“EVALUATION OF EFFICACY OF HARITAKI PHALA CHURNA      IN THE MANAGEMENT OF TAMAKA SWASA”                                  ...
Declaration by the candidateI here by declare that this dissertation / thesis entitled “Evaluation of efficacyof Haritaki ...
D.G.M.AYURVEDIC MEDICAL COLLEGE         POST GRADUATE STUDIES AND RESEARCH                                      CENTRE    ...
© Copy right                Declaration by the candidate        I here by declare that the Rajiv Gandhi University of Heal...
J.S.V.V. SAMSTHE’S                   D.G.M.AYURVEDIC MEDICAL COLLEGE                POST GRADUATE STUDIES AND RESEARCH CEN...
ABSTRACT       Tamaka Swasa vis-a- vis Bronchial Asthma is one of the most distressing diseaseand is quite common in all t...
CONTENTS                                     Page No1. Introduction                        1-32. Objectives               ...
ABBREVIATIONSA.H.          Asthanga HridhayaA.S.          Asthanga SamgrahaARM.N         Abhidana Ratnamala Nigantu.B.P.  ...
LIST OF TABLES Table No                     List of Table                                 Page NoTable - 1    Paryaya of H...
Table No                     List of Table                          Page NoTable – 22   Results of patient by age         ...
Table No                     List of Table                    Page NoTable – 43   Distribution of patients by Addiction   ...
LIST OF GRAPHSGraph No   List of Graph                                       Page NoGraph -1   Distribution of patient by ...
ACKNOWLEDGEMENT       This is a moment of great pleasure and contentment for me as the last phase incompletion of this res...
My Sincerely thanks to P.M.Nandakumar Statistician,Sri.V.M.MundinamaniLibrarian for their timely help during my study I wi...
Introduction                              Introduction Ayurveda, the Indian System of Medicine, can easily be said the mot...
Introductionconditions. The classification of Charaka Samhita under dashemani points to use of tensingle drugs having spec...
Introduction      Between 100 and 150 million people around the globe, suffer from asthma and this                        ...
Objectives                                 Objectives Tamaka Swasa vis-a vis Asthma and allergies, such as atopic disease ...
Disease Review                                  Disease ReviewNirukti:       The word Tamaka Shwasa composed of two conjoi...
Disease ReviewVijaya Rakshita: Explains Tamaka Shwasa as:“Shwasasthu bhasthrikadmana Samavathordwa gamani”.       It means...
Disease Reviewthis - Svasocchvasatmaka Prana (am-1-33) and Avasocchusa Hinastu NiscitamMuktaevasaha. Angira and Brihaspati...
Disease ReviewSusruta Samhita:        Even in Susruta Samhita elaboration of etiology, types, pathogenesis, clinicalmanife...
Disease ReviewMEDIEVAL PERIOD:Cakrapanidatta: On the basis of the information available in Brihatrayi, the illness SwasaRo...
Disease ReviewNidana of Tamaka SwasaTable –13 Nidana of Tamaka Swasa 144-148S.No             Nidana                C.S    ...
Disease Review20        Pista padartha                        +           -           -         -      -21        Ama rasa...
Disease Review41      Pandu                                    +          -          +          -      -42      Rookshana ...
Disease ReviewPoorva Roopa of Tamaka SwasaTable – 14 Poorva Roopa of Tamaka Swasa 149-153S.No      Poorva Roopa           ...
Disease ReviewRoopa (Lakshana) of Tamaka SwasaTable – 15 Roopa of Tamaka Swasa 154-158S.N                       Laxanas   ...
Disease Review19      Muhar swasa, Muhuschiva avadhamyati              +       +       +        +      +        (Short bre...
Disease ReviewSamprapti (Pathogenesis) of Tamaka SwasaSwasa Roga Samprapti         Charaka opines that the Vitiated Kapha ...
Disease Review           Similar to this in Tamaka Swasa also,Kapha Dosha that afflicts the Rasa Dhatucontributes to the r...
Disease Review           Productive cough is another effect of obstruction of Pranavata in the PranavahaSrotas. As the cou...
Disease Review   Schematic diagram of Samprapti of Tamaka SwasaNIDANA SEVANASANCHAYA                   AGNIMANDYA DOSHA DU...
Disease Review                   Smprapti GhatakaDosha                     : Charaka – Kapha, Vata                        ...
Disease Review1) Sankhya Samprapti       The Tamaka Swasa is categorized under pancha bheda of Swasa.181Tamaka   Swasa doe...
Disease Review5) Bala Samprapti         Bala of Vyadhi depends on virulence of the hetus, presence of Poorva roopa inthe c...
Disease ReviewAnupashaya of Tamaka Swasa.           Ahara, Vihara, and Oushadhi aggravates the condition of the Tamaka Swa...
Disease Review   Sadhyasadhyata of Tamaka Swasa.         Tamaka Swasa, which is chronic of more than one year, is consider...
Disease Review           Vyavachedaka nidana of Tamaka Swasa           Differential Diagnosis between panchavidha Swasa   ...
Disease ReviewCHIKITSA       The effective treatment of Tamaka Shwasa cannot be united, as its pathologyinvolves multiple ...
Disease Reviewcan be achieved by Abhyanga and Swedana over the chest thereby allowing the freepassage of Pranavayu.       ...
Disease ReviewDhoomapana:       This is another procedure also aimed at eliminating the Kaphadosha from theSrotas. Dhoomap...
Disease Review       After Virechana, Samsarjana Karma is advised for about 3 to 5 days. Thisprocedure eliminates Doshas i...
Disease Review          Virechana followed by Vyadhihara Rasayana and Brihmana Chikitsa forms theideal treatment in betwee...
Disease Review 3)      Usually starts in childhood                    Starts in adult life 4)      Proceeded by infantile ...
Disease ReviewPathogenesis of Asthma: This can be expalined under two heading.       i)      Atopic Asthma       ii)     N...
Disease Review       The secondary mediators are, Leukotreins C4, D4 and E4, extremely potentmediators which causes prolon...
Disease ReviewEvaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa   65
Disease ReviewDifferential Diagnosis:COPD: History of cigaratte smoking, chronic cough, sputum production (i.e. is in chro...
Disease ReviewPATHYAPATHYA         In a patient suffering from Tamaka Swasa certain predisposing factors are said toinitia...
Disease ReviewKulatha                                -             -           +           +         +V Shakha VargaGuduch...
Disease ReviewVII Phala VargaJambira                                -             -           -           +         +Draks...
Disease ReviewSathu                                 -             -           +           -         -Varuni               ...
Disease ReviewTable –19 Apathya in Tamaka Swasa:Apathya AaharaI Shimbi DhanyaNishpava                               +     ...
Disease ReviewDhuma                                  +             +            +          +         +Anila               ...
Drug Review                                  Drug review Historical review of HaritakiAmong the earliest references, Panin...
Drug ReviewThere are references about Haritaki in almost all Nighantu’s. A story has been told inBhavaprakasha Nighantu, R...
Drug Review          Synonyms and its meanings   1) Abhaaya----“Na bhayam asyaha iti ||” (Bh.D)                      It re...
Drug Review     9) Haritaki----“Harasya Bhavane jata Hareeta cha swabhavataha |                     Sarvaroganscha cha Har...
Drug ReviewSynonyms of HaritakiTable – 1 Paryaya (Synonyms) according to different authors 11-18.SlNo Synonyms            ...
Drug Review19   Bhishagvara        -       -       +       -       -       +       -           +20   Pranada              ...
Drug ReviewClassifications:        Classification is the basis of development of every branch of science. The 1stattempts ...
Drug Review6       Dhanavantari nighantu                       Guduchyadi varga7       Priya nighantu                     ...
Drug ReviewTYPES OF HARITAKISeven types of Haritaki 19-21   1. Vijaya   2. Rohini   3. Putana   4. Amruta   5. Abhaya   6....
Drug Review           PROPERTIES ACCORDING TO DIFFERENT AUTHORS           Table – 3.RASA 25-36S.N      Rasa         C.S   ...
Drug ReviewProbable Mahabhuta dominance of Haritaki, according to Rasapancaka1)     Rasa → Pancarasa, Kasaya dominance (La...
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Evaluation of efficacy of haritaki phala churna in the management of tamaka shwasa -ANAND. M. DODAMANI, Department of Dravya Guna, Post Graduate Studies & Research Centre, D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE,GADAG

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  1. 1. “EVALUATION OF EFFICACY OF HARITAKI PHALA CHURNA IN THE MANAGEMENT OF TAMAKA SWASA” BY ANAND.M.DODAMANI Dissertation submitted to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore In partial fulfillment of the degree of Ayurveda Vachaspati M.D. In DRAVYA GUNA Under the Guidance of Dr. KUBER. SANKH .MD (AYU) Department of Dravya Guna Post Graduate Studies & Research Centre, D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG - 582103 2004-2007
  2. 2. Declaration by the candidateI here by declare that this dissertation / thesis entitled “Evaluation of efficacyof Haritaki phala churna in Tamakaswasa”is a bonafide and genuineresearch work carried out by me under the guidance ofDr. Kuber Sankh M D (AYU) Asst. Professor in Dept of Dravya Guna,DGMAMC, PGS&RC, GadagDate: Anand.M.DodamaniPlace: Gadag
  3. 3. D.G.M.AYURVEDIC MEDICAL COLLEGE POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG-582103 This is to certify that the dissertation entitled “Evaluation of Efficacy of Haritaki phala churna in Tamakaswasa” is a bonafide research work done by Anand.M.Dofamani. in partial fulfillment of the requirement for the post graduation degree of “Ayurveda Vachaspati M.D. (Dravya Guna)” Under Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka.Date: Guide:Place: Gadag Dr. KUBER SANKH M.D. (Ayu) Asst.Professor Dept. of Dravya Guna DGMAMC, PGS&RC, GADAG
  4. 4. © Copy right Declaration by the candidate I here by declare that the Rajiv Gandhi University of HealthSciences, Karnataka shall have the rights to preserve, use anddisseminate this dissertation/ thesis in print or electronic format for theacademic / research purpose.Date : ANAND.M.DODAMANI.Place : Gadag © Rajiv Gandhi University of Health Sciences, Karnataka
  5. 5. J.S.V.V. SAMSTHE’S D.G.M.AYURVEDIC MEDICAL COLLEGE POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG, 582 103 Endorsement by the H.O.D,Principal / Head of the Institution This is to certify that the dissertation entitled “Evaluation of efficacy ofHaritaki phala churna in Tamakaswasa” is a bonafide research work done byAnand.M.Dodamani under the guidance of Dr. KUBER SANKH, MD (AYU)Asst.Professor in Dept of Dravya Guna, in partial fulfillment of the requirement forthe post graduation degree of “Ayurveda Vachaspati M.D. (Dravya Guna)” UnderRajiv Gandhi University of Health Sciences, Bangalore, Karnataka.(Dr. G. V. MULAGUND) (Dr. G. B. PATIL) Professor & HOD Principal, Dept. of Dravya Guna DGM Ayurvedic Medical College, PGS&RC. Gadag Date: Date: Place: GADAG Place: GADAG
  6. 6. ABSTRACT Tamaka Swasa vis-a- vis Bronchial Asthma is one of the most distressing diseaseand is quite common in all the socio-economic strata in all the age groups and almost allover the world. The ancient sages knew the entity of this disease from very beginning. The Objective of the study is - To evaluate the efficacy of Haritaki Phala Churnain the management of Tamaka Swasa.and To evaluate the Bronchodilatory effect ofHaritaki Phala Churna. Through pulmonary function test – Peak Expiratory Flow Rate.Method:In this Prospective Clinical study 30 patients are selected from suffering from TamakaSwasa. The study duration is 60 days In Tamaka Swasa there is predominance of KaphaVata Dosha, here Haritaki is Tridosha Shyamaka action and Ushna veerya property.Haritaki Phala Churna is implemented in this clinical study. With dose of 3 gms individed dose with Ushna Jala Anupana. Efficacy was assessed by the difference of beforeand after treatment from the subjective and objective parameters.Results:Teevra vega Swasa and Ghurgurukatwam is pratyatma niyata lakshana of Tamaka Swasaobserved 100% in all patients.Statistically all subjective and objective parameters showHighly significance. Haritaki Phala Churna doesn’t cause any untoward effect. Thus HaritakiPhala Churna in Tamaka Swasa is the best-recommended drug with their requisite action.Key words:Haritaki, Tamaka Swasa, Asthma, Swasa Roga, PEFR, BHT, AEC. III
  7. 7. CONTENTS Page No1. Introduction 1-32. Objectives 43. Literature Review a) Drug Review 5-35 b) Disease Review 36-724. Methodology 73-865. Results 87-1196. Discussion 120-1287. Conclusion 129-1318. Summary 132-1349. Bibliographic References 135-14910. Annexure 1-7 IV
  8. 8. ABBREVIATIONSA.H. Asthanga HridhayaA.S. Asthanga SamgrahaARM.N Abhidana Ratnamala Nigantu.B.P. BhavaprakashB.P. N. Bhavaprakash NighantuB.R. Bhaishajya RatnavaliB.S. Bhela SamhitaC.Chi. Charaka Samhita Chikitsa sthanaC.D. ChakradattaC.S. Charaka SamhitaD.N. Dhanvantari NighantuD.G. Dravya Guna by P.V.SharmaG.N. Gada nigrahaI.M.M Indian Materia MedicaI.M.P. Indian Medicinal Plants.K.N. Kaiyadev NighantuM.N. Madanapala Nighantu.Mao.N Maoushadhi NighantuN.A. Nighantu Adarsha.R.N. Raja NighantuR.T. Rasa taranginiSH.N Shaligrama NigantuS.S. Sushruta SamhitaY.R. Yoga Ratnakara V
  9. 9. LIST OF TABLES Table No List of Table Page NoTable - 1 Paryaya of Haritaki according to different authors 9-10Table -2 Gana and Varga of Haritaki according to different authors 11-12Table - 3 Rasa of Haritaki according to different authors 14Table - 4 Guna of Haritaki according to different authors 14Table - 5 Veerya of Haritaki according to different authors 14Table - 6 Vipaka of Haritaki according to different authors 14Table - 7 Dosha Karma of Haritaki according to different authors 16Table - 8 Actions of Haritaki according to different authors 16-17Table - 9 Prayoga of Haritaki according to different authors 18-19Table - 10 Contraindications of Haritaki according to different authors 20Table - 11 Vishishta Yoga of Haritaki 22-24Table - 12 Prayojya Anga of Haritaki according to different authors 33Table – 13 Nidana of Tamaka Swasa 41-43Table – 14 Poorva Roopa of Tamaka Swasa 44Table – 15 Roopa of Tamaka Swasa 45-46Table – 16 Vyavachedika Nidana of Tamaka Swasa 56Table – 17 Types of Asthma 61-62Table – 18 Pathya in Tamaka Swasa 67-70Table – 19 Apathya in Tamaka Swasa 71-72Table – 20 Table showing the demographic data 87-88Table – 21 Distribution of patients by age 89 VI
  10. 10. Table No List of Table Page NoTable – 22 Results of patient by age 89Table – 23 Results of patient by gender 90Table – 24 Distribution of patients by Religion 91Table – 25 Results of Patient by Religion 92Table – 26 Distribution of patients by Occupation 92Table – 27 Results of patients by Occupation 93Table – 28 Distribution of patient by Economical status 94Table – 29 Results of patients by Economic status 94Table – 30 Distribution of patient by Food Habits 95Table – 31 Distribution of patient by Presenting Complaints 97Table – 32 Distribution of patient by Associated features 99Table – 33 Results of patients by mode of onset 101Table – 34 Distribution of patients by frequency of attack 102Table – 35 Distribution of patients by Duration of attack 102Table – 36 Distribution of patient by mode of progress 102Table – 37 Distribution of patient by Periodicity 103Table – 38 Distribution of patient by Preceding Factors 103Table – 39 Distribution of patients by aggravation factors 103Table – 40 Distribution of patients by Comfort Posture at attack 104Table – 41 Distribution of patients by Agni 104Table – 42 Distribution of patients by Bowel habits 104 VII
  11. 11. Table No List of Table Page NoTable – 43 Distribution of patients by Addiction 105Table – 44 Distribution of patients by Prakruti 105-106Table – 45 Distribution of patients by Dosha Vruddhi 106-107Table – 46 Distribution of patients by Dosha Kshaya 108Table – 47 Distribution of patients by Ahara Nidana 109Table – 48 Distribution of patients by Vihara Nidana 110Table – 49 Distribution of patients by Anya Nidana 111Table – 50 Distribution of patients by Srotas 112Table – 51 Distribution of patients by Poorva Roopa 113Table – 52 Subjective parameter assessment 114Table – 53 Showing Objective parameters 115-116Table – 54 Statistical Assessment of Subjective Parameters 117Table – 55 Statistical Assessment of Objective Parameters 118Table – 56 Over all assessment and Result 119 VIII
  12. 12. LIST OF GRAPHSGraph No List of Graph Page NoGraph -1 Distribution of patient by Age – Gender 90Graph –2 Distribution of patients by Religion 91Graph –3 Distribution of patients by Occupation 93Graph -4 Distribution of patients by Economic status 95Graph –5 Distribution of patient by Food Habits 96Graph –6 Distribution of patients by presenting complaints 98Graph -7 Distribution of patient by Associated features 100Graph –8 Distribution of patients by mode of onset 101Graph –9 Over all assessment and Result of Clinical trail 119 IX
  13. 13. ACKNOWLEDGEMENT This is a moment of great pleasure and contentment for me as the last phase incompletion of this research work I am deeply indepted to our beloved Principal Dr.G.B.Patil. For his constantencouragement during the entire phase of the study I take this glorious opportunity to knowledge with deep sense of gratitude toDr.G.V.Mulagund. Professor, H.O.D.Department of postgraduate studies researchDravyaguna Shri D.G.M.A.M.C.Gadag. For his valuable guidance and close supervisionthroughout the dissertation work I express my deep sense of gratitude to my guide Dr.Kuber Sankh. LecturerDepartment of Dravyaguna Shri D.G.M.A.M.C.Gadag. For his constant encouragementthroughout this dissertation work I also take this opportunity with deep sense of gratitude to Dr.G.S.Hiremath.Professor Department of Dravyaguna Shri D.G.M.A.M.C.Gadag. I express my heartly gratitude to Dr.S.B.Nidagundi.lecturer Department ofDravyaguna Shri D.G.M.A.M.C.Gadag. I am very much thanks full to Dr.Veena kori,lecturer Department of Dravyaguna Shri D.G.M.A.M.C.Gadag. I thank to department ofDravyaguna, teaching and non-teaching staff for providing the necessary facilities tocarry out this work. I wish to convey thanks to my respected HOD’s of other dept Dr.V.Varadacharyalu,Dr.Purushottamacharyulu,Dr.M.C.Patil,and lecturers Dr.K.S.R.Prasad,Dr. Shivaramudu, Dr. Shashidhar Doddamani, Dr.R.V.Shetter, Dr.Girish Danappagoudar,Dr. Santosh Belavadi, Dr Jagadish Mitti, Dr.Mulkipatil, Dr.Shankargouda. Acknowledgement I
  14. 14. My Sincerely thanks to P.M.Nandakumar Statistician,Sri.V.M.MundinamaniLibrarian for their timely help during my study I wish to thank R.M.O and all thephysicians and other staff of the hospital and all my patients for their co-operation duringmy clinical study. I am very much thankfull to my roommates Dr. Umesh Kumbar,Dr.Vijay.G.Hiremath, Dr.Sharanu.Angadi, Dr.Jagadish Handiganoor, Dr.LinagareddyBiradar, Shivu, Naveen & Manjunath for supporting me in preparing the dissertation rightfrom beginning to end. My sincere thanks to my colleaguesDr.C.B.Inamdar, Dr.S.S.sajjanar,Dr.Ashok Bingi,Dr.AshwinDev,Dr.KrishnaJigalur,Dr.AshokM.G,Dr.K.S.Hiremath, Dr.S.S.Gangur,Dr.V.M.kataraki,Dr.Suvarna,Dr.Anita.Dr.Ashwini vastrad, Dr.Shivalilakudari, Dr.ShaliniSharma, Dr.Shivakumar. Somlapur, Dr.Savita Bhat, Dr.Jaya Malgoudar, Dr.KalavatiPethlur, Dr.Mukta Arali I am thankful to my friends Santosh Meti, Amith Das, Vinay Achalkar for their kindco-operation and encouragement during the course of this study.I express my deepest gratitude to my parents Sri.M.B.Dodamani, Smt.G.M.DodamaniSri.L.Udaykumar, Smt.Shoba Udaykumar,Sri.S.G.Babaleshwar. My brothers Sunil andAnil and my wife Smt.Laxmi.A.Dodamani Who have inspired me to continue my PG Study with their constant moralsupport.Finally my sincere thanks to who are nearer and dearer to me for theirencouragement and help during the course of this study. Anand.M.Dodamani Acknowledgement II
  15. 15. Introduction Introduction Ayurveda, the Indian System of Medicine, can easily be said the mother of all thesystems of medical sciences. When we peep in to the history of medical sciences, therecords of this system of medicine are the oldest to find. It is in Vedas – the ancient mostliterature of human world that details of Ayurveda System of Medicine are found. Breathing is one of the normal physiological functions of body starts with birth andends with death. Pranavata and Apanavata are responsible for the breathing in andbreathing out. 1To and fro air through the Pranavaha Srotas is the vital sign of Prana.2 Normalcy of breathing in and breathing out suggests health and abnormalityindicates diseases and its cessation indicates death.3 This is the unique sign of life, isaffected in the diseases of Tamaka Swasa.4 The disease Tamaka Swasa has beenmentioned in the classics. Its similarities with the bronchial asthma according to thecontemporary sciences are well known. Tamaka Swasa is one of the most distressing disease and is quite common in all thesocio-economic strata in all the age groups and almost all over the world. The entity ofthis disease was known to the ancient sages from very beginning. The human being appears to be afflicted with more diseases than any other animalspecies. There can be little doubt then that he, very early, sought to alleviate hissufferings from injury and disease by taking advantage of plants growing around him. Inthe past, almost all the medicine s used were from the plants, the plant being man’s onlychemist for ages. The Samhitas classified drugs in different ways based on the features ofmorphology, pharmacological action and on the basis of the therapeutic effect in clinical Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 1
  16. 16. Introductionconditions. The classification of Charaka Samhita under dashemani points to use of tensingle drugs having specific therapeutic potential. Sushruta Samhita and AshtangaHridaya have also made classification of drugs in the form of ganas to groups listing anumber of drugs with specific therapeutic potentials. Further, these drug group (gana) intoto can be utilized or by removing a few from them or by adding a few more also withimmense therapeutic advantage suited to the clinical conditions. According to Acharya Charaka (Chi.S.1/33) Haritaki is explained in themanagement of Tamaka Swasa and many nighantukaras explained Haritaki having theSwasa Hara property. The present work “ Evaluation of Efficacy of Haritaki PhalaChurna in the Management of Tamkaswasa” is planned to assess its therapeutic effectin cases of shwasa roga. Because of the faulty methods of living, scarcity of balanced diet and various otherreasons the incidence of Tamaka Swasa is increasing day by day. There is no satisfactorytreatment available in contemporary sciences. It was because of these facts that decisionwas taken to take up this problem for intensive study. Tamaka Swasa some times severe and fatal also. It is the serious public healthproblem in the countries through out the world. Nearly 5-to10% of the world populationat some stage during life suffers from asthma. 5 The disease can occur at any age andaffects 5% of adults and 7-10% children commonly.6 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 2
  17. 17. Introduction Between 100 and 150 million people around the globe, suffer from asthma and this 7number is rising. Worldwide, deaths from this condition have reached over 180,000yearly. Tamaka Swasa is also generally comes in proximal attacks and one has to managethe attack immediately.8 Tamaka Swasa if not treated properly it will kill the patient likethe fire burns the dried bush even though it is a Yapya Vyadhi, it becomes Sadhya if it isNavothitha.9 There is a feeling among the common masses that shwasa roga will go only whenshwasa (prana) goes away. Shwasa is considered krichhra sadhya or difficult to cure. Inthis condition Kapha, the predominant dosha causes obstruction in the Pranavaha srotas,thereby disturbing the movement of Vata. Consequently Vata is aggravated and itspratilomagati takes place, which results in shwasakashtata. Pranavaha srotas, Annavahasrotas and Udakavaha srotas are also involved in the Tamaka shwasa, a condition, whichin modern parlance is known as bronchial asthma. Bronchial asthma is characterized by paroxysms of dyspnoea, accompanied bywheezing, resulting from narrowing of the bronchial airways by muscle spasm, mucosalswelling or viscid secretion. The airflow obstruction causes mismatching of alveolarventilation and perfusion and increases the work of breathing. Being more marked duringexpiration it also causes air to be trapped in the lungs. The narrowed bronchi can nolonger effectively clear mucus by the act of coughing and in patients with severe acuteasthma; many of the smaller bronchi become obstructed by inspissated and often verytenacious mucus. 10 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 3
  18. 18. Objectives Objectives Tamaka Swasa vis-a vis Asthma and allergies, such as atopic disease (i.e, bronchialasthma, allergic rhinitis, atopic dermatitis and allergic contact dermatitis), are commonmedical problems. Tamaka Swasa and its management through various methods arepossible viz. Abhyanga Swedana, Virechana, Vamana, Dhoomapana, Shamana, Kaphanissarana, Srotomardavata, vata kaphahara, kapha vilayana, Kasagnee, Brumhana effectswill be very effective in combating the Tamaka Swasa. Considering the above theHaritaki Phala Churna as a shamanoushadhi is under taken for the trail that has all ofthese therapeutic effects is opted for this study. The present study intended to focus on the disease evaluation of efficacy of HaritakiPhala Churna in the Management of Tamaka Swasa vis-à-vis. Bronchial asthma.Hypothetically Haritaki Phala Churna is the best therapeutic efficacy on the TamakaSwasa (Bronchial Asthma).In this regard the objectives proposed in the study are- 1. To evaluate the efficacy of Haritaki Phala Churna in the management of Tamaka Swasa. 2. To evaluate the Bronchodilatory effect of Haritaki Phala Churna. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 4
  19. 19. Disease Review Disease ReviewNirukti: The word Tamaka Shwasa composed of two conjoint words. They are Tamakaand Shwasa. The word Tamaka is derived from the Dhatu (root). “Tamaka glanou” withKwip Pratyaya (syllable). It suggests to choke, darkness, be suffogatted (Apti dicti). It is also defined as “Tamayati iti Tamaka”.122 “Tama eva Tamaka” in Shabdha Kalpa dhruma. It means where “Tama” occurs that is Tamaka. The word Shwasa is derived form the dhatu. ‘Swas’ with ‘Gahs’ pratyaya. Itmeans to breath (Apti). In shabdhartha kousthubha, it is stated that ‘Shwasathi iti Shwasa’. It means tobreath, by which respiratory movements takes place. 123 The word Tamaka Shwasa is formed by Karmadhareya Samasa as “TamakacchaAska Shwasacha Tamaka Shwasa’. It means difficulty in breathing which occurs mainlyduring night hours. 124Paribhasha:Susruta: Defines “Tamaka Shwasa as Vischeshat durdine tamyethi Shwasaha” as“Tamaka Shwasa”. It means the attack of Shwasa with tamapravesha which occursespecially during “Durdhina”. The meaning of durdhina is not explained in this context. But in Charaka Samhitait is stated that symptoms aggravated during cloudy days. 125 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 36
  20. 20. Disease ReviewVijaya Rakshita: Explains Tamaka Shwasa as:“Shwasasthu bhasthrikadmana Samavathordwa gamani”. It means it is a disease where in the expiration of air produces a sound similar tothe sound of bellow of blacksmith.HISTORICAL REVIEWPREVEDIC AND VEDIC PERIOD: The description of Prana Vayu as well as Apana Vayu and its role in the act ofrespiration is available in literatures of Prevedic and Vedic period. Few references tomention from Rigveda - Pranadvayu jayate (10-90-13), 126 Ayumapranaha (1-66-1), 127 inthese citations the word Prana is used to refer the act of respiration. At a number ofoccasions the mentioning of the word Hridaya is seen in Rigveda. This Hridaya isconsidered as the Mula of Pranavaha Srotas in Ayurveda. Quite similar to this few more 128references from Yajurveda like Vatam Pranena Nasike (Yaju 15-2) Pranasya 129Apyathatvam (Yajur 16-15), these lines express the act of respiration and effort ofexpiration in regards to Prana Vayau. Further in Atharvaveda, Pranavayu is referred bythe name Matarishwa. “Vatoprana Ucyata” is a line from Atharvaveda that express therole of Pranavayu in respiration. 130 Pundarika is the word used to describe the Hridaya inAtharvaveda. Pundarika refers to the blossom of Nelumbo nucifera and the shape of thisblossom simulates the Hridaya.UPANISHATH KALA: The detailed account of respiration; inspiration and expiration the two phases ofrespiration all are available in the Upanishats. Inhaling and exhaling the air is mentionedas the sign of life in Amanaskopanishath. The original reference in this regard goes like Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 37
  21. 21. Disease Reviewthis - Svasocchvasatmaka Prana (am-1-33) and Avasocchusa Hinastu NiscitamMuktaevasaha. Angira and Brihaspati are the two names used in Chandogyopanishath 131referring to Pranavayu. Added to this Pranavayu is said to nourish the body (CHA1:2:10/11/12). Yogachudamanyam is another treatise in which the diseases related to PranavahaSrotas like Hikka, Swasa and Kasa are elaborated to some extent. The cardio respiratory system is compared to the bird Crane; the two wings of thebird representing the lung, the trunk indicating the heart, and the neck of the birdsymbolically expressing the windpipe are discussed in detail in SwetaswataraUpanishat.132 The rate of respiration is said to be 21600 per day in Varahopanisat. Similarreferences are also available in other Upanishats.SAMHITA PERIOD:Caraka Samhita: The full account of the illness Swasa Roga is elaborated in the 17th chapter ofCikitsa Sthana in Caraka Samhita. The text includes the Nidana, Samprapti, Purvarupa,Rupa, Sadhyasadhyata and Cikitsa of the Swasa Roga. Santamaka and Pratamaka Swasaare told as variant forms of Tamaka Swasa. Swasa is also cited as a symptom of manyother diseases like Pandu, Udara, and Karshya etc. Few prescriptions of Dhumapana inTamaka Swasa are also available in this Caraka Samhita and are worth mentioning. 133 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 38
  22. 22. Disease ReviewSusruta Samhita: Even in Susruta Samhita elaboration of etiology, types, pathogenesis, clinicalmanifestation as well as treatment is made. 134Bhela Samhita: Harita Samhita: 135, 136 Falling in line with Caraka and Susruta Samhita, even in Bhela and HaritaSamhita vivid description of the etiology, types, signs and symptoms as well as treatmentis elaborated at full length.Kashyapa Samhita: Explanation related to Swasa Roga is restricted to brief description in the KhilaSthana of Kashyapa Samhita 137Ashtanga Hridaya and Ashtanga Sangraha: 138, 139 In these treatises the Nidana aspect of the illness is described in the NidanaSthana, like wise therapeutic aspect of the Swasa Roga is elaborated in the CikitsaSthana. The interrelation between Kasa Roga and Swasa Roga in the causation is stressedin these works.Madhava Nidana: Swasa Roga is elaborated in the 12th chapter of Madhava Nidana. The descriptionincludes the etiology, pathogenesis, types, symptomatology as well as prognosis of theSwasa Roga. 140 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 39
  23. 23. Disease ReviewMEDIEVAL PERIOD:Cakrapanidatta: On the basis of the information available in Brihatrayi, the illness SwasaRoga is described in Cakradatta. 141Arunadatta: In his nowel work, a commentary on Astangahridaya, Aruna Datta hasstressed the importance of Vata and Kapha Dosha in the pathogenesis of Swasa Roga.Further he opined that Kasa Roga in due course may precipitate Swasa Roga and likewise the Swasa Roga may also lead to the occurrence of Kasa Roga.Ayurvedarasayana: Morbid Kapha Dosha is incriminated to cause the illness Swasaaccording to Indukara. 142 143Bhavaprakasha and Yogaratnakara: In these two texts the description of SwasaRoga at full length is based on the Bhrihatrayi. The Pathya- apathya of the Swasa Roga isalso mentioned in these works. The addition of herb mineral compounds in the treatmentof Swasa Roga is unique. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 40
  24. 24. Disease ReviewNidana of Tamaka SwasaTable –13 Nidana of Tamaka Swasa 144-148S.No Nidana C.S S.S A.H M.N G.N A) Ahara Sambandhi1 Sheetapana + + + + +2 Shaata ashana - + - + +3 Guru bhojana + + - + +4 Abhishyandi bhojana + + - + +5 Rooksha bhojana + + - + +6 Vidahi ahara + + - + +7 Vistambi ahara + + - + +8 Adyashana + + - - -9 Sleshmala ahara + - - - -10 Jalaja mamsa + - - - -11 Anupa mamsa + - - - -12 Ama ksheera + - - - -13 Dadhi + - - - -14 Shaluka + - - - -15 Masha + - - - -16 Nishpava + - - - -17 Vishamashana + + - - -18 Pinyaka + - - - -19 Tila taila + - - - - Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 41
  25. 25. Disease Review20 Pista padartha + - - - -21 Ama rasa - + - - - B) Vihara Sambandhi24 Sheeta vata sevana + + + + +25 Raja sevana + + + + +26 Dooma sevana + + + + +27 Vyayama + + + + +28 Vega dharana + + - + +29 Sheeta sthana - + - + +30 Bhara vahana - + + + +31 Atapa sevana - - - + +32 Abhishyandhi upachara + - - - -33 Sheetashana - + - - -34 adhwagamana + - - - -35 Dwandwa sevana + - - - - B) Vyadhi/Avastha Sambandhi36 Apatharpana + + - + +37 Atisara + - + + +38 jwara + - + + -39 Chardi + - + - -40 Kasa - + + - - Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 42
  26. 26. Disease Review41 Pandu + - + - -42 Rookshana + - - - -43 Anaha + - - - -44 Vibandha + - - - -45 Amapradosha + + - - -46 Shuddhi atiyoga + - - - -47 Pratishyaya + - - - -48 Kshata kshaya + - - - -49 Dourbalya + - - - -50 Vishoochika + - - - -51 Udavarta + - - - -52 Raktapitta + - - - - D) Agantu Karana53 Marmaghata + + + - -54 Visha + - + - -55 Kantorasa pratighata + - - - - E) Kala56 Durdina - + - - -57 Meghacchadita dina + - + + + Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 43
  27. 27. Disease ReviewPoorva Roopa of Tamaka SwasaTable – 14 Poorva Roopa of Tamaka Swasa 149-153S.No Poorva Roopa C.S S.S A.H M.N G.N1 Anaha + + + + +2 Adhmana - - - + +3 Arathi - + - - -4 Bhaktadwesha - + - - -5 Hritpeeda + + + + +6 Kantha Gurutwa + - - - -7 Kashaya Vadanata + - - - -8 Parshwa Shoola + + + + +9 Prana Vilomata + - + - -10 Shankha Toda - - + + +11 Uro Guruta + - - - -12 Vaktra Vairashya - + - + + Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 44
  28. 28. Disease ReviewRoopa (Lakshana) of Tamaka SwasaTable – 15 Roopa of Tamaka Swasa 154-158S.N Laxanas C.S S.S A.H M.N G.N1 Swasa (Dyspnoea) + + + + +2 Ghurughuraka (Wheezing) + + + + +3 Prana prapeedana (Discomfort) + + + + +4 Kasa (Cough) + + + + +5 Pratamyati (Loss of consciousness) + + + + +6 Sannirudyati (Immobilized) + - - + +7 Pramoha + + + + +8 Shleshma vamokshante labhate sukham + + + + +9 Kantodwamsa (Throat irritation) + - - + +10 Krichrena bhashitam (Difficulty in + - - + + speech)11 Na labhate nidra (Sleeplessness) + - - + +12 Shayanasya swasa peedita (Discomfort in + + + + + lying down posture)13 Parshwa shoola (Sides pain) + - + + +14 Ushna abhinandana (Like hot thing) + - + + +15 Uchritaksha (Wide opened eyes) + + + + +16 Lalat sweda (sweating on forehead) + + + + +17 Brushramarthi (Maximum distress) + - + + +18 Shushkasyata (Dryness of mouth) + - + + + Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 45
  29. 29. Disease Review19 Muhar swasa, Muhuschiva avadhamyati + + + + + (Short breath with all effort to breath)20 Megha, Ambu, Sheeta, + - + + + Pragwaha,Shleshmalancha pravardhanti (Increase after exposure to kaphakaraka ahara)21 Pratishyaya (Normal discharge) + - + + +22 Aruchi (Anorexia) - + + - -23 Trishna (Excessive thirst) - + + - -24 Vepathu (Tremors) - - + - -25 Vamathu (Expectoration) - + - - -26 Ghoshena Mahate - + - - - Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 46
  30. 30. Disease ReviewSamprapti (Pathogenesis) of Tamaka SwasaSwasa Roga Samprapti Charaka opines that the Vitiated Kapha along with vitiated Vata obstructs theSrotas; the obstructed Vayu tries to over come the obstruction and moves in all thedirection resulting in Swasa. 159 Sushruta says the pranavayu goes against its individual (Prakruti) combineswith Kapha causing Swasa Roga. 160 Bhavamishra 161 and Yogaratnakar,s 162 opinion regarding Samprapti coincideswith Charaka, Madhavakara,s 163 corresponds with Sushruta. 164 Vagbhata further emphasized that the Annavaha Srotas is also involvedand hence the production Kapha in Amashaya is affected. Thus Swasa Roga is regardedas Amashaya Samudbhava.Tamaka Swasa Samprapti Vata Dosha and Kapha Dosha are invariably involved in the pathogenesis of 165Tamaka Swasa. Imbalance of Vata Dosha is best treated by Snigdha line oftreatment.166 Whereas, vitiated Kapha Dosha is treated by Ruksha line of treatment. 167Theoretically, when both Vata and Kapha Dosha are vitiated mutually, contradictorytherapeutic procedures have to be employed, thus posing a practical problem in planningthe final treatment. Kapha Dosha and Rasa Dhatu both belong to the same category inrelation to their properties. 168 It is a general principle of pathogenesis, that the Dosha andthe Dhatu belonging to the same category have a natural tendency to rapidly progress inthe process of pathogenesis. 169 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 47
  31. 31. Disease Review Similar to this in Tamaka Swasa also,Kapha Dosha that afflicts the Rasa Dhatucontributes to the rapid development of the illness. Further, during the course of theillness, the Hridaya Marma is said to be afflicted.170This adds to the severity of illness. Put together, the mutual contradictory treatment, involvement of Dosha andDushya belonging same category, as well as affliction of Hridaya Marma explains in theacute onset, chronic course and severity of the illness. The normal upward course of the Pranavata is obstructed by the abnormallystiff Pranavaha Srotas. Secondly, like the other Srotas, secretion is the natural processseen in the Pranavaha Srotas. Here Kapha is the normal secretion and the vitiatedPranavata abnormally increases it. In further it adds to the obstruction of the passages andPranavata leading to Prana vilomata. Narrowing of the Pranavaha Srotas together withthe accumulation of Sleshma obstructs the smooth flow of Pranavata. Prana vilomata andresulting turbulent breathing lead abnormal audibility of respiration or to say thisprocedure Wheezing. Charaka opines that the obstruction to the passage of Pranavata alsoleads to rapid breathing. 171 Vitiated Prana Vata irritates the causing increased secretion andmanifestation like Peenas Kshawathu etc. 172 Further the prasena of Kapha in Pranavaha Srotas more particularly in Kanta(neck) region obstructs the Pranavata. The Pranavata passing through this Kapha, causesbubbling and a peculiar sound, which is called as Kanta Ghurughuruka is, produced. 173 It is said that this Sleshma is thick, sticky and tenacious and contributes to thePranavaha Srotas. Excessively secreted tenacious Sleshma is expectorated out with muchdifficulty during the bouts of coughing. 174 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 48
  32. 32. Disease Review Productive cough is another effect of obstruction of Pranavata in the PranavahaSrotas. As the cough brings out the sleshma, obstruction to the Pranavata is minimized,leading to temporary relief in breathlessness to the patient. 175 Other than the usual presentation, involvement of Pitta Dosha may be seen incertain patient of Tamaka Swasa.176When this is the case the over all presentation of theTamaka Swasa is also changed accordingly.The frequent episodes of Tamaka Swasa arerelated to the exposure to cold, cloudy days, and heavy breeze and/ or such other factorsthat are provocative to Vata and Kapha Dosha, which is the usual presentation in TamakaSwasa. 177 If the association of Pitta Dosha is present this nature of the illness is reversedand hence exposure to these factors may bring about remittance of symptoms in thepatient. This unique nature of the illness is attributed to Pitta Dosha involvement. Thesesymptoms like Jwara, Murcha are suggestive of Pitta vitiation. Such a varient form ofTamaka Swasa with the typical symptoms of Pitta Dosha is called as Pratamaka andSantamaka Swasa. 178 The imbalance of Vata and Kapha Dosha afflicts the Rasa Dhatu in thepathogenesis of Tamaka Swasa.during the attack of Tamaka Swasa almost all thesymptoms of Kapha Dosha vitiation are mediated through the Rasa Dhatu. Among the listof symptoms: productive cough, sputum etc are the symptoms pathogenic of Rasa Dhatuabnormality. Moreover, abdominal symptoms like Anaha, etc are also the result ofincriminated Rasa Dhatu.179 As the disease runs a chronic course, the vitiated Vata Doshadries up the circulating Rasa Dhatu contributing to the weakness and emaciation in thepatient. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 49
  33. 33. Disease Review Schematic diagram of Samprapti of Tamaka SwasaNIDANA SEVANASANCHAYA AGNIMANDYA DOSHA DUSHTI (VATA & KAPHA DUSHTI)PRAKOPA AMARASOTPATTI MALAROOPA KAPHAPRASARA PARIBHRAMANA PRATILOMAGATI OF VATA PRANAVAHA SROTOGAMANA STHANA KAPHA makes AVARANA to PRANA VAYUSANSHRAYA PRANA try to overcome the AVARANAVYAKTAVASTHA SHWASA (shwasavarodha, shwasativriddhi, Ghurghurkam etc.) Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 50
  34. 34. Disease Review Smprapti GhatakaDosha : Charaka – Kapha, Vata : Sushruta- Dominance of Kapha : Arunadatta – Both Kapha and Vata are involvedDushya : RasaSrotas : Pranavaha, Udakavaha, AnnavahaSrotodushti : AtipravruttiUtpatti sthana : Vagbhata – amashaya : Charaka – Pitta sthanaSanchara sthana : Urah Kantha SirasVyaktatha sthana : UrahasRogamarga : AbhyantaraAdhisthana : ShareerikaSamprapti Bhedas For the complete understanding of the disease, Samprapti can be classified asSankhya, Pradanya, Vidhi, Vikalpa, Bala and Kala. 180 In the disease Tamaka Swasa also detail study of Hetu Samprapti, Lakshanaand Sadhyasadhyata can be elaborated in the framework of Samprapti bhedas as- Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 51
  35. 35. Disease Review1) Sankhya Samprapti The Tamaka Swasa is categorized under pancha bheda of Swasa.181Tamaka Swasa doesn’t have direct classification to fit in the Sankhya Samprapti, but have Pratamaka and Santamaka as avastha bhedas. 1822) Pradhanya Samprapti Charaka has considered Tamaka Swasa, as Kaphavatatmaka Vyadhi. 183 Where asMadhavakara has considered it as Kapha pradhana.184its Samprapti indicates theKaphaPradhanyata, as per the clinical course of the disease and principles of treatment 185both Kapha and Vata seems to be Pradhana. Vata holds prime importance in themanagement.3) Vidhi Samprapti Under Vidhi Samprapti, Tamaka Swasa can be classified in different categories as,Ashukari, 186 Yapya, 187 and Krichra sadhya. 188 According Charaka Hikka and Swasa areAshukari, Ghora, and Sheeghra Pranaharaka. Further he explained with chronicity as more than one year are considered asYapya and of duration less than one year in the durbala rogi, as Krichra sadhya. AcharySushruta has considered Tamaka Swasa as Krichra sadhya; and Asadhya in durbala rogi.4) Vikalpa Samprapti. Observing of Tamaka Swasa Samprapti, lakshana, Upashsaya and Anupashayaspresence of vikriti in Pranavata and is aggravated by the properties such as Sheet, Ruksha 189gunas and increase in its Chala guna. Similarly Urosthitha Avalambhaka Kapha getsaggravated by Guru, Snigdha, Sheeta, and Abhishyandhi gunas and becomes Ghana andPichchila. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 52
  36. 36. Disease Review5) Bala Samprapti Bala of Vyadhi depends on virulence of the hetus, presence of Poorva roopa inthe course development of disease or in developed form. And also it depends on theinvolvement of different Srotases, Rogamarga and vital parts of the body. Hence the balaof the Vyadhi differs for individual patients, thus the Tamaka Swasa is considered asKrichra Sadhya, Yapya and Ashukari Vyadhi by various authors. 1906) Kala Samprapti The name of disease itself indicates of the nature of disease with respect to thetime factor. It is episodic, paroxysmal and mostly nocturnal in its nature. Some times it iseven observed that the symptoms get aggravated in the early morning, and with respect toseasons it aggravates in the winter and autumn due to cold climate. 191Upashaya of Tamaka Swasa Any of the Dravya bhuta (Oushadhi, Ahara etc.) or Adravyabhuta (Vihara) 192Upacharas leads to Sukhanubandha is defined as Upashaya. Sleshma Vimokshana is 193considered as Upashaya in Tamaka Swasa, which can be achieved by mechanicalprocess such as coughing etc, by pharmacological measures such as administeringSleshmavilayana dravyas. The Dravyas possessing Ushna guna i.e. properties can be administered as 194Upashaya in Tamaka Swasa. Non-pharmacological procedures such as change ofposition; relives from the severity for short period. 195 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 53
  37. 37. Disease ReviewAnupashaya of Tamaka Swasa. Ahara, Vihara, and Oushadhi aggravates the condition of the Tamaka Swasa arecalled as Anupashaya of Tamaka Swasa. They are Asatmya to the Vyadhi. 196 Meghambu 197sheetapragvatai sleshmalaischa abhivardheyate is considered as Anupashaya. “Nachapinidramlabhate Shayanahasvasapeeditaha” indicates the aggravation of thedisease in the recumbent position. 198Upadrava of Tamaka Swasa. There is an direct reference regarding the upadravas of Tamaka Swasa mentionedin ‘Trishna Chikitsa’ is Trishna appears as upadrava in Jwara, Kshaya, Swasa etc. 199Aristha of Tamaka Swasa. Regarding the Aristha lakshana, there is no direct reference in the context ofTamaka Swasa, where as in reference with different contexts Aristha laxana for Swasacan be established. At the time of death whatever the disease he may suffer, ultimately hewill die with Hikka and Swasa. 200 It is mentioned that the person producing unnatural sounds with heavy breath,suffering with Atisara, Trishna, Shushkasyata and loss of body strength is definitely 201going to die. The person whose Urdhwa swasa is rapid, throat occluded by Kapha;reduction in strength, complexion and food intake is not going to survive for longer 202period. The person taking long inspiration and gives of short expiration gets fainted;such person is stated to die within short period.203 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 54
  38. 38. Disease Review Sadhyasadhyata of Tamaka Swasa. Tamaka Swasa, which is chronic of more than one year, is considered as Yapyaand of duration less than one year in the durbala rogi, as Krichrasadhya.204 If TamakaSwasa is Navovita (newly developed) it is Sadhya (curable). 205 Sushruta has consideredTamaka Swasa as Krichrasadhya Vyadhi and Asadhya in Durbala rogi.206 According toVagbhata Tamaka Swasa is Yapya, but can be Sadhya if it is treated in early stages in thestrong persons.207 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 55
  39. 39. Disease Review Vyavachedaka nidana of Tamaka Swasa Differential Diagnosis between panchavidha Swasa Table –16 Vyavachedaka nidana of Tamaka Swasa 208Lakshana Tamaka Swasa Maha Swasa Urdhwa Swasa Chinna Swasa Kshudra SwasaSwasa Ateva teevra vega Uchaihi Swasati Dheergam swasati, Swasate Ruksha swasa Urdhwam swasati, vichinnam aayasottha adhoswasa nirodha SwasaShabda Ghur-ghurak Matta vrashabho vattConsciousness Pramoha Pranastha jnana Pramoha Moorcha vijnanaNetra Uchritaksha Vibhranta Urdhvadristhi and Viplutaksha, lochana and vibhrantaksha raktaika vivrataksha lochanaShula Shayanasya Vedanarta Marmachedavat parshvagraha rugarditahaVak Kruchrakrichnoti Viksheena vak Pralapana bhashitahaAsya Vishushkasya Shushkasya ParishushkasyaSweda Lalata sweda Sarva daihikaUpashaya Sleshma vimokshanaSadhyasadhyata Yapya Asadhya Asadhya Asadhya Sadhya Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 56
  40. 40. Disease ReviewCHIKITSA The effective treatment of Tamaka Shwasa cannot be united, as its pathologyinvolves multiple varying factors as vitiated Vata and Kaphadosha stemming out from thePittasthana, afflicting the Rasadhatu in Pranavaha Srotas produces the illness. Thereforethe treatment aimed at the rectification of the imbalances of Vatadosha as well asKaphadosha, forms the sheet anchor of treatment of Tamaka Shwasa which isindividually quite opposite. Thus, the unique pathogenesis posses complexity in planningthe treatment. The final treatment planned should pacify the Vata dosha as well asKaphadosha effectively. Simultaneously not causing any further addition to theimbalance of Vata and Kaphadosha, with the due consideration of this, followingprinciples of treatment for Tamaka shwasa are advocated in the Ayurvedic classics.Abhyanga and Swedana: Treatment of Tamaka Shwasa differs both during the attack and in between theattacks. During the episode of Tamaka Shwasa, the Doshas are in a state of provocationand contrary to this, in between the attacks the Doshas are silent and are not apparent.Thus demanding different treatment to make it more clear, the treatment is plannedduring the attack to negate the effect of Samprapthi. In contrast to this, in between theattack, the treatment is planned to prevent the initiation of new Samprapthi therebyforming the complete treatment of Tamaka Shwasa.209 Prana vaya vilomata is a pathological event during an episode of Tamaka Shwasaand is said to be due to tenacious Kapha obstructing the passage of Pranavayu. Bringingit out by liquifying the sputum is the principle and first treatment of this condition. This Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 57
  41. 41. Disease Reviewcan be achieved by Abhyanga and Swedana over the chest thereby allowing the freepassage of Pranavayu. Acharya Charaka has prescribed application of oil added with rock salt over thechest followed by sudation in the form of Nadi, Prastara and Sankara Sweda.Vamana Karma: The clinical presentation is patients suffering from Tamaka Shwasa are notuniform. Some patients present with symptoms suggestive of dominant Vata Dosha andare characterized mostly by dry cough and prominent wheezing. In such patients,Vamana Karma is not ideal choice. Yet, other patients presents with symptomssuggestive of dominance of Kaphadosha, which is characterized by paroxysmalproductive cough, where the sputum is tenacious, bouts of distressing paroxysmal coughbrings out small amount of sticky sputum and this is associated with breathlessness. Insuch patients, with the predominant vitiation of Kaphadosha, Vamana Karma is mostideal. This renders clarify of the Pranavaha Srotas and thereby allowing free passage ofthe Pranavayu. The procedure of Vamana Karma is advisable only in patients who are physicallystrong and can tolerate the strain of Vamana Karma. The mild form of Vamana is alwaysadvisable in all patients of Tamaka Shwasa and it can be repeated during every attacks. After subjecting the patient to Abhyanga and Nadi Sweda over the chest, in theevening, the patient is allowed to take food that provocates the Kaphadosha like mealswith curds or fish. This Kaphotklesha procedure renders easy elimination of Kaphadoshaby Vamana procedure, which is carried out on the immediate next day, in the morninghours.210 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 58
  42. 42. Disease ReviewDhoomapana: This is another procedure also aimed at eliminating the Kaphadosha from theSrotas. Dhoomapana is advised after the Vamana Karma and it eliminates some amountof Kaphadosha that is still left out after the Vamana Karma or else, if the Kaphadosha inthe Srotas is minimum, as in Vata dominant cases or in cases of milder attacks.Dhoomapana may be performed alone without prior Vamana Karma. Further, indebilitated patients, where prefactory procedure is not possible. Dhoomapana alone helpsin the elimination of Kaphadosha. Added to this, the drugs used in Dhoomapana alsoreduces spasm or stiffness of Pranavaha Srotas bringing about Srotomardavata thatensures free passage of Vatadosha.211Virechana Karma: Abnormal response of patients for simple factors like dust is said to be due to Khavaigunyata of the Pranavaha Srotas. In the modern counterpart, this is described ashypersensitivity or allergy of the respiratory system. This may be said as Khavaigunyataor else called as Asatmyata or even may be named as faulty Vyadhi Kshamatva, and thefact is that, the patients unfavourably respond to simple factors like dust, atmosphericchange or food. The answer for such a nature of illness is Virechana Karma and RasayanaChikitsa. Charaka pronounced this as “Tamaketu Virechanum”212 when employed inbetween the attacks, prevents the attack of Shwasa, renders its severity, minimizes theduration of illness. Even in some patients, this procedure in combination with RasayanaChikitsa brings about complete cure. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 59
  43. 43. Disease Review After Virechana, Samsarjana Karma is advised for about 3 to 5 days. Thisprocedure eliminates Doshas in Tamaka Shwasa eliminated as is told in the classics.Virechana procedure eliminates Doshas stemming out from Pittasthana is. It is worthmentioning here that, Vata Dosha is the predominant Dosha involved in the Samprapti ofTamaka Shwasa, Virechana normalizes the course of Vata Dosha and thus helps in thereversal of Vilomagati of Pranavayu. Distension of abdomen, constipation and such othersymptoms may be associated in some patients and these symptoms are best treated by thisprocedure.Brimhana and Rasayana Chikitsa: The difference in response to atmospheric changes in a normal person, in contrastto patients of Tamaka Shwasa, where in atmospheric changes reflects as disease in patientis said to be due to Khavaigunyata an abnormality of the Pranavaha Srotas. This can berectified by Vyadhihara Rasayana. This unique treatment may be much helpful insubsiding the attack of Asthma. Also in due course, improves the defence mechnism of Pranavaha Srotas, reducesthe tendency of abnormal reaction to simple factors in the surroundings. Further, in thelong run, the disease cause emaciation of the body. this can be corrected by the BrimhanaChikitsa. This adds to the benefit.213 To sum up, sequential administration of Abhyanga and Swedana over the chest,and increasing the tendency of Kapha to get eliminated Vamana and Dhoomapanafollowed by Shamana Chikitsa is the sheet anchor of treatment of Tamaka Shwasa duringan episode. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 60
  44. 44. Disease Review Virechana followed by Vyadhihara Rasayana and Brihmana Chikitsa forms theideal treatment in between the attacks. These procedures are very much effacacious ineliminatig the symptoms as well as preventing the attack of Tamaka Shwasa.BRONCHIAL ASTHMADefinition: Bronchial asthma is a disease characterised by hyper reactive airways, leading toepisodic, reversible broncho constriction, owing to increased responsiveness of thetracheo-bronchial tree to various stimuli.214Types:215 In western science for the epidemiological and clinical purpose asthma is broadlyclassified into 2 varieties but because of the unclear pathological and clinical distinction,a third variety is added. They are,1) Allergic asthma or extrinsic asthma.2) Idiosyncratic asthma or Intrinsic asthma.3) Mixed variety.Table- 17 Types of Asthma Sl. Extrinsic Intrinsic 1) Immune reaction type 1 hyper sensitivity Non immune abnormal autonomic regulation of airways. 2) Family history of hyper sensitivity is No family history common Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 61
  45. 45. Disease Review 3) Usually starts in childhood Starts in adult life 4) Proceeded by infantile eczema and hyper No evidence of atopy sensitivity to food 5) Predisposition to form IgE antibodies IgE antibodies may be found but no particular predisposition 6) Recognisable allergens like pollens, No recognisible allergens dandruff, house dust, mite, etc. 7) Attacks often diminish in later years Attacks increases in severity as years passes 8) Chronic bronchitis seldom develops Associated with nasal polyps chronic bronchitis 9) Emphysema unusual Emphysema commonly develops 10) No drug sensitivity Drug sensitivity may develop (Aspirin, Pencilin, etc.) 11) Increased level of IgE found in serum Normal level of IgE in serum 12) Positive response to skin provocation test Negative skin provocation testClinical features: Cardinal symptoms of all these types of asthma are1) Dyspnoea2) Wheeze3) Cough4) Sensation of chest tightness.216 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 62
  46. 46. Disease ReviewPathogenesis of Asthma: This can be expalined under two heading. i) Atopic Asthma ii) Non-atopic Asthma. Atopic Asthma can be explained in two phases i) Early phase Reaction ii) Late phase Reaction.Early phase Reaction: This occurs in case of airborne antigen, The reaction occurs 1st in sensitised mastcells on the mucosal surface. So, mediators released from the mast cells i.e. is histamine,leukotriens, cytokinease, etc. So, these mediatiors opens the mucosal intercellular tightjunction, more antigen entered into submucosal mast cells. In addition direct stimulationof sub epithelial vagal receptors provokes bronchial constriction through central and localreflexes. This occurs within a minute after the stimulation and is called the acute orimmediate reaction or response. IgE triggered reaction includes release of both primaryand seconday mediators. The primary mediators are Histamine and Leukotriens B4. The Histamine causesbroncho constriction by direct and cholinergic reflex action. Increased venularpermiability and increases the secretion. Leukotriens B4, which attracts eosonophils andneutrophils. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 63
  47. 47. Disease Review The secondary mediators are, Leukotreins C4, D4 and E4, extremely potentmediators which causes prolonged broncho constriction and increased vascularpermiability and increases mucus secretion. Prostoglandin D2, which causes bronchoconstriction and as well as increased permiability and increased mucus secretions.Platelete activating factor. which causes aggregation of platelets and release of histaminand serotonin from the mast granules. In late phase reaction, it starts after 4-8 hours later and may persist for 12-24hours. It is mediated by leukocytes i.e. eosonophils, neutrophils and lymphocytes. Theseare released by the chemotactic fatcors and cytokines, derived from the mast cells duringacute phase response or by other mediators produced by the chronic inflammatory cellsalready present in asthmatic patient. These leukocytes releases a mediators that stimulatesthe late reaction. Histamine releasing factor produced by various cell types i.e. Basophils,Neutrophils, Eosonophils. Basophilis causes broncho construction and edema.Neutrophils causes further inflammatory injury. Eosonophils causes epithelial damageand airway constructions.Non-atopic Asthma: It is non-allergic, microbial antigen play a role. Here there will be a hypersensivity to microbial antigen. “Viruses induces inflammation of the respiratory mucosalowers the threshold of the sub epithelial vagal receptors to irritants. So, inhaled airpollutants such as So2, ozone, No2, etc. contribute to chronic airway inflammation andhyper reactivity.217 Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 64
  48. 48. Disease ReviewEvaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 65
  49. 49. Disease ReviewDifferential Diagnosis:COPD: History of cigaratte smoking, chronic cough, sputum production (i.e. is in chronicbronchitis) and dyspnoea (in emphysema), rhonchi, decreased intensity of breath soundsand prolonged expiration on physical examination. airway limitation on pulmonaryfunction tests.Left heart failure (Cardiac asthma): Usually there will be a history of paroxysmalnocturnal dyspnoea with cardiac abnormality or hypertension or other signs of cardiacfailure. The sputum will be wateryfrothy crackles are more than wheeze. Basalcrepitation is observed on physical exmaination. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 66
  50. 50. Disease ReviewPATHYAPATHYA In a patient suffering from Tamaka Swasa certain predisposing factors are said toinitiate an attack of the illness. Or else, if the patient is in an attack of breathlessnessthese predisposing factors are likely to worsen the attack. Further in the long run, thereoccurs deterioration of the immune mechanism of the Pranavaha Srotas there byincreasing risk of frequent attacks of the Tamaka Swasa on exposure to trivial factors.There fore it is mandatory to identify and avoid these incriminatory factors to getmaximum relief. Thus it is important to know the Pathya and Apathya in patients ofTamaka Swasa. The following tables show the list of Pathya and Apathya of TamakaSwasa.Table -18 Pathya in Tamaka Swasa: 218-222Pathya Ahara C .S. S .S. A .H. Y.R. B.R.I Shaali DhanyaPurana Shali + - - + +Tandula - - - + +II Vrihi DhanyaShashtika + - + + +III Shooka DhanyaYava + - + + +Godhuma + - + + +IV ShimbiMudga + - + - - Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 67
  51. 51. Disease ReviewKulatha - - + + +V Shakha VargaGuduchi + - - + +Patola - - - + +Vartaka - - + + +Rasona - - - + +Bimbi - - - + +Vastuka - - - - +Moolaka + - + - +Potaki - - - - +Shigru + - - - -Kasamarda + - - - -VI Mamsa VargaJanghala - - - + +Shasha + - - + +Titira - - - + +Bhuka - - - + +Lava - - - + +Dhanva - - - + +Shuka - - - + +Mruga Dwija - - - + + Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 68
  52. 52. Disease ReviewVII Phala VargaJambira - - - + +Draksha + + - + +Mathulunga + + + - +Amalaka + + + - -Bilwa + + + - -VIII Madhya VargaSura - + - + +Varuni - - + - -IX Madhu VargaMadhu + + + + +X Mootra VargaGomutra - - - - +XI Dugdha VargaAja Kshira - - - + +XII Ghrta VargaPurana sarpi - + - + +Ajasarpi - - - + +XIII Krtanna VargaYusha + - + - -Yavagu + - - - -Peya + - + - - Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 69
  53. 53. Disease ReviewSathu - - + - -Varuni - - + - -Pathya ViharaVirechana + - - + +Swedana + - - + +Dhumapana + - - + +Prachardana - - - + +Swapanam Diva - - - + + Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 70
  54. 54. Disease ReviewTable –19 Apathya in Tamaka Swasa:Apathya AaharaI Shimbi DhanyaNishpava + - - + -Masha + - - + -Thila + - - - -Sarshapa - - - + +II Shaaka VargaKanda - - - + +III Mamsa VargaJalaja + - - - -Anupa + - - - +Pishita + - - - -Matsya - - - + +IV Dadhi VargaDadhi + - - - -V Kshira VargaKshira + - - + +Mahisha Kshira + - - - -VI Grita VargaMahisha Gritha - - - + +VII Kritanna VargaTailabhrsta Nishpava - - - - +Pistanna + - - - -Pinyaka + - - - -Apathya ViharaSheeta Snana + + + - -Raja + + + + + Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 71
  55. 55. Disease ReviewDhuma + + + + +Anila + + + + +Vyayama Karma + + - - -Bhara - + - - +Adhwat - + - - +Vegaghata - + - - -Apatharpana + + - - -Marmaghata + - + + +Sooryatapa - - - - +Daurbalya + - - - -Aanaha + - - - -Abhighata - + - - -Strigamana - + - - -Vegavarodha-Mootra, - + - - -Udgara, Chardi, Trushna, Kasa The diet, behavioral as well as environmental factors that helps in homeostasis ofVata and Kapha Dosha both during and in-between the attacks are considered as Pathyain Tamaka Swasa. The patient is encouraged to follow these Pathya. Contrary to this,factors related to food, behavior or environment that incriminates the Vata and KaphaDosha or Pranavaha Srotas is identified as Apathya in Tamaka Swasa. These have to bestrictly avoided by the patient suffering from Tamaka Swasa. Strict observation of thePathya and avoidance of Apathya minimizes the severity of the illness, reduces thefrequency of the attacks and helps in early recovery from the illness. Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 72
  56. 56. Drug Review Drug review Historical review of HaritakiAmong the earliest references, Panini described it for the management of dysurea /anurea and constipation (Mootra Purisha Nirodha) – (Pa.Ga. 4/4/53).Haritaki is one of the important as well as commonest herbs used by folk, householdand traditional medicine. Its fruit rind is used in medicine and is one of the ingredientsin Triphala.It is mainly indicated for constipation, Respiratory problems, certain Skin disorders,Eye disease etc. charaka highlighted its Rasayana properties in Chikitsa sthana. Hespecially stated Haritaki as best among the herbs to be used regularly (HaritakiPathyanam Ch.Su.25.)Sushruta in his Samhitha Sutrasthana mentioned that Haritaki can be used for bringingabout chemical reaction i.e. Rasakriya. Sushruta in his Samhitha Sutrasthanamentioned that Haritaki can be used as a pad or pill i.e. Varthi.Vagbhata in his Samhitha in 10th Chapter 31st sloka mentioned Haritaki under Kashayavarga.Vagbhata in his Samhitha mentioned Haritaki in the context of treatment, whichreduces Medas.Shivadatta described Haritaki plant by making simile with Vasa leaves (Vasadalodrumo adristhaha phalam tasya Haritaki).Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 5
  57. 57. Drug ReviewThere are references about Haritaki in almost all Nighantu’s. A story has been told inBhavaprakasha Nighantu, Raja Nighantu about the origin of the drug, Haritaki. Dakshaprajapati asks Ashvini Kumara’s about Haritaki, questioning them. Wherethe Haritaki was born, what are its features, Colourrs, types etc. Ashvini Kumara’s say that when Lord Indra was drinking Amruta the drops ofAmruta that fell down to earth grew as Haritaki plant. (B.P.Ni.1-3).And also Bhavaprakasha explains importance of Haritaki as follows- As mother is supreme and she always make Hita to their children’s, like thatHaritaki is best for humans. It will not cause any harm to the body. Some times mothermay become angry but use of Haritaki does not make any complication, henceHaritaki is supreme than mother. Whose mother is not there, those can be consider Haritaki as a mother likeThat, Bhavaprakasha given prime importance for Haritaki.Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 6
  58. 58. Drug Review Synonyms and its meanings 1) Abhaaya----“Na bhayam asyaha iti ||” (Bh.D) It relives fear against all the disease. 2) Avyatha---- “Na vyatha yasyaha iti ||” (Bh.D) “Na vyathayati iti va | (Ni.A) Its usage will provide relief from many Diseases. 3) Kayastha---- “ Kayaha tishtati anaya iti |” (Bh.D) “ Kaye tishtati iti va nishphala na bhavati ityarthaha |” (Ni.A) Once used internally, it does not go waste i.e it definitely. Provides relief any disease. 4) Chetaki---- “ Chetayati anaya srotaha shuddhe |” (Ni.A) It will do the Sroto Sudhi. 5) Pathya-----“ Pathoanapeta iti | Pathi sadhu iti pathya hita ityarthaha ||” (Ni.A) It is useful for all the Srotas (Channels). 6) Putana-----“ Pootam karoti iti | Virechanatwat |” (Ni.A) It purifies (puta or pavitra) the body through the process of Purgation. 7) Shreyashi—“ Ati prashasta iti | Shreyaskartwat |” (Ni.A) It is renouned for its good Qualities / Properties. 8) Shiva------“ Shivam (Mangalam) karoti iti |” (Bh.D) It brings good fortunes.Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 7
  59. 59. Drug Review 9) Haritaki----“Harasya Bhavane jata Hareeta cha swabhavataha | Sarvaroganscha cha Harate ten Khyata Haritaki ||” (D.N, M.N.) Its utpanna in shivasya nivasasthana i.e. Himalaya parvatha. Swarupatha it is Haritha varna and cures all types of roga, thus It is prasidha by the name Haritaki. “Harate prasabham Vyadhin Bhuyastarati yadvapuhu | Haritaki tu sa prokta tatra keerdiptivachakaha ||” (R.N). The Haritaki is one, which forcibly removes the disease from Ones body. The Ki Shabdha is Deepti Vachaka. “Dehe sanga malanam harati bahutaram sa haritabhyabhikhya||” (P.N). Haritaki, the name because it does nirharana of vibaddha mala of Shareera. 10) Haimavati— “ Himavati jata | Tatrai jataha | (Bh.D) It grows on Himavati parvata. 11) Amruta ------- The drug which having the nectar like properties. 12) Rechani ------ It does the purgation.Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 8
  60. 60. Drug ReviewSynonyms of HaritakiTable – 1 Paryaya (Synonyms) according to different authors 11-18.SlNo Synonyms D.N M.N R.N K.N BP.N Mao.N ARM.N SH.N1 Haritaki + + + + + + + +2 Abhaya + + + + + + + +3 Pathya + + + + + + + +4 Kayastha - + + + + + - +5 Putana + + + - + + - +6 Amruta + + + - + - - +7 Haimavati + + + + + + - +8 Avyatha + - + - + + - +9 Chetaki + + - - + + - +10 Shreyasi - + + + + + + +11 Shiva + - + + + + + +12 Vayastha - + - - + + - +13 Vijaya + + + + + + + +14 Jivanti - - + - + - + -15 Rohini + + + - + + - +16 Jaya + + + - - + + -17 Prapathya + + + + - - + -18 Jivapriya - - + - - + - +Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 9
  61. 61. Drug Review19 Bhishagvara - - + - - + - +20 Pranada + - + + - - + -21 Jivaya - - + - - + - -22 Nandini + + - - - - - -23 Amogha - + - - - - - -24 Jeevaneeya - + - - - - - -25 Divya - - + - - - - -26 Shaka - - - - - + - -27 Balya - - - - - + - -28 Sudha - - - - - + - -29 Bhishagpriya - - - - - + - -30 Chetanika - - + - - - - -31 Jeevanika - - + - - - - -32 Devi - - + - - - - -33 Rechani - - - - - - + -Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 10
  62. 62. Drug ReviewClassifications: Classification is the basis of development of every branch of science. The 1stattempts on classification of drugs was seen in the Vedas on the basis of leaf, flowers,fruits, stem, etc. and as per the availability, property and action the Dravyas has beenclassified into several Vargas. In the Samhitas drugs are classified more systematically and scientifically. Theclassifications in Samhitas are based on the source of drugs, properties and action, etc.Table- 2. GANA AND VAARGA ACCORDING TO DIFFERENT CLASSICSSl.No CLASSICS GANA1 Charaka samhita Arshoghna gana Kusthaghna gana Kasahara gana Jwarahara gana Prajasthapana gana Virechanopaga gana2 Sushruta samhita Mustadi gana Triphala gana Amalakyadi gana Parushakadi gana3 Bhavaprakasha nighantu Haritakyadi varga4 Madanapal nighantu Haritakyadi varga5 Kaiyadeva nighantu Aoushadhi vargaEvaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 11
  63. 63. Drug Review6 Dhanavantari nighantu Guduchyadi varga7 Priya nighantu Haritakyadi varga8 Raja nighantu Amradi varga9 Shaligrama nighantu Haritakyadi varga10 Mahaoushadhi nighantu Phaladi varga11 Nighantu adarsha Haritakyadi vargaEvaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 12
  64. 64. Drug ReviewTYPES OF HARITAKISeven types of Haritaki 19-21 1. Vijaya 2. Rohini 3. Putana 4. Amruta 5. Abhaya 6. Jeevanti 7. ChetakiTwo types of Haritaki 22 1. Haritakki 2. Bala haritakiThree types of Haritaki 23 1. Neeraja or Jalaja 2. Vanaja 3. parvateeyaThree types of Haritaki 24 1. Sukahali haradee (Guj) Badi harada (Hindi)/ Ilelekabali (Parsi) Two tola in weight rounded Haritaki place- Bombay 2. Harad (Guj)/ Ilelaha Asfar (Arabi)/ ilela Jarda(Parsi) it is used for colour. 3. 3.Himaja (Guj)/ Jouhada, Chote harre (Hindi)/ Balaharada (Marati)/ Ilale shyaha(Parsi).Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 13
  65. 65. Drug Review PROPERTIES ACCORDING TO DIFFERENT AUTHORS Table – 3.RASA 25-36S.N Rasa C.S S.S AH.S B.N K.N D.N P.N R.N M.N S.N N.A Mou.o N1 Lavana Varjita + - - + + + + + + + + + Pancha rasa2 Kashaya Amla - + - - - - - - - - - -3 kashaya - - + - - - - - - - - - Table – 4.GUNA 37-46 S.No Guna C.S S.S AH.S B.N D.N P.N M.N S.N Mou.N K.N 1 Laghu + - - - - + - - - - 2 Laghu - + + + + - + + + + Ruksha Table – 5.VEERYA 47-56 S.No Veerya C.S S.S AH.S B.N K.N P.N M.N S.N NA Mou.N 1 Ushna + + + + + + + + + + Table – 6.Vipaka 57-64 S.No Vipaka S.S AH.S B.N K.N M.N S.N NA Mou.N 1 + + + + + + + + Madhura Evaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 14
  66. 66. Drug ReviewProbable Mahabhuta dominance of Haritaki, according to Rasapancaka1) Rasa → Pancarasa, Kasaya dominance (Lavanavarjita) Kasaya → Prthvi + Vayu Tikta → Akasa + Vayu Katu → Agni + Vayu Amla → Prthvi + Agni Madhura → Prthvi + Jala Thus, total picture of Mahabhuta dominance, according to Rasa Prthvi - 3 + Jala - 1 + Agni - 2 + Vayu - 3 + Akasa - 1 According to Guna1) Laghu → Agni + Vayu + Akasa2) Ruksa → Agni + Vayu According to Virya Usna → Agni According to Vipaka Madhura → Prthvi + Jala Therefore, total Picture of Mahabhuta Dominance, according to Rasa Pancaka Prthvi - 4 + Jala -2 + Agni - 5 + Vayu - 5 + Akasa - 2 So, Agni and Vayu Mahabhutas are showing equal dominancy according toRasa PancakaEvaluation of Efficacy of Haritaki Phala Churna in the management of Tamaka Swasa 15

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