out renal cortex,
Patient consulted to allopathic hospital and was
bilateral toutous ureters with over distended urinary
suspected with obstructive uropathy (bladder outlet
bladder
obstruction) with vesico-ureteric reflux. He was
catheterized and given the antibiotic cover. The USG (03/08/2018)
symptoms were relieved. Later, patient again
Gross dilated PCS and ureters, sludge and
developed the same problems and this time the
thickening in Urinary bladder, lower ureter sludge
catheterization was obstructed and could be done
with difficulty. Patient was advised for clean Pre-voiding urine volume: 120ml
intermittent bladder catheterization for lifetime. The
Post void residual urine volume: 40 ml
patient, then came for Ayurvedic consultation. The
Table I
Investigation 27/07/2018 3/08/2018 10/08/2018 28/08/2018 8/09/18 (during

name ayurvedic
treatment)
RBS 130.5 78 155
S.urea 131.87 106 98 86 25
S. Creatinine 4.02 3.08 2.94 3.33 0.6
Na+ 138.4 137 179
K+ 6.22 5.15 4.04
Cl- 107.7 mMol/L 117 116
Urine Sugar, WBC- full field

protein –nil
Pus cells 18-20
PTH 302.8
Hb 6.8 8.2 8.6 11.5
ALP NAD 268
JOA, XII-4, 2018,; 133-136
Diagnosis: The symptoms of patient in Ayurvedic terms can be understood as following
Table - II
Symptom in patient’s language Symptoms according to Ayurveda
Micturition with pain Sakashtamutrata
Scanty urination Mutrasanga
Turbid urine Shwetasandra mutra
Pain in both flanks Katigrah
Pain in lower abdomen Udara shula
Anorexia Apakti
Weakness Daurabalya
Constipation Vid sanga
The symptom painful maturation suggest Dashmoola Kashayam 50 ml BD and Sanjeevani vati
primarily Mutrakrichchha3. The obstruction of urine 2 tab BD were added to the previous treatment and
has been resulted in the backflow of urine and the pain Godanti bhasm was omitted. The treatment continued
by virtue of Vimrgagaman of vata and this for one more week. The complain of fever subsided.
symptom is suggestive of Mutrajathar, a condition Then, the patient was given five basti viz. first
of Mutraghata4. The other associated symptoms like Anuvasan Basti with Dashmoola tailam, after that
Mutravitsanga, Apakti also confirms the diagnosis5. three niruha basti of Varunadi Kashayam,
The appearance of turbid urine can be taken for Trunapanchmula kashayam and then again a
superimposed Kaphaja Mutrauksada which is also a Anuvasan Basti with Dashmoola tailam and
condition of Mutaghata 6 . The condition vesico Panchtiktaghritam. The pain in flanks and complain
urteric reflux can be considered congruent with of constipation were relieved and pain during
“Mutrajathara”. maturation got relieved to a greater extent. Shilajatu
250 mg was added to the prescription. After one
Treatment given:
week the turbidity of the urine was also reduced.
The aim of the treatment was to ease the Then the patient was discharged. The discharge
maturation process, increase the urine outflow, prescription was Shilajatu 125mg OD, Dashmoola
pacification of vata and subsiding the other kashyam 50 m BD, Sanjeevani vati 2 tab BD,
symptoms. The Ayurvedic line of treatment for Varunadi kashyam 50ml BD, Trunapanchmula
obstructive uropathy is facilitating the urination kashyam 50 ml BD. The investigation results during
(Mutavirechan), pacification of vata (Vatanuloman) the treatment have been mentioned in table1 (08/
and symptomatic treatment. 7 The treatment 09/2018).
prescribed was Trunpanchmula kashayam 50 ml BD
Discussion
plus 250 mg Shwetaparpati BD, Gokshur paneeyam,
Gokshuradi guggulu 2 tab BD, Godanti bhasma 250 It is evident from the symptoms that the
mg BD. The treatment was continued for one week. Basti Marma of the patient is affected.8 In text, the
The complains like pain in flanks and pain during treatment of Basti Marma has been mentioned as
maturation were very mildly relieved. The amount Basti Karma, Virechana and Vatanuloman.9 As per
of urine increased. Fever and constipation was the line of treatment Gokshur churna along with
persisting on and off. The pus appearance in urine Shweta parpati were given. These drugs have
was persisting. Then, Varunadi Kashayam 20 ml, Mutravairechanik effect so it decreses the post
JOA, XII-4, 2018,; 133-136
voidal urine volume.10 The Trunpanchmula kwath 5. Agnivesha: Carakasamhita: Ayurveddipika

facilitates micturition and cleanses the urinary Commentary by Chakrapanidatta: Edited by Vaidya
Yadavji Trikamji Acharya: Chaukhambha Surbharati Prakashan,
bladder. Godanti Bhasm was given to combat fever
Varanasi: Revised Edition 2011:p719
condition. The other preparation Gokshuradi guggulu
6. Agnivesha: Carakasamhita: Ayurveddipika Commentary by
further worked as adjuvent in facilitating the urine
Chakrapanidatta: Edited by Vaidya Yadavji Trikamji Acharya:
out, to relieve pain and have rejuvenating effect on Chaukhambha Surbharati Prakashan, Varanasi: Revised Edition
excretory system. Later, Sanjeevani vati was added 2011:p719
for subsiding the indigestion and anorexia and to 7. Agnivesha: Carakasamhita: Ayurveddipika Commentary by
relieve Jvar. Dashmoola kashayam which added for Chakrapanidatta: Edited by Vaidya Yadavji Trikamji Acharya:
pacification of Vata and to relive the pain11. Varunadi Chaukhambha Surbharati Prakashan, Varanasi: Revised Edition
Kashyam which is indicated for Antarvidradhi 12 2011:p719
(internal suppuration) was added to stop the pus 8 Agnivesha: Carakasamhita: Ayurveddipika Commentary by
appearance in urine as the stagnation and back flow
Chaukhambha Surbharati Prakashan, Varanasi: Revised Edition
of urine have resulted in the suppuration and
2011:p717
appearance of pus. After sometime Basti therapy was
given which is the best therapy for Basti marma and Chakrapanidatta: Edited by Vaidya Yadavji Trikamji Acharya:
vata shaman as indicated in the text 13. After that Chaukhambha Surbharati Prakashan, Varanasi: Revised Edition
Shilajatu was added which is considered as best 2011:p717,718
Rasayan for diseases of Mutravaha srotas 14. The 10. Agnivesha: Carakasamhita: Ayurveddipika Commentary by
functional abnormalities of excretory system came Chakrapanidatta: Edited by Vaidya Yadavji Trikamji Acharya:
to normal in terms of laboratory parameters. The Chaukhambha Surbharati Prakashan, Varanasi: Revised Edition
2011:p33
patient didn’t feel for the artificial evacuation of
urine during the treatment. 1 1 . Vagbhata:Ashtanghrdayam: Commentaries Sarvangasundara of
Arundatta and Ayurvedarasayana of Hemadri: Edited by Pt.
References: Bhisagacharya Harishashtri Paradkar Vaidya :Krishnadas
Academy, Varanasi: Reprint 2000: p 232
1 https://www.msdmanuals.com/professional/
12 Sushruta: Sushrutasamhita: Nibandhasamgraha Commentary
genitourinary-disorders/obstructive-uropathy/
by Dalhana: Edited by Narayana Ram Acharya Kavyatirath:
obstructive-uropathy
Chaukhamba Subharati Prakashan, Varanasi: Revised Edition
2. Agnivesha: Carakasamhita: Ayurveddipika 2003 : p 165
Commentary by Chakrapanidatta: Edited by Vaidya
Yadavji Trikamji Acharya: Chaukhambha Surbharati
Prakashan, Varanasi: Revised Edition 2011:p 719
Chaukhambha Surbharati Prakashan, Varanasi: Revised Edition
3 Sushruta : Sushrutasamhita : Nibandhasamgraha 2011:p717.
Commentary by Dalhana: Edited by Narayana Ram
14. Vagbhata: Ashtanghrdayam: Commentaries Sarvangasundara
Acharya Kavyatirath: Chaukhamba Subharati
of Arundatta and Ayurvedarasayana of Hemadri: Edited by Pt.
Prakashan, Varanasi: Revised Edition 2003 : p 792
Bhisagacharya Harishashtri Paradkar Vaidya: Krishnadas
4. Agnivesha: Carakasamhita: Ayurveddipika Academy, Varanasi: Reprint 2000: p943
Commentary by Chakrapanidatta: Edited by Vaidya
Yadavji Trikamji Acharya: Chaukhambha Surbharati
Prakashan, Varanasi: Revised Edition 2011:p719
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ISSN No:2321-0435
ORIGINAL ARTICLE
Functional Outcome of Basti Karma in Avascular Necrosis of
Femoral Head – A Case Report
*Dr. Gopesh Mangal, **Dr. Pravesh Srivastava
*Assistant Professor & Head (I/C), **PG Scholar,
PG Department of Panchakarma, National Institute of Ayurveda, Jaipur-302002, Rajasthan
ABSTRACT
Avascular necrosis (AVN) is the disease characterized by collapse of bone, joint pain, bone destruction
and loss of function mainly due to temporary or permanent suppression of the blood supply. AVN of the
femoral head is the most common type among all AVN. Modern treatment modalities like arthroplasty,
femoral head graft, hip compression, hip replacement, osteotomy, etc. having higher failure rate. Most of
the surgical treatments are cost worthy and having poor prognosis. Hence an effort has been made to evaluate
the efficacy of Panchatikta Ksheer Basti in the management of the AVN of femoral head.This is single case
study of 35 years old male suffering from pain and stiffness in bilateral hip joints, difficulty in walking and
restricted movement of both legs. It was diagnosed case of avascular necrosis of femoral head based on MRI
report. As per Ayurveda the case was diagnosed as Asthimajjagata Vata Vikara and was admitted in the
male ward of Panchakarma, NIA and Jaipur. The whole treatment includes Sarvanga Abhyanga, Swedana
for 16 days, Panchatikta Ksheer Bastialong with Shamana Chikitsa. Assessment was done on the basis of
sign and symptoms.The therapy provided remarkable symptomatic relief with increase in functional activities
in avascular necrosis of femoral head. On the basis of this case study it can be concluded that Basti Karma
along with ShamanaChikitsa is effective in the management of AVN of femoral head. Since the single case is
not enough more rooted study in this is required.
Keywords : Avascular necrosis, Basti
Quick Response Code: Karma, Asthimajjagata Vata Vikara
How to cite this article : Mangal G,

Srivastava P, Functional Outcome of Basti Karma
in Avascular Necrosis of Femoral Head – A Case
Report, JOA XII-4 2018; 137-142
Introduction
Address of correspondence: Avascular necrosis (AVN) is the disease
Dr. Gopesh Mangal characterized by collapse of bone, joint pain, bone
Asst. Professor and HOD (I/c) destruction and loss of function mainly due to
PG Department of Panchakarma temporary or permanent suppression of the blood
National Institute of Ayurveda, Jaipur (Raj) supply. 1 The etiological factors of AVN includes
[email protected] trauma, genetic factors, metabolic factors, use of
Mobile : 8619849011 glucocorticoids, alcoholism, gout, disease that
Mangal G, Srivastava P, Functional Outcome of Basti Karma in Avascular Necrosis of Femoral Head – A Case Report,
JOA XII-4 2018; 137-142
promotes hypercoagulable states etc. 2, 3,4 AVN is Pariksha and Systemic examination was done.
difficult to diagnose in early stages from clinical [Table 1, Table 2]. Ficat and Arlet classification was
findings and plain radiograph so early MRI should be used and diagnosed as 3 rd stage avascular necrosis
done to verify clinical suspicion.5In early stages AVN of head.12 Patient was admitted tomale IPD ward of
is asymptomatic but as the disease progress there is Panchakarma Department, NIA. The patient was
constant pain in affected joints with decrease in the treated on the line of management of Asthimajjagata
function of joints.. Factors like pain in lower limbs, Vata Vikara.
alcohol history, hidden diseases, disease of lower
Table I “Astavidha Pariksha”
limbs etc may lead to the misdiagnosis of the AVN.6
Modern treatment modalities like arthroplasty,
Astavidha Pariksha
femoral head graft, hip compression, hip
replacement, osteotomy, etc. having higher failure Nadi 84 bpm
rate.7,8,9
Mala Samayak
On the basis of sign and symptoms avascular
Mutra Samayak
necrosis resembles with Asthimajjagata Vata in
Ayurveda. Symptoms such as pain in joints, wasting Jivha Niram
of muscles and bones, disturbed sleep, constant body
Shabda Spasta
ache are caused due to vitiation of Vata residing in
Asthind Majja.10AsthimajjagataVata can be cured if Sparsha Samshitoshana
treated in acute stage but it becomes difficult for the
Drik Spasta
complete recovery in chronic stages.11Treatments of
AVN are cost worthy and having poor prognosis so Akriti Madhyam
an effort is made to evaluate the efficacy of
Panchatikta Ksheer Basti in the management of the
AVN. Table II “Systemic Examination”
Case Report
Systemic Examination
This is a case study of 35 years old health
workerwho visited to OPD of Panchakarma BP 130/70 mm of hg
Department, NIA, Jaipur (Reg. no. 26614022019)
Temp 98.6 F
with complaints of pain and stiffness in bilateral hip
joints, pain radiating to bilateral knee joint, restricted Pulse 84 bpm
movement of both lower limbs and difficulty in
Sleep Disturbed
walking for past 2 years. Since past year, pain has
gradually deteriorated and his daily activities such Gait Changed
as walking, standing, working etc have been
Pain in B/L Hip Present
hampered. Sleep was disturbed due to pain.
joints
Symptoms were aggravated by cold climate, supine
posture and during night hours and got relieved by Stiffness Present
warm weather. Patient consulted to orthopaedic
Pain during Present
department where he was diagnosed asavascular
walking
necrosis of bilateral femoral head from MRI and was
advised for surgical intervention. Then he came at Movements of Restricted
Panchakarma Department, NIA for the Ayurveda joints
treatment. Past history reveals road traffic accident
Power of lower Grade 4 bilaterally
5 years back. There was no any significant past
limbs
history of DM, STDs, HIV, addiction, etc. Astavidha
JOA XII-4 2018; 137-142
and homogenous mixture was obtained. It was
Involuntary Absent
filtered, kept in Basti Putak and was made luke warm
movements
before adminstration. Both Anuvasana and Ksheera
Trendelenburg sign Positive Basti was given in left lateral position as mentioned
Raising of lower Right leg up to 15 in the Ayurveda texts. Pathyadiet was advised to the
limbs degree and left leg patient during and after the treatment.
20 up to degree Table III : Ingredients of Panchatikta
Ksheer Basti13
Interventions- Panchatikta Ksheer Basti [Table
3]along with Shamana Chikitsha was given [Table Dravya (Materials) Qty.
4].10 Anuvasan and 6 Ksheer Basti was given as per Madhu (Honey) 50 ml.
Kaal Basti schedule [Table 5]. Initially 50gm of Saindhav Lavana (Rock Salt) 5 gm.
honey was taken for Ksheer Basti along with 5 gm of
Tiktagugglugrhitam 50 ml
Saindhava Lavana and was stirred well. 50ml of
(Medicated Ghee)
Tikta Guggulu Grihtam was added and mixed well.
Panchatikta Ksheer Kwath was prepared by Shatpuspa Kalka 10gm
Ksheerpaka Vidhi. Finally 400 ml of prepared Panchatikta Kwatha + Ksheer (Milk) 400ml
Panchatikta Ksheer Kwatha was added, mixed well
Table IV: “ Interventions”
Date Drug Dose Frequency
14/02/2019 Yograj Guggul 2tab Thrice a day

Rasna saptak kwath 20ml Twice a day
Ashwaghanda Churna + 2gm Twice a day
Nagradhya Churna + 1gm
Chopchini Churna 1gm
Panchasakar Churna 5gm Once during bed time
15/02/2019 Panchatikta Ksheer Basti 400ml In Kala Basti Format

With Dasmool Taila Anuvasan Basti 60ml
after Sarvanga Abhyanga Swedana
Table V: “Basti Pattern”
Days 1 2 3 4 5 6 7 8
Type of Basti A A K A K A K A
Days 9 10 11 12 13 14 15 16
Type of Basti K A K A K A A A
A= Anuvasan Basti, K = Panchatikta Ksheer Basti
Assessment Criteria - Assessment was done on the basis of subjective parameters. [Table 6]. Pain and
stiffness was markedly reduced after Basti Karma. After completion of the treatment patient was able to
walk freely, walking distance was increased, sleep was occasionally disturbed, leg raising to 40º and
trendelenburg sign was negative[Table 7]. On discharge patient was advised to continue the Shamana Aushadh
for 3 months.
JOA XII-4 2018; 137-142
Table VI. Grading of Subjective Parameters
S.N Symptom Criteria Grade
1. Pain No pain while walking 0

Mild Pain while walking 1
Moderate Pain while walking 2
Severe pain while walking 3
2. Stiffness No stiffness 0
Stiffness for 10-30 min 1
Stiffness for 30 – 60 min 2
Stiffness for more than 1 hr 3
3. Movement of joints Normal 0
Mildly restricted 1
Moderately restricted 2
Severely restricted 3
4. Radiating pain Pain never radiates 0
Occasionally radiating 1
Mostly radiating 2
Radiating all the time 3
5. Gait Unchanged 0
Occasionally changed 1
Walk with support 2
Unable to walk 3
6. Sleep Normal 0
Occasionally disturbed 1
Frequently disturbed 2
Unable to sleep due to pain 3
Table VII “Assessment before and after treatment”
Before After Completion After follow up

treatment of Basti Karma of 15 days
Pain 3 1 1
Radiating pain 3 1 0
Stiffness 2 1 1
Movement of joints 2 1 1
Gait 2 1 1
JOA XII-4 2018; 137-142
Sleep 3 1 1
SLR Rt leg-15º, Rt leg-30º, Rt leg-40º,

Left leg-20º Left leg-40º Left leg-40º
Trendelenburg sign Positive Negative Negative
Discussion: of Shothahara (anti-inflammatory) Vedanahara

(analgesic) and acts on the Sukshma Srotsas of the
Avascular necrosis is bone tissue death due
body. Nagradhya Churna having anti- inflammatory
to cessation of blood supply causing collapse of the
and neuroprotective action due to its Madhur, Ushna
bone, leading to pain, loss of joint function and
and Snigdha property. Dasmool Taila having
ultimately damage of the joint.14 Avascular necrosis
Vatahar, Balya and Brihman properties due to its
is usually of traumatic and non traumatic causes. In
Sneha Guna. Rasna Saptak Kwath having Vatahara
traumatic injury blood supply is interrupted due to
Guna and anti-inflammatory in action. Thus Basti
injury in the femoral artery. Some non traumatic
Karma along with Shamana Aushadha shows
AVN are found to be associated with corticosteroid
significant improvement in the avascular necrosis of
usage, alcoholism, infections, storage disorders,
femoral head.
coagulation defects and some autoimmune disease.15
Conclusion:
Here the Avascular necrosis of femoral head
on the basis of sign, symptoms, Dosha and Dushya Panchatikta Ksheer Basti along with
is treated on the line of Asthimajjagata Vata Vikara. Anuvasana Basti shows remarkable symptomatic
Snehana and Swedana is considered as the 1st line relief with increase in functional activities in
treatment of Vata Vyadhi.16 In Asthimajjagata Vata avascular necrosis of femoral head. The results need
Vikara Snehan either internal or external is to be studied in more numbers of populations for the
indicated.17Swedana helps in reducing the heaviness, better assessment.
stiffness and increases the blood circulation. 18
Financial Support And Sponsorship:
According to Acharaya Gangadhar for vitiated Vata
Basti Should be the choice of treatment and Nil
administered Vata below Nabhi Pradesh (Umblical
Conflict Of Interest:
region). 19 Basti by its action on Pakwashya and
Purishdhara Kala helps in the treatment of Vata There is no conflict of interest.
Vyadhis. For the treatment of Asthi Dhatu Acharya
References
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Balya in nature having Vata-Pitta Shamak property O’brien CA, Manolagas SC. The pathophysiological
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growth factor for the treatment of femoral head
in treatment of Asthi and Majja Vikara and also
osteonecrosis: An experimental study in canines. World
balances the Apana Vayu through its Vatanulomana
journal of orthopedics. 2018 Sep 18;9(9):
Property. Ashwagandha acts as Balya, Rasayana 120.[PubMed]
and Dhatuposhaka drug. Chopchini having property
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the femoral head. Twenty years later. Acta Sanskrit Sansthan; Charaka Samhita. p. 744.
orthopaedica Belgica. 1999;65:3-4. [PubMed] 1 2 . Sultan, A.A., Mohamed, N. et al. International
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avascular femoral head necrosis. Der Orthopade. 2018 1 3 . Vd. Harish Chandra Singh Kushwaha editor Ayurveda
Aug.[Pubmed] Deepika commentary, Sutrasthan. 28th Adhyaya 27 th
6. Chen ZW, Li TX, Wan XX, Wang RT, Chen WH. Study shloka,reprinted 2018, Varanasi: Chaukhambha
on the risk factors for the misdiagnosis of femoral head Sanskri Sansthan; Charaka Samhita. p. 477.
osteonecrosis. Zhongguo gu shang= China journal of 1 4 . Tofferi JK, Gilliland W, Avascular Necrosis. Available
orthopaedics and traumatology. 2017 via eMedicine. Accessed 18 Sep 2018.
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1 5 . Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld
7. Sadile F, Bernasconi A, Carbone F, Lintz F, Mansueto G. Y, Gershwin MEPathogenesis and natural history of
Histological fibrosis may predict the failure of core osteonecrosis. Semin Arthritis Rheum.
decompression in the treatment of osteonecrosis of the 2002, 32(2):94–124. [PubMed]
femoral head. International Journal of Surgery. 2017
1 6 . Vd. Harish Chandra Singh Kushwaha editor Ayurveda
Aug 1;44:303-8.
Deepika commentary, Chikitsasthana 75-78 th shloka,,
8. Morita D, Hasegawa Y, Okura T, Osawa Y, Ishiguro N. reprinted 2018, Varanasi: Chaukhambha Sanskrit
Long-term outcomes of transtrochanteric rotational Sansthan; Charaka Samhita. p. 745.
osteotomy for non-traumatic osteonecrosis of the
femoral head. The bone & joint journal. 2017
Deepika commentary, Chikitsasthana 28th Adhyaya
Feb;99(2):175-83.[Pubmed]
93 rd shloka, reprinted 2018, Varanasi: Chaukhambha
9. Sallam AA, Imam MA, Salama KS, Mohamed OA. Sanskrit Sansthan; Charaka Samhita. p. 749.
Inverted femoral head graft versus standard core
decompression in nontraumatic hip osteonecrosis at
minimum 3 years follow-up. Hip International. 2017
80 th shloka, reprinted 2018, Varanasi: Chaukhambha
Jan;27(1):74-81.
Sanskrit Sansthan; Charaka Samhita. p. 746.
33rd shloka. reprinted 2018, Varanasi: Chaukhambha
89 th and 90 th shloka, reprinted 2018, Varanasi:
Sanskrit Sansthan; Charaka Samhita p. 734.
Chaukhambha Sanskrit Sansthan; Charaka
1 1 . Vd. Harish Chandra Singh Kushwaha editor Ayurveda Samhita.p. 750.
‚Ê⁄UÊ¥‡Ê
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◊¥ ¬˝÷Êfl‡ÊË‹ „Ò– ÿ„ ‡ÊÊœ ÷Áflcÿ ◊¥ (AVN) ∑§ ⁄UÊÁªÿÊ¥ ∑§ Á‹∞ ¬ÿÊ¸# Ÿ„Ë¥ „Ò, ß‚Á‹∞ •Áœ∑§ ⁄UÊÁªÿÊ¥ ¬⁄U ß‚∑§Ê •äÿÿŸ
Á∑§ÿÊ ¡ÊŸÊ •Êfl‡ÿ∑§ „Ò–
Annexure I
Manuscript no. JOA/NIA/200 /
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Annexure II
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Journal of Ayurveda

A Peer Reviewed Journal

Dr. Mansi, Dr. Aparna Sharma

A Study of Vyanghara Karma of Laksha obtained 73

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 1

Anti-Microbial Study On Different Samples of Lavangadi Vati 85

Dr. Amitabh Mazumder, Dr. Parween Bano, Prof. K. Shankar Rao

In-Vitro Evaluation of Anti-Microbial Effect of Herbal Formulation 92

Dr. Goyal Arun, Dr. Rath Sudipt, Prof. Kotecha Mita

An in-vivo study of toxicological effects of Shudha Dhatura Beej and its 98

A Study of Asthi Sharir In Context of Various Types of Asthi 105

Comprehensive approach of Lifestyle Modification in Diabetes Mellitus 113

Conceptual study on Aartavakshaya 120

An Analytical Study on Tamra Patra Sthita Jala 129

Dr Nidhi Sharma, Dr Asit K Panja

Functional Outcome of Basti Karma in Avascular Necrosis of 137

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 2

Clinical Practice on Ayurvedic principles….

Prof. Sanjeev Sharma

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 3

Key Words: Kampavata, Parkinson’s disease, Kampa, Kampavatari Rasa

How to cite this article : Singh R.C.

Ayurveda is a monumental contribution of

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 4

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 5

Table No- I Subjective Criteria With Grading

PARAMETERS FINDING POINTS

Hands Detectable slowing of the supination-pronation rate; beginning 1

Moderate slowing of the supination-pronation rate in one or both 2

Severe slowing of the supination-pronation rate; unable to write or 3

Detectable rigidity in neck and shoulders; activation phenomenon is 1

Moderate rigidity in neck and shoulders; resting rigidity is present 2

Severe rigidity in neck and shoulders; resting rigidity cannot 3

Posture Normal posture; head flexed forward less than 4 inches 0

Beginning poker spine; head flexed forward more than 5 inches 1

Beginning arm flexion; head flexed forward up to 6 inches; one or both 2

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 6

Upper Swings both arms well 0

Extremity One arm definitely decreased in amount of swing 1

Swing One arm fails to swing 2

Both arms fail to swing 3

Gait shortened to 12-18 inch stride; beginning to strike one heel; 1

Stride moderately shortened to 6-12 inches; both heels beginning 2

Onset of shuffling gait; steps less than 3 inches; occasional stuttering- 3

Tremor No detectable tremor found 0

Less than 1 inch of peak-to-peak tremor movement observed in limbs 1

Maximum tremor envelope fails to exceed 4 inches; tremor is severe 2

Tremor envelope exceeds 4 inches; tremor is constant and severe; 3

Facies Normal; full animation; no stare 0

Detectable immobility; mouth remains closed; beginning features 1

Moderate immobility; emotion breaks through at markedly increased 2

Speech Clear loud resonant easily understood 0

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 7

Marked harshness and weakness; very difficult to hear and to 3

Requires help in certain critical areas; very slow in performing most 2

Continuously disabled; unable to dress feed self or walk alone 3

Table No- II Interpretation The walking time was measured by asking

Journal of Ayurveda Official publication of National Institute of Ayurveda, Jaipur Rajasthan 8

Table No- III Effect Of Kampavatari Rasa On Subjective Parameters