siddadarada amavata rs010_gdg
DESCRIPTION
Preparation and Analytical study of Sri Sidhadaradamrita Rasa and its clinical efficacy in Amavata - Dr. Pradeep Agnihotri, Department of rasashastra, Post graduate studies and research center, Shri D. G. Melmalagi Ayurvedic Medical College, GadagTRANSCRIPT
PREPARATION AND ANALYTICAL STUDY OF SRI SIDDHADARADAMRUTA RASA AND ITS CLINICAL
EFFICACY IN AMAVATA
By
Pradeep Agnihotri
Dissertation Submitted to the Rajeev Gandhi University of Health Sciences,
Karnataka, Bangalore.
In partial fulfillment of the requirements for the degree of
AYURVEDA VACHASPATHI M. D.
In
RASASHASTRA
Under the guidance of
Dr. M. C. Patil M.D. (Ayu)
Under the co-guidance of
Dr. G. N. Danappagoudar
M.D. (Ayu)
DEPARTMENT OF RASASHASTRA, POST GRADUATE STUDIES AND RESEARCH CENTER,
SHRI D. G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG – 582103.
2003-2006
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.
DECLARATION BY THE CANDIDATE
I here by declare that this dissertation / thesis entitled
“Preparation and Analytical study of Sri Siddhadaradamruta Rasa and its
Clinical Efficacy in Amavata” is a bonafide and genuine research work
carried out by me under the guidance of Dr. M. C. Patil, M.D. (Rasashastra),
Professor and H.O.D, Post-graduate department of Rasashastra and under
the co-guidance of Dr. G. N. Danappagoudar M.D. (Rasashastra), Lecturer,
Post-graduate department of Rasashastra.
Date: Place: Pradeep Agnihotri.
SHRI D.G. MELMALGI AYURVEDIC MEDICAL COLLEGE, GADAG. POST GRADUATE DEPARTMENT OF RASASHASTRA.
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “Preparation and
Analytical study of Sri Siddhadaradamruta Rasa and its Clinical Efficacy in
Amavata” is a bonafide research work done by Pradeep Agnihotri in partial
fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.
(Rasashastra).
Dr. M. C. Patil, M.D. (Rasashastra)
Professor & H. O. D. Date: Department of Rasashastra, Place: Gadag. Post Graduate Studies and Research Center, D.G.Melmalgi Ayurvedic Medical College, Gadag.
SHRI D.G. MELMALGI AYURVEDIC MEDICAL COLLEGE, GADAG. POST GRADUATE DEPARTMENT OF RASASHASTRA.
CERTIFICATE BY THE CO-GUIDE
This is to certify that the dissertation entitled “Preparation and
Analytical study of Sri Siddhadaradamruta Rasa and its Clinical Efficacy in
Amavata” is a bonafide research work done by Pradeep Agnihotri in partial
fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.
(Rasashastra).
Dr. G. N. Danappagoudar M.D. (Rasashastra)
Lecturer Date: Department of Rasashastra, Place: Gadag. Post Graduate Studies and Research Center, D.G.Melmalgi Ayurvedic Medical College, Gadag.
ENDORSEMENT BY THE H.O.D. AND PRINCIPAL OF
THE INSTITUTION
This is to certify that the dissertation entitled “Preparation and
Analytical study of Sri Siddhadaradamruta Rasa and its Clinical Efficacy in
Amavata” is a bonafide research work done by Pradeep Agnihotri under the
guidance of Dr. M. C. Patil, M.D. (Rasashastra), Professor and H.O.D, Postgraduate
department of Rasashastra and under the co-guidance of Dr. G. N.
Danappagoudar M. D. (Rasashatra) Lecturer, Postgraduate department of
Rasashastra.
Dr. M.C. Patil, M.D. (Rasashastra) Dr. G. B. Patil.
Professor & H.O.D Principal
Department of Rasashastra, D G M A M C, Gadag.
P G S & R C, D.G.M A M C, Gadag.
Date: Date:
Place: Gadag. Place: Gadag.
COPYRIGHT
Declaration by the candidate
I here by declare that the Rajiv Gandhi University of Health
Sciences, Karnataka shall have the rights to preserve, use and disseminate this
dissertation / thesis in print or electronic format for academic / research purpose.
Date:
Place: Gadag. Pradeep Agnihotri.
© Rajiv Gandhi University of Health Sciences, Karnataka
ABBREVIATION
1) A. H. – Ashtanga Hridaya.
2) A. P. – Ayurveda Prakash.
3) A. S. S. – Ayurveda Sara Sangraha.
4) A. T. – After treatment.
5) B. P. – Bhavaprakasha.
6) B. R. – Bhaishajya Ratnavali.
7) B. R. R. Su. – Bruhat Rasaraja Sundar.
8) B. T. – Before treatment.
9) C. D. – Chakradatta.
10) C.S. – Charaka Samhita.
11) D. G. – Dravyaguna Vignana.
12) D. N. – Dhanwantari Nighantu.
13) FRLHT – Foundation for Revitalisation of Local Health Traditions 14) K. N. – Kaiyadeva Nighantu.
15) Ra. – Rasamruta.
16) R. A. – Rheumatoid arthritis.
17) R. C. – Rasendra Chudamani.
18) R. J. N. – Rasajala nidhi.
19) R. K. – Rasa Kamadhenu.
20) R. N. – Raja Nighantu.
21) R. Pr. Su. – Rasa Prakasha Sundar.
22) R. R. S. – Rasa Ratna Samucchaya.
23) R. S. S. – Rasendra Sara Sangraha.
24) R. T. – Rasatarangini.
25) S. S. – Sushruta samhita.
26) SSDR – Sri Siddhadaradamruta Rasa
27) Y. R. – Yoga Ratnakara.
III
ABSTRACT
The Rasa dravyas are basically classified on the basis of Agni samskaras they
have undergone that’s how Kharaleeya, Parpati, Kupipakwa, and Pottali rasayanas came
in to existence with varying grade of therapeutic efficacy.. There are certain other
preparations which cannot be grouped under these categories the agni samskara given to
them also varies. These preparations are few and do have the equivalent therapeutic
efficacy as above. Sri Siddhadaradamruta Rasa , a preparation involving Shodhita
Hingula which when subjected to Dahana and Pachana samskara with specified drugs
like Vata ksheera, Palandu swarasa, Bhallataka, Lavanga and Grutha is claimed to
increase the therapeutic efficacy which is advocated in Amavata as one of its indication
along with Purana Guda as anupana. After thorough preparation as per classics the drug
was analytically studied to ascertain the effect of samskaras on it. There was presence of
media substrates in to the sample like Fat. Its Organoleptic character variations such as
change in colour from Red to Dark Brown was noticed along with changes in Hg% and
S% before and after the preparation (Hg% from 86.6 to 62% and S% from 12.83 to 12.28
respectively). The ESCA reported the presence of HgO and HgS in the ratio of 60:40. It
was noted that there was a presence of selenium in lesser proportion which was not in
elemental form. This was therapeutically tested over 15 cases of Amavata in a single
blind prospective clinical trial. The result in the trials statistically showed highly
significant in the cardinal symptoms like sandhi shotha, Sandhishoola, Gouravata,
Jadyata, jwara (Sthanika Ushmata) Nidraviparyaya ( p-value <0.001). Thus it was
inferred that the Samskaras has a definite role in increasing the therapeutic efficacy of the
drug. It was found promising in navottha Amavata.
Key Words: Samskara; Dahana; Pachana; Sri Siddhadaradamruta Rasa; Amavata; Organoleptic Characters; ESCA; Clinical efficacy.
IV
ACKNOWLEDGEMENT
I salute to Lord Venkateshwara and HisHoliness Shri Abhinav Shivanand swamiji to have bestowed their blessings through out my carrier.
I express my heartfelt obligations to my honorable guide Dr. M C Patil MD (Ayu) Professor and HOD, PG Dept of Rasashastra, DGMAMC, Gadag, for his critical suggestions, guidance, and encouragement at every stage in the accomplishment of this work.
I am greatful and obliged to my co-guide Dr G N Danappagoudar MD (Ayu) Lecturer, PG Dept of Rasashastra, DGMAMC, Gadag, under whose guidance and inspiration I have been able to complete this work.
I am happy to convey my deep sense of gratitude to Dr G B Patil Principal, PGS & RC, DGMAMC, Gadag, for his encouragement and providing facilities during this research work worthwhile.
I offer my sincere thanks to Dr RKGacchinmath, Professor and HOD, UG Dept of Rasashastra, DGMAMC, Gadag, for his constant support and valuable directions.
Humble thanks to Dr DilipkumarB, Asst Professor, PG Dept of Rasashastra, DGMAMC, Gadag, for his valuable suggestions and critical views.
My sincere gratitudes to Dr J G Mitti, Lecturer, PG Dept of Rasashastra, DGMAMC, Gadag, for his valuable information in bringing out this work.
I express my earnest gratitude to Dr GS Hiremath, Dr Varadacharyulu, DrBSPatil, Dr Avvanni, Dr Prushottamacharyulu, Dr Mulugund, Dr KSR Prasad, Dr SH Doddamani, Dr Shettar, Dr Belawadi, Dr Paraddi, Dr Sankh, Dr Nidagundi, Dr Mulkipatil, Dr Shankargouda, Dr Samudri, and Dr Yasmin for their great co-operation.
I ackwoledge my sincere thanks to Nandakumar for his statistical work, DrDVijaykumar, DrRevati, ShriChandur, ShriSuresh, ShriDNPatil, ShriPolicepatil for their kind co-operation and help in analytical study.
I extend my gratitude to Shri VMMundinmani and Sureban and SSRAMCollge for providing the required books during the study.
I render my sincere thanks to Tungabhadra Grameena Bank for monitory support. I am greatful Dr KY Krishnaji, Dr BB Joshi, Dr Gudagnatti, Dr RS Hiremath, Dr
MAHullur, Dr SKBannigol, Dr AS Prashant, and Dr Jadar for their heartfelt co-operation and advise.
With pleasure I extend my sincere gratitude to Dr SDYarageri RMO, Dr UVPurad, DrAMAdi,Principal,AMC,Ron, DrKotturshetti, DrBGSwamy, DrVMSajjan,
I
SmtPKBelwadi, Smt Sarangmath, Tippanagoudar, Kallangoudar, Biradar, SmtEkbote, MMJoshi, Shri Shankar Belwadi for their co-operation and help during the study.
I am always at rememberance of Mr and Mrs Lalitprasad and Mr and Mrs DrBabu Vijayanathan whose encouragement is the result of my present work.
This work remains incomplete without mentioning my brother Mr Bhaskar and sister in law Mrs Geeta Bhat whose love and affection has brought me up to this altitude, I am greatful to them.
I am ever thankful to my intimate friends Dr BYGanti, DrShaila, DrMouli, DrUday, DrRatna who stood with me all the way at my turmoil.
I thank my kiths and kins especially Mrs and Mr Malteash, Mrs and Mr Gururaj, Shashi for their in time support valuable help during my work. I extend my regard to my sisters Anju, Roopa, Deepa for their affection.
I owe my immense thanks to Mrs and Mr Dr BDBhat, CDPatil, RDPatil, ASeenam Bhat for their love and affection shown through out my life.
I have no words to explain my feelings towards my all time friends Mrs and Mr CBRaj, Mrs and Mr Jagdish, Mr Chandru, Dr Basavaraj, Mr Ghouse and Dr SatishPai who are spirit behind my enthusiasm. I am ever thankful to them.
My in depth regards to Dr Koteshwar, DrChetan, DrDPJoshi, DrSantoji, DrVSHiremath, DrPattanshetti, DrVeenaK, DrSReddy, DrYadalli, Dr PDDeshpande, Dr GSKulkarni, DrVMKullolli, DrAIAkki, DrTeggi, DrSubin, DrFebin, DrSatish, DrMaheshAbhang, Dr SAPatil, DrAnita, DrSantosh Kulkarni, DrBani and DrVarsha for their friendly affection.
I am also thankful to my junior friends DrAnandH, DrAnita, DrSuvarna, DrSharanu, DrJayashri, DrSuma, DrRudraxi, DrKattimani, DrJagdishH, DrVijaySH, DrHakkandi, DrAshwin, DrGavi, DrAnandHD, DrAshwini, DrJiglur, DrSarvi, DrAshok, DrSulochana, DrManjunath, DrAmnish, DrShibaprasad, DrGavimath, DrPrasanna, DrBudi, DrMadhushri, DrPayappagouda, DrShivaleela, DrKumbar and Dr ArunkumarBiradar for their support and affection.
I acknowledge my patients for their kind co-operation and whole-hearted consent to participate in this clinical trial. I express my thanks all those who have helped me directly and indirectly with apologies for my inability to identify them individually.
Finally I dedicate my whole effort to my beloved parents Mr A.Shankar Bhat and Mrs Uma.S Bhat who are the driving force behind all my fruitful endeavors.
Date: Place: Dr Pradeep Agnihotri.
II
CONTENTS
Page No.’s
01. Introduction 1-3
02. Objectives 4
03. Review of Literature 5-53
04. Methodology 54-77
05. Results 78-101
06. Discussion 102-114
07. Conclusion 115-117
08. Summary 118-119
09. Bibliography 120-130
10. Annexure
i. Shlokas of Sri Siddhadaradamruta Rasa
ii. Case sheet Proforma
IV
Graph No
Contents Page No
01. Showing Distribution by age Group 78
02 Showing the distribution of patients by Sex. 79
03 Showing Patients distribution by Religion 80
04 Showing the distribution of patients by Socio-economic status. 81
05 Showing the distribution of patients by Occupation 82
06 Showing the distribution of patients by Prakriti. 85
07 Showing the distribution of patients by desha 88
08 Showing the distribution of patients by chief complaint 89
09 Showing the distribution of patients by associated complaints 90
10 Showing the distribution of patients by Nidana. 91
11 Showing the response of the therapy in Sandhishoola. 92
12 Showing the response of the therapy in Sandhishotha. 93
13 Showing the response of the therapy in Jwara 94
14 Showing the response of the therapy in Gouravata. 95
15 Showing the response of the therapy in Nidraviparyaya 96
16 Showing the response of the therapy in Jadyata. 97
17 Showing the overall result assessed on the basis of subjective & objective parameters
98
V
Sl.No Content Page No
01 Shows list of synonyms of Hingula according to different authors.
07
02 Shows inclusion of Hingula under different classes. (As per different texts)
09
03 Showing the bhedas of Hingula. 10 04 Sowing the rasa of Hingula according to various texts 13 05 Showing the doshaghnata of Hingula according to various
texts 14
06 Synonyms according to different authors 17 07 List of Synonyms of vata 23 08 Synonyms of Palandu according to different authors 26 09 Synonyms of Lavanga according to different author 29 10 Showing synonyms of Guda. 32 11 Synonyms of Grutam. 34 12 Showing the samanya laxanas of Amavata 40 13 Showing the different treatment modalities adopted in
Amavata according to various authors. 44
14 Showing the pattern of onset of Rheumatoid arthritis. 49 15 Results of Hingula Shodhana 57 16 Showing the quantity of Hingula before shodhana and after
shodhana 57
17 Showing weight of Bhallataka before and after shodhana. 59 18 Showing weight of Hingula before and after threading. 60 19 Showing details of Pachana Samskara. 61 20 Showing details of Ghruta Pachana. 63 21 Showing the gradation which is adopted in statistical
evaluation of clinical symptoms. 75
22 Showing the gradation which is adopted in statistical evaluation of walking time.
76
23 Showing Distribution by age Group 78 24 Showing the distribution of patients by Sex 79 25 Showing Patients distribution by religion 80 26 Showing the distribution of patients by Socio-economic
status 81
27 Showing the distribution of patients by Occupation. 82 28 Showing the distribution of patients by marital status 83
VI
Sl.No Content Page
No 29 Showing the distribution of patients by food habits 83 30 Showing the distribution of patients by addiction. 84 31 Showing the Distribution of patients by predominant Rasa in
diet. 84
32 Showing the distribution of patients by Prakriti. 85 33 Showing the distribution of patients by Sara. 86 34 Showing the distribution of patients by Samhanana 86 35 Showing the distribution of patients by Satwa. 87 36 Showing the distribution of patients by Vyayama shakti. 87 37 Showing the distribution of patients by desha. 88 38 Showing the distribution of patients by chief complaint. 89 39 Showing the distribution of patients by associated complaints 90 40 Showing the distribution of patients by Nidana. 91 41 Showing the response of the therapy in sandhishoola. 92 42 Showing the response of the therapy in sandhishotha. 93 43 Showing the response of the therapy in Jwara (Sthanika
Ushmata) 94
44 Showing the response of the therapy in gouravata. 95 45 Showing the response of the therapy Nidraviparyaya 96 46 Showing the response of the therapy in Jadyata 99 47 Showing the overall result assessed on the basis of subjective
& objective parameters. 98
48 Showing statistical analysis before and after treatment. 99
VII
1
Ayurveda, the upaveda of Atharvaveda is the first systematically dealt medical
system ever known to the man kind with a vital panorama to preserve health, alleviate
diseases and even prevent them .The distinctive principles of approach to an ailment
and its thorough management has been a boon to the existing medical world.
Ayurveda defines swastha as one whose physical, spiritual, social and
environmental aspects are in harmony.
With the advent of Rasashastra, this has a parallel thought as that of Ayurveda
was clubbed to fortify the results in a short duration. It pledged the dehasiddhi using
different minerals, metals, pearls etc after subjecting them to various samskaras. The
samskaras help in Gunaantardhana of a dravya which is being subjected. This could
be understood as the one by which it enhance the property of the dravya used. Sri
Siddhadaradamruta Rasa, a unique mode of preparation which does not fall under
chaturvidha rasayanas, involves chiefly the pachana samskara of Shodhita Hingula
with Vatakseera, Palanduswarasa, and Dahana with Shuddha Bhallataka, and lastly
pachana with Gogrutha. Such pachita Hingula for long hours develops properties to
cure Amavata. Different Acharyas have explained the management of Amavata
involving the Hingula, Bhallataka separately. The Rasataranginikara came up with
unique preparation for the management of Amavata which involves these drugs
together and also with a simpler procedure of preparing the drug. The efficacy of
Hingula has been highlighted by Brahatrasaraja sundara, Rasataranginikara in
Amavata, Pliha and Garavisha. Similarly the Bhallataka is made use for management
of Amavata by Yogaratnakara in Amavata chikitsa.
Amavata being a crippling disease claiming maximum loss of human working
power ranging from simple Artharalgia to severe complication like deformities,
systemic disturbances and may cause temporary or permanent disabilities.
Introduction
2
Amavata is a condition in which improperly metabolized intermediate by
product known as Ama, becomes the core cause of the disease and get deposited by
prakupita vata at different Shleshmasthanas.
Rheumatoid arthritis (RA) is an autoimmune musculoskeletal disorder
explained in modern medicine closely resembles with the clinical entity of Amavata.
It occurs in all races and ethnic groups. Females are more affected (3:1) as compared
to males.
There are several preparations listed in Ayurvedic classics for Amavata like
guggulu preparation and gold preparation. They are costly and even give varying
degree of relief. Ayurveda believes that every individual differs form each other and
require a specific yoga in a disease.
Sri Siddhadaradamruta Rasa is considered as an ideal preparation by
Rasataranginikara and found promising for Amavata.
The whole study has been arranged in to following chapters –
01. Introduction
This part introduces the subjects by laying emphasis on its importance in the
present time. Plan of study is also dealt.
02. Review of Literature
It is based on the description of Ayurveda texts and also modern,
pharmacotherapeutic properties of the Hingula, Bhallataka, Vata, Palandu, Lavanga,
and Grutha. Description of Amavata and Rheumatoid arthritis is dealt.
Introduction
3
03. Methodology
a. Pharmaceutical study
This chapter includes the selection of raw materials, shodhana of Hingula, and
collection of Vata dugdha, Shodhana of Bhallataka and executing the preparation of
Sri Siddhadaradamruta Rasa.
b. Analytical study
This chapter includes the Organoleptic and chemical analysis of Shuddha
Hingula and Sri Siddhadaradamruta Rasa which assess the changes in it.
c. Clinical study
This includes single group prospective clinical study and explains about
efficacy of Sri Siddhadaradamruta Rasa in Amavata.
01. Results
In this part the results obtained are systematically presented, which include
demographic data, data related to disease and data related to response to treatment.
02. Discussion
In this chapter observation, findings and results of various studies have been
found out with possible explanation for its effects.
03. Conclusion
The essence of the whole study is mentioned in this chapter.
04. Summary
It contains the information of the overall work in a nut shell.
Introduction
4
Aims and Objectives:
1. Preparation of Sri Siddhadaradamruta Rasa.
2. Analytical study of Sri Siddhadaradamruta Rasa.
3. To study the clinical efficacy of Sri Siddhadaradamruta Rasa in the selected cases
of Amavata.
Objectives
5
Sri Siddhadaradamruta Rasa
All the Rasa classics have mentioned the use of Hingula along with combination
of one or the other herbal drugs. Sole use of Hingula is not advised, but Hingula after
subjecting to different Samskara is made suitable for its sole administration along with
suitable anupana. Such preparations are few and Sri Siddhadaradamruta Rasa is one
among them. The other preparations involve more or less same drugs for samskara as
well as procedure involved.
Different methods of samskara to Hingula to enrich its Rasayana properties: 1
Rasaratnakara–va-Sidda Prayoga sangraha under the heading of Hingula
Rasayana has enumerated different procedures that are adopted for Hingula to make it fit
for internal administration and to enrich its Rasayana properties.
1. 5 Tola cake of Hingula is embedded in Indrayana Phala and is encrusted with
mud. When dried it is burnt. When it is red hot it is brought out this is repeated for
21 times. This is called Hingula Rasayana.
2. 40 Tola of Lavanga is grounded to paste with Palandu swarasa and is converted in
to a glass shape. This glass is placed in an Iron pan and kept over the fire. Place
20 Tola Hingula cake in to the glass and exactly above the pan place the vessel
filled with 5 lit (approx) of onion juice. The juice is made to drop over the
Hingula drop by drop. The agni is maintained in such a way that the juice should
evaporate as soon as it falls on the Hingula. Later it is powdered and stored.
3. Asuddha Hingula 20 Tola, Bhallataka 80 Tola, Gogrutha, Erenda Taila and
Madhu 60 Tola each. Hingula is made into cakes and Bhallatka are broken in to
yava kuta choorna. Half of the Bhallataka choorna is spread in a pan over which
Hingula is placed and is covered with rest of the Bhallataka. Upon this Grutha
Drug review
6
Taila, and Madhu is put and is placed over fire for 4hrs over samanya agni. When half
is burnt in this way, then the rest is burnt by burning the content directly in the pan.
After Swanga sheeta the cake of Hingula is removed and used.
4. Rasatarangini kara in 9th taranga has explained similar formulation: 2
Shodhita Hingula is prepared in to cake and tied with cotton thread. This is
subjected to pachana in Vatadugda and Palandu swarasa till whole of the liquid
evaporates. Then Pachita Hingula is placed over lavanga choorna in a pan and over
which Shuddha Bhallataka is placed in a conical manner and gaps are filled with
Lavanga choorna and subjected to Dahana till all Bhallataka is turned in to ashes.
That Hingula is collected and again subjected to Pachana with grutha which is ten
times more than Hingula in quantity. Later threads are removed, Hingula is powdered
and administered.
Thus prepared, is best indicated in Amavata, Pleeha vrudhi, Pakshaghata and
Klaibya. This method is taken for the study.
5. The reference of Sri Siddhadaradamruta Rasa is also quoted by
Sri harisharananda vidya in Bhasma vignana3 where he calls it as Hingula
bhasma. Even he has taken the reference from Rasatarangini.
6. In Ayurvedasara Sangraha same method of preparation and indication is
explained. 4
Drug review
7
Hingula
Introduction –
Hingula is compound of Parada and Gandhaka, which occurs as a mineral in the
mines, associated with other minerals and also made artificially. This is a chief source of
mercury since ancient times to this date. In ancient times mercury was obtained from it
through patana process. Many varieties of this mineral have been described in ancient
texts. Out of these Hamsapada variety is considered best as it consists less impurities.
Synonyms –
Table No. 01. Shows list of synonyms of Hingula according to different authors.
Sl. Synonym RT R. Sa. Sn. AP RA DN RA KN01. Hingulam - - - - + - - 02. Hingul + - - - - - - 03. Hingula + + + + - + - 04. Ingula + - - - - - - 05. Hingulaka - - - - - - + 06. Mleccha + - + + + + + 07. Rakta + - + - - - + 08. Gairika + - - - - - + 09. Suranga + - + - - - - 10. Chitranga + - - - - - + 11. Churna parada + - - - + - - 12. Rasodbhava + - - - + - - 13. Rasasthana + - - - + - - 14. Ranjana + - - - - - - 15. Kapishirshaka + - - - - - - 16. Raktakaya + - - + - - - 17. Hamsapada + - - - - + + 18. Darada + + + - - - - 19. Barbara - - - - - - - 20. Shuka tunda - - - - - - - 21. Jati - - - - - - + 22. Rasagandha sambhuta - - - - - - - 23. Daitya raktaka - - - - - - - 24. Maraka - - - - + - - 25. Maniraga - - - - - - + 26. Rasagarbha - + + - + - - 27. Charmanu ranjana - - - - - - - 28. Ati rakta - - - - - - + 29. Parvata - - - - - - + 30. Saikta - - - - - - +
Drug review
8
Vernacular name –
English name – Cinnabar.
Scientific name – Red sulphide of mercury.
Sanskrit – Hingula, darada.
Hindi – Hingula, Singraph.
Bengal – Hingula.
Marathi – Hingula.
Gujarathi – Higualo.
Assam – Janjapher.
Pārsi – Sangarph.
Telagu – Ingulakam.
Kannada – Ingulika.
Historical Background
Vedic period:
No references about Hingula are available in any of the Vedas.
Samhita kala:
No reference about Hingula is available in Brahatrayees and Samgrahas.
The author of Kautilya Arthashastra, Chanakya has mentioned Hingula in his text
for the first time. He mentioned it for testing various metals. He was using this for testing
the suvarna. The uses of Hingula as a medicine was not described by him.5
In Samhita kala, there were no references of Hingula. But, we get references of
parada. It is assumed that in olden days, it was imported from other countries.
Drug review
9
According to history of oldest text of rasashastra, Rasendra Mangala, we get the
references of Hingula. Here, he used the word Darada for Hingula6. Rasa Hridaya
tantrakara mentions, it is one of the rasadravya.7 Author of rasarnava considered, as it is
one of the maharasa dravya.8 while describing synonyms, Rasendra sara samgraha,
mentioned it as Rasa Gandhaka Sambhoota.9 The usage of Hingula as a medicine started
between sixth and eighth century.
Inclusion of Hingula
Different authors of various Rasa Granths have included Hingula under the
various titles.
The classification of all Rasa dravyas done generally, according to their usage and
importance in the procedure related with parada. The important Rasa texts have included
Hingula under following classes –
Table No. 02. Shows inclusion of Hingula under different classes. (As per different texts)
Dravya Rasa Maharasa Uparasa Sadharana
rasa
Hingula Rasahridaya
tantra10
Rasarnava11 Anandkanda,12 R.S.S,13
B.R.R.Su.14, A.P15
R.J.N. 16
R.C. 17
R.Pra. Su 18
R.R.S.19
Drug review
10
Hingula Bheda
No description about varieties of Hingula is available in Resendra Mangala and
Rasa Hridayatantra. But we get reference of Hingula bheda in other texts.
Table No. 03. Showing the bhedas of Hingula.
Sl. Name of the text Charmara Shukatunda Hamsapada Anya
01. Anand kanda20 + + + -
02. Rasendrachudamani21 - + + -
03. Ayurevda prakasha22 + + + -
04. Rasaratnasamuchhaya23 - + + -
05. Rasaprakasha
sudhakara24
+ + + -
06. Rasatarangini25 - - - Kritrima
khanija
07. Rasamrita26 - - + Mlechha
Drug review
11
Charmara Hingula
Shuka varna i.e. Greenish colour.
Shukatunda Hingula
Sapeeta varna i.e. Yellowish colour.
Hamsapada Hingula (Grahya Hingula) 27
It has Pravala samana and having sweta rekhas on the surface of Hingula. It is
considered to be best for therapeutic purpose.
Among these three are having the quality of uttarottara gunavan.
Asuddha Hingula dosha28
If ashuddha Hingula is consumed, causes – Moha, Prameha, Chittavibhrama,
Andhyata, Klama, Kshainya and this directs to use always Shodhita Hingula.
Tasya chikitsa29: It is treated similar to the ashuddha parada bhakshanajanya doaha. The
person should be administered Shuddha Gandhaka for 2 months.
Shodhana of Hingula:
Various shodhana methods are explained in different classics, according to
availability, cost efficacy and medicinal formulations.
01. Do mardana with amla rasa dravyas and give 7 bhavanas of mahisha
dugdha30.
Drug review
12
02. Keep Hingula in kushmanda khanda, do pottali, and give swedana in
Lakucha swarasa poorita Dola yantra. 31
03. Give 7 bhavanas of adraka swarasa or lakucha swarasa. 32
04. Give 7 bhavanas of adraka swarasa. 33
05. Give 7 bhavanas of nimbu swarasa. 34
Satwapatana35
Shodhita Hingula is smeared in the upper part of adhapatana yantra, water is filled
in lower vessel. This apparatus is placed in the earth. Give heat to the upper vessel. We
get parada samana satwa in lower vessel.
Marana36
Generally marana is not advised for Hingula. Shodhita Hingula can be used for
the preparation of yogas.
However elaborate process of marana has been described in Ayurveda prakasha.
Hingula is wrapped in the cloth and kept inside nila kanda, which is then covered
with the mud paste around. When dried, it is subjected to puta, and baked in 10 vanopala
such 100 putas are given similarly it is kept inside vanavarataka and given 100 putas then
in mandara phala and given hundred putas then in indravaruni phala and subjected to 100
putas and lastly in amlavetasa phala and given 100 putas. At the end Hingula attains
intense red colour.
Drug review
13
Hingula Properties
Rasa – Various opinions are available regarding the Rasa of Hingula.
Table No. 04. Sowing the Rasa of Hingula according to various texts
Sl. Author Madhura Tikta Kashaya Katu
01. Rasarnava + + - -
02. Dhanwantari
nighantu
+ + - -
03. Raja nighantu + + - -
04. Bhava prakasha - + + +
05. Ayurveda prakasha - + + +
06. Rasendra purana - + + +
Guna –
Most of the texts considered Hingula as ushna gunayukta dravya.
Veerya and Viapaka –
No rasa shashtriya text has mentioned veerya and vipaka of Hingula, though the
Dhanwantari nighantu being the text of dravya guna vignana has mentioned Hingula is
having the ushna veerya and katu vipaka.
Doshakarma –
Even though almost all the authors enormously agree the tridoshaghna karma of
the Hingula, still some of the texts mention either kaphaghna or kapha pittaghna action of
Hingula as well.
Drug review
14
Table No. 05. Showing the doshaghnata of Hingula according to various texts –
Sl. Author Kaphaghna Kapha-pittaghna Tridoshaghna
01. Rasatarangini + - -
02. Bhava prakasha - + -
03. Ayurveda prakasha - + -
04. Rasendra chudamani - - +
05. Rasendrasara
sangraha - - +
06. Rasendra purana - - +
07. Rasamrita - - +
Rasaratnasamuchhyakara has quoted Hingula as sarva doshahara, deepana,
atirasayana, sarvarogahara, vrishya. It is useful in dhatujarana, Parada extracted form
Hingula is equal to the property of Gandhaka jarita parada. 37
Rasaprakashasudhakara quoted that the Hingula has the property of deepana,
sarvadoshaghna, atirasayana, sarvarogahara. It is helpful in dravana karma. Parada
extracted form Hingula is said to be equal to the property of shadguna Gadhaka jarita
parada. 38
Ayurveda prakashakara has quoted the property of Hingula as tikta, kashaya rasa,
kapha-pittahara. It subsides netra roga, hrillasa, kushta, kamala, pleeha, amavata and
krutrima visha. It also cures navajwara and santapajwara. 39
Rasendrachudamanikara quoted the property of Hingula as sarvadoshaghna,
deepana, atirasayana, sarva rogahara, vrishya. It is helpful in jarana samskrara. 40
Drug review
15
Rasamrita quoted the properties of Hingula that it pacifies all the tridoshas. It has
deepana and powerful rasayana effect. It can destroy all diseases and may be used for the
marana of gold and iron, metals. 41
Mercury extracted form the Hingula is considered to be equal in properties to the
mercury in which gandhaka jarana has been carried out.
Rasataranginikara quoted that, it has a property of netrarogahara, kaphanashaka,
pittajaroga nashaka. It subsides pleeha, kushta, gara visha, kamala. It is pachaka agni
vardhaka and ama pachaka. It is pramehgna. It enhances shareera kaanti, and bala. It
cures prakupita amavata and jwara. 42
Dhanwantari nighantukara quoted that, it has katu vipaka, ushna veerya. It subside
visha, kushta, visarpa and twak vikara. It is madhura tikta in rasa, and is kapha vata
shamaka. It cures tridoshaja and dwandwaja jwara. 43
Rajanighantukara quoted that it is having madhura tikta rasa and ushna veerya. It
subside vata and kapha roga, dwandwaja and tridoshaja jwara. 44
Kaiyadeva nighantukara 45 quotes that, Hingula is laghu, tikta and katu rasa, katu
vipaka and ushna veerya. It subsides netra peeda, kushta, visarpa, visha, pitta and kapha .
Vishishta Yoga
Hinguleshwara rasa, Mrityunjaya rasa, Ananda bhairava rasa, Siddha daradamrita
rasa, Darada vati.
Drug review
16
Cinnabar 46
Chemical composition – Sulphide of mercury (HgS). It contains 13.8% of
Sulpher and 86.2% of Mercury
Form – Trigonal or rhombohydral usually. Massive, granules. Intense red in
colour, sometimes brownish red in colour.
Streak – Red.
Transparency – Opaque or translucent.
Hardness – 2-2.5.
Specific gravity – 8.09.
Luster – Admentine.
Variety – Hepatic with liver brown colour.
Occurrence – Generally occurs due to the volcano activity. Also available near
hot springs. Important places of occurrence are Spain, Italia, Western states of
USA, Mexico.
Cinnabar classification-
• Dana class - Contains sulfides including Selenides and Telluride.
• Strunz class - Contains sulfides and Sulpho salts.
Drug review
17
BHALLATAKA- Semicarpus Anacardium Family: Anacardiaceae.
Introduction:
Earliest references about Bhallataka are found in the Panini sutras. Later
Charaka emphasized the Rasayana property of Bhallataka and described ten types of
preparations with it. He considered Bhallataka as the best drug to cure the disease
related to kapha 47. Susruta mentioned it as the drug of choice in the management of
arshas along with kutaja. Vagbhata has quoted Bhallataka as the best drug of choice
in the management of suska arsas. Bhallataka asthi shall be considered for dipaniya
purpose 48Yogaratnakara has explained yogas of Bhallataka in Amavata chikitsa. 49
Vernacular Names:
Hindi -Bhilava
English - Marking Nut.
Bengali -Bhela.
Telugu - Nall jidi chettu.
Kannada - Keru
Gujarati & Marathi - Bilama.
Table No. 06: Synonyms according to different authors:
Sl.No DRUG D.Ni K.Ni B.Ni R.T. R.Ni 01 Bhallataka + + + + + 02 Agnika + - - + + 03 Dahana + - - - + 04 Tapana + - - + + 05 Aruskara + + - + + 06 Virataru + + - - - 07 Agnimukha + + - - - 08 Dhanu + + - - - 09 Balli - + - - - 10 Anala - + - - + 11 Vrunakrut - + - - - 12 Spotahetu - + - - - 13 Krumighna - - - + + 14 Vatari - - - + + 15 Tailabeeja + 16 Prutak Beeja + 17 Dhanur Beeja +
Drug review
18
Botanical Description: 50,51,52
A moderate sized, deciduous tree, exudating a dark juice .young branches,
inflorescence, petioles and under side of leaves pubescent.
a) Leaves- Oblong, obovate, rounded at apex, cartilaginous at margin, very
coriaceous.
b) Flowers- Fasciculate, arranged in erect, compound, terminal panicles, greenish
yellow colored.
c) Fruits- Drupes, obliquely oval or oblong, smooth, shining, purplish-black when
ripe, cup orange red flowering round the year, mostly during May-June, fruits ripen
from November to February.
d) Habitat- This tree is found growing on the sub Himalayan and tropical part of
India as for east as Assam.
e) Chemical constituents:
The fruits of Bhallataka yielded Bhilawanol which was shown to be a mixture of
cis and trans isomers of ursuhenol Bhilawanol was found to be a mixture of 1,2-
dihydroxy-3-(pentadecenyl-8')-benzene and 1,2- dihydroxy-3-(pentadecadienyl-
8',11')-benzene studies on methylated Bhilawanol showed that it contained more
than seven components; two major components were identified as dimethyl ethers
of 1-pentadeca-8-enyl-2,3-dihydroxybenzene (I) and 1-pentadeca-7,10-dienyl-1,3-
dihydroxybenzene (II); defatted nuts yielded three biflavones A, B and C; latter
two compounds were characterised as 3',8-binaringenin and 3',8-biliquiritigenin,
re-examination of bhilawanol showed it to be comprised of two components,
Drug review
19
1,2-dihydroxy-3-pentadecenylbenzene (32-32%) and its corresponding diene
analogue (68-70%); a new biflavan, tetrahydrorobustaflavone and
tetrahydroamentoflavone were isolated from nuts; leaves yielded only
amentoflavone
• Confirmation of structure of Semecarpus biflavanone B by chemical studies was
carried out; a new biflavonoid, jeediflavanone was isolated from nut shells and
characterised; galluflavanone was isolated from nut shells and its structure
determined; isolation and structure elucidation of semecarpuflavanone from nut
shells was reported.
• Isolation of a biflavonoid, jeediflavanone from nutshells, a biflavonoid,
galluflavanone from nutshells, a third biflavanoid, semecarpuflavanone from
nutshells and a new dimeric flavonoid nallaflavanone were reported and the
structure of nallaflavanone was determined and confirmed; isolation of another
new biflavonoid semecarpetin from nutshells and its characterisation were
reported.
• A new biflavanone, anacarduflavanone was isolated from nut shells and its
structure established
• The acetate of a novel phenolic glycoside,1-O- β-D-glucopyranosyl-(1→6)- β-D-
glucopyranosyloxy-3-hydroxy-5-methylbenzene, anacardoside was isolated from
the fruits of Semecarpus anacardium, and its diastereomers were first synthesized
using Koenigs-Knorr method from D-glucose through six steps with total yields
33% and 16% respectively.
Drug review
20
• Chemical constituents of the shell liquid have not been exhaustively investigated.
The major constituent (~ 46% of the weight of extract) is bhilawanol, C21H32O2,
which distils over at 225-26°/3 mm. when the shell liquid is subjected to vacuum
distillation; it is an o-dihydroxy compound with a catechol nucleus and an
unsaturated C15-side chain; it has since been shown to be a mixture of cis and
trans- isomers of urushenol [3-(pentadecenyl-8')-catechol]. A small quantity (c.
0.1 %) of a monohydroxy phenol, semicarpol, C17H28O (distilling at 185°-
90°/2.5 mm.) is also present. The dark tarry residue left after distillation contains
high boiling phenols and hydrocarbons. Thermal degradation of the shell liquid at
400° gives catechol and a mixture of phenols and hydrocarbons.
Grahya Bhallataka53: The pakwa Bhallataka which sinks in the water has to be
collected for shodhana procedures.
Bhallataka Shodhana:
1. Bhallatakas are to be tied into a pottali along with Ishtika choorna and subjected to
slight gharshana. This is done till the external skin is peeled off and oil is properly set
free in to the isthika choorna. Later it is washed with hot water and brought to use. 54
2. Bhallataka is cut in to pieces and is subjected to swedana with narikela jala for
two hours. This purifies Bhallataka. 55
3. Bhallataka is tied in a pottali and is subjected to swedana for 12 hrs in the mixture
of buffalo dung and water in the ratio 1:4. Later swedana in godugdha and gomutra
Drug review
21
for 4hrs each is done. Then it is washed in hot water and again swedana is done in
narikela jala for 12 hrs, and brought to use.56
4. Bhallataka to be subjected to swedana in gomutra for 4 praharas and washed with
hot water and brought to use. 57
Antidote:
Application of coconut oil externally
Internally Coconut oil with tila and haritaki.
Part used:
• Fruit, Seed, Seed kernel, Gum and oil.
Dosage: Choorna - 1 to 3 Gunja.
Taila - 1 to 2 Drops.
Avaleha - ¼ to ½ Tola .
Ksheera paka - 1 to 2Tola.
Guna karma:
Rasa – Katu, Tikta, Kashaya. Guna – Tikshna, Laghu, Snigdha.
Veerya – Ushna. Vipaka – Madhura.
Dosha karma: Kaphavatahara, Rasayana, Shukrala, Medhya, Bhedana.
Drug review
22
Bhava prakashakara has included the drug under the Hariyakyadi varga.
Bhallataka is best indicated in Kusta, Arsha, Grahini, Gulma, Jwara, Agnimandya, Krimi
and Vruna. 58
Dhanwantari Nighantu includes Bhallataka under Chandanadi varga. It is
good in Krumi vikaras, Gulma, Arsha, Grahani, and Kusta59.
Kaiyadeva nighantukara explains that the pakwa phala of Bhallataka is
Vistambi, Bhrumana, Shukrala, Raktapitta nashaka. Its Asti is Pachaka, Chedi ,Bhedi,
Medhya, Agnikara. Bhallataka is indicated in Kustha, Arsha, Gulma, Shopha, and Jwara.
The majja of Bhallataka is vrushya.60
Rasataranginikara has similar views as of other Acharyas. He mentioned
Bhallataka is Rasayana and Balakara.61
Rajanighantukara explained that the majja is exceptionally Daha shamaka
and does agni vardhana and pitta shamaka.62
The fruits are acrid, hot and anti-helminthic; it is considered beneficial in
ascites, tumours, warts, acute rheumatism, asthma, neuralgia, epilepsy and psoriasis.
They are thermogenic, emollient, digestive, anti-arthritic, depurative, anti-inflammatory,
uterine stimulant, alterant, expectorant, liver tonic, febrifuge and rejuvenating. They are
used in sciatica, neuritis, dyspepsia, flatulence, constipation, colic, hemorrhoids,
splenopathy and hepatopathy. They are also useful in cough, asthma, beriberi, leprosy,
leukoderma, diabetes, dismenorrhoea, amenorrhoea, ulcers and general debility.63
Plant -Showed anti-inflammatory activity in rats. Nut - Milk extract was active in
rats Vs Carragenin, It suppressed primary inflammation of adjuvant arthritis in rats and
had no effect on secondary lesion. Significant effect was seen as anti-arthritic. The milk
extract of S. anacardium produces regression of hepatocarcinoma by stimulating host
immune system and normalizing tumor markers including alpha-fetoprotein levels.
Drug review
23
Vata – Ficus Bengalensis Family: Moraceae
Introduction:
It is one among panchavalkalas. It is a big tree with adventious roots to support its
branches. It spreads up to miles. It is commonly found all over India.
Vernacular Name:
Hindi: Vada Kannada: Ala
Gujarati: Vadalo Punjabi: Bera, Baragad Tamil: Alum
Table No. 07: List of Synonyms
Sl.No Drug R.Ni D.Ni K.Ni B.Ni 01 Vata + + + + 02 Jatala + - - - 03 Vyagroda + - - - 04 Rohini + - - - 05 Rohini + - - - 06 Vitapi + - - - 07 Raktaphala + - - - 08 Skandaruha + - - - 09 Mandali + - - - 10 Mahachaya + - - - 11 Shrungi + + + + 12 Yakshavasa + - + - 13 Yakshataru + - - - 14 Neela + - - - 15 Ksheeri + - - - 16 Shiparocha + - - - 17 Bahupada + + + + 18 Vanaspati + + + - 19 Padarohini + - + - 20 Nyagroda - + + + 21 Skandaja - + + + 22 Vishravanaja - + - + 23 Danto - - + - 24 Dhruvaha - - - +
Drug review
24
Botanical Description: 64
Banyan trees are huge and out spreading. Trunk is whitish grey in color.
Leaves – are big, oval in shape, 12 to 14 cms long, thick, turgid and dark green having 3
to 5 veins.
Fruits- These are Red and round in shape. Flowers bloom in spring and Fruiting occurs
in Monsoon. Tree survives many years.
Habitat – Found all over India.
Chemical Constituents65, 66: Bark and young buds contain about 10% of Tannin, wax
and caoutchoue. Fruits contain oil, albuminoids, carbohydrates, fiber and ash 5% to 6 %.
The bark contains Leucoanthocyanin, Tiglic acid, β-sitsterol-a-D-glucoside.
Part Used: Panchanga.
Dose: Decoction ─ 50 to 100 ml.
Powder ─ 3 to 5 gms.
Latex ─ 5 to 10 drops.
Guna Karma:
Rasa – Kashaya Virya : Sita Guna : Guru, Ruksha Vipaka : Katu
Karma- Kapha- pittahara, Mutra sangrahaniya, Varnya. Stambana.
Charaka has classified Vata under Mutrasangrahaniya while Sushruta and
Vagbhata have classified under Nyagrodadi gana.
Drug review
25
Kaiyadeva Nighantukara has dealt it in oushadi varga. He claims that drug cures
Visarpa and improves the shareera varna67.
Dhanwantari nighatukara explains the same and includes Raktapitta nashana
property.68
Bhavaprakashakara and RajNighantu explain similar properties along with
Yonidoshahara property.69
The latex of Vata is applied on Wounds, Cracked soles, Synovitis, Arthritis,
Lymphadenitis. Internally it is used to treat Diarrhea, Amoebic dysentery and bacillary
dysentery.70
Palandu - Allium Cepa Family: Liliacae
Introduction:
It is an annual herb with bulb and white flowers. It is cultivated all over
India palandu is quoted in the Bruhattrayee texts. Chakrapani considered Grunjanaka as
Lohita Palandu.
Vernacular Names:
Hindi: Pyaz Telugu: Ullipaya English: Onion Marathi: Kanda
Drug review
26
Table No. 08: Synonyms according to different authors:
Sl.No Drug Bp.Ni K.Ni R,Ni D,Ni
01 Palandu + + + +
02 Mukhadushika + + - +
03 Sukanda - + - +
04 Yavanesta + - + +
05 Durgandha + - - -
06 Raj palandu - - + -
07 Nrupahwaya - - + -
08 Raj priya - - + -
09 Mahakanda - - + -
10 Dheerga patra - - + -
11 Rochaka - - + -
12 Nrupesta - - + -
13 Nrupakanda - - + -
14 Nrupapriya - - + -
15 Raktakanda - - + -
16 Rajesta - - + -
Botanical Description: 71 The shrub grows to a height of 60 to 90 cms.
Leaves- Thick, round, and green with Green Coloured flower stalk at the top. It
bears white flowers in clusters. These produce triangular seeds.
Flowering and fruiting occurs after winter.
Drug review
27
Verities: 1. Red ─ Rakta palandu- Small in size.
2. White ─ Swetaksheeri palandu- Large in Size.
Habitat: All over India. Onions growing in Maharastra are large.
Chemical Constituents: 72, 73
Onions have a unique combination of three families of compounds that are
believed to have salutary effects on human health — fructans, flavonoids and
organosulfur compounds. A great deal of research has focused on one flavonoid,
quercetin, which is found at particularly high levels in onions. Onion contain many sulfur
containing active principles mainly in the form of cysteine derivatives, viz. S-alkyl
cysteine sulfoxides which decompose into a variety of thiosulfinates and polysulfides by
the action of an enzyme allinase on extraction
Part used: Bulb and seeds
Dose: Juice ─ 10 to 30 ml.
Seed Powder ─ 1 to 3 gms.
Guna and Karma:
Rasa: Madhura, Katu. Veerya:Ushna
Vipaka: Madhura Guna: Guru, Snigda, Tikshna.
Dosha karma- Vatahara, Vrushya, Rasayana
Drug review
28
Bhavaprakakara has included this under Haritakyadi varga. Palandu is excellent
remedy for Agnimandya as it is Agnivardhaka. It is also Vrushya, Uttejaka and best
Vatahara next to lashuna.74
Kaiyadeva Nighantukara has also considered this as next to lashuna but a little
milder to it.75
In Rajanighantu, apart from the above mentioned properties he adds that Red
palandu is Kshareeya, teekshna and is best deepaka.76
In Dhanwantari Nighantu it has been included in Karaveeradi varga. He explains
properties same as other Acharyas.77
Research studies have shown organosulfur compounds to:78
– Reduce symptoms associated with diabetes mellitus.
– Inhibit platelet aggregation (involved in thrombosis).
– Prevent inflammatory processes associated with asthma.
Many of these studies used non-human subjects. The organosulfur compounds are
believed to possess anti-inflammatory, anti-allergic, anti-microbial, and anti-thrombotic
activity by inhibition of cyclooxygenase and lipoxygenase enzymes. Most likely the
compounds work through sulfur-sulfur or sulfur-oxygen linkages. Quercetin’s anti-
inflammatory effect on prostaglandins, eukotrienes, histamine release and subsequent
antiasthmatic activity has been investigated.
Drug review
29
Lavanga: Syzygium aromaticum Family: Myrtaceae.
Introduction: It is a less utilized herb during the Brahattrayee period. At later times
especially in yoga granthas we come across the utility of Lavanga in therapeutics.
Traditionally cloves have been used to treat flatulence, nausea, vomiting.
Vernacular Names:
Hindi: Laung Telugu: Lavangaumu. English:clove Tamil: Kirambu
Kannada: Lavanga
Table No. 09: Synonyms according to different author
Sl.No Drug K.NI D.NI R.Ni B.p.Ni
01 Lavanga + + + -
02 Devakusuma + + + -
03 Shrungaram + - - -
04 Shikaram + + + -
05 Lavam + + + -
06 Sripuspam + + + -
07 Varijam + - - -
08 Sravyam + - - -
09 Devyam + + + -
10 Chandanapuspakam + + - -
11 Brungaram - + + -
12 Varisambhavam - + + -
13 Lavanga kalika - - + -
14 Ruchiram - - + -
15 Teekshnapushpam - - + -
16 Greevana kusumam - - + -
Drug review
30
Botanical Description: 79 Tree full of green leaves, 10-13 mts height. Bark of trunk
yellowish white and tender. Branches appear from the bottom and are tender and directed
downwards. Flowers brown externally, four triangular petals. Fruits are fleshy, 3 cms
long, seeds-single in each fruit. Flowering season is summer and fruiting in pre-monsoon
flowering starts after nine years of plantation.
Habitat: Originally from Malaya-Saillbius island. At present cultivated in southern India.
Chemical Costituents:80
A heavy volatile oil 16% to 20%., A Camphor Resin 6%, Caryophyllin occurs in
silky stellate needles. Oil distilled from cloves contains:-
1) Eugenol 85% to 92% chemically resembling phenol.
2) Acetyleugenol
3) Caryophyllene, a sesquiterpene, furfural and Methyl-amyl-ketone.
Parts used : Floral bud, Clove oil.
Dose: Powder ─ 1to 2 gms.
Oil ─ 1 to 2 drops.
Gunakarma:
Rasa: Tikta, katu, Guna: Laghu, Snigdha
Virya: Sita Veepaka: Katu.
Karma: Kaphapitta hara, Ruchya, Deepaneeya, Pachana, Netryam.
Drug review
31
Rajnighantukara explained Lavanga to possess vata, pitta and kaphahara
properties. Hence, best in shiro rogas.81
Kaiyadeva nigantu kara has included it in the Ousadivarga and attributes it
to posses the Hridya, Netrya and Pachaka. This cures Shoola, Anaha, Tridosha, Kasa,
Swasa, Visha, and Peenasa.82
Dhanwantari nighantu kara highlights its Vajikarana properties with all
other properties as explained by other acharyas.83
Eugenol, the primary component of clove’s volatile oils, functions as an anti-
inflammatory substance. Clove also contains a variety of flavonoids, including
kaempferol and rhamnetin, which also contribute to clove’s anti-inflammatory (and
antioxidant) properties.84
Nutrient Amount
Manganese 1.32 mg
Omega 3 fatty acids 0.20 g
Dietary fiber 1.52 g
Vitamin C 3.56 mg
Magnesium 11.60 mg
Calcium 28.40 mg
Drug review
32
Guda
Vernacular Names:
Hindi: Guda English: Tracle, Jaggery Kannada: Bella
Synonyms; Table No.10.showing synonyms.
Sl.No Drug R.Ni
01 Guda +
02 Ikshurasa +
03 Madhura +
04 Rasapakaja +
05 Sishupriya +
06 Sitadi +
Utpatti: Well-cooked sugarcane juice when solidifies and become hard like stone is
known as guda.
Drug review
33
Guna Karma:
Rasa: Madhura Guna- Laghu Doshagnata- Tridoshashamaka.
Purana guda is said to be best because of its action over all dhatu vaha
samsthana. It is Agni vardhaka, Ruchya, there by it gets digested easily and nourishes
body and kindles the Jatharagni. It is Vrishya and also claimed as Sadhya Sukrala, Hence
in association with Sukravardhaka dravya Ikshu vikaras esp Purana guda is prescribed.Its
role on Rakta and Raktavaha srotas, Nidravaha srotas is remarkable. It enriches the
production and shows the qualitative and quantitative increase of Rasa and Rakta dhatu.
It is also hridya as its action conferred on Rasa and rakta reflects as such RasaRakta
complex is flown in the Hrudaya and Dasha dhamani. It is said as Mala, Mootra vikara
shodhaka and acts on Prameha as it is Mootrala. Very especially it cures a condition of
Rakta kshaya and Anidra. It is Shramaharam also.85
Sushruta quotes that Guda is Kshara yukta and Madhura and not Atiseeta. And is
Snigdha and it is Mutra and Rakta shodaka, and it does not mitigate excessive aggravated
Pitta, but it is best Vata shamaka and Medovrruddikaraka and Krimi and Kapha karaka
and increases the Bala of the body and Vrushya.86
Guda is said to posses Pittanashaka, Madhura, Vatanashaka, Raktaprasadaka
qualities and a year old guda (Purana guda) posses more qualities and it is Pathy karaka.
Drug review
34
Grutha
English: Clarified Butter. Hindi-Ghee Telagu- Nayee Kannada- Tuppa
Synonym: Table no 11. Synonyms of Grutam.
Sl.No Synonyms K.N R.N
01 Ghrutam + +
02 Aajyam + +
03 Havi + +
04 Sarpi + +
05 Pavitra + +
06 Navaneetaja + +
07 Amrutam + +
08 Abhigara + +
09 Jeevaneeya + -
10 Homya - +
11 Ayu - +
12 Taijasa - +
Ghruta is Agnideepaka, Balya, and Ayushya dayaka. It makes shareera Sthira. It
is Madhura in Vipaka Sheeta in Veerya and Vatapitta shamaka, Vishahara.87
Cow’s ghee has sufficient oxygen and is considered the best for the diseases
relating to the area of the head. Kerotine is ten times more in cow’s ghee than in that of
buffalo’s. When instilled in the nostrils the oxygen of cow’s ghee cures the diseases
created as a result of imbalance of Vata, Pitta, Kapha. In the problems of obesity which is
rampant these days, amount of ghee consumed in one month will directly &
proportionately reduce obesity while in the undernourished people it will proportionately
increase the weight. In short cow’s milk & ghee are the best nourishment and the
fundamental regulators of a healthy body.88
Drug review
35
Ardraka
Latin name – Zingeber officinale.
Synonyms – Adraka, gulma, moola, mulaja, kandala, vara, shringavera, mahija,
saikateshta, anupaja, apekshika, adravya, rahu chhatra shishuka, shagra, aardra shakha,
sachaka.
Vernacular names –
Sanskrit – Ardraka.
English – Green ginger.
Hindi – Adraka.
Malyali – Alia.
Telagu – Allam.
Tamila – Inji.
Bengali – Duk.
Marathi – Shunti.
Kannada –Shunti
Characters – The plant with the dingy yellow flowers on a leafless flowers stalk and
long lanceolate leaves on a separate stem.
Rhizomes – 2 to 4 inch long.
Tubers – Branched, knotty and some what compressed on one side lobed and clavately
branched without a wrinkled corcky epidermis. Buff coloured and striate on section
fracture meanly and fibrous showing many scattered resin cells and fibro-vascular
bundles.
Odour – Agreeable, aromatic, penetrating.
Taste – Acrid and pungent.
Drug review
36
Chemical Constituents – A volatile oil 2%, fat acquired liquid oleo resin, gingerol, or
gingerin insulase, resin, starch 20%, ash 4%. The volatile oil contains camphene and
phelladrene. Gingerol, an active principle extracted form ginger is a viscid, inodourous
pungent liquid.
Habit – Through out India, West-Indies, Africa, cultivated in Jamica, Sierraleone.
Part used – Rhizomes.
Adraka –
Rasa – Katu.
Guna – Laghu.
Veerya – Sheeta.
Vipaka – Madhura.
Dosha – Kaphahara.
Karmaghnata – Hridya, deepana, ruchikaraka. It subsides kaphajnya
vikara and kantha roga.
Gomutra
Gomutra is used as a medicine since olden days. We get the reference about it in
brihatrayees. Charaka considered, it as one of the ashta mutra varga dravya.
Synonyms – Gomutra, Gojala, Goambu, Gomashanda, Godrava.
Drug review
37
Vernacular names –
⇒ Sanskrit – Gomutra.
⇒ Hindi – Gomutra.
⇒ English – Cow’s urine.
⇒ Kannada – Gomutra.
Properties –
Rasa – Katu.
Guna – Teekshna, Ushna, Kshara.
Dosha – Kapha-vata shamaka, pitta janaka.
Karmaghnata – Agni deepaka, medhya, shoolahara, gulma, anaha. It is
used in virechana karma and asthapana basti.
Charakacharya quotes that Gomutra has madhura rasa, dosha nashaka and krimi
and kanduhara. By abhyantarapana it subside doshajanya udara roga.
Nadakarni in his material medica explains Gomutra contains ammonia in a concentrated
form and is much used in both internal and external purpose. Gomutra is a laxative,
diuretic, and used in preparation of various medicines. Eg. Poonarnava mandura. It is also
recommended by Chakradatta as an anupana for eranda taila given as virechana.
It is used as externally in the purification and roasting of various metals and
preparation of oils, decoctions.
Drug review
38
Disease review
Historical review:
The Vedas are the earliest documented sources of knowledge. Of these Vedas as
an offshoot Ayurveda developed. The disease Amavata does not find its references in any
of the Vedas.
In the samhita period though brahatrayees did not explain about the disease
separately but there are few passing remarks about Amavata in charaka. He has dealt in
detail about the production of Ama and its treatment. Amavata finds a mention in the list
of therapeutic indication of Kamsaharetaki in Shwayathu chikitsa and Vishaladi phanta in
Pandu chikitsa.
It was Madhavacharya who in Madhavanidhana, included Amavata as an
independent disease entity and dealt in detail about its nidana vinishchya. Later
chakradatta an outstanding work pertaining to the treatment of disease contributes the line
of management and many remedies for the disease. Works of Bhavaprakasha,
Yogaratnakara, and Bhaishajyaratnavali have only corroborated the descriptions with
additional principles of treatment.
ETYMOLOGY OF AMAVATA:
Amam cha vatam cha Amavatam: The word Amavata comprises of two meaningful terms
‘Ama’ and ‘Vata’ which forms the pathogenic basis of the disease.
Ama:
In the context of Udararoga89 it has been highlighted that Hypofunction of agni is
the cause of all diseases. Therefore it is not alone tridoshas which takes part but the
deficient function of Agni which plays important role in efficient nourishment of body
can cause disease.
Ama is of dual origin –
01. Formed by apakwa anna rasa90.
02. Dhatwagni durbalata91.
DDiisseeaassee rreevviieeww
39
Apakwa anna rasa – Due to the impaired agni in the amashaya there is malformation of
ahara rasa and this incomplete ahara rasa is defined as ama.
Dhatwagnimandyajanya ama – At the level of dhatus due to hampering of dhatwagni.
Concept of Ama
Biologically Ama corresponds to the undigested protein, carbohydrate, fat,
bacterial content. When they gain accesses in to the general circulation they act as
antigens.
Antigen92
Are usually proteins, with in the body they stimulates antibody production.
They are of two types
1) Exogenous antigen – Infectious agent’s drugs and chemical.
2) Endogenous antigen – Involves blood components.
Production of Ama can also be expressed in two ways-
Ama which is a resultant of hypo function of agni(exogenous sources).
Vagbhata explains that vitiated doshas may combine together to form Ama
within the body (endogenous sources).
Thus the ama from either of the above source become unwholesome to the body
and part of it gets access into the circulation and ends up in causing disease Amavata
which resembles RA.
Nidanapanchaka 93, 94
Various classical texts have explained the same nidana for the Amavata.
01. Viruddha ahara
02. Viruddha cheshta
03. Mandagni
04. Nischeshta (Sedentary habits).
05. Who does the exercise after snigdha ahara bhojana.
DDiisseeaassee rreevviieeww
40
o Viruddha ahara – Those substances, which are accumulated in the body and
increase the dosha with in the body, are known as viruddha ahara. They remain
antagonistic to the dhatus.
o Viruddha cheshta – It comprises of wide variety of causative factors like
Divaswapna, sedentary habits, exercise after bhojana, excessive indulgence in
sex, suppression of natural urges. Etc
Poorva Roopa
There is no description regarding poorva roopa in any of the Ayurvedic classics.
Laxanas
Samanya laxanas95.96 –
Table No. 12. Showing the samanya laxanas of Amavata.
Sl. Laxana Madhavakara Yogartnakara
01. Angamardha + +
02. Aruchi + +
03. Trishna + +
04. Hrullasa + +
05. Gourava + +
06. Jwara + +
07. Apaka + +
08. Shunata anga + +
09. Aalasya + +
10. Kati,Prusta,Janu Sandi akuncana and
sashabadata
+ +`
11 Nidraviparyaya + +
DDiisseeaassee rreevviieeww
41
Samprapti
a) Primarily ama (undigested or improperly digested Ahararasa) is produced in the
digestive tract.
b) Secondly this ama circulates in the body through Dhamani ie along with the blood.
c) While circulating the materials do not completely undergo further metabolic changes.
d) This improperly metabolized ‘Ama’ mixes with the doshas ie, vata, pitta & Kapha
which further vitiates Ama.
e) This vitiated ‘Ama’ by its selective discrimination produces blocking (Abhishyanda)
of the shrotasas.
f) Blocked channels get inflamed and further transformation of the nutrient materials do
not take place resulting into inflammation and permanent or chronic damage of
shleshmasthana.
Viruddha ahara + Vihara
Agni dushti in Amashaya
Formation of Amarasa
Sanchara all over the body by prakupita vata dosha.
Samadosha accumulates in the shleshmasthana like Amashaya, shandhi.
Amarasa gets vidagdata and circulates in to shrotasas.
Formation of kleda in different srotas of the body due to the picchila guna.
Leads to durbalata and Gouravata
DDiisseeaassee rreevviieeww
42
Vata and ama vitiates at a time
Enters into trika, koshta, sandhis.
Where ever vikruta doshas travels produces angamarda, aruchi, apaka, gourava,
jwara, shotha, ruja.
AMAVATA
Pravriddha Amavata Laskhana 97.
Ruja,
Shotha in hasta-pada-shira-gulpha-trik-janu-and uru sandhi.
Wherever dosha travel it causes pain which resembles the string of
scorpion.
On keen observation we can categories the laxanas as below
1. Lakshana specific to involvement of sandhi.
2. Lakshana specific to involvement of Ama
3. Lakshanas produced as a consequence of the disease process.
1. Lakshana specific to involvement of sandhi:
∗ Shoola and Shotha in hasta-pada-shira-gulpha-trik-janu-and uru sandhi.
∗ Shunata Anganam (Swelling in Sandhi)
∗ Gatrastabdhata.
∗ Jadyata.
∗ Sandhi Vikunchana
∗ Sankocha
DDiisseeaassee rreevviieeww
43
2. Lakshanas specific to the involvement of Ama:
∗ Chardi
∗ Arochaka
∗ Aruchi
Shrotodusti lakshana of Annavaha shrotas.
∗ Anaha Rasavahasroto dusti lakshana.
∗ Angamardha
∗ Alasya
3. Lakshanas produced as a consequence of the disease – process:
The others like
∗ Bhrama
∗ Moorcha
∗ Nidraviparyaya
Upadrava98
Agnimandya, praseka, aruchi, gaurava, utsahaheena, vairasya, daha,
bahumutra, kukshi shoola, nidra viparyaya, trishna, chardi, moorcha, hrit graha,
vit vibandhatwa, jadya, antra kujana.
Doshanubandha Amavata Laskahana99
Pittanubandha -daha and raga,
Vatanubandha -shoola,
Kaphanubandha - stimita, granthila and kandu.
Sadyaasadyata100
o Eka doshaja Amavata sadhya,
o Dwidoshaja Amavata yapya,
o Sarva shareera shothayukta sannipata Amavata is kricchra sadhya.
DDiisseeaassee rreevviieeww
44
Amavata Chikitsa101,102,103
Table No. 13. Showing the different treatment modalities adopted in Amavata according
to various authors.
Sl. Chiktsopakrama YR CD BR
01. Langhana + + +
02. Ruksha swedana + + +
03. Deepana by tikta and katu dravyas + + +
04. Snehapana + + +
05. Virechana - + +
06. Basti - + +
07 Shamanoushadi + + +
Pathya104 –
Patola,Ardraka, Punarnava, Karavellaka, Yava, Raktashali, Kulattha, Kodrava,
Shigru, Ushnajala, Lasuna sanskruta takra, Jangalamamsarasa.
Apathya –
Dadhi, Matsya, Dugdha, Mashapisti, Virrudhabhojana, Asatmyapadartha,
Vegaavarodha, Ratrijagarana, Vishamabojana, Gurupadartha, Abishyandi
padhartha.
DDiisseeaassee rreevviieeww
45
RHEUMATOID ARTHRITIS105
Definition:
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that may
affect many tissues and organs – skin, blood vessels, heart, lungs and muscles but
principally attacks the joints, producing a nonsuppurative proliferative synovitis that
often progresses to destruction of the articular cartilage and ankylosis of the joints.1
Rheumatoid arthritis is a chronic multi system disease of unknown cause.
Although there are a variety of systemic manifestations the characteristic feature of RA is
persistent inflammatory synovitis, usually involving pheripheral joints in a systemic
distribution. The potential of the synovial inflammation to cause cartilage destruction,
bone erosion and subsequent changes in joint integrity is Hallmark of the disease106.
Rheumatoid arthritis (RA) is an immmuno-inflammatory disease that affects
joints and entire articular tissues107.
PATHOLOGY108
The earliest change in swelling and congestion of the synovial membrane and the
underlying connective tissues, which becomes infiltrate with lymphocyte, plasma cells
and micro phases. Diffusion of synovial fluid into the joint space takes place during
active phase of disease. Hypertrophy of the synovial membrane occurs with the formation
of lymphoid follicles resembling an immunologically active lymph node. Inflammatory
granulation tissues (pannus) is formed spreading over and under the articular cartilage,
which is progressively eroded and destroyed later fibrosis adhesions may be formed
between the layers of pannus across the joint space and fibrosis or bony ankylosis may
occur. Muscles adjacent to inflamed joints atrophy and there may be focal infiltration
with lymphocytes.
DDiisseeaassee rreevviieeww
46
ETIOLOGY109.
The case of RA remain unknown it has been suggested that RA may be the
manifestation to the response to an infectious agent in genetically susceptible host. A
number of possible causative agent have been suggested, micoplasma Epstein – Bar virus
(EBV), cytomegalo virus, parvo-virus, and rubella virus, but convincing evidence that
these are other infectious agents cause RA has not emerged. Alternatively the
microorganisms or response to the microorganisms might induce an immune response to
components of the joints by altering its integrity and revealing antigenic peptide. Recent
work has focused on the possible role on the super antigens produced by the number of
microorganisms including staphylococci, streptococci and M–arthritis. Super antigens are
proteins with the capacity to bind to HLA-DR molecule and particular VB segment of the
heterodinimic T cell receptor and stimulate particular T cell expressing the VB gene
products of all the potential environmental triggers. The only clearly associated with the
development of RA is cigarette smoking.
Gastro-intestinal Aetiology of RA: The co-existence of arthritis and diseases of gastro-
intestinal tract has aroused increasing interest in recent years.
The hypothesis of malabsorption of aminoacids in the aetiology of rheumatoid arthritis is
capable to explain the deficiency of protein, histine, arginine, glutamine and thyrosine
etc.
DDiisseeaassee rreevviieeww
47
ENTEROPATHY AS PRIMARY CAUSE OF RHEUMATOID ARTHRITIS:
Genetics Environment
Enteropathy
Malabsorption
Impeded Biosynthesis of proteins in system.
Fibrinoid changes Excessive dissolution of collagen tissue
Collagen diseases
e.g.: Rheumatoid arthritis.
PATHOGENESIS110.
Localization of antigens in joints
Antigen by microphages
Activation of helper T cells
Release of intraleukin – 2
Cytokenes like IL-4, IL-6, IFN are released by Cd4 cells
DDiisseeaassee rreevviieeww
48
Cytokenes increases the expression molecules like ICMA-1, LFA –1, MAC-1
It helps in localization of inflammatory cells
Cytokines stimulates, activates and proliferation of
B cells produce antibody producing plasma cells.
These cells produce antibodies against Fc fragment of IgG (RA)
RA factor forms immuno complex with IgG
Production of Ca3, C5a, C3b and C5,6,7,8,9
Ca3 and C5a as anapphylotoxins Release of histamines C5,6,7,8,9 is capable of damage
cells by drilling pores in their membrane.
Inflitration of neutrophills
Release of oxygen free radicals, inflammatory metabolites, arachidnic acid pathway like
prostaglandins leutrines metalo-proteins like collagenase.
Damage of articular cartilage demineralization of underlying bone erosion of the joint
margins laxicity of the joint capsule leading to deformity.
DDiisseeaassee rreevviieeww
49
Articular Features111
The onset is usually insidious but may be acute or systemic, symmetrical joint
involvement is common in middle aged women. Asymmetrical presentation is common
as a disease progresses. Acute onset with asymmetrical polyarthritis is more often seen in
elderly patients.
In the pelidromic onset type abrupt self limiting exaggeration of joint swelling
erethrima and warmth over the joint occur and resolve completely within hours to few
days. Only reoccur after period of time.
The characteristic pattern of joint involvement in descending order is frequently
in metacarpals (MCP), wrists, proximal, intraphalangeal (PIP), metatorso-phalangeal
(MTP) joints, knee, ankles, hips and elbows. The affected joints are painful to start with
then become swollen, warm, and tender with restriction of movement.
Pattern of Onset
Table No. 14. Showing the pattern of onset of Rheumatoid arthritis.
Sl. A B
01. Insidious, > 70%,
Acute 10-15%)
Sytemic - <10%,
palidromic least <5
Common. >5patient.
Oligoarticualr 45 to 50 ,
Polyarticualr 30-35%
Monoarticular 20-25 %.
DDiisseeaassee rreevviieeww
50
Extra Articular Manifestation of RA
Systemic Cardiac Respiratory Low grade fever Pericarditis Plural effusion
Fatigue Myocarditis Fiborsing alveolitis
Loss of weight Aortitis Nodules
Loss of appetite Conduction disturbances Bronchitis
Musculo-skeletal Hematological Neurological
Muscle wasting Anemia Entropment syndrome
Bursitis Thrombocytosis Cervical compression
Tenosynovitis Esinophilia Mononeuritis multiplex
Skin Felty’s syndrome Others
Subcuatneous nodules Spleenomegaly Systemic vasculitis
Vasculitis Eye Amylodosis
Ulcers Sicca syndrome
Gangrene Episcleritis
Pyoderme gangrenosum Scleritis
Nail fold infarcts Scleromalacia
Deformities112
Hand –
Hands include button hole associated with flexion at the PIP joints and
hyperextension of the distal intraphalangeal joints.
Swan neck deformity associated with flexion of the digital interphalangeal and
hyperextension of PIP joint.
Z deformity of thumb and ulnar deviation of the finger.
DDiisseeaassee rreevviieeww
51
Feet –
Feet involvement of MTP joints causes plantar subluxation of the metatarsal
heads. Resulting in cock-up toes. The deformity seen in the feet include Hallex valgeus or
varus, and Hammer toes,
Axial joint involvement is restricted to the cervical spine, where it takes the form
of either atlanto axial subluxataions or subaxil subluxation.
Laboratory Investigations113, 114
Laboratory investigations may help either to establish a clinical diagnosis or to
assess the prognosis and the possible cause of the disease.
ESR – Is elevated in RA and comes down as the disease remitts.
Hb% – May shows a normocytic normochromic anemia.
C- reactive protein – High levels of CRP at the onset of disease correlates with
poor prognosis.
Serological – The most important immunological investigation is detection of
rheumatoid factor. Other auto antibodies seen include antinuclear (ANA), Anti collagen,
Anti keratin, Antiperinuclear (ANA) and anti-rheumatoid arthritis antibodies.
Synovial fluid analysis – Synovial fluid analysis confirms the presence of
inflammatory arthritis, although none of the findings are specific.
The fluid is usually turbid, with reduced viscosity, increased protein content and
slightly decreased or normal glucose concentration.
White blood cell – WBC count is usually normal, but mild leukocytosis may be
present.
Radiographic evaluation – Plain radiograph of the joint in the early stages shows
soft tissues swelling around the affected joint and later jextra articular osteoporosis;
erosions are seen as the disease progresses. In later stages there is destruction of the
cartilage, resulting in joint space narrowing, cyst formation subluxation of the joints and
deformities.
DDiisseeaassee rreevviieeww
52
Treatment / Management115
Because the etiology of rheumatoid arthritis is unknown, treatment is empirically
directed towards –
♣ Relief of symptoms.
♣ Suppression of active progressive disease.
♣ Conservation and restoration of function in affected joints.
To a greater or lesser extent these are achieved by combining:-
♣ Treatment of the patient – Drugs, rest, physiotherapy, surgery.
♣ Modification of the environment – Aids, appliances, housing,
occupation, statutory benefits.
General Treatment
Physical rest, anti-inflammatory therapy and maintenance exercises are important
treatment for rheumatoid arthritis. The rest from physical and emotional stress provided
for 2-3 weeks in hospital is usually sufficient to induce a marked remission of symptoms.
Rest splints can be used to support a particular painful joint to correct flexion deformities.
Medications
Medications for rheumatoid arthritis include some for pain relief, others to reduce
inflammation. Some medications are disease modifying anti rheumatic drugs (DMARD)
which to try to show the course of the disease.
Intra-articular cortico-steroidal injections are given to bring symptomatic relief.
Non-steroidal anti-inflammatory drugs therapy is beneficial chloroquine phosphate or
hydroxy chloroquinine sulphate are used as the initial adjacent to basic therapy.
Auranofin an oral gold compound, pencillamine, and parental gold are also used
and immuno modulators are also used in the treatment.
DDiisseeaassee rreevviieeww
53
Surgical Treatment
Surgical decompression and synovectomy are needed when NSAID’s, local
insatous of corticosteroids and simple physical measurement failed to reduce movement
of limbs.
Prognosis116.
The course and prognosis in RA is very variable. 25% will have a complete
remission of symptoms and remain fit for all normal activities. 40% will have only
moderate improvement of function despite exacerbation and remission of disease. 25%
will be more severely disabled. 10% will be severely crippled.
A poor prognosis may be associated with –
01. High titer of RA factor.
02. Insidious on set of disease.
03. More than a year of active disease without remission.
04. Early development of nodules and erosion.
05. Extra articular manifestations.
06. Sever functional impairment.
Mortality is gradually increased in RA patients with functional impairment. The 5
years survival for severely disabled RA patient is reduced by 50%, the prognosis in
such patients is similar to that of patients with 3 vessels coronary artery disease.
DDiisseeaassee rreevviieeww
54
Methodology
Methodology can be studied under three headings,
1) Pharmaceutical study.
2) Analytical study.
3) Clinical study.
PHARMACEUTICAL STUDY
The study involves proper identification, collection, processing of raw drugs
and preparation of Sri Siddhadaradamruta.
The rationale of this branch is to make available the effective, safe, and
suitable medicine. It is evident that samskara given to the drug will change the quality
of the drug and also acts in a different manner when mixed with other drugs. Timings
of medication and anupana also direct the medicine to act in a different ways.
Study design
This section includes major steps,
Step 01: Identification and Collection of raw drugs.
Step 02: Purification and Processing of raw drugs.
Step 03: Preparation of Sri Siddhadaradamruta.
Date of Commencement:
Date of Completion:
Ref: Rasatarangini-Navama Taranga.
Method:
Pharmaceutical study
55
Step 01: Identification and Collection of raw drugs.
Date of Commencement: 26.11.04
Date of Completion: 26.11.04
An important part in the preparation of medicament lies in the proper
identification and procurement of the raw materials. Only this determines the quality
of drugs. So this section of the study deals with the same. Sri Siddhadaradamruta
contains;
Key ingredient: Hingula
Samskarartha Prayojya Ghatakas:
Vataksheera, Palanduswarasa, Bhallataka, Lavanga and Ghruta.
Special request was made to the herbo mineral drug shop dealer to get the
particular quality drugs and those were screened for classical grahya lakshanas and
those were certified by the concerned departments.
Step 02.Purification and processing of raw drugs
Shodhana procedures are mentioned for certain drugs with the intention to
enhance their therapeutic value and to make them sajateeya from vijateeya dravyas. It
is also done to make the drug free from its toxic properties. Hence this has to be done
with utmost care as improper purification may prove drug fatal.
Pharmaceutical study
56
Practical No; 1
Title: Hingula Shodhana.
Date of commencement : 02.12.04
Date of completion : 09.12.04
Reference: Rasa Ratna Samuchaya 3/152,153.
Materials required: Khalwa yantra.
Drugs used:
a) Hingula-500gms.
b) Ardraka swarasa-Q.S
Procedure:
* Hingula was taken in khalva yantra and powdered nicely.
* 130 ml of fresh ardraka swarasa was added and mardana was done for
8Hrs till it became dry.
* The Hingula was subjected for continual and cautious mardana till powder
completely absorbs the swarasa and this completes one bhavana.
* Similar such bhavana was repeated for another six times.
* In the 7th bhavana when Hingula was thick paste it was converted in to a
cake of approximately equal weights.
Pharmaceutical study
57
Table No. 15. Results of Hingula Shodhana
Ingredients In quantity
Bhavana dravya in quantity
Mardana in hours
Results Remarks
Ardraka swasa 130 ml 8 hours 505 gms Gain – 5 gms.
Ardrakaswarasa 130 ml 8 hours 512gms Gain – 7gms.
Ardrakaswarasa 130 ml 8 ½ hours 518gms Gain – 6gms.
Ardrakaswarasa 130 ml 8½ hours 525gms Gain – 7gms.
Ardrakaswarasa 130 ml 9 hours 530gms Gain – 5gms.
Ardrakaswarasa 130 ml 9 hours 538gms Gain – 8gms.
Hingula 500 gms.
Ardrakaswarasa 130 ml 10 hours 545gms Gain – 7gms.
Table No. 16.Showing the quantity of Hingula before shodhana and after shodhana.
Draya Quantity of Hingula before
shodhana (in gms)
Quantity of Hingula after shodhana
(in gms).
Hingula 500 545
Observation:
o Hingula can be made in to fine powder without much effort.
o A fine powdered Hingula appears bright red with a free flow character.
o Shodhita Hingula is deep red in appearance and its flow is reduced.
Precaution:
o When Hingula attained semisolid consistency the mardhana was carried out
continuously.
Pharmaceutical study
58
Practical no: 02
Title : Bhallataka Shodhana
Date of commencement : 10.12.04
Date of completion : 10.12.04
Reference: Rasatantra sara- Dravya Shodhana prakarana.
Drugs used: a) Grahya Bhallataka- 800gms
b) Gomutra-7 lit.
Procedure:
* The Bhallataka which sinks in water were identified and tied in to the
cloth and pottali was prepared.
* A mud pot of 3 lit capacity was taken in which this pottali was hanged
such that it moved freely in the pot. Distance of 4 angula from below to
the Pottali height was maintained.
* Gomutra was filled up to 3/4th of the pot.
* It was placed on mandagni over gas stove for 12 hrs.
* Gomutra was added in between whenever the level of gomutra was
reduced.
* After 12 hrs the Pottali was removed and the Bhallatakas were washed
with hot water.
Observations:
* Gomutra turned black tiny oil miscicles seen in it.
* After shodhana when Bhallataka was washed with hot water, it gained dull
appearance.
Pharmaceutical study
59
Precaution:
* When Gomutra starts boiling the froth is produce. This overflows from the
pot. Hence during that period, for few minutes the agni has to be lowered.
* Whenever the level of Gomutra is reduced, fresh Gomutra was added to
bring it up to the level of ¾ of the pot.
Table No. 17. Showing weight of Bhallataka before and after shodhana.
Dravya Weight of Bhallataka
before Shodhana
Weight of Bhallataka
after Shodhana
Bhallataka 800 gms 750 gms
Practical No 3:
Name : Preparation Hingula cake:
Date of commencement : 08.01.05
Date of completion : 08.01.05
Reference: Rasatarangini Navama Taranga
Materials Required:
1. Shodhita Hingula cake
2. Cotton thread
Procedure:
* Shodhita Hingula cakes were taken and weighed.
* Each Hingula cake was tied with cotton thread separately such that the
whole of the Hingula was densely covered with cotton thread, in a way not
to expose it outside.
* Later they were weighed again.
Pharmaceutical study
60
Table No. 18. Showing weight of Hingula before and after threading.
Drug Before Threading After Threading
100gm 105gm
110gm 115gm
110gm 115gm
110gm 115gm
Shuddha Hingula cakes
115gm 120gm
Observation: The threads are to be fastened very closely and carefully such that no gaps
are to be formed.
Precaution: Care is taken that whole of the Hingula is covered with threads so that
Hingula is not revealed at the outset.
Practical No 4:
Name : Pachana Samskara- I
Date of commencement: 27.01.05
Date of completion : 27.01.05
Reference: Rasatarangini Navama Taranga
Materials Required:
1. Vata ksheera – 250 ml
2. Palandu swarasa – 2 litre
3. Hingula cakes – all 5.
Pharmaceutical study
61
Procedure:
* A moderate sized deep fry pan was taken in which all the five Hingula
cakes tied with cotton thread were placed.
* Both Vataksheera and Palandu swarasa were poured in to pan.
* Pan was placed over mruduvagni, till all the liquid in the pan evaporated.
* When the pan was dry all the cakes were collected.
Table No. 19. Showing details of Pachana Samskara.
Drug Pachanadravya Quantity Temperature/
Total no of
hours
Total wt.
before
Total wt.
after
Vata ksheera 250 ml Shuddha
Hingula cake Palandu swarasa 2litres
80˚C for 5
hours
570gms 650gms
Observation:
* A sweet smell emerged through out the procedure.
* At the end of the pachana, the fibers with rubbery consistency remained at
the bottom.
Precaution:
The Mrudu agni has to be maintained through out the procedure.
Pharmaceutical study
62
Practical No 5:
Name : Dhahanasamskara
Date of commencement: 29.01.05
Date of completion : 29.01.05
Reference: Rasatarangini Navama Taranga
Materials Required:
1. Pachita Hingula
2. Shuddha Bhallataka
3. Lavangachoorna
4. Funnel.
Procedure:
* Two tola of lavanga yavakuta choorna is spread at the bottom of a pan.
* Over this place pachita Hingula.
* Make the heap of shudha bhallataka over Hingula cake in the form of
cone.
* Fill the gaps with lavanga choorna such that it forms a tight pack.
* Over this inverted funnel is placed such that the funnel wall covers
completely the cone of Bhallataka.
* Now surround the funnel with charcoal and set fire to it.
* When whole of Bhalataka is burnt the Hingula cake is taken and cleaned
and taken for next procedure.
Observation:
* When Bhallataka burns inside fumes come out from the opening of the
funnel.
* When all Bhallataka is burnt the fumes stop coming from the funnel. This
can be considered as the end point of this procedure.
Pharmaceutical study
63
Precaution:
* While burning Bhallataka it is better not to sit within its vicinity as it
causes boils over the exposed skin in sensitive person.
* Apply coconut oil over hand and face to avoid its reactions.
Practical No 6:
Name : Pachana Samskara- II
Date of commencement: 02.02.05
Date of completion : 07.02.05
Reference: Rasatarangini Navama Taranga
Materials Required:
1. Hingula cake -135gms.
2. Grutha -1350 ml (ten times that of Hingula)
Procedure:
* Taka a deep frying pan and place the Hingula cake at the center.
* On mandagni pour little by little grutha on Hingula khanda and make it to
evaporate.
* This is repeated till all the grutha is evaporated. Temperature during the
procedure was 260oc- 280oc.
* When all the grutha evaporates the cake is collected and the threads are
untied and made it in to powder and administered.
Observation:
* At the end of the procedure the grutha turned black.
* The residual grutha turned to thick, rubbery consistency material which
further did not evaporate.
Table No. 20. Showing details of Ghruta Pachana.
Drug
Wt before Pachana Wt after Pachana
Dahita Hingula 135gms 130gms
Pharmaceutical study
64
ANALYTICAL STUDY
The Rasoushadhies mentioned in Ayurvedic Pharmacopoeia should be analyzed
for physical and chemical properties to confirm the genuinity and safety before
administration in human beings. Hence it becomes obligatory to adopt modern analytical
methodology for better understanding & interpretation of physico-chemical changes
occurred during the process.
In the present study sample is collected at the completion of the preparation &
subjected to modern analytical methods
1. Loss on drying 1100:
One grams of Sri Siddhadaradamruta accurately weighed, heated on electric oven
up to1100 c & again weighed. The difference in weighed was calculated & the result is
attached.
Result: 0.21%
2. Acid insoluble ash:
The ash obtained was taken with dilute HCl filtered through Whatmann no. 42
filter paper. The residue was washed with hot water till it was free from chloride. The
residue was taken in a crucible, dried & ignited at a low temperature. The percentage of
acid insoluble ash was calculated with reference to the moisture free drug.
Result: 0.42%
3. The fineness of particle test:
It can be possible to use the ordinary microscope for particle size measuring in the
range of 0.2 micro meters to about 100 micro meters. According to microscope
method the fine powder was sprinkled on the slide covered with covering slip &
Analytical study
65
placed on a mechanical stage. Initially standardization of micrometer was carried out
by coinciding with the lines of both Oculo-micrometer and stage micrometer &
standardized by using the formula;
SM
-------- X 10 = m
OM
In the next step, the stage micrometer was removed & the mounted slide was
placed on a mechanical stage & focused. The particles are measured along the arbitrarily
chosen fixed lines covered by the particles using the Oculo- micrometer. The size of the
particle was calculated using the standard value.
Result:
Sample AMD in µm Mean Surface Volume Diameter µm
Shodhita Hingula 6.534 9.222
Sri Siddhadaradamruta Rasa 4.788 8.198
4. Flow property:
Sri Siddhadaradamruta is very fine powder so to maintain the actual dose and for
better dispensing, it was subjected to flow property test i.e., “Angle of repose” by which
we can analyze goodness of flow property.
Angle of repose: - It is the maximum angle that can be obtained between the free
standing surface of a powder heap & the horizontal plane i.e., tan θ = 2h / D
Where D is the diameter of the circle & ‘h’ is the height of the powder heap.
This test involves the hollow cylinder half is filled by Sri Siddhadaradamruta with
one end sealed by transparent plate. The cylinder is rotated about its horizontal axis until
the powder surface cascades. The curved wall is lined with sand paper to prevent
Analytical study
66
preferential slip at this surface. If the value comes between 200– 400 indicates reasonable
flow potential.
Shodhita Hingula: 32.86±2.75 Sri Siddhadaradamruta Rasa: 37.46±7.86
5. Flow rates:
A simple indication of the ease with which a material can be induced to flow is
given by application of a compressibility index “I”
I = 1 – V x 100
V0
Where ‘V’ is the volume occupied by sample of the powder after being subjected to a
standardized tapping procedure.
V0 = volume before tapping procedure
In this procedure one measuring cylinder is taken and is filled with Sri
Siddhadaradamruta. The level of the Sri Siddhadaradamruta Rasa is noted. Then at a
height of 2 cm continuous 10 tapping should be done, after that the level of the Sri
Siddhadaradamruta Rasa in the cylinder is once again noted & the value ‘I ’ is calculated
with respect to the Vo & V value. If the value ‘I’ is below 15% usually having good flow
rates.
Shodhita Hingula-12% Sri Siddhadaradamruta Rasa -15%
7. Determination of pH –
The pH value of the sample was determined by a digital pH meter. One percent
solution was prepared, as the sample was dry and solid in the form of capsules. The
powder was separated and one gram of the sample was weighed accurately and dissolved
in 100ml of water and pH was noted in the digital pH meter.
Result:
pH (1% solution)- 6.66
Analytical study
67
8. Determination of total ash:
Procedure – Take about 2gms accurate weighed, ground drug in a previously traced
silica dish, previously ignited and weighed. Scatter the ground dry in a fine even layer on
the bottom of the dish. Incinerate by gradually increasing the heat not exceeding dull red
heat (4500C) until free from carbon. Cool and weigh. Calculate the percentage of ash with
reference to the air-dried drug.
Total ash- 29.1%
9. Determination of sulphur:
Eschka Mixture – Mix two parts by weight calcined magnesia with one part of
anhydrous sodium carbonate.
Procedure –
Cover the bottom of a 50 ml crucible with 0.5 gm of Eschka’s mixture. Weigh
accurately the appropriate quantity of the sample material and mix it immediately with
2gms of Eschka’s mixture and put evenly on the previously weighed Eschka’s mixture.
Level the contents by tapping gently on a bench. Cover this uniformly with 0.5gm of
Eschka mixture. Place crucible in the muffle furnace. Raise the temperature from room
temperature to 8000C + 250C in about one hour and then heat for further 90 minutes.
Transfer the ignited mixture as completely as possible from the crucible to a
beaker containing 25 to 30 ml of water. Wash out the crucible thoroughly with about
50 ml of hot distilled water and add the washings to the contents of the beaker.
Add carefully sufficient quantity of concentrated hydrochloric acid to dissolve the
solid matter, warming the content of the beaker to effect solution. Boil for 5 minutes to
expel carbon dioxide. Add drop wise from a pipette; warm 5% Barium chlorine solution.
Stir the solution constantly during the addition. Allow the precipitate to settle for a
minute or two.
Analytical study
68
Then test the supernatant liquid for complete precipitation by adding a few drops
of Barium chloride solution. If a precipitate is formed, add slowly a further 3 ml of the
reagent allow the precipitate to settle as before and test again, repeat this operation until
an excess of Barium Chloride is present. When an excess of the precipitating agent has
been added, keep the covered solution hot, but not boiling for an hour (steam bath) in
order to allow time for complete precipitation. The precipitation should settle and a clear
supernatant liquid should be obtained. Test the latter with a few drops of barium chloride
solution for complete precipitation. If no precipitate obtained, the Barium sulphate is
ready for filtration.
Filter the solution through an ash less filter paper (Whatmann No. 42). Wash the
precipitate with small portion of hot water. Dry the paper and place it in a silica or
porcelain crucible, previously ignited to redness and cooled in desiccators and weighed.
Gradually increase the heat until the paper chars and volatile matter is expelled. Do not
allow the paper to burst into flame as mechanical loss may thus ensue. When charring is
complete, raise the temperature of the crucible to dull redness and burn off carbon with
free excess of air. When the precipitate is white ignite the crucible at red heat for 10-15
minutes. Allow the crucible to cool in air, transfer it to desiccators and when cold, weigh
the crucible and contents. Repeat until constant weight is attained.
A blank is necessary. Calculate the percentage of sulphur converting Barium
sulphate X 0.1374.
Sulphur: Shuddha Hingula- 12.83% and Sri Siddhadaradamruta – 12.28%.
10. Determination of mercury
Procedure –
Dissolve about 0.3gms of the sample in 5ml of Aquaregia and add 100 ml of water. Add
40ml of 0.05N EDTA, 5ml of Ammonia buffer solution and 0.5ml of solo chrome black
Analytical study
69
indicator. Titrate the solution with 0.05 M Zinc sulphate until the blue colour changes to
purple (do not overshoot the end point), add 3gms of Potassium iodide, swirl to dissolve.
Allow to stand for two minutes. Then, continue the titration with zinc sulphate solution to
the same end point as before. Each ml Zinc sulphate solution required after addition of
potassium iodide = 0.0103 Hg.
Mercury: Shuddha Hingula- 86.10% and Siddhadaradamruta Rasa -64.28%.
11. Solubility:
About one gram of the sample was weighed and dissolved in 10ml of the solvents.
When the sample did not dissolve, an excess of solvent by 10 ml quantity up to 100ml
was added and noted that the sample was sparingly soluble in water and 1M Hydrochloric
acid (1 gm of sample in 100 ml of water and 1 M Hydrochloric acid) and slightly soluble
in chloroform and alcohol (1 gram of sample in 600 ml to 1000 ml of chloroform and
alcohol.
Solubility tests Results
Water Slightly soluble.
Chloroform Slightly soluble.
Alcohol Soluble.
12. Electron Spectroscopy for Chemical Analysis (ESCA)
ESCA of Sri Siddhadaradamruta Rasa (final product) was carried out at Indian
Institute of Chemical Technology (IICT), Hyderabad for both Qualitative and
Quantitative analysis.
Among the methods of surface analysis based on ultra high vaccum techniques,
which have been developed dramatically during the past years, only ESCA – which
stands for ‘Electron Spectroscopy for Chemical Analysis’ or XPS X-ray photo electron
spectroscopy, besides Auger electron Spectroscopy (AES) and Secondary Ion Mass
Analytical study
70
Spectrometry (SIMS) became well established in the field of Materials surface analysis.
ESCA involves the determination of the energy distribution of electrons emitted from X–
ray irradiated compounds. In principle all the electrons of a compound, from the atomic
cores of the Valence levels, can be studied, however, the technique is used principally for
the study of core electrons.
Physical Principle of ESCA
ESCA has its origin in the investigations of the photoelectric effect in which X –
rays were used as the existing photon source. In addition to the valence electron, which
provide the bonding for the systems. Each atom present in the surface (except H2 and He)
posses core electrons not directly involved in the bonding (Anti-bonding electrons). The
so-called binding energy Eb of each core electron (conceptually, but not strictly
equivalent of I.E. of the electron) is characteristic of the individual atom to which it is
bound. In the basic ESCA experiment the samples source (Depth of analysis between 1.5
and 6 nm). The resultant photoelectrons (emitted particles) have a Kinetic energy (Ek) in
the range of 20 to 2000 ev which is related to X-ray energy (hγ) and binding energy (Eb)
Ek = hγ – eb - ψ
Where ‘h’ is plancks constant, γ is frequency of the exciting radiation, ψ is the work
function of spectrometer (the energy required brining an electron from the Fermi level
of the spectrometer to its zero level).
If the photoelectrons have sufficient Kinetic energy that they are able to escape
from the surface by overcoming the work function, photoemission occurs. Since the
energy levels are quantised the photoelectrons have a Kinetic energy distribution
consisting of series of discrete bands, which essentially reflect the shell from electronic
structure of the atoms in the sample. In this way ESCA is the experimental determination
of Kinetic energy distribution by analysis of the photoelectrons produced by exposure to
X – rays.
Analytical study
71
Experimental conditions
ESCA recorded on a KRATOS AXIS 165 with a dual anode (Mg and Al)
apparatus using the Mg K ∝ anode. The pressure in the spectrometer is about 10-9 torr.
Spectrum was deconvoluted using the sun solaris based vision 2 curve resolver. The
location and the full width at half maximum (fwhm) for a species was first determined
using the spectrum of a pure sample. The location and fwhm of the products, which were
not obtained as pure species, were adjusted until the best fit was obtained as pure species,
were adjusted until the best fit was obtained symmetrical Gaussian shapes were used in
all cases. Binding energies for identical samples were in general reproducible to with in +
1 ev.
Routinely used X – ray sources are Mg K ∝ (1253.6 ev) and Al K ∝ (1486.3 ev)
as incident particles, which normally cover of an area of many mm2. Alk ∝ radiation can
be mono chromate and this leads to some focusing may be to spot diameter of about
10µm as lateral resolution. The ESCA Spectrum is usually a plot of intensity of the
photoelectrons versus binding energy (Eb).
ESCA – General aspects
ESCA yields information on the elemental analysis and their composition, the
oxidation state of the elements and in favourable cases on the dispersion of one phase
over another. ESCA can be used to give reasonable quantitative accuracy (up to + 10%)
provided that good calibration standards are used. The detection limit is about 10– 3.
A major advantage of the technique is that photo electron energy is dependent on
the precise chemical configuration of the surface atoms and pronounced chemical shifts
are produced in the position of peak in the ESCA, is amenable to virtually all vaccum
compatible samples since the incident rays do not normally cause surface damage due to
the beam. Therefore the techniques can be used even with very delicate material. Using
sample charging is minimal. The collection of spectra is normally fast (typically less than
5 min) and the reproducibility of results is high. ESCA shows a narrow range of
sensitivity and the range of sensitivity across the element range is about a factor by 10.
Analytical study
72
Results:
In the sample Mercury is present in Oxide and Sulphide forms. No
elemental mercury is present. Majority of mercury is in the form of oxide and less in the
Sulphide form as the sulphide indicated is 5.51% where as Hg in 24.69% and oxide
20.79%. The sample has mercury oxide and sulphide in the ratio of 60:40. The peak at
59.3 is due to Selenium oxide and if it is due to elemental selenium it will be at 54.8,
because it is too low in concentration it can not be marked.
13. Estimation of FAT content:
Weigh about 2 g of previously dried sample. Take in a thimble made of coarse
filter paper and knotted with thread. Extract with 25ml anhydrous alcohol, free ether or
petroleum ether in a soxhlet extraction apparatus. Extraction period may vary from 4
hours at condensation rate of 5-6 drops/sec to 16 hours at 2-3 drops per sec. evaporate
solvent and dry the extract to a constant weight at 1100C. Calculate the fat content
percentage.
Result: 7%.
Analytical study
73
CLINICAL STUDY
Rasoushadhies are basically divided in to four types viz- Khalviya,
Parpati, Kupipakwa, and Pottali. In all these preparation one major difference we note is
the pattern of agni (to attain Agnisthayitwa), based on which the Rasayana property of
these kalpas are enhanced. This also reflects on the dose to be administered, as it is noted
that the dose of Pottali kalpa is very minute. Sri Siddhadaradamruta Rasa not mentioned
in these four basic kalpas and is subjected for different samskaras with agni. To evaluate
its liability in therapeutics it was put to test in Amavata. Efficacy can be determined by
finding out the difference between the baseline data and assessment data.
The materials and methods of the present study consist of following headings.
I. Selection of patients.
II. Research Design.
III. Duration and Method of administration of drug.
IV. Parameters of Assessment.
V. Criteria for Assessment of Results
1. SELECTION OF PATIENTS:
The patients were diagnosed based on the presentation of history, signs,
symptoms, and detailed clinical examination. 15 patients were selected after critical
adaptation of inclusion and exclusion criteria.
a) Source of data:
15 patients of Amavata with confirmed diagnosis were taken from OPD and IPD of
DGM Ayurvedic Medical College Hospital, Gadag.
The Samples were selected by simple sampling technique.
b) Inclusion criteria:
a) Patients of Amavata having the history of less then 5years.
b) Patients of Amavata between the age group of 20 to 50 years of either sex.
c) Classical signs and symptoms will be considered for selection of patients.
Clinical study
74
c) Exclusion Criteria:
a) Patients of Amavata having the history of more than 5 years
b) Patients of Amavata having the systemic diseases.
c) Patients of Amavata below 20 years and above 50 years of age.
d) Pregnant women and lactating mothers.
d) Intervention:
a) The patients are assessed before and after the treatment as per assessment
criteria.
b) The nature of the study is explained to the patients in detail and pre treatment
consent is taken.
c) The patients have full right to withdraw from the study at any time.
d) The data is maintained confidently.
e) 15 patients of Amavata of either sex are taken in simple randomized selection
of sampling techniques.
II RESEARCH DESIGN:
The study was conducted on total 15 patients who could continue the treatment
for full duration and came for follow up till to the last; the patient was selected from the
OPD, DGM Ayurvedic Medical College & Hospital for prospective clinical trial.
III DURATION AND METHOD OF ADMINISTRATION OF DRUG:
Study duration - 30 days.
Follow up - 15 days.
Method of Administration: Sri Siddhadaradamruta was administered orally
Dosage – ½ Ratti (62.5 mg) two times a day.
Anupana – Purana Guda.
Clinical study
75
IV PARAMETERS FOR ASSESSMENT:
Subjective parameters:
Signs and Symptoms explained in the Ayurvedic texts
Table No. 21. Showing the gradation which is adopted in statistical evaluation of clinical
symptoms.
Sl.No Symptoms Severity Grade01 Sandhi Shoola No complaints
Patients tells about it After inquire Patients frequently complaints Excruciating condition
0 1 2 3
02 Shotha No complaints Slight Obvious Covers well the boney prominence Much elevated
0 1 2 3
03 Jwara (sthanika ushmata) Normal During severity of pain During severity of pain with swelling `Continuous pain with pain.
0 1 2 3
04 Gouravata No Gouravata During morning up to 1hrs. Continuous in the morning less than 24Hrs Throughout day
0 1 2 3
05 Nidraviparyaya No discomfort Discomfort during night Discomfort during night and affects day. Day sleep and night awakes.
0 1 2 3
06 Jadya No stiffness Stiffness for 5 min-1hour Stiffness for 1-2 hours More than 2 hours.
0 1 2 3
Clinical study
76
Objective Parameters:
Hb%, TC, DC, ESR, Walking time, Grip strength,
Table No 22. Showing the gradation which is adopted in statistical evaluation
of walking time.
Sl No To cover 21 Meters Grading
01 02 03 04
Up to 20 Seconds 21 to 30 Seconds 31 to 40 Seconds 41 to 50 seconds
0 1 2 3
Grip strength: - Patient’s grip strength is assessed before and after treatment
according to the readings in the grip strength meter in terms of pound.
Assessment of Result:
Subjective and objective parameters before and after treatment data
comparison is assessed for result.
V CRITERIA FOR ASSESSMENT OF RESULTS
The results are classified into four groups as listed below –
A. Complete remission
1. Sandhi Shoola (pain)
2. Sandhi Shotha (swelling)
3. Gouravata
4. Jwara (Sthanika ushmata)
5. Nidraviparyaya
6. Jadya
7. No elevation of ESR.
8. Complete subsidence of above subjective parameters.
Clinical study
77
B. Major improvement
1. Complete subsidence >2 or <6 below mentioned subjective parameters i.e.
I. Sandhi Shoola (Pain)
II. Sandhi Shotha (Swelling)
III. Gouravata
IV. Jwara (Sthanika ushmata)
V. Nidraviparyaya
VI. Jadya
2. ESR may be elevated.
C. Minor improvement
1. Complete subsidence of any one below mentioned subjective parameters i.e.
I. Sandhi Shoola (Pain)
II. Sandhi Shotha (Swelling)
III. Gouravata
IV. Jwara (Sthanika ushmata)
V. Nidraviparyaya
VI. Jadya
2. Elevation of ESR.
D. No improvement
1. No change or exaggerations of signs and symptoms
2. Elevation of ESR.
The persons who don’t come under above three criteria’s will come in these criteria.
Clinical study
ANALYSIS REPORT OF Dr Pradeep Agnihotri
3. DVK PA SReport: Mercury is present in oxide and sulphide forms. No elemental Mercury is present. Majorly mercury is in the form of oxide and less in the sulphide form as the sulphide indicated is 5.51% where as Hg in 24.69% and oxide 20.79%. The sample has mercury oxide and sulphide in the ratio of 60:40.
DVK PA SR_Report: Mercury is present in oxide and sulphide forms. No elemental Mercury is present. Majorly mercury is in the form of oxide and less in the sulphide form as the sulphide indicated is 5.51% where as Hg in 24.69% and oxide 20.79%. The sample has mercury oxide and sulphide in the ratio of 60:40.
78
DEMOGRAPHIC DATA Distribution of patients by age; Table No. 23. Showing Distribution by age Group
Sl Age group No. of pts Percentage
01 21-30 05 33.33
02 31-40 04 26.66
03 41-50 06 40
It was observed that, the maximum number of patients 06(40%) were in the age
group of 41-50; 05 (33.33%) from the age group of 20-30 years.
Graph.1: Showing Distribution by age Group
DISTRIBUTION BY AGE GROUP
33%
27%
40%
21-30 31-40 41-50
Results
79
Distribution of patients by sex;
Table No. 24. Showing the distribution of patients by Sex
Sl Sex No of Pts Percentage
01 Male 04 26.66
02 Female 11 73.33 Graph 2: Showing the distribution of patients by Sex.
DISTRIBUTION BY SEX INCIDENCE
4 1126.66
73.33
0
20
40
60
80
Male FemaleNo of Pts Percentage
It was observed that, out of 15 patient’s maximum number of patients i.e.
11(73.33%) were females and males were 4 (26.66%).
Results
80
Distribution of patients by Religion;
Table No. 25. Showing Patients distribution by Religion
Sl. Religion No. of Pts. Percentage
01. Hindu 13 86.66
02. Muslim 2 13.33
03. Christian - -
04. Others - -
It was observed that, the majority of patients were from Hindu, 13
(86.66%) and Muslim 2, (13.33%).
Graph No 3; Showing Patients distribution by Religion
Distribution by Religion
0
2040
6080
100
Hindu Muslim Christian Others
No. of Pts. Percentage
Results
81
Distribution of patients by Socio-economic status;
Table No. 26 Showing the distribution of patients by Socio-economic status.
Sl. Socio-economic No. of Pts. Percentage
01. Poor 7 46.66
02. Middle 8 53.33
03. Upper class 0 0
It was observed that, the maximum number of patients i.e. 8 (53.33%) belong to
middle socioeconomic class, poor 7 (46.66%).
Graph No 4 Showing the distribution of patients by Socio-economic status.
Socio-economic status.
0
20
40
60
No. of Pts.Percentage
No. of Pts. 7 8 0Percentage 46.66 53.33 0
Poor Middle Upper class
Results
82
Distribution of patients by Occupation;
Table No. 27 Showing the distribution of patients by Occupation.
Sl. Occupation No. of Pts. Percentage
01. Labour 4 26.66
02. Sedentary 0 0
03. Active 3 20
04. House wife 8 53.33
It was observed that, the majority of the patients were from the housewife
8(53.33%), labor 4 (26.66%), and active 3 (20%).
Graph No 5 Showing the distribution of patients by Occupation
Distribution by Occupation
4
0
3
8
26.66
0
20
53.33
0 10 20 30 40 50 60
Lbr
Sed
Actv
H.W
No. of Pts. Percentage
Results
83
Distribution of patients by marital status;
Table No. 28 Showing the distribution of patients by marital status;
Sl. Marital status No. of Pts. Percentage
01. Married 12 80
02. Unmarried 3 20
It was observed that, the maximum number of patients were married 12 (80%)
and unmarried 3 (20%).
Distribution of patients by food habits;
Table No. 29 Showing the distribution of patients by food habits.
Sl. Food habits No. of Pts. Percentage
01. Vegetarian 13 86.66
02. Mixed 2 13.33
It was observed that, the maximum number of patients 13 (86.66%) were
vegetarian and only 2 (13.33%) mixed food habits.
Results
84
Distribution of patients by addiction;
Table No. 30 Showing the distribution of patients by addiction.
Sl. Addiction No. of Pts. Percentage
01. Smoking 1 6.66
02. Alcohol 0 00
03. Tobacco 3 20
04. No habits 11 73.33
It was observed that, the out of 15 patients 11 (73.33%) had no habits, smoking
addiction 1(6.66%), and tobacco addiction 3 (20%).
Distribution of patients by predominant Rasa in diet;
Table No. 31 Showing the Distribution of patients by predominant Rasa in diet.
Sl. Rasa pradhanyata in ahara
No. of Pts.
Percentage
01. Madhura 08 53.33
02. Amla 3 20
03. Lavana - -
04. Tikta - -
05. Katu 4 26.66
06. Kashaya - -
It was observed that, the maximum number of patients 8 (53.33%) had madhura
predominance in diet, katu predominance 4(26.66%).
Results
85
Distribution of patients by Prakriti;
Table No. 32 Showing the distribution of patients by Prakriti
.
Sl. Prakriti No. of Pts. Percentage
01. Vata-pitta 05 33.33
02. Vata-kapha 7 46.66
03. Pitta-kapha 3 20.00
It was observed that, the majority of patients were vata-kapha 7 (46.66%) and
vata-pitta 5 (33.33%) and pitta-kapha prakriti 3 (20%).
Graph No 6 Showing the distribution of patients by Pra
Distribution By Prakruti
5 73
33.33
46.66
20
0
10
20
30
40
50
Vata-pitta Vata-kapha Pitta-kapha
No. of Pts.Percentage
Results
86
Distribution of patients by Sara;
Table No.33 Showing the distribution of patients by Sara.
Sl. Sara No. of
Pts.
Percentage
01. Pravara 2 13.33
02. Madhyama 11 73.33
03. Avara 2 13.33
It was observed that, the maximum number of patients were madhyama sara
11(73.33%), pravara were 2 (13.33%) and avara 2(13.33%).
Distribution of patients by Samhanana ;
Table No. 34 Showing the distribution of patients by Samhanana.
Sl. SamhananaNo. of
Pts. Percentage
01. Pravara 2 13.33
02. Madhyama 11 73.33
03. Avara 2 13.33
It was observed that, the maximum patients were madhyama samhana 11
(73.33%), pravara 2(13.33%) and avara 2 (13.33%).
Results
87
Distribution of patients by Satwa
Table No. 35 Showing the distribution of patients by Satwa.
Sl. Satwa No. of
Pts. Percentage
01. Pravara 4 26.66
02. Madhyama 9 60
03. Avara 2 13.33
It was observed that, the maximum patients were madhyama satwa 9 (60%),
pravara 4(26.66%) and avara 2 (13.33%).
Distribution of patients by Vyayama Shakti;
Table No. 36 Showing the distribution of patients by Vyayama shakti.
Sl. Vyayama
shakti
No. of
Pts. Percentage
01. Pravara 3 20
02. Madhyama 9 60
03. Avara 3 20
It was observed that, the majority of the patient were madhyama vyayama shakti 9
(60%), avara 3(20%), pravara 3 (20%).
Results
88
Distribution of patients by Desha
Table No. 37 Showing the distribution of patients by desha.
Sl. Desha No. of Pts. Percentage
01. Jangala 5 33.33
02. Anupa 0 0
03. Sadharana 10 66.66
It was observed that, the maximum number of patients was from sadharana desha
10 (66.66%) and jangala 5 (33.33%).
Graph 7 Showing the distribution of patients by desha
Destribution Showing Desha
50
10
33.33
0
66.66
010203040506070
Jangala Anupa SadharanaNo. of Pts. Percentage
Results
89
Distribution of patients by chief complaint;
Table No. 38 Showing the distribution of patients by chief complaint.
Sl. Chief complaints No. of Pts. Percentage
01. Sandhi shoola 15 100
02. Sandhi shotha 15 100
03. Jadyata 15 100
04. Gaurava 15 100
05. Vrischika damshavat peeda 03 20
06. Jwara(sthanika ushmata) 15 100
It was observed that, the almost all patients were with Sandhi shoola, Sandhi
shotha, jadya, jwara, gouravata in 15(100%), Vrischik damshavat peeda 3 (20%)
Graph 8 Showing the distribution of patients by chief complaint
CHIEF COMPLAINTS.
15
15
15
15
3
15
Sa shl Sa sho Jad GaV Vd P Jwr sth
Sa Shl – Sandhishoola; SaSho – Sandhishotha; Jad – Jadya; GaV – Gauravata; Vd P – Vrischikadamshavata peeda; Sth Jwr – Jwara(sthanika ushmata).
Results
90
Distribution of patients by associated complaints;
Table No. 39 Showing the distribution of patients by associated
complaints.
Sl. Associated complaints No. of Pts. Percentage 01. Anga marda 9 60 02. Aruchi 11 73 03. Nidraviparyaya 15 100 04. Trishna 1 6.6 05. Apaka 2 13.33 06. Daha 3 20 07. Alasya 6 40 08. Vid baddhata 8 53.33
It was observed that, the maximum patients of Nidraviparyaya i.e. 15 (100%),
Aruchi 11(73%), Anga marda 9 (60%),Malabaddhata 8 (53.33%), Alasya 6 (40%), Daha
3 (20%), Apaka 2 (13.33%),Trishna 1(6.6%).
Graph 9: Showing the distribution of patients by associated complaints
Distribution By Associated Complaints
02468
10121416
AM Ar NV Tr Ap Dh Als VitVibAssociated Complaints
No
of P
t'S
AM – Angamarda; Ar – Aruchi; NV – Nidra viparyaya; Tr – Trishna; Ap –
Apaka; Dh – Daha; Als – Alasya; Vid Vib – Vid vibandha.
Results
91
Distribution of patients by Nidana; Table No. 40 Showing the distribution of patients by Nidana.
Sl. Nidana No. of Pts. Percentage
01. Viruddha ahara 3 20
02. Viruddha chestha 2 13.33
03. Mandagni 8 53.33
04. Sasnigdha ahara, bhojanottara vyayama 4 26.66
It was observed that, the maximum nidana of patient were having 8 (53.33%)
mandagni, snigdha ahara bhojanottara vyayama 4 (26.33%), virudha ahara 3 (20%).
Graph 10: Showing the distribution of patients by nidana.
Nidana
3, 18% 2, 12%
4, 24%8, 46%
V ah V ch Man Ssn, bjn, vym
V Ah- Viruddha Ahara, V Ch- Viruddha Chesta, Man- Mandagni, SSn,aha, bjn Vym-
Sasnigda Ahara, Bhojanottara Vyayama.
Results
92
Data related to response to the treatment;
Sandhi shoola (Pain)
Table No. 41 Showing the response of the therapy in sandhishoola.
B.T. A.T. Sl. GradingNo. of Pt.’s
% No. of Pt.’s
%
01. 0 0 0 6 40 02. 1 2 13.33 5 33.33 03. 2 9 60 4 26.66 04. 3 4 26.66 0 0
Among the 15 patients, 9(60%) patients had the grade 2 pain and 4 (26.66%)
patients had the grade 3 pain before the treatment. Patients with grade1 pain were
2(13.33%). After the treatment 4 (26.66%) patients had 0 grade pain and7 (46.66%)
patients had the 1 grade pain & 4 (26.66%) patients had the 2 grade pain. No patient had
grade 3 pain. Statistically it is highly significant, where p value is <0.001.
Graph 11: Of Sandhishoola.
0
6
2
5
9
4 4
002468
10
No.
Pt'S
0 1 2 3Gardings
Showing Sandhishoola
B.T. No. of Pt.’s A.T. No. of Pt.’s
1– 0 grade of sandhishoola; 2 – 1 grade of sandhishoola; 3 – 2 grade of
sandhishoola; 4 – 3 grade of sandhishoola.
Results
93
Sandhi shotha (Swelling);
Table No. 42 Showing the response of the therapy in sandhishotha.
BT AT Sl. GradingNo. of pt. % No. of Pt. %
01. 0 0 0 7 46.66 02. 1 7 46.66 5 33.33 03. 2 5 33.33 3 20 04. 3 3 20 0 0
Among the15 patients 5 (33%) patients had grade 2 shotha , 7(46.66%)patients
had grade 1 shotha and 3(20%) patients had grade 3 shotha before treatment. After the
treatment 7 (46.66%) patients had grade 0 shotha and 5 (33.33%) patients had grade 1
shotha, 3 (20%) patients had grade 2 shotha. Statistically it is highly significant, where p
value is <0.001.
Graph 12: Showing the response of the therapy sandhishotha.
0
7 75 5
3 3 3
02468
1 2 3 4GRADINGS
Response of the Therapy Before and After in Sandhi Shotha
No. of pt. No. of Pt.
1 – 0 grade of sandhishotha; 2– 1 grade of sandhishotha; 3 – 2 grade of sandhishotha; 4 – 3 grade of sandhishotha.
Results
94
Jwara (Sthanika Ushmata)
Table No. 43 Showing the response of the therapy in Jwara (Sthanika Ushmata)
BT AT Sl. Grading
No. of pt. % No. of Pt. %
01. 0 0 0 8 53.33
02. 1 7 46.66 4 26.33
03. 2 5 33.33 3 20
04. 3 3 20 0 0
Among 15 patients7 (46.33) patients were observed with grade 1, 5(33.33)
patients with grade 2 and 3(20%) patients were in grade 3 jwara before treatment. After
treatment 8 (53.33%) patients had 0 grade fever, 4(26.33%) patients were in grade1,
3(20%) patients were in grade 2.
Graph 13: Showing the response of the therapy in Jwara
0
87
45
3 3
0012345678
No o
f Pt's
1 2 3 4Grading
Jwara(Sthanika Ushmata)
BT AT
1 – 0 grade of Jwara (Sthanika Ushmata) 2– 1 grade of Jwara; 3 – 2 grade of Jwara;
4 – 3 grade of Jwara.
Results
95
Gouravata: Table No. 44 Showing the response of the therapy in gouravata.
BT AT Sl. Grading
No. of pt. % No. of Pt. %
01. 0 0 0 12 80
02. 1 10 66.66 1 6.66
03. 2 2 13.33 2 13.33
04. 3 3 20 0 0
Among 15 patients10 (66.66%) patients were observed with grade 1, 2(13.33%)
patients with grade 2 and 3(20%) patients were in grade 3(20%) gouravata before
treatment. After treatment 12(80%) patients had 0 grade gouravata, 1(6.66%) patients
were in grade1, 2(13.33%) patients were in grade 2.
Graph 14: Showing the response of the therapy in gouravata.
Gouravata
0
10
23
12
12
002468
101214
1 2 3 4Grading
No. o
f Pt's
BT AT
1 – 0 grade of Gouravata. 2– 1 grade of Gouravata; 3 – 2 grade of Gouravata; 4 – 3 grade of
Gouravata.
Results
96
Nidraviparyaya: Table No. 45 Showing the response of the therapy Nidraviparyaya;
BT AT Sl. Grading
No. of pt. % No. of Pt. %
01. 0 0 0 6 40
02. 1 6 40 6 40
03. 2 6 40 3 20
04. 3 3 20 0 0
Graph 15: Showing the response of the therapy in Nidraviparyaya
0123456
No
of P
t's
0 1 2 3Grading
Nidraviparyaya
BT No. of pt. AT No. of Pt.
Among 15 patients 6 (40%) patients were observed with grade 1, 6(40%) patients
with grade 2, and 3 (20%) patients were in grade 3(20%) of Nidraviparyaya before
treatment. After treatment 6(40%) patients had 0 grade Nidraviparyaya , 6(40%) patients
were in grade1, 3(20%) patients were in grade 2.
Results
97
Jadyata:
Table no 46: Showing the response of the therapy in Jadyata
Grade B.T No.of Pt’s % A.T No.of Pt’s %
0 0 04 26.66 1 0 0 6 40 2 11 73.33 3 20 3 4 26.66 2 13.33
Graph 16: Showing the response of the therapy before and after in Jadyata.
0
4
0
6
11
34
2
02468
1012
NO o
f Pt'S
0 1 2 3
GRADING
SHOWING JADYATA
B.T No.of Pt’s A.T No.of Pt’s
Among 15 patients 5(33.33%) patients were observed with grade 1, 7(46.66%)
patients with grade 2, and 3 (20%) patients were in grade 3 of Jadyata before treatment.
After treatment 5(33.33%) patients were observed with grade 0 of Jadyata, 6(40%)
patients were in grade1, 2(13.33%) patients were in grade 2, 2(13.33%) patients remained
in grade 3.
Results
98
OVERALL RESULT
Table No. 47 Showing the overall result assessed on the basis of subjective and objective
parameters.
Sl. Overall result No. of Pts. Percentage
01. Complete remission 4 26.66
02. Major improvement 4 26.66
03. Minor improvement 4 26.66
04. No improvement 3 20
Among the 15 cases of Amavata shows the following results which was assessed
on the basis of subjective and objective parameters –
4 patients (i.e. 26.66%) had shown complete remission.
4 patients (i.e. 26.66%) had shown major improvement.
4 patients (i.e.26.66%) had shown minor improvement.
3 patients (i.e. .20%) reported in no improvement group.
Graph 17: Showing the overall result assessed on the basis of subjective andobjective
parameters.
Overall Result
4
44
3
CR Mj imp Mi imp No imp
Results
99
Table No. 48 showing statistical analysis before and after treatment.
Sl.No Parameter Mean S.D S.E t-value p-value Remarks01 Sandhi shoola 1.266 0.242 0.062 20.41 <0.001 H.S 02 Sandhi Shotha 1.00 0.00 0.00 - - - 03 Gouravata 1.2 0.414 0.106 11.32 <0.001 H.S 04 Jwara 1.066 0.258 0.066 16.15 <0.001 H.S 05 Nidraviparyaya 1.00 0.00 0.00 - - - 06 Jadyata 1.066 0..7030 0.1815 5.8732 <0.001 H.S 07 Hb% 0.96 0.54 0.139 6.906 <0.001 H.S 08 TC 303.33 224.77 58.03 5022 <0.001 H.S 09 DC(L) 6.133 1.06 0.273 22.46 <0.001 H.S 10 ESR 9.4 6029 1.626 5.78 <0.001 H.S 11 Walking time 1.00 0.00 0.00 - - -
Right hand 3.752 2.603 0.672 5.58 <.0001 12 Grip Strength Left hand 3.433 2.135 0.551 6.23 <0.001
H.S
. Overall all the parameters show highly significant before and after the treatment.
The subjective parameters orderly Jwara, jadya, gouravata and Sandhi shoola shows
more highly significant. But the parameters Sandhi shota and Nidraviparyaya shows
the same mean effect before and after treatment (by comparing p-value, t-value)
The parameter gouravata shows high net mean effect with high variation, where
as Nidraviparyaya and Sandhishota show same mean net effect with zero variation.
(by comparing mean and S.D).
Among the objective parameters DC (L) and Hb% show more highly significant
than other (P<0.05). The mean net effect of TC is more with more variations. The
mean net effect of Hb% is low with low variance. The parameter walking time shows
zero variations before and after treatment. The mean net Grip strength right hand is
more with more variance even though left hand grip strength show more highly
significant then Right hand Grip strength. This is due to the sampling errors and
variations among the patients (samples)[by comparing mean, S.D.]
The parameter ESR also shows more highly significant than TC and also the
mean ESR reading lies with in normal range for both sexes.
Results
Master Chart of SUBJECTIVE PARAMETERS
Sandhi Shoola
Sandhi Shotha
Jwara(Sthanika Usmata)
Gouravata Nidraviparyaya JadyataSl.no OPD No
BT AT BT AT BT AT BT AT BT AT BT AT
Response
01 5430 3 2 2 1 2 1 1 0 2 1 3 2 Min Imp 02 0573 2 0 1 0 1 0 1 0 1 0 2 0 Comp.Rem03 1684 2 0 1 0 1 0 1 0 2 0 2 1 Maj .Imp 04 2859 1 0 1 0 1 0 1 0 1 0 2 0 Comp.Rem05 3000 2 1 2 1 2 1 2 0 2 1 2 1 Min Imp 06 3123 3 2 3 2 3 2 3 2 3 2 3 3 Not Resp 07 3346 2 1 2 1 2 1 1 0 2 1 2 2 Min Imp 08 3373 3 2 3 2 3 2 3 2 3 2 3 3 Not Resp 09 3415 2 1 2 1 2 1 1 0 2 1 2 1 Min Imp 10 3416 2 0 1 0 1 0 1 0 1 0 2 0 Maj Imp 11 3638 1 0 1 0 1 0 1 0 1 0 2 0 Comp.Rem12 3934 2 1 1 0 1 0 1 0 1 0 2 1 Maj Imp 13 4181 2 0 1 0 1 0 1 0 1 0 2 0 Comp Rem14 5010 2 1 2 1 2 0 2 0 2 1 2 1 Min Imp 15 5021 3 2 3 2 3 2 3 2 3 2 3 2 Not Resp
Min Imp- Minor Improvement, Not Resp-Not Responded, Maj.Imp- Major Improvement,
Comp Rem- Complete Remission, BT- Before Treatment, AT- After treatment.
100
Master chart of OBJECTIVE PARAMETERS
Grip Strength Hb%
TC DC(BT) DC(AT) ESR WalkingTime RIGHT LEFT
Sl.no OPD No
BT AT BT AT N L E N L E BT AT BT AT BT AT BT AT
Response
01 5430 11 12 6500 5900 55 38 07 62 32 06 35 30 3 2 13 15.2 13 20 Min Imp 02 0573 10 12 7200 7000 61 35 04 65 30 05 18 10 3 2 20 23.99 13 18.5 CompRem 03 1684 10.2 11 6200 6000 57 37 06 63 30 07 14 12 1 0 38 42 31.2 32.28 Maj Imp 04 2859 10 11 6000 5900 50 42 08 58 36 06 24 15 1 0 28 31.2 22.66 28 CompRem 05 3000 7 7 6900 6000 58 37 05 65 30 05 45 28 2 1 13 15.2 13. 14.1 Min.Imp 06 3123 9 9.5 7000 6600 56 39 05 65 30 05 85 80 3 2 13 13 11.8 11.8 Not Resp 07 3346 8.4 9 6850 6700 53 40 07 61 34 05 40 32 2 1 13 18.5 13 18.5 Min Imp 08 3373 8 8.5 8000 7500 51 41 08 57 36 07 72 68 3 2 20 23.99 13 18.5 Not Resp 09 3415 10 11 7200 7000 48 45 07 58 38 04 60 45 1 0 22.6 25.2 20 22.5 Min Imp 10 3416 12 13 6400 6000 35 61 04 38 56 06 36 28 1 0 28 3102 22.6 25.2 Maj Imp 11 3638 9.2 10 5050 5000 56 41 03 60 35 05 21 14 1 0 38 50 38 42 CompRem 12 3934 10 12 4950 4800 56 40 04 61 32 07 18 12 2 1 38 42 32.8 38 Maj Imp 13 4181 9.6 10.5 5450 5150 64 32 04 65 28 07 20 15 1 0 38 42 38 40 CompRem 14 5010 8 905 5800 5600 54 39 07 64 32 04 55 30 2 1 28 31.2 25.2 28 Min Imp 15 5021 7 7.5 5800 5600 49 42 09 55 36 09 62 45 3 2 13 15.2 13 14.28 Not Resp
Min Imp- Minor Improvement, Not Resp-Not Responded, Maj.Imp- Major Improvement,
Comp Rem- Complete Remission, TC-total count, DC- differential count, N-neutrophils, L-Lymphocytes, E-Eosinophil, BT-before Treatment, AT-After Treatment, Hb%- in gms/dl.
101
102
DISCUSSION
The present topic deals with the interpretation of the materials, which are
explained in previous chapters. Discussion is the solution for most of the things explained
in previous chapters.
Hingula:
It is a chief ore of Mercury and combination of Mercury and Sulphur. In samhita
kala there were no references of Hingula, but we get the reference of parada. The reason
behind this is, in olden days it was assumed to be imported from other countries.
According to Rasendra Mangala Hingula has been called as Darada, because may
be it was available in Darada desha. Rasendra sara samgraha explained Hingula as
Rasagandhaka Sambhoota. It proves that they were very much aware about chemical
composition of individual mineral.
There is a bit of controversy on varieties of Hingula and there is no reference
regarding Hingula varieties in Rasendra Mangala and Rasa Hrudaya Tantra. Rasaratna
samucchaya, Rasendra Chudamani classified Hingula as Hamsapada and Shukatunda.
Ayurevda prakasha and Ananda Kanda classified Hingula in three varieties – Charmara,
Shukatunda and Hamsapada. Rasatarangini classified it as Khanija and Kritrima. Because
it is available in natural form and also can be prepared artificially with the help of
mercury and sulphur.
Hamsapada Hingula has been accepted for this study, because of its less
impurities and ideal one for therapeutic one according to Rasagranthas.
Hingula can be administered after proper purification. Shodhana is adopted to
reduce its toxicity and also to deal for therapeutic purpose. If impure Hingula is
administered, leads to many complications.
Hingula satwa is parada. Rasaprakasha sudhakara quotes that the parada,extracted
from Hingula is having equal property of Shad guna gandhaka jarita parada.
Discussion
103
Rasaratna samucchyakara and Rasamritakara, explains that the Hingulottha
parada is equal to the property of Gandhaka jarita parada.
Generally, marana is not advised for Hingula. Shodhita Hingula can be used for
the preparation of yogas.
Rasamrita explains that, it is used for the marana of Swarna and Loha, because of
its chemical constituent Parada.
Hingula is sarva doshahara, deepana, atirasayana, vrishya, these are explained by
Rasaratna samucchayakara because it contains Parada.
Bhallataka:
It is classified under upavisha. Charaka has explained it as a best kapha and Vata
hara drug. He has advocated use of Bhallataka in 10 different forms like ghruta, ksheera,
etc.
Rasataranginikara has explained its synonym as Vatari, this explains its active
role against vata. Bhallataka is the best drug for kapha and vataja rogas. It should be
subjected to shodhana before it is used. As ama is kaphaja bhava the Bhallataka is used in
resolving the ama and pacifying the vata in Amavata.
Its efficacy in Amavata may be due to its anti inflammatory, Neuroprotective,
immunomodulator, anti rheumatism action.
Vata:
Charaka has included it under Mutrasangrahaniya varga where as Sushruta and
Vagbhata included it under Nyagrodadi gana.
Vata has a property of Kaphahara more than Pittahara. The Latex is Anti-
inflammatory.
Palandu:
All Brahttrayee texts have quoted Palandu. The properties are Vatahara, Vrushya,
and Rasayana. It is an organosulphur compound. The sulphur is essential in the
production of Glucosamine sulphate along with other Proteins. This helps in the
Discussion
104
regeneration of joint tissues and cartilages. It is also proved to be anti inflammatory in
action. The Flavanoids are known to deactivate molecules that are injurious to health.
Lavanga:
It is said to possess kapha pittahara property and is best Ruchya, Deepanapachana.
Kaiyadeva nighatukara has explained its property as Shoolaghna, Vishaghna. The
alkaloid Eugenol along with other Alkaloids is proved to be Anti inflammatory.
Guda:
An Ikshu Vikara obtained by concentrating the juice of Ikshu. It is a rich source of
Iron and Puranaguda is best Vatanashaka, Raktaprasadaka. It is a sucrose sugar.
Ghruta:
It is a Vatapitta shamaka, Balya, Agnidipaka, and is Vishahara. This pacifies the
teekshanata of Bhallataka. This is ascertained by its presence in prepared sample.
Sri Siddhadaradamruta Rasa
A unique preparation for Amavata explained by Rasataranginikara and other Rasa
classics under Hingula Rasayana. The uniqueness of this yoga is potenciating Shuddha
Hingula by Pachana and Dahana samskaras with the drugs which have Amahara and Vata
hara properties. The dose of the drug is also being low i.e. ½ gunja pramana which can be
increased according to the dosha and bala prabhlyata of a patient. The drug is
administered along with Puranaguda in cases of Amavata. In Bhasma vignana it is
explained as Hingula bhasma prepared by Samputa paka.
PHARMACEUTICAL STUDY
The Rasa dravyas being Vijateeya they are subjected to Shodhana samskara
which make them Sajateeya, that is to say that, they are converted in to homogenenous to
the body systems. The Shodhana samskaras has diversified meanings which not only aim
Discussion
105
at making dravya sajateeya but also act in many different ways like increasing the
concentration of active principle, reducing toxicity, enhancing the property of drug.
Hingula Shodana:
Shodhana was carried for Hingula with 7 bhavanas of ardraka swarasa. One of the
advantages of bhavana is to reduce size of the particles. It will be easy for absorption in
GIT.
After bhavana weight of the Hingula was increased i.e. from 500 gms to 545 gms.
Ardraka swarasa contains fibrous matter and starch in abundant which may be the cause
of increase in weight.
Bhallataka Shodhana:
The pericarp of the Bhallataka contains corrosive juice. To minimize its ill effects
its Shodhana with Gomutra is mentioned. During this the juice escaped in Gomutra
Colouring it black and as a tiny droplets.
Gomutra contains certain amount of Ammonia in it. This Ammonia is a good
solvent. It brings out the excess of oils from the pericarp to out side.
Vataksheera Collection:
The collection of Vataksheera was done in Hemantha ruthu i.e. in the month of
Oct- Dec. The period was the sprouting of off shoots. This is what is called as “Pallava”.
When this off shoot was broken it yields latex. This latex was collected and stored in
fridge. The yield was more in the early house of the day i.e. between 5:30 to 7 am.
Palandu Swarasa:
The moderate sized Palandu a red verity was selected for the extraction of
Swarasa. 1 kg of Palandu yielded ½ liter of Swarasa. The Swarasa was pink to look with
characteristic odour.
Cotton Thread:
As cotton is known to tolerate heat for longer hours hence this was made use to
act as a barrier between Hingula and the media used for samskara.
Discussion
106
Samputapaka
The author of Bhasma Vignanam explains that the dravyas which are susceptible
to high temperature like Hingula and somala are usually subjected to this method of paka.
The temperature they obtain by this method is usually between 2500C to 3000C. This is
carried out by jacketing dravya with mamsa pisti, dough, Bhallataka, and frying in taila
or grutha. By this method the structural changes is anticipated.
Dahana Procedure:
In the classics use of funnel for dahana procedure is not mentioned. Dahana if
done directly, the Hg from cinnabar escapes out and there will be great amount of weight
loss in Hingula cake. To minimize the loss by this way the alternate method was planned
i.e. bhalltaka heap was covered with a inverted funnel as a barrier and the sides was filled
with charcoals and ignited. This was most appropriate arrangement as after dahana the
Bhallataka and lavanga choorna was charred and the Hingula also retained its weight.
Probably this is what it was meant by saying “tatha Prajwalayet vanhi Rasatantra
Visharadaihe”
Ghruta Pachana:
The vaporization point of ghruta is very high. At the temperature of 2600C-2800C
It starts evaporating. It means to say that Hingula should be in contact with ghruta at the
temperature till all the ghruta evaporates i.e.10 times the weight of the Hingula. It takes
120 hrs/ 5 days to finish the process. At the end of the procedure thick fiber like structure
were remained with un-evaporated mass. This would be due to the formation of the
polymer which remained rubbery consistency.
After all the samskaras there was a weight loss of 5 gms in each cake. The loss
could be due to the evaporation of Hg from Hingula. This was inferred from the first cake
was prepared according to the classical verses when 80 gms was lost (before 115gms
after 35 gms). Hence the Dahana procedure was modified using in direct heat.
Discussion
107
ANALYTICAL STUDIES
Organoleptic Characters:
The colour of Sri Siddhadaradamruta Rasa is dark brown with Faint smell and
Fine Touch. The colour of Hingula, as noted, changed with the change in temperature and
nature of preparation. The faint smell is seen same in all prepared samples with Hingula.
Flow property:
As the drug is in powder form it is tested for its flow property. This analysis
makes us to know weather any adjuncts are essential for proper flow of drug during
Capsule or Tablet preparation. Flow property was identified by “Angle of Repose
(Tanθ)” and Flow rate by “Compressibility index (I)”. Sri Siddhadaradamruta Rasa has a
good Flow property with Tanθ=37.46±7.86 and Flow rate I=15%.hence it can be said that
it does not need any adjuncts in capsule preparation.
Particle size:
Smaller the particles better the absorption. To know the size of particles the drug
was viewed under microscope and was calculated according to the procedure. This was
done for the sample of Shodhita Hingula and to the prepared drug. The mean Arithmetic
mean was calculated. The mean of both samples are as under-
Arithmetic mean of Shodhita Hingula: 6.53 microns.
Arithmetic mean of Sri Siddhadaradamruta Rasa: 4.788 microns.
The results clearly indicate that the particle size is less for Sri Siddhadaradamruta
Rasa than for Shodhita Hingula even though both are with in the permissible range.
Total fat content:
Sri Siddhadaradamruta Rasa contains 7% of Fat in it. This ascertains that there
was an exchange of pachana material through the cotton thread barrier to the Hingula.
Discussion
108
Test for Alkaloids:
As per the analytical tests there was no Alkaloids detected. The procedure
employed in detection of Alkaloid also plays an important role in interpreting about the
pharmaco kinetics and dynamics of a drug. Here the Alkaloid detection was done using
chemical procedures. Instead if TLC procedure was adopted there would be certain
amount of Alkaloid separation would have been expected, unfortunately the solvent for
cinnabar was not identified.
Assay for Hg% and S%.
Hg% and S% was analysed in Shodhita Hingula and Sri Siddhadaradamruta Rasa
to ascertain the changes after the procedure or in other words the effect of Dahana and
Pachana Samskaras on the Shodhita Hingula was studied.
Sample Hg% S%
Shodhita Hingula 86.10% 12.83%
Sri Siddhadaradamruta Rasa 64.28% 12.28%
Loss on drying at 1100 C.
Sri Siddhadaradamruta Rasa was subjected to the test “Loss on drying 1100c”.It
was evident that weight loss is very minimum i.e. 0.12% which indicates the
preparation is completely free from the moisture.
Solubility:
It is learnt that it is soluble in Alcohol and slightly soluble in water and
Chloroform. That is to say that, 10-30 parts of Alcohol and 30 to 100 parts of
Chloroform and water is essential to dissolve 1gm of the sample.
Discussion
109
ESCA Studies:
In the sample Mercury is present in Oxide and Sulphide forms. No elemental
mercury is present. Majority of mercury is in the form of oxide and less in the Sulphide
form as the sulphide indicated is 5.51% where as Hg in 24.69% and oxide 20.79%. The
sample has mercury oxide and sulphide in the ratio of 60:40. The grutha contain o2 in
abundant quantity and drug is also in oxide form. Perhaps this o2 might have acted in
converting the sulphide in to oxide form. This needs further studies for through
understanding. The peak at 59.3 is due to Selenium oxide and if it is due to elemental
selenium it will be at 54.8, because it is too low in concentration it can not be marked.
This result is in parlance with the views of acharya Hari Sharananda author of Bhasma
vignanam. He has included this drug in Bhasma prakarana and says the Samputapaka
adopted will convert Hingula in to Bhasma form. The drug Sri Siddhadaradamruta Rasa,
satisfies the Bhasma gunas like Rekha purnata, nirasa, but fails to pass varitaratwa. In the
indications of Sri Siddhadaradamruta Rasa one is in Klaibya, as it contains SELENIUM
in smaller doses even this could prove efficacious in such cases. In a recent news article
published in Times of India (27th Feb. 2006) “Jayesh Bellare, Professor, IIT-Bombay,
said, Bhasmas seem to be a natural recipe to make protein coated nano-particles”.
Transforming the inorganic material in to its finest state along with both bringing and
preserving therapeutic property is the sole aim of Ayurvedic pharmaceutics like Bhavana,
Puta, Kupipakwa Rasa, Pottali Rasa.
This is the method of bio-transformation wherein it is a process of pharmaceutics
but not merely a chemical reaction taking place. There occurs a series of chemical
reactions which are useful but not harmful to the body. It is a complex process; analysis
of an isolated preparation cannot concretely give the whole idea. Whatever we are
describing is a tip of an iceberg but it does not describe complete iceberg. In the same
way, the study is to be further carried out so as to know what the possible, probable
reactions may be taking place.
Discussion
110
CLINICAL STUDIES
It is clear in classics that the efficacy of Rasa is enhanced when it is made
agnisthayi hence Parpati, Kupipakwa, Pottali kalpas are put in ascending superiority
therapeutically. In the present context Hingula, again ore of Rasa is subjected to agni
samskara like Dahana, Pachana which is believed to enhance its therapeutic efficacy for
this reason it was subjected to Clinical trail in the cases of Amavata.
It was a prospective clinical trial over 15 patients, randomly selected in a single
group. The results obtained were statistically analysed and mean percentage, SD, SE, and
t values were calculated by using t test. The patients were of either sex, age group
between 20-50 years. The age group assumed as the sex of the patient is concerned, so it
refines the classics. There are more patients 6 (40%) in 41-50 years. Females dominated
11 (73.33%) in the study.
The study records larger no of Hindus 13 (86.66%) compared to other religions.
As the sample size is too small, it cannot be concluded that Hindus are more susceptible
for the disease Amavata. Other reason may be that, it is the reflection of geographical
predominance of particular section of the society i.e., Hindus are dominant in Gadag.
In the study as maximum patients were housewives (53.33%), which simply
correlate with the maximum percentage of female patients. Otherwise occupation as such
was not significant. Majority of the patients belonged to middle (53.33%) socio-
economic group.
86.66% of the patients were vegetarians and 13.33% were having mixed food
habit. This only reflects the predominant diet of the religion.
However majority of the cases under the study had tendency towards kaphaja
ahara (Madhura- 53.33% and Amla- 20%).
Maximum no of patients were having vata- kapha prakruti (46.66%) followed by
vatapitta (33.33%).
Discussion
111
Majority of the patients (73.33%) had no bad habits and 20% were addicted to
tobacco chewing.
Majority of the patients having madhyama sara (73.33%), madhyama satva (60%)
and madhyama samhanana (73.33%) suggesting as in any other disease greater
susceptibility among those who were not in the pink of health.
Sandhi shoola, Sandhishotha, Sthanika ooshmata (jwara), Gouravata, Nidra
viparyaya, jadya were presented by all the patients. The presence of Gouravata in all
patients reflects the involvement of Ama.8 (53.33%) patients had mandagni as nidana at
the same time 8 (53.33%) patients had vid bhaddata as associated complaints.
Cent percent patients were free from extra articular manifestation in eye,
respiratory system, cardiac system, and nervous system. Out of extra articular
manifestation, majority of the patients were affected with systemic complaints such as
loss of appetite. This suggests the early stage of the disease and their prognosis was good.
Clinical response of the treatment:
In this study an effort has been made according to the guide lines laid down by
our classical texts in the selection of patients. All the cardinal symptoms were scored
according to the severity grade. The clinical response of the therapy was assessed on the
basis of change in the severity score after the treatment. The cardinal symptoms like
Sandhishoola, Sandhishotha, Sthanikaooshmata (jwara), Gouravata, Nidraviparyaya,
jadyata were taken into consideration of the functional activity of the patients, laboratory
investigations were also assessed before and after treatment.
Effect on Sandhishoola:
40 % of patients were completely relieved in shoola. The reduction of severity of
pain grade reported statistically significant where p value is less than 0.001.
Effect on Gouravata:
80 % of the patients were completely relieved in Gouravata. Statistically it proved
highly significant with p value < 0.001.
Discussion
112
Effect on Jwara (Sthanika Ushmata):
In Amavata samprapti it clearly explains that the produced Ama under the
influence of vata is taken into the sleshmasthanas hence the Sthanika Ushmata is taken in
to consideration. In pravrudda avastha of Ama sarvanga Jwara is appreciated.
As in the group of patients the pyrexia was not significantly noted, for which
Sthanika Ushmata of the involved joint was considered. 53.33% of patients were
completely relieved in Jwara. Statistically it was reported highly significant with p value
< 0.001.
Effect on Sandhishotha and Nidra Viparyaya:
46% of patients with Sandhishotha were relieved completely whereas 40% of the
patients were relieved completely with Nidraviparyaya. The mean net effect for both the
parameters is same with zero variation.
Effect on Jadyata:
4 (26.66%) patients were relived from Jadyata and 2(13.33%) patient did not
respond to the treatment. This data implies that the effect of drug on Jadyata is good in
the initial stages. Statistically it showed highly significant with p value <0.001.
Effect on Walking Time:
40% patients showed improvement in the walking time. The variation within the
group was zero. Hence same net mean effect before and after the treatment was observed.
Effect on Grip strength:
Certain degree of improvement was recorded among the patients. The statistical
analysis shows highly significant as p value is < 0.001. The mean net Grip strength of
right hand is more with more variance even though left hand grip strength shows more
highly significant than right hand grip strength. This is due to sampling error and
variations among the patients.
Discussion
113
Effect on ESR:
There was a notable change in the ESR reading, before and after the treatment.
The statistical analysis showed highly significant as p value is < 0.001. This reduction is
of much importance which explains the relief in disease process.
Effect on Hb%:
Improvement in the Hb% is a good sign in such patients. In the study there was
marginal increase in Hb% in patients. Statistically it shows highly significant with p
value < 0.001.
Effect on DC:
The lymphocyte also showed highly significant.
Total Effect:
In 15 patients 4 cases showed complete remission, 4 patients demonstrated major
improvement and 4 patients illustrated minor improvement and 3 cases showed no
improvement.
Discussion on Dose
In the classics it is mentioned that the dose of the drug is ½ gunja matra and can
be varied according to the bala of the patient and disease. In the study it is noticed that in
chronic patients the dose was not sufficient. In such condition the dose was increased to 1
gunja two times a day. The maximum dose tried in the trial is 1 gunja three times a day.
Probable mode of Action:
Ama and Vata are the root cause of Amavata. Ama circulates all over the body
causes sroto-avarodha and gets lodged in sandhis and contributes to the formation of the
disease Amavata. The gunas of Ama and Vata are both contradictory in nature, except the
sheeta guna which in common to both.
Discussion
114
Sri Siddhadaradamruta Rasa is prepared with Shodhita Hingula by subjecting into
samskara with drugs like Vataksheera, palandu swarasa, bhallatka, lavanga and ghruta.
Among them, Bhallataka, Lavanga and Palandu have Katu Rasa in common and except
Lavanga both are ushna in veerya. The other drugs are Vata and kaphahara in nature.
They do the deepana, pachana of Ama and relieve sroto-avarodha and pacify Vata, thence
breaking the Ama and same Vata complex.
Hingula has the property of tikta, katu, kashaya and ushna veerya, katu vipaka,
tridoshahara, deepana and amapachaka. It subside Amavata and jwara. It is Rasayana and
balavardhaka, by these properties Hingula pacify jwara and does amapachana, and help in
resolving the samprapti.
Vataksheera and palandu swarasa are best vatahara drugs. Bhallataka is best
known for kaphahara property. It is best deepaka and pachaka. It liquefies the Ama and
thereby resolves Amavata.
It is also known as an immuno-modulator drug, hence it’s used in Amavata and
immune related disorders are much beneficial. It is proved for its anti-inflammatory
activity. Ghruta helps in reducing the teekshnata due to the use of Bhallataka.
Palandu, Hingula are sulphur containing compounds which increase the bile
secretion from liver. This intern helps in correction of digestion and Metabolism within
the body and there by may help in the formation of certain essential proteins, histine,
arginine, and glutamine. Besides sulphur is bacteriostatic, Antiseptic in nature
It is found in ESCA analysis that SSDR contain selenium in oxide form in traces,
because of its action over many of the enzymatic systems under immune system, it may
be responsible for Rasayana activity justifying its phalasruti.
In the present study Puranaguda was selected for Anupana which has a property
of vata shamaka, Agnivardhaka, Ruchya. It is also Raktaprsadaka therefore it improves
the quality of Rasa and Rakta. It is also Ksharayukta and NaatiSheeta hence the quality of
Rasa is improved by it as Anupana in the cases of Amavata.
Discussion
115
Conclusion
1. The inferences of the pharmaceutical study are as under -
The Hingula shodhana was done using Ardraka swarasa Bhavana which again
aims increasing its Amapachana property.
The Bhallataka was made Shuddha by subjecting it to swedana in Gomutra which
is again beneficial in Amavata.
The temp recorded are as –
Pachana with Vata Ksheera and Palandu Swarasa- 800C
Pachana with Grutha-2600 C- 2800C for 5days.
For dahana procedure using inverted funnel was most convincing as in this
procedure the loss of Hg can be cut down to greater extent.
2. Inferences of analytical studies are summed up as-
Samskarohi gunaantardhana ucchate is what was tried to establish by
Analytical gadgets like Organoleptic characters, Hg%, S%,
Pachana and dhahana samskaras adopted in the preparation has definite role in
potencefying the Shodhita Hingula.
The media has certain interaction with the enveloped Hingula cake which was
evident with the presence of 7% fat in the prepared sample and slight acidic ph
(6.66) of prepared sample.
The size of the particle of Sri Siddhadaradamruta Rasa is significantly less than
Shodhita Hingula which means that the samskara had role in making it fine and
obviously make it better absorption.
Colour of Shodhita Hingula is changed from Red to Dark Brown. The taste and
smell remained unchanged.
Loss on drying is 0.12% which determines that the moisture is in negligible
percentage.
Conclusion
116
As a result of Dahana samskara there was certain amount of loss in both Hg% and
S%.
Alkaloids were not identified by the methods adopted. Superior methods should
be taken for help.
The ESCA report suggests that the Selenium presence is increased markedly after
the samskaras.
There is no direct reference for the use of Shodhita Hingula internally, but by this
dahana and pachana samskaras it was made possible for sole administration.
During the clinical study the inferred observation are as-
As the word suggests, in Amavata, the pivoting entities in disease process are
Ama and Vitiated Vata.
Pathogenesis of Amavata is initiated by Ama, occupying various Shleshma
sthanas, mainly joints
On the basis of observations preponderance of Vata and Kapha dosha was found
to play an important role along with Tridosha dushti in the disease. Majority of
patients were middle aged (40%) females (73.33%), Hindus (86.66%),
Housewives (53.33%), of Middle economic status (53.33%), Married (80%),
Vegetarian (86.66%) and having Tobacco addiction (20%)
All the patients of this study were having Dwandaja prakriti with maximum of
Kapha-Vata prakriti (46.66%), madhyama Sara (73.33%), Madhyama Samhanana
(73.33%), Madhyama Satva (60%), sadharana desha (66.66%).
From the findings of the clinical study it can be concluded that Sri
Siddhadaradamruta Rasa is better effective in Navottha Amavata.
Conclusion
117
The statistical data showed highly significant (p<0.001) in all individual
subjective and objective parameters, affirms that there was significant efficacy of
the drug noted in the clinical study justifies it.
The over all result is 4 (26.66%) patients showed complete remission, 4 (26.66 %)
patients showed major improvement, 4 (26.66 %) patients showed minor
improvement, 3 (20%) patients showed no improvement,
Limitations
1. The duration of the study was precise.
2. As the sample was small and it was a prospective clinical trial.
3. Minimum instrumental and investigatory facilities.
Scope for further study.
1) The samskaras might influence on the structural change or has the chance of
converting the drug in to its isomer. This has to be appreciated by sophisticated
instrumental analysis like x-ray diffraction.
2) Further the drug has to be tried over the other indications to establish its efficacy.
3) The drug has to be tried in chronic Amavata condition with higher dosage.
4) Various shodhana procedures has to be carried out on Hingula and then subjected
to Pachana and Dahana samskaras with same media and analytical and clinical
study may be compared.
5) The exact solvent for Hingula has to be identified and tested for the separation of
Alkaloids.
6) The study of nano particles in relevance to this Hingula bhasma is proposed.
Conclusion
118
SUMMARY
The present dissertation work entitled “Preparation and analytical study of
Sri Siddhadaradamruta Rasa and its clinical efficacy in Amavata” contains topics
introduction, methodology which embraces pharmaceutics, analytical study, clinical
study, observations, results, discussion and conclusion.
“Samskaro hi naama Gunantardhanam Ucchyate” is best explained by taking
into account of the Rasa Rasayana kalpas. The agni samskara given to parada to make it
agnisthayi improves its efficacy to manifold. Sri Siddhadaradamruta Rasa is one such
preparation, wherein Hingula, the ore of parada, is subjected to dahana and pachana
samskaras with different media which makes its properties enhanced to greater extent.
The media used in the study are like Vata ksheera, Palandu swarasa, Shodhita Bhallataka,
lavanga, ghruta in toto have amapachana, kaphahara, vatashamaka, Rasayana properties.
Amavata is a crippling disease which presents with simple arthralgia to severe
complications. It is a disease entity wherein improperly metabolized intermediate by
product, Ama, under influence of vata takes shelter in the sleshma sthanas. The treatment
modality aims at breaking the Ama and vata complex- samprapti and resolve Ama.
The impact of samskara on the drug is analysed by the changes in the organoleptic
characters and analytical methods focusing mainly on Hg % and S % before and after the
samskara, presence of alkaloid and media substrates in the prepared sample. It was noted
that there was significant change in the organoleptic characters, flow rate, fineness of
particle. There was presence of media used for pachana in the prepared sample like
ghruta which may imply the exchange of materials through the barrier i.e., a cotton thread
envelope. The chemical tests for the presence of alkaloid using picric acid and vagnors
reagent did not establish the presence of alkaloid. To know the status of mercury and
sulphur in the compound further ESCA was done, which reported that Hg was both in the
form of sulphide and oxide in 40:60 ratio respectively. It could be approximated that the
Summary
119
drug after samskara has turned in to a Bhasma form bearing in mind for the opinion of Sri
Harisharananda sharma.
With this analytical background it was assumed to have definite changes in
therapeutical activity. Hence it was put to test in the selected cases of Amavata which
diagnosed as per classical signs and symptoms.
It was a prospective clinical trial over 15 patients, randomly selected in single
group. The results obtained were statistically analysed and mean percentage, SD, SE, and
t value were calculated by using student t test.
The cardinal symptoms like sandhishoola, sandhishotha, jwara (Sthanika
Ushmata), gouravata, nidraviparyaya, jadya were present in almost all the cases. The
parameters which reflects the Ama condition was considered for assessment. The
objective parameter ESR was assessed which is a marker of disease process along with
other parameter like walking time and Grip strength.
There was a marked response after treatment in the parameter sandhishoola
(40%), sandhishotha (46.66%), jwara (Sthanika Ushmata) (53.33%), gouravata, (80%)
nidranasha (40%).jadyata (26.66%) The ESR also showed highly significant statistically.
The changes in the ESR readings were present but not drastic changes. The parameters
walking time and grip strength were also statistically highly significant. The overall
response in the treatment was that 4 patients had shown complete remission, 4 patients
had shown major improvement. 4 patients had shown minor improvement, and 3 patients
had no improvement.
Summary
120
Bibilography
1. Rasatantrasara-va- Siddhaprayoga Sangraha,16th edition,Krishna gopal Ayurveda
bhavan , Part -1 Kharaleeya Rasayana, Pg-484.
2. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 36-49, p. 905.
3. Hari sharananand vidya, Bhasmavignana part-2,1st edition-1, publisher-Panjab
Ayurvedic press, 1954 pg-393.
4. Ayurveda Sarasangraha, Edt by Vd.Ramnarayana Sharma 12th edition,Kolkatta:
Bydyanath Ayurved bhavan, Rasayana Prakarana, p-412.
5. Siddhinandana Mishra, Ayurvediya Rasashastra, 5th Edition, Varanasi :
Choukhamba Orientalia, 1994, Sadharana Rasavarga, p. 485.
6. Nagarjuna, Rasendra Mangala, edited by Kaviraj H.S. Sharma, 1st edtion, Varanasi :
Choukhamba Orientalia, 2003, 1st chapter, shloka 43, p. 18.
7. Srimad Govinda Bhagvatapadacharya, Rasahridayatantra, edited by Rameshwara
Dayalu Someeyajilu, 1st edition, Varanasi : Krishnadasa Academy, 1998, shloka no.
4. p. 76.
8. Indradeva Tripathi, Rasaavarana Nama Rasaratnam, 4thedition, Varanasi :
Choukhamba Sanskrit Series, 2001, Jwarachikitsa, shloka 2, page 86.
9. Indradeva Tripathi, Rasendrasara Sangraha, edited by Siddhinandana Mishra, 1st
edition, Varanasi : Choukhamba Orientalia, 2003, Jwarachikitsa, shloka 235, page
60.
Bibiliography
121
10. Srimad Govinda Bhagvatapadacharya, Rasahridayatantra, edited by Rameshwara
Dayalu Someeyajilu, 1st edition, Varanasi : Krishnadasa Academy, 1998, shloka no.
4. p. 76.
11. Indradeva Tripathi, Rasaavarana Nama Rasaratnam, 4th edition, Varanasi :
Choukhamba Sanskrit Series, 2001, Saptamapatala, shloka 2, page 86.
12. Radhakrishna Shastri, Ananda Kanda, Tanjore : S. Gopanalan TMSSM Library,
1952, Kriyakarma nama dwitiya vishruti, prathama ullasa, shloka 4, p. 522.
13. Indradeva Tripathi, Rasendrasara Sangraha, 1st edition, Varanasi : Choukhamba
Orientalia, 1989, chapter 1st, shloka 118-119, p.30.
14. Dattaram Choube, Brihatrasaraj Sundar, 2nd edition, Varanasi : Choukhamba
Orientalia, 2000, p.164.
15. Acharya Madhava, Ayurveda Prakasha, editor Gularaja Sharma Mishra, Varanasi :
Choukhamba Bharateeya Academy, 1999, chapter 2nd, shloka 1, p. 252.
16. Shri. Buddhadeva Mookerjee, Rasajala nidhi, edited by Siddhinanadana Mishra, 2nd
edition, Varanasi : Shri. Gokulamangala Mudranalaya, 1984, p.2.
17. Acharya Somadeva, Rasendra Chudamani, editor Siddhinanadana Mishra, 2nd
edition, Varanasi : Choukhamba Orientalia, 1999, chapter 11th, shloka 60-61, p.
190.
18. Acharya Yashodhara, Rasaprakasha Sudhakara, editor Siddhinanadana Mishra, 3rd
edition, Varanasi : Choukhamba Orientalia, 2004, chapter 6th, p. 127.
19. Vagbhatacharya, Rasaratna Samucchaya, editor Ambikadatta Shastri, 9th edition,
Varanasi : Choukhamba Ambarabharati Prakashana, 1998, chapter 3rd, shloka 126-
127, p. 80.
Bibiliography
122
20. Radhakrishna Shastri, Ananda Kanda, Tanjore : S. Gopanalan TMSSM Library,
1952, Kriyakarma nama dwitiya vishruti, prathama ullasa, shloka 181-182, p. 542.
21. Acharya Somadeva, Rasendra Chudamani, editor Siddhinanadana Mishra, 3nd
edition, Varanasi : Choukhamba Orientalia, 1999, chapter 11th, shloka 106, p. 194.
22. Acharya Madhava, Ayurveda Prakasha, editor Gularaja Sharma Mishra, Varanasi :
Choukhamba Bharateeya Academy, 1999, chapter 2, shloka 69-71, p. 272-273.
23. Vagbhatacharya, Rasaratna Samucchaya, editor Ambikadatta Shastri, 9th edition,
Varanasi : Choukhamba Ambarabharati Prakashana, 1998, chapter 3rd, shloka 147,
p. 83.
24. Acharya Yashodhara, Rasaprakasha Sudhakara, editor Siddhinanadana Mishra, 3rd
edition, Varanasi : Choukhamba Orientalia, 2004, chapter 6th, shloka 85, p. 130.
25. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 4, p.199.
26. Yadavaji Trikamaji Acharya, Rasamrita, editor Damodara Joshi, 1st edition,
Varanasi : Choukhamba Sanskrit Bhavana, 1988, chapter 1st, p. 26.
27. Vagbhatacharya, Rasaratna Samucchaya, editor Ambikadatta Shastri, 9th edition,
Varanasi : Choukhamba Ambarabharati Prakashana, 1998, chapter 3rd, shloka 149,
p. 83.
28. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 11, p.200.
29. Brihat Rasarajasundar,edited by Dattaram Choube, 3rd edition, Varanasi :
Choukhamba Orientalia,2000, UparasaPrakarana,p-168.
Bibiliography
123
30. Indradeva Tripathi, Rasaavarana Nama Rasaratnam, 4thedition, Varanasi :
Choukhamba Sanskrit Series, 2001, Saptampatala, shloka 236, page 60.
31. Acharya Yashodhara, Rasaprakasha Sudhakara, editor Siddhinanadana Mishra, 3rd
edition, Varanasi : Choukhamba Orientalia, 2004, chapter 6th, shloka 86, p. 130.
32. Vagbhatacharya, Rasaratna Samucchaya, editor Ambikadatta Shastri, 9th edition,
Varanasi : Choukhamba Ambarabharati Prakashana, 1998, chapter 3rd, shloka 152-
153, p. 83.
33. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 12, p.201.
34. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 16-17, p.202.
35. Vagbhatacharya, Rasaratna Samucchaya, editor Ambikadatta Shastri, 9th edition,
Varanasi : Choukhamba Ambarabharati Prakashana, 1998, chapter 3rd, shloka 154,
p. 84.
36. Acharya Madhava, Ayurveda Prakasha, editor Gularaja Sharma Mishra, Varanasi :
Choukhamba Bharateeya Academy, 1999, chapter 2, shloka 76, p. 275.
37. Vagbhatacharya, Rasaratna Samucchaya, editor Ambikadatta Shastri, 9th edition,
Varanasi : Choukhamba Ambarabharati Prakashana, 1998, chapter 3rd, shloka 151-
152, p. 83.
38. Acharya Yashodhara, Rasaprakasha Sudhakara, editor Siddhinanadana Mishra, 3rd
edition, 2004, Varanasi : Choukhamba Orientalia, chapter 6th, shloka 87-88, p. 130.
39. Acharya Madhava, Ayurveda Prakasha, editor Gularaja Sharma Mishra, Varanasi :
Choukhamba Bharateeya Academy, 1999, chapter 2, shloka 72, p. 274. %%%%
Bibiliography
124
40. Acharya Somadeva, Rasendra Chudamani, editor Siddhinanadana Mishra, 3nd
edition, Varanasi : Choukhamba Orientalia, 1999, chapter 11th, shloka 107-108, p.
195.
41. Yadavaji Trikamaji Acharya, Rasamrita, editor Damodara Joshi, 1st edition,
Varanasi : Choukhamba Sanskrit Bhavana, 1988, chapter 1st, shloka 52-53, p. 27.
42. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 18-19, p.202.
43. P.V. Sharma, Dhanwantari Nighantu, editor Guruprasada Sharma, 1st edition,
Varanasi : Choukhamba Orientalia, 1982, chapter Suvarnadi varga, shloka 37-39, p.
185.
44. Narahari Pandita, Rajanighantu editor Indradeva Tripathi, 2nd edition, Varanasi,
Krishnadasa Academy, Suvarnadi varga,, shloka 58, p. 439.
45. P.V. Sharma, Kaiyadeva Nighantu, 1st edition, Varanasi : Choukhamba Orientalia,
1989, chapter Dhatuvarga, shloka 92, p. 238.
46. Shri Gopala Krishna, Rasendra Sarasangraha, editor Ashok D. Satputte, 1st edition,
Varanasi : Krishnadasa Academy, 2003, chapter 1, p. 147.
47. Agnivesha, Charaka samhita, editor Kashinatha Shastri and Gorakhanatha
Chaturvedi, 12th edition, Varanasi : Choukhamba Bharatee Academy, 1994,
chikitsasthana, chapter 1st chapter, shloka 16-19, p. 33.
48. J.L.N.Shastry, Illustrated Dravyaguna Vijnana, 1st edition, Varanasi : Choukhamba
Orientalia, p.135.
49. Yogaratnakara, Yogaratnakara, edited by Laxmipati Shastri, 5th edition, Varanasi,
Choukhamba Sanskrit Samsthana, 1993, Poorvardha, shloka 1, p. 567
Bibiliography
125
50. J.L.N.Shastry, Illustrated Dravyaguna Vijnana, 1st edition, Varanasi : Choukhamba
Orientalia, p.136.
51. Kirtikar .K.R.andB.D. Basu, Indian medicinal plants, Edited by E Blatter,J.F.Caius
and K.S.Mhaskar. 2nd edition, 1999, vol-I p-667.
52. FRLHT CD document
53. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 24th Taranga, shloka 473, p.734.
54. I.Bid, shloka 477-478,p-735
55. I.Bid, shloka 479,p-735
56. Rasatantrasara-va- Siddhaprayoga Sangraha,16th edition,Krishna gopal Ayurveda
bhavan , Part -1 DravyaShodana Prakarana, Pg-.76
57. I.Bid, Pg-77
58. Bhavamishra, Bhavaprakasha nighantu, edited by Bheemashankara shastri, 6th
edition, Varanasi : Choukhamba Samskruta Samsthana, 1984, chapter Haritakyadi
varga, shloka 232, p. 139.
59. P.V. Sharma, Dhanwantari Nighantu, editor Guruprasada Sharma, 1st edition,
Varanasi : Choukhamba Orientalia, 1982, chandanadi varga, p. 114.
60. P.V. Sharma, Kaiyadeva Nighantu, 1st edition, Varanasi : Choukhamba Orientalia,
1989, chapter Oushadhi varga, shloka 494-500, p. 90.
61. Sadananda Sharma, Rasatarangini, edited by Kashinatha Shastri, 11th edition,
Varanasi : Motilala Banarasi Das, 1979, 9th Taranga, shloka 480-481, p.736.
62. Pandita Narahari, Rajanighantu, edited by Indradeva Tripathi, 2nd edition, Varanasi
: Krishnadasa Academy, 1998, chapter Amradi varga, shloka 66-69,p. 352
Bibiliography
126
63. Kirtikar .K.R.andB.D. Basu, Indian medicinal plants, Edited by E.Blatter, J.F.Caius
and K.S.Mhaskar. 2nd edition, 1999, vol-I p-667.
64. Vaidya V.M.Gogte, Ayurvedic Pharmacology and Therapeutic uses of Medicinal
Plants.1st Edition 2000, pg-714.
65. K.M. Nadakarani, Indian Materia Medica Vol - I, editor A. K. Nadakarni, 3rd
edition, Bombay : Popular Prakashana Private Limited, 1982, p.544.
66. J.L.N.Shastry, Illustrated Dravyaguna Vijnana, 1st edition, Varanasi : Choukhamba
Orientalia, p.941.
67. P.V. Sharma, Kaiyadeva Nighantu, 1st edition, Varanasi : Choukhamba Orientalia,
1989, chapter Oushadhi varga, shloka 423, pg-78.
68. P.V. Sharma, Dhanwantari Nighantu, editor Guruprasada Sharma, 1st edition,
Varanasi : Choukhamba Orientalia, 1982, Amradi varga, Sholka 69-70,p.161.
69. Bhavamishra, Bhavaprakasha nighantu, edited by Bheemashankara shastri, 6th
edition, Varanasi : Choukhamba Samskruta Samsthana, 1984, chapter Haritakyadi
varga, shloka 1-2, p.513.
70. Kirtikar .K.R.andB.D. Basu, Indian medicinal plants, Edited by E.Blatter, J.F.Caius
and K.S.Mhaskar. 2nd edition, 1999, vol-III p-2313.
71. Vaidya V.M.Gogte, Ayurvedic Pharmacology and Therapeutic uses of Medicinal
Plants.1st Edition 2000, pg-658.
72. http.www.liv.ac.uk/onion/biosynthesis.htm date;20/11/05
73. Ibid., dept of Biochemistry,University of Kerala, India
Bibiliography
127
74. Bhavamishra, Bhavaprakasha nighantu, edited by Bheemashankara shastri, 6th
edition, Varanasi : Choukhamba Samskruta Samsthana, 1984, chapter Haritakyadi
varga, shloka 226, p.134.
75. P.V. Sharma, Kaiyadeva Nighantu, 1st edition, Varanasi : Choukhamba Orientalia,
1989, chapter Oushadhi varga, shloka 1222-1224, pg-226.
76. Pandita Narahari, Rajanighantu, edited by Indradeva Tripathi, 2nd edition, Varanasi
: Krishnadasa Academy, 1998, chapter Amradi varga, shloka 57-61,p. 199
77. P.V. Sharma, Dhanwantari Nighantu, editor Guruprasada Sharma, 1st edition,
Varanasi : Choukhamba Orientalia, 1982, Amradi varga, Sholka 66-67,p.133.
78. Journal: Onion-Phyto chemical and health properties provided by the national onion
association. www.liv.ac.uk. Date: 20/11/05
79. Vaidya V.M.Gogte, Ayurvedic Pharmacology and Therapeutic uses of Medicinal
Plants.1st Edition 2000, pg-475.
80. www.essentialoils.co.ze/glossary date: 20/11/05
81. Pandita Narahari, Rajanighantu, edited by Indradeva Tripathi, 2nd edition, Varanasi
: Krishnadasa Academy, 1998, chapter Amradi varga, shloka 81-84,p. 412
82. P.V. Sharma, Kaiyadeva Nighantu, 1st edition, Varanasi : Choukhamba Orientalia,
1989, chapter Oushadhi varga, shloka 1333-1334, pg-247.
83. P.V. Sharma, Dhanwantari Nighantu, editor Guruprasada Sharma, 1st edition,
Varanasi : Choukhamba Orientalia, 1982, Sholka 39-40,p.98.
84. www.essentialoils.co.ze/glossary date: 20/11/05
Bibiliography
128
85. Bhavamishra, Bhavaprakasha nighantu, edited by Bheemashankara shastri, 6th
edition, Varanasi : Choukhamba Samskruta Samsthana, 1984,Poorva khanda,
chapter Ikshuvarga, shloka 26, p.895.
86. Sushruta, Sushruta samhita, editor Ambikadatta Shastri, 13th edition, Varanasi :
Choukhamba Saskrit Samsthana, 2002, Sutrasthana, chapter 45, shloka 160, p. 183.
87. P.V. Sharma, Kaiyadeva Nighantu, 1st edition, Varanasi : Choukhamba Orientalia,
1989, chapter Oushadhi varga, shloka 135-136.
88. Net source: Journal: East Meets West Times Globe staff. Authour: Dr. G.
R.Gokani. [email protected]
89. Agnivesha, Charakasamhita, Chikitsasthana, editor Kashinatha Shastri 12th edition,
Varanasi : Choukhamba Bharateeya Academy, 1984, chapter 13th, shloka 9, p. 382.
90. Vagbhatacharya, Ashtanga Hridaya, editor Yadunandana Upadhyaya, 11th edition,
Varanasi : Choukhamba Orientalia, 1993, chapter 13, shloka 25, p. 99.
91. Vagbhatacharya, Ashtanga Hridaya, editor Yadunandana Upadhyaya, 11th edition,
Varanasi : Choukhamba Orientalia, 1993, chapter 13, shloka 26, p. 99.
92. Ayurmedline, Dr. S. Prabhakara, Jan. to June 2001, Dr. Seetaram Banglore, Pravin
Madikonda, Prof. R.H. Singh, New dimensions of concepts of Ama, p. 33-36.
93. Acharya Madhava, Madhava nidana, Vijayarakshita, Sudarshana Shastri, 25th
edition, Varanasi : Choukhamba Sanskrit Bhavama, 1995, shloka 1-5, p. 460.
94. Yogaratnakara, Laxmipati Shastri, 6th edition, Varanasi : Choukhamba Sanskrit
Samsthana, 1997, Poorvardha, Amavata nidana, shloka 1-5, p.564.
95. Acharya Madhava, Madhava nidana, Vijayarakshita, Sudarshana Shastri, 25th
edition, Varanasi : Choukhamba Sanskrit Bhavama, 1995, shloka 6, p. 462.
Bibiliography
129
96. Yogaratnakara, Laxmipati Shastri, 6th edition, Varanasi : Choukhamba Sanskrit
Samsthana, 1997, Poorvardha, Amavata nidana, shloka 1-2, p.564-565.
97. Acharya Madhava, Madhava nidana, Vijayarakshita, Sudarshana Shastri, 25th
edition, Varanasi : Choukhamba Sanskrit Bhavama, 1995, shloka 7, p. 462-463.
98. Acharya Madhava, Madhava nidana, Vijayarakshita, Sudarshana Shastri, 25th
edition, Varanasi : Choukhamba Sanskrit Bhavama, 1995, shloka 8-10, p. 463.
99. Acharya Madhava, Madhava nidana, Vijayarakshita, Sudarshana Shastri, 25th
edition, Varanasi : Choukhamba Sanskrit Bhavama, 1995, shloka 11, p. 463.
100. Acharya Madhava, Madhava nidana, Vijayarakshita, Sudarshana Shastri,
25th edition, Varanasi : Choukhamba Sanskrit Bhavama, 1995, shloka 12, p. 464.
101. Yogaratnakara, Laxmipati Shastri, 6th edition, Varanasi : Choukhamba Sanskrit
Samsthana, 1997, Poorvardha, Amavata nidana, shloka 1, p. 568.
102. Chakrapani Datta, Chakradatta Jagadishwara Pasada Tripathi, 4th edition,
Varanasi : Choukhamba Sanskrit Series, 1976, chapter 25th, shloka 1, page 225.
103. Shri. Govindadas, Bhaishajya Ratnavali edited by Ambikadatta Shastri, 11th
Edition, Varanasi : Choukhamba Sanskrit Samsthana; 1996, Chapter 29th Amavata
chikitsa, shloka 1, p. 431.
104. Yogaratnakara, Laxmipati Shastri, 6th edition, Varanasi : Choukhamba
Sanskrit Samsthana, 1997, Poorvardha, Amavata nidana, shloka 1-4, p. 573.
105. Vinayakumar, Basic Pathology, 5th edition, Philadelfia, W. B. Sundar’s company,
1992, chapter 6th, p. 145.
106. Harisson’s, Principles of Internal Medicines, Vol – II, 15th edition, Braunwald,
Fauci Casper, Jemsons, 2003, Boston : Mc Graw Hill, chapter 12th, p. 1928.
Bibiliography
130
107. A.P.I. Textbook of Medicine, editor Dr.Siddharth.N..Shah, 7th edition, Mumbai :
Association of Physicians of India, 2003, Section 17th, p.1160.
108. Davidson’s, Principles and Practice of Internal Medicine, CRW, Ederverts,
Bouchers, 7th edition, Edinburgh, Churchill Livingstone, 1995, chapter 15th, p. 889.
109. Harisson’s, Principles of Internal Medicines, Vol – II, 15th edition, Braunwald,
Fauci Casper, Jemsons, 2003, Boston : Mc Graw Hill, chapter 12th, p. 1929.
110. A.P.I. Textbook of Medicine, editor Dr.Siddharth.N..Shah, 7th edition, Mumbai :
Association of Physicians of India, 2003, Section 17th, p.1161.
111. Ibid.
112. Ibid Pg-1161-1162
113. I.Bid,Pg-1163.
114. Harisson’s, Principles of Internal Medicines, Vol – II, 15th edition, Braunwald,
Fauci Casper, Jemsons, 2003, Boston : Mc Graw Hill, chapter 12th, p. 1933.
115. Davidson’s, Principles and Practice of Internal Medicine, CRW, Ederverts,
Bouchers, 7th edition, Edinburgh, Churchill Livingstone, 1995, chapter 15th, p. 896-
902.
116. Davidson’s, Principles and Practice of Internal Medicine, CRW, Ederverts,
Bouchers, 7th edition, Edinburgh, Churchill Livingstone, 1995, chapter 15th, p. 903.
Bibiliography
CASE SHEET PROFORMA
DEPARTMENT OF RASASHASTRA DGM AYURVEDIC MEDICAL COLLEGE, GADAG
Topic: PREPARATION AND ANALYTICAL STUDY OF SRISIDDHADARDAMRUTA
RASA AND ITS CLINICAL EFFICACY IN AMAVATA.
Guide: Dr.M.C.Patil Dr. Pradeep.Agnihotri M.D(Ayu) P.G.Scholar
Co-Guide: Dr.G.N. Danappagoudar M.D (Ayu)
01. Name: Sl.No:
02. Father’s/Husband’s Name: O.P.D.No. 03.Age : D.O.I. : Years 04. Sex: D.O.C.: 05. Marital Status:
06. Religion : 07. Occupation: 08.Ecconomical Status: 09. Address:
Telephone :
Married Unmarried
Hindu Muslim Christian Others
Labour Sedentary Active Housewife
Poor class Middle class Upper class
M F
Complete remission
Major improvements
Minor improvements
No improvement
10. Result : 11.Consent : I ------------------------- Son| Daughter| Wife of---------------- Exercise my free will in
the said study, I have been informed to my satisfaction by the attending the purpose of the clinical evaluation and nature of drug treatment. I was also aware of my right to quit at any time during the schedule.
Patient’s Signature
1
11. Chief complaints:
Sl.No. Complaints P/A Duration
01. Sandi shoola
02. Sandhi shotha
03. Jadya
04. Jwara
05. Vrischika Danshavata Peeda
12. Associated complaints:
Sl.No. Complaints P/A Duration
01. Angamarda
02. Aruchi
03. Gourava
04. Nidra viparyaya
05. Bahumootrata
06. Trushna
07. Apaka
08. Daha
09. Alayasya
10. Vid vibandhata
2
13. History of present illness: Mode of onset Insidious Acute Chronic Sequence of joint involved:
Monoarticular Polyarticular Asymmetrical symmetrical Oligoarticular
Aggravating factors:
Relieving factors: Nature of disease: Progressive Regressive Constant Intermittent
Routine activities
Mild Moderate Severe Not affected
affected: 14. Family history: 15. Previous treatment history: Steroid dependent: NSAID’s: Others:
3
16. Personal history: Ahara : Jatharagni: Nidra : Vyasana : Artava pravriti: 17. General examination: 18. Atura bala pareeksha: Prakriti Sara: Samhana: Satmya:
Manda Teekshna Vishama Sama
Sukha Alpa Ati Vaishyamya
Smoking Alcohol Tobacco No habit
Days Samya Alpa Adhika Rajo nivritti
Pulse B.P. Temp. Resp.rate Height Weight Heart rate
V P K VP KP VK VPK
Pravara Madhyama Avara
Pravara Madhyama Avara
Pravara Madhyama Avara
Taste Sweet Sour Salt Vegetarian Mixed Predominance Pungent Bitter Astringent
4
Satwa:
Pravara Madhyama Avara
Vyayama shakti:
Pravara Madhyama Avara
Vaya: Balya Youvana Vruddha Desha: Jangala Anupa Sadharana Ashtasthana pareeksha:
• Nadi: Shabda: • Mootra: Sparsha :
• Mala: Drika: • Jihwa: Akruti:
19. Systemic examination:
a) Cardiovascular system:
b) Respiratory system:
c) Digestive system d) Nervous system:
5
20. Special examination of the joints:
A] Pain:
i) Mode of onset: Sudden Gradual
ii) Site: Localized Referred to other joints iii) Trauma: P/A If P
iv) Character: Aching Throbbing Pricking v) Moment aggravates pain: Yes No
vi) Relation to
weather: Worst in weather
B] Morning stiffness: Present Absent 0 1 2 3 C] Inspection:
P/A If P i) Any other deformity: ii) Soft tissue swelling: Present Absent iii) Skin over the joint: Redness Itching Glossiness Oedma iv) Muscle wasting: P/A If P Above the
affected joint Below the
affected joint
v) Rheumatoid nodes:
P/A If P
6
D] Palpation: i) Local temperature: Present Absent
ii) Maximum tenderness: Bone Ligament Tendon
sheet Others
iii) a. Flexion deformity b. Extension deformity 21. Nidana pareeksha:
` I. Nidana :
Viruddha Bhojana
Virudha chesta
Vyayama after Snigdha Bhojana
Mandagni
II. Upashaya / Anupashaya : 22. Lab investigations:
Sl.No Name of the test Value A Blood 01. Hb% mg % 02. ESR mm for I hour 03. Total count %
N E B M L 04. Differential count
b. Radiological examination:
7
23 . Intervention: Trail medicine drug: Sri Siddhadaradamruta rasa.
Dose : Started on:
Anupana : Completed on :
24. Assessment of results: Subjective parameters
Objective parameter:
Sl. No. Complaints 0 day 15 days 30 days 45 days 01. Sandhi shoola 02. Sandhi shotha 03. Jadya 04. Jwara 05 Gouravata 06 Nidraviparyaya
S.No Parameters 0 day 30 days
01. Hb % 02. TC
N E B M L N
E B M L 03. DC
04. ESR
Sl.No Parameter 0 day 15 day 30 day 45 day
05 Walking time
06 Grip strength Rt- Lt- Rt- Lt- Rt- Lt- Rt- Lt-
Investigator note: Signature of Scholar Signature of Guide Signature of Co-Guide
8
Score sheet 01. Sandhishoola. 0=No complaints 1=Patient tells about after inquiry 2=Patient frequently complaints 3=Excruciating condition 02. Sandhi shotha 0=No complaints 1=Slight obvious 2=Covers well the boney prominence 3=Much elevated
03. Jwara(Sthanika Ushmata) 0 = Normal 1= During severity of Pain 2 = During severity of pain with swelling. 3 = Continue shula with pain 04. Jadya 0 = No stiffness. 1 = Stiffness for 5 minutes to 1 hour. 2 = Stiffness for1-2 hours. 3 = Stiffness for more than 2 hours.
05. Nidraviparyaya: 0= No discomfort. 1= discomfort during night. 2= discomfort during night and affects day. 3= day sleep and Night awakes. 06 Gouravata: 0= No gouravata 1= during morning up to 1Hr 2= continues in the morning<24 Hrs. 3=throughout the day. Walking time: (To cover 21 meters) 0= Up to 20 seconds.
1= 21 – 30 ” 2= 31 – 40 ” 3= 41 – 50 ” 4= 51 – 60 ” 5= 60 ”
9
Annexure I •
Slokas of - • • • • •• • • • • • • • • • • •• •
• • • • • • • • • •• • • • • • • • • • • • • • • • • •• • • • • • • •• • •• • •• • • • • • • • • • • • • • • • • • • • • • • • •
• • • • •• • • • • •• • •• • • • •• • • •• • •• • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • •• • •• • • • • • •• • • • • • • • • • • • •• • • • • •• • • • • • • • • • •• • • •• • • • • • • • •• • • • • • • • • • • • • • • • •• • • • • • • • • • • •• • • • •• • • • • • • • • •• • • • •• • • • • • •• • • • •• • • • • • • • • • • • • • •• • • •• • • • • • • • • • • • • • •• • • • •• • • • • • • • •• •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • •• • • • •
• • • • •• • • • • • • • •• • • • • • • •• • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • •• • • • •• • • • • • • • • • •• • • •• • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • •• • ••• • • • • • • • • • • • • • • • • • • • • • • • • • •
• • • • •• • • • • • • • •• • • • • •• • • • • • • •• • • • • • • • • • • • • •• • • • • • • •• • • • • • • • • • • • •• • • • •• • • • • • • • • • •• • • •• • • • • •• • • • • • • • • • • • • • • • •• • • • • • • • • • • • •• • • • •• • • • •• • • • • • • • • •• • • • • •• • • •• • • •• • • • • • •• • •• • • • • • •• • • •• • • •• • • • • • • • • • • • • • • •• • • • • • • • • • • • •• • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • •• • • • • • • • • • • • •• • • • • • • • •• • • • •• • • •• • • • • • • • • • • • • •• • • • • • •• • •• • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • •• • • • • • • • • • • • • • • • •• • ••• • • • • • • • • • • • • • • • • • • • • • • • • • ••
• • • • • •• • • • • • • • • • • • • • • • • •
• • •• • • • • • • • • • • • • • • •• • • • • • • • • • •• • • • • • • • •• • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • •
• • • • • • • • • • • •• • • • • • • • • • • •• • • • • • • • • • • • •• • • • • •• • • •• • • • • • •• • • • • • • • • • •• • • •
• • •• • • • • • • • • • • • • • • • • • • • • • • •• • •• • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • •• • • • ••• • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • •• • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • •• • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • •• • • • •