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The preparation, physico-chemical analysis of darada vati and evaluation of its clinical efficacy on sandhigata vata” (Osteoarthritis)” - Dr. Kallappa. M. Jaggal, Department of rasashastra, Post …

The preparation, physico-chemical analysis of darada vati and evaluation of its clinical efficacy on sandhigata vata” (Osteoarthritis)” - Dr. Kallappa. M. Jaggal, Department of rasashastra, Post graduate studies and research center, Shri D. G. Melmalagi Ayurvedic Medical College, Gadag


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  • 1. “THE PREPARATION, PHYSICO-CHEMICAL ANALYSIS OFDARADA VATI AND EVALUATION OF ITS CLINICAL EFFICACY ON SANDHIGATA VATA (Osteoarthritis)” By DR. KALLAPPA .M. JAGGAL B.A.M.S DISSERTATION SUBMITTED TO THE RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE IN PARTIAL FULFILLMENTS FOR THE DEGREE OF “DOCTOR OF MEDICINE” (AYURVEDA) In RASASHASTRAGUIDE CO-GUIDEDR.M.C.PATIL DR. GIRISH.N.DANAPPAGOUDAR M.D.(R.S) M.D(R.S)Prof. Head of the Department Lecturer. Departmentof Rasashastra. of Rasashastra. DEPARTMENT OF RASASHASTRA, POST GRADUATE STUDIES & RESEARCH CENTER, D.G.M. AYURVEDIC MEDICAL COLLEGE. GADAG –582103 FEBRUARY- 2005 ENDORSMENT BY THE HOD, PRINCIPAL/HEAD OF THE
  • 2. Department of Post Graduate INSTITUTATION Post Graduate cum Research Center,Studies in RASASHASTRA D.G.M.Ayurvedic Medical College Gadag –582103 J.S.V.V. SAMITE’S ENDORSEMENT ΕΡΤΙΦΙΑΧ I here by declare that this dissertation entitled “THE PREPARATION, PHYSICO- CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITS CLINICAL EFFICACY ON SANDHIGATA VATA(Osteoarthritis)” is a bonafide and genuine research work done by Dr.Kallappa.M.Jaggal under the guidence of Dr.M.C.Patil Professor, HOD Department of Post Graduate Studies & Dr.Girish.N.Danappagoudar Lecturer, Department of Rasashastra, Post Graduate Studies in D.G.M.Ayurvedic Medical College, Gadag. Seal & Signature of the Principal: Seal & Signature of the HOD. Name: Name: Date: Place: Date: Place: Gadag.
  • 3. Department of Post graduate Post Graduate cum Research Center,Studies in RASASHASTRA D.G.M.Ayurvedic Medical College Gadag –582103 J.S.V.V. SAMITE’S CERTIFICATE I here by declare that this dissertation entitled “THE PREPARATION, PHYSICO- CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITS CLINICAL EFFICACY ON SANDHIGATA VATA(Osteoarthritis)” is a bonafide and genuine research work done by Dr.Kallappa.M.Jaggal in partial fulfillment of the requirement for the degree of Ayurveda Vachaspati (M.D) in Rasashastra of Rajiv Gandhi University of Health sciences, Bangalore, Karnataka. Date: Guide Place: Gadag. Dr.M.C.Patil. M.D.(RS) Head of the department Rasashastra, Post Graduate cum Research Center D.G.M. Ayurvedic Medical College Gadag –582103
  • 4. Department of Post graduate D.G.M.Ayurvedic Medical College &Studies in RASASHASTRA Post Graduate cum Research Center Gadag –582103 Dist: Gadag J.S.V.V. SAMITE’S CERTIFICATEI here by declare that this dissertation entitled “THE PREPARATION, PHYSICO-CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITSCLINICAL EFFICACY ON SANDHIGATA VATA(Osteoarthritis) ” is a bonafideand genuine research work done by Dr.Kallappa.M.Jaggal in partial fulfillmentof the requirement for the degree of Ayurveda Vachaspati (M.D) in Rasashastra ofRajiv Gandhi University of Health sciences, Bangalore, Karnataka.Date: Co-GuidePlace: Gadag. Dr.Girish.N.Danappagoudar M.D.(RS). Lecturer Rasashastra Post Graduate cum Research Center D.G.M. Ayurvedic Medical College Gadag –582103
  • 5. J.S.V.V. SAMITE’S DECLARATIONI here by declare that this dissertation entitled “ THE PREPARATION, PHYSICO-CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITS CLINICALEFFICACY ON SANDHIGATA VATA (Osteoarthritis)” is a bonafide and genuine researchwork carried out by me under the guidance of Dr.M.C.Patil. Professor &HOD, Department of Post Graduate Studies in Rasashastra, Post Graduate cum ResearchCenter, D. G. M Ayurvedic Medical College, Gadag –582103Date: Dr.Kallappa.M.Jaggal P.G.Schalor, Place: Gadag. of Rasashastra, Post Graduate Dept. cum Research Center, D.G.M Ayurvedic Medical College Gadag –582103
  • 6. COPYRIGHT I here by declare that the Rajiv Gandhi University of Health Sciences,Karnataka shall have the rights to preserve, use and disseminate this dissertation inprint or electronic format for academic / research purpose.Date: Dr.Kallappa.M.Jaggal P.G.Schalor, Dept. of Rasashastra, Post GraduatePlace: Gadag cum Research Center, D.G.M. Ayurvedic Medical College Gadag –582103© Rajiv Gandhi University of Health Sciences, Karnataka
  • 7. ACKNOWLEDGEMENT My father & mother is the only Inspiration. This work carries some sweatmemories to express & record about some distinguished personalities by whom I had beeninspired during the course of this thesis.I express my deep sense of gratitude to my respected guide Prof.Dr.M.C.Patil. MD(Ayu)Head of Dept. of RS, DGMAMC & PGSRC, Gadag. He has been very kind to guide me in thepreparation of thesis & for who extraordinary efforts, tremendous encouragement & mostvaluable thought provoking critical suggestions, made me to complete this work. I am extremely greatful & obliged to my co-guide Dr.Girish .N.Danappagiudar.MD(Ayu). Lecturer in Rasashastra, PG studies & Research center DGMAMC,Gadag, for patiently going through the draft of thesis & correcting with precious remarks whichhave been very useful. I am thankful to Dr.G.B.Patil principal, DGMAMC, PGSRC,Gadag, forproviding all necessary facilities for this research work. I wish to convey thanks to my teacher Prof.Dr.R.K.GachchinamathHOD,Rasashastra dept,(UG) DGMAMC, Gadag, for being kind & affectionate through hisvaluable suggestions & advises. It gives me immense pleasure to express my gratitude to Dr. Dilipkumar B.MD (Ayu). Asst. Prof. PGSRC for kind advise encouragement during the study. I acknowledge the valuable help given to me by my best friends Dr.Jagadish Mitti MD(Ayu). Lecturer & Dr. Shashikant Nidagundi MD(Ayu) Lecturer, fortheir support during my PG study.
  • 8. I am greatful for the support and advise given by Dr. S.H.Doddamani MD(Ayu). Asst. Prof. PGSRC. DGMAMC, Gadag, during my clinical trail and encouraged meall the time during this work. I express my deep gratitude to Dr. B.M.Mulkipatil MD (Ayu), Lecture,PGSRC, Gadag, for his fullhanded whole hearted, co-operation and suggestions in thisstudy, for which I will be ever greatful to him. I wish to convey thanks to all UG & PG lectures of DGMAMC, Gadag, fortheir timely help & constant co-operation during my PG work. I sincerely thank my beloved classmates Dr. K.S.Santoji, Dr. P. KoteshwarRao, Dr. V.S.Hiremath, Dr. R.B.Paattanashetti, for their deep co-operation and involvementin the study. I am also thankful to scholars of PG Dept. of Rasashastra who have directlyor indirectly helps my thesis work. & expected their co-operation & support during my PGwork. I am glad to express my heartiest thanks to Dr. Chandur Medical pharma .J.T.College Gadag, having helped me in carrying out analytical works, and for giving kindsuggestions. I wish to convey my thanks to beloved librarian, Sri. V.M.Mundinamani,Asst. S.B.Sureban for providing many valuable references in the study. I am thankful to Sri.B.S.Tippanagouda, Lab technician, who extended this co-operation in investigations. I tender my sincere thanks to Nandakumar, statistician for his help instatistical evaluation & results.
  • 9. I wish to thank the physicians , House surgeons, Hospital staff, nurses &non teaching staff for their timely assistance in completion of this work. Let me express my thanks to all patients, those were on trial for theirconsent for enrolling in this clinical study & obedience to advises. I am highly indebted to my beloved parents brothers sisters & other familymembers for their love & affection rendered through out my career. I am thankful to computer operator in bringing out the computer presenceof my thesis in such a elegant way. I express my thanks to all the persons who have helped me directly &indirectly with apologies for my ability to identify them individually. Lastly I prey my deep homage & tribute to my grand parents for the love &affection rendered through out my career.GadagFebruary 2005 Dr: K.M.Jaggal
  • 10. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA CONTENTS • Acknowledgement • List of Tables • List of Photographs And Diagrams • Abbreviations ABSTRACT Chapter name Page No. 1. Introduction 1-3 2. Objectives 4 3. Review of Literature’s 5-59 4. Materials and Methods 60-83 5. Results 84-98 6. Discussion 99-108 7. Summary and Conclusion 109-111 • References • Appendix 4
  • 11. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA INTRODUCTION Kaya Vagbuddhi Vishayo ye malaha Samupasthita ⎜ Chikitsa laxanaadyatma shastrai stesham vishuddhaya⎜⎜ (V.P) Kaya, Vak, Buddhi, Doshas can be Corrected by chikitsa, Vyakarana, Adhyatmarespectively, which are studied under the roof of Ayurveda. Ayurveda is one of the most ancient systems of health science based on its own uniqueoriginal concepts, fundamental principles. The development of Science is by Brihatrayis andlaghutrayis. These texts have described well developed eight clinical specialties for thepurpose of chikitsa In this chikitsa, vanaspathija dravyas are most dominant and next pranja dravya, veryfew metal minerals were used. In Bouddhika kala the practice of shalya and panchakarma were declined, as they werethe followers of “ahimsho paramu dharma”. These leads to development of alternativemedicinal remedies with use of metals and minerals keeping in view that “yatha lohe tathadehe.” Mahaboutika compositions of metal and minerals will differ, than the tissue element ofthe body; these raw heterogeneous and toxic properties are removed by shodhana, maranadisamskaras, according to the nature of the dravya and the diseases for which they are to beused, such drugs become more potent thus they can be used in minimal dose. The rasa dravyas are classified differently by various authors on the basis oftherapeutic effect and process makes fit for uses. 5
  • 12. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA In these parada is supreme one because of “kastoushadhyo nage nago vangastavangamapi shulbe ⎜ shulbam tare taram kanake kanakam cha liyate cha suthe⎜⎜”1 and ithas the power to assimilate all the other metal and minerals, and preventing from the jara,akalamrityu, curing diseases when it processed in proper way. Parada can be extracted by darada, so darada is one of the measure sources of parada.Parada extracted from this is called Hingulottha parada. This has the property of ashtasamskarita parada, gandhaka jarita parada. Hingula can be studied under sadaranarasa as well as maharasa, uparasa rasadhatuvarga, according to different opinion. Shodhita hingula act as a Sarvarogaghna, Sarvadoshaghna, Rasayana, Balavardhaka,Medhya, Agnivardaka, and Yakritaplehavikaranashaka, Meha, and Kushta etc.vikara nashaka. According to Rasamritakara shodhita hingula should be subjected to bhavana withLasuna, Palandu, Tambula, and Ardraka sawrasa seven times with each. The vati prepared byit may be act on all vatakaphaja vikara especially sandhigatavata, puranapinasa, by virtue ofproperties like agnideepaka, balya, tridoshaghna, rasayana property. Sandhigata vata is explained in almost all Ayurvedic classics in vata vyadhi adhyaya,they explained about sign and symptoms those are sandhishoola, shotha, atopa, etc. and alsomentioned different chikitsa procedures like abhyanga, swedana, snehana, basti and drugs insingle, compound drug formulations like kashaya, guggulu kalpa, and churana etc. According to modern signs and symptoms resembles like osteoarthritis, osteoarthritis isa degenerative inflammatory joint disease characterized by destruction of articular cartilageand formation of new bone at the joint surface and margin, in this pain is universal problem,which has an unpleasant sensory and emotional experience associated with actual or potentialtissue damage, it does not lead to mortality but it definitely causes morbidity. 6
  • 13. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Radiological and autopsy surveys shows that a steady rise in degenerative changes in the joint from the age 30 yrs, 65% of people have radiographic evidence of osteoarthritis, 35% may have symptoms, male and female both were affected but more generalized, more severe in older women’s. Geographical survey show different in both the prevalence of osteoarthritis and pattern of joint involvement, cold and damp climates are associated with more symptoms but not in greater radiological. Now a day this common disease affecting in 25% of population and more generalized. The disease treated by many drugs, there is no satisfactory treatment is established. In this view the rule of Darada Vati may be as an effective drug. Plan of study The study has been planed as below1. Objectives2. Review of literature – Drug review and Disease review3. Methodology- Pharmaceutical study, Analytical study, Clinical study.4. Results5. Discussion6. Summary7. Conclusion 7
  • 14. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAAims and Objectives of the Study1. Preparation of Darada vati2. Physicochemical analysis of darada vati3. Clinical evaluation of Darada vati on sandhigatavata 8
  • 15. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Drug Review HINGULAHistrological aspect: The possible available references regarding hingula since, ancient period to presentday are as follows. There is no reference in Prevedic, Vedic, Purana, Upanishad period.Samhita kala (100 B.C):- All the literatures which are written during the Samhita kala are not available atpresent, the leading Samhita available are charaka, sushruta, kashyapa, etc. In these textsalso there is no reference of hingula is found. In these Samhita only use of parada available.Kautilya arthashastra (200 B.C): Chanukya has mentioned hingula in his text for the first time. But the usage ofhingula as a medicine is not described by him. He has mentioned hingula with swarnadidhatu. “Ghanasushire vaa roope swarna mrit valuka hingula kalko vaataptovatishthate”(Kou Arth 2/14/40) Another reference of hingula is found in the methodsfor testing of various metals. He has mentioned four types of testing methods namely 1. Parikuttanam (hammering), 2. Avachahedana (cutting), 3. Ullekhana (scratching), 4. Parimardana (rubbing), Here hingula is mentioned in the parimardana (Kou Arth 2/14/54)Nighantu period: In Dhanwantari, Raja, Kaideva, in these nighantu reference of hingula available inbhouma dhatu varga.Rasakala (6th-8th century A.D): 9
  • 16. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAI.Rasarathanakara (6th century): Rasarathanakara tantra written by nagarjuna,nagarjuna was first time mentioned the hingula for therapeutic purposeII. Rasendramangala2 (8th century A.D): The oldest text of rasashastra rasendramangalaas per the first time descried about shodhana and the therapeutic usage of hingula isdiscussed, and this is also used for the preparation of loha bhasma. He has consideredHingulottha Parada is the satwa of hingula.III.Rasa hridaya tantrakara (10th century A.D): Acharya bhagvata govinda pada hasmentioned in the list of eight rasa dravyas.IV. Rasarnava3 (12th century A.D): He has considered hingula as a maharasa; he alsodescribed the synonyms varieties properties and satwapatana of hingula. He utilized theterm “Rasagandasombhotam”. From this world it is understood that he was aware ofchemical composition of hingula.V. Rasaratnakara4 (15th century A.D): Rasaratnakara described the hingula and alsomentioned the artificial preparation of hingula; this indicates they were well known aboutchemical composition.VI. Other rasagranthas (6th – 20th century A.D) Rasa ratna samuchchaya5, Rasa prakasha sudakara, Rasendra Sara sangraha6,Rasendra chudamani, etc. and Naveena rasa grandha likeRasa tarangin7i, rasamritakara, Ayurveda prakasha8, siddha bhaishajya manimala, etcmentioned the Synonyms, varieties, properties, shodhana, grahyalakshana and uses, thesetexts also mentioned the artificial preparation of hingula. 10
  • 17. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAVII. Modern Historical Aspect9& 10: Before 3000 yrs hingula was collected from mines situated near by Konia inminor Asia for colouring purpose. Reference of hingula can be found in the text on stoneswritten by Theofiastice (300 B.C). He has described a method for the separation of mercuryfrom hingula by adding copper powder and vinegar, Diokaridase used iron powder insteadof copper for the same purpose. Hingula is being obtained from almond (Spain) since 2000 yrs.Classification: Hingula was classified into different groups in different texts according to author’sopinions is given below.Table No. 1 Showing the class of Hingula according to different text Sl.no Classification Rasagranthas 1 Rasa Rasa Hridaya tantra 2 Maharasa Rasarnava11, Rasaratna samucchaya12, Rasakalpa, Rasakamadhenu13, Goraksha Samhita, Rasaviveka 3 Uparasa Anandakanda, Rasaratnakara, Rasaprakasha 14 sudhakara, Rasasarasangraha , Rasamanjari, Rasendra chintamani, Ayurveda prakasha15, Bavaprakasha, Rasapradeepeka, Rasoddhara tantra, Brihatyogatarangini. 4. Sadharana Rasaratna samuchchaya16, Rasaendra 17 rasa chudamani, Rasajalanidhi , Rasachandansh, Rasadhatuprakash, Bharatiyarasashastra18, 5 Suvarnadi Dhanwantarinighantu, Rajanighantu19, 6 Rasadhatu Rasamrita20, yogaratnakara21 7 Bhouma Dravyagunavignan. uparasa 11
  • 18. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Vernacular names22&23 Sanskrita ---- Hingula, Darada, Churnaparada, Mlechch Hindi----- Hingula, Singarpha, Latin name –Sulphuatumhydragyrium English------ Cinnabara, Redsulphide of Mercury Kannada----- Ingalika, Marathi----- Hingula, Assami----- Janophar Telagu------ Ingulikam, Gujarati--- Hingula Malyali------- Sedilengam, Arabic----- Zunjefer Nepal------- Sabita, Persian---- Shengherf SynonymsRasaganda sambuta, Maniragaja, Kandarasa24Hinguala, Hingulik, Hingoola, Ingalika, Mlecch, Rakth, Suranga, Chitranga, Churnaparada,Rasodbhava, Rasasthana, Ranjani, Kapishirshaka25, Raktakaya, Hamsapada. Shukatunda,Pravalabha, Bimbiphala. Kuravinda, Gandhika.Table No. 2 Showing different synonyms of Hingula according to content place coloursimilarity uses Content Place Colour(similarity) UsesOrigin26- Rasodbhava Hingula Rakta,,raktakaya Ratnaragakari Churnaparda M Darada Suranga,,hamsapada lohaghnaythol Rasagandhasambuta Mleccha Chitranga,,japakusum Ranjaniogic Rasagarbha Chinipisti Daityarakta,,shukatund hingulaal Lagukandarasa Bimbiphala Maniragajastory charmargandika pravalabha kuravinda 12
  • 19. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAhas been described that hingula is virya of lord shiva which was recived by god Agni butdue to its high intensity he vomited it, this vomited material fell in daradadesh and becomemixed with the earthy material, this mixture is known as hingula.Chemical composition27 (HgS): According to rasarnava “Rasagandha samnbutham”by this hingula is a compound ofparada and gandaka,Chemically it is called as red sulphide of mercury; it contains 86.2%of parada and 13.8% ofgandaka and trace amount of arsenic, iron pyrite, clay, gypsum, black earthy materialsoccurrence28&29: It is obtained from the mines as a natural mineral and also prepared artificially In ancient days hingula was available in darada desh.at present it can be found atmany places all over the world i.e., Spain(almandine), Italy, Russia, Yugoslavia,Jechoslovia, Germany (idria mines), Japan, china, USA,Austraila,Nepal etc…. But now a day no deposit of cinnabar can be detected in India. For that purposeartificial hingula is prepared in Surat and Calcutta.The hingula what we get from market is almost artificial prepared.Preparation of artificial hingula Preparation of artificial hingula prepared since rasaratnakara30 period, next after thisnumber of text also mentioned the artificial preparation of Hingula. Here the ratio of paradaand gandaka is differing from text to text.According to Rasa tarangini31---- 42 part parada and 8 part gandaka subjected to paka inmrudangayantraAccording to rasakamadhenu and Ayurveda prakasha321 part ashuddha parada and 4 part ashuddha gandaka, subjected to pachana in lohapatra.after paka 1/10 part manashila was added and make mardana fill in kachakupiAfter filling kept in valuka yantra and subjected to paka karma (mridu, madyam, teevra)According to Materiaindica33, 13
  • 20. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Red sulphide of mercury may be obtained from the block sulphurent by heating itred hot in a flask, and then gray sublimate is produced.The cinnabar is compound of about eight parts of mercury with one part of sulpur ismanufactured to a great extent in Holland as a red pigment.Varieties Ancient rasagranthas like Rasa Hirudaya Tantra, Rasa Prakasha Sudakara34, Rasendrachudamani35 etc. considered two varieties. 1. Shukatunda 2. Hamsapada According to Rasamrita36- 1. Hamsapada 2. Mlecchaka Rasagranthas of middle period like Anandakanda, Rasakamadhenu37, Ayurvedaprakasha38, etc. considered three varieties1. Charmara 2. Shukatunda 3. HamsapadaModern rasagranthas like Rasatarangini39, Rasamritha described two varieties according to itsorigin 1. Kritrima (artificial) 2. Khanija (natural)According to Haridatta shastri commentator of Rasa Tarangini further classified artificialhingula into two types in his prasadini commentary i.e. 1. Mrisrina 2. KathinaAccording to Bharatiya Rasa shastra40 kritrima hingula again classified into two types1) Rumi Hingula(Rakta Varna) 2) Katha Hingula (Krishna Hingula) Table No. 3 showing classification of hingula according to ancient period. Ancient Middle period Modern rasagranthas acharya RHT, RPS, RC, RK, AU PR, RT, RA AK 1. shukatunda 1. charmara 1. Kritrima 1. Mrisrima 2. hamsapada 2. shukatunda 2. khanija 2. katina 3. hamsapada 14
  • 21. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAProperties of Standard Quality Hingula: According to Rasaprakasha sudhakara41, Hamspada is the best variety of 3 types According to Rasendrasarasangraha42 Bimbi pahal samana rakta varana According to Rasatarangini43 Japakusumavarnayukta, Mritsna, Shlakshna, Bhara, is thebest.Shodhana44, 45, 46, 47Rasagranthas have described different methods of hingula shodhana and drugs also differ inthis process. Yantra used for the shodhana are only two yantras i.e 1. Khalva yantra, 2. Dola yantraMethods used for shodhana are Bhavana, Swedana, Prakshalana with Swarasa of herbal drugsand pranija dravyas like Dugdha, Mutra of, etc some authors told that Prakshalna has to becarried out after bhavana. Bhavana is suggested after swedana karma.Shodhana drugs according to origin 1. Animal origin – Dugdha and Mutra of Go, Aja, Mahisha, Meshi, 2. Plant origin – Amla vargiya dravya swarasa like Jambira, Nimbu,Matulunga,Lakucha, and Drakshaphala swarasa, Kusmandu swrasa, Ardraka swarasa,Shunti kashaya,Jayanti swarasa , Laksha rasa, Taila, Ksharajala,Laksh rasaAlmost all reference mentioned Bhavana Method with Amlavargia dravya swarasa,Ardraka swarasa.According to Rasa mrita, shodhana is by Meshi Dugdha for one times after this seventimes Nimbu swarasa Bhavana.Matra48, 49: ½ to 2 ratti (62.5mg to 250mg)Anupana50:Maricha, Guda, Pipali, Guduchi swarasa, Madhu, Ardraka swarasa, Tambula SwarsaProperties: 15
  • 22. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAThe properties of shodhita Hingula equal to property of Rasasindura and parada extractedfrom this equal to Gandhaka jarita parada.Rasa; We have different opinions regarding the rasa of hingula 1. Most of the authors have towards the Tikta Katu Kashaya rasa51 2. Some other opinions Madhura Tikta rasa52 3. Least reference is available about only katu and only Tikta rasa53. Table No. 4 showing rasa of hingula according to different grantha Sl.no Rasa Rasagranthas 1. Katu B.P., A.P., Aryuveda Chintamani, Parada Samhita Tikta Rasendra purana, Rasadhatu Prakasha, Brihat Yoga Kashay Tarangini 2. Madhura Rasarnava, Basavarajiya, Danwantharinighantu, Tikta Rajanighantu 3. Tikta Rasendra Chintamani, 4. Katu Gadatimir bhaskara, Guna: Ushna Guna54 Veerya: Ushna Veerya54 Vipaka: Katu vipaka54 Doshaghnata: Tridoshaghna55, Vatakaphaghna, Kaphaghna, kaphapittaghna56 16
  • 23. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Table No. 5 showing Doshaghnata of Hingula according to different text Sl.No Doshaghnata Rasagranthas 1. Vata Basavarajiya, Rasendra Chudamani, Rasendra Pitta Sara sangraha, RSS, Danwantharinighantu, Kapha Rasamrita, Rasachandanshu, Rasadhatu prakasha 2. Kapha B.P., A.P., Aryuveda Chintamani, Parada Pitta samhita, Rasendra Bhaskara, rasoddhara tantra, Si.Bh.Ma.Ma. Bha.Ra.Sha, Bri YoTarangini, 3. Kapha RasataranginiKrama: Sarvadoshaghna, Aghivardhaka, Rasayana Balya, Medhya, Kantivardhaka,Garavishnashaka, Netraroga, Pramehahara, Ruchikaraka, Hriudayotsadaka,Jawaranashaka, Aruchinashaka, Hrillashanashaka.Upayoga57,58,59: Prameha, Jwara, Hridroga, Kusta, Garavisha, Amlapitta, Kamala, Pleehavraddi, Mandagni, Aruchi, Amavati, Sandhivata, Hrillasha Lohamarnarta, Lohajanarta, Parada niskarshanartha, etc. According to Brandus manual of chemistry volume 2 this has been consider hasAlternative, Deobservent and at one time was much used in Rheumatic Affection, Leprouscases and also in Worm cases Arabians knew that fumigating the Hingula in old venerealcomplaints. Hindus knew how to prefer it in a course manner and considered it asAntispasmodic and also as valuable remedy for cuetaneous affection and for fumigating insuch a case of the Venereal diseases as are attained with ulcers in the mouth, throat. 17
  • 24. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATATable no.6 shows the properties of hingula according to different text. Properties RJN RPS AP RC RSS RRS RT RP RM BRSsarvadoshaghna + + KP + - + KV - + KP Deepana + + - + - + - - + + Atirasayana + + - + - + - - + +Sarvarogahara + + - + - + - - + - Vrishya + - - + - + - + + - Jaranartha + - - - - + - + - + Meha + - + - + - + + - + Kusta + - + - + - + + - + Aruchi + - + - + - - + - + Medhya + - + - + - + + - + Balya + - + - + - + + - +Agnivardhaka + - + - + - + + - - netraroga - - + - - - + - - + Hrillasa - - + - - - - + - + jwara - - + - - - - + - + Kamala - - + - - - + + - + Pleeha - - + - - - + + - + Amavata - - + - - - + + - + Garavisha - - + - - - + - - - Dehakanti - - - - - - + - - -lohamaranarta - - - - - - - + - - Dravanarta - + - - - - - - - -Ashuddha and asamykashuddha hingula dosha60 Rasagranthas have given description about ashuddha and Asamykashuddha HingulaDosha; Ashuddha Hingula administration may produce dangerous toxic symptoms,Klama. Moha Bhrama, Klaibya, Kusta, Kshinatha, Andatha, Murcha, Prameha, according toUnani Dravy Guna some toxic symptoms like Hridspandana, Akulath, Vishadatha, 18
  • 25. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Table no. 7 shows that complications according to different text Name of Text 1 2 3 4 5 6 7 8 Basava Rajiya - - + + + + + - Ayurveda prakash + + - + + + - - Yogaratanakar + + - + + + - - Parada Samhita - + - + + + - - Rasa Chandanshu - - + + + + + - Rasa Jalanidhi - - + + + + + - Rasendhara Purana - - + + + + + - Rasa Tarangini + + - + - + - - Rasa Dhatu Prakash - - + + + + + - Br,Ra,Ra,Su - - - + + + + - Unani Dravya Guna - - - - - - - +1. Andhata, 2.Kshinata, 3.Kusta, 4.Klama, 5.Bhrama, 6.Moha, 7 Klaibhya, 8 Hridayavasada.Chikithsa of complication caused by Ashuddha and asamykashuddha hingula dosha61 Rsabhaskara mention the treatment about this here management should be done asper the management of apakva parada bhasma asamykashuddha parada sevan “Tpadhayat yat vyadhi daradasayani sevan nuth / tat sutavat sarvh kuryat shanthiprati kriya // 13/41”Shuddha gandhaka should be administered till the complication subsided.Marana: - Most of the Rasagranthas have not described mrana for hingula.very list 62, 63, & 64reference available about marana Hingula bhasma is red sulphide ash is prepared by taking Hingula (Red Sulphide) 4 Part Haratala (Orpiment) 1 Part Lavanga (Cloves) 4 Part 19
  • 26. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAThe Powder of Shodhita Hingula, Haratala and Lavang all these are mixed and making abolus in the Juice of fresh ginger, After drying kept in the crucible subjected to puta.Hingula Bhasma Matra: - 1/3 – ½ grainUpayoga65: Atyanta Agni deepaka with Tambul swrasa anupana. Kamottejaka, Medhya,Atyanta Rasayan, 66, 67, 68, 69&70Satwapatana : Extracted Parada from Hingula has considered as Satwa of HingulaThis Satwa can be extracted by different methods1. Urdvapatana Yantra Vidhi2. Adhapatana Yantra Vidhi3. Kanduka Yantra Vidhi4. It is also extracted by Candle method according to Siddh Bhaishajya Manimala.Preparations 71 Anandha Bhairava Rasa, Hingulehsawar Rasa, brihat hinguleshwara rasa.Tribhuvana Kirtirasa, Kanak Sundar Rasa, Atisara Haravati 72Kasturi Bhairava Rasa Jwaramurari Rasa , Vasanth Malik Rasa 74Rasa Garbha Potali73iDarada Vati 75Darada Sudha Bhasma, HinguladhigutikaHingula rasasindoor, Srisiddhadaradamritarasa, Hingulia Manikya Rasa 76Hinguladyamalahara, Hingulamrutamalahara, Srisiddhahinguleshwar rasa 77Dradeshwar rasa . 20
  • 27. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Modern aspect of Hingula78&79Cinnabar is only important ore of mercury, it is, massive or oarthy, it some times occursbeautifully crystlised in small complex and highly modified hexagonal crystals; usually thecrystals are rhombohedral or prismatic in habit. it is also transparent, translucent or opaque,sometime cochineal red in colour often inclining to brown its streak is scarlet to reddishbrown. Adamantine to luster prefect prismatic cleavage. Sometimes with an earthycoatings.VarietiesThe varieties are made according to colour and percentage of HgS in it.1. Cinnabar native – This is one of the most important ore of mercury. As mentionedpreviously, chemically it is contain 95% mercury sulphide. It is bright and dark red incolour it contains other impurities like Carbon, Silica, Quartz etc. are present.2. Hepatic cinnabar – When percentage of carbon impurities are higher in cinnabar, itscolour becomes darker like liver colour such, an ore is called as hepatic cinnabar.3. Meta cinnabar – This type contains muddy dust is more percent and that makes itscolour still darker almost to a black shade.4. Coral ore – This ore especially occurring in Germany and Italy. This ore in the form ofrose colour earthen material, when mercury sulphide in coral ore is separated. it is rosy incolour, it contains about 5% of mercury..5. Idrialate – The variety called idrialate, always occurs cinnabar at Idria, as white andcrystalline in structure when toward and it is found in impure with clay, pyrite, gypsum as abrownish black earthy material because of its combustibility and presence of mercury it iscalled inflammable cinnabar.Physico chemical property1. Cinnabar is a red or whitish red coloured mineral. This ore is a red crystalline mass thatis easily distinguishable from all other red minerals by its peculiar shade of colour and itsgreat weight.2. It is heavy and its specific gravity is 8.01 to 8.9.3. Hardness of this mineral is 2-2.5.4. It is insoluble in water and acids but dissolve in aquaragia (mixture of HCl and HNO3)and forms mercuric chloride. 21
  • 28. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA In the presence of a strong oxidizing agents like potassium chlorite formingmercuric chloride5. Roasting – usually the unconcentrated ore is roasted in air cinnabar is oxidized tomercuric oxide and sulphur dioxide is released at the temperature of the furnace andmercuric oxide so forms decomposes to give mercury and oxygen. 2HgS + 3O2 2SO2 + 2HgO 2HgO 2Hg + O2 The mercury obtained by above method is the purest mercury.6. Mercury Sulphide reacts with concentrated potassium sulphide solution to give acomplex thio salt. HgS + K2S K2HgS2 On sublimation mercuric sulphide becomes red. 22
  • 29. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA DISCRIPTION OF BHAVANA DRAVYA 80& 81 MESHI DUGDHA Varga-Dugdha Varga Synonyms- Dugdha Ksheera Vernacular names-English-milk, Hindi, Guja, Moha-Dudh Tamil Telgu –Palu, Malyali-Musu, Kannada- Halu. Source-Mammary glands of eves Description: white emulsive faintly alkaline fluid little more viscous than water tastes is sweet land blond, odour faint) and peculiar specific gravity-1.027-1.034 under microscope, numerous minute fat globules are seen floating in the form at emulsion milk because spoiled after 10-12 hours, after which it is indigestible and harmful and acts as poison to the system such milk should be avoided milk contains all the elements necessary for the growth and nutrition of bones nerves muscle and other tissue milk contains also vitamins which are natural antidotes to rickets, scurvy and other results of defective nutrition. According to Astanga Sangraha- Ushna Vata Vyadhinashaka the milk of eve which is supposed to resemble cow (metria indica) Pharmaco dynamics –Rasa-Madhura, Guna-Snigdha, Guru. Veerya-Ushna, Doshaghna-Vataghna. Uses: eves or sheeps milk is bone ficial in obesty flatulence and gonorrhoea is a good diet in rheumatism and hectic cough milk of red eve increases too much both the bile and phlegma. 82, 83& 84 NIMBUKA Botanical Name-Citrus Limon (Linn) Family-Rutaceae Gana-Charaka-Phala Varga, Amla Varga, Susruta and Vagbhata-Phala Varga Synonyms-Nimbu-Nimbuka, Dantsatha 23
  • 30. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAVerncular Names-Hindi-Nimbu, Kannada-Nimbe Hannu, English-Lemon, Telgu- Nimma Chettu.Description: a strangling, bussy, small tree 3-4 meter high with thorny branches, Leaves- ovate, Petiole margined or winged flowers –small white or pinkishsweet scented fruit-oblong or ovoid, usually with a nipply shaped extremely brightyellow rind thick pulp acid pale yellow.Distribution: cultivated/grown in U.P. Maharashtra Tamil Nadu and Karnataka, foundwild in the North West regions of India.Phyto chemistry: citric richer juice 90% and the average amount of citric acid available 3.7% from 100 cc lemon juice (chopra I,D of I pp 123/124 a paleyellow volatile oil derived either by distillation or by sample expression from the fresh outer part of the pericarp.Pharmaco dynamics: Rasa-Amla, Katu. Guna-Laghu, Tikshana, Virya-Ushna, Vipaka_AmlaDoshakarma_Vala kaphaharaKarma- Dipana, pachana chaksusya Agnimandya, gulya sheel amlapitta visuchi vataroga vatashlesma vibandhagna.Uses-agnimandya,Aruchi,Netra roga,amlapitta,Vataja roga,Vibandha,etc.According tomodern science,Medicinal claims includes uses for treatmentforHighbloodpressure,Dyspepsia,Anemia,Acne,Arthritis, lemon juice used for makingvit C concentration.Vit C is essential for the normal functioning of living cells and isinvolved in many enzymatic reaction.It is required for the development of cartilage,bone and teeth. It also help for wound healig, for absorption of iron from the intestine.It has reducing and antioxidant properties, the Vit C are utilized in the food industries,& in the formulations formulation of some pharmaceutical preparation. Part used – fruit Dosage – fresh juice 10-20 ml Formulation – Jambiradi Panaka, Nimbuka tail 24
  • 31. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA RASONA85 & 86Botanical Name – Allium sativa linaFamily – LiliaceaeSanskrit name –Rasona, Lasuna, Yavanesta UgragandhaVernacular names- English –Garlic Hindi –Lasuna Marathi –lasuna Punjabi- Thum Thum Malayalam - LahasanDescription Glabrous bulbous herb with pungent odour.Leaves radical some times sheathing the scape. Scapes erect bearing a terminal umbelof small flowers surrounded by an iguolucre of 2 or 3 thin membranous bracts. sometimes united to from a spathe perianth bell shaped or rotate 6 parted stamens, 6 at thebase of the segments, ovary 3 shelled 3 angled, style straight stigma, minute terminalovule, few capsule 3 valved seeds 1-2 inches, 5 black bulbils bulb covered with white orlight pinkish papery layer or covering consisting 5-12 bulbils or cloves.Distribution – Plant is cultivated widely throughout the country.Photochemistry - Bulb contains an acrid yellow volatile oil which is the activeprincipal consisting organic sulphur compounds (allyl, propyl disulphide and other). Italso contains starch mucilaginous matter (29% carbohydrate) albumin (56% protein,0.1% fat) and calcium, vitamin C and iron, copper.Pharmaco dynamics Rasa – Pancharasa Katu (Dominating taste) Amla rahita,Root – Katu, Leaves – Tikta, Stalk –kashaya, stalktop (valagra)-lavana Seeds –madhura Guna – Snigdha, Tikshna, Picchila, Guru, Sara. Veerya – Ushna Vipaka – KatuDoshakarma –Vata Kaphashamaka 25
  • 32. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAProperties – Vedana, Sthapaka, Vataghna, Shothahara, Depan, Pachana, Anulomuna,Yakrduuejaka, Hridayottejaka, Mutrajanana, Rasayana Kothaprashamana, SvedajananaJvaraghna,Rogaghnata – Vatavyadhi, Sandhivata, Gradhrasi, Ardita, Manystambha, Shotha,Vedanayuktavikar, Agnimandhya, Aruchi, Ajirna, Vibhandha, Asthibhagna JvaraJeernajvara etc.Therapeutic uses – Vedana sthapana (Analgesic), Uttejaka (stimulates), vatahara, It is allayingprovoked vata and kapha dosha. It is appreciated as rasayana and medhya, speciallyincreasing or promoting functional power of indriya.Much used for cardiac disorders, chronic fever, gout, ossification of fractured bones.Anathematic: Aphrodisiac cardiac stimulant and atherosclerosis, High blood pressure. Itis used in anorexia cough, Consumption. Rasona is internally administered as a singledrug and a major ingredient of several formulations and recipes recommended in anumber of disease. The drug is effective in several disease of nervous. Circulatory,Respiratory, Urinary reproductive, Digestive system and whole body. Rosona is a majorrasayana drug used in geriatricsParts used- Bulbis, Tuber. OilDose paste -3-5gm oil 1-2 dropsFormulations - Lasonacdi vati, Rosona panda, Lasunastaka votiyoga,Rasona staka yoga, Rasona vati Rasonadi kashaya, Rasona pinda Lasunadya ghrta,Lasuna tail Rasona vataka, Lasona KsheerapakaCurrent research1. Allin – A change in the mucoprotien levels & ESR was observed by (SreenivasaMurthy at 1962)2. Allisatin (200mg / 100gm / day) showed inhibitory activity against formalin inducedarthritis. (Prasad at 1966)3. Anti-inflammatory activity (Bhakumi at 1969)4. Diallyn trisulphide showed antimicrobial activity (Chem. Abst 1981)5. Ajoehe showed strong inhibition of plateht aggeration ()6. Allicin inhibited human platelet aggregation in vitro without affectingcyclooxyginase. 26
  • 33. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 87, 88 & 89 PALANDUBotanical name: Allium cepaFamily: LiliaceaeSanskrita name: Palandu Durgandha.Ulli, Tikshnakandha: Yuvanesta, Mukhadusaka,Visvagandha: Sukanda, Durdruma, Rochana Sudrapriya,Vernacular Name:- Hindi : Pyaja, Piaj, English : Bulb Onion Kannada: Ullagaddi, Telugu : Niruli Marthi : Kandha Konrha, Tamil : SInrulli Arabic: Vasi, Panjabi : PiyajDescription:A glabrous bulbous herb possessing a strong pungent aromatic odour.Leaves: Subdistichous fistular shorther than the inflated scape head bearing. Flower:Pedicels shorter than the stellate flowers. Sepal’s linear oblong filaments exerted simpleof the linear two tooth at the base, bulb free solitory. Sometimes bulbils along withflowering on spadix.Fruit: Tri cellular with small block seeds.Distribution: It is cultivated throughout India. Farming on wide scale commonly forproducing onion having dictory utility.Verities: Palandu has two kinds of bulbs viz. Red and WhiteBulb of bigger size and white in colour is known as sveta palandu.Rajapalandu and ksira palandu (Nighantu)phyoto chemistry: Bulb contains protein 1.2% carbohydrate 11.6% Calcium, Iron,Vitamin A, B&C. Bulb and green fresh herb yield a pungent volatile oil with unpleasantsmell fixed oil contains Allyl propyldisulphate.Pharmaco dynamics: Rasa: Madhura, Katu Guna: Guru, Snigdha, Tikshna Virya: Isat ushna (Isadusna) Vipaka: MadhuraDoshakarma: Vata kaphahara pittavardhaka 27
  • 34. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAProperties: - Vedanasthopana shothara Dipana pacana Rochana. Anulomana.Rogaghnata: Vatavyadhi Nadisula vranasotha Ekangika sotha. Agnimandhya Aruchivibhandha, Hridourbalya sotha, Mutrajanana sukrodourbaly klaibya, DourbalyaOjaksaya.Therapeutic uses: The blub are used in various vatavikara such as neuralgia, sciatic joints,swelling, convulsions, hysteria other ailments caused by provocation of vata dosa. In various gastro intestinal disease. It is given frequently. It is take in piles,prolaps of rectum jaundice and constipation. Palandu is specifically indicated invisucika (Siddhbhaisajya manimala 4-273)Palandu is aphrodisiac, diuretic, expectorant, and stimulant. It is used in anorexia, andAnasarca. It is a cardiac depressant.Palandu is an effective vatahara, drug as indicated by vrddha vagabhata.Palandu is useful in impotency, Jaundice nervine neurological diseases.The drug is vedanasthapana and vatahara.Parts used: - Bulb, Seeds, and Leaves.Dose: Bulb juice 10-30ml. Seed powder 1-3gm.Current research1. Essential of oil of onion-decrease in coagulation time and fibrinolitic activity(Bordia-1974)2. Antitumer effect (Chem abstr 1961) 28
  • 35. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 90, 91 TAMBULABotanical Name: Piper betel LinnFamily : PipcraceaeClassical Name : TambulaSanskrit Name : Tambula, Saptasira, Tambulavalli Nagini, Tambulavallari.Vernacular Names: Hindi : Pan, English : Betel Marati: Nagbel, Gujarathi: Nagarbel Tamil : Vittilai, Kannada: VilydeleDescription: A perennial dioeciously creeper. (Probably native of Malaysia andcultivated in India since ancient times) its leaves for tambula charvan bhakshanbelonging to I heritage) stems semi woody climbing by short adventitious roots.Leaves: 5-20 cm long broadly ovate. Slightly cordate and often unequal at the base.Shortly acuminate acute entire with an undulate margin glabrous yellowish or brightgreen shining on both sides. Petiole stout 2.0-2.5cm long. Flower: Male spikes dencecylindrical. Female spikes 2.5-5.0 cms long pendulous.Fruits: Rarely produced oftensunk in the fleshy spike forming nodule like structure.Distribution: Plant is grown in warm and moist regions especially Southern India.Bengal, Bihar, Orissa and Srilanka.Varieties: There are many betal types which are grown in various regions throughoutthe country under highly specialized cultivation practice. There are more than 35cultivated types of betel in different zones of India. In classical texts of India medicine Tambula or nagavalli is well describedcovering different aspect of tambula patra and its utilisation as medicine as well asmasticatory aromatic. Several classical names of varieties are mentioned. Eg. Srivatiamlavati. Satsa Saptasira Amlasara Patulika Hresaniya Parna Sira, Sirnatumbala. Krsnasulohra parna (Raja Nighantu Amradivarga 249-255)Phyoto chemistry: Analysis of sample of fresh leaves. Moisture: 8.54mg, Protein: 3.1mg Carbohydrate 6.1mg Fat: 0.8mg 29
  • 36. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Fibre: 2.3mg , Mineral matter 2.3mg, calcium230mg phosphorous 40mg, Iron 7mg, Potassium Nitrate 0.26-0.42%,A light aromatic and volatile oil known as betel oil and chavicol a very volatile paleessential oilLeaves yield an aromatic pungent and sharp taste essential oil about 0.7-2.6% whichcontains phenol and teprene and sesquiterpene.Pharmacodynamics: Rasa - Katu tikta Guna - Laghuruksh tikshna Veerya - Ushna Vipaka - KatuDosakarma - KaphavataShomaka, pitta vardkakaPropertiesHridayottejaka, Balya, Mukha Vishuddhkaraka, Durgandhahora, Dipana, Pachana,Anulomana, Kamoddipana, Vajakarana, Kaphaghna, Jvaraghna Katupoustika,VedhanasthapanaRogaghnata: Mukharoga. Asyavairasya, Mukhadourgandhya, Aruci,Agnimandya.Vibandha, Krimi, Pratishya, Swarabedh, kasa, swasa, parshva shoola,Hriddorbalya,Hridayarasada,Granthi, Shotha,Vrunshotha,Stamshotha, Dhvaja bhang,Klaibya, Dourbalya.Therapeutic uses: The drug Tambula is aromatic anthelmintic & aphrodisiac. It is used in AnorexicDyspepsia foul smell of mouth & intestinal worms.acording to Vrindamadhava 12-31medha prakarsana leaf with 10gm maricha/day up to 2 months. Bhavaprakashamadhyam 45-120 in slipada. Tambula is suggested to be used regularly in the form ofleaves paste mixed with salt along with water. Sharangadhar & Gadanigraha forexternal application particularly prescribed for use in skin disease and conjunctivitis.Tambula patra posses an antioxidant action. The essential oil and extracts of the leavespossess an antimicrobeal activity against several gram positive and negative bacteria. 30
  • 37. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAAntiseptic activity is probably due to the presence of chavicol. The essential oil and leafextracts also showed antifungal activity.Parts Used - LeavesDosage - Juice 5-10mlFormulation - Tambulasava, tambula Savarasa Ardraka92, 93Botanical Name: Zingiber officinale RoseFamily: ZingiberaceaeGana Charaka-Triptighna, Dipaniya, Shulaprashamana, Trishnanigrahana, Sushruta,-Pippalyadi, Trikatu, Vagbhata- Pippalyadi,Classical Name: ArdrakaSanskrit Name: Ardraka Vishvabhesaga Sringvera Mohoushrada.Vernacular names: Hindi : Sonth Sounth, English: Ginger Telgu : Ardrakama, Allaem, Tamil : Chukku, Inzi Marathi: Ale, Gujarati: Sunth, Urdu : Adraka, Arab : Zingabil Persi : Janjabl Kannada: Shunthi.Description:A perennial erect herb with a creeping fibrous rhizome.Root stock horizontal tuberousaromatic stout rhizome with erect leafy stems 0.6-1.4meter high, stem elongated, leafy 15-150cm tall. Leaves narrow, linear sessile sub-sessile on the sheath with an alternative baseacuminate glabrous 10-15cm long lower part surrounding the stem 5-10inches long smoothligulae glabrous, sheaths glabrous.Flowers: - Spike terminating the leafy system up to3inchs long bracts 2.5 x 2 cm greenish. Stalks slender, enveloped by membranous 1mtrlong bracts, corolla greenish yellow. Corolla lobes yellowish lip dark purple often spottedyellow 3 lobed flowers greenish & a small dark purple or purplish black lip in radical spike3.8 - 7.5cm long and 2.5cm on peduncle 15-30cm long lip often 3 lobed orbicular dullpurple with creamy blotches anthers appendage dark purple. Stamens dark purple as longas the lip rather shorter than the corolla. 31
  • 38. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATARhizomeThe outer most layer of the rhizome is single cell epidermis. Next is cork with irregularlyarranged tangentially elongated cells and an inner zone of rectangular tangentiallyelongated cells cork cambium is not distinct. Below the cork is the cortex cortical cellsthick walled polygonal parenchyma cells packed with starch grains. Large oil globules areyellowish orange colour oil. Cells are scattered in cortical region. Vascular bundle iscomposed of an outer phloem and inner Xylem. Phloem consists of thin walled polygonalcells with sellve tubes. The cortex is singly layered endodermis with thin walledrectangular cells pericycle consists of thin tangentially elongated cells. The inner steleconsists of parenchyma cells with starch grains and oil globules. There are various varieties categories & qualities of ginger as of market drug.Fresh rhizome in green state is Ardraka. The fresh ginger and dry rhizome is known asSunthi or Sounth the dry ginger.Distribution: Found throughout tropical Asia and India, warm and moist zones. Widelycultivated in India with many rhizome producing regions.Phyto chemistry: Rhizomes contain yellowish colored volatile oil 1-5% and yellow bitter substance,Gingerol and oily resinous substance as main active principle. Ginger in and other resins,starch (40-60%), fat (10%), protein (10%) in organic material (6%) and other contents,Gengerol is not volatile with oil.Phormadymamics: Rasa - Katu Guna - Shunti,-Laghu, Snigdha, Ardraka- Guru Tikshna Veerya- Ushna Vipaka -MadhuraDoshakarma - KaphavatashamakaAction (Karma)Ruchan, Dipana, Pachana, Triptighana, Vatanulomana, Shulaprasamana,. Pittashamaka,Raktashodhaka, Hridayottejaka,. Shothahara, Kaphaghna, Svasahara, Kasaghna, Vrisya,Uttejaka. Balya, Vedhanasthapaka, Nadyuttejaka. 32
  • 39. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATARogaghnata:-Abhyuntara – Vatavyadhi, Aruchi, Hrillasa, Chardi, Mukhavairasya, Agnimandhya,Ajirna, Adhmana, Andya, Visharoga , Shula, Kostastabdhata, Hriddourbalya, Anaha,Udara, Hricchula, Shoth, Amavata, Dourbalya, Prasavattara dourbalya.UsesThe fresh ginger is cut into pieces and mixed with little common salt is recommended to betaken just before meal or the ginger fresh pieces are chewed before consuming food or anyother time This kind of use is very appetizer. Stomachic and helps to relish the food and also its digestion and silugogue,Stimulant check the bad taste and smell affection of mouth, tongue and throat. The Rhizomes are useful in heart disease. It is given in heart palpitation cardiacpain and as cardiac tonic and also in edema The juice is used in dropsy ascites and. liver enlargements and it also acts as gooddiuretic. It is used in abdominal disease dyspepsiaJaundice and VomitingThe part of ginger rhizomes is a local stimulant and rubefacient in case of headache,toothache.The root skin is considered useful in corneal opacity. Rhizomes are considered useful ineye diseases.The rhizomes powder and infusion are used by mothers after delivering in debility and puraliments.Part used: Rhizomes fresh and dry gingerDoses: Juice 2-5ml, powder 10-20grains, Infusion 8-10ml.Formulation Adrakakhanda. Soubhagya Shunti, Rasnadikwatha, Saindhuvaditaila, Sunthighritama Nayarachurna. 33
  • 40. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Disease Review Historical review Sandhigatavata is one among those diseases that was told in Veda purana and major ayurvedic classics. In Veda Rigveda – one of the mantra describes that “I am removing your disease from each organ hair and joints. Yajurveda- also one of mantra chikitsa destroy the pakshaghata, sandhigata vata, Katishula, Shirubhighata,Vataja shula, Murcha, Atharvaveda- vata vikara are mentioned “Destroy the Balasa created on the organ and joints which is responsible for loosing bones and joints”. In Purana: Agnipurana -total no of joints in human body and treatment for Sandigatavata is mentioned. In Samhita:1. Charaka mentioned about Sandigatavata as sandhigata anila in chikitsa sthana942. Sushruta under Vatavyadhi Nidana. He has mentioned about Sandigatavata95.3. Astang Sangarah & Hridaya same view of Charaka & Susruta96.4. Bhela under Asthimjjaghata vatavyadhi a description sandhivichyuti is available97.5. Hareeta also mentioned the treatment aspect of Sandigatavata. Madhyam Kala & Adhunika kala some of the Acharyas mentioned about this disease.Madhava supposed to be the best in Nidana aspect has clearly explained this disease98.Bhavaprakash: Under Vatavyadhi chapter Sandigatavata lakshan are explained with its treatment 99. In other Ayurvedic granthas like Yogaratnakar, Gadanigraha, Vangasena, etc11. Both the treatment aspect and clinical entity has been found100 Now days, in ayurvedic field lot of research studies were conducted on this disease in various research centers and post graduates research centers. 101, 102 Modern aspects of disease history Sandhigatavata can be correlated with osteoarthritis in modern science. This is due to the nature of disease & similarity of cardinal symptoms. Osteoarthritis is the most common joint disease in human beings and other vertebrates.In early ages Hippocrates 34
  • 41. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAthe Father of modern medicine observed the prevalence of osteoarthritis in agedindividuals (Benard 1944) due to the detailed study of this disease by Heberden (1803),the osteoarthritis nodes on the fingers was named after him Osteoarthritis wasdifferentiated from rheumatoid arthritis and named as degenerative arthritis by Nicholasand Richardson (1909) on morbid anatomical grounds. The appearance of Herberdons nodes in relation age sex & hereditary factors wasmentioned by Strecher 1940. Intermitted claudication in the osteoarthritis of lower limbincluding hip knee and ankle was observed by Byod (1949) The term osteoarthritis was used due to the absence of synovial thickening orinflammatory infiltration in uncomplicated condition by Kellgrem (1961). The termOsteoarthritis, Hypertrophic arthritis are mentioned under degenerative arthritis bySamuel .L. Turek (1989) Etymology of SandigatavataSandhigatavata is one among the vatavadhis explained by acharyas. Its word meaning isthe disease which originates when vata resides in sandhi. The term Sandigatavata iscombination of 3words ie Sandhi + Gata + Vata. 103Sundhi: - this is formed by Sam+ Dha + KihiNirukti – “Sandhinaam Samyoga” “Asthidwya Samyogasthana”According to Sushruta there are various type of sandhi in the body like those of Peshi,Snayu, and Sira. Sandhi etc. but in this context we have to consider asthisandhi as the 104meaning of sandhiSandhi can be correlated as junction, joint, connection, combination, union, withcontaining, conjunction, transition; from one to another is the term for junction.Gata: The word formed by the combination of GUM+KTHA. The meaning of thisword indicates the movements. 105Vata: The term is derived from the root “Va-Gati Gandhanayo” ie to move 106Bhela – States that so long as vata lasts as long does life exists vagbata - vata has itscontrol over the functions of the body swift actions, strength, capacity to vitiate otherfactors independent movement and large number of disease produced due to its 107vitiation . 35
  • 42. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 108The chalatva (mobilises) has been qualified to be very swift Chakrapani explains vata 109is Amurta (Adrashya) and Anavasthita (Unstable) 110 Normal functions enthusiasm, inhalation, exhalation, movement of body parts etcAccording to Vagbhata vata is located on the asthi with relation to Ashrayashrayisambandha. Generally the doshas & dathus are inter related when doshas are increasedparticular dathu related with it also increases and viceversa. But in case of vata and 111asthi, when vata increases asthi decreases Osteoarthritis: It is the combination of 3 words Osteon, Arthron and Itis, meansbone joints inflammation. The meaning of the word is inflammation of bony joint and itis the most common form of arthritis. The cartilage lining the end of the bones formingthe joint or the shock absorber gradually erode over a period of time. The bone endsthickens and over grow. This process occurs primarily in weight bearing joints and isassociated with inflammation.Definition: In almost all Ayurvedic treatises Sandhigatavata is mentioned in Vatavyadhi adhyaya. Charaka has mentioned that when vitiated vayu reaches in one or more sandhi it iscalled as Sandhigatavata. In this disease the joints gets vitiated by vayu & palpation is 112felt like a bag filled with air. There will be pain during extension and flexon. 113Sushruta: When vata dosha is vitiates in the joints it produces shoola & shotha. otherssupport same Madhavacharya adds one extra symptoms “Atopam” than other . 114symptoms. This can be considered as the classical symptoms of SandhigatavataOsteoarthritis: is defined as a degenerative non inflammatory joint diseasecharacterised by destruction of articular cartilage and formation of new bone at the jointsurface and margins.115steoarthritis also anonymously called degenerative joint diseaserepresents failure of diarthrodial joint. In primary Osteoarthritis at the most commonform of the disease no predisposing factor is apparent. Secondary Osteoarthritispathologically indistinguishable from idiopathic but is attributed to an underlying 116cause 36
  • 43. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAEpidemiology:Sandhigatavata (Osteoarthritis) is the most common joint disease of human among theelders. Knee Osteoarthritis is the leading cause of chronic disability. Under the age of55yrs the joint destruction at Osteoarthritis in men & women is similar. In olderindividuals hip Osteoarthritis is more common in men while Osteoarthritis ofinterphalangeal joints & the thumb base are more common in women. The racial difference exists in both the prevalance of osteoarthritis & the pattern ofjoints involvement. The Chinese in HonKong have a lower incidence of hip than thewhites & osteoarthritis is more frequent in Native Americans than in whites.Interphalangeal joint osteoarthritis especially hip osteoarthritis is much less common in 117South Africans blacks than white in the same populationAnatomy and PhysiologyAs mentioned earlier this study was given more importance concentration to knee jointosteoarthritis for that detailed information about this particular joint is very muchessential. Acharys Sushruta was the first person to dissect the human body and became theauthority of early anatomy. All these aspects can be well discovered from his works. Hein his classic has described each and every point of the human body anatomy in detail. In Sushruta Sharirasthana he has classified the joints into eight divisions named as theobjects which they respectively resemble in shape. The knee joint was described underKora types of Sundhi hinged or lap shaped118 Acharaya vagbhata in Astanga hriudaya while describing about the divisions of kuphahas mentioned about the properties and functions of sleshaka kapha. The kapha whichresides in sandhis which gives firmness to it is called as sleshaka kapha119 Acharya sushruta has described about the sleshaka kapha. He states that the kaphasituated in the joints keeps them firmly united protects their articulation. It opposes theirseparation and disunion and also nourishes the sandhi120 37
  • 44. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAKnee Joint 121Anatomy and PhysiologyThe knee joint is a synovial joint of the condylar variety. It is a compound joint havingtwo distinct articular surfaces on the medial and lateral condyles of femur forarticulation with corresponding surface on medial & lateral condyles of the tibia. Theanterior aspect of the lower end of the femur articulates with the posterior surface of thepatella. Knee joint is complex because its cavity is partially divided into upper andlower parts by plates, cartilages called the medial and lateral menisci. The proximal articular surface covers the anterior, inferior and posterior aspects ofmedial and lateral condyles of femur. Anteriorly the medial and lateral articulatessurfaces are continuous with each other but posteriorly they are separated byintercondylar notch. The part of the femural articular surface situated on the anterioraspects of its lower end, articulate with the patella. It is concave from side to side and issubdivided by a verticular groove in too larger part and a smaller medial part. A smallpart of the inferior surface of the medial condyle adjacent to the interior part of the intercondular notch comes in contact with the patella in extreme flexion of the joint. The distal articular surface of the knee joint is present on the upper surface of themedial and lateral condyle of tibia. These surfaces are slightly concave centrally and flatat the periphary where they are covered by corresponding menisci. The posterior surface of the patella bears a large articular area for the femur. It isconvex and is subdivided by a ridge into a large lateral part and small medial part. Theattachment of capsule of the facet that anteriolrly the capsule bends in distinguishablywith the lower tendinous part of the quadriceps femoris muscle. Anertiorly below the patella, the capsule is replaced by the ligamentum patella. Thisligament is attached above to the non articular lower part of the posterior surface of thepatella and below to the upper smooth part of the tibial tuberosity. Posterior aspect ofthe capsule is strengthened by the oblique popletial ligament. The anterior cruciateligament is attached below the anterior part of the intercondular area of the tibia. Theposterior cruciate ligament is attached below to the posterior part of the intercondulararea of the tibia. Medial and lateral menisci of the knee joint are intra- acrticular discmade of fibro cartilage. They have a thick peripheral border and a thin inner border. 38
  • 45. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA The synovial membrane of the knee joint covers all the structure within the jointexcept the articular surface and surface of the menisci. It lies in the inner side of thetendenous expansion of quadriceps femoris and some part of the tibia and femurenclosed within the capsule just above the patella. The synovial membrane forms apouch called the supra patellar bursa. The arteries supplying the joint are the descending genicular. The genicular branch ofpoplitial. The recent branches of anterior tibial and the descending branches of thelateral circumflex, femoral branch of the arteria profunda femors.The nerves are derived from the abturator femoral tibial and common peroneal nerve.Muscle producing the movement of the knee joint.Flexion: - Biceps femoris. Semitendenous and semi membranous assisted by gracilis.Sartorius and popliteus.When the foot is on the ground gastro-nimus and planteris are capable of participatingin the movement.Extension: - Quadriceps femoris with some assistance from tensor fascia late.Medial rotation of the fledged leg- popliteus semi membranous and Semitendenosusassisted by sartorius and gracilis.Lateral rotation of the fledged leg: - Biceps femoris alone.Joints are surrounded by membrane called the synovial membrane (Synovium) whichforms a capsule around the ends of the bone involved. The membrane secretes a liquidcalled synovial fluid. It has many functions all of them are important. Among these itserves as a lubricant, a shock absorber and nutrient carrier.As a lubricant it is without equality when the joint is healthy. It makes the joint slickerthan wet ice. When our body cannot produce enough glucose amine and chondrotin.However the normally thick synovial fluid becomes thin and watery. In this state itcannot do the job it was intended to do as a lubricant as shock absorber. Our cartilageimmersed in the synovial fluid protects our bones from the tremendous compact. Theywould receive when we walk, run, jump etc. This fluid also has a remarkable propertyas a shock absorber or hydraulic fluid. It belongs to a rather unusual group of liquids known as dilatent liquids. These liquidsare characterised by the rare quality of becoming thicker that is more viscous. Whenshear is applied to them. Thus the synovial fluid on our knee and hip assume a very 39
  • 46. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAviscous nature at the movement of shear in order to protect the joints and then it turnsout again to its normal viscosity instantaneously. To resume its lubricating functionbetween shock. All this happens again and again very rapidly during the course ofvigorous exercise. Such as during an engagement in sports, dancing, walking etc.When our body cannot produce enough glucose amine and chondroitin. This wholemechanism breaks down. The viscosity is dramatically reduced giving thin waterysynovial fluid which then fails as the shock absorber and lubricant. It normally excels.As this results in the pain stiffness and decreased mobility that characterizedosteoarthritis. Now we will discuss the role of synovial fluid as a nutrient carrier when we takeknee cases. We get the building blocks needed to rebuild cartilage. Now we have to getthose building blocks to the cartilage. So the rebuilding can take place. Cartilage itself isavascular i.e it does not have blood vessels. Hence the synovial fluid is the liquid that must carry the raw material from the bloodto the cartilage. This can happen by a number of mechanisms. First it can be diffusionwhich is a slow process. In this situation, a second and efficient process is convectionwhich is achieved through exercise. One way to visualise what happens in convection isto thicken our cartilage as a sponge immersed in synovial fluid. When we exercise ourknee for eg. It is like repeatedly squeezing that sponge out in a basket of synovial fluid.Another method viewing convection would be as a pumping action produced byexercise in which nutrients containing synovial fluid are constantly washing over thecartilage. In this way our cartilage is constantly getting supplied by nutrients dissolvedin synovial fluid when we exercise our joint. 40
  • 47. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Nidan Panchaka of Sandhigatavata.Nidan:-Sandhigatavata is disease caused by vata and is included under the vata vyadhies by allacharayas. There is a no much difference in the case of nidanas among vatavyadhies.The difference is occurs mainly in the case of samprapti that is in all the vata vyadhiesvata prakopaka karanas are almost same and the different forms of appearance likesandhigatavata gridhrasi. Pakashaghat etc. are only due to the samprapti vishesh ofvitiated vata. 122Aharaja nidan-- Tikta. Katu. Kashaya rasa pradana dravya and Ruksha. Sheeta. 123Laghu guna pradana dravya increases vata. They are Chanaka, Harenu, Uddalaka,Jambu, Tinduka, Mususra, Vatarka, Mudga, and Adhaki. Ahara sevana vidhi isimportant. Abojana Heenabhojana, Sushkabhojana, Trushitabhojana, Kshatitambupana,Adhyasana, Vishamasana, Pramitaasana, etc vitiates vata.Viharajanidana: Ayurvedic classics have given importance to proper vihar likeVyayam, Swapna, Vyavaya, etc. The vihara which vitiates vata are Ativvayama,Ratrijagarna, Ativyavaya, Plavana, Atyuchobhashana, Upavasa, AdharaniyaVegadharana, Vishamopchara and Marmaabhighata, Atiraktsravana, Abhigata.Manasika Karana: Direction of sense organs is one of the functions of vata. Therefore 124vata is said to be the controller and conductor of mind . Therefore mental factors likechinta, shoka, krodha, bhaya etc are the causes for upset of mind and relatively asconsequence of it vataprakopa in the indriya ayatana as well as in the body which 125simultaneously can produce the psychic as well as the somatic disorders .Vayakarana: As per the ayurvedic theories. In the later stages of human life vata will be 126predominant . During this period there will be natural tendency to vitiate vata.Alpavatakara, aharavihara, causes vata prakopa. This causes kaphakshaya in the body.Due to this process the shleshaka kapha situated in the sandhi shows kshaya causingvata prakopa in the particular part. 41
  • 48. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAOther nidanas: 127a) Desha: The desha where vata dosha is predominant is called jangaladesha .Those who live in these deshas will be having the predominance of respective doshas.This is the cause for predominance of vata roga for those who stay in jangaladeshawhen compared to other disease.b) Kala: Kala is an important factor in the production of disease. According to rutusvatachaya in grishmarutu, kopa in vrsharutu and shamana in sharadrutu so more vata 128vikaras can be seen in varsharutu .According to Ayuavasata vriddhavastha is vatapradana.c) Prakruti: Among the seven prakrutis mentioned vataprakurti is considered as 129heenaprakruti . One who is born with vataprakruti will be most susceptible for getting 130vatikaroga. And it will be very difficult for its cure .d) Satwa: Satwa is considered as the capacity of mind to withstand things going 131wrong. A person who is having a good satwabala will be easy for treating. Thereforevatavyadhi will be more in Heenasatwa. According to Charaka pepole who are more 132susceptible to manodoshas like bhaya, shoka, krodha etc will be prone to disease .e) Satmya:-The qualities which are equal to dosha, dhatu, mala, increases and which 133are opposite decreases. This is a general principle of nature . Ruksha, Laghu, Sheeta 134etc are the qualities of vata. Tikta, katu, kashaya are the rasa causes vitiation of vata .One who is satmya with all these definitely vata will vitiation and further causes’ vatavyadhi.According to modern 135Risk factors of OsteoarthritisAge- Age is the most powerful risk factor for Osteoarthritis. Radiological survey ofwomen less than 45yrs old only 2% and 45 to 64yrs the prevalence was 30% and thoseolder than 65yrs it was 68%. In males the figures were similar but some what lower inthe old age group.Sex: It is told that women are at high risk than male. In developing osteoarthritisparticularly after menopause. Most of the epidemiological studies suggest that hormone 42
  • 49. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAreplacement therapy confirms a protective on the development of knee and hipOsteoarthritis. The effect of sex hormone on cartilage may vary with menopausal statusand stage of osteoarthritis.Hereditary Factors: The relation of heredity is less ambiguous. Thus the mother andsister of women with distal interphalangeal joint osteoarthritis are respectively twiceand thrice as likely to exihibit osteoarthritis in these joints as the mother and sisters ofunaffected women. Point mutation in the cDNA coding for articular cartilage collagenhave been identified in families with chondrodysplasia and polyarticular secondaryosteoarthritis.Race: Racial difference exists in both the prevalence of osteoarthritis and the pattern ofjoint involvement. The Chinese in Hong Kong have a lower incidence of hiposteoarthritis than hhe whites. Osteoarthritis is more frequent in Native Americans thanin whites Interphalangeal joint osteoarthritis & especially hip osteoarthritis are muchless common in South Africans blacks than white in the same population whether thesedifferences are genetic or are due to difference in joint usage related to lifestyle.yet tobe understoodOccupational Factor: Repetitive movements may lead excessive strain leading toerosion and joint damage. Vocational activities such as those performed by jackhammeroperators, cotton mill and shipyard workers and coalminers may lead to osteoarthritis inthe joints exposed to repetitive occupational use. Men whose jobs require knee bendingand atleast medium physical demand had a higher rate of radiological evidence of kneeosteoarthritis and more severe radiological changes than men.Obesity: Obese persons have a high risk of osteoarthritis. For those in the highestquintile for body mass index at baseline. The relative risk for developing kneeosteoarthritis in above 30yrs was 1.5 for men and 2.1 for women. For severe kneeosteoarthritis the realitive risk factor is 1.9 for men and 3.9 for women suggesting thatobesity play an even larger rule in the etology of the most serious cases of kneeosteoarthritis. 136Traumatic factor : Trauma to the joint seems to enhance the occurrence of arthritis. Itdisturbs the ligaments of the joints and over a period of time. The mal ligament maylead to excessive wear and tear leading to arthritis. In both human and animals modelanterior cruciate ligament insufficiency and meniscus damage lead to knee 43
  • 50. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAosteoarthritis. Although damage to the articular cartilage may occur at the time of injurywith the use of affected joint. Even normal cartilage will degenerate. If the joint isunstable a person with a trimaleolar fracture will almost certainly develop ankleosteoarthritis.Abnormal enzyme factors: Though not conclusively proved, it is suspected that someabnormal enzyme released by the cartilage cells may lead to cartilage breakdown andjoint destruction.From all the above nidana factors obesity is aharaja and viharaja factors soundspredominant. So nidana parivarjana should be done before starting the treatment. Evennidana parivarjana helps in relieving the disease in the early stages. 137PathologyThe changes in ostheoarthiritics are usually seen in load bearing of the articularcartilage in the early stages the cartilage is thicken than normal but with progression ofotheoarthitics the joint surface thins. the cartilage softens. The integrity of the surface isbeached and vertical cleft develop deep cartilage ulcers. Extending to bone appears.areas of fibrocartelageneous repair develop but the repair tissue is inferior to pristinehyaline articular cartilage in its ability to withstand mechanical stress. all of thecartilage is metabolically active and the chondrocytes replicate forming cluster later thecartilage become hypocellular.Remodeling and hypertrophy of bone are also major features of OA, appositional bonegrowth occurs in the subchondral region. Leading to the bony sclerosis, seenradiographically. The abraded bone under a cartilage ulcer may take on the appearanceof very. Growth of cartilage and bone at the joint margins leads to osteophytes whichafter the contour of the joint and may restrict movement cular muscle wasting iscommon and may play a major role in symptoms and in disability 138Pathogenesis Current consepts of the pathogenesis of osteoarthritis, based on the assumption thatwhatever the provoking cause. The pathway of changes in articular cartilage will beidentical. Two mechanical hypothesis merit consideration. The first suggest that theinifiating event is fatigue fracture of the collagen fibre net work which is followed byincreased hyderation of the articular cartilage with unraveling of the profeoglycans and 44
  • 51. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAloss of profeoglycans in to the synovial fluid. There is some tentative supportiveeuidence of augmented natural protease and collagenolytic activity but collagen mayalso be lost simply as a result of mechanical attriation.The alternative hypothesis suggests that the intial leasions are microfractures of thesubchondral bone following repatative loading. healing of micro fracture leads tosignification loss of resilience of subchondral bone which in turn creats a shear stressgardiant in the adjacent articular cartilage. As the process evolves. The cartilage surfacebecomes fibrillated and deep clefts appear with reduplication and proliative changescommence at the joint margins with formations of osteophytes. Eventually articularcartilage is last altogether in areas of maximum mechanical stress and the underlyingbone becomes hardend and eburnate, cysts may form but bony allcylosis does not occur.Table no. 8 shows that pathogenisis of osteoarthritis Rpeatative loadingIncreased hydration of the articularcartilage unraveling of protepglycons Micro fracture of the subchondral bone Significant loss of resilience ofFracture of the collagen fiber network subchondral bone Which in turn creats a shear stressAnd loss of proteoglycons in to synovil gralient in adjacent articular cartilagefluid. The cartilage surface become fibrillatedIncreased natural protease and and deep cletts appearCollagenolyticactivity Reduplication and proliferation of condrocytes within thingsCollagen last simply as a result of Formation of osteophytes due tomechanical attriation. proliferative changes at the joint margins. 45
  • 52. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 139Clinical feutures -The joint most frequently involved are those of the spine, hips,and knee.the disease is confermed to one or onely few joints in the majority of patients.The symptoms are gradual in onset. Pain is at first intrimittent, aching and provoked bythe use of the joint and relieved by rest. As the disease progress. Movement in the jointbecomes increasingly limited, initially as a result of pain and musculars spasm, but laterbecause of capsular fibrosis osteophyte formation and remodeling of bone. They may berepeated effusions in to joints especially after minor twists or injuries crepitus may befelt or even heard. Associated muscle wasting is an important factor in the progress ofthe disease as in the absence of normal musculars control the joint, pain becomes moreprone to injury, pain areas from trabecular microfactures tramatic leasions in thecapsule and particular tissue and a low grade synovitis. Nocturnal aching may beattribuatable to hyperaemia of subchondral bone.Pooravaroopa of Sandhigatavata.Pooravaroopa is the prodromal symptoms of a forthcoming disease which do not clarifythe peculiarity of the dosha taking part in the samprapti of the disease. These symptomsare few and not clear. According to Madhavanidana poorvaroopa are the symptoms which are producedduring the process sthanasamsraya by vitiated doshas. When samprapthi has not beencompleted the disease is not manifested. Sandhigatavata being one of the vata vyadi thepoorvaroopa of vata vyadhi can be considered as the pooraroopa of sandhigatavata.Here archaryas are specifying that the unmanifested symptoms of the particularvatavadhi should be considered as poorvaroopa. From recorded data of the paitents we can say that the poorvaroopa of sandhigatavatais manifested with guruthwa (heaviness) of joints occasional twinkling sensation andpain which is ignored by the patient and finally it turns to roopavastha. 46
  • 53. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATARoopaWhen symptoms in the stage of poorvaroopa become fully or clearly manifested whenthese are called as roopas. Samsthana, Vyanjana, Linga, Lakshana, Chinha and Akruthiare the synonyms of the roopa.The cardinal symptoms mentioned by acharayas for sandhigatavata 1. Sandhisoola (Joint Pain) 2. Sandhishotha (Joint inflammation) 3. Sandhisthabdhata (Stiffness) 4. Vatapurnadrutisparsh (Air filled bag to touch) 5. atop (Crepitation) 6. Gamane ativedana (Pain after excess movement) 7. Prasarna akunchanavedana (Restricted range of joint movement) 8. Sandhi vishleshan (Looseness of joints) 9. Nisha ruk (Nocturnal Pain)Sandishoola: In sandhigatavata joint pain is mentioned by all the acharayas.Sandhishotha: Almost all the acharayas have mentioned about the presence of shotha.Vatapurnadrutisparsha: Charaka, Vagbhata have mentioned the typical characteristic ofShoph. The Shoph resembles like an air filled bag to touch.Atopa: Especially Madhava has mentioned Table No. 9 shows the Laxana of Sandhigata Vata according to different achary. Sl No Samhita Laxana 1 Charaka Vatapoornadrutisparsha. Shopha Prasaranaakunchanapravrathivedhana. 2 Sushruta Sandhisoola, Sandhishopha 3 Ashtanga Vatapoornadrutisparsh. Shopha hridaya Prasarana akunchana pravratti vedhana. 4 Madhavanidan Sandhishoola Atopa 5 Bhavaprakash Sandhisoola, Sandishopha 47
  • 54. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATASymptoms of OsteoarthritisPain, Stiffness, Restricted range of joint movement, swelling of the joint, Tenderness,CrepitationPain: Joint pain in Osteoarthritis is often described as a deep ache and is localised to theinvolved joint. Typically the pain is aggravated by joint use and relived by rest. But asthe disease progresses it may become persistent. Nocturnal pain interfering with sleep isalso seen.Swelling: The physical examination of the joint may reveal soft tissue swelling andsynovial effusion palpation may reveal some warmth over the joints.Stiffness: Stiffness of the involved joint is seen in the morning or after period ofinactivity.Restricted range of movements: Due to pain and stiffness of the joint movements willbe restricted and difficult. If there is loose bodies in a joint there will be lacking orgiving away of joints.Tenderness: Localised tenderness will be present during the physical examinationCrepitation: Bony crepitus is a characteristic sign of osteoarthritis. The growth ofcartilage and bone at the joint margins leads to ostephytes, which when comes intocontact produces the crepitation.Upashaya Anupashaya.The ahara, vihara and aoushadhi, constitute upashaya when it produces the relief in thesymptoms and anupashaya when it aggravates the symptoms. It is a trial and errormethod. These are very mch important especially during the treatment. Usually drugshaving properties like Shnigdha, Ushna etc are prescribed in vata vadhi. Due to theirefficacy to pacify the qualities of vata such as Sheetatwa, Rukshatwa etc. This should beadopted only in the condition of niramavastha of vatavadhi which helps in subsidingvata.This is the upshaya method. When same drugs are prescribed in samavastha ofvatavadhi the disease aggrivates causing complication. This is anupashaya. 48
  • 55. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATASampraptiSeveral etiological factors contributing to disease & the vitiation of doshas attack thebody. Some of them can be avoided by taking proper precautionary measures, whilesome factors like kala, desh, are mostly inevitable. If the body’s resistance power(Vyadhikshamatwa) is high, the Dhatus, Srotasis, Agni are functioning well and thebody fights against the etiological factors successfully there by maintaining health. Butif the etiological factors are stronger than the resistance power of the body they vitiatethe doshas, indirectly the dushya also and the process of disease starts, manifestetion ofdisease is from Hetus to the Vyaktata of laxana is samprapti.Sandhigata vata. The samprapti of vata vyadhi should be considered. Charakamentioned that due to the vatakara aharavihara vata vitiates and travels through thebody channels. The vitiated vata finally enters and settle in srotamsi riktani resulting inthe production of different types of vatavyadhis pertaining to the region140.Acharaya Charaka and vagbhata state that dhatukshaya and margavarodha are the twocausative factors of vata vyadhi141. Acharya vagabhata states that due to intake ofexcess dhatukshayakara ahara and vihara the vata travels throughout that srotasis. It fillsthe srotasas and due to the avarana by other dosha in the srotas the vata becomesstronger and vitiation takes place142. Achary charaka states that vayu which is vitiatedby its nidana and due to its respective sites different varieties of vata vyadhis areproduced.While explaining the five divisions of vata by vagabhata. Vyanavata one of thedivisions of vata resides in the heart and travels all over the body. It helps in functioning 143like walking, body movements etc .In sandhigata vata the function of vyanavayu is affected. I.e. difficulty in moving thejoints. It is specifically told by charaka that in nanatmaja vata vyadhis anubandha ofkapha or pitta should be considered and also specifies that the knowledge of it depends 144on understanding of specific dosha laxanas .It is mentioned that kapha helps in binding the joints and maintaining its strength. In thespecific properties of pancha kapha shleshaka kapha resides in the sandhis. By thesestatements it is clear that in the sandhi kapha is also important for its functioning. It isvery important to discuss the changes happening during the dosha kshaya. The 49
  • 56. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAdecreased doshas become incapable of performing their normal functions of the body.This state is manifested in the form of decreased activity of that particular dosha.Acharya Charaka has mentioned that when the kshaya of particular dosha occurs,natural functioning of dosha is not seen. According to vagbhata, when kaphakshayaoccurs lakshana like Bhrama, Sleshmashayanam Shunyatwam, Hridrava andshlathasandhi take place. Here the slathasandhi is due to kaphakshaya in the sandhi i.e.shleshaka kaphakshaya. So as per acharays reference in sandhi gata vata. Vataprakopa(Vyanavayu) and kaphakshaya, (shleshaka kaphakshaya) is taking place.SAMPRAPTI (Etiopathogenisis) Pactice of Vatavardhaka Ahara Vihara Manas Karana, Sthoulya, vaya prikriti Nidana sevana Dhatukshaya Chayavastha Avarana Vitiation of vata at its own places (mainly pakvashaya) PrakopavasthaTransmission of vitiated vata through body channels PrasaravasthaAccumulation of vata in sandhi due to Khavaigunya Sthana samsraya Diminutions of Shleshaka kapha and destructive change in asthi (Doshadushya sammurchana) Yakta Manifestation of sign and symptoms of sandhi gata vata Sandhigata vata 50
  • 57. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATASamprapti ghatakas Dosha -Vata, Vyanavata vrudhi, Kapha shleshakakaphakshaya Dushya -Asthi, Majja, Snayu Srotas -Astivaha, Majjavaha, Medovaha, Mamsavaha Agni - Jataragni, Dhatwagni Ama-Jataragnimandyajanya, Medagnimandyajanya, Astiagnimandyajanya Udbhavasthana - Pakwashaya Vyaktasthana - Sandhi Sankhya samprapti: - Only one variety Vikalpa samprapti: - Increased vayu guna like Ruksha, Laghu. Pradhanya samprapti: - Vata pradhana can be seen other than two dosha Bala samprapti: - mostly occours in vriddhavastha due to heena bala. Kala samprapti: - The symptoms aggrivated at night after digestion andVriddhavasthaSadhyasadhyata:Before starting the treatment it is necessary for to know the sadhyasadhyata of thediseases. A physician must know the avastha of disease, whether it is curable or not oris it difficult to cure, by the lakshana etc, plan the treatment accordingly which helps infast recovery. So knowledge about sadhyasadhyata helps in the treatment.Vatavyadhis are considered as one of the mahagadas by Brihatrayees, the vatavyadhiswhich is old and if the rogi bala is less than the rogabala then that vatavyadhi is 145kastasadhya . Generally vatavyadhis are very difficult to cure due to the deep seatednature of the disease. Sandhigata vatavyadhi is one of the vatavyadhi which usuallyoccurs in vraddhvastha. The kala which is predominant of vata. Which is purana, havinglong history, which is originated in the jangala pradesha146 and also that which is havinga family history, will also be difficult in curing. So which comes under these categoriescan be called as asadhya. 51
  • 58. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAVyavacchedakanidana:-Vyavachedakanidana helps a physician to establish accurate diagnosis of the disease. Sandhigata vata is mainly a disease of bony joints. So virtually every disease thataffects the joints enters into the differential diagnosis of sandigata vata. The mostcommon differnetation that has to be made in between Sandhigata vata, Vatarakta, 147Amavata, Koshtruka shershaka . according to modern, the most common differentiation that has to be made arebetween Osteoarthritis, Rheumatoid arthritis, Gout, Tubercular arthritis, Gonococalarthritis, Rheumatic fever. In view of asrayasrayee bhava, particularly between Asthi and Vata the effect is morepronounced on the bones of the affected joints. It should also be noted that the disease,Sandhigata vata is one of a vata vikara so it will be have the similar characters of othervatika rogas148, which affects on the sandhi. The most common joint affected is the kneejoint. But other joints may also be affected depending upon the wear and tear due to theexcessive use. Erosion and degeneration of the cartilage and bone in the joints is thecommon. 52
  • 59. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Detailed Vyavachedaka Nidana of sandhigata vata and other related disease are given below in the table. Sandhigata vata Vatarakta Amavata Kroshtuka sheersha Vata Rakta prakopaka, Vatakara Ahara Vatakara Ahara Vihara1. Nidana Viruddhaahara, Viruddha cheshta Vihara Atimaithuna, Kshuta, Sama, Sada, Vatakopa lakshanas Hridaya dowrbalya Vatakopa lakshanas2. Poorvaroopa Slathangata, Sfuranam gowrava Sandhishoola, Kandu, Sandhisoola, Sopha Teevra ruja, Gradhita paki Vrischika damshtravat Prasarana akunchana swayadhu soola, Maharuja, Janu3. Roopa vedana,Vatapoorna druti Pidaka yukt sopha Sopha sparsha Sandhi Hasta, Pada, Shira, Gulpha,4. Adhishtana Padamoola,Hastamoola Janu madhya Trika, Janu, Uru Sandhies Vata5. Doshas Vata, rakta Kapha, vata Vata, raktHa Ushna, Snigdha6. Upashaya Sheetha Rooksha, ushna Snigdha, sheeta 53
  • 60. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA InvestigationLab Investigation:-Usually in primary Osteoarthritis the ESR may be normal or slightly accelerated. Anemiaand leukocytosis are absent. Rheumatic factors studies are absent. Synovial fluid analysisreveals minimal abnormalities useful in the different diagnosis. Viscosity is good andmucin clot formation with glacial acetic acid is normal. Slight increase in cell count are 14 9noted .X-Ray reveals:-• Loss of joint space (Due to destruction of articular cartilage)• Sclerosis (Due to increased cellularity and bone deposition)• Subchondral cyst (Due to synovial fluid intrusion into the bone) Osteophytes (Due to revascularisation of remaining cartilage and capsular traction)• Bony Collapse (Due to compression of weakened bones)• Loose bodies (Due to fragmentation of osteochondral surface)• Deformity and mlalalignment (Due to destruction of capsules and ligaments)Bone Scan shows increased uptake of technetium-99m, MRI and CT scan also helps to 150diagnose Subchondral cyst, Osteophytes etc . CHIKITSA The word chikitsa was derived from the root word “KITH”. It means to cure thedisease; Chikitsa is also called as the kriya done against roga or kriya done forvyadhiharana. Charaka states that Chikista is not only removing the causative factor of the disease butalso to bring back the equilibrium of doshas. Vata vyadhies are occurred due todhatukshaya or avarana151 In the aspect of Ckikista the line of treatment of vatavyadhi is the use of Sarpi, Taila,Vasa, Majja and treatments like Seka, Abhyanga and Basti are indicated by Charaka. 54
  • 61. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA In Pancha karma Basti is told as important treatment for vata vyadhies. It is alsomentioned as sampoorna Chikista. Other treatments are vatahara oushadhas, ahara and vihara.Principles of treatment:- Our Acharyas have designed a particular treatment for a particular disease, which isknown as Chikista siddhanta. In this disease, Sushruta has more emphasised thetreatments like local applications like Agnikarma,Lepa etc rather than the internalmedication. As per Acharya Suhsruta the treatment of Sandhigata vata is snehana, upanahana,agnikarma, bandhana and mardana152. In other classics like Ashtanga hridaya, Chakradatta, Bhavaprakasha,Bhaishajyaratnavali, Yogaratnakara etc, the treatment principles of Sushruta has beenadopted for sandhigata vata. Among all Acharyas Sushruta is the only person who mentioned the specific line oftreatment for sandhigata vata.1. Snehana: The qualities of sneha are Drava, Sukshma, Sara, Snigdha, Pichila, Guru,Sheetala, Manda and Mrudu. All these qualities are just opposite to Vata properties. Soby theory opposite qualities subsides and similar qualities increases, thus above qualitieswill definitely pacify Vata. Snehaha nourishes the dhatus as well as does balavardhana (strengthens) andagnivardhana (proper digestion). One who is adopting snehana in the right manner will behaving good jataragni, koshtashudhi, nourished dhatus, good bala and Varna, jitendriya,devoid of premature ageing and even he lives for hundred years. These are the gunas ofsnehana are according to acharya Vagbhata. In the treatment of sandhigata vata Achrya Dalhana states that both bhaya andabhyantara snehas should be administrated.2. Upanahana: Upanahana is a type of swedana. In persons who are having shula injanu pradesha and sopha also this type of sweda can be done. Charaka has describedUpanahana as a variety of Swedana. 55
  • 62. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Sushruta acharya has described and divided sweda into four groups and in that he hastold about the upanaha sweda. It is a kind of sweda done by applying herbal paste overthe affected part. Vagbhata is having the opinion that vatahara Patras should be used forupanahana. Charaka while explaining vatavyadhi chikitsa says that the drug which ismixed with snehana should be used for upanahana karma. Sushruta mentions thatvatahara drug’s roots should be made into paste with kanji in that saindhavalavana andsneha should be mixed to from a paste. The paste should be heated and applied in theaffected parts.3. Bandhana: Upanaha sweda is divided into three by Susrutha. They are pradeha,sankara and bandhana. In the bandahana sweda the upanaha dravyas are tied into theaffected part and there by the action of the medicine is attained.4. Mardana: - Mardana is usually done in vatavyadhis. It is a form of bhayasneha by applying oil externally and massage is done by gentle pressure. This helps theoil to absorb and improves the blood circulation and lymph drainage from the part.5. Agnikarma: - Agnikarma is a surgical procedure, so it is mentioned by Acharyasushruta. He states that agnikarma is of twagdagda, mamsadagda, sirasnayudagda andsandhidagda. According to Dalhana in sira, snayu, asthi and sandhi vikaras evendahanakarma of mamsa itself gives good relief. Sushruta states that when vitation oftwak, mamsa, sira, snayu, asthi and sandhies by vata, which causes pain, agnikarma givesgood relief.6. BASTI:- Basti is one among the panchakarmas and it has given much importance in vatavyadhiChikista due to its ability to pacify vata. Charaka has told Basti as balavardhaka,brimanam and vatanashanam. According to Ashtanga hridaya, basti is important invatadhika samsarga, sannipataja diseases and kevalavatavyadhi. It is the best treatmentthan other treatments for vata vitation. Vata is the cause for vitation of other dosha so thatvata is considered as sarvarogakaraka. For this vitiated vata the only remedy is Basti. So 56
  • 63. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAit is mentioned that if we are taking all the treatments is depending on Basti i.e. Basti caneven cure the disease where all other treatment methods failed.Shamanoushadhies in Sandhigata vata:-Kwatha : Maharasnadi Kwata Dhanwantaram Kwata Sahacharadi Kwata, Rasna Saptaka KwataKalka : Tagaramoolakalka with takraChoorna : Alambushadya Choorna, Abhadi ChoornaVati : Ajamodadi vatiGuggulu preperations: Kaisora guggulu, Yogaraja guggulu, Brihat Yogaraja guggulu, Trayadashanga guggulu, Adityapake uggulu, Simhanadaguggula, Rasoushadi: Panchananarasa Louha, Darada Vati, Vriddha Vata Gajankushu Rasa, and Vatarakshasa Rasa.Sneha: Dhanwatharamtailam,Phalatrikadi Sneha,Majja Sneha,Prasarni tailam,Sidharthatailam,Nakula tailam, Shatatuspadi taila, Amruthadi taila, Bala taila, Bala Aswagandhaditaila, Ksheera Bala taila, Pinda taila, Gandha taila, Rasonadhi talai, Gandharva Hasthataila, Guggulu Tiktaka ghrita, Rasna Dashamoola ghrita.Asavarista: Dashamoola rishta, Bala rishta, Ashwagandha rishta, Pathyaapathya:- Treatment is nidana privarjana and samprapti vighatana. Pathya is termed as ahara andvihara, which prevents the aggravation of the disease and helps in curing the disease.Charaka states that is which is suitable to the body and mind during the healthy and indiseased condition. Samanya vatavyadhi pathyapathya should be adopted for it.Pathya Ahara:1.Rasavarga – Madhura, Amla, Lavana.2.Shukadhanyavarga – Naveena godhuma, Sali Samvatsarothitha, Rakthasali, Shashtikasali3.Shimbi varga- Naveena Tila, Naveena Masha, Kulatha4.Shaka varga – Patola, Shigru, Lasuna.5.Phala varga – Draksha, Pakwamra, Parushaka, Jambeera, Dadima, Pakvatalaphala. 57
  • 64. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA6.Mamsa varga - Ushtra, Go, Varaha, Mahisha, Mayura, Bheka, Nakula, Chataka,Kukkuta, Titira, Sheelindra, Kurma, Rohita etc.7.Jalavarga – Ushna Jala, Shritasheetala Jala, Narikela Jala8.Dugdha varga – Go, Aja, Dadhi, Ghritha, Kilata, Kurchila9.Mutra varga – Gomutra10. Madhya – Dhanyamla, Sura11. Sneha – Tila, Ghrita, Vasa, MajjaVihara Bhushayya, Snana, Samvahana, Slightly walking, Slight swimming, Steam bath,etcApathya Ahara: - Rasa – Katu, Tikta, Kashaya Shimbi dhanya – Rajamasha, Mudga, Shuka dhanaya – Truna Dhanya, Trunaka Kangu, Koradhusha, Neevara, Shamaka, Chanaka Phalavarga – Jambu, Udumbara, Karmuka, Tinduka Mamsa varga – Suska Mamsa, Kapota, Pravata Jalvarga – Sheetambu, Tadakajala Ksheera – Gardhaba KsheeraVihara1.Manasa – Chinta, Shooka,Bhaya2.Shareeika – Jagarana, Shrama, Vyayama, Chankrama, Vegadharana, Long standing,Sitting, Automobile driving, staying in A.C etc. Now a days due to the change in life style and culture, people are exposed tomodernised foodstuffs. This does a severe impact especially to Sandhigata vata patients.Management of Osteoarthritis:- Treatment of Osteoarthritis is aimed at reducing pain, maintaining mobility andminimising disability. The vigor of the therapeutic intervention should be detected by theseverity of the condition in the individual patient. For those with only mild disease,reassurance, instruction in joint protection and occasional analgesic may require. For 58
  • 65. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAthose with severe Osteoarthritis a comprehensive program comprising a spectrum of nonpharmacological measures supplemented by an analgesic or anti inflammatory drug isappropriate. Non-pharmacological measures, reduction of joint loading, correction of poor postureand a support for excessive lumbar lordosis can be helpful. Patients with Osteoarthritis ofknee or hip should avoid prolonged standing, kneeling and squatting. Obese patientsshould be loose weight. Rest periods during the day may be helpful. But complete immobilisation of the painfuljoints is rarely indicated. In patients with unilateral osteoarthritis of the hip or knee, acane held in the contra lateral hand may reduce joint pain by reducing the joint contactforce. Bilateral diseased may necessitate use of crutches or a walker. Physical therapy, application of heat to the joint may reduce pain and stiffness. A hotwater shawer is also preferable. Occasionally a better analgesic effect may be obtainedwith ice than with heat. Drug therapy of osteoarthritis today is palliative, no pharmacologic agent has beenshown to prevent, delay the progression of or reverse the pathologic changes ofosteoarthritis in humans.Intra or periarticular injection of a depot gluco corticoid preparation may provide markedsymptomatic relief for weeks to months. Because studies in animals models havesuggested that glucocorticoids may produce cartilage damage, and frequent injection oflarge amounts of steroids have been associated with joint breakdown in humans, theinjection sould generally not be repeated in a given joint more often than 4-6 months. Joint replacement surgery should be reversed for patients with advanced osteoarthritisin whom aggressive medical management has failed. Osteotomy, which is surgicallymore conservative, can eliminate concentration of peak dynamic loading and mayprovide effective pain relief in patients with hip or knee osteoarthritis. Arthroscopicremoval of loose cartilage fragments can prevent locking and relive pain. Chondroplastyalso has some popularity as treatment for Osteoarthritis, but well controlled of its efficacyare laking. 59
  • 66. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAInternal MedicationIndomethacin tab - 25mg. 2-3 time dailyPiroxicam tab - 10-30Mg. dailyIbufrofen tab - 1.2 – 1.8g / day in 3-4 divided doses after foodDiclofenac tab - 50Mg. BidNimesulide tab - 100-200 Mg bidRehabilitation:-Simple changes around the home and daily activities cause dramatic improvement in thesymptomatology of Osteoarthritis.a) Use of higher chair, which require less effort to get in and get out, should beconsidered.b) Patients are advised to limb the stairs leading the good leg taking one stair at a timeand to descent the stairs leading with the bad leg, again taking one stair at a time.c) To reduce the force acting across the injured joint patient is advised to use awalking stick, which acts as a third limb. The stick should be held in the hand opposite tothe affected part. A walking stick, by providing a third limb through which forces can betransmited, enables the reduction of forces across the injured joint.d) Footwear with hard soles and high heels should be avoided.e) Mental and physical support from the family members will be useful in the rehabilitation of the patient.Exercises:-Mainly two types of exercises are mentioned. They are flexibility exercise andstrengthening exercise.Flexibility exercise – Sit in a chair and rest the foot on another chair, then gently press theknee towards the floor.Strengthening exercise – To strengthen the knee straight the leg and press the knee on tothe bed, hold for 6 seconds , repeat 5-10 times. 60
  • 67. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAYoga:- Yoga is the one of the ancient science of our land, which inters relates with our culture.Its practices in daily lifes restore the health and relief to disease. The Asanas which give relief to Arthritis is the Pavanamukthasana. These Asanas are very easy to practice and help him relieving stress by loosening the joints. 61
  • 68. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA MATERIALS AND METALSMaterials and methods studied mainly under 3 headings1. Pharmaceutical study2. Analytical study3. Clinical study Pharmaceuticals Study MaterialsThe following material and instruments are necessary for this study.1. Hingula, 2. Meshikshira, 3. Nimbu swarasa, 4. Rasona swarasa,5. Palandu swarasa, 6. Tambula swarasa, 7. Ardraka swarasa. Instruments like khalva yantra, ulukalu yantra, vastra etc. Methods: The preparation of Darada vati includes the following proceduresI. Darada Shodhana A. Darada shodhana with Meshi Kshira- 1 bhavana B. Darada shodhana with Nimbu swarasa- 7 bhavanaII Darada Bhavana A. Darada bhavana with Lashuna –7 bhavana B. Darada bhavana with Palandu swarasa 7 bhavana C. Darada bhavana with Tambula swarasa 7 bhavana D. Darada bhavana with Adraka swarasa 7 bhavanaIII Darada vati nirmana -1 Gunja pramana. Darada vati is one of the khalvi rasayana. This preparation includes threepharmaceutical procedures. Those are 1. Shodhana, 2. Bhavana, 3. Vati nirmana 62
  • 69. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAKhalvi rasayana- The medicines, which are prepared by khalva yantra, are said to bekhalvi rasayana. All the Rasa and Vanaspatija dravya are taken in Khalva and Drava darvya isadded and trituration is carried out till the drug dries. The product obtained by thisprocedure is known as Khalvi rasayanaShodhana : Shodhana is the process, which makes metal and minerals fit fortherapeutic use. Shodhana is done by many processes like Mardana, Swedana, Bhavana,Pachana, Prakshalana, Nirvapa, Dhalan etc with some vanaspati dravya swarasa. Taila,kshira and pranija dravya like mutra, rakta, ghrita, dugdha etc for a specific period.Concept of shodhanaShodhana makes heterogeneous into homogeneous formShodhana reduces the hardness of the mineral and metalShodhana reduces the particle size and increase the absorption rateShodhana enhances drugs propertyShodhana convert the toxic metal and mineral into non-toxic.Shodhana eliminates, separate the unwanted toxic things form the drug.Bhavana (Triturating with some liquid for a specified time.) Various metallic and mineral drugs, which are subjected to marana process, haveto pass through a number of stages and bhavana is the must important of them. Beforesubjecting them to actual bhavana process the materials are to be purified and made in topowder and then if necessary, they are to be mixed with certain marana drugs mentionalespecially for particular substance. A liquid juice or decoction is then added to it andtriturated well for a specified period, till the liquid added is dried. Now the whole mass isdivided into small pieces, even in micro particle size.Concept of bhavana1. Bhavana makes the sanghata bhedan of drugs and finally make particles finer in size.2. Bhavanaa induces the new properties into the main drugs through various liquids usedduring the process. 63
  • 70. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA3. Bhavanaa enhances original property of drugs.4. Bhavanaa also helps in the biochemical action of the drugs and living cells.Vati kalpana - Vati kalpana is the upakalpana of kalka kalpanaVati’s are prepared with the combination of kashtaoushadhis drugs churna and shodhitamarita, rasoparas, sadharana, rasa etc with adding of guda, swarasa, mutra guggalu,sarkara etc as binding agents. On the basis of shape, dose. Root of administration. These are named as Gutika,Vati, Modaka, Vatika, Pindi, Varti etc. Darada vati Yavanesta palandunam tambuly ardrakajaih rasaih I Daradam saptavarani bhavayitva vatium karet ll55ll Gunjaduayomita hanti rogan vatokapho dbhavana l Sandhivatam visheshen puranum pinasam tatha ll56ll Shodhita Darada should be subjected to bhavana with, Lasuna Palandu; Tambula& Ardraka juice seven times with each, and after prepare its vati measuring 2 ratti each. Itmay be used to cure all types of vata kaphaja diseases specially sandhigata vata & puranapinas. 64
  • 71. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No. 1Title – Darada shodhanaReference – Rasamrita Chap-1/55SDate of commencement – 1. 11.2003Date of completion – 1-11-2003Time taken – 4hrsMaterial required – khalva yantra, measuring glass, vastraDrugs used – Darada 250gms, Meshi kshira – Sufficient QuantityMethod – Darada was taken in a khalva yantra and powdered nicely.Sufficient quantity of Meshi Kshira was added &Mardana was done for tillThe end product dries up (approximant 4 hur’s)After the process Darada attained completely powder form.Observation - 1 While powdering of Darada white shining lines were seen. 2 The drage will have red colour after completion of Meshi kshira bhavana 3 weight of Darada after Bhavana was 255 GmsPrecautions - Initially powdering should be done slowly, to avoid the spoilage of Darada. Afterit attains semisolids consistency, the mardan should be done firmly and continuously.Dugdha should be heated and filtered 65
  • 72. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No.2Title – Darada shodhanaReference – Rasamrita Chap-1/55Date of commencement – 2-11-03,Date of completion - 8-11-03Time taken – 4hrsMaterial required – khalva yantra, knife, Juice extractor, Measuring glassDrugs required – Meshi kshira bhavita darada –255gms Nimbu swarasa- Sufficient QuantityMethod – Nimbu swarasa was added to meshi kshira bhavita darada and Bhavan was given for4 hur’s then darada became completely dry.This method was continued for 7 times.Observation –1. Slight silvery shining colour appears around the edge of the powder after adding oflemon juice2. Colour of the darada after complete mixing of juice turn to red more than pervious.3. Lemon juice odour was observed after completion and during the Mardana process.4. Weight of darada after complete of 7th bhavana 270 GmsPrecautions: Initially powdering should be done slowly, to avoid the spoilage of Darada.After it attains semisolids consistency 66
  • 73. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No.3Title –Darada BhavanaReference – Rasamrita Chap-1/55Date of commencement – 9-11-2003Date of completion - 15-11-03Time taken – 6hrsMaterial required – Khalva yantra, Vastra, Measuring glassDrug required – Shodhita darada –270 Gms Rasona swarasa- Sufficient QuantityMethod – Shodhita darada taken in khalva yantra then sufficient quantity of Rasona swarasa isadded and subjected to Bhavana. This process was done for 6 hrs, after completion ofbhavana.Same procedure repeted for seven times.Observations –1. After adding of Rasona swarasa the powder become sticky shining and brightyellowish red colour is obtained.2. The process of mardana becomes difficult when darada is in the state of semisolid andlast stage of dying.3. Garlic odour is dominant and lemon odour reduced.4. Weight of darada after completion of 7th bhavana is 290gms.Precautions: Initially powdering should be done slowly, to avoid the spoilage of Darada.After it attains semisolids consistency 67
  • 74. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No. 4Title – Darada bhavanaReference – Rasamrita Chap-1/55Date of commencement – 16-11-03Date of completion - 22-11-03Time taken – 6 hrsMaterial required – Khalva yantra, Vastra, Measuring glass.Drugs required –Rasona swarasa bhavita darada 290gms. Palandu swarasa – Sufficient QuantityMethod – Rasona swarasa bhavita darada was taken in Khalva yantra and palandu swarasa wasadded and subjected to Bhavana process for 6 hrs, this process continued for seven times.Observations –1. Phalandu swarasa make the Rasona bhavita darada less bright colour.2. At the time of mardana and after completion of process the odour of the darada now iscombination of Rasona and palandu.3. Weight of darada after completion of 7th bhavana 303gms.Precautions: Initially powdering should be done slowly, to avoid the spoilage of Darada.After it attains semisolids consistency 68
  • 75. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No.5Title – Darada BhavanaReference – Rasamrita Chap-1/55Date of commencement -23-11-03 toDate of completion -29-11-03Time taken – 6 hrsMaterial required – Khalva yantra, Vastra, Measuring glassDrugs required – Plandu swarasa bhavita darada 303gms Tambula swarasa Sufficient QuantityMethod – Palandu swarasa bhavita darada is taken in Khalva yantra added sufficient quantityof fresh tambula swarasa and sjubected to bhavana precess up to 6hur’s after drying,again added fresh swarasa then the same proceduer is continued for 7 times .Observations-1. The brightness of the darada completely losses after 7 bhavana with Tambula swarasaand become greenish red colour.2. Odour become mixture of Rasona palandu tambula3. Weight of darada – after completion of 7th bhavana 320gms.Precautions: Initially powdering should be done slowly, to avoid the spoilage of Darada.After it attains semisolids consistency 69
  • 76. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No. 6Title – Darada BhavanaReference – Rasamrita Chap-1/55Date of commencement -30-11-03Date of completion -6-12-03Time taken – 6 hrsMaterial required – Khalva yantra, Vastra, Measuring glassDrugs required –Tambula swarasa bhavita darada 320gms. Adraka swarasa sufficient QuantityMethod – Tambula rasa bhavita darada was taken in khalva yantra added 75ml of Adrakaswarasa after adding subjected to mardana process upto 6 hrs and the same procedure iscontinued for 7 times.Observations – 1. The colour of darada become brick red colour 2. Odour becomes mixture of all bhavita dravya. 3. Weight of darada – after completion of 7th bhavana 342gms.Precautions: Initially powdering should be done slowly, to avoid the spoilage of Darada.After it attains semisolids consistency 70
  • 77. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Practical No.7Title – Darada vati nirmanaReference – Rasa mrita Chap-1/56Date of commencement – 7 –12- 2003Date of completion -8-12-2003Material required - Khalva yantra, Vastra, Measuring glass.Drug required –Bhavita darada-340gms. Adraka satwa-30gms Adraka swarasa- 50mlMethod – After completion of 7th bhavana with Ardraka swarasa,30gm of Ardraka satwa and50ml of Adraka swarasa is added to the bhavita Darada and next subjected to bhavanaprocess till the consistency become sutable for vati preparation after consistency seenthen the vati is prepared measuring about 1 ratti (125mg)Observation –1. The colour of the vati like brick red colour2. Odour – Mixture of bhavita dravya especially Rasona Palandu dominant odour.3. Taste – Madhura rasa pradhana, katu rasa.Precautions – Initially powdering should be done slowly, to avoid the spoilage ofDarada. After it attains semisolids consistency While preparing the vati Adraka satwa was coted to the varti because darada stick tothe hands. 71
  • 78. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Table no. 10 shows the weight and observation of daradaSl.No Practicals Wt. of Wt. of Colour Odour darada B.P darada A.P 1. Shodhana I 250gms 255gms Red Sligh milky 2. Shodhana II 255gms 270gms Thick red Lemon 3. Bhavana I 270gms 290gms Yellowish Garlic red 4. Bhavana II 290gms 303gms Red Mixed 5. Bhavana III 303gms 320gms Greenish Mixed red 6. Bhavana IV 320gms 340gms Brick red Very pungent 7. Vati nirmana 340gms 375gms Brick red Mixture of all 72
  • 79. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA ANALYTICAL STUDY Qulitative Analysis of Mercury1. Solution of Mercury salts with hydrogen sulphide make black precipitate which is insoluble in ammonim sulphide solution and in boiling dilute nitric acid.2. Solution of Mercury salts are free from an excess of nitric acid, deposit a coating of mercury on bright copper foil, the deposit becomes bright when it is rubbed and may be volatilized from the foil by heat and obtained in globules.3. Solution of mercury salts when treated with stannous chloride solution yields a white precipitate, which rapidly becomes gray with an excess of the reagent.4. Neutral solution of mercury salts when treated with potassium iodide solution yield a scarlet precipitate, which is soluble in excess of the any agent and in a considerable excess of the solution of the mercury salt.5. Solution of mercuric salt when treated with sodium hydroxide solution yield a yellow precipitate Quantity estimation of mercury present as sulphide In the presence of the organic matter Transfer an aliquate of the well mixed (sample expected to contain 0.1-0.15 grams of mercury)to kjeldahl standard joint flask of 300ml capacity and 7ml concentrated nitric acid and 15ml of concentrated sulphuric acid attached to a standard joint condenser and heated under reflex gently at first and then more strongly for about 30 minutes, so that all the organic matter is dissolved, cooled,then 12ml of concentrated nitric acid is added and boiled , continue the addition of nitric acid and boiling until the liquid becomes colourless or pale yellow in colour and continue boiling, cooled and wash down the condensor with 100ml of water remove the flask and 1% of potassium permanganate solution is added drop by drop until a pink colour persists, one drop of 6% hydrogen peroxide solutions is added to remove excess of permanganate followed by 3ml of concentrated nitric acid and titrated with N/10 ammonium thiocyanate using ferric alum as a indicator. 1ml of N/10 thiocyanate =0.01003 gram of mercury 73
  • 80. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAQualitative analysis of sulphurSulphates1. Solution of sulphates when treated with barium chloride solution yields a whiteprecipitate which is insoluble in hydrochloric acid.2. Solution of sulphates when treated with lead acetate solution yield a white precipitatewhich is insoluble in ammonium acetate solution and in sodium hydroxide solutionQuantity analysis of sulphurTotal sulphurTransfer a weighed quantity of the well mixed sample of a long necked flask of 250mlcapacity (a kjeldahl flask may be used). Added 10ml of saturated solution of bromine in acarbon tetra chloride covered and let stand for about 30 minutes, stirring several times,(added 15ml of concentrated nitric acid covered and let stand for about 30 minutesstirring several times). Heated over a low flame, adding small quantities of concentratednitric acid, from time to time untill the solution is clear and does not darken on standing.Transfered the solution quantitatively to 250 ml beaker with the full of water, evaporationon a hot plate to about 15ml (complete the determination as a given under free sulphur)Free Sulphur: Extract a suitable quantity of the sample accurately weighed, with carbondisulphide in a soxhlet extraction apparatus lefting the extraction thimble drain at least 12times transfer the extract to a 250 ml beaker evaporate carbon disulphide in a draught atroom temperature, added 10 ml of saturated solution of bromine in carbon tetrachloridecovered and let stand for about 30minutes stirring several time, added 15 ml ofconcentrated nitric acid covered and let stand for about 30 minutes stirring several timesevaporate on a hot plate at about 5 minutes, about 50 ml of water is added filtered andwashed with 2 percent hydrochloric acid.Added 2 drops of bromophenol blue (0.1 g +1.5 ml N/10 NaoH in25 ml of water) andthen ammonia to first colour change added Hcl drop wise until distinctly acid then add 5drops in excess. dilute to 150 ml with water heated to boiling and 10% barium chloridesolution is added drop wise until 50% excess in present covered the beaker and digestedon steam both for one hour cool to room temperature filter through quantitative filterpapear (what man No.42) wash 10 minutes with hot water, ignite residue in a weighedporcelain silica crucible at 500 0c cool in a desicator and weigh as BaSo4 74
  • 81. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAAsh value – Incinerate about 2-3 gm of accurately weight of prepared shample in aplatinum or silica dish at a low temperature until free from carbon, cooled and weighted.if a carbon free ash cannot be obtained in this way extract the charred mass with hotwater, collect the residue on and ashless filter paper. Incinerate the residue and filterpapers add the filtrate, evapourate to dryness and ignite to constant weight at a lowtemperature.Calculate the percentage of ash with reference to moisture free drug.30-40% w/wAcid insoluble ash: Boil the ash for five minutes with 25ml of dilute hydrochloric acid(6N) collected the insoluble matter in a gooch crucible or on an ashless filter paperwashed with hot water and igniated to constant weight at a low temperature and thepercentage of acid insoluble ash is calculated with reference to the moisture free drug.The finess of particle test: The particle size can be measured by microscope and withthe help of occulominometer, in this particle size measuring in the range 0.1 to 100 micrometersMethod: - before measuring, the standardization of occulominometer was carried out bycoinciding the lens of both occulominometer and style minometer and standardized byusing the formula SM/OMX10= -micrometer after the coinciding the style minometerwas removed the fine powder was sprinkled on the slide and covered with covering slipthis mounted slide was placed on mechanical stage and focused, the particles aremeasured an orbitary chosen fixed lines covered by the particles using theocculominometerLoss on drying 1100c-1gram of accurately weighed and heated on electric oven up to1100c and again weighed, the difference in weighed was calculated by Initial weighed-weighed after 1100c=- gram 75
  • 82. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAPost – compression parameters:Shape of tablets: Uncoated tablets were examined under a lens for the shape of the tablet.Uniformity of thickness: Ten tablets were picked from each formulation randomly & thickness was measured individually.It is expressed in mm & standered deviation was also calculated.The tablet thickness was measured using dial caliper (Mitutoyo, Japan)Hardness test: Hardness indicates the ability of a tablet to withstand mechanical shocks while handling. The hardness of the tablets were determined using Monsanto hardness tester. It is expressed in kg / cm2. Ten tablets were randomly picked & hardness of the same tablets from each formulation were determined.The mean & standered deviation values were also calculated.Friability test: The friability of tablets were determined using Roche Friabilator.It is expressed in percentage.Ten tablets were initially weighed( Wt initial )& transeferred into friabilator.The friabilator was operated at 25 rpm for 4 minutes or run up to 100 revolutions.The tablets were weighed ( Wt final ) again.The % friability was then calculated by, Wt initial – Wt final F = ------------------------- x 100 Wt initial 76
  • 83. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAWeight variation test: Ten tablets were selected randomly from each formulation & weighed individually to check for weight variation. A little variation is allowed in the weight of a tablet by the US Pharmacopoeia. The following % deviation in weight variation is allowed: Average weight of a tablet Percentage deviation 130 mg or less 10 More than 130 mg & less than 324 mg 7.5 324 mg or more 5 In all the formulations the tablet weight is more than 324 mg, hence 5%maximum difference allowed.6. In vitro Disintegration Test: The process of break down of a tablet into smaller particles is called asdisintegration. The in-vitro disintegration time of a tablet was determined usingdisintegration test apparatus as per I.P. specifications. Place one tablet in each of the 6 tubes of the basket. Add a disc to each tube & run H 0 0the apparatus using P 6.8 (simulated saliva fluid) maintained at 37 + 2 c as theimmersion liquid. The assembly should be raised & lowered between 30 cycles per H 0 0minute in the P 6.8 maintained at 37 + 2 c. The time in seconds taken for completedisintegration of the tablet with no mass remaining in the apparatus was measured &recorded. 77
  • 84. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Clinical Study1. Research approach: The present study the investigators objective is to evaluate thetherapetic effect of Darada Vati in the management of Sandhigata Vata; efficacy can bedetermine by finding out of difference between the base line data and assessment data.2. Research design: This study was for a period of one year, bemographic data and dataregarding the disease Sandhigata Vata, are collected according to the case record fromgiven in the appendix.3. Population: 30-60year patients with Sandhigata Vata, attainding the out patientsdivision of DGM Ayurvedic college and hospital Gadag, were included under the study.4. Samples: The sample for the present study consists of 30 patients with SandhigataVata, reporting to DGM Ayurvedic College OPD and selected as per selection criteria.5. Selection criteria: The cases were selected as per the inclusion criteria and weretreated, age limit for the selection of the patients were are between 30 to 60yearsirrespective of sex.Inclusive criteria: pain and tenderness over the knee joint,Swelling of the knee joint, crepitation of the knee joint,Age of the patient’s 30-60years.Exclusive criteria: patients below 30 and above 60 years of agePatient developed deformity, pregnant women and lactating mother6 Duration of the study: The duration of the study was one year data was collected fromthe first week of December 2003; individual patients were monitored for 30 days andfollow up 15 days for the efficacy of the trial drug. 78
  • 85. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 7. Posology: - Internal Darad Vati 1 Ratti (125mg) BID 8. Anupana: - Ushna Jala 9. Data collection: Patients selected are thoroughly examined both subjectively and objectively; detailed general history and physical examination findings are noted, routine investigation of blood are done to exclude other pathology 10. Examination of knee joint: Osteoarthritis is the common nest kind of knee joint disorder found in elderly peoples, a thorough physical examination is necessary for the patients with the knee joint pain Before taking history a glance is given at the overall picture presented by the patients, the patients will be having the pain and swelling on the knee joint a) history: knee joint pain is a system hard to evaluate, hence detailed history in chronological sequence is the first stand, a patient with knee problems usually presents with the following complaint: 1. Pain- This may be acute or chronic and there may be a history of trauma. 2. Swelling- This could be due to the effusion or synovial membrane thickening; localized swelling could be due to bursal enlargement. 3. Limp- This may be due to pain muscular spasm stiffness or arthritis. 4. Risticted movement locking- It could be due to meniscal tear or loose bodies, in locking patient’s complaint of inability to complete the last few degrees of extension, rigid block suggest loose bodies or fixed flexion deformity. Deformity- In Genuvalgum, Vaurm and Precuvatum. Patient’s usualy presents with deformity. B. Physical examination – As in the other parts of the body examination of knee joint consists of Inspection, Palpation Measurements, and Movements. And stability tests particular to the lence. Examination of the knee is carried out form the front. Sides and back.A. Inspection.First look at the hight and weight of the patient 79
  • 86. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Looks for the standing aligument of the knee which should be 3-7 degrees valgusLook for the abnormality of the feet like flate feet .etc which may be contribute to the kneeproblem.Wasting of the thigh and leg muscle are to notedSwalling this could be due to intraarticular or extraarticular cause. If all natural depre ssionsabove, below and by the sides of putell are obeterated. The cause could be intra articular inextra articular causes. All the natural fossae will not be obliterated and the swelling usuallyextends over the patella. Dffusion hacmarthrosis beyond knee could be due to bursitis exostases. Or osteophytes. Knee flextion test- This is to detect the cause of genu Valgues whether it lies in the femur or fibia .It the detormity disappears with flexion of the knee. The cause lies in the lower end of the femur and if it persists on flexion the cause lies in the upper end of tibia. Genu varum is difined as lateral angulation of the knee. The longitudinal axis of femur and tibia deviates medially. Type Unilateral – Due to growth abnormalities of opper tibial epiphysis. Infections like osteomyelitis etc. Trauma near the growth epiphysis of femur tumours affecting the lower end of femur and upper end of tibia. Bilateral – Physiological gets corrected by four years. Phothological – congenital causes. Postural abnormalities. Developmental disorders.Metabolic disorders. Endocrine dissordes. Degenerative disorder (Osteoarthritis of knee this is a common cause) Occupational.disorders, Idiopathic Pagets’ disease blounts disease. The ankle of Varum is calculated on a standing radiograph of the whole limb. 80
  • 87. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAGenuvarum Complex- The priming deformity in genuvarum is lateral angulation ofknee. In response to this secondary deformities in the tibia and the foot. These togetherare known as genuvarum complex.Genu reccurvatum is defined as back word bending of the knee. Up to 5 degree of genuxreccurvatum is some times seen in women with laxLigaments and is usually generalised.Features- Limitation of knee flexion form mild to severe.Effusion and evidence of knee abnormality is absent.Some times a dence band that becomes tens during flexion of the knee could be palpatedin the proximal part of the patella, patella is always located more proximally and sometime latterlyCauses: congenital disorders, Quadriceps contracture is the most common cause inacquired genue reccurvatum, Neurological disorder,Malunited fractures around the knee.During the inspection look for old scars, sinuses etc. as evidences of injury, surgerytrauma, or infection also should look for the position of patella wether latral high or low .b) Palpation:Temperature: Local rise of temperature felt with the dorsum of the handTenderness: Tenderness should be eliciated and graded, proced from normal area to theaffected part for better patients complaients grading can be done as 0- No tenderness, 1-patients says the joint is tender, 2-patient winses on pressure, 3-patient winces and withdraw, 4 patient will not allow to touch.Swelling: Swelling of the joint is usually due to effusion within the joint which indicatesdamage to joints and the presence of major cause must always be ruled out, synovialmembrane thikness is the other common cause.Types of swelling:Small: In these causes there will be bulging of the sides of the patellar ligaments andobliteration of the hollows of the medial and lateral adjust of patellarLarge-Distention of the supra patellar pouchLocalised- This is due to Osteophytes. Exostosis bursae cyst etc. 81
  • 88. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Swelling due to synovial membrane thickness is almost always due to chronicinflammatory disorders.The features of the swelling are prominent. Usually above the patellar near the suprapatellar pouchBaggy to feelLocal rise of temperatureTest- the following test helps to evaluate the swelling of the knee.Patellar top test:StepI: - In the horizontal position considerable amount of excessive synovial fluidgravitates in to the supra patellar pouch. From 6 inch above the patellar excess fluid inthe supra patella pouch is driven back in to the joint by sliding down firmly with indexfinger the thumb.Step II:- The tips of the three fingers and the thumb of the free hand is placed over thearticular surface of the patella and quick jerk is given downword. If the fluid is presenteda click sound is heared as the patella can be felt to strike on the femoral condyle andbounces back. The patella tap is not always reliable. It is negative in tense swelling duetoo much fluid, small swelling due to too little fluid it is positive only in moderate kneeeffusion.Crepitation: Crepitation derived from a joint can be detected by feeling the joint with onehand while it is moved passively with the other.It is usually felt in osteoarthritis joints.Walking time: The patients were asked to walk a distance of 60 feet, the time take toreach the mark of 60 feet was recorded by using stop watch this was recorded beforetreatment and after treatment.Examination of movements: The important movements taking place at the joint areflexion and extension. In semi flexed position slight side to side and rocking movementsare possible.Flexion: The normal range of knee flexion is 130-150 degreesMuscle testing: The patient is prone, examiner places one hand over the pelvis to stabilesit while the offer graded rsistance with the other hand at the ankle as the patient attempts 82
  • 89. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAto flex the knee flexion is tested with the ankle externally rotated biceps femoris is testedand if the ankle roatated medially semimembranosus and semitendinous are tested.Extension: The knee should normally extended to a straight line (0 degree) occasionallycan hyper extended to 15 degree in some women.Muscle testing: Patient site with the legs hanging over the edge of table the examiner thenstabilized the thigh by one hand over the pelvis or proximal thigh against the resistanceprovided examiner the patient slowly extends the knee through its range of motion.Stability test: valgus stress test-the patient is in supine position with the knee extendedstand on the ipsilateral side of the patellar palce one against the medial aspect of the knee.Grip the ankle with the other hand and attempt to drag the leg laterally to open the medialside of the knee joint if there is evidence of pain above, below or at the joint line the testis positive for medieo colateral ligaments.Varus stress test –patients is in supine position with the knee extended, standing on theipsilateral side of the patellar place one against the medial aspect of the knee. Grip theankle with the other hand and draw the leg medially in one attempt to open the lateralside of the knee joint. if the patient is complaints of pain above, below or at the joint linethe test is positive.Investigation: The patients who are selected randumely with intial data collecting fromthe DGM Ayurvedic college hospital will be subjected to undergo lab investigation andX-ray.Labinvestigations: TC.DC.ESR.Hb%, SAP, RBSBlood investisgations like TC, DC, &ESR, Hb% were investigate to rull outAnemia, blood sugar was investigated to rule out systemic disease diabities. SAP wasinvestigated to rollout osteopytis deformans osteomalasia matastatic bone disease etc.X-ray: X-ray at lateral and AP views of affected knee were taken rsduction of joint spaceformation of osteopytis, lose bodies etc. were taken out to consideration for the diagnosispost treatment X-ray was not adovocated because past studies shows there will not be anychange in X-ray within 30 days. 83
  • 90. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA10. Assessment of response to treatment: In this study Ayurvedic and modernapproaches were utilized in the selection of patients, there classification and finalanalysis of results, the results were assessed on the basis of clinical signs and symptomsand functional capacity of the patient. Functional capacity measuring by walking time, aspatient’s impression gives much important to the final conclusion it was taken to draw aconclusion regarding the efficacy of the treatmenta) Clinical assessment: 1. Pain: pain of the joint- grade No pain 0 Mild pain + 1 Moderate pain + + 2 Severe pain + + + 3 The report of the patient was taken in to consideration for the duration of pain 2. Stiffness of the joint Grade No stiffness 0 Mild stiffness for 5-30 minutes 1 Moderate stiffness for 30-2hrs 2 Severe stiffness more than 2hrs 3 3. Tenderness of the joint garde No tender 0 Patient says the joint is tender 1 Patient winces 2 Patient winces and with draw the affected part 3 The patient will not allow the joint to be touched 4 84
  • 91. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 4. Swelling of the joint grade No swelling 0 Mild swelling slightly obvious 1 Moderate swelling covers well the bony prominence 2 Severe swelling much elevated 3 5. Crepitation of joint grade Absent 0 Present 1 6 Walking time (60feet distance) grade Within 20 sec 0 20-40 sec 1 40-50 sec 2 50-60 sec 3 60 and above 411. over all assessment of the treatment: for assessing the over all effect of the therapycertain criteria were adopted the result are classified in to four groups as listed below:Excellent: absence of pain, stiffness, tenderness, swelling, crepitation and walking timenormal.Good: more than 60% reduction in pain 60% and reduction instiffnessMore than 60% reduction in the tendernessMore than 60% reduction in the swellingWalking time reduced to more than 60%.Crepitation absentResponded: 25% reduction in all criteriaNot responded: pain persists as such or increased stiffness and tenderness swellingwalking time not improved or increased.Plan for data analysis:All the data were statically analysed before and after the treatment and comparison wasdone t- test was employed to find out the level of the significance. 85
  • 92. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Clinical Study Results In the clinical trial subjective and objective changes were considered for theassessment in the management of sandhigata vata. Total 45 patients were reported withclinical symptoms. Among these 35 patients were included in the study. Satisfying thediagnostic criteria 10 patients were excluded due to age and systemic disorders,deformity. Among 35 patients 5 patients were discontinued and 30 patients completed thetreatment and follow up successfully.Table No.14 showing the criteria of exclusion in the 10 excluded patient Sl.No. Reason No. of patient 1 Above 5 years history 1 2 Above 65 years age 3 3 Hypertension 2 4 Diabetes 2 5 Trauma 1 6 Muscle wasting 1The total data was collected as follows sections: Section-A Demographic data Section-B Data related to disease sandhigata vata Section-c Data related to response to the treatment 86
  • 93. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Section-A1. Age and sexTable No.15 Shows distribution of patient in age and sex among 30 treated cases Sl.No. Age Male % Female % Total % 1 30-40 2 6.66 3 10.00 5 16.66 2 41-50 5 16.66 4 13.33 9 30.00 3 51-60 7 23.33 9 30.00 16 53.33 Total 14 46.65 16 53.33 30 100In 30 cases 2 male (6.66%) and 3female (10%) were in 30-40 years age group. 5 male(16.66%) and 4female (13.33%) were in 41-50 years age group. 7 male (23.33%) and 9female (30%) were in 51-60 years age group. More patients were recorded in 51-60 yrsage group. Females were dominant in these study 16 cases (53.33%). Histogram 1 10 9 8 No of Patients 7 6 Male 5 4 Female 3 2 1 0 30-40 41-50 51-60 Age and sex 87
  • 94. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA2. Social and Economical StatusTable No.16 Shows the socio economical status of 30 treated patientsSl.No. Socio Economical Status No. of Patients % 1 Poor 9 30.00 2 Middle class 15 50.00 3 Upper class 6 20.00Total 30 100 The incidence of sandhigata vata is prevalent in the middle class group. 15 out of 30case (50%), poor in group is having 9 out of 30 cases (30%), and upper class group 6 outof 30 cases (20%) was recorded. Histogram 2 16 14 No. of Patients 12 10 Poor 8 Middle class 6 Upper class 4 2 0 Social and Economical status 88
  • 95. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA3. Nature of workTable No.17 Shows the nature of occupation among the 30 treated patients Sl.No. Occupation No. Patients % 1 Sedentary 10 33.33 2 Active 14 46.66 3 Labour 6 20.00 Total 30 10010 patients out of 30 (33.33%) of cases were in sedentary group, 14 patents out of 30(46.66%) cases were in active group, 6 out of 30 (20%) of cases were in labour group.Histogram 3 16 14 No. of Patients 12 10 Sedentary 8 Active 6 Labour 4 2 0 Nature of Work 89
  • 96. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA4. Food habit Table No.18 Shows the food habit a among the 30 treated patients Sl.No. Food Habit NO. Patients % 1 Vegetarian 18 60 2 Mixed 12 40 Total 30 100 According to the food Habits 18 out of 30 cases were vegetarians reaming 12 (40%)patients were using mixed diet. Histogram 4 20 18 16 No. Of Patients 14 12 Vegetarian 10 8 Mixed 6 4 2 0 Food habit 90
  • 97. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA5. Religion Table No.19 Shows the religion among the 30 treated patients. Sl.No. Religion N No. Patients % 1 Hindu 14 46.66 2 Muslim 10 33.33 3 Christian 4 13.33 4 Other 2 6.66 Total 30 100.00 According to religion 14 (46.66%) of 30 cases are Hindu. 10(33. 33) out of 30 casesare Muslim, 4 (13.33) out of 30 cases are Christian, 2 (6.66) out of 30 cases are other. Histogram5 16 14 No. of Patients 12 Hindu 10 Muslim 8 Christian 6 Other 4 2 0 Religion 91
  • 98. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Section –BData related to disease sandhigata vata1. Chief complaintsTable No. 20 Showing the Chief complaints among the 30 treated patientsSl.No. Presenting Complaints No Patients % 1 Sandhi shoola 30 100.00 2 Sandhi shopha 20 66.66 3 Prasaranakunchan vedana 28 93.33 4 Sandhi Sankocha 18 60.00 5 Sandhi stabdata 22 73.33 6 Gamane ativedana 30 100.0 7 Vatapurana druti sparsha 6 20.00 8 Nisharuk 12 40.00 9 Sandhi vishleshana 1 3.33Among the 30 treated patients all are having Sandhi shoola and Gamane ativedana30(100%) . 28 patients are having Prasaranakunchna vedana (93.33%) 22 patients arehaving Sandhi stabdata (73.33%), 18patients are having Sandhigati sankocha (60%),20patients are having Sandhi shopha (66.66%),12 patients are having Nisha ruka(40%),6patients are having vata purana druti sparsha(20%),1patient having Sandhivishleshana(3.33%). Histogram 6 Sandhi shoola 35 30 Sandhi shopha 25 No of Patients Prasaranakunchan 20 vedana 15 Sandhi shopha 10 Sandhi stabdata 5 0 Gamane ativedana Chief complaints Vatapurana druti2 .Duration 92
  • 99. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Table no. 21 –Showing the chonicity among 30 treated patient Sl, No Chonicity No patient % 1 1-6months 6 20.00 2 6-1 years 3 10.00 3 1-2years 4 13.33 4 2-3years 5 16.66 5 3-4years 5 16.66 6 4-5years 7 23.33 Total 30 100.00The duration for which the patients had there illness ranged from 1 month to 5 years, 7patients (23.33) are having duration ranged from 4 to 5years, 6 patients (20%) are havingthe duration of 1 to 6 month, 5 patients (16.66%) are having the duration 3 to 4 years and5 patients (16.66%) are having the duration 2 to 3 years, 4 patients (13.33%) are havingthe duration 1 to 2 years, 3 patients (10%) are having the duration 6 month to 1 year. Histogram 7 8 7 6 1-6months No of patient 6-1 years 5 1-2years 4 2-3years 3 3-4years 2 4-5years 1 0 Duration 93
  • 100. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA3. Involvement of jointsTable no.22 – Showing the pattern of joint involved among the 30 Treated patientsSl.No pattern No patient %1 unilateral 20 66.662 bilateral 10 33.33 Among the 30 patients 20 patients (86.66%) are affecting the unilateral joint at the 4patients (13.33%) are involved in the bilateral joint of the knee. Histogram 8 25 20 No of Patient 15 unilateral bilateral 10 5 0 Involvement of joints 94
  • 101. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA4. NidanaTable no.23- Showing the Nidana among the 30 treated patientsSl.No Aharaja Nidana No % Viharaja Nidana No % pts pts1. Rooksha Bhojana 26 86.66 Nishajagarana 3 102. Tiktaoshana Kashaya 16 23.33 Ativyayama 20 66.663. Alpamatra Bhojana 14 80.00 Atyuchchabhashana 4 13.334. Pramita Bhojana 8 26.66 Bhaya dukha chinta 5 15.66Among the30 patients 26 patients(86.66%)having the history of consumption of Rookshabhojana,16patients (23.33%)having the HO taking of Tiktoshana kashaya,14patients(80%)having HOAlpamatra bhojana and 8patients(26.66%)having HO takingPramitabhojana.In vihara 3patients(10%)belongs toNishajagarana,20 patients (66.66%)belongs to the Ativyayama, 4patients (13.33%) belongs the group Atyuchchbhashanaand5 patients (15.66%)comes under the group Bhaya, dukha,chinta etc. 95
  • 102. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Section C The subjective and objective data of all the patients is assessed before and after the treatment ie the cordinal symptoms of sandhigata vata like pain, stiffness, tenderness also the factors such as swelling, crepitation, time taken for 60feet walk is considered and also it is statistically analysed by paired t- test. Table no 24-Showing the % of clinical symptoms before and after treatment Subjective parameters Pain Stiffness TendernessGR BT % AT % GR BT % AT % GR BT % AT %III 5 16.66 - - III 4 13.33 - - IV 4 13.33 - -II 16 53.33 2 6.66 II 8 26.66 6 20.00 III 8 26.66 2 6.66I 9 30.33 16 53.33 I 10 33.33 10 33.33 II 16 53.33 8 26.660 - - 12 40.00 0 8 26.66 14 46.66 I 2 6.66 10 33.33 0 0 0 10 33.33 Gradation of Pain Gradation of Stiffness Gradation of Tenderness 0- No pain 0- No stiffness 0- No tenderness I- Mild pain I- Mild stiffness I- The patient says the 5-30 minutes joint is tender. II- Moderate pain II- Moderate stiffness II-Patient winces 30-2 hrs III- Sever pain III- Sever stiffness III- Withdraw the joint More than 2 hrs IV- Patient will not Allow the joint to be Touched 96
  • 103. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA1. Pain - It is observed that 5 patients (16.66%) are in grade 3 and 16 patients(53.33%) are in grade 2, 9 patients(30.00) are in grade 1, this is to say that aftertreatment 2 patients (6.66%) are in grade 2, 16 patients (53.33%)are in grade in 1 and12 patients (40.00%) are in grade 0 or relived.2. Stiffness- It observed that before treatment 4 patients (13.33%) are in grade 3. 8patients (26.66%) are in grade 2. 10 patients (33.33%) are in grade and 8 patients(26.66%) are in grade 0.it is observed that after the treatment 6 patients (20%) are ingrade1. 14 patients(46.66%) are in grade 0 or relived.3. Tenderness- It is observed that 4 patients are (13.33%) in grade 4. 8 patients (26.66%)are in grade 3,16 patients (53.33%) are in grade 2, 2 patients (6.66%) are in grade 1,after treatment it is observed that 2 patients (6.66%) were in grade 3,8 patients (26.66) arein grade 2.10 patients (33.33%) are in grade 1,and 10 patients (33.33%) are in grade 0 orrelived. 97
  • 104. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Table no.25 showing the % of objective parameters before and after the treatment Objective parameters Swelling Criptaion Walking timeGr BT % AT % Gr BT % AT % Gr BT % AT %III 4 13.33 0 I 18 60.00 5 16.66 IV 1 3.33 0 0 20.0II 8 26.66 6 0 12 40.00 25 83.33 III 3 10.00 0 0 0 26.6 I 8 26.66 8 II 6 20.00 4 13.333 6 53.30 10 33.33 16 I 8 36.66 6 20 3 0 12 40.00 20 66.666 Gradation of Swelling Criptation Walling Time 0-No Swelling 0-Nil I – 20-40 Second I Mild swelling I – Present’ II – 40-50Second II Moderate swelling III – 50-60second III Severe IV – 60-Above 98
  • 105. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA1. SWELLING---- It is observed that before treatment 4 patients (13.33%) are in gradeIII, 8 patients (26.66%) are in grade II , 8 patients (26.66%) are in grade II,10 patients(33.33%) are in grade I , 10 patients (33.33%) are in grade 0. After treatment 6 patients(20.00%) were in grade II, 8 patients (26.66%) were in grade I and 16 patients (53.33%)were in grade 0.2. CRIPATION: It is obsevered that before treatment 18 patients(60%) are in grade I ,and 12 patients(40%) are in grade 0, , after treatment 5 patients(16.66%) are in grade I,and 25 patients(83.33%) are in grade 0,3. WALKING TIME------ It is observed that before treatment 1 patient (3.33%) are ingrade IV,3 patients (10.00%) are in grade III, 6 patients (20.00%) are in grade II,8patients (26.66%) are in grade I, 12 patients (40.00%) are in grade 0,after treatment it isobserved that 4 patients(13.33%)are in grade II.6 patients(20.00%) are in grade II, and 20patients (66.66%) are in grade 0. 99
  • 106. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA STATISTICAL ANALYSIS Table no.26 showing the statistical analysis of 30 patientsParameter Mean S.D S.E t-value p-value RemarksPain 1.2 0.407 0.074 16.216 <0.001 H.SStiffness 0.566 0.504 0.092 6.152 <0.001 H.STenderness 1.4 0.563 0.102 13.725 <0.001 H.Screpitation 0.433 0.504 0.092 4.706 <0.001 H.SSwelling 0.566 0.568 0.103 5.495 <0.001 H.SWalking 0.633 0.556 0.102 6.205 <0.001 H.StimeConclusion: All the parameters shows highly significant by using paired t-test.The parameter pain shows highly significance (as P<0.001) in parameter, and tendernessis have the net more mean effect .The swelling has more variation, the effect in the parameter stiffness and swelling issame.The variation stiffness and crepitation is same,The parameter pain is having uniform net effect on the patient (by comparing co-efficient of variations) 100
  • 107. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA DISCUSSION The study “preparation physco chemical anylasis of darada vati and evaluation ofits clinical efficacy on sandhigatavata (osteoarthritis). Is presented in four chapters:1. Literary study 2. Pharmecitical study,3. Anylitical study, 4. Clinical study.Literary study: this included drug and diseases reviewDrug review: in drug review hingula is reviewed in detail and herbal (shodhana andbhavana) drugs also reviewed.Hingula: Historical ascepts – Hingula was known since koutilya period but in that day itwas used only for loha vada. In Samhita, sangraha kala no reference available abouthingula. However in this period only reference for parada is available. In a rasakala and nighantu kala therapatic uses of hingula was available.Rasagrantha written by nagarajuna i.e rasarathanakara was first mentioned the propertiesand therapatic uses, and also used for marana process of other hard metals like iron,copper, gold etc.Later number of rasagranthas mentioned properties uses availability, varieties, shodhana,satvapatana (hingulakrista parada) and they also mentioned artificial preparation.Class: hingula kept in different classes according to different opinions of rasagranthas. Asit is classed under maharasa and rasa class. The important of hingula can be thoughthingula is major source of parada, later some acharyas kept hingula in uparasa becausethe sources of hingula became less and they got native parada, After this some acharyaconsidered hingula in sadharana rasa varga in this period natural source became very lessand artificial preparation has brought into practice. This lead to consider it assadharana rasa.Dathu varga: according to nighantu these consider as a one of dathu forthat reason kept in dathu varga.Rasa dathu varga: rasaamritakara has classified drugs according to their main ingredient.As hingula is containing main ingredient as parada so this is considred in rasadathuvarga. 101
  • 108. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATASynonyms: indicate the source, composition uses and colour of the drug.According to the name chinipisti, mleccha, darada, hingula etc. shows place of origin andavailability. Rasagarbha, churna parada etc, these name show presence of parada,rasagandha sambhuta, gandhika by this we know the presence of gandhaka. lohaghna,rathnaragakari, ranjani, these name indicate uses of hingula, hamsapada, charmara,shukatunda, bimbiphala, pravalaba, kunkuma,raktakaya, rakta, etc. indicate colour ofhingula and also other materials present in that. In this colouring temperature has mainrole in formation of compound.Origin: In this point rasaratna samucchaya in first chapter mentioned the origin ofhingula.Shodhana : the concept of shodhana is to make the hingula to easy absorption and itseparates the other foreign materials present in that.By swedhana it sperats the foreignmetriel and hingula.After again subjected to bhavana to check the bad effect by thoseorganic acids and organic sulpphur compounds and other elements present in herbal juice. They also enhance the property of hingula by adding their property to that.Marana: Very least references are available for marana of hingula.as the shodhita hingulaattains properties like rasasindhura and as it contains gandaka marana is not told.However marita hingula may have more properties than shodita hingula. The actions likeatyantaagni deepaka, kamottejaka, dorubalya nashaka, atimedhya, atirasayana are in themaritha hingula.Artificial preparation: After 13th century artificial preparation of hingula was mentionedbecause the deficiency of natural source of it. In that period they were known aboutchemical composition. To prepare hingula different authors mentioned.Anupana: guduchji, tambula, maricha, guda, pipali, are maintained.Matra: a matra of hingula is similar to parada yoga like rasa sindura, kajjali, paradabhasma; here the matra is ½ to 2 ratti (62.5- 250 mg) in divided dose per day.Uses: Hingula in shodhita avasta, acts on gastro intestinal, geneto urinary and nervoussystem it also have the actions like agnideepaka, yakrita plihavikara, mehaghna,kamottejeka, balya, medhya, rasayana and sarva rogahara.etc.Marita hingula: this is having more penetrating property than the shodita hingula. It hasproperties like atyantaagni deepaka, kamottejeka, ati rasayana property. 102
  • 109. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAPreparation: Nomber of preparations of hingula are available in many text,preparationslike , Hinguladya rasasindura, Hinguliya manikya rasa , Darada bhasma, Darada vati,Ananda bhairava rasa, Shatarka darada, Shree Siddha daradaamrita etcHerbal drugs: Used for shodhana and bhavana of hingula. Shodana dravyas are meshi dugdha and nimbu swarasa, Meshi dugdha itreduceses the tikshnata of hingula by madhura rasa seetaveerya, madhura vipaka and italso contains much nutrients which are helpful in nourishmentNimbhu swarasa is rich of citric acid and vitamin c these help in much enzymatic actionof cells and also by oxidation property it prevents the complications caused by hingulaand there by maintain normal functions of cells.Other bhavana drugs.1 Rasona – Rasona is one of the pathya dravya in sandhigata vata. Itcontains 55% carbohydrates 29% protein vitamin c, organic sulphur and theircompounds. It also contain other elements like calcium, iron, copper, all these are helpfulin diseases, helps in promoting the digestion and absorption of yoga. The oil present inrasaona.there by it enhances the property of hingula and cures the disease2. Phalandu: It has similar property of rasona. It also contains organic sulphurcompounds vit A, B and C and also contains like calcium, iron, potassium, butcarbhohydrate is less percentage.3. Tambula- Tambula is an important anupana dravya mentioned in classic for paradaand hingula. It also contains many elements like calcium, phosphorus, iodine, potassiumnitrate, and vit A, C and also has anti-oxydant property. It enhances the propery ofhingula and checks the complications.4. Ardraka – Ardraka contains rich starch and protein, gingerol present in that is majorprincipal. Ginger acts as the adsorbent, carminative. Adsorbent property of ginger on GItract causes adsorption of toxin and acids. It enhances the gastric motility by carminativeproperties. It blocks the hyper reaction of gastric cells All the herbal drugs used for the prepartion of darada vati have the similarpoperties of hingula by this they enhance the property of hingula. Those properties arevatakaphashamaka, vedhanashamaka, shothaghna, balya, rasayana, agnideepaka, hridya,pachaka.vatanulomaka etc. These properties are explained in nighantu.samhita and they 103
  • 110. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAalso suppress the complications may be caused by hingula the complications may arisedfrom hingula are moha, brama, hriudaya avasadhaka, klaibhya, klama, prameha etc.Diseases review: Sandhigata vata is well known to the Ayurvedic authorities since fromthe good hold period Rugveda, Yujarveda, Athranaveda, Purana, Brihatrayi, Lagutrayi,and other samhita, Rasa granthas.All authoretis considerd Sandhigata vata under theheading of vatavyadhi so the Nidana of Vatavyadhi is to be considerd as a Nidana ofSandhigata vata.(Dhatu kshayajanya and Margavarodhajanya).The common signs andsymptoms are Sandhishoola,Sandhishotha,Gamaneativedhana,Sthabdhataetc,Madhavakara was the first person who mentioned one more laxana ie Atopha andAshtanga sangrakara mentioned special laxana ie Vata purana driti sparsha.The signs and symptoms of Sandhigata vata resembles the Osteoarthritis characterized bypain, stiffnes, swelling and tenderness, which is the resultant of Degenarative andInflamation of joint. Most of the Ayurvedic autheraties differentiated with Vatarakta,Amavata, and Kroshtuka sheersha.Even modern authorites differentiated with rheumatoidarthities, Gout, Tubecular arthritis, Gonococal arthritis, and Rheumatic fever. Now daysthis diseas becomes common due to change in life style. Sushruta acharya was the first person who correlated Sadhigata vata with Vata raktawhere the Nidana and treatment is same in both diseas but samprapthy is differs. Thecommon line of treatment is Snehana, Swedhana, Abhynga, Basti fallowed byShamanoushadhi.Sushruta acharya being a Shalya karma specialist mentioned one morespecial treatment ie Agni Karma..Pharmaceutical Study: In preparation of Darada Vati Shodhana, Bhavana, and VatiNirmana these are the procedure adopted here1. Shodhana of Darada: Shodhana process is done by one meshikshira Bhavana and seven nimbu swarasa bhavana in some texts shodhana is mentioned with seven meshikshira bhavana and seven nimbu swarasa bhavana or any amla dravya swarasa bhavana. Now a days used hingula is artificial preferred one this does not have any other materials, so one meshikshira Bhavana and seven nimbu swarasa bhavana sufficient, for shodhana karma of hingula. Rasa taranginikara has told that after nimbu swarasa bhavana prakshalana is to be done with jal up to complete niramlatva. 104
  • 111. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA But here prkshalana is not done because bhavana dravya help full in disease this contains citric acid, vitamin C, and other organic things. After this shodhana colour of hingula becomes kunkum varana or pravalavarana, after shodhana it gians becous of the weight of bhavana dravya2. Bhavana: Shodhita hingula is again subjected to bhavana with Lasuna, Palandu, Tambula and Ardraka swarasa seven times with each sawrasa .Here shodhita hingula is fit for use in any disease but bhavana dravyas make hingula potential against the pathology of sandhigata vata and other vata kaphaja diseases. Lasuna bhavana becomes very difficult due to very thick and sticky nature of its swarasa. It takes more time then nimbu swarasa bhavana. The colour of hingula is bright yellowish red colour, odour is in garlic nature. palandu bhavana reduces the stickiness of lasuna bahavitha hingula. Tambula patra swarasa also reduces the stickiness. The colour becomes greenish red colour; odour is mixture of previous bhavitha dravya. Ardraka swarasa bhavana Here ardraka is also rich in starch and fibers makes the hingula to fit for vati nirmana and also enhance the property of hingula.The use of these drugs enhance the vyadhi shamaka and rasayana property of hingula3. Vati nirmana: when seventh Ardraka bhavana is given and paste becomes fit for preparation of vati then stop the bhavana process make varti and prepared vati about one ratti pramana. These vatis were not dried even after seventh day. Later kept in sunlight then they became again very smooth due to sun rays. Again Ardraka satwa (30 gm) is added to it and Ardraka sawrasa bhavana was given till it attain the consistency to prepare vati. Then the vati is prepared. The vati are gradually dried completely and preserved in air tight containerAnylatical study: Organaleptic text of vati shows the odour and taste of vati were pungent (mixtureof all herbal smell and taste), appearance, shape and colour property are shiny, spherical,brick red in colour.All these properties were seen due to shodhita and bhavita dravyaswarasa.Particle size - The partical size of shodhita hingula 112 micron and after completion ofbhavana it become 34 mircon. This test indicate the process of bhavana reduces the 105
  • 112. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAparticle size of hingula.This reduced particle may enter in to very minute channels oftissues.Loss on drying 1100C – Here vati losses the weight 7% , this indicates 7% of moistureand volatile oil present is present in the vati, therefore these vatis always preserved in airtight container and kept in moisture free conditionHardness: The hardness of vati is 7.5 ± 0.5 kg. It indicates Darada vati has goodmachanical strength so it can resist the transportation and manual handling damage.Thehardness value of vati is moderate (maximum10kg), so its dissolution rate is alsomoderate.Weight in variation: Vati prepared manualy so this is necessary to find out the weightvariation of vati, by this test we confirm that ±6.67mg % variation is present(125±6.67mg). Which is more than the Pharmocopheal standerd value but to prepare thevati 10% Ardraka satwa is added so this value can be taken as a standerd one when it iscompaired with the only concentrated drug.It indicates this vati contains 95%ofpotenciated drug.Shape and size: Shape of vati is spherical; by measuring the diameter of vati 4.41mmlength and four readings are taken from each tablet we confirmed that ±0.14mm variationpresent in diameter. This value is comes under the Pharmaco pheal stander value ( +5%).It indicates even though vati is prepared manualy but the standerd dose is maintaindvery perfectly means vati is prepared in standerd manar.Friability Test: The rate was 1.57 % weight loss. It indicates in packing system frictionbetween container and vati, it may because the 1.57%weight of variation in each tabletthis value is slightly greater than the Pharmacopheal standerd value (0.5-1%). It might bedue to over dring of trhe drug, so during dispening it should be paked completly byputting some amount of cotton in container so that it can resist the mechanical damage.Assy for mercury: assy for mercury was done the value obtained indicate each vaticontain 20% of mercury w/w.Assy for sulphur: The value obtained indicates 9.21 % of total sulphur w/w.Ash value: The ash value determined after complete removal of carbon from the sample.This carbon removed at about 4500C. The remaining material may be some inorganicelements. The value is 6.42% ash w/w.which comes under the Pharmcopheal standerdvalue (13 to15%w/w). 106
  • 113. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAAcid insoluble ash: Darada vati has the Acid in solubale ash value 2.13%w/w .Which isless than the Pharmacopheal standerd value (2.5%w/w), it indicates it does not containany Silicus matter so it does damage the vital organs.Clinical Study:Plan of study: In this study a specific plan and design was adopted for better analisation.total 45 patient were reported with clinical symptoms of Sandhigata Vata among 35patients included in the study, satisfying the diagnostic criteria, 30 patient are completedthe course of treatment.The excluded cases are above 60 year, Diabetic, Trauma, Hypertension, Muscle wastingand above 5 years history.Selection: The disease was diagnosed as sandhigata vata based on the sign andsymptoms explained in classical Ayurvedic and modern text, routine blood text wereconducted to rule out infection and other pathologies.General Description of patient: Age and sex- In total 30 patient more patients 16 (33.33)are in 50-60 years. Females were dominant 16 (53.33) this in indicates the disease morepredominant in female and during the period after 50 yearsSocio Economical: In this 15 patients are in middle class the areas were the study isconducted was dominated by business people; here there is no relation between socialand economical status with sandhigata Vata.Nature of work: In this 14 patient (46.66%) are in active group due to the continues stressaffecting on joints due to activeness at the particulars joint become degenerated causingSandhigata Vata, 10 patient (33.33%) were in sedentary in this mostly the house wife andtable worker.Food habit: 18 patient (60%) are vegetarian, remaining 12patient (40%)are belongsmixed food habit , in this locality the availability of vegetarians are more due to thevegetable cultivation and highly populated by Hindus those who are strict in takingvegetarian dietReligion: 14 patient (46.66%) are belongs to Hindu, 10 patient (33.33%) are Muslim,6patients belongs to other religion there is no relation between religion because thepopulation dominancy. 107
  • 114. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATANidan: Among 30 patient Aharaja Nidan-- Roksh Bhojan Sevena is noted in 26 patients(86.66%) and Katu Tikata Kashaya rasa pradhana bhojana is noted in 16 patients(23.33%). In study conducted place the people are more used to take Roksh Bhojan,TiktaKatuKashaya bhojana. Viharaja Nidana-- Ativyayamaja 20 patient (66.66) ispresent, due to excess use of joint leads to degeneration of jointPresenting complaints: In this 30 treated patient all were (100%) presented withSandhishoola and Gamane ativedhana. 28 (93.33%) are in Prasarana Akunchana Vedana,22 patient (73.33%) are Sandhi Stabdata, 20 patient (66.66%) are in Sandhi shopha and12 patient (40%) are in Nisharuk only few patient complaints, 6 patient (20%) are in VataPurana Druti Sparsha, 1 patient (3.33%) having Sandhi vshleshana.Chonicity- In this 30 treated patient 7 patient (23.33%)are having H/O 4-5 years, 5patients (16.66%) are having H/O 2-4years, 5 patient (16.66) are having H/O 2-3 years, 4patient are (13.34%) having H/O 1-2 years from this it is highlighted the chonicityincrease towards the later stages of age.(50-60)Probable of mode of action of Darada Vati in Sandhigata Vata;Sandhi gata vata is caused by the vitiation of Vata and Kapha (vyana vayu vriddhi,shleshaka kapha kshaya) here kapha kshaya means Shleshaka kapha loses its normalgunas(shnigdh, guru,manda,etc)ther by it does not performes its normal function leadingto Pain, Stiffness, Tenderness,Swelling etc in joint.This theory is also belived by the modern authority ie in Asteo arthritis when our bodydoes not produces enough amount of Glucosamine and Chondrotin the synovial fluidloses its viscocity and convert into watery solution which does not perform its normalfunctions ie Lubrication , Shearing, Nourishment of cartilage etc resulting in toDegenration and leading to same pathology. The Darada Vati can reduces the symptoms as well as degenerative process due toaction of Darada, Meshikshira, Nimbu Swarasa, Lasuna, Palandu, Tambula, and ArdrakaSwarasa,It is very difficult to draw the exact mechanism of action of Darada Vati but by observingthe theoraphitic effect hypotheses can be presumed for the mechanism.The drugs of theVati all are VataKapha Shamaka, Agnivardhaka Balya, Rasayana, Vedanashamaka,Shothghna etc. 108
  • 115. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATADarada which is the main content. of the preparation, the property of the Darada equal tothe Rasa Sindoor ie the properties are Tridoshaghna, Atirasayana, Agniverdhaka, Balya,etc.As Darada is purified by giving Bhavana with Meshidhugdha, and Nimbu Swarasa, thesewill check the toxic effect of Darada, Nimbu Swarasa is rich in citric acid and vitamin c,this normalize the functioning of living cells and involves in many enzymatic function inthe body, it also play main role in the development of cartilage, bones and in woundhealing, it also has the antioxidant property which counteract the Degenration.The other bhavana drugs like Lasuna ,Plandu,Tambula, Ardraka Sawrasa arehavingVataKaphahara, Rochaka,Pachaka,Agnipradeepaka,Rasayana,Vedana Sthapaka,Shothaghna,etc property will help in enhancing the absorption of Darada,even Rasona,Tambula,Ardraka having atioxydent property which conteract the Degenaration, so thispotentiated Darada, mitigates the Kapha Dosha(bringes the normal gunas ie snigdha,guru,sthira, manda etc) by its Ushna Veerya it clears off the blockages of channels and givestrength to Sandhi by proper nursing of cartilage , bone, synovial fluid . 109
  • 116. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA SUMMARYThe present study titled “Preparation, physico chemical analysis of Darada vati andevaluation of its clinical efficacy on Sandhigata Vata (Osteoarthritis)This study includes the following chapter that is1. Introduction2. Objective3. Review of literature4. Methodology, which contains pharmaceutical study, analytical study and Clinical study.5. Results.6. Disscusion,7. Conclusion1. Introduction - In the introduction part, importants of Ayurveda, aim and objective ofRasa Shastra, importants of Parada and properties of Darada, Discription of SandhigataVata, and necessity for the assortment of this research work is explained in brief.2. Aim and objectives of the present study are mentioned in the objective chapter3. Review of literature is dealt in two main headings 1.Drug review 2.Disease review.Drug review- Historical first referance of hingula, synonyms, classification, occurance,properties, standard qualities of hingula, ashuddha, agrahy hingula dosha and chikatsa,shodhana, marana, satwapatana, uses, anupana, matra. Modern view of Hingula physicalproerties and chemical properties, verities.Disease Reviewed- Deals about Historical, Etymology, Defination, Nidana Panchaka andLine of treatment according to various authorities.Modern aspects also review.Materials and Methods This deals about pharmaceutical, analytical, clinical study. 1.Pharmaceutical study includes Daradashodana, Darada Bhavana, and Daradavatinirmana2. Analytical study deals about Physico chemical analysis of Dharadavati carried out inIndian bureau of mines, regional ore dressing laboratory, Bangalore and some physicalanalysis carried out in J.T.Pharmacy College, Gadag. 3. in clinical study-special campswas conducted by post graduate department of Rasashastra DGM Ayurvedic medical 110
  • 117. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATAcolage and hospital Gadag. The patient of sandhigata vata after the complete diagnosiswere selected, clinical trial was done administering Darada Vati 125mg bid withUshnajala Anupana for 30day and the patients were assessed for the same criteriaIn the clinical results the patients were assessed according to the subjective and objectivecriteria and results are given with the help of statistical value P-value,t –value, S.D, S.Eetc.In the chapter discussion first drug and disease discussion has been done in both the viewthat is Aryuveda as well as modern aspect. In the part of pharmaceutical discussionShodhana, Bhavana, rationalities were discussed.In analytical discussion role of Physico chemical analysis of Darada Vati is discussed andin clinical discussion of Sandhigata Vata patients as well as probable mode of action ofDarada Vati explained. CONCLUSSION1) Parada and Gandhaka yogas are consided superior in Rasa shastra, so Hingula iscompound of Parada and Gandhaka has the properties similar to the Rasasidhura hanceDarada vati is to be considerd suprim in Sandhigata vata.2) After pharmaceutical procedure Hingula become non toxic and theraphaticallyeffective, the specific drugs used in procedure may check the pathogensis and normalizesthe function of tissue.3) Procedure bhavana make the partical size of the Hingula in very micro form(34micron).4) Physico-chemical analytical study of vati passes all the Pharmcopheal standerd valueand assy of Mercury is 21%, Sulphar is 9.1%.5) By clinical evaluation we conclude that it reduced the subjective and objectiveparameters of disease. 111
  • 118. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA SCOPE OF STUDY1) Comparative study is necessary between other Parada Gandhaka yogas(kajjali, rasa sindhura, rasa perpati ) in degenarative joint disease.2) Hingula is considerd as ati rasayana so how for it encounters theDegenaration in Osteo arthritis or in Degenarative disorders is to necessaryto analyze it by experimental study. 112
  • 119. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA REFERENCE1. Srimad Govindbhagavatpada-Rasa Hridaya tantra, Chaturbhuja mishra edition 2, 2001 Choukambha publisher varanasi,chap 1 sloka 12 page 92. Nagarjuna-Rasendra Mangala-Kaviraj H.S Sharma Edition I, 2003 Chouknumbha Orientalia Varnasi Chap 1,3,4,Sloka 43,56,1893. Inderdev Tripati Rasarnava-Edition 4th, 2001, Choukhumba Sanskrit Series Office Varanasi Chap 6, 7, Slok103, 46, Page79,1094. Nithayanath Sidda- Rasaratnakara, Swaminath Mishra –Edition 1, 1991, Choukambha Orientalia Varnasi Chap21,Sloka41-45,Page3015. Sri. Vagbhatacharya- Rasaratna Samucchaya, Sri Dharmananda Sharmana Edition 2ndReprint 1996 Motilala Baanarasidasa Publication Chap3 Sloka147-154 Page60-616. Sri. Gopalkrishnabhatta-Rasendra Sara Sangraha, Interdev Tripati Edition 3rd 2003 Choukambha orientalia Varnasi Chap1 Sloka114-115, 226-231 Page86-87, 140-1447. Sri. Sadanad Sharma- Rasa Tarangini, Kashinath Shastri Edition-11.2000 Motilal Banarasi Dass Varnasi Chap9 Page 198-2088. Acharya Madhava- Ayurveda Prakasha, Sri. Gulrajsharma Mishra. Edition 2nd reprint 1999, Choukambha Bharti Academy Varnasi Chap2 Sloka69-86 Page273-2779. White Law Ainslie – Materia indica –Volume 2 Chapter 2 X1Xpage 540 -54610. Sri. Vagbhatacharya- Rasaratna Samucchaya, Sri Dharmananda Sharmana Edition 2ndReprint 1996 Motilala Baanarasidasa Publication Chap Hingula prakaran Page 20811. Rasarnava-Indradeva Tripati Edition 4th , 2001, Choukhumba Sanskrit Series Office Varanasi Chap 7, Sloka2 Page8612. Sri. Vagbhatacharya- Rasaratna Samucchaya, Sri Dharmananda Sharmana Edition 2ndReprint 1996 Motilala Baanarasidasa Publication Chap6 Sloka45Page11313. Vaidy Sri Chudamani --Rasakamadhenu Part I Vaidy Sri Yadavaji Trikamaji Acharya 1990 Choukambha Orieostalia Varanasi , Dvitiya Dhatu Sangraha Pada Tritiyodhikar page233-23414. Sri. Gopalkrishnabhatta-Rasendra Sara Sangraha, Interdev Tripati Edition 3rd 2003 Choukambha orientalia Varnasi Chap1Sloka114-115Page86-87 113
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  • 123. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA63. Acharya Madhava- Ayurveda Prakasha, Sri. Gulrajsharma Mishra. Edition 2nd reprint 1999, Choukambha Bharti Academy Varnasi Chap2Sloka72Page27464. Niranjan Prasad -Parad Samhita 1997 Choukambha publication Varnasi chap 51 page 44465. Pundit Ram Prasad-Rasendra Purana-2000 Khemaraj, Sri Krishnadas Prakashan, Mumbai chap5sloka10page140-14266. Sri. Gopalkrishnabhatta-Rasendra Sara Sangraha, Interdev Tripati Edition 3rd 2003 Choukambha orientalia Varnasi Chap1Sloka47.48Page5067. Sri. Vagbhatacharya- Rasaratna Samucchaya, Sri Dharmananda Sharmana Edition 2ndReprint 1996 Motilala Baanarasidasa Publication Chap3Sloka154Page6168. Acharya Yashodhara- Rasaprakash Sudakara, Siddinandanmishra Edition 2nd 1998 Choukambha orientalia Varnasi Chap3Sloka2,5Page5269. Sri.Krishnarum, Bhatt, Siddha Bhaishajya Manimala Sri.K.Kaludhara Bhatt Edition 3rd .2003. Choukambha Krishnadas Academy Varanasi Chap5Sloka3,6page 35370. Nithayanath Siddha- Rasaratnakara, Swaminath Mishra –Edition 1, 1991, Choukambha Orientalia Varnasi Chap2Sloka48-53Page20-2171. Sri Govindadasa- Bhaishajya ratnavali-Kaviraja Sri Ambhikadatta Shastra Edition-17 2002 , Choukhumbha Sansthan varanasi, Chap5,6Sloka473,474,482,76,78,Page8272. Sri. Gopalkrishnabhatta-Rasendra Sara Sangraha, Interdev Tripati Edition 3rd 2003 Choukambha orientalia Varnasi Chap3Sloka3-4Page31573. Acharya Yashodhara- Rasaprakash Sudakara, Siddinandanmishra Edition 2nd 1998 Choukambha orientalia Varnasi74. Yadavji Trikamji-Rasamrta. Dr. Damodhar Joshi Edition-1st 1998 Choukambha Sanskrit Sansthan Varanasi Chap1Sloka55-56Page2775. Pundit Dutaaram Choube Rasa Tantra Sara Editon3rd 2000 Choukambha orientalia Varanasi page 24 and 55376. Sri. Sadanad Sharma- Rasa Tarangini, Kashinath Shastri Edition-11.2000 Motilal Banarasi Dass Varnasi Chap9Sloka25-62Page203-20977. Vaidy Sri Chudamani --Rasakamadhenu Uttardha Vaidy Sri Yadavaji Trikamaji Acharya 1990 Choukambha Orieostalia Varanasi , Chap33 Sloka242-244 Page78. Damodar Joshi-Rasashastra, Dr.K.P.Sri.Kumari Edition 1st !986 Kerala Govt. Ayurvedic Publication series Kerala Section 2 Page 176 117
  • 124. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA79. Sri. Vagbhatacharya- Rasaratna Samucchaya, Sri Dharmananda Sharmana Edition 2ndReprint 1996 Motilala Baanarasidasa Publication Chap3Sloka154Page6180. Dr.K.M Nadakrani – Indian Materia Medica Volume II – A.K Nadakarni Edition 3rd Reprint 2002 Popular Prakasha Bombay ,page 18581. Vagbhatacharya- Astanga Sangraha, Sutrasthana Dr. Ravi Datta Tripatia Edition 2nd 1992, Choukambha Sanskriti pratisthana varanasi Chap6Sloka59Page10082. Dr. Gynandries Pandya- Dravya Guna Vignana Value 1 Edition 2nd 2002 Section 2 79-191, Page 45983. Dr. J L N Shastri- Dravya Guna Vignana Volume 3 2nd Edition, 2002 Page 105-10784. Trease and Evans-Pharmacognosy Edition 14th 2001, WB Sunders company Ltd. London Page 445-45085. Dr. Gynandries Pandya- Dravya Guna Vignana Value3 Edition 2nd 2002 Section 238- 24886. Dr. J L N Shastri- Dravya Guna Vignana Volume 3 2nd Edition, 2002 Page 531-53587. Dr. Gynandries Pandya- Dravya Guna Vignana Value 3 Edition 2nd 2002 Page 11-1688. Dr. J L N Shastri- Dravya Guna Vignana Volume 3 2nd Edition, page 996-99789. Kartika Chandrbhosa-Pharmacopoeia Indica Edition 1st 1984, the book company Ltd. College Square Calcutta,90. Dr. Gynandries Pandya- Dravya Guna Vignana Volume 3, Edition 2nd 2002 page 602-60791. Kartika Chandrbhosa-Pharmacopoeia Indica Edition 1st 1984, the book company Ltd. College Square Calcutta. page-135-13692. Dr. Gynandries Pandya- Dravya Guna Vignana Volume 1 Edition 2nd 2002 Section 2, page 179-191,93. Dr. J L N Shastri- Dravya Guna Vignana Volume 3, 2nd Edition, page 519-52694. Agni Vesha, Charaka- Charaka Samhita ,chikitsa stana, Pt. Kashinatha Shastri th Edition 6 , 2000 Choukambha Publication New,Delhi,Chapt28, Sloka 39, Page 78395. Sushruta Acharya-Sushruta Samhita, Nidana stana Dr. Ambhika Datta Shastri Edition 13 , 2000, Choukambha Publication Chapter 1, Sloka 28, Page 23096. Vagbhatacharya- Astanga Sangraha, Nidana Prof.K.S.Srikanta Murthi Edition 1st 1996 Choukambha publication Varnasi Chap 15, Sloka 14, Page243-4 118
  • 125. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA97. Bhelacharya- Bhela Samhita Chikitsa Stana – Sri Girija Dayalushukla Edition 1, 1959 the Choukambha Vidya Bhavana Varanasi Chapter 26, , Sloka 3,Page 22098. Madhava Kara – Madhava Nidana – Purvardha , Ayurveda Charya, Sri Yadunanndana Upadaya , Edition 13th , 1994 Choukambha Sanskrit Sansthana Varanasi , Chapter 22, Sloka 21, page 418.99. Sri Bhava Mishra–Bhava Prakasha,chikitsa, Uttar Tantra, Sri Brahama Shankara Mishra Edtion 6,1984 Choukambha Sanskrita Sansthana Varanasi, Chap24,Page 227100. yogarathanakara – yogarathanakara purvardha, vaidhya- lakshmipati shastri edtion 4, 1988, Choukambha vishwa bharathi, varanasi, sloka 1,page 505.101. Ayurveda samivalana oct 2003102. W.N Kelly el al , The text book of Rheumatology, edition 5, 1995,103. Bhattayacharya TT – sabdastomamahanidhi 1997 choukamba series varanasi104. Sushruta Acharya-Sushruta Samhita, sharira stana Dr. Ambhika Datta Shastri Edition 13 , 2000, Choukambha Publication Chapter 5, Sloka28-34, Page 46105. Bhattayacharya TT – sabdastomamahanidhi 1997 choukamba series varanasi106. Bhelacharya- Bhela Samhita Chikitsa Stana – Sri Girija Dayalushukla Edition 1st 1959 the Choukambha Vidya Bhavana Varanasi Chapter 26, Page 220,107. Vagbhatacharya- Astanga Sangraha, Dr. Ravi Datta Tripatia, edition 2nd, 1992, Chap 19, sloka 3, page 358108. Agni Vesha, Charaka- Charaka Samhita, vimana stana Pt. Kashinatha Shastri Edition 6 , 2000 Choukambha Publication New,Delhi,Chapt 8, Sloka 98, .Page 773109. Agni Vesha, Charaka- Charaka Samhita,sutra stana Pt. Kashinatha Shastri Edition 6th , 2000 Choukambha Publication New,Delhi,Chapt12 , Sloka 7, .Page245110. Vagbhatacharya- Astanga Sangraha,sutra stana Dr. Ravi Datta Tripatia, edtion 2nd , 1992, Chap19, sloka 3, page 357111. Vagbhatacharya- Astanga Sangraha, Dr. Ravi Datta Tripatia edtion 2nd , 1992, Chap19, sloka13, page 364112. Agni Vesha, Charaka- Charaka Samhita, chikitsa Pt. Kashinatha Shastri Edition 6 , 2000 Choukambha Publication New,Delhi,Chapt 28, sloka 39, page 783113. Sushruta Acharya-Sushruta Samhita, Nidana stana, Dr. Ambhika Datta Shastri Edition 13 , 2000, Choukambha Publication Chapter 1 , sloka, 28, page 230. 119
  • 126. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA114. Madhava Kara–Madhava Nidana, Purvardha , Sri Yadunanndana Upadaya , Edition 13th , 1994 Choukambha Sanskrit Sansthana Varanasi , Chapter 22, sloka 21, page 418115. Samuel L Turek orthopedics principals and their applications edition IV 1989, Jaypee brothers New-Delhi116. Harrison’s, principals of internal medicine Volume 2 Part 12 section3 Kenneth P. Brandt edition 14th 1984, Asian student. singpur page 1935,1936117. Harrison’s, principals of internal medicine Volume 2 Part 12 section3 Kenneth P. Brandt edition 14th 1984, Asian student. singpur page 1939,1941118. Sushruta Acharya-Sushruta Samhita, sharira Dr. Ambhika Datta Shastri Edition 13, 2000, Choukambha Publication Chapter 5 sloka 29, page 46.119. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia, edition 2, 1992, Chap 20, Sloka6, page 380.120. Sushruta Acharya-Sushruta Samhita, sutra stana, Dr. Ambhika Datta Shastri Edition 13, 2000, Choukambha Publication Chapter 21, sloka 14, page 90.121. Indrabirsingh – text book of anatomy, vol. 1, edition 2, Jaypee brothers, New Delhi122. Vagbhatacharya- Astanga Sangraha, sutra stana, Dr. Ravi Datta Tripatia edition 2nd, 1992, Chap1, sloka 36, page 15.123. Vagbhatacharya- Astanga Sangraha, sutra stana, Dr. Ravi Datta Tripatia, edition 2nd, 1992, Chap1, sloka 34, page 14.124. Sushruta Acharya-Sushruta Samhita, sutra stana, Dr. Ambhika Datta Shastri Edition 13, 2000, Choukambha Publication Chapter 21, sloka 5, page 87.125. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia, edition 2 , 1992,Chap1, sloka 25, page 9.126. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia edition 2nd , 1992,Chap1, sloka 25, page 9.127. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia edition 2nd, 1992, Chap1, sloka 46, page 20.128. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia edition 2nd, 1992, Chap21, sloka 9, page 399.129. chap1,sloka27,page20 120
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  • 128. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA146. Agni Vesha, Charaka- Charaka Samhita, chikitsa stana Pt. Kashinatha Shastri Edition 6th , 2000 Choukambha Publication New,Delhi,Chapt28 Sloka58 Page775147. Agni Vesha, Charaka- Charaka Samhita Sutra Stana , Pt. Kashinatha Shastri Edition 6th , 2000 Choukambha Publication New,Delhi,Chapt15 Sloka7 Page200148. Sushruta Acharya-Sushruta Samhita, chikitsa stana, Dr. Ambhika Datta Shastri Edition 13, 2000, Choukambha Publication Chapter4 Sloka5-8 Page78.149. Robert berkow – the merk manual of diagnosis and therapy, edition 13, 1997, merk sharp and dohme research laboratory.150. John Ebenezer 2, 2000, Jaypee brothers New Delhi. - The text book of orthopedics,151. Agni Vesha, Charaka- Charaka Samhita chikitsa stana, Pt. Kashinatha Shastri Edition 6th , 2000 Choukambha Publication New, Delhi, Chapt29 Sloka104 Page785152. Sushruta Acharya-Sushruta Samhita, chikitsa stana , Dr. Ambhika Datta Shastri Edition 13 , 2000, Choukambha Publication Chapter4 Sloka8 Page26 122
  • 129. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Subjective parameter Objective parameter Results Sl.No OPD.No Pain Stiffness Tenderness Swelling Creptation W.time BT AT BT AT BT AT BT AT BT AT BT AT 1 3760 3 2 3 2 4 3 3 2 1 1 4 2 Responded 2 4277 2 1 2 1 3 1 2 1 0 0 2 1 Responded 3 4505 2 0 2 1 2 1 0 0 1 0 0 0 Good 4 270 3 2 3 2 4 2 3 2 1 1 3 2 Responded 5 1253 2 1 2 1 3 1 2 1 1 0 1 0 Good 6 1282 1 0 0 0 2 0 1 0 0 0 0 0 Good 7 1295 2 1 2 2 3 2 2 1 1 0 2 1 Responded 8 1296 2 1 1 1 3 1 2 1 0 0 2 1 Responded 9 1299 2 1 1 0 2 0 1 0 1 0 1 0 Good 10 1306 1 0 0 0 2 0 0 0 0 0 0 0 Good 11 1311 1 0 0 0 2 1 1 1 0 0 0 0 Responded 12 1313 3 1 3 2 4 2 3 2 1 1 3 2 Responded 13 1310 2 1 1 0 2 1 2 1 1 0 1 0 Good 14 1341 2 1 2 1 3 2 1 0 1 0 0 0 Good 15 1362 2 1 1 0 2 1 1 1 1 0 1 0 Good 16 1430 2 0 1 0 2 0 0 0 1 0 0 0 Excellent 17 1435 1 0 1 1 2 1 0 0 0 0 0 0 Good 18 2234 3 1 2 1 3 2 2 1 1 1 2 1 Responded 19 2450 3 1 2 1 3 2 2 1 1 1 2 1 Responded 20 2766 2 0 1 1 2 0 0 0 1 0 0 0 Good 21 2790 1 0 0 0 1 0 1 1 0 0 1 0 Good 22 2816 1 0 1 1 2 1 0 0 0 0 0 0 Responded 23 3019 2 1 2 1 3 2 1 1 1 0 2 1 Responded 24 3104 1 0 0 0 2 1 0 0 0 0 0 0 Good 25 3215 2 1 2 2 2 0 1 0 1 0 1 0 Good 26 3260 1 0 0 0 2 0 1 0 0 0 0 0 Excellent 27 3347 2 1 1 0 3 2 1 1 1 0 2 1 Responded 28 3504 2 1 1 0 2 0 1 0 0 0 1 0 Good 29 3759 2 1 1 1 2 2 1 0 1 0 1 0 Responded 30 3813 1 0 0 0 2 1 0 0 0 0 0 0 GoodMaster Chart - Subjective & Objective parameter & effect of Darada vati on Sandhigata vata 123
  • 130. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Special case sheet proforma for Sandhigata vata(Osteoarthritis) Post graduate and research center (Rasashastra) Shri D.G.M. Ayurvedic Medical College, Gadag. Guide: Dr.M.C.Patil M.D (Ayu) Scholar: K.M.Jaggal P.G.Scholar Co - guide: Dr.G.N.Danappagoudar .M.D (Ayu) 01.Name : Sl.No.: 02.Father’s/Husband’s Name: O.P.D.No. : 03.Age : Years D.O.A: 04.Sex : D.O.D: M F 05.Religion : Hindu Muslim Christian Others 06.Occupation : Sedentary Active Labour 07..Ecconomical Poor class Middleclass Upper classStatus : 08. Address : Telephone: 09. Result : Excellent Good Responded Not Responded 10. Consent : I ------------------------- , I giving my consent to be included as subject in the clinical trail and fully convinced with the disease drug and , I am also aware of my right to quit the trail at any time during the course of trail. 124
  • 131. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Patient’s Signature11. Presenting Complaints Sl.No. Complaints P/A 0 10thday 20thday 30thday 01. Sandhi shoola 02. Sandhi shopha 03. Vata purana druti sparsha 04. Prasaranakunchana vedana 05. Sandhigati sankocha 06. Sandhi stabdhata 07. Nisharuk 08. Gamane ativedhana 09. Sandhi vishleshana12. History of present illness: 1. Joint involved: 2. Mode of Onset: Gradual Suddenly 3. Nature of Disease: Progressive Regressive Constant Intermittent 4. Routine activities affected Yes No 5. Nature of pain: 6. Severity of pain: Mild Moderate Severe 7. Variation of pain: Increase on use Increase on disease 8. Aggrivating factors: 125
  • 132. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 9. Relieving factors:13. History of Post illness: H/O Episodes of similar complaints: Yes No14. Family History: Present Absent15. Treatment History: Yes No Moderate medicine: NSAID’S Steroids Local injection Ayurvedic medicine: Guggula Rasoushadhi Others Antheropy Relief with previous Complete Partial Temporary Notreatment:16. Personal History: Diet: Veg Mixed Appetite: Poor Moderate Good Bowels: Free Constipated Urine: Normal Abnormal Sleep: Normal Less More Distrubed Habit: Smoking Alcohol Tobacco No habits Menstrual cycle: Regular Irregular Menopause17. General Examination: Appearance: Healthy Un well Ill Nutrition: Absence Moderate Poor Memory: Normal Subnormal Poor 0 Height cms Weight kg Temperature F Pulse rate times/min Heart rate times /min 126
  • 133. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA Respiratory rate times/min B.P mm Hg18. Dasha vidha pareeksha: Dosham Vata Pitta Kapha Rasa Rakta Mamsa Meda Asthi Majj Sukra Dhushy: Pureesham Mutram Swedan Desham: Jangalam Anupam Sadharanam Balam: Rogi bala Prauaram Madhyam Awaram Vasanta Greeshma Varsha Sharad Hemanta Shishira Kala: Analam: Mandam Teekshna Vishamam Samam Prakruti: V P K VP PK VPK Vayas: Bala Madhyama Jeerna Satwam: Pravaram Madhyamam Avaram Satmyam: Aharam:19. Sroto pareeksha: Mamsa - Medha - Asthi - Majja - 127
  • 134. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA20. Special examination of joints: I. Inspection Deformity: Present Absent Present Absent Flexion: Joint swelling: Present Absent Grade: 0 1 2 3 Muscular wasting: Present Absent Above the affected joint Below the affected joint II. Palpation: 1. Local rise of temperature: Present Absent 2. Tenderness: 0 1 2 3 4 Refropatelor Medical comportment Lateral comportment Site: 3. Movements: a) Active: Restricted Limited Free b) Passive: Restricted Limited Free 4. Crepitation: Present Absent 5. Degree of limitation: a) Range of extension: 128
  • 135. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA b) Range of flexion:21. Nidan: Ahara Vihara Others Rooksha Bhojana Nisha Jagarana Alpamatra Bhojana Atyucha Bhojana Tiktosna Kashaya Antivyayacha Pramita Bhojan Bhaya Dukhe Chinta22. Upashaya / Anupashaya:23. Lab investigation: Sl.No Name of the test Value 01. ESR 1st hour 02. HB% mg % 03. Total count WBC Per cms RBC 04. Differential count N E B M L 05. Blood glucose mg/dl 06. Serum Alkaline phosphatase Unit/L 129
  • 136. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA24. Radiological Examination: X-ray of affected joint AP / Lateral view. Joint space: Reduced Increased Unaltered Unicomposition Formation of Osteophyte: Present Absent Subchondral sclerosis: Present Absent Loose bodies: Present Absent Degree of virus –present: Present Absent25. Treatment protocol: Started on: Dose:26. Assessment of Result: Sl.No Particulars Day – 0 Day– 10 Day – 20 Day-30 1. Pain 2. Stiffness 3. Tenderness 4. Swelling 5. Walking time 6. CrepitationInvestigative Note. Signature of supervisor 130
  • 137. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATANote: Clinical Assessment: 1. Assessment of pain: Grade No pain 0 Mild + 1 Moderate + + 2 Sever +++ 3 2. Assessment of Stiffness: Grade No stiffness of the joint 0 Mild stiffness (for 5 to 30 mins) 1 Moderate stiffness (for 30 to 2 hours) 2 Severe stiffness (More than 2 hours) 3 3. Assessment of Tenderness: Grade No tender 0 The patient says the joint is tender. 1 The patient winces. 2 The patient winces and with draw the affected part. 3 The patient will not allow the joint to be touched. 4 4. Assessment of Swelling: Grade No swelling 0 Mild swelling (Slightly obvious) 1 Moderate swelling (covers well the bony prominence) 2 Severe swelling (much elevated ) 3 5. Assessment of Crepitus: Grade Absent 0 Present 1 6. Assessment of Walking time (60 feet distance): Grade Normal(within 20 second) 0 20 – 40 seconds 1 40 – 50 seconds 2 50 – 60 seconds 3 131
  • 138. PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA 60 and above 132