Aushadh pratishaya

Medicine used in rhinitis

1. AUSHADH PRESENTATION MEDICINE IN PRATSHYAYA BY DR. EISHAN JAIN UNDER THE GUIDANCE OF ALL TEACHING STAFF OF KAUMARBHRITYA DEPARTMENT 1

2. INRODUCTION The disorder of nasa have been described widely by all the Acharyas . Acharya Susrutha has described 31 nasagatha rogas . Among them pratishyaya is one of the most important disease. He has described the disease very elaborately including its complications as diseases of eyes, nose and ear. On the basis of signs and symptoms, the disease pratishyaya can be compared to allergic rhinitis in modern medicine characterized by sudden and frequent attacks of sneezing, profuse watery nasal discharge associated with nasal obstruction which is intermittent watering of eyes, heaviness of head, respiratory distress and anosmia . Allergic reaction is produced when the body comes in contact with allergens. 2

3. निरुक्ति सुश्रुत संहिता २४ 3

4. निदान 4

5. पूर्वरूपम् 5

6. संप्राप्ति 6

7. सम्प्राप्ति 7

8. Samprapti Ghataka of Pratishyaya Dosha - Vata Kapha Pradhana, Alpa Pitta Dushya - Rasa, Rakta Agni - Jatharagni , Rasadhatwagni Ama - Rasadhatwagnimandhya Srotas - Pranavaha , Rasavaha Srotodushti - Sanga,Vimargagamana , Atipravruthi . Udbhavasthana - Amashaya Sancharisthana - Gala, Urdhwajatru , Nasa , Ganda Pradesha Vyaktasthana - Nasa Rogamarga - Abhyantara Vyadhiswabhava - Ashukari Vyadhi Avastha - Vyakta Adhisthana - Nasa , Shiras 8

9. Types of प्रतिश्याय According to आचार्य सुश्रुत वातज प्रतिश्याय पित्तज प्रतिश्याय कफज प्रतिश्याय संन्निपातज प्रतिश्याय दुष्टज प्रतिश्याय रक्तज प्रतिश्याय 9

10. TREATMENT OF PRATISHYAYA 10

11. Sl. No. Name of the formulation Dosage form Daily dose Anupana Reference 1 Shunthi Churna 3gm bd Honey D.V- vol2 P.V sharma 2. Maricha Churna 3gm bd Curd & jaggery B.R. Nasa roga 3. Citraka haritai Avlehya 12 gm bd Water/ milk B.R. Nasa roga 4. Vyoshadi vati Vati 1 gm bd Chewable S.S.Ma.K 5. Laxmivilasrasa Vati 250 mg bd Honey B.R. rajyashma chi. 6. Anu taila Taila 2 drops S.Y.Pa.P 11

12. HARIDRA Phyto -constituents- curcumin 50-60% Rasapanchaka Rasa – Tikta , Katu PITTA SHAMAK Guna - Ruksha , Laghu Veerya – Ushna KAPHA SHAMAK Vipaka - katu Prabhava – krimighna Dosha karma – Kapha pittahara . 12

13. Respiratory System- Its tikta and tikshna property act as a expectorant. 13

14. Mechansm of Haridra in breaking pathophysio of rhinitis 14

15. MARICHA RASA PANCHAKA RASA – Katu GUNA – Rooksha , teekshna VEERYA – Ushna VIPAKA – Katu DOSHAGHNATA - KaphaVatahara 15

16. CHEMICAL CONSTITUENTS Through its active component Piperine , Black Pepper is able to modify supplement and drug metabolism. Piperine inhibits drug detoxifying enzymes. This typically increases bioavailability of any compound which would normally be attacked by said enzymes. Kantakari Ghrita – Given to children with complaints of shwasa , kasa , jwara , aruchi . ( Bhai . Rat. Balaroga ) 16

17. VACHADI SYRUP 17 S.N DRUG BOTNICAL NAME USABLE PART 1. Vacha Acorus calamus Linn. Rhizome 2, Yavani Trachyspermum ammi Linn. Fruit 3. Aamalaki Phyllanthus emblica Linn. Fruit 4. Vibhitaki Terminalia belliricaRoxb. Fruit 5. Haritaki Terminalia chebula Retz. Fruit 6. Shunti Zingiber officinalis Roscoe. Rhizome

18. 18 DRUGS RASA GUNA VIRYA VIPAKA DOSHKARMA V acha K atu-tikta G uru, tikshna U shna Katu Vatakaphahara Yavani K atu-tikta G uru, tikshna ushna Katu Vatakaphahara Aamalaki A mla pradhan panchrasa G uru, ruksha Sheeta Madhur Tridoshahara Vibhataki K ashaya L aghu, ruksha U shna Madhur Tridoshahara Haritaki Kashaya pradhan panchrasa L aghu, ruksha U shna Madhur Tridoshahara Shunti Katu G uru, ruksha, tiksna ushna Madhur Vatakaphahara

19. Mode of action of Vachadi syrup The drug for the clinical study was referred from Harita Samhita , 3 rd sthana , 2 nd chapter where Acharya Harita has explained the treatment for Pratishyaya (rhinitis) in children. The drug contains ingredients Vacha , Yavani , Amalaki , Vibhitaki , Haritaki and Shunthi . Here, Vacha , Yavani , Haritaki and Shunthi by their properties of Ushna Veerya (hot potency), Laghu (lightness), Teekshnaguna (sharp in property) does Amapachana (digestive), Vatanulomana (proper movement of Vata ) and are VataKapha hara . Whereas Amalaki and Vibhitaki by their Madhura vipaka (post digestion) acts as Tridoshahara . Altogether, this drug acts on Tridosha , corrects Agnimandya (digestive fire), relieves Srotodushti (clears obstruction in the channels) and does Vatanulomana . 19

20. Discussion Pratishayaya had got simulation with Allergic rhinits which is the burning problem in the present generation and as there was no successful management for these conditionsin allied science. Hence present clinically study was designed.Vachadi Syrup shows highly significant result in Nasasrava (nasal discharge)(86%), Gandha-ajnana (loss of sense of smell) (85%), Mukhashosha (dryness of mouth) (82%), Kshavathu (sneezing) (78.5%), Ghranavarodha (nasal obstruction) (95%), Shirovedana (headache) (92.5%), Trishana (thirst)(81%), Kasa (cough) (80%), Aruchi (loss of appetite)(83%), Nasal congestion(87%), Nasal itching(80%) relief respectively. Significant result was obtained in Swarasada (altered voice) with 60%, Shirogaurava (heaviness of head) with 66% and not significant in Nasagra-paka (nasal mucosa inflammation) with 40% relief respectively. 20

21. Ingredient Of Vyoshadi Vati 1. Sunthi ( zinzberofficinale ), 2. Marich ( pipernigrum ), 3. Pippali ( piperlongum ), 4. Amlavetas ( Garcina Peunculata ), 5. Chavya ( Chavivaroburghii ) 6. Talispatra ( Abies webbiana ), 7. chitrak ( Plumbago Zeylancia ) 8. Jiraka ( Cuminum Cyminum ) 9. Guda ( Jaggery ) (Black). 21

22. Method of preparation of drug All the mentioned drugs were taken in equal quantity in powder form except Guda ( Jaggery ). Guda ( Jaggery ) was taken 4 times of all mixture powder. Guda ( Jaggery ) & all powder were mixed properly & tablets were prepared. 22

23. PROBABLE MODE OF ACTION In the pathogenesis of pratishyaya , predisposing factor was Kapha vitiated diet & vihar . Prime factor was Rasadhatwagni mandyta . Most of drug having Tikta Rasa, Katu Vipaka & Ushana Virya . They also have function like Kaphasaman & lekhan ( depletive). Amapachana & Dhatu - Shoshan properties of Vyoshadi Vati normalize the function of Agni. The drugs p ossess the Tikta Rasa which helps in the clearing the obstruction in the Strotas (channels). Kapha & rasadhatu both are Prithvi & Jala Mahabhuta entities. So in the management of pratishyaya , the drug must be opposite of these two Mahabhut . This achieved by Tikta Rasa as it has Khara property. Amlarasa & Guda ( Jaggery ) has potency to reach at cellular level & restore function of dhatwagni . The extract of ginger due to its katu rasa and teekshna guna it acts as vata kapha hara , deepana and bhedana . 23

24. Laxmi Vilas Ras ( Nardiya ) Reference: Bhaishajya Ratnavali , Rasayana Adhikara 55 – 68. It is a Ras Aushadhi . Mercury is known as Rasa in Ayurveda and medicines that are prepared using purified mercury, purified Sulphur , Bhasma etc. are named as Ras Aushadhi (Mercurial Preparations). Para, Parad , Rasa or mercury is a heavy metal that remains liquid at room temperature. It is used in Ayurveda only after proper detoxification as per classical Ayurvedic texts. Parad is ingredient of numerous medicines due to its powerful medicinal properties. It balances Vata , Pitta and Kapha . Ras Aushadhi ( Parad containing medicine) are fast acting. It nourishes whole body and has tonic, aphrodisiac, rejuvenative , anti-aging, wound-healer, and antimicrobial effect. The combination of mercury with other medicinal ingredients enhances the therapeutic efficacy of medicine due to Yogvahi property of Parad . 24

25. Ingredients 10 g fine powder of each of:- Abhraka Bhasma - Purified and processed Mica Shuddha Parada - purified Mercury Shuddha Gandhaka - purified Sulphur Karpoora - Camphor - Cinnamomum camphora Jatiphala - Nutmeg (fruit) - Myristica fragrans Jatikosha - Nutmeg Vriddhadaru - Argyrea speciosa Dhattura - Datura metel Bhanga - Cannabis sativa Vidari - Pueraria tuberosa Shatavari - Asparagus racemosus root Nagabala - Grewia populifolia Atibala - Abutilon indicum Gokshura - Small caltrops (whole plant) - Tribulus terrestris Kuchula - Strychnos nux vomica Nagavalli - Piper betel - juice extract - quantity sufficient. 25

26. Method of Preparation Fine powder ingredients are triturated with each liquid for three days. Then paste is prepared, and tablets are made. Dosage - 250 mg. It is traditionally administered along with buttermilk, milk and fruit juices. 26

27. In preparation of Ras Aushadhi /medicine first Kajjali is made from purified Parad and Gandhak . As these medicines contain heavy metals, it is better to take them as prescription drugs. Laxmi Vilas Ras , contains detoxified minerals-metals, cannabis seeds, Datura seeds and therefore it is recommended to take this medicine in recommended dosage, under medical supervision. 27

28. Benefits of Laxmi Vilas Ras It is a broad spectrum medicine. It is a Rasayan ( Rejuvenative tonic;nourishes all dhatu and builds Ojas ). It has anti-pyretic, aphrodisiac, expectorant, antiseptic and stomachic activities. It cures all types of fever. It is an excellent medicine to treat cough, asthma, fever due to cough, chronic sinusitis etc. It is useful in all twenty types of Prameha . It has aphrodisiac property and increases libido. It gives strength to heart. It cures various diseases of head, skin, and genito -urinary system. It improves hemoglobin level, gives strength and nutrition. 28

29. Uses of Laxmi Vilas Ras ( Nardiya ) Udara Prameha (Urinary disorders) Dhatu Kshaya (Tissue wasting) Urdhvanga Roga . Guda Roga ( Anorectal disease) Bhagandara (Fissure) Nadivrana (Fistula) Kushtha (Diseases of skin) Vrana (Ulcer) All kinds of shlipada ( Filariasis ) Gala- shosha (Dryness in throat) Kasa (Cough) Yakshma (Tuberculosis) Pinasa (Chronic rhinitis/sinusitis) Antra Vriddhi (Hernia) Atisar ( Diarrhoea ) Amavata (Rheumatism) Disorders of Mouth Ear Nose and Eyes Arsha ( Haemorrhoids ) Sthaulya (Obesity) 29

30. STUDY ON N.L.V.RAS In one trial, 240 cases of bronchial asthma were administered Nardiya Lakshmi Vilas rasa and Godanti Bhasma in a dose of 0.5 and 1.0 g, respectively, three times/day with honey for a varying period of 4 to 12 weeks. 96 patients received 100% relief. 27 patients received 75% relief. 50 patients received 50% relief. 18 cases received 25% relief. and 28 remained unchanged. 21 cases left against medical advice. 30

31. VYAGHRI TAILA The contents of vyaghri taila are vyaghri , danti , vacha , shigru , surasa , pippali , maricha , shunti, Saindhava and tila taila. 31

32. Properties Vyaghri has the properties like Antiinflammatory , antibiotic, vasoconstrictor and histamine releasing activity. Hence it is proved to be effective in the management of Dushta Pratishyaya (Chronic Simple Rhinitis). Danti is said to be possessing qualities like kaphapittahara which can be considered as vyadhi pratyanika dravya . Further Vacha , shigru , Surasa medicines are also possessing properties of antibacterial, anti-inflammatory & shirovirechana . These drugs are immunomodulators also. 32

33. Pippali has antiallergic activity. A common use of the fruit is in the prevention of recurrent attacks of bronchial asthma and common cold. Maricha has anti-oxidant, anti- Inflammatory, antibacterial properties. Shunthi inhibits prostaglandin synthesis, antiinflammatory , antioxidant and antibacterial. Tila has properties like free radical scavenging, decreases susceptibility to oxidative stress. All these factors made Vyaghri taila , a good ayurvedic medicine for controlling Dushta Pratishyaya . 33

34. Mode of action of Nasya In Purva Karma of Nasya , Abhyanga and Swedana is done. Abhyanga causes Mruduta of Doshas and Swedana causes Vilayana ( liquification ) of accumulated Doshas . In the language of modern science, Abhyanga and Swedana increases the local blood supply and Swedana also liquefies the mucous. Due to vasodilatation the permeability of blood vessels increases, which makes the drug absorption faster. In Pradhana Karma , the drug in Churna form is administered into the nostrils through Pradhamana Nadiyantra in the head-low position of the patient. Thus, the drugs reach the Shringataka and from there, through different Siras , it spreads to other parts like Netra , Shirah , etc. and removes the morbid Doshas . By the properties of drug, it causes Srotoshuddhi and makes the Anulomana Gati of Vayu (mitigation of Vayu ), which is hampered in Dushta Pratishyaya . In Pashchata Karma , Urdhvanga massage and Swedana helps to drain out the Doshas and Swedana also causes Srotomukhavishodhana . In addition, the drug compound has Srotoshodhana , anti-inflammatory, antibacterial, etc., properties, which help to treat the disease. 34

35. Pratishyaya Pathya (Do’s) Apathya (Don’ts) Cereals Old shali rice Pulses Kulattha , green gram ( mudga ) Fruits & vegetables Paravala , drum stick ( shigru ), radish, garlic Others Hot freshly prepared food, jaggery , powder of roasted cereals ( sattu ), haritaki , shadangayusha , shadabindu taila , chyavanaprasha Life style Lightening, drinking of clarified butter ( ghrita ), sudation, therapeutic emesis ( vamana ), snuffing ( avapidana nasya ) Use of excessive cold water for drinking and bathing, excessive worry ( atyadhika chinta ), intake of alcohol, dry food, suppression of natural urges, day sleeping, sleeping on the ground 35

36. Dushta pratishyaya Pathya (Do’s) Apathya (Don’ts) Cereals Old shali rice Pulses Kulattha , green gram ( mudga ) Fruits & vegetables Paravala , drum stick ( shigru ), radish, garlic Others Chitraka haritaki , jaggery , curd, black pepper Intake of alcohol, dry food Life style Intake of warm water, therapeutic emesis ( vamana ), shadabindu taila , intake of luke warm water through nasal passage, smoking Use of cold water for drinking and bathing, excessive thinking, suppression of natural urges, smoke, dust, day sleeping, sleeping on the ground 36

37. Thank you… 37