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INDEX – GJRMI - Volume 4, Issue 2, February 2015
INDIGENOUS MEDICINE
Ayurveda - Review Article – Dravya Guna
CONTRIBUTION OF DHANWANTARI NIGHANTU TOWARDS DRUG SAFETY: A CRITICAL
REVIEW
Anagha Ranade*, Rabinarayan Acharya 20–29
Ayurveda - Review Article – Moulika Siddhanta
CONCEPT OF LIFESTYLE IN AYURVEDA CLASSICS
Saylee Deshmukh*, Mahesh Vyas , Hitesh Vyas, Dwivedi R R 30–37
Ayurveda – Kaumarabhritya
CLINICAL EVALUATION OF AN AYURVEDIC FORMULATION IN THE MANAGEMENT OF
MENTAL RETARDATION
Deepa Makhija*, Pratap Makhija, Babasaheb Patil 38–45
COVER PAGE PHOTOGRAPHY: DR. HARI VENKATESH K R, PLANT ID – FRUIT OF SHWETHA GUNJA – ABRUS PRECATORIUS L. OF THE
FAMILY LEGUMINOSAE PLACE – KOPPA, CHIKKAMAGALUR DISTRICT,
KARNATAKA, INDIA
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal
CONTRIBUTION OF DHANWANTARI NIGHANTU TOWARDS
DRUG SAFETY: A CRITICAL REVIEW
Anagha Ranade1*, Rabinarayan Acharya
2
1PhD scholar, Department of Dravyaguna, IPGT & RA, G.A.U, Jamnagar, Gujarat, India
2Professor, Department of Dravyaguna, IPGT & RA, G.A.U, Jamnagar, Gujarat, India
*Corresponding Author: [email protected]
Received: 02/01/2015; Revised: 25/01/2015; Accepted: 03/02/2015
ABSTRACT
The concern about safety of Ayurvedic medicines is augmented with their increased use globally.
The concept of Pharmacovigilance in Ayurveda is taking roots in this line. Acharyas have already
cautioned about the optimum and careful drug usage in Ayurveda. Pertaining to Dravyaguna, the
Nighantus give a vivid drug to drug description along with its pharmacovigilant aspects.
Dhanwantari nighantu, one of the oldest among them specifies adverse effects of drugs and even
food items. The present paper is an attempt to highlight the pharmacovigilant aspects of certain
medicinal plants documented in Dhanwantari nighantu.
KEYWORDS: Pharmacovigilance, Ayurveda, Dhanwantari Nighantu
Review article
Cite this article:
Anagha Ranade, Rabinarayan Acharya (2015), CONTRIBUTION OF DHANWANTARI
NIGHANTU TOWARDS DRUG SAFETY: A CRITICAL REVIEW,
Global J Res. Med. Plants & Indigen. Med., Volume 4(2): 20–29
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
INTRODUCTION:
Pharmacovigilance also known as Drug
Safety, is the pharmacological science relating
to the collection, detection, assessment,
monitoring, and prevention of adverse effects
with pharmaceutical products (Anonymous,
2002). In this modern era of medicine, this
branch is gaining attention and moreover the
broad target is the evaluation of safety and
efficacy of traditional systems of medicine;
Ayurveda being on the top in the list as regards
to its manifold usage across the globe.
Ayurveda has way back considered the drug
to be a double-edged sword and cautioned
about its adverse reactions (Yadavji Trikamji,
2011). Ayurvedic literature gives detailed
description of drug-drug and drug-food
incompatibilities which has been included in
various Samhitas (treatise) in proper (Yadavji
Trikamji, 2011). The varied modes of
prevention of many undesired events have also
been highlighted by advocating usage of
techniques of Shodhana (detoxification) in
some compendias (Indradeo tripathi, 2011).
Samhitas have portrayed the vigilance of
adverse effects of drug while denoting the
treatment module e.g. in case of administration
of Bhallataka (Semecarpus anacardium Linn),
prior intake or application of ghee internally in
the oral cavity is indicated to avoid adverse
effects (Yadavji Trikamji, 2011). Other literary
sources like Nighantus (lexicons) have entailed
a vivid description of pharmacotherapeutic
properties of individual drugs which is lacking
in Samhitas. The side effects have been
reported subtly in these texts. In the recent
literature, Pharmacopoeias have specified
various tests and permissible limits of toxic
material in crude drugs. (Anonymous, 2007)
Among the lexicons, Dhanwantari
Nighantu is one of the oldest texts which a
distinctive categorization of drugs manner in
the form of 7 different Vargas based upon their
morphology and therapeutic value (P V
Sharma, 2008). The author has given an
account of poisons and their classification (P V
Sharma, 2008). The text has given a lucid
explanation of the adverse effects of individual
medicinal drugs. Thus, the pharmacovigilance
aspect has been taken into consideration in
Ayurveda too. The present review is about the
possible adverse effects caused by
inappropriate administration of some medicinal
plants that have been documented by author of
Dhanwantari Nighantu. The observations have
been given in a tabular form consisting of the
name of the plant, part used, botanical name, its
effect on dosha, dhatu, mala and others.
RESULT AND DISCUSSION: (Table 1)
The observed data in relation to the possible
adverse effects of drugs mentioned in
Dhanwantari Nighantu have been tabulated in
table -1.
Drugs: Dhanwantari nighantu comprises of a
total of 373 drugs. Out of them, the
pharmacovigilant aspects of 140 drugs have
been found to be denoted after a thorough
review through the text. Among them, 88 drugs
are of plant origin, 2 are of kshara (alkali
preparation) and 2 are lavana (salts) followed
by 11 dravyas of mineral origin, 24 drugs are of
animal origin, 9 belong to alcoholic
preparations and 4 belong to jala varga.
The adverse reactions of the respective useful
parts has been mentioned but out of 87 drugs of
plant origin, the direct reference of part used is
given in case of 65 drugs. The rest is unclear.
The botanical identity of certain plant drugs
like Kashthapatala, Vaalukam, Shirnavrinta,
Satala, Shuklabandi, Rakta apamarga, Renuka,
Lamajjak, Shweta kambhoji, Rajakshavak,
Sumukh, Shara, Kshudramlika, Mada is not
specified clearly.
Dosha karma: Among the 140 dravyas, 29
have been reported to vitiate Vatadosha; 31
have been reported to Vitiate Pitta dosha; 13
have been reported to vitiate Shleshma dosha
and 9 have been mentioned to cause Tridosha
vitiation.
Dhatu karma: Among the 140 dravyas, In
relation to adverse effect on dhatus (tissue
system), only 8 references are available among
which 5 are raktadhatu pradushaka, one is
sarvadhatupradushak (Ashuddha Tamra-
copper) and the remaining 2 are shukranashana
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(Nishpav- Dolichos lablab L) & Ashuddha
Raupya (crude silver).
Mala karma: Data on adverse effects of 7
drugs is available on malas. Among them three
are Mutravriddhikara (quantitative increase in
urine) (Kshira vidari, Ikshu, Nishpav); one
(Dhanyamash) is stated to be bahumala
(increasing excretory matter production); one
(Aashu vrihi) is stated to be Bahuvinmutra
whereas two (Tila & Ashwa dahi) are
alpamutrakrit (decreasing urine output).
Others: 6 dravyas have been mentioned as
Atisheeta (very cold in potency), 4 drugs are
Vantikrit (emetic), 14 are specified to possess
Vishtambhakari (obstruction of flatus)
property; 9 are mentioned to be Durjara; 12 are
stated to be Atyushna (increased hot potency)
and Tikshna; 4 are Madakrit (stupefying); 5 are
virya nashana (causing impotency). Apart from
this, many are reported to cause ocular
disorders, giddiness and diarrhoea.
Guduchyadi Varga: In this varga, the adverse
effects of 20 drugs have been specified. Among
the 17 plants whose part used are mentioned, 5
are roots, 2 seeds, 2 rhizomes and 8 fruits.
Many of the symptoms given on excess
consumption of these drugs include Vata
vriddhi in particular and other symptoms
include vomiting and indigestion pertaining to
Gastro-intestinal system. The contra-indication
in case of consumption of Haritaki (Terminalia
chebula Retz.) fruit is unique and should be
made applicable in clinical practice.
Shatapushpadi Varga: In this varga, adverse
effects of a total of 8 drugs have been
mentioned among which 4 belong to lavana
and kshara category viz. Audbhida lavana
(kind of mineral salt), Yavakshara (impure
carbonate of potash), etc. Excess of these lead
to serious disorders due to Ushna and tikshna
properties. Yavani (Hyoscymus niger L.) is
another drug specified which is a known CNS
depressant.
Chandanadi Varga: The adverse effects of 12
individual drugs have been described in this
varga. The drugs list contains aromatic drugs
like Karpura (camphor), Puga (areca nut);
drugs of mineral origin include sulphur,
Hemamakshik (crude copper pyrite),
Samudraphena (cuttle fish bone), etc. The
adverse effects of most of them have been
given as Atishishira (possess intense cold
potency).
Karaviradi Varga: The adverse effects of 13
individual drugs have been described in this
varga. The botanical sources of some are
controversial like Rajakshavak, Shweta
kambhoji, Sumukh, Kashthakadali, etc. Two
poisonous drugs of herbal origin namely
Karveera (Nerium indicum Mill.) and Dhattura
(Datura stramonium L) have been mentioned.
The untoward effects stated in this Varga are
mainly pertaining to CNS dysfunction. A
unique effect of Shweta kambhoji is given as
Vashikaran (hypnotic) whereas Aasuri
(Brassica juncea) is stated to be Nidrakari,
Grahakari. Dhattura beeja is known to
produce Bhrama (dizziness) (MS Baghel,
2011)
Aamradi Varga: The adverse effects of 19
individual drugs have been described in this
varga. All of these are fruits which are
otherwise considered healthy but still pose
problems when consumed recklessly. A keen
observation of author is observed when he
mentions the adverse effects of the specific
parts of fruit viz. Phala majja of Amlika
(Tamarindus indicus L), phala tvak of Bijapura
(Citrus medica L), pakva phala of Udumbara
(Ficus glomerata Roxb.), Apakva phala of
Tinduka (Diospyros embryopteris Pers.). All
the fruits are durjara (difficult to digest) which
suggests optimum consumption. A unique
comment about Tilaka (Wendlandia exerta DC)
is found that states it to be punstvaghni
(rendering sterility). Thus, a cautious diet with
a thorough knowledge is necessary for
maintenance of health.
Suvarnadi Varga: Herein, adverse effects of a
total of 70 drugs including food items have
been mentioned. Starting with metals, author
has given a clear idea about the toxicity caused
due to Ashuddha sevana i.e. bhasmas not
prepared according to the scientific protocol are
prone to cause toxicity. Along with metals, the
toxicity caused by precious stones like Hiraka
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
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(diamond), Vaikranta are also specified. The
harmful effects of irrational use of cereals and
pulses has been described subtly viz.
Punstvaghna karma of Chanaka (Cicer
arientum L), Shukranashana, rakta vikara
janaka karma of Nishpava (Dolichos lablab L),
Vata vyadhi utpadak of Masura (Ervum lens
L), etc. An account of oil bearing seeds with
harmful effects have been mentioned that
mainly includes oil derived from Kusumbha
(Carthamus tinctorius L) which is
Sarvadoshaprakopaka, secondly Sarshapa
(Brassica juncea) which is stated to cause
ocular disturbances. Later, author has
highlighted some harmful effects arising due to
improper consumption habits of milk, curd,
alcoholic preparations and different types of
meat. A contra-indication regarding milk
consumption is worth to apply in daily practice
because there is a common notion among
public that milk is a complete food which has
meagre side effects. Perishing time of milk has
also been stated. As regards to alcohol
preparations, which are otherwise considered to
possess therapeutic value in a optimum dose, if
consumed carelessly result into infertility and
GIT disorders.
Among the mamsa varga, wherein fish in
particular are said to be pittaprakopaka and
abhishyandi as well if taken in excess quantity
or against the code of food consumption given
in Ayurveda. Apart from this, author has also
portrayed ill-effects of the water consumed
from different resources. Among Mutra varga,
Gomutra which is gaining popularity in recent
eras is also said to be Pittala.
Mishraka Varga: Here author describes
various categories of poisons along with their
properties. Next, among a special therapeutic
classification, dvitiya chaturbhadra is reported
to be Pittala if consumed inadvertently.
Table 1: The adverse effects of drugs mentioned in Dhanwantari nighantu:
Sr.
no
Drug Part
used
Botanical name/
Common name if not
plant
Dosha Dhatu Mala Others
Guduchyadi varga
1) Musta Rhizome Cyperus rotundus L Atishishira
2) Patola Root Trichosanthes dioca
Willd. Miers
Virechak
3) Bilva Ripe
fruit
Aegle marmelos Corr. Putimarutam
(causing
putrid
flatulence)
Vidahi (causing
heart burns),
Vishtambh
(obstruction of
flatus)
4) Kashthapatala Root Kinchit
marutakaram
(vitiating
Vata)
5) Mudgaparni Root Phaseolus trilobus
Ait
Kaphakar (vitiating Kapha)
6) Kshiravidari Rhizome Ipomoea digitata L Atimutrala (diuretic)
7) Shitivara Seed Celosia argentia L Sangrahi
(infrequent bowel
movements)
8) Katukalambuni Fruit Lageneria vulgaris
Ser.
Shodhani
(cleansing activity)
9) Urvaaru Fruit Cucumis utilissimus
Roxb.
Vitiates vata
on excess
consumption
10) Vaalukam Fruit Bhedana (osmotic
laxative)
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
11) Shirnavrunta Fruit Pittakrit
12) Bimbi Fruit Coccinia indica W&A Vata, Kapha
vardhak
13) Haritaki Fruit Terminalia chebula
Retz.
Ahitakara
(contraindicated) in
case of thirst,
dryness of mouth,
stiffness of jaw,
recent fever ,
debility and in
pregnancy.
14) Prachinamalaka Fruit Flacourtia
cataphracta Roxb.
Pitta,
Kaphakrit
Durjara, (difficult
to digest) guru
(prolonging
digestion process)
15) Satala Marutkrit
16) Shuklabhandi Root Anilakopini
17) Indravaruni Root Citrullus colocynthis
Schrad.
Atyushna (hot in
potency)
18) Apamarga Achyranthes aspera L Vantikrit (emetic)
19) Rakta
apamarga
Vantikrit,
Vishtambhi
20) Jyotishmati Seed
oil
Celastrus
panniculatus Willd
Atyushna, Tikshna
Shatapushpadi Varga
21) Yavakshara Impure carbonate of
potash
Pittadushaka Raktadush
aka(
causing
morbid
blood
disorder)
Virukshana,
Tikshna
22) Tankankshara Borax Pittadushana Tikshna,
virukshana
(causing dryness in
body)
23) Vidlavan Ammonium chloride Tikshna
24) Audbhida
lavana
Tikshna, Utkledi
(increasing
sliminess in body
fluids)
25) Tumburu Zanthoxylum alatum
Roxb
Tikshna
26) Maricha Fruit Piper nigrum L. Pittakrit
27) Yaavani
yavaani
Fruit Hyoscymus niger L. Maadini,(stupefyin
g) Grahini
28) Kapittha Fruit Feronia elephantum
Corr.
Vatala Asvarya ( choking
voice)
Chandanadi Varga
29)
Karpura
Exudate
Cinnamomum
camphora Nees &
Ebern.
Madakarakam
30) Puga Fruit Areca catechu L. Bhedi
31) Renuka Seed Atyant shishira
32) Mura Rhizome Selinum sp. Atyant sheeta
(excessive cold in
potency)
33) Elavaalukam Fruit Prunus cerasus L. Atyant sheeta
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
34) Lamajjaka Atyant hima
35) Dhataki Flower Woodfordia
floribunda Salisb.
Madakrit
36) Gandhaka Sulphur Atigandhakrit
37) Siktha Wax Bhedana
38) Shallaki Exudate Boswellia serrata
Roxb.
Atisheeta
39) Hemamakshika Copper pyrite Ashuddha:
Vishtambh,
Mandaanala,(reduc
ing digestive fire)
producing ocular
pain ,dermal
disorders.
40) Samudraphena Os sepiae Lekhana
(therapeutic
scrapping)
Karveeradi Varga
41) Karaveera Root Nerium indicum Mill. Visha (poison)
42) Dhatura Datura stramonium L. Bhrama utpatti
(producing
dizziness)
43) Shweta
kambhoji
Seed Vantikara,
vashikaran
44) Rajakshavak Pittala Drishti, basti
pradushini.
45) Sumukh Pittakrit
46) Aasuri Seed Brassica juncea Linn. Atitikshni,
Nidrakari,
grahakari.
47) Rasona Allium sativum L Sutikshna.
48) Kadali Fruit Musa sapientum Linn. Vatakar,
Kaphakar.
49) Kashthakadali Durjara
50) Ikshu Fruit Saccharum officinale
L.
Kaphakar,
vatkara
Mutrakrit
51) Shara Kinchit Vatkar
52) Padmabeeja Nelumbo nucifera
Gaertn.
Marutkrit
53) Mrinala Stalk Nelumbo nucifera
Gaertn.
Vatakopana Durjar,
Vishtambhi.
Aamradi varga
54) Amra Fruit Mangifera indica
Linn.
Vishtambhi,
ajirnakrit
(dyspepsia)
55) Amrataka Fruit Spondias mangifera
Willd.
Pittakrit,
Marutkrit
Raktakrit Guru
56) Jambira Fruit Citrus limon L. Pittala
57) Naranga Fruit Citrus reticulate
Blanco.
Durjara
58) Bijapura Fruit
skin
Citrus medica L. Durjara
59) Madhukarkati Fruit Citrus decumana L. Durjara
60) Amlika Fruit
pulp
Tamarindus indica L. Bhedi, Vishtambhi
61) Kshudramlika Pittakrit
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
62) Tinduka Unripe
fruit
Diospyros
embryopteris Pers.
Vatakopana
63) Pilu Fruit Salvadora persica L. Tikshnaka
64) Parushaka Fruit Grewia asiatica Linn. Pittakrit
65) Mada Marutkari
Pittanut
Dahanut
(producing burning
sensation)
66) Priyala Fruit Buchanania latifolia
Roxb.
Durjara
67) Jambu Fruit Eugenia jambolana
Lam.
Vatala Hritkantha kashana
68) Udumbara Ripe
Fruit
Ficus glomerata
Roxb.
Krimikrit(producin
g worms)
69) Shami Fruit Prosopis spicigera L. Causing hairfall
70) Kareera Fruit Capparis aphylla
Roth.
Adhmanakar
(abdominal
distension)
71) Karmarda Fruit Carissa carandas L. Pittakar
72) Tilaka Bark Wendlandia exerta
DC.
Punstvaghni(impot
ency)
Suvarnadi varga
73) Svarna Aurum Ashuddha (impure)
Balanashan,
Viryanashan
Rogotpattikar
74) Raupya Argentinum Shukranas
hak
(causing
oligosper
mia)
Ashuddha:
Dahajanaka,
Vibandhakarak,
(severe
constipation)
Viryanashak,
Balanashak.
75) Tamra Cuprum Sarvadhatu pradushak
(dysfuncti
on at all
tissue
level)
Ashuddha:
Kantihar, Vantikar,
Kusht
76) Trapu Tin Ashuddha:
Pandu,
Kushtha,Vatvikara,
Murccha (fainting)
77) Loha Ferrum Sarvadosha-
prakopa
Ashuddha:
Hritpida,(cardiac
pain)
Rogotpattikar
78) Parada Hydrargyrum Ashuddha:
Shariranasha,
Kushtha
79) Vaikrant Ashuddha:
Pandu (Anaemia)
,Jvara,Hridroga
(cardiac disorders),
Parshvapida,
Kushtha.
80) Hirak Ashuddha:
Santapjanak
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 20–29
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
Kshaya, Kushtha,
Pandu, Dussaha
pida (excruciating
pain)
81) Vrihi Seed Pittakara
82) Patal Seed Tridoshkrit Atyushna,
Bahunishyandi
83) Aashu vrihi Seed Tridoshala Bahuvin
mutra
(produci
ng excess
faecal
and urine
output)
Bahushma
84) Dhanya
Priyangu
Seed Setaria italica L. Vatkrit
85) Makushtha Seed Phaseolus
aconitifolius Jac.
Vatala
86) Aadhaki Seed Cajanus indicus
Spreng.
Marutkopini
87) Masur Seed Ervum lens L. Vatamaykar
88) Dhanyamash Seed Phaseolus mungo L. Bahumala
89) Chanak Seed Cicer arientum L. Vatala Punstvaghna
90) Kalay Seed Pisum sativum L. Vatala
91) Jurnaa Seed Vishtambhi
92) Karat Seed Lathyrus sativus L. Ativatala
93) Nishpav Seed Dolichos lablab L. Anila, pittakar Shukranas
hana
Mutravri
ddhi
(diuresis)
Raktavikara.
94) Methika Seed Trigonella foenum-
graecum L.
Pittaprakopa Raktaprak
opa
95) Khastila Seed Papaver somniferum
L.
Vishoshana
96) Tila Seed Sesamum indicum L. Kapha
pittakrit
Alpamut
akrit
(oliguric)
Agnisadak
97) Sarshapa Seed
oil
Achakshushya
98) Eranda Seed
oil
Visra
99) Kusumbha Seed
oil
Sarvadoshapra
kopak
100) Maahisha
dugdha
(Buffalo milk) Mahabhishyandi,
vanhisadak
101) Mrita vatsaa,
bala vatsa
Milk whose calf is
dead)
Doshakarak
102) Pinyak, amla
aashi
The fermented fodder
eating cow’s milk
Abhishyandi
103) Dharoshna
dugdha
Amavatakar
(produces
rheumatoid arthritis
on excessive
consumption)
104) Kurchika
(milk product )
Shleshmavardhak
105) Dugdha sevan
nishedh
Navjvara,
mandagni,
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amadosh, shula,
kushtha.
106)
Dugdha
perishing time
After 5 muhurta –
(4 hrs) vikrit;
Dviguna kaal-
Vishavat (turns
toxic after 8 hrs)
107) Mahisha dadhi Curd made out of
buffalo milk
Mahabhishyandi
108) Ashwadadhi Curd of horse milk Vatala Mutrapa
ham
(oliguria)
109) Dadhisar Vatala Vishtambhi
110) Dadhi
anaharya
Raktapitta ,
kaphajvikara
111) Takra nishedh Buttermilk Kshat, Murccha,
Bhrama
112) Takrakurchika Durjara
113) Madya Alcoholic preparation Pittadushana Raktadush
ana
Vishavad (toxic)
114) Madhulika Alcoholic preparation
made from barley
Vishtambhini
115) Madhukasidhu Alcoholic preparation
made from flowers of
Madhuca indica
Tridoshprakop
ak
116) Kohlo jagal Avrishya
117) Bakkas Vishtambhi
118) Kharjuram Alcoholic preparation
made from dates
Vatala alpamadakari
119) Maireya Madkrit
120) Jambavsidhu Alcoholic preparation
made from Eugenia
jambolana fruit pulp
Vatakopana
121) Nav madya Tridoshakarak Abhishyandi
122) Anartava vari Rainfall not according
to season
Tridoshakarak
123) Vapya jala Water from wells Pittala
124) Kedar jala Water from reservoir Doshakarak Abhishyandi
125) Dhar jala Vishtambhi, Durjar
126) Bhuktottara
jalapaan
Water consumption
after meals
Vishavat
(toxic)
127) Jirna
Narikelodaka
Stale coconut water Pittakar Vishtambhi
128) Hastimamsa Meat of elephant Pittakar Raktaprak
opak
129) Ashwa mamsa Meat of horse Kapha
pittakrit
130) Ashwatar Kapha
pittalam
131) Mesha mamsa Meat of goat Pittakaphakar
132) Sukar mamsa Pork Pittala Visra
133) Matsya mamsa Fish Kaphapittakar
134) Mukha matsya Shleshmala
135) Irasa matsya Pittashleshma
atikopana
136) Pulanga Vishtambha
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Matsya
137) Shafari matsya Kaphapittala Abhishyandi, ushna
138)
Sarovar
matsya
Grahini,
Drishtinashan
139) Uluka mamsa Pittala,
vataprakopak
Bhrantikar
140) Gomutra Pittala
141) Ajamutra Marutkopana
142) Dvitiya
chaturbhadra
Pittala
CONCLUSION:
After a critical analysis of the adverse
effects of various drugs mentioned in
Dhanwantari nighantu, it is found that a vivid
idea of pharmacovigilance was present even in
the Nighantu period. These aspects do not rest
only with medicines but also foodstuffs that are
consumed daily. Author has highlighted certain
contra-indications regarding milk and milk
products which should be applied in by
physicians to rule out the etiology of a disorder.
The adverse effects caused by inadvertent use
of foodstuffs in daily routine have an impact on
the basic normal physiology of the body.
Hence, this point must be taken into
consideration even during prescription and
consultation of Pathya.
Regarding medicines, Ayurveda is always
accused of possessing medications that produce
metal toxicity; but the information reported
herein along with the contra-indications
suggests that pharmacovigilance was a well-
developed even in traditional medical system,
particularly Ayurveda. Thus, it can be
concluded that Dhanwantari Nighantu
encompasses a well-organised data in the
context of pharmacovigilant aspects of various
dravyas of Ayurveda.
REFERENCES:
Anonymous (2007), Ayurvedic Pharmacopoeia
of India (API) Dept. of AYUSH, New
Delhi, Part II, Vol 1, Appendix 2,
Pg.no.148–179.
Anonymous (2002), The importance of
Pharmacovigilance, WHO. Available
on:
http://en.wikipedia.org/wiki/Pharmacov
igilance#cite_note-1
Baghel M.S (2011), Standardization of
Ayurvedic Clinical terminologies, IPGT
& RA, GAU, Jamnagar, Gujarat.
Indradeo Tripathi (2011), Editor of
Chakradutta of Chakrapani Dutta,
Vatavyadhi chikitsa, verse 285-295,
Chaukhambha orientalia Bhavan,
Varanasi: p.155–156.
PV Sharma (2008), Editor of Dhanwantari
Nighantu, Chaukhambha orientalia,
Varanasi.
Yadavji Trikamji Acharya (2011), Editor of
Charaka Samhita, Ayurveda Dipika
Vyakhya, Sutrasthana, Chap 1, verse
126, Chap 26 verse 82–84,;
Chikitsasthana, 1/3/13, Chaukhambha
Prakashan, Varanasi. p.23; p150, p 382.
Source of Support: Nil Conflict of Interest: None Declared
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ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal
CONCEPT OF LIFESTYLE IN AYURVEDA CLASSICS
Saylee Deshmukh1*
, Mahesh Vyas 2, Hitesh Vyas
3, Dwivedi R R
4
1Ph.D.Scholar, Department of Basic Principles, Institute of Post Graduate Teaching and Research in
Ayurveda, Gujarat Ayurved University, Jamnagar- India 2Professor, Department of Basic Principles, Institute of Post Graduate Teaching and Research in Ayurveda,
Gujarat Ayurved University, Jamnagar- India. 3Associate Professor, Department of Basic Principles, Institute of Post Graduate Teaching and Research in
Ayurveda, Gujarat Ayurved University, Jamnagar- India. 4Professor and Head of Department, Department of Basic Principles, Institute of Post Graduate Teaching and
Research in Ayurveda, Gujarat Ayurved University, Jamnagar- India.
*Corresponding author: Email: [email protected]
Received: 19/01/2015; Revised: 15/02/2015; Accepted: 23/02/2015
ABSTRACT
Increased number of deaths due to non-communicable diseases has been proved to be because of
lifestyle related factors like physical inactivity etc. It is a responsibility to focus on lifestyle
modifications in the 21st century. Ayurveda has great contribution in treatment of diseases as well as
prevention of diseases. Conducts like Dinacharya (conducts in daytime), Ratricharya (conducts in
night), Ritucharya (seasonal conducts), Ahara Vidhi (diet rules), Sadvritta (good conducts) etc. are
described in detail in Ayurveda, can be included under the heading healthy lifestyle. It has a
tremendous role in prevention of diseases. Present article aims to elaborate the concept of Lifestyle
in Ayurveda classics.
KEY WORDS: Lifestyle, Ayurveda, Dinacharya, Ahara Vidhi.
Review article
Cite this article:
Saylee Deshmukh, Mahesh Vyas, Hitesh Vyas, Dwivedi R R (2015), CONCEPT OF LIFESTYLE IN
AYURVEDA CLASSICS, Global J Res. Med. Plants & Indigen. Med., Volume 4(2): 30–37
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 30–37
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
INTRODUCTION:
According to the health statistics of WHO,
among 57 million global deaths in 2008, 36
million or 63% were due to non-communicable
diseases (NCD) like cardiovascular diseases
(17 million deaths or 48% of all NCD deaths),
cancers (7.6 million, or 21% of all NCD
deaths), respiratory diseases, including asthma
and chronic obstructive pulmonary disease (4.2
million) and 37% were due to communicable
diseases. Therefore it can be said that non-
communicable diseases (NCD) are prone to kill
more people than communicable diseases
worldwide. Amongst them lifestyle disorder is
a group of diseases whose occurrence is
primarily based on the daily habits of people
and are a result of an inappropriate relationship
of people with their environment. WHO states
the top 10 lifestyle diseases in the world
affecting health are Alzheimer's Disease,
Arteriosclerosis, Cancer, Chronic Liver
Disease/Cirrhosis, Chronic Obstructive
Pulmonary Disease (COPD), Diabetes, Heart
Disease, Nephritis/CRF, Stroke, Obesity. The
factors contributing to lifestyle diseases mainly
include incompatible food habits, physical
inactivity, wrong body posture, and disturbed
biological clock. (Mukesh Sharma et al., 2009).
It has been proved that in case of non-
communicable diseases, simple lifestyle
measures are more effective in preventing or
delaying the onset of these diseases. Ayurveda
has a great contribution in the treatment of
diseases as well as prevention of diseases. In
the last few years, According to the ‘seed and
soil theory’ in Ayurveda, (Brahmanand
Tripathi, 2006) manifestation of disease takes
place when there is favorable condition for
disease which is being created by wrong
conducts like day sleep, being vigil at night,
irregular food habits etc. Therefore for
maintenance of health and prevention of
disease it is very important to follow an ideal
lifestyle.
A growing body of scientific evidence has
demonstrated that lifestyle intervention is an
essential component in treatment of chronic
disease that can be effective as medication but
without risks and unwanted side effects.
Lifestyle medicine (LM) is a branch which
includes management of diseases the use of
lifestyle interventions like diet, exercise, stress
management, de-addiction in the treatment and
management of diseases. This field has been
growing from last 2 decades.
This article is an attempt by the authors to
elaborate the concept of lifestyle in Ayurveda
classics.
MATERIALS AND METHOD:
Classical Ayurvedic texts like Charaka
Samhita, Sushruta Samhita, Astanga
Samgraha, Astanga Hridaya with their
commentaries and concerned topics from the
texts Kashyapa Samhita, Bhavaprakasha,
Bhela Samhita and Kaiyyadeva Nighantu,
research articles related to this topic.
Concept of Lifestyle:
Lifestyle is the way in which a person lives.
It is a set of attitudes, habits, or possessions
associated with a particular person or group
(Lynn R. Kahle, Angeline G. Close, 2011). i.e.
how, where and when a person is sleeping,
playing, wandering, eating, swimming,
walking etc.
As quoted by Acharya Sushruta, Vyadhi
nigraha hetavah (treatment modalities) are
divided as Samshodhana (purificatory),
Samshamana (palliative), Ahara (food) and
Achara (activities) (Ananta Ram Sharma,
2008). Achara is of 3 types – Kayika karma
(physical activities) like Vyayama (exercise),
Vachika karma (Verbal behavioral) like
Swadhyaya (reading) and Manasika karma
(psychological behavior) like Sankalpa
(determination). Among them, Achara can be
included under the heading lifestyle (Y.T.
Acharya, 2012).
By the above definition of Lifestyle, it can
be said that Vihara, Ahara vidhi and Achara
described in Ayurveda classics, can be included
under the heading Lifestyle. Arunadatta has
classified Vihara as Niyata kala (regular) and
Aniyata kala (according to specific condition).
Niyata kala vihara includes Dinacharya and
Ritucharya. Aniyata kala vihara includes
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Vihara according to avastha (condition); (Y.T.
Acharya, 2010) it can be taken as Vyadhi
avastha. Ahara Vidhi includes Ahara Vidhi
vidhana (rules of diet) and Bhojanottara Vidhi
(conducts after meal); Achara includes
Sadvritta (good conducts) (Table.1).
Table.1: List of conducts in Lifestyle
Dinacharya Ritucharya According to Vyadhi
Dantadhavana
(cleaning teeth)
Abhyanga (Oil application) As a cause:
Vega Udirana-
Dharana (suppression
and forceful production
of urges)
Pravata (strong wind)
Adhva (brisk walking)
Chankramana
(walking)
Anjana (collyrium) Udvartana (massage)
Nasya (nasal drops) Dhumapana (inhalation of
medicated smoke)
Kavala-Gandusha
(mouth gargles)
Kavala Gandusha (mouth
gargles)
Dhumapana
(inhalation of
medicated smoke)
Tambula Bhakshana
(chewing of betel
leaves )
Anjana (collyrium) As a treatment:
Abhyanga (oil
application)
Anjana (collyrium)
Kavala-Gandusha
(mouth gargles)
Nasya (nasal drops)
Dhumapana (inhalation
of medicated smoke)
Abhyanga (Oil
application)
Shayana (sleeping)
Vyayama (exercise) Vastra Dharana (wearing
clothes)
Udvartana (massage) Mani-malyadi Dharana
(wearing stones etc.)
Snana (bathing) Vyayama (exercise)
Mani-malyadi
Dharana (wearing
stones etc.)
Vyavaya (copulation)
Vastra dharana
(wearing clothes)
Snana (bath) As cause and
treatment:
Vyayama (exercise)
Snana (bathing)
Vyavaya (copulation)
Nidra (sleep)
Atapasevana (exposure
to sunlight)
Karnapurana
(insertion of oil in ear)
Nidra (sleep)
Vyavaya (copulation)
Padatrana Dharana
(footwears)
Vihara includes the conducts by a person in
daily or seasonal routine. This includes
Abhyanga (oil application to the body),
Vyayama (exercise), Nidra (sleep), Vega
dharana (suppression of natural urges),
Vyavaya (sexual intercourse), Chankramana
(walking), Adhva (brisk walking), Atapa
sevana (exposure to sunlight), Asana (sitting),
Snana (bathing), Pravatasevana (exposure to
strong wind) etc. Amongst them Acharyas have
quoted their importance and usefulness or
harmfulness according to the specific condition
e.g. Ardhashaktya Vyayama (exercise upto half
of the capacity) with prior Abhyanga (oil
application) is useful in Hemanta ritu (winter)
and strong individuals but excess Vyayama is
harmful in Grishma ritu (summer) and weak
individuals (Brahmanand Tripathi, 2007). Also,
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Divaswapna (daytime sleep) is useful in
Grishma ritu and emaciated person while
harmful in Vasanta ritu (autumn) and obese
person (Brahmanand Tripathi, 2006). Also,
Acharya Sushruta has given limit of
Divaswapna as 1 muhurta i.e. 48 min (Ananta
Ram Sharma, 2008). Ratrau jagarana (vigil at
night) is contraindicated always by Acharyas
for maintenance of health. About Snana
(bathing), Acharyas have strictly
contraindicated it in the condition of Ajirna
(indigestion), Atisara (diarrhea) etc.
(Brahmanand Tripathi, 2006). Vegadharana
(suppression of natural urges) of mala (faeces),
mutra (urination) etc. has always been
contraindicated because of their harmful effect
in the body. (Brahmanand Tripathi, 2006). In
Ayurveda, detailed description about rules of
Vyavaya (sexual intercourse) is also available
(Ananta Ram Sharma, 2008).
About Ahara Vidhi, Acharyas have advised
to take Ushna (Luke-warm) and Snigdha
(unctuous) food in proper quantity and proper
time with full concentration to get easily
digested. If one takes cold food it slows down
the process of digestion. Unctuous food helps
for easy passage of food (Brahmanand Tripathi,
2006). About quantity of food, Acharyas have
quoted that it varies according to digestive
capacity of person and nature of the food items.
To decide the ideal quantity of food, Acharyas
have given the symptoms which are produced
in the body after taking food in such a quantity
which is suitable for him which varies
individually (Brahmanand Tripathi, 2006).
About the proper time for intake of food,
Acharyas have advised to take lunch during 2nd
Yama (i.e. between 3–6 hrs after sunrise) and
dinner should be taken at the end of first
Prahara of night (i.e. within 3 hrs after sunset)
(Brahma Shankara Mishra, 2012). It has also
been advised to take food as suitable to his
prakriti (constitution), age, habitat etc.
(Brahmanand Tripathi, 2006). About Ahara
sevana krama i.e. sequence of intake of food
items, it has been stated by Acharyas that food
items having Madhura rasa (sweet) should be
consumed first because it is difficult to digest.
It gets more in contact with digestive enzymes
when consumed first (Ananta Ram Sharma,
2008).
About Bhojanottara Vihara, Acharya
sushruta has advised Rajavat asana (sitting in
comfortable position), Shatapada gamana
(walking about hundred feet i.e. for a while),
Vamaparshwa shayana (lying down in left
lateral position), manonukula shabda, sparsha,
rupa, gandha sevana (to indulge in sound,
sight, taste smell and touch which are pleasing
to the mind) (Ananta Ram Sharma, 2008). This
helps the food to stay more in amashaya
(stomach) and get more in contact with the
Agni (digestive enzymes) (Brahma Shankara
Mishra, 2012).
About water drinking habits, it has been
stated that water should be taken sip by sip
during meal instead of taking it before and after
meal in large quantity. It should not be taken
more than required quantity. Intake of water on
being hungry is also contraindicated. As it
leads to harmful effects on body (Ananta Ram
Sharma, 2008).
Sadvritta includes guidance about the
dressing, speaking, social behavior, personal
and social hygiene etc. (Brahmanand Tripathi,
2006; Brahmanand Tripathi, 2007).
According to different conditions like
Rajaswala (menstruating woman), Garbhini
(pregnant woman), Sutika (puerperal woman)
have been given in Ayurveda. Abhyanga,
vyayama, vyavaya etc. has been contraindicated
in these conditions (Ananta Ram Sharma,
2008).
DISCUSSION:
In Ayurveda, it has been quoted that ratrau
jagarana is harmful to the body. It leads to
Vataprakopa and Agnidushti. In human body,
there exists a circadian rhythm in activities of
digestive enzymes. Wakefulness in night
causes disruption in circadian rhythm and
disturbance in activities of digestive enzymes
which leads to indigestion (Masayuki Saito et
al., 1975). Except in Grishma ritu, it causes
vitiation of Kapha-Pitta and also it is a cause
for Agnidushti. According to the researchers,
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daytime sleep disrupts the circadian rhythm of
digestive enzymes. (Charles W. Atwood,
2008). In 21st century, due to industrialization,
there is increase in number of shift workers.
Health of shift workers is now becoming a
problem. 2007 study led by the IARC
(International Agency for Research on Cancer)
showed that shift work has been associated
with cancer (Kurt, Straif, 2007). Most common
disorder in shift workers is Shift work sleep
disorder (SWSD). It is a circadian rhythm sleep
disorder which requires medications with
circadian changes (C C Caruso, 2012).
According to the modern researchers, there
exists Gut-Brain-Endocrine axis which
involves Ghrelin-Leptin hormones, Insulin,
Orexins etc. Disturbance in this axis due to
disturbed sleep pattern leads to diseases like
Diabetes mellitus, Cancer etc. (Annette L.
Kirchgessner, 2002; Y Wang, H Yang, 2004)
According to Ayurveda, Vyayama leads to
increase in bala (strength), agni (digestion).
Modern researchers have proved that exercise
increases significantly the plasma GH
concentration and their combined effect
induces a highly synergistic rise in GH (Foued
Ftaiti, 2008). Exponential relationships were
found between increases in core temperature
and plasma growth hormone, prolactin, and
catecholamines during exercise, suggesting the
existence of a thermal threshold for stimulation
of hormonal release during exercise (M W
Radomski, 1998). Physical exercise activates
hypothalamus-pituitary-adrenal axis and
increase number, function and movement of
lymphoid cells (Alexander J. Koch, 2010).
Mild to moderate exercise stimulates gastric
emptying (Campbell J.M.H, 1928) and
increases secretions of gastric juice which leads
to rapid and healthy digestion (William
Beaumont, 1838). Now days, due to growing
use of technologies, daily physical activity is
decreasing. Lack of exercise/ sedentary
lifestyle leads to delayed gastric emptying
(Campbell J.M.H, 1928). Exercise has role in
treatment of diseases. It has been proved that
exercise has role in the treatment of Diabetes
mellitus and Obesity (Zinker B A et al., 1993;
Epstein LH et al., 1996).
Acharyas have quoted that Abhyanga is
essential for maintenance of health. According
to modern researchers, skin blood flow
increases diverting blood from muscle
following 12 minutes of massage which helps
in lactate clearance and recovers body from
fatigue due to accumulation of lactate in
muscles after prolong exercise (Hinds T et al.,
2004).
Vegadharana has been contraindicated by
Acharyas as it is a direct cause of many
diseases. Researchers have been proved that
voluntary suppression of defecation delays
gastric emptying. (Tjeerdsma HC et al., 1993)
and retention of urge of micturition causes
significant increase in the level of blood
pressure, pulse rate, respiratory rate, Plasma
Catecholamine, Plasma 5-HT, urinary
catecholamine and 5- HIAA (5-
hydroxyindoleacetic acid) in healthy volunteers
(Madhu Shukla et al., 1988). According to the
modern researchers, voluntary suppression of
cough reflex is often associated with lung
infection and also it leads to aggravation of
symptoms of bronchiectasis (Wells A et al.,
1992).
As stated in Ayurveda, intercourse has been
contraindicated in the period of menstruation
and pregnancy. According to the researchers, in
the menstruating women it increases the
chances of infection (Mayer, 1982) and coitus
in the 1st trimester causes disturbance in the
process of growth of foetus and results in the
malformation of foetus and coitus during 3rd
trimester leads to premature labor due to
contraction of uterus (Senatur and Kaminer,
1927).
Vishamashana means taking food in
irregular quantity and at irregular time. Now a
days, due to irregular job or business schedule
people take meal at irregular time and irregular
quantity. Irregular time of food intake disrupts
the normal digestive pattern which adhered to a
circadian rhythm (Melinda Blackman et al.,
2010). Intake of Ushna ahara has been advised
by Acharyas. It helps for digestion. It lacks due
to intake of cold food items which results in
indigestion (William Beaumont, 1838). In
Ayurveda, it has been stated to take water
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between the meals which has been proved to
stimulate gastric secretions (S Wyard, 1935)
and contraindicated to take water before and
after meal. Intake of water in large amount
before meal dilutes the stomach acid, it also
stimulates digestive system to prepare for
incoming food from stomach. This stimulation
causes a dump of very basic digestive enzymes
into the lower gastrointestinal tract (American
Academy of Orthopaedic Surgeons, 2013).
Excessive intake of water after taking meal can
result in prolonged abdominal muscle
relaxation which in turn can cause indigestion
(Ronald Ross Watson, 2012).
CONCLUSION:
Concept of healthy Lifestyle in Ayurveda is
wider which includes the conducts like dietary
habits under the heading Ahara vidhi vidhana
e.g. intake of luke-warm food on proper time in
proper quantity with full concentration etc.
water drinking habits, general behavioral
pattern under the heading Sadvritta, daily and
seasonal conducts like exercise, oil application
etc. under the heading Dinacharya and
Ritucharya, Ratricharya. Healthy lifestyle has
great role in prevention of diseases and
Lifestyle modification has been proved to be
successful treatment in various diseases.
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Source of Support: Nil Conflict of Interest: None Declared
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Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal
CLINICAL EVALUATION OF AN AYURVEDIC FORMULATION IN THE
MANAGEMENT OF MENTAL RETARDATION
Deepa Makhija1*, Pratap Makhija
2, Babasaheb Patil
3
1,2Research Officer (AY) scientist-2, Ayurveda Central Research Institute, Punjabi Bagh, New Delhi-26, India
3Professor, B.S. Ayurveda College, Sawantwadi, (MH), India
*Corresponding Author: Mobile No. 09911331074; E-mail: [email protected]
Received: 09/01/2015; Revised: 25/02/2015; Accepted: 28/02/2015
ABSTRACT
The aim of the study was to assess the efficacy of an Ayurvedic formulation in the management
of Mental Retardation. The participants of the study were included 15 Mentally Retarded children
between age group of 8 months to 12 years. Combination of Vacha, Rudraksha, Haridra, Hingu was
administered twice daily for 90 days. Findings of the study revealed that treatment was highly
effective over behavioural disorders, but very minimal response to treatment was noticed over mental
age and social age. Also significant improvement was observed over psychological, psychomotor
and biological factors.
KEYWORDS: mental retardation, behavioural disorders, psychological, intelligent quotient, mental
age, social quotient, social age.
ABBREVIATIONS:
MR - Mental Retardation
SFB - Seguin Form Board
V.S.M.S - Vineland Social Maturity Scale
IQ - Intelligent Quotient
MA - Mental Age
SA - Social Age
SQ - Social Quotient
CA - Chronological Age
Research article
Cite this article:
Deepa Makhija, Pratap Makhija, Babasaheb Patil (2015), CLINICAL EVALUATION OF AN
AYURVEDIC FORMULATION IN THE MANAGEMENT OF MENTAL RETARDATION,
Global J Res. Med. Plants & Indigen. Med., Volume 4(2): 38–45
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 38–45
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
INTRODUCTION
Mental Retardation (MR) refers to
significantly sub average general intellectual
functioning resulting in or associated with
concurrent impairment in adaptive behaviour
and manifested during the development period
(American Association for Mental Retardation,
1983).
It is formally diagnosed by an assessment
of Intelligent Quotient (IQ) (below 70) and
adaptive behaviour. Adaptive behaviour, or
adaptive functioning, refers to the skills needed
to live independently. Children with intellectual
disability learn more slowly than a typical
child. Children may take longer to learn
language, develop social skills, communication
skills, and take care of their personal needs,
such as dressing or eating (Daily DK et al.,
2000).There are varying degrees of intellectual
disability, from mild to profound.
Classification according to DSM IV is designed
as mild (IQ 50–55 to approximately 70),
moderate (IQ 35–40 to 50–55), severe (IQ level
20–25 to 35–40), profound (IQ level below 20
or 25). Mental retardation affects about 1% to
3% of the population. (Mental retardation,
Retrieved 2015 from
http://www.psychologytoday.com)
Other behavioural traits associated with MR
(but not deemed criteria for an MR diagnosis)
include aggression, dependency, impulsivity,
passivity, self-injury, stubbornness, low self-
esteem, and low frustration tolerance. Some
may also exhibit mood disorders such as
psychotic disorders and attention difficulties
(Mental retardation, Retrieved 2015 from
http://www.psychologytoday.com).
Research work in various aspects of MR
has been conducted all over the world with
growing awareness in order to solve this
complex phenomenon. Currently, there is no
"cure" for an established disability, though with
appropriate support and teaching, most
individuals can learn to do many things. There
are four broad areas of intervention. These
include psychosocial treatments, behavioural
treatments, cognitive-behavioural treatments,
and family-oriented strategies. (Mash, E., &
Wolfe, D. 2013). Psychotropic drugs have been
used extensively to reduce the symptoms
associated with psychiatric disorders, but they
too have their own side effects. (R Antochi,
2003)
In Ayurveda classics references like Jada
(inert), Mudha (dull) etc. are found in different
context, meaning intellectually impaired
persons (Acharya Jadavaji Trikamji, 1994). But
the condition was considered more of a social
discrimination rather than as a separate clinical
entity. Ayurveda has got a different approach
towards diseases which are evasive even to
most sophisticated researchers in modern
medicine. The acquaintance with the names of
diseases is not always necessary to cure
diseases. It is thorough knowledge of dosa,
dusya, site of manifestation and aetiological
factors rather than the names of diseases which
count for the purpose of their treatment
(Acharya Jadavaji Trikamji, 1994). In MR,
treatment should be directed to a) promoting
the intellect and correcting the behavioural
disorders. b) Improving adaptive behaviour. c)
Managing the associated disorders, for example
sensory and motor disabilities, incontinence,
visual and hearing defect, speech disorder etc.
Some drugs explained in our classics are
believed to improve intelligence and to cure
various mental deficits. Vacha, Rudraksha,
Haridra, Hingu is a few among them. The
present study was undertaken with an objective
to assess efficacy of an Ayurvedic formulation
(Vacha, Rudraksha, Haridra, Hingu) in
mentally retarded children based on a model
explained by Chawla Deepa Nanakram, (2000).
MATERIALS AND METHODS
For the clinical study, a total of 15 patients
approaching to the outpatient department of
Basic Principles, Government Ayurveda
College Hospital, Trivandrum, Kerala, India
were selected for the study. The patients were
assigned into a single group taking into
consideration inclusion and exclusion criteria.
Complete history and clinical examination of
all children was carried out and recorded in a
specially designed proforma by the post
graduate department of Basic Principles,
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Government Ayurveda College, Trivandrum,
Kerala, India. Social age and social quotient
was assessed by using Vineland Social
Maturity Scale. Mental age and mental quotient
was calculated by using Seguin Form Board
Test.
The Clinical research design was approved
by the Research Review Committee of Kerala
University. Before administering tests, parents
of MR children were made clear about the
purpose of this study and were told that the
result of tests would be kept strictly
confidential and would be used for research
purpose only.
Inclusion Criteria
Persons presenting with the clinical
features of Mental Retardation
Age group between 8 months to 12 years
Sex-No sex discrimination.
Exclusion Criteria
Persons affected with severe debilitating
illnesses
Persons below 8 months and above 12
years of age
Persons having severe convulsive
disorders.
Preparation of the drug
Table 1.Ingredients of Ayurvedic formlation with botanical name and part used
S.No. Sanskrit name Botanical name Part used
1 Vacha Acorus calamus Linn. Rhizome
2 Haridra Curcuma longa Linn Fruit
3 Hingu Ferula narthex Boiss Gum resin
4 Rudraksha Elaeocarpus sphaericus Roxb. Rhizome
Raw drugs (Table 1) of Vacha (Acorus
calamus), Haridra (Curcuma longa), Hingu
(Ferula narthex) and Rudraksha (Elaeocarpus
sphaericus) were procured from local market,
Trivadrum, Kerala, India. The drugs were
identified from department of Dravyaguna,
Government Ayurveda College Hospital,
Trivandrum, Kerala, India. Samples were
stored in the department for future reference.
These Raw drugs were washed well and dried
in shade. Since, Rudraksha was very hard, it
was soaked in water for 24 hours and dried in
sun for about 15 minutes. Hingu was very
sticky to powder hence was sun dried and fried
with ghee. Later all the drugs were powdered
separately in a pulverizer and then mixed
together. Fine powder was weighed out and
sealed in polythene packets. Powder was given
orally twice a day for 90 days in a dosage given
below (Table 2).
Dose and duration
Table 2.Dose and duration of treatment
S.No. Age (yrs) Dosage Time Anupana Duration
1 8 months –2 years 300 mg 7am & 7pm Warm water or Honey 90 days
2 2 years–5 years 500 mg 7am & 7pm Warm water or Honey 90 days
3 5 years–9 years 750 mg 7am & 7pm Warm water or Honey 90 days
4 9 years–12 years 1 gm 7am & 7pm Warm water or Honey 90 days
Instructions were given to rub pieces of
Vacha and Rudraksha (2–3 rounds) with water,
and the obtained paste mixed with honey was
advised to be applied over tongue and inside
the mouth (oral) cavity once a day in the
morning for 90 days.
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Statistical analysis
Values obtained were statistically
evaluated using paired „t‟ test.
Parameters for assessment
a. Seguin Form Board (SFB) test (Goel, S. K.,
& Bhargava, M. 1990)→ To assess Mental
Age (MA) and Intelligence Quotient (IQ)
b. Vineland Social Maturity Scale (V.S.M.S.)
test (Indian adaptation by D. A.J. Malin
1965)→ To estimate Social Age (SA) and
Social Quotient (SQ)
c. Specially designed proforma by post graduate
department of Basic Principles, Government
Ayurveda College, Trivandrum, Kerala, India
for assessing treatment response considering
different symptoms or factors (psychological,
psychomotor and biological including)
including behavioural disorders.
Social Quotient is computed by using the formula→
(Social Age ÷ Chronological Age) × 100
Intelligence Quotient is computed by using the
formula→ (Mental Age † Chronological Age) ×
100
Observations
Maximum no. (67%) of the patients were of
the age group 5 to 8 years. Male and female
were almost in same number (male 7 and
female 8). More than half patients (about 67%)
were from middle class. Family history of MR
was found in 40 % and epilepsy in 20% of
patients. In 40% patients perinatal aetiology
such as prematurity, delayed birth cry,
instrumental delivery was found etc. Prenatal
aetiology (chromosomal and genetic disorder)
was observed in 20% of cases. 33.33%,
26.67%, 33.33%, 6.67% children were having
mild, moderate, severe and profound MR
respectively.
RESULTS
Though SA was improved in 3 patients, SQ
was found to be increased only in one patient
since SA was not increased in accordance to
chronological age (CA). In remaining cases no
change in SA was seen. As CA of patients was
increased SQ came somewhat less after
treatment (Table 3).
Table 3.Social age (SA), social quotient (SQ) mental age (MA) and intelligent quotient (IQ)
before and after treatment
Pati
ent
No.
Before treatment After treatment Before treatment After treatment
SA SQ
Aver
age
SQ
SA SQ
Aver
age S
Q MA IQ
Aver
age
IQ MA IQ
Aver
age
IQ
Yea
rs
Month
s
Yea
rs
Month
s
Yea
rs
Month
s
Yea
rs
Month
s
1 1 2.1 19.72
42.19
1 3.3 19.74
41
54.19
57.53
2 0 9.1 23.68 0 9.1 21.95
3 3 7.2 48.86 3 7.2 47.25
4 2 0.1 50 2 0.1 47.06
5 2 11.6 32.73 3 1 32.74
6 3 0.9 52.86 3 0.9 50.68
7 2 - 42.10 2 - 40
8 1 8.1 23.81 1 8.1 22.99
9 2 2.3 28.89 2 2.3 27.96
10 4 6 62.07 4 6 60
11 1 7.3 29.23 1 11.8 34.28
12 4 10 69.05 4 10 65..52 4 8 65.88 5 5 73.86
13 4 7.3 45.84 4 7.3 44.71 4 3 42.5 4 3 41.2
14 3 5.5 56 3 5.5 53.85
15 2 0.8 48.08 2 0.8 45.45
SQ= (SA÷CA) × 100 IQ=(MA÷CA) ×100
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Table 4. Mean and standard deviation of individual factors score before treatment and after 90
days of treatment and level of significance
Factors
Score
Mean
difference SD diff. T value P value
Before
treatment
After 90 days
Mean SD Mean SD
A. Psychological
1.cognition
2. mood
1.76 0.88 2.46 0.64 0.94 0.61 5.87 <0.001
1.26 0.8 2.33 0.97 1.06 0.95 4.33 <0.001
B. Psychomotor
1.locomotion
a. Activeness
b. Performance
2. Drooling of
saliva
3. Speech
4. Habits
1.8 0.68 2.27 0.59 0.47 0.57 3.61 <0.01
1.53 1.24 2.2 1.01 0.67 0.9 2.91 <0.02
2.33 0.9 2.6 0.5 0.267 0.46 2.2 <0.05
2.13 1.64 2.73 1.87 0.6 0.63 3.75 <0.01
0.53 0.84 1.33 0.82 0.8 0.86 3.64 <0.01
C. Biological
1.Bed wetting
2. Immunity
1.13 0.91 1.33 0.9 0.2 0.41 1.82 Not sig.
1.07 0.8 1.33 0.49 0.27 0.2 5.4 <0.001
Table 5.Mean and Standard Deviation of scores of behavioural disorders before treatment and
after 90 days of treatment and level of significance
Time of assessment Mean SD Mean diff. SD diff. t-value P value
Before treatment 6 1.96
2.53 1.77 5.5 <0.001 After 90 days of
treatment
8.53 1.68
Among 15 children, only 2 patients could
perform SFB test. Out of two, MA and IQ were
increased in one patient, while in other MA
remained same. Average IQ was increased
from 54.19 to 57.73 after treatment.
Response to treatment was observed over
psychological, psychomotor and biological
factors (Table 4). Maximum response was
found over psychological factors followed by
psychomotor factors. Student t-test was found
highly significant for individual psychological
factors (cognition and mood). In case of
psychomotor factors „t‟ tests were significant
for all the factors. Drooling of saliva was
present only in 6 children. The „t‟ value for
drooling of saliva was found significant at 1 %
level when calculated for 6 patients The „t‟ test
was highly significant for immunity. No
statistically significant improvement was found
in bed wetting.
Under behavioural disorders factors like
mood disorders, activeness, drooling of saliva,
habits, and sleep disturbance were calculated.
The „t‟ test was highly significant over
behavioural disorders (Table 5). It means
treatment was very effective over behavioural
disorders.
DISCUSSION
Mental retardation is an intellectual and
adaptive behaviour disability that begins during
the developmental period. Other behavioural
traits like aggression, dependency, impulsivity,
passivity etc. and mood disorders such as
psychotic disorders and attention difficulties
may be associated with MR. Various single or
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compound herbo and herbo-mineral
preparations which promote intellect are
described in Ayurvedic classics under the
context of Medhya Rasayana (intellect
promoting drugs). While all the Rasayana
drugs improve the mental faculties in addition
to exerting a beneficial effect on the body,
Medhya Rasayana are those drugs that have
specific effect on mental performance. They
are claimed to promote cognitive functions of
the brain and used in various mental disorders.
Some examples of scientific validation of
Medhya Rasayanas in dementia, depression
and memory impairment are mentioned here.
Study conducted (Stough et al., 2001) for the
chronic effects of an extract of B. monnieri
(Keenmind) on cognitive function in healthy
human subjects and reported that that B.
monnieri may improve higher order
cognitive processes that are critically
dependent on the input of information from our
environment such as learning and memory.
Agrawal and Singh (1998) conducted an open
trial of Mandukaparni (Centella asiatica) in
cases of educable mental retardation indicating
significant improvement in performance IQ,
Social Quotient, immediate memory span and
reaction time. Kapikacchu (Mucuna pruriens)
is a Rasayana-Vajikarana plant drug. It is
frequently used for the treatment of
Parkinson‟s disease and depressive illness in
elderly persons. On Phytochemical studies
Mucuna pruriens seeds have been shown to
contain significant quantity of L-Dopa which
could be the basis for its anti-Parkinsonism
effect (R.H.Singh 2008). Thus, the Medhya
Rasayana drugs such as Vacha,
Ashwagandha (Withania somnifera), Brahmi,
Mandukaparni, Sankhapuspi, Kapikacchu and
several other such herbal and herbo-mineral
drugs are very useful in the management of
depression, dementia and other mental
disorders of elderly. Conceptually it is held that
all Rasayana drugs produce their effect by
acting through nutrition dynamics (Rasa, Agni,
Srotas) at molecular level. They may not
possess sharp pharmaceutical activities if used
in holistic form and hence as such they may be
treated as soft and safe medications which are
the popular professional demand in present
times.
Medhya drugs can be classified in two
broad groups. First group- Madhura rasa
(sweet in taste), Guru- snigdhaguna (heavy and
unctuous in quality), madhuravipaka (sweet
after digestion) and shitavirya (cold in
potency). Second group- katu- tikta rasa
(pugent and bitter in quality), laghu-
rukshaguna (light and dry in quality),
katuvipaka (pungent after digestion) and
ushnavirya (hot in potency).
The first group drugs provide nourishment
to the brain and the second group drugs
promote satwa quality of mind and removes
rajo and tamodoshas of mind. In other words
they stimulate the brain.
The combination Vacha, Rudraksha,
Haridra, Hingu acts as Medhya Rasayana..
The constituents of the combination (except
Rudraksha) predominantly are katu-tikta
(Pungent and bitter) in taste, laghu (light) in
quality, katu in vipaka (pungent after digestion)
and hence pacifies kapha –vatadosa (functional
entities of our body) (Bramhmasankara Sastri,
2007). Rudraksha is amla (sour) in taste,
snigdha (unctuous) in quality and madhura
(sweet) after digestion (P.V.Sharma, 1990).
Vacha is intellect promoting, anticonvulsant.
Susruta says it is very good for children to
increase their mental abilities. It is useful in
epilepsy, delirium, amentia, convulsions, manic
conditions, depression and other mental
disorders (Bramhmasankara Sastri, 2007). It is
indicated in classics from the first day of birth
mainly to reduce kapha dosa (functional
entities of our body) and promote intellect.
Haridra is antimicrobial (Bhawana et al.,
2011), immunomodulatory (Tan X et al.,
2011), neuroprotective (Dohare P, Garg P et
al., 2008) and exhibits synergistic effect
(Mansi AP & Gupta SV, 2012). It is among the
first 6 drugs which are very frequently
indicated in more than 150 different
preparations prescribed for mental conditions.
Hingu is anticonvulsant and nervine stimulant
(Bramhmasankara Sastri, 2007) and
antioxidant (Mallikarjuna GU et al., 2003). It
promotes the Agni (fire) (Bramhmasankara
Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 2 | February 2015 | 38–45
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Sastri, 2007). Rudraksha possess antioxidant
(Kumar ST., 2008) and anxiolytic activities
(Shah G., 2010). It is useful in epileptic fits,
manic conditions, convulsions, insomnia and
other mental disorders.
The combination predominantly acts as
stimulant to brain, also provides improvement
in the nutritional status of the neural tissues
(Brain etc.). Like other Ayurvedic drugs
Vacha, Rudraksha, Haridra, Hingu is a
combination of potentially effective drugs that
acts at various levels in a holistic way to
improve the mental deficits and promote
cognitive functions of the brain.
CONCLUSION
The tested Ayurvedic formulation posseses Nootropic and cognitive enhancing property. It acts as Medhya rasayana. The scientific
studies conducted in recent years with this class of drugs have given evidence of neuronutrient effect, neural metabolic modification and improved blood perfusion to the Brain, which is mostly responsible for their clinical effects. The present clinical study revealed that the combination is effective in the management of mental retardation. The Ayurvedic formulation was very effective over Psychological factors like cognition and mood followed by psychomotor factors. Immunity was also found improved with the selected combination. Maximum response was observed over behavioural disorders.
ACKNOWLEDGMENT
Authors gratefully acknowledge the kind
guidance and support given by Dr. K.
Sundaran, during the course of the study.
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Source of Support: NIL Conflict of Interest: None Declared
Call for Papers – Vol. 4, Issue 4, April 2015
Submit your manuscripts (Research articles, Review
articles, Short Communications, Letters to the Editor,
Book Reviews) to Global Journal of Research on
Medicinal plants & Indigenous medicine – GJRMI
Submit it online through www.gjrmi.com or mail it to
[email protected] on or before
March 10th
2015.
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