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Insomnia#dg10 gdg

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Evaluation of efficacy of maricha patra and pippalimoola in the management of nidranaasha (primary insomnia) – a comparative clinical study – sunita, Department of Dravya Guna, Post Graduate Studies & …

Evaluation of efficacy of maricha patra and pippalimoola in the management of nidranaasha (primary insomnia) – a comparative clinical study – sunita, Department of Dravya Guna, Post Graduate Studies & Research Centre, D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE,GADAG

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  • 1. Evaluation of efficacy of Maricha Patra and Pippali Moola In the mangement of Nidranasha(Primary Insomina) – A Comparative Clinical Study By Sunitha Dissertation submitted to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore In partial fulfillment of the degree of Ayurveda Vachaspati M.D. In Dravya Guna Under the Guidance of Dr. T.R. Bhagyalaxmi M.D. (Ayu) and Co- Guidance of Dr. Kuber Sankh M.D. (Ayu) Department of Dravya Guna Post Graduate Studies & Research Centre D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG 2006
  • 2. D.G.M.AYURVEDIC MEDICAL COLLEGEPOST GRADUATE STUDIES AND RESEARCH CENTRE GADAG, 582 103 This is to certify that the dissertation entitled “Evaluation of efficacy of Maricha Patraand Pippali Moola in the mangement Nidranasha (Primary Insomia)-A ComparativeClinical Study” is a bonafide research work done by Sunitha in partial fulfillment of therequirement for the post graduation degree of “Ayurveda Vachaspati M.D. (Dravya Guna)”Under Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka.Dr. KUBER SANKH Dr. T.R. Bhagyalaxmi M.D. (Ayu) M.D. (Ayu)Co- Guide GuideLecturer in Dravya Guna Assist ProfessorDGMAMC, PGS&RC, GADAG Dept. of Dravya GunaDate: DGMAMC, PGS&RC, GADAGPlace: Gadag Date: Place: Gadag
  • 3. J.S.V.V. SAMSTHE’S D.G.M.AYURVEDIC MEDICAL COLLEGE POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG, 582 103 Endorsement by the H.O.D, Principal/ head of the institution This is to certify that the dissertation entitled “Evaluation of efficacy of MarichaPatra and Pippali Moola in the mangement of Nidranasha (Primary Insomia)-AComparative Clinical Study” is a bonafide research work done by Sunitha under theguidance of Dr. T.R.Bhagyalaxmi M.D. (Ayu), Assist Professor and Dr. KUBERSANKH, M.D. (Ayu), in partial fulfillment of the requirement for the post graduationdegree of “Ayurveda Vachaspati M.D. (Dravya Guna)” Under Rajiv Gandhi University ofHealth Sciences, Bangalore, Karnataka.. (Dr. G.V.Mulagund) (Dr. G. B. Patil) Professor & HOD Principal, Dept. of Dravya Guna DGM Ayurvedic Medical College, PGS & RC Gadag Date: Date: Place: Gadag Place: Gadag
  • 4. Declaration by the candidate I here by declare that this dissertation / thesis entitled “Evaluation ofefficacy of Maricha Patra and Pippali Moola in the mangementNidranasha (Primary Insomia)-A Comparative Clinical Study” is abonafide and genuine research work carried out by me under the guidance ofDr. T.R.Bhgyalaxmi M.D.(Ayu) Assist Professor and Dr. Kuber Sankh,M.D.(Ayu), Lecturer in Dravya Guna, DGMAMC, PGS&RC, Gadag.Date :Place : Gadag ( Sunitha )
  • 5. © Copy right Declaration by the candidate I here by declare that the Rajiv Gandhi University of Health Sciences,Karnataka shall have the rights to preserve, use and disseminate thisdissertation/ thesis in print or electronic format for the academic / researchpurpose.Date :Place : Gadag ( Sunitha )© Rajiv Gandhi University of Health Sciences, Karnataka
  • 6. ACKNOWLEDGMENT I express my deep sense of gratitude to my respected guide Assistant professor DrT.R. Bhagyalaxmi M.D (Ayu),Dravyaguna dept. D.G.M Ayurvedic Medical College andPost Graduate and research center, Gadag she has been very kind to guide me in thepreparation of thesis and for whose tremendous encouragement and most valuablethought provoking advise made me to complete this work I am also grateful to my respected professor Dr G.V Mulugund M.D (Ayu) Head ofdepartment of Dravya Guna. D.GM.Ayurvedic Medical College and Post Graduate andresearch center, Gadag whose valuable thought provoking suggestions made me to completethis work I am also grateful to my respected co-guide Dr KuberSankh M.D (ayu) lecturer inDravya Guna,PGARC,D.G.M Ayurvdic Medical College,Gadag.for patiently going throughthe draft of thesis and correcting with precious remarks, which has been very useful I am extremely thankful to our principal Dr G.B.Patil for providing all necessaryfacilities for this research work. I am very much grateful to Dr. G.S Hiremath H.O.D of Dravya Guna & Dr. S.BNidagundi Lecturer in the dept of P.G.S in D.G for their valuable suggestion in this work I wish to convey thanks to my respected Lectures,Dr V.Varadacharyalu.DrPurushottamacharyulu. Dr M.C Patil. Dr Shashidhar Doddamani, , Dr.K.S.R Prasad, DrShivaramudu. Dr R.V Shetter, Dr G Danappagoudar, Dr.Santhosh Belavadi. Dr K.S.Paraddi.Dr Mitti.Dr.Shankargouda and other lectures of our college for their suggestion. I very much thankful to Mr T.M Nandakumar for his help in statisticalevaluation.
  • 7. I sincerely thanks my beloved classmates and also seniours Dr Veena.Kori, Dr S.BBani, Dr K.S.Hiremath, Dr Ashok Bm Dr. Shivakumar S, Dr Anand D, Dr jagadish H,Dr C.B Inamdar, Dr. Shalini S, Dr Shivaleela K, Dr Ashwini V, Dr. V.Kataraki, DrShaila B, Dr Shivaleela Dr.Pradeep.Dr Ganti. and all classmates for their constantco-operation. I wish to convey my thanks to beloved Librarian Shri V.M.Mundimani and Mr S.BSureban for providing me essential references on the study. I am thankful to Mr B.S.Tippanagoudar lab technician who extended his co-operationin Investigations. I am thankful to Vijay,Ashwini who helped me in typing work within stipulated time. I wish to convey my thank to beloved friends Dr Nagaraj S, Dr Kishor K, Nivedita,Dr and others U.G friends for their co-operation. I am highly indebted to my beloved Father in law Late Shri SharanegoudaGaddigoudar and Mother in law Smt Mallamma for their inspiration. I am also highly thankful to my beloved parents Shir Pampangouda Patil,and SmtMahantamma who are the basement for my studies.& my career. I am also thankful to my beloved brothers Mahesh Patil Udayashankar,MahenteshPatil and my sister Anitha and brother in law Mounesh gouda & Sharanamma, Suvarna,Uma .Najaratna & their family for their love and affection. This list is incomplete without remembering my beloved husband Dr AyyanagoudaS.Gaddigoudar who is the root cause for my P.G studies and helped me in all respects.Encouraged and inspired me every moment to complete this valuable dissertation work.DatePlace Sunita
  • 8. ABBREVIATIONA.H - Astamga HrudayaA.P.I - Ayurvdic Pharamacopoeia of IndiaA.R - Abhidana RatnamalaA.S - Astanga SangrahaB.P - BhavaorakshaB.P.N - Bhavapraksha NighantuC.S - Charaka Samhita Sutra StanaC.S - CharakasmhitaD.N - Dhanvantari NighantuD.G.Pr - Dravyaguna Vijnana by Priyavrat SharmaD.G.V.MG - Dravyaguna Vijnana by V.M. GogteDGYT - Dravyaguna Vijnana by Yadavji TrikamjiI.M.M - Indian Materia MedicaI.M.P - Indian Medicinal PlantsK.N - Kaiyadeva NighantuM.N - Madanapala NighantuMau.N - Mahaushadha NighantuN.A - Nighantu AdarshaR.N - Raja NighantuSha.Sm - Sharangadhara Samhita Madhyama KhandaSu - Sushruta SamhitaV.S - Vangasena
  • 9. ABSTRACT Charaka included Asvapna in 80 Nonataja vata vikara but has not explained in chikitsasthana Madhavakara also mentioned Nidranasha as lakshana in some diseases.Nidranasha can be correlated with Insomnia on the basis symptoms mentioned in litratures.Insomnia is difficulty in initiating or maintaining sleep and may be short term or chronic.compartive clinical trail has been carried out with the required parameters. HerePippalimoola(Roots of Pipper longum) and Maricha(Piper nigrum) are used in the form ofvati to find out their comparative efficacy in Nidranasha (V.N 1/718 1/712).OBJECTIVES1.To evaluate the efficacy of Maricha patra choorna in Nidranasha.2.To evaluate the efficacy of Pippalimoola choorna in Nidranasha.3.To compare the efficacy of Maricha patra and Pippalimoola in Nidranasha.METHODIn this comparative clinical study, 30 patients randomly selected & grouped as A & Breceives Marichapatra vati & Pippalimoola vati respectively for the duration of 30 days withdose of 1gm B.D.Efficacy was assessed by the difference of before & after treatment fromthe subjective parameters.RESULTSIndividually all the 2 groups showed highly significant in subjective parameters.Comparatively group B shows more significant than the group A.INTERPRETATION AND CONCLUSIONThis clinical study shows the mean overall performance of group A and B(Marichapatravati & Pippalimoola vati) in all the parameters highly significant after the treatment.B(Pippalimoola vati) than the group A(Marihapatra vati).
  • 10. KEY WORDSNidranasha; Primary Insomnia; Pippalimoola(Roots of Pipper longum); Maricha patra(Leaves of Piper nigrum); Methods; Clinical study; Results.
  • 11. CONTENTS Page No1. Introduction 1-22. Objectives 3-33. Review of literature A) Drug Review 4-43 B) Disease Review 44-714. Methodology 72-815. Results 82-1126. Discussion 113-1207 Conclusion 121-1218 Summary 122-1229 Bibliography 123-13010 Annexure 131-137
  • 12. LIST OF TABLES Table 1 MARICHA Page No.Table 1.1 - Showing synonyms according to different authors 06Table 1.2 - Showing Gana and Varga according to different classics 07Table 1.3 - Showing Guna & Karma according to different authors 08Table 1.4 - Showing Prayoga according to different authors 09Table 1.5 - Showing use of Maricha in different Yoga’s 10-12 Table 2 PIPPALI MOOLATable 2.1 - Showing synonyms according to different authors 27Table 2.2 - Showing Gana and Varga according to different classics 28Tables 2.3 - Showing Guna according to different authors 29Tables 2.4 - Showing Karma according to different authors 30Table 2.5 - Showing Prayojyanga according to different authors 31Table 2.7 - Showing use of Pippalimoola in different yoga’s 32-33 Table 3 DISEASETable 3.1 - Showing synonyms according to different authors 52Table 3.2 - Showing Nidranasha as a svatahtra vyadhi 53Table 3.3 - Showing Nidranasha as a Lakshana in various disease 54Table 3.4 - Showing Nidranasha as Nidana in various diseases 54Table 3.5 - Showing Nidranasha as a pooravarupa of various diseases 54Table 3.6 - Showing Causative factors for Insomnia 69
  • 13. Table 4 OBSERVATIONS AND RESULTS Page NoTable 4.1-Showing age distribution of 30 patients.Table 4.2-Showing sex distribution of 30 patientsTable 4.3-Showing distribution of religion of 30 patientsTable 4.4-Showing distribution of patients according to the occupationTable 4.5-Showing distribution of patients according to the economical statusTable 4.6-Showing distribution of patients according to the diet habitTable 4.7-Showing presenting symptoms of thirty patientsTable 4.8-Showing duration of the patients in the present studyTable 4.9-Showing prakruti of thirty patientsTable 4.10-Showing Agni of thirty patientsTable 4.11 -Showing grades of Reduction in sleep time before treatment in Group A, BTable 4.12-Showing grades of Reduction in sleep time after treatment in Group A & BTable 4.13-Showing grades of difficulty in initiating sleep before treatment in Group A &BTable 4.14-Showing grades of difficulty in initiating sleep after treatment in Group A & BTable 4.15-Showing grades of wakefullness during normal sleep before treatment in Group A & BTable 4.16-Showing grades of wakefullness during normal sleep agter treatment inGroup A & BTable 4.17-Showing grades of Angamarda before treatment in Group A . BTable 4.18-Showing grades of Angamarda after treatment in Group A & BTable 4.19-Showing grades of Shirogourava before the treatment in Group A & BTable 4.20-Showing grades of Shirogourava after the treatment in Group A & BTable 4.21-Showing grades of Jrumbha before the treatment in Group A & BTable 4.22-Showing grades of Jrumbha after the treatment in Group A & BTable 4.23-Showing comparative results of Group A & B with reduction in sleep timeTable 4.24-Showing comparative results of Group A & B with difficulty in initiatinsleepTable 4.25-Showing comparative results of Group A & B with wakefullness during normal sleepTable 4.26-Showing comparative results of Group A & B with AngamardaTable 4.27-Showing comparative results of Group A & B with ShirogouravaTable 4.28-Showing comparative results of Group A & B with JrumbhaTable 4.29-Showing statistical analysis of subjective parameters in Group ATable 4.30-Showing statistical analysis of subjective parameters in Group BTable 4.31-(a) Showing comparative treatment result of Group A & B
  • 14. Table 4.32-Showing comparative overall assessment of therapeutic response of Group A&B
  • 15. LIST OF GRAPHS. Page NoGraph 1 - Showing Age distribution of 30 patients 82Graph 2 - Showing Sex distribution of 30 patients 83Graph 3 - Showing distribution patients according to the Religion 84Graph 4 - Showing distribution of patients according to the Occupation85Graph 5 - Showing distribution of patients acc to the Economical status86Graph 6 - Showing distribution of patients acc to the diet habbit 87Graph 7 - Showing presenting symptoms of 30 patients 89Graph 8 - Showing duration of the patients in the present study 90Graph 9 - Showing Agni bala of 30 patients 91Graph 10 - Showing prakruti of thirty patients 92Graph 11 - Showing comparative results of Groups A & B with Reduction in sleep time 99Graph 12 - Showing comparative results of group A & B difficulty in 100 initiating sleepGraph 13 - Showing comparative results of Group A & B c wakefulness 101 during normal sleepGraph 14 - Showing comparative results of A & B with Angamarda 102Graph 15 - Showing comparative results of A & B with Shirogurava 103Graph 16 - Showing comparative results of A & B with Jrumbha 104Graph 17 - Showing comparative over all assessment of therapauic 108 Response of Group A & B
  • 16.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha INTRODUCTION Ayurveda is a science of life with two main aims maintenance of normal health andpromotion of possitive health, and cure of the diseases. In 1971 W.H.O recognizedAyurveda the Indian tradition of medicine is much popular for curing the most of thediseases. As the drug being one among the chikitsa chatuspada and the armour of thephysician. So the drug occupies as prime position for the achievement of the success oftreatment. The drug is given vital importance because of its efficacy, cost effective easyavailability and multiple formulations. Since the time immemorial herbs as being used asfood as time immemorial herbs are being used as good as for medicinal purpose andalso for making materials like chariot etc. Nidranasha is a nonotmaja Vata Vyadhi mentioned by charaka and it is also aLakshana of some of the diseases, according to Madhavakara & Yogaratnakara.Nidranasha can be correlated to Insomnia. Which is difficulty in initiating or maintainingsleep, and may be short term or chronic. The onset of primary insomnia is usually inyoung adult hood and middle age. About 25% of elderly people and 5% of the general population suffers fromInsomnia. In India about 3-4% of total population suffer from this complaint. So                                                                                                                            
  • 17.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaNidranasha has become a major problem in the present days due to altered life styles,busy schedules and stressful living. The management of Insomnia in contemporary sciences mainly depends on mostcommonly available antidepressant drugs, sedatives, tranquilizer and hypnotic drugspresent available treatment with contemporary science is only able to give a temporaryrelief to the patients. therefore there is a great demand for the drugs which will relievesleeplessness. So Ayurvedic approach to this problem of Nidranasha aims, basically to correctthe deranged sleep. Then to provide induction of sleep there by giving a long lastingrelief to the patients. Among the various formulations indicated in the management of Nidranasha,Maricha patra (leaves of Piper Nigrum Linn) and Pippali moola (Roots of Piper LongumLinn) appears to be very cost effective, easily available and there is no adverse effect. The Maricha possesses Katu tikta rasa,Ushna veerya and Katu vipaka Vata haraproperty due to Ushna veerya it allivates the aggrevated Vata, As Nidranasha is causedby the Vikruti of Vata this property helps in curing Nidranasha and Pippali moola ishaving Katu tikta rasa,Katu vipaka,Ushna veery,Vata hara, Shoolahara,yogavahi andRasayana properties. Which are helpful in the Shamana of Vata & Pitta and makes dhatuposhana and mentains the regular sleep. The present study aims at a comparative study on the efficacy of Maricha patra andPippali moola in the management of Nidranasha (Primary Insomnia).                                                                                                                            
  • 18.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  OBJECTIVES1.To evaluate the efficacy of the Maricha patra choorna in Nidranasha.2. To evaluate the efficacy of Pippalimoola choorna in Nidranasha.3.To compare the efficacy of Marichapatra and Pippalimoola choorna in Nidranasha.4.To provide cost effective and cheaper therapy                                                                                                                                  
  • 19.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  DISEASE REVIEWHISTORICAL REVIEWThe knowledge of history assists us to pave the pathway for future. It is a general beliefthat documentation of Indian culture starts from the Vedic period. As Nidranasha is notmentioned as a separate disease so review on Nidranasha along with Nidra from theVedic period is being presented here chronologically.Vaidika Kala: In Atharva Veda Shaunakeeya Shakha, during explaining the maulika Siddhantain Dravyaguna the reference of Nidrajanana as a Karma is available.Samhita Kala:In this period Charaka, Sushruta, Bhela and Kashyapa Samhita gave descriptions relatedto Nidra and Nidranasha. Charaka and Sushruta have not described Nidranashaseparately. Charaka has described Nidana of Nidranasha in the context of AtinidraChikitsa in Sutrasthana 21st Chapter and then Chikitsa of Nidranasha is also described.Sangraha Kala: In Astanga Sangraha and Astanga Hridaya the Nidana & Chikitsa of Nidranashaare available. Madhavakara also mentioned Nidranasha as lakshana in some diseases.Adhunika Kala: Bhavaprakash and Yogaratnakara have described Nidana and Chikitsa ofNidranasha and also explained it as lakshana in some diseases.
  • 20.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha CONCEPT OF NIDRA Etymological derivation of Nidra119:(1) Root Ni + dra + rak + ta = Nidra The word Nidra is formed by the prefix Ni + dra + rak + ta. It is always used in feminine gender. This is a state of nature which causes encapsulation to the consciousness of the person.Nidra: So the acharyas of Ayurveda has given importance to the sleep by considering itone among Trayopasthambha and discussed its role in maintenance of life120. Sleep is mentioned as one among the thirteen Adharaneeya Vegas121 The happiness, nourishment, strength, virility, knowledge and life depends on theproper or adequate sleep122 Charaka has called the Sleep as Bhuta Dhatri which occurred by nature of Night,that nourishes all the living beings. Sushruta has mentioned it as a SvabhavikaRoga123,124 Like Aahara the adequate sleep is essential for maintenance of the body 125 Sushruta called Nidra as Vaishnavimaya on a metaphoric language which is aphysiological process and provides nourishment to the living body and maintains thehealth126 Bhavaprakasha has described importance of sleep in fetal life. He hasemphasized that the fetus in the womb enjoys better rest and comfort when the mothersleeps during pregnancy127
  • 21.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Definition of Nidra: Nidra cannot be explained in a concise form. From the time immemorial it is aquestion in every mind that what is sleep, how it occurs and what is its role in health.Though there are various views regarding sleep but all considered it as one of theessential function for the living beings.Different opinions are as follows:(i) Nidra is the state of life where Jnanendriaya and Karmendriaya are not doing their functions128(ii) Nidra is the state where mind and intellects are at rest129(iii) Sharngadhara mentions that Nidra is a state where predominance of Kapha and Tamas is seen130
  • 22.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha i) Ayurvedic concept: Several concepts have been put forward by our ancient Ayurvedic Acharyas in their texts to explain the phenomenon of Nidra which can be studied under following headings. a) Tamoguna theory : 1. Sushruta explains Utpatti of nidra by giving importance to Hridaya which is considered as Chetana Sthana. When Chetana Sthana Hridaya is over come or enveloped by Tamas, the person goes to sleep131. 2. Astanga Hridaya states that at night, Tamas being powerful and the higher psychic centers being over powered by it, then the living organism goes to sleep132. 3. According to Kashyapa the Satvaguna is Prakashaka (brightening), Raja guna is Pravartaka (promoter) and Tama guna is Niyamaka (controller). So predominance of Tamoguna than Satva and Raja is the prime cause for sleep133. b) Kapha Dosa Theory : 1) Sushruta mentions that when the Sanjavaha srotas are filled with Kapha and Indriyas are deprived from their respective objects of senses, the person goes to sleep. He also clearly mentions the role of Kapha and Tama for Nidra Utpatti134. 2) Astanga Sangraha states that due to Avarana by Shlesma of the Srotas and Shrama of both types of the Indriyas occur which dissociates from their respective senses then Nidra occurs135. 3) Astanga Hridaya describes that whenever the sensation conveying channels of the body are blocked or filled up by the Shleshma and when this Shleshma is over saturated with the Tamasika quality the living being gets sleep136.
  • 23.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  c) Fatigue theory: This theory is mainly stated by Aatreya school of Ayurveda and both Astanga Sangraha and Astanga Hridaya followed this view. 1) Charaka states that when the mind including Jnanendriya and Karmendriya are exhausted they dissociate themselves from their objects, and then the individual sleeps137. 2) Vagbhata gives importance to the Kapha Dosha and Shrama of the Indriya and Manas in the normal onset of sleep138. d) Svabhava : Ayurveda always gives emphasis on nature or Svabhava. According to this description even though we considered various theories still the natural instinct appears to be more powerful cause than others. Charaka and Sushruta have mentioned by nature, the night serves as a causative factor for sleep139,140.Types of Sleep: Various Acharyas have given various opinions regarding the types of sleep. Butbroadly it can classify into 2 types. 1) Svabhavika Nidra – which comes regularly and naturally at night. 2) Asvabhavika Nidra – which comes due to some other causes. Other types of Nidra according to different Acharyas are as follows:1) According to Charaka –141 a) Tamobhava b) Shleshmasamudbhava c) & (d) Manashareera Shrama Sambhava e) Agantuki f) Vyadhyanuvartini g) Ratri svabhava
  • 24.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 2) Sushruta classifies as follows:142 a) Tamasi b) Svabhavika / Vaishnavi c) Vaikarika3) Vagbhata’s classification of sleep is similar with Charak’s classification but the names differ143. a) Tamobhava e) Agantuki b) Kaphabhava f) Kalasvabhava c) Chittakhedaja g) Amayaja d) Dehakhedaja
  • 25.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Nidra Tamasi Prakruta Vaikruta Tamobhava Sleshma Manoshrama Shareera shrama samudbhava sambhava sambhavaBenefits of Sleep1) Properly and timely taking sleep brings the happiness, nourishment, strength, virility, knowledge and maintains the life144.2) As the real knowledge brings about siddhi in a yogi similarly properly intake of sleep brings about happiness and longevity in human beings145. Persons who intake proper sleep in proper time will not suffer from diseases, their mind will be peaceful, they will gain strength, good complexion, good virility, attractive body and they will not be too lean or too fatty and they live good 100 years146.Concept of Nidranasha147 All the great sages of Ayurveda considered Nidra as a very essential factor for all theliving beings. Inadequate intake of Nidra (Nidranasha),leads to various problems likeDukha, Karsya, Abala, Klibata, Ajnana and at last leads to death also. Acharya Charaka explains Nidra and Nidranasha in the context of Asta NinditiyaAdhyaya of Sutra Sthana. Charaka included Asvapna (Nidranasha) in 80 Nanatmaja VataVikara but has not explained in Chikitsa Sthana148. Vagbhata in Astanga Sangraha mentions it in Viruddha Annavijnaniya Adhyaya and inAstanga Hridaya the Nidra, Nidra Vikaras and Chikitsa are mentioned under AnnarakshaAdhyaya149.
  • 26.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Etymological derivation of Nidranasha: The word Nidranasha is formed by composition of two words i.e. Nidra &Nasha.1. Nidra150 : Nidra is the state where mind and intelects are rest2. Nasha : Sabdastoma Mahanidhi explains ‘Nasha’ as Kshaya, Samkshaya, Apachya,Hrasa, Adarshana and Bhanga. So ‘Nasha’ means being lost, elimination, disappearance,destruction, etc. The definition of Nidranasha is not mentioned in any of the popular dictionariessuch as Monier William’s Sanskrit-English dictionary. But in translation work of 20thcentury authors have termed Nidranasha as Insomnia.Based on the above Nirukti the term Nidranasha can be broadly defined as the loss ofsleep or the derangement in the quality and quantity of sleep.Paryaya of Nidranasha: The word Nidranasha is described in different names in different contexts intexts. Various words used to denote Nidranasha are presented in the table.
  • 27.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha A) Table No. – 1. Synonyms of Nidranasha Sl No Paryaya nama CS151 SS152 AH153 1 Anidra + + + 2 Alpanidra - + + 3 Asvapna + + + 4 Jagarana + - + 5 Nidranasha + + + 6 Nidravighata + - - 7 Nastanidra + - + 8 Nidradaurbalya - + - 9 Nidrabhramsa - - + 10 Nidrakshaya - + +Alpa Nidra : ‘Alpa’ means small, minute which refers to reduction in sleep time.Jagarana : ‘Jagarana’ means awake or waking Nidra Rahita, Nidra Abhava which refersto the loss of sleep or no sleep.Nidra Kshaya : ‘Kshaya’ means Hrasa, Adarshana, Bhanga So this term refers todisturbances in sleep, reduction in sleep time.Nidra Bhanga : The word ‘Bhanga’ means breaking, splitting, dividing which showsdisturbances of sleep.Nasta Nidra : ‘Nasta’ means lost, disappeared, deprived which convey the meaning ofloss of sleep.By seeing all these synonyms Nidranasha can be considered as difficulty in initiation ofsleep, reduction in sleep time and disturbances during sleep either one or more (ICD –10).
  • 28.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Classification of Nidranasha154:  Nidranasha may be classified under the following two broad headings byconsidering its etiological factors. 1) Svatantra Nidranasha – where Nidranasha is an independent disease. 2) Paratantra Nidnranasha – where Nidranasha appears as a Lakshana or Etiopathological factor, Poorvaroopa, Upadrava or Asadhya lakshanas of some disease.1. Svatantra Nidranasha : It may be seen rarely in ancient time but at present time it is a common problem in our society. Charaka, Vagbhata, etc. have mentioned Nidranasha as a disease condition under Nanatmaja Vatavyadhi and Pitta Vridhi Lakshanas. Sushruta has given the causative factors of Nidranasha as vitiated Vata and Pitta but it has not been described as a separate disease (Su.Sha 4/41) as shown in Table No.2B) Table No. - 2 Nidranasha as a Svatantra Vyadhi (as a disease) Name of Texts Vatika disorder Paitika disorder C.S. (Su,20/11) Asvapana - A.S.(Nidna stana) Asvapana + M.N. (22/7) Anidrata +
  • 29.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 2. Paratantra Nidranasha : Apart from the lists of Vataja Nanatmaja Vikara and Pitta Vridhi Lakshanas, Nidranasha also present in numerous diseases as a part of Nidana, Lakshana, Poorvaroopa, (Table No. 3 to 5)C) Table No. – 3 Nidranasha as a Lakshana in various diseases Sl. No Disease CS155 SS156 AH157 1 Vataja Jvara Prajagarana Nidranasha Jagarana 2 Vata pittaja Jvara Nidranasha Svapna nasha Anidrata 3 Vataja madatyaya Prajagarana - JagaranaD) Table No. - 4 : Nidranasha as Nidana in various diseases Sl. No Disease CS158 SS159 AH160 1 Vata raktha Prajagarana Jagarana - 2 Vataja madatyaya Nisinidram - - Nishatya cha 3 Pandu roga - - Jagarana Table No. - 5 Nidranasha as a Poorvarupa of various diseases Sl. No Disease CS161 AH162 1 Jvara Prajagarana - 2 Sannipatjwara - Jagarana 3 Vatavyadhi - -
  • 30.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 1. Nidana of Nidranasha162 : There is no direct references regarding the causative factors of Nidranasha. InCharak Samhita, Astanga Hridaya and Astanga Samgraha the Acharayas are explainedthe Chikitsa procedure of Atinidra and in this context they mentioned that if any Atiyogaoccurs to these Chikitsa procedures it may leads to Nidranasha condition. So Atiyoga ofthese Chikitsa procedures may be taken as causative factors of Nidranasha byconsidering the Charaka’s opinions of ‘Eva Eva Cha Vigneyo NidranashasyaHetavaha.These factors are: 1) Atiyoga of Vamana 2) Atiyoga of Virechana 3) Atiyoga of Nasya karma 4) Atiyoga of Rakta mokshana 5) Atiyoga of Dhoomapana 6) Ati Chinta 7) Ati Krodha 8) Ati Bhaya 9) Ati Vyayama 10) Ati Upavasa 11)Asukha sayaa
  • 31.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Further Sushruta has mentioned some extra Nidana factors which may causeNidranasha. These factors are163 1) Vata Vridhi 2) Pitta Vridhi 3) Manastapa 4) Kshaya 5) Abhighata Some other Nidana factors which may also causes the Nidranasha according toAstanga Sangraha are as follows164: 1) Lobha 2) Harsha 3) Vyatha 4) Atimaithuna 5) Ati kshudha 6) Rukshanna sevana 7) Yavanna sevana 8) Anjana So considering all these Nidana factors the Sharirika Doshas such as Vata, Pitta,and Manasika Dosa Raja may be the principal causative factors for Nidranasha. All these Nidana factors have been described in under following headings: 1) Aharaja Nidana – Rookshannasevana165. 2) Viharaja Nidana – Vyayama,Upavasa,Asukha Shayya166. 167 3) Manasika Nidana – Bhaya,Chinta,Krodha .
  • 32.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Vagbhata has described the symptoms which are produced due to Nidranasha are asfollows167a:• Angamarda • Bhrama• Shirogaurav • Apakti• Jrumbha • Tandra• Jadyata • Vataja Rogas• GlaniSamprapti168 As Nidranasha is not explained as a separate disease in Ayurveda so its sampraptiis also not available. However it can be constructed on the basis of Dosha, Dushya, etc.involved. Nidranasha is explained as Vataja Nanatmaja Vikara, in Vata and Pitta Vridhilakshanas and lakshanas of some other diseases. In aged Nidranasha is common. During the description of Nidra Utpatti Acharayas have mentioned that SharirkaDosha Kapha, Manasika Dosa Tama, Chetana Sthana Hridaya and Sanjnavaha Srotas areresponsible for it. According to Yogic concept when Atma having contact withManomaya Kosa then Susupti Avastha (Sleep) occurs. So if there will be any changes inthis physiological process or in this physiological path it causes the Nidranasha. Hence it is evident that the Vata, Pitta, Raja, Hridaya and Sanjnavaha Srota playimportant role in the Samprapti of Nidranasha. So the vitiation of these factors leads tothe condition of Nidranasha.
  • 33.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha The schematic diagram of Samprapti of Nidranasha can be represented as follows: Nidana Aaharaja, Viharaja Manasika & Anya ↑ Vata ↑ Pitta ↓ Kapha ↑ Satwa ↑ Raja ↓ Tama (Chala, Ruksha (Ushma & (Snigdha, Guru & Laghuguna) Tikshna guna) & Manda guna) Kaphakshaya Tamakshaya Lack of sleshma or Tama avarana to Chetanasthana hridayaor Sanjnavaha Srotas NidranashaBahya Upacharas for Nidranasha169Charaka mentioned Abhyanga,Utsadana,Samvahana,Akshitarpana,Moordhni Taila asbahya upacharas.Manasika Upacharas for Nidranasha170Charaka mentioned Manonukula vishaya grahana,Manonukula sabdagranaha,Manonukula gandha granaha, as manasika upacharasAahara Upacharas for Nidranasha171Charaka mentioned Gramya mamsa rasa,Anupa mamsa rasa,Jaleeya mamsarasa,Mahisha ksheera,Peeyusha,Morata as manasika upacharas
  • 34.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Some other measures, which can be advised to the patient of Nidranasha, though arenot mentioned in Ayurvedic texts, are as follows:• Maintaining regular time for going to bed.• Avoid smoking, tea, coffee or alcohol at night before going to sleep.• Not indulge in any type of work or reading till late night.• Should devoid of thoughts tensions before going to bed.• Hearing soft music or favorite songs also induces sleep.• 5-10 minutes mediation before going for sleep.• Offering prayer before sleep.• Washing of hand, feet and face before goes to sleep.• Avoid of day sleep.• Proper evacuation of stool and urine.• Avoid mosquito bites.• Maintenance of adequate privacy and free from disturbance.
  • 35.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Concept of Sleep Definition of Sleep172 Sleep is defined as a state of changed consciousness or partial unconsciousnessand a state of physical and mental inactivity from which the subject can be aroused bystimuli.Physiology of Sleep173 Modern research workers and scientists are doing many experiments and clinicalobservations to find out the exact nature of the physiological process of sleep. But tilldate, no single explanation can be accepted as the final theory for the understanding ofphysiology of sleep in any modern text. There were so many theories exist regarding the phenomenon of sleep which areas follows:1) Vascular Theory: Decreased reduction in the blood supply to the brain is the basic phenomenon of sleep.2) Chemical Theory : Some chemicals like lactic acid, acetyl choline, bromide or specific fatigue toxins were supposed to accumulate during working which irritates the nerve cells of the brain and causes sleep as a result.3) Cortical theory or Kleitman’s theory : Sleep is caused due to reduction of the muscle tone and discharge of less afferent impulses, thereby keeping the cerebral cortex inactive.
  • 36.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 4) Pavlov’s Theory : Pavlov as a result of his study of conditioned reflexes in dogs, proposed a theory for sleep, based upon the cortical inhibition caused by the repeated elicitation of a condition response without reinforcement. The conditioned inhibition slowly spread the entire cortex that caused sleep, according to Pavlov (The living body, C.H.Best & N.B. Taylor).Passive Theory : This is the earlier theory for sleep which suggests in the awake statealertness of the cerebral cortex (the conscious brain)5) Is mediated by the ‘RAS’ (Reticular Activating System), when RAS activity declines, cerebral cortical activity declines as well. Thus lesion of RAS nuclei results unconsciousness. However sleep is much more than simply turning of the arousal (RAS) mechanism.6) Active Theory : It based on an experiment that – sleep is probably caused by an active inhibitory processSo there seems to be some center or centers located below the mid pontine level ofbrainstem that actively cause sleep by inhibiting other parts of the brain.7) Role of Neuro humoral substance : Stimulation of several specific areas of brain can produce sleep.The most conspicious stimulation areas for causing almost natural sleep is the raphe nuclei in the lower half of the pons and in the medulla.It is also known that many of the endings of the fibers from their raphe neurones secret serotonin which assumed that serotonin is the major transmitter substance associated with production of sleep.Experiment shows when a drug given which blocks the serotonin secretion cause the animal awake for several days.
  • 37.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Sleep-wake cycle174: The term ‘sleep-wake cycle’ means in a 24 hours period a man sleeps how manyhour and how many hours remains awake. For example if a person sleeps 7 hours andremains awake 17 hours, then the sleep-wake cycle of that person is 7/17 hours. Thenthis is also called as ‘Circadian clock’. When the sleep centers are not activated, the release from inhibition of themesencephalic and upper pontine reticular nuclei allows this region to becomespontaneously active. This in turn from excites both the cerebral cortex and theperipherals nervous system both of which then send numerous positive feed back signalsback to the same reticular nuclei to activate them still further. Once wakefulness begins,it has a natural tendency to sustain itself because of all this positive feedback activity. After the brain remains active for many hours, even the neurons within theactivating system presumably will become fatigued consequently, the positive feedbackcycle between the mesencephalic reticular nuclei and the cortex will fade and theinhibitory effects of the sleep centers will take over, leading to rapid transition from thewakefulness state to sleep state. Then one could postulate that during prolonged sleep, the excitatory neurons ofthe reticular activating system gradually become more and more excitable because of theprolonged rest, whereas the inhibitory neurons of the sleep centers become less excitablebecause of their over activity, thus leading to a new cycle of wakefulness. It can also explain arousal, the insomnia that occurs when a person’s mindbecomes preoccupied with a thought the wakefulness that is produced by bodily activity.Many other conditions that affect the person’s state of sleep or wakefulness.
  • 38.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Types of Sleep175: In terms of the EEG pattern the sleeps are of 2 types 1) Slow wave sleep or NREM sleep (Deep sleep) – where the brain waves are very slow. 2) REM sleep – where the eyes undergo rapid movements despite the fact that the person is still asleep. Each night a person goes through stages of 2 different types of sleep thatalternate with each other. Most sleep during each night is of the NREM sleep which is the deep sleep.There is a periodical alteration in REM and NREM sleep with each cycle lastingapproximately 70-90 min. REM sleep typically occupies 20-25% of the human circadiansleep period while NREM sleep occupies the remaining 75-80% of the time spent asleep.1. REM Sleep (Paradoxical sleep or Desynchronized sleep):i. It usually appears on the average of every 90 min. interval.ii. 1st bout of REM sleep occurs after 80-100 min of sleep.iii. Bouts of REM sleep lasting 5-30 min.
  • 39.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Characteristics of REM sleep:• Usually associated with active dreaming.• More difficult to arouse by sensory stimuli then NREM sleep.• Eyes move rapidly under the lids during REM sleep. It is mainly due to dreaming.• Most dreaming occurs during REM sleep.• Most nightmares, night terrors occurs during 3rd and 4th bouts of REM sleep.• In adolescents and adult male, REM sleep is associated with erections of penis.• Oxygen used by brain during REM sleep is greater than during the awake state because brain is highly active in REM sleep and over all brain metabolism may be increased as much as 20%.• Increase of Body temperature, Heart rate, Respiratory rate and Blood pressure.• Decrease of GIT motility.• Most of the body’s muscles are actively inhibited and go limp. This temporary paralysis prevents us from acting out our dreams.• Muscle tone through out the body is exceedingly depressed which indicates the strongly inhibition of the spinal projection from excitatory area of the brain stem.
  • 40.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 2. NREM Sleep : This sleep is exceedingly restful and is associated with a decrease in bothperipheral vascular tone and many other vegetative functions of the body as well. Thereis a 10-30% decrease in Blood pressure, Respiratory rate and BMR. It frequently called as dreamless sleep but dreams and night mares may occuroften during this sleep. The dreams in REM sleeps are remembered where as in NREMSleep are not.Stages of NREM Sleep : It have 4 stages -Stage 1 : Eyes are closed and relaxation begins. Thoughts flit and out and driftingsensation occurs. Vital signs like temperature, pulse, blood pressure, respiratory rate arenormal.Stage 2 : Sleep gradually deepens. It follows within minutes of Stage1.Stage 3 : Sleep deepens, vital signs begin to decline. Skeletal muscles very relaxed.Dreaming is common. It takes about 20 min. after the onset of Stage 1.Stage 4 : Vital signs reach to their lowest normal levels, digestive system motilityincreases. Skeletal muscles are relaxed. Arousal is difficult. Bed wetting and sleepwalking occurs during this stage.
  • 41.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Benefits of sleep176:1) Sleep is necessary for processes of energy regulation and also for cellular rejuvenation2) Slow-wave sleep (NREM) serves as protective functions as follows: a) The association between Slow-wave sleep and anabolic steroid secretion. b) Diminished capacity for Slow-wave sleep rebound in affective disorder and schizophrenic patients compare to healthy controls. c) The correlation between Slow-wave sleep rebound and improvement in mood following sleep deprivation in endogenous depressives.3) Persons having 7-9 hrs sleep/night have significantly lower rates of illness.4) Decrease in metabolic rate during night sleep by 5-25% which caused conservation of energy.5) Particularly NREM sleep serves restorative function for the whole body while REM sleep for brain (cognitive functions) restoration. a) Total body restoration : - Consumption of oxygen is lowest during slow-wave sleep. - Rate of anabolism is at its peak during sleep. - It has been postulated that Slow-wave sleep (NREM) being more important for macromolecular synthesis and REM sleep for removing of the synthetic products of slow-wave sleep to maintain synaptic connections which is necessary to maintain cognitive functions (ABC of Sleep disorders). b) Brain restoration :Some research workers have postulated that it is the brain not the body that recuperatesduring sleep and that counteracts the effects of the metabolism of the brain during theday.
  • 42.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Sleep Disorders177 Interests on sleep disorders started in the early 1970’s when obstructive sleepapnea becomes established as a common and often life threatening condition. A numberof survey’s carried out in different countries indicates that sleep related complaints aremost commonly encountered in modern medicine. The disturbances of sleep are alsovery common complaints in psychiatry. Sleep is disturbed in several ways in its pattern,quality and duration. As age advances the average sleeping time decreases which isnormal phenomenon. In some pathological problems like mania, insomnia may be total.Delay in falling asleep (early insomnia) occurs in anxiety, depression is characterized byearly waking up (late insomnia) and the sleep is usually non-refreshing. The sleep wakepattern is disturbed in certain organic conditions like delirium and dementia. Sleep isinterrupted in several conditions. So the proper appreciation and understanding of sleeprelated symptoms are therefore vital for an internist.Classification of Sleep Disorders:A. The classification of sleep disorders introduced in 1979 by the Association of Sleep Disorders Centers (ASDC) which has been widely accepted. It consists of 4 major types of sleep disorders.i. DIMS (Disorders of initiating and maintaining sleep)ii. DOES (Disorder of Excessive somnolence)iii. DOSWS (Disorder of sleep wake schedule)iv. Parasomnias
  • 43.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha B. Sleep disorders according to ICSD (International Classification of Sleep Disorders) i. Dyssomnias ii. Sleep disorders associated with medical or psychiatric illness iii. Parasomnias iv. Proposed sleep disorders (Sleep related laryngeal spasm)C. Sleep disorders according to DSM-IV i. Dyssomnias ii. Parasomnias iii. Sleep disorders related to another mental disorders iv. Others sleep disorders1) Dyssomnias : Some author described the following classification under Dyssomnias a) Insomnia (DIMS) b) Hypersomnia (DOES) c) Disorders of Sleep-wake schedule (DOSWS)a) Insomnia (DIMS) – described later onb) Hypersomnia (DOES) – It may be due to - Psychological or associated with psychiatric disorders - Use of drugs or alcohol - Sleep induced ventilatory impairments i.e. sleep apnoea, etc. - Periodic leg movements and restless leg syndrome - Narcolepsy / Cataplexy - Idiopathic CNS hyper somnolence
  • 44.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha INSOMNIA178 During classification of sleep disorders Insomnia is mentioned under Dyssomnia.A synonym also gives for insomnia which shows its clinical features i.e. DIMS(Disorders of Initiation and Maintenance of Sleep).Table No : 6Causative factors of Insomnia: Psychiatric / environmental Symptoms Medical conditions conditions 1. For falling asleep • Any painful or • Anxiety (Difficulty in uncomfortable • Pre psychotic tension (stress) initiation of sleep) conditions • Environmental changes • CNS lesion • Sleep-wake cycle disorders2. For remaining asleep • Sleep apnoea syndrome • Depression (Difficulty in • Nocturnal myoclonus • Sleep-wake disorders maintaining of sleep) • Parasomnias • Dream interruption • Alcohol withdrawal • Environmental changes • CNS/ Painful diseases • Mania • Drug effects • Dementia, etc. Two unique disorders, which produce DIMS, include periodic leg movementsand restless leg syndromeDiagnosis of Insomnia: People are varying in their amount of sleep they require and some of those whocomplain of insomnia may be having enough sleep without realising it.
  • 45.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Usually the diagnosis of Insomnia can be based on the account given by thepatient. EEG recordings are occasionally helpful whether there is continuing doubt aboutthe extent and nature of the insomnia. So diagnosis of insomnia made on the basis offollowing points:• The sleep disturbances like – - Difficulty in initiation of sleep - Difficulty in maintaining of sleep (may be frequent awakening or early morning awakening) - Non restorative sleep (i.e. despite adequate duration of sleep, feeling of not having proper sleep) (Poor quality of sleep)• It causes either marked distress or interferes with social and occupational functioning. Above sleep disturbances (either one or more) if occurs at least 3 times in a weekfor at least one month can be diagnosed as Insomnia.Types: Mainly Insomnia is of 2 typesi) Primary – No discernible cause for insomniaii) Secondary – It is caused by one of several medical conditions that affect sleep.
  • 46.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 1. Primary Insomnia : About 15% of all the insomnia is primary origin. They are rare in childhood andadolescences but become more prevalent as age advances. Females are more affected.Symptoms of primary insomnia are - Difficulty in initiating of sleep (more common in younger adults) - Difficulty in maintaining of sleep (common in elderly) - Not related to any mental disorders or physical conditions - Individual shows excessive worry during the day about not being able to fall asleep. - In evening the person shows intense efforts to fall asleep but becomes unsuccessful. - Person complaining of lethargy, fatigue, lack of concentration, easily irritable.He may resort to hypnotics or alcohol to reduce tension or cups of coffee or otherstimulants to overcome the tired feelings.2. Secondary Insomnia - Secondary to other disorders - Several psychiatric disorders are associated with insomnia - Also occur secondary to substance abuse like alcohol, amphetamine, steroids and several others - After a course of progressive worsening a chronic stable stage is reached with continue for several years. Sometimes the course is episodic with short periods of improvement and worsening.
  • 47.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaA) DRUG REVIEW CLASSICAL REVIEW OF THE DRUG MARICHA HISTORICAL ASPECT OF THE DRUG1,2 According to vedic litrature (Pa upanishad.Bhoja 2/2/77). Brahmans should not sell maricha and pippali. It means the utility of Maricha is very less compared to that of pippali in the Rugveda. However, in the Samhita period the utility of black pepper is more realized and used extensively in the therapeutics. The drug is also mentioned in the works of kalidas (4th century A.D), Bhana bhatta (7th century A.D) & in Amarakosha, (6th century A.D). In Gupt kala some important spicy drugs were being transported from India to Arab country among them Maricha is one. Brhattrayi exensively decribed this plant as apetizer,carminative and antimicrobial. Sharangdhara quoted it as the example for chedana & pramathi group of drugs. Brhattryai have quoted another variety of Maricha i.e Sweta maricha (C.S Ci 20/193, S.S 54 46/224.A.H.Ut 16/2-5 & A.H U 36/71). In the Nighantu period we get explaination of Maricha.       
  • 48.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaSYNONYMS WITH MEANING Maricha - That which dispels poisons. Ooshanam - That which causes burning sensation. Krishnam - Fruits are black when dried. Vallija - It is born on the creepers. Vrittaphalam - Fruit is round in shape. Dharmapattanam - That which grows near Dharmapatanam. Vritta - It is potent drug for disorders caused by kapha. Shakanga - It is also one of the spieces. Yavanistam - That which is liked by Westerners. Suvruttam - The fruit is round in shape. Teekshna - As it is sharp in quality Katuka - It causes secretion from eyes, nose and mouth Vellaja - It grows near rivers. Kolakam, Kolam - Fruits are in clusters.      
  • 49.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 1.1 : SYNONYMS ACCORDING TO DIFFERENT AUTHORS. Synonyms Cha3 Su4 A.H5 D.N6 BP.N7 R.N8 M.N9 K.N10 N.A11 Maricha + + + + + + + + + Vellija - - - + + + + + - Krishna - - - + + - - - + Ooshana - - - + + + - + + Dharmapattana - - - + + + - - + Palita - - - + - + - - - Shyama - - - + - + + + - Yavanesta - - - + - + - + - Shirovrutta - - - + - + - + - Kolaka - - - + - + - + - Teekshna - - - - - - + + - Malinam - - - - - - + + - Vruttaphala - - - - - + - - - Shakanga - - - - - + - - - Katukancha - - - - - + - - - Veeram - - - - - + - - - Kaphavirodhi - - - - - + - - - Suvrutta - - - - - - - + - Charmabandanam - - - - - - - + - Vallija - - - - - - - - + Dhanvantari - - - - - - - - +      
  • 50.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 1.2 : GANA AND VARGA : ACCORDING TO DIFFERENT CLASSICS. Charaka Samhita Deepaniya Shoola prashamana Krimighna Shirovirechana Shirovirechanopaga Aharopayogi varga Sushruta Samhita Pippalyadi Trikatu Shirovirechana Rakta pravarataka Astanga Sangraha Shirovirechana gana Vatsakadi Pippalyadi Deepaniya Dhanvantari Nighantu Shatapushpadi varga Madanapala Nighantu Shuntyadi varga Raja Nighantu Pippalyadi varga Kaiyadeva Nighantu Oushadi varga Bhavapraksha Nigantu Haritakyadi varga Mahaushada Nigantu Mahaushada varga Nighantu Aadarsha Aadrakadi varga Abidana Ratnamala Katuskanda      
  • 51.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha GUNA KARMATable 1.3 : GUNA (PROPERTIES) ACCORDING TO DIFFERENT AUTHORS. GUNA Cha12 Su13 A.H14 D.N15 M.N16 R.N17 K.N18 BP.N19 P.V.S20 Rasa - Katu + + + + - + + + + Tikta - - - + + + - - - Guna - Laghu + + + + - + + - - Rooksha - - + + + + + + - Ushna + + + + + + + + + Teekshna - - + - - + - + - Veerya - Ushna + + + - - - + - + Vipaka - Katu + + + - + - + - - Doshagnata-Kapha + + + + + + + + + Vata shamaka + + - - + + + + +Table 1.4 : KARMA (ACTIONS) ACCORDING TO DIFFERENT AUTHORS Karma Cha21 Su22 A.Hr23 D.N24 M.N25 K.N26 BP.N27 Mau.N28P.V.S29 R.N30 Krimighna + - + + + + + + + - Shwasahara + - + - + + + + + - Deepana + + + - + + + + + - Shoolaghna + - + - + + + + + - Rochana + - + - + + + + - + Shirovirechana + + - - - - - - - - Hridya - - - - - - - - - + Kustahara + - - - - - - - - - Kasahara + - - - - + - - - - Chakshushya - + - - - - - - - - Gulmahara + - - - - - - - + - Rakta - + - - - - - - - - Pravartaka Jwarahara + - - - - - - - - -      
  • 52.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 1.5 : PRAYOGA ( USES ) ACCORDING TO DIFFERENT AUTHORS. Prayoga Cha31 Su32 D.N33 R.N34 M.N35 K.N36 BP.N37 Mau.N 38 Shoola + + + - + + + + Krimi + - + - + + - + Swasa + - - - + + - + Agnimandya + - - - + + - + Shirashula + - - - - - - + Jwara + - - - - - - - Aruchi + - - + - + - + Hridorga - - - + - - + - Shotha - - - - - - + - Gulma + - - - - - - - Udakodara + - - - - - - - Vamana - - - - - + + - Prameha - - - - - - - - Kapha prakopa + - - - + - - - Unmada + - - - - - - - Udara + - - - - - + -BHEDA(VARITIES)39 The Maricha,which we are using in medicines, is of two types. They are,1. Krishna maricha2. Shweta maricha.ADULTERATION Seeds of evening prime rose are mixed.40PRAYOJYA ANGA – Phala ( fruit )41      
  • 53.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 1.6 : USE OF MARICHA IN DIFFERENT YOGAS.SL.NO YOGA INDICATION REFERENCE 1 Amrtaprashaghrita Jwara,Trishna A.H.Chi 94/101 2 Cyavanaprashavaleha Atidaha Kasa,Shwasa Hridroga Cha.Chi 1/62-74 3 Hingu Suvarchaladya Ghrita Shoola,Anaha, Gulma Cha.chi 5/69-70 4 Madhvasava K & P prameha,Pandu, Grhani Kotha Cha.Chi 15/65-67 5 Kanakabindvarista Mahakusta,Kshudra Kusta, Cha.Chi 76/80 Bhagandhara, Kasa 6 Kanakakshiri Taila Krimi,Kandu,Mandala Kusta Cha.Chi 111/116 7 Punaranavadyarista Jwara,Arochaka,Gulma Cha.Chi 34/38 Kusta,Bhagandara 8 Kamsa Haritaki Shota,Swasa,Jwara,Aruchi,Prameha. Cha.Chi 50/52 9 Chitrakadi Ghrita Amavata,Raktapitta,Arsha,Gulma,Shoola Cha.Chi 55/56 10 Naryana Churna Udararoga,Shota, Vata Vistamba, Gulma Cha.Chi 112/114 11 Nilinyadya Churna Gulma,Udara Cha.Chi 5/137/138 12 Manashiladyanjana Netrakandu,Timira Shuklarma Su:u 19/102 13 Hapushadi Ghrita Shwasa,Gulma Kasa Cha.Chi 5/71/73 14 Hingvadi Churna Anaha,Mootrakriccha,Grahani Cha.Chi 5/79/83 15 Talishadi Gutika Rajayakshma Cha.Chi.8/145-147 16 Lashunadi Ghrita Apasmara,Unmada Cha.Chi 9/49-51 17 Dashamuli Ghrita Vishamajwara,Gulma Cha.Chi 5/142 18 Trayooshanadi Choorna Shoola,Anaha, Arsha Cha.Chi 14/62-64 19 Chavyadi Ghrita Mutrakrichha,pravahika,Arsha Cha.Chi 14/107-109 20 Abhayarista Pandu, Jwara,Kamala Cha.Chi 14/157-143 21 Kanakarista Hridroga,Pandu Cha.Chi 14/157-168 22 Navayasa Choorna Jwara Pandu, Hridroga Cha .Chi 16/70-71 23 Yoshadi Ghrita Pandu Cha.Chi 16/119      
  • 54.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaSL.NO YOGA INDICATION REFERENCE 24 Kusmanda Rasayan Kasa,Jwara.Shwasa Kshaya A.H Chi. 114-118 25 Sadava Churna Swasa, Kasa A.H.Chi 141b-144a 26 Chavikadighrta Kshayaja Kasa A.H Chi 159-161 27 Padmakadi Churna Kasa A.H.Chi 172-173 28 Yavanyadi Churna Hridroga,Aruchi,Arsha,Grahani A.H.Chi 55b-58a 29 Talisadi Churna Aruchi,Kasa,Swasa,Pandu A.H.Chi 58-60 Jwara,Atisara 30 Astanga Lavana Kaphaja Madatyaya A.H.Chi 40b-41 31 Abhayarista Pandu,Kusta,Udara,Shota A.H.Chi 64b-68a 32 Dadimastaka Churna Vataja Atisara A.H.Chi 113b-115 33 Dadhika Ghrita Apasmara.Unmada A.H Chi 13b-21a 34 Tiktaka Ghrita Kandu,Pandu,Nadi Vruna A.H.Chi 2B-7 35 Kalpataru rasa Kasa,Shwasa Bha.Praksha Chi Jwaradikara 310-314 36 Chitrakadivati Agnimandya,Ajeerna Bha.Chi Atisaradhi Kara 37 Trayooshana Mandura Pandu, Kusta, Kamala Bha.Chi Panduroga Vataka dhikara 50-54 Sholka 38 Astadashanglouha Pandu,Halimaka Shota Bha.Chi 55-56 Sholka 39 Manashiladyanjana Prameha,Netrakandu,timira Su.Uttaratantra 19/100-102 40 Gutikanjana Kukunaka Roga Su. Uttaratantra 20/19th Shloka 41 Panchagavya Ghrita Vishamajwara Su.U.39/223 42 Jwaranagara Churna Jwara,Kasa,Shoola Bhaishajya Ratnavali 5/466-478 43 Hata Vati Kasa, Shwasa Bhaishalya Ratnavali 5/534-535 44 Chitrakadi Churna Ajeerna Bhai.Ratnavali 7/27 45 Nagaradi Kwatha Raktapitta,Pittashoola Sha.S.M.Kha 2/97 46 Shuntyadi Kalka Parinama Shoola Amavata Sha.S.M.Kha 5/18 47 Panchakola Choorna Deepana,Pachana ,Anaha Sha.S.M.Kha 5/13-14      
  • 55.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaSL.NO YOGA INDICATION REFERENCE 48 Shuntyadi Choorna Amatisara Sha S.M. Kha 6/46 49 Chitrakadi Choorna Gulma,Grahani Sha.S.M. Kha 6/110-113 50 Yoshadi Vati Swasa, Kasa Sha.S.M. Kha 7/22-23 51 Pippalyadi Grutha Vishamajwara,Pleeharoga Sha.S.M. Kha 9/19-20 52 Changeri Grutha Grahani Vata Vikara Sha.S.M. Kha 9/21-27 53 Nagaradi Kashaya Jwara,Atisara C.D 2/4 54 Nagaradi Kwatha Atisara,Shoola C.D 2/30 55 Navayasa Loham Pandu,Kusta,Hrudroga C.D 8/10-11 56 Vishwadi leha Vatika kasa C.D 11/6 57 Kantkari Grutha Swarabheda,All types of Kasa C.D 13/12 58 Amrutadi Choorna Amavata,Sandishotha C.D 25/14 59 Patyadi Choorna Shotha,Agnimandya, Amavata C.D 25/24 60 Trikatukadi vati Anaha & Shoola C.D 29/8-9 61 Varunadi Kwatha Ashmani C.D 34/2-1 62 Ashta Dashanga Kwatha Jwara Y.R.Jwaradhikara. Chi 3rd Sholka 63 Navayasa Choorna Pandu,Hridroga Y.R.Pandu Roga Chikitsa 1st Sholka      
  • 56.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha MODERN REVIEW OF THE DRUG MARICHABOTANICAL NAME :-PIPER NIGRUM. Meaning of piper nigrum42 is – Piper - ( peppero-Greek ) derived from Pippali Nigrum - black, slightly tinged with grey colour.VERNACULAR NAME :43,44 Latin - Piper nigrum English - Black pepper Sanskrit - Maricha, Napusha Bengal - Golmaricha Marathi - Miri Telagu - Miriyalu Tamil - Milagu Kannada - Menasu Malayalam - Nallamulaku Tulu - Savyaamu Hindi - Kalimaricha French - Poivre Italian - Pepe German - Pfeffer Sindh - Gulmarich Urdu - Kalimirch Deccan - Choca, Kalimirchi      
  • 57.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTAXONOMICAL CLASSIFICATION OF MARICHA.45 Kingdom - Plantae Division - Monochlamydeae Class - Dicotyledones Subclass - Archichlamydeae Series - Micrembryae Order - Piperales Family - Piperaceae Genus - Piper Species - NigrumFAMILY CHARACTER – PIPERACEAE46 Habit - Herbs or shrubs, often with swollen nodes usually aromatic. Leaf - Simple, entire, sometime secculent, alternate, rarely opposite or whorled, often gland dotted. Stipule - Absent or present and adnate to the petiole. Flower - Minute, hermaphrodite, or unisexual, in an axillary or terminal catkin.like Spikes subtended by a peltate bract. Perinath zero. Sepels - None Petals - None. Stamans - 2-6(rarely 7-8)hypogynous      
  • 58.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha Anthers - Often jointed on the filaments, the cells some times confluent, dehiscence ,longitudinal. Ovary - Ovary of 3-4 carpels with many ovules, less commonly ovary 1-celled with 1 ovule, sessile penicillate. Ovules - Orthotropous. stigmas distinct on the free carpels. Fruit - Small,indehiscent in the 1-celled species or of cocci or follicles in the many carpelled species. Seeds - Seeds may be globose, ovoid or ablong, testa thin,albumin copious,floury,embryo enclosed in an amniotic cavity. cotyledons minute or obsolete, radicle superior.      
  • 59.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaGENUS CHARACTERS – PIPER LINN. MORPHOLOGY ( HABIT )47 HABIT :- Shrubs (rarely herbs), errect or scandent, often glandolous and aromatic. Leaves - Entire, often unequal sided Stipules -Various. Flowers - Diecious (very rarely hermophrodite), minute,spicate with or without 2-lateral bracteoles. Sepels - None. Stamens - Stamens 2-4 (rarely more). Filaments - Short,anthers 2-celled, the cells distinct. Ovary - 1-celled,ovule solitary,erect Ovules - Solitary, erect. Style - Short, conic beaked or zero Stigma - 2-5 in number. Fruit - A small ovoid or globose one seeded berry. Seeds - Usually globose, testa thin, albumin floury within. With hardened periphery.      
  • 60.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaCHARACTERS OF PIPER NIGRUM.MORPHOLOGY ( HABIT )48 A stout glabrous climber, stems terete,sparingly rooting much thickend at the nodes. Leaves - Coriaceous, 10-18 by 5.12. 5cm. Broadly ovate ,acuminate, glabrous, 5- 9 nerved,the suprabasal nerves usually alternate,base usually rounded,more or less oblique. Petioles - Stout 1.3 –2.5 cm long.grooved above. Flower - Slightly interrupted glabrous spike of variable length (*5-15cm) diecious or some times polygamous Bisexual achlamydeous or without any perianth, bractate,the bracts more or less adnate to axis & forming a short. Inflorescence - Leaf opposed, simple, pendulous, slender glabrous, interrupted spikes, 10-20cm long but very variable in length & thickness or stoutness,bearing many flowers Stamens - 2 in number Stigma - 2.4 cm Fruit - Globose,6mm in diameter or less at first yellow,after wards becoming red when fully ripe. Seeds - Usually round with hardened periphery solitary with perisperm & floury Endosperm      
  • 61.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaDISTRIBUTION ( HABITAT)49 The plant pepper is found abundantly in the cultivated state in various parts of India from konkan southwards,especially N.Kenara & Kerala. It is cultivated also in ASSAM in the North. The plant frows well in places of fairly heavy rain fall and tolerates shade to some extent. The plants are trained on certain trees whose foliage is not very dense such as Moringa pterigosperna,Mangi fera Indica etc.PHARMACOGNOSTICAL FEATURES OF MARICHA50a) Macroscopic The colour of the drug is blackish – brown or greyish black. It is aromatic and pungent. The berries are 3.5-6 mm in diameter,globular and coarsely reticulatly wrinkled with remains of stigma at the apex. The pericrap is thin with a single white Kernal. The Kernal is hallow at the centre,entirely consisting of perisperm and a small endosperm and embryoa) Macroscopic-fruits greyish-black,hard,wrinkled,0.4-0.5 cm in diameter, odour, aromatic, taste pungent.b) Microscopic The transverse section of drug shows tabular epidermal cells followed by thin walled parenchymatous hypodermis with rectangular stone cells. The inner pericarpic layer is brown coloured and is made up of sclerenchyma. Seed coat layer is attached to it and is reddish-brown. Pericarp and perisperm contains oil glands and abundant starch grains are also present.      
  • 62.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranashac) Microscopic character of fruit :- Fruit consists of a thick pericarp for about one third of fruit and an inner mass of perisperm, enclosing a small embryo. Pericarp consists of epicarp, mesocarp and endocarp, epicarp composed of single layered, slightly sinuous, tabular cells forming epidermis.below which are present 1 or 2 layers of radially elongated,lignified stone cells adjacent to group of cells of parenchyma, mesocarp wide, composed of band of tangentially elongated parenchymatous cells having a few isolated,tangentially elongated oil cells present in outer region and a few fibro – vascular bundles, a single row of oil cells in the inner region of mesocarp, endocarp composed of a row of beakershaped stone cells. Testa single layered, yellow coloured thick walled sclerenchymalous cells, perisperm contains Parenchymatous cells having a few oil globules and packed with abundant; oval to round, simple and compound starch grains measuring 5.5-11.0 in diameter having 2-3 components and a few minute alevrone grains.      
  • 63.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaPHYTOCHEMISTRY51 Pepper consists of an alkaloid piperine (5-9%), volatile oil (1-2.5%), pungent resin (6.0%), piperidine and starch (about 30%), pipeline. The volatile oil which is yellow in colour contains mainly 1 – phellandrene and caryophyllene. It has specific gravity of 0.898-0.900; optical rotation, -30 to 50, and refractive index of 1.4539-1.4977. and in minor quantity it contains piper longuminine, pipeartine, N-iso butyldeca trans-2, trans- 4-diemaide,pipernonaline,piperunde calidine,sesamin,allgnin derivative terpenoids, resin dihydrostigmasterol.Identity Purity and Strength52 Foreign matter - Not more than 2 percent. Total ash - Not more than 5 percent. Acid insoluble ash - Not more than 0.5 percent. Alcohal-soluble extractive - Not less than 6 percent.      
  • 64.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaCULTIVATION AND COLLECTION.53 Large scale cultivation of crop is mostly confined to submountanious tracks of westernghats.i e Kerala,karnataka and part of Maharastra. Approximately, 1,60,000 hectares of land isunder cultivation of pepper well distributed annual rain fall of 250 cm is ideal for successfulcultivation of drug. It can be cultivated right from sea level up to an altitude of 1200 meters.Temperature variations of 100 to 400 is tolerated by the plant. Pepper thrives best in virgin soilrich in humus content. Clay is best suited for the plant, but still it can be grown on red loomssandy looms and even alluvial soil. When grown on sloppy land, slopes facing south arc toavoided as it is to be protected from severe sunlight. Pepper is cultivated by sowing the seeds or by propagating cuttings. The plantsraised from cutting start bearing from second year and survive up to 15 years. The seed-raised plant starts fruiting after 7 to 8 years and can even survive up to60years The cuttings are planted in March – April by keeping the distance of 3 – 4 metersin either direction. The supports or stands for every vine are also raised at the time of planting thecuttings. The plant climbs well on silver oak,coconut) arecanut,palms and ErythrinaIndica An application of close of about 100gm of poyash, 500g of ammonium sulphate,1kg of super phosphate &10kg of rotten cattle compost per year for each tree is desirable.Flowering occurs in may venue and harvesting of berries are dried in air The drugdevelop wrinkles and also becomes black in color during drying. a plantation of onehectare containing 100 vines yields about 100kg of dry pepper annum      
  • 65.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha USES OF PLANT IN OTHER SYSTEMS AND COUNTRIES.ACTION AND USES IN UNANI.54 The fruit has a sharp,pungent,slightly bitter taste,carminative,aphrodisiac,purgative,useful in toothache,inflammation,pain in the liver and muscels,diseases of spleen, eructations, leucoderma, lumbago,chronic fevers,paralysis,facilitatesmenstruations,dries the humours of the body.In Cambodia55 – It is used as a cure for dysentry.In China56 – Pepper is considered an energetic stimulant diaphoretic and carminative.In Malaya57 – Black pepper is some times used by women as an abortificient. Whetheradministered internally or applied externally the fruit is equally used in the treatment ofsnake bite (Mhaskar & caius) and scorpion sting. Strong friction with pepper and salt will make the hair grow again upon the baldpatches left by ring worm of the scalp. Finely powdered black pepper and sesame oil well mixed and heated over a mild fireform an efficient application over the affected parts in cases of paralysis. In Bengali – For jaundice, ILAJ-UL-GURBA recommends a preparation made up ofequal parts of black pepper & leaves of cassia accidewalis pounded well & minced withsome water. It is to be prepared & taken twice daily.      
  • 66.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaCLASSICAL REVIEW OF THE DRUG PIPPALIHISTORICAL ASPECT OF THE DRUG58 In Atharva veda (6/109) for Pippali there are three chantings mentioned. They areKshiptabheshaja, Atividdabheshaja and Vatikrutabheshaja. Saayana quotes that Pippali isuseful in the treatment of Dhanurvata, Akshepaka, (Vatavyadis) etc. Hindu mythology reveales that Pippali has its origin during Samudramanthanamalong with amruta. One context from Jaiminiya Bramana delineate that the saint Vasistaconsumed pippali to attain health and wealth. In Kaushika dharmasutra pippali andsarshapakanda are advocated for administration to neonates along with other herbs. This process is claimed to be medhya. It is enumerated along the Bheshaja gana ofAtharvaparishista. According to Keshava paddati (26/33-40) it is indicated for vatavikaras and also mentioning of pippali moola is seen. Abhidana chintamani and Kaiyadeva nigantu give chitakashira as a synonym forpippali moola. Bhavamishra gives ooshana synoynm for this pippali. In Samhita and various nighantus pippali has been mentioned. In Vishnudharma sutrawhile explaining the contraindicated drugs for shradda pippali is mentioned. All these references indicate that pippali is a very old drug known to Indians from along time and its antiquity goes beyond 2000-3000 years.      
  • 67.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaSYNONYMS AND ITS MEANINGS1. Upakulya - That which fruit is composed of many small particles.2. Ooshana - It has ushna quality.3. Kana - That which fruit is composed of many small particles.4. Krishna - Its fruit colour is black.5. Kola - The fruit is one kola pramana.6. Chapala - Its seeds are very pungent.7. Teekshna tandula - Its seeds are very pungent.8. Pippali - Its usage restores and maintains good health or it protects health.9. Magadhi - It was abundantly available in magadhi desha.10. Vaidehi - It was grown in videha desha.11. Granthika - As it is having small glands or nodes.12. Shadgranthi - It has got about 6 glands.13. Chataka shira - It looks like the head of a sparrow.14. Sumulakam - Roots are nice in appearance.      
  • 68.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 2.1: SYNONYMS ACCORDING TO DIFFERENT AUTHORS. Synonyms Cha59 Su60 A.H61 D.N62 R.N63 K.N64 BP.N65 M.N66 S.N67 Mau. Sad. N68 N69 Pippali + + + + + + + + + + + Krishna - + + + + + + + + + + Magadha - + - - - + - + + - - Granthika - - - + + - - + + + + Moola - - - + + - - + - - - Vaidehi - - - - + + + + + + - Shoundi - - - + + + + + + + +Teekshnatandula - - - + + + + + + + + Chapala - - - + + + + + + + + Pippalimoola - - - + + - - + + + + Chavikashira - - - + + - - + + + - Kolamoola - - - + + - - - + + - Katugranthi - - - + + - - - + - - Katumoola - - - - + - - - + - - Katuushna - - - + + - - - + - - Sarvagranthi - - - + + - - - + - + Patradhya - - - - + - - - + - - Virupa - - - - + - - - + - -Shoshasambhava - - - - + - - - + + - Sugranthi - - - - + - - - - - - Ooshana - - - + - - - + + + - Kanamoola - - - - - - - + + + -      
  • 69.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 2.2: GANA AND VARGA ACCORDING TO DIFFERENT CLASSICS.Charaka Samhita Shirovirechanopaga Kasahara Hikkanigrahana Shirovirechana Shoolaprashamana Vamana Triptighna Deepaniya Astapanopaga Sheeta prashamanam KantyaSushruta Samhita Pippalyadi Oordhvabhagahara ShirovirechanaKaiyadeva Nighantu Oushadi vargaDhanvantari Nighantu Shatapushpadi vargaMadanapala Nighantu Shuntyadi vargaRaja Nigantu Pippalyadi vargaBhavaprakasha Nighantu Haritakyadi vargaMahaushadi Nighantu Mahaushada vargaMadhava Dravyaguna Shresta vargaAbidana ratnamala Katudravya sangrahaShaligrama Nighantu Haritakyadi vargaAmarakosha Vanoushdi varga      
  • 70.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaBHEDA (VARIETIES)70,71Raja Nighantu mentioned about four types of pippali. They are,1. Pippali2. Gajapippali3. Saimhalee pippali4. Vana pippali According to Dymock(1885) pippali moola is of three types.1. Mirza puri 2. Bengali 3. Malva GUNA KARMATable 2.3: GUNA(PROPERTIES) ACCORDING TO DIFFERENT AUTHORS. GUNA Ch72 Su73 A.H74 BP.N75 D.N76 R.N77 K.N78 M.N79 N.A80 RASA Katu + + + + + + + + + Tikta - - - - - - - - - GUNA Snigdha guna + + + + + + + - - Laghu guna - - - + - - + + - VEERYA Ushna + - - + + + - + - Eshat ushna - - - - - - + - - Sheeta - + + - - - - - + VIPAKA Katu + - - - - + - - - Madhura + + + + + - + + +DOSHAGHANATA Tridoshara - - - + - - - - - Vatahara + + + - + + + + + Kaphahara + + + - + + + + +      
  • 71.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 2.4: KARMA(ACTIONS) ACCORDING TO DIFFERENT AUTHORS. Karma Cha81 Su82 A.H83 D.N84 R.N85 K.N86 BP.N87 M.N88 Mau.N89 P.V.S90 Jwarahara + + + + + + + + + + Trishnahara + + + + - - - - + - Rasayana + + + + - + + - + + Vrushya + + + - + + - + - + Deepana + + + - + + + + - + Swasahara + + + - + + + + - + Kasahara + + + - + + + + - + Kshayanashaka + - + - + - - - - + Ruchikaraka + + + - - + - - - + Pachana + + - - + + + - - Shoolahara + + + - - + + + - - Medhya + - - - - - - - - - Krimighna + + - + - - - - + - Gulmahara + - + - - + + + - + Pleehaghna + + + - - + - + - + Anahahara + + - - - - + - - - Hridya + + + - - + - - - - Nidrajanaka - - - - - - - - - + Amavatahara + + + + - + + + + - Kusthara + + + - - + + + - - Pramehagna + + + - - + + + - +      
  • 72.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha Table 2.5: PRAYOGA(USES) ACCORDING TO DIFFERENT AUTHORS.PRAYOGA Cha91 Su92 A.H93 D.N94 M.N95 R.N96 K.N97 BP.N98 Mau.N99 P.V.S100 Shoola + + + - + - + + - - Kasa + + + + + + + - + Shwasa + + + - + + + + - + Jwara + + + + + + + + + + Prameha + + + - + - + + - + Amavata + + + + + - + + + - Anidra - - - - - - - - - + Aruchi + + + - + - + + - - Krimi + - - + - - - - + - Gulma + + + - + - + + + - Trishna + + + + - - - - + + Hridroga + + + - - - + - - - Table 2.6:PRAYOJYANGA ACCORDING TO DIFFERENT AUTHORS.PRAYOJYA ANGA R.N101 B.P.N102 N.A103 Y.T.A104 P.V.S105 Phala + + + + + Moola + + + + +       
  • 73.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTable 2.7: USE OF PIPPALI IN DIFFERENT YOGA’S Sl.No Yogas Indications Reference 1 Pippalyadi Ghrita Jwara,Halimaka,Aruchi,Tuberculosis A.H.Chi 90-91 Sholka 2 Vyaghri Leha Hridroga,Kasa,Swasa A.H.Chi 63b-67a 3 Agastya Rasayana Rasayana,Cures 5 types of A.H.Chi 127-132 Kasa,Kashya,Swasa 4 Vasista Rasayana Rasayana A.H.Chi.133-141a 5 Chavikadi Ghrita Ksayaja Kasa A.H.Chi 159-161 6 Kasamardadi Ghrita Kshaya Jwara,Enlargement of spleen & A.H.Chi 162-163 all types of Kasa 7 Haritakileha Swasa and Kasa A.H.Chi 167b-169a 8 Padmakadi Churna Kasa,Shwasa A.H.Chi 172-173 9 Tejovatyadi Ghrita Cures disease of vata localised in A.H.Chi 52b-55a extrimities Arsa,Grahani,Hritshoola 10 Eladi Churna Cures excess Praseka,Aruchi, A.H chi 54-55a Hritparswashoola Kasa & Shwasa 11 Yavanyadi Churna Hridya,Aruchi,Grahini,Arsa,Kasa,Swasa, A.H.Chi 58b-58a Pandu, Jwara 12 Talisadi Churna Aruchi,Kasa,Swasa,jwara,Atisara A.H.Chi 58b-60 13 Dadimastaka Churna Vataja Atisara A.H.Chi 113b-115 14 Dhanvantara Ghrita All varieties of Prameha Pidika,Pandu, A.H.Chi 196-24 Vidradhi,Gulma,Arsa,Shosa,Shofa 15 Dadhika Grhita Apasmara,Unmada,Mutraghata & A.H.Chi 13b-21a diseases caused by Vata 16 Lasunadi Ghrita Cures all the abnormalities arising from A.H.Chi 26-27a Gulma 17 Hingvastaka Churna Increases Agni & cures Vataja Gulma A.H.Chi 35 18 Dadimadi Ghrita Hridroga,Pandu,Gulma Arsa A.H.Chi 2-4 19 Tiktaka Ghrita Pittaja Kusta,Pittaja A.H.Chi 26-7 Daha,Trishna,Kandu,Pandu,Nadivruna 20 Kalyanka Guda Cures A.H.Chi 17-21a Kusta,Arsa,Kamala,Gulma,Bhagandara 21 Kalpataru Rasa Cures Vata & Kaphaja Bhavaprakasha Jwaradhi Kara Kasa,Swasa,Agnimandya 310-314 Shloka 22 Gudapippali Cures Nidranasha. Bhava.Chi.Jwaradhi Kara 325-326 Sholka 23 Chitrakadi Vati Amapachana & Agni deepana Bhava Praksha Chi Atisaradhikara 52-53 Sholka      
  • 74.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha Sl.No Yogas Indications Reference 24 Trayooshana Mahdura Pandu,Kusta,Shota,Urustamba, Bhava.Praksha.Chi Panduroga Vatika Kamala,Prameha Dhikara 50-54 Sholka 25 Astadasanga Louha Pandu,Halimaka,Shota Bhavapraksha 55-56 Sloka Prameha,Kasa,Raktapitta 26 Cyavana Prasa Rasayana,Kasa,Swasa,Ksaya, Cha.Chi 62-74 Hridroga 27 Aindra Rasayana Rasayana,Promotes Cha.Chi 24-29 Swara,Varna,Kusta,gulma, 28 Pippali Vardamana Rasayana Cha.Chi 32-3 Rasayana 29 Vrsya Gutika Vajkarana Cha.Chi 30-38 30 Hingu Sauvarchaladya Shoola,Anaha,Gulma Cha.Chi 69-70 31 Satyadi Churna Gulma,Anaha,Kasa,Aruchi,Pandu, Cha.Chi 86-90 Hikka 32 Madhrasava Kaphaja & Paittika type of Cha.Chi 41-44 Prameha,Pandu,arsa,Aruchi,Grahani 33 Mustadi Churna Kusta,Pandu,grahani Cha.Chi 65-67 34 Kanakabindvarista Mahakusta,Ksudra Kusta,Bhagandara, Cha.Chi 76-80 Kasa,Kilasa.Prameha 35 Kanakaksiritaila Cures mandala type of Kusta,Cures Cha.Chi 111-116 Krimi,Kandu 36 Sitopaladi Churna Cures Cha.Chi (103-104) Swasa,kasa,Suptajiwhya,Aruchi, 37 Daralabhadi Grhta Jwara,Daha,Bhrama,Kasa,trsna. Cha.Chi 106-116 Atisara 38 Triphaladyarista Pandu,Shota Cha.Chi 39-40 39 Kamsa Haritaki Shota,Swasa,Jwara,Aruchi,Prameha, Cha.Chi 50-52 Udara,Amavata,Raktapitta 40 Chitrakadi ghrita Arsa,Gulma,Shota Cha.Chi 55-56 41 Panchakola Ghrta Cures Udara roga,Arsa Cha.Chi 124-133 Parikartika,Ajeerna 42 Nilinyadya Churna Gulma,Udara Cha.Chi 137-138 43 Pippaladya Taila Arsa,Shopha Cha.Chi 131-134 44 Gutikanjana Kukunaka Roga Su.Uttaratantra 20/19th Shloka 45 Chandanddilepa Nasya for Shirashoola Su.Uttaratantra 26/7th Shloka 46 Guduchyadi Ghrita Cures Kshaya Swasa,Kasa,Ajeerna Su.Uttaratantra 39/223      
  • 75.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha MODERN REVIEV OF THE DRUG PIPPALIBOTANICAL NAME:- PIPER LONGUM(Linn)Meaning of the Piper longum106 Piper = Peperi(Derived from Sanskrit names) Longum = LongVARNACULAR NAMES.107 Latin - Piper longum Linn Hindi - Gajpipal, pipal, pipalmula English - Long pepper Kannada - Pippaliya beru Marathi - Pimpli Tamil - Argadi, Atti, Kalini Telugu - Modi, pippali Malayalum - Chapala,kana,maghadi Urdu - Pipul Arab - Darfil fil Punjab - Darfil fil,maghzpipal Burma - Peikehin Bengal - Piplamol,pipli,piplimula Nepal - Pipal, piplamol Deccan - Pipplie, pipulmul Malaya - Pit root      
  • 76.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaTAXONOMICAL CLASSIFICATION OF PIPPALI108 Kingdom - Plantae Division - Monochlamydeae or Incomplete Class - Dicotyledones Subclass - Archichalamydeae Series - Micrebryae Order - Piperaces Family - Piperaleae Genus - Piper Species - LongumMORPHOLOGY109Root - Root stalk is erect, thick jointed, branched.Stem - Numerous 0.6-0.9 mm, ascending or prostrate (not climbing) much branched, Stout, cylindrical, thickened above the nodes.Leaves - Numerous, 6.3-9cm. Lower ones broadly ovate, very cordate at the base . Entire, glabrous thin bullate with reticulate venation. Dark green and shining above pale and dull beneath. Stipules - Stipules are about 1.3cm, membranous, lanceolate, obtuse, soon falling.Petioles - Petiole of lower leaves 5-7.5cm, stout of upper leaves , very short or none.      
  • 77.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaSpikes - Soliatry, pedunculate, male slender, bracts narrow, female 1,3- 2.5cm bracts circular flat peltate.Stamens - Two in number.Stigmas - Stigmas are 3 or 4 in number short spreading, persistant.Fruit - Very small ovoid completely sunk in solid fleshy spike which is 2.5-3.8cm. Ovoid, ablong,erect, blunt and blackish green shining.HABITAT.110This plant is indigenous to North-Eastern and Southern India and Ceylon, and cultivatedin Eastern Bengal.      
  • 78.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaPHARMACOGNOSTICAL FEATURES OF PIPER LONGUM111MACROSCOPIC Drug available in cut pieces, having distinct internodes and swollen nodes with anumber of small rootlets and root scars; stout, cylindrical, 0.2-0.6cm thick, reddish brownto grey, odour aromatic taste pungent.MICROSCOPIC Stem- Shows a single layered epidermis followed by a continous ring ofcollenchymatous and round to oval thin walled, parenchymatous cells; vascular bundlesshow peripheral and medullary arrangement, separated from each other by a wavy strip ofsclerenchyma forming a ring, enclosing pith; bundles collateral and arranged in rings,having sclerenchymatous sheath of pericyclic cap over phloem; xylem wedge shaped;starch grains simple and compound having 2-7 components, round to oval, measuring 3-14 micron in diameter, present abundantly throughout the section.POWDER Reddish-brown to creamish-grey; under microscopic shows scalariform vessels,aseptate fibres, simple and compound starch grains measuring 3-14 microns in diameter      
  • 79.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaPHYTOCHEMISTRY112,113Piper longum fruits contains Resin, volatile oil, starch, Gum, fattyoil, inorganic matter, piperine 1-2%.Roots of piper longum contains Essential oil, piperine, β-sitosterol, cepharadiones.The nutritive values of piper longum areMoisture - 12.2gmProtien - 6.4gmFat - 2.3gmMinerals - 4.8gmFibre - 8.5gmCarbohydrates - 65.8gmEnergy - 310k calCalcium - 1230mgPhosphorus - 190mgIron - 62.1mgIDENTITY, PURITY AND STRENGTH.114Foreign matter - Not more than 2 percent.Total ash - Not more than 5.5 percent.Acid insoluble ash - Not more than 0.2 percentAlcohol-soluble extractive - Not less than 4.0 percent.Water-soluble extractive - Not less than 12 percent.      
  • 80.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaCULTIVATION AND COLLECTION115 Long pepper locally known as Pippalamodu was originally found growing wild inthe agency areas of Andrapradesh. Preparatory cultivation :- Loamy soils are best suited for this crop. The duration ofthe crop is about 10 months. The crop is planted once in a field and usually grown asratton crop for about 10 years. The soil is well dug to 2 – 3’ deep and filled withFarmYard Manure. In the first year generally either sweet potato or Ragi is raised to findout whether ‘Pippala Modu’ can be taken up in the field. If the sweet potato or Ragi cropcomes up well, people believe that soil is suitable for Pippalamodu and is grown in thesubsequent year. Normally the plant flowers once in a year. No fruits will be observed onthe plant. Seeds and sowing: - Seed multiplication is by cutting of vines 20,000 cuttings ofone feet length are sufficient to plant one acre. The cuttings are planted longitudinally.Manuring :- Usually 20 to 30 cart loads of Farm Yard Manure per acre is applied.Chemical fertilizers are not appliedInter culture :- The crop is wedded 3 to 4 times and hoeings will be done at intervals for40 days.Pests and Diseases:- Generally no pests and diseases are noticed so far on the crop. Harvesting :- Maturity of crop is indicated by yellowing of the leaves and the stem.Harvesting is done annually by uprooting the plant by means of crowbars and exposingthe root. Optimum season is Feb or March. Collection :- Roots of different radii are sorted out and they are dried in the sun for 2to 3 days and it is ready for market. The average yield of Pippalamodu root is 200 kgs.Per acre. Large sized roots fetch high value than the small sized ones.      
  • 81.                                                         Efficacy of Marichapatra & Pippalimoola in NidranashaUSES OF PLANT IN OTHER SYSTEMS AND COUNTRIESACTION AND USES IN UNANI.116,117 The root and fruit are used in palsy, gout, lumbago. The fruit has a bitter, hotsharp taste; carminative, tonic to the liver, stomachic, emmenagogue, abortificient,aphrodisiac, haematinic, diuretic, digestive, general tonic useful in the inflammation ofthe liver, pains in the joints, snake bites, scorpion sting, night blindness. In Travancor, an infusion of the root is prescribed after parturition, with theview of causing the expulsion of placenta. It appears to part take in a minor degree, of thestimulant properties of the fruit. As an alternative tonic long pepper is recommended for use in a peculiar manner.An infusion of three long peppers is to be taken with honey on the first day then for tensuccessive days the dose is to be increased by three peppers every day, so that on thetenth day the patient will take thirty at one dose. Then the dose is to be gradually reducedby three daily and finally the medicine is to be omitted. Thus administered is said to actas a valuable alternative tonic in paraplegia, chronic cough, enlargement of spleen andother abdominal viscera disorders. In the Konkan, the roasted amentias are beaten up with honey and given inrheumatism, they are also given powered with black pepper and rock salt(two parts oflong pepper, three of black, and one of salt) in half tola doses in colic. The dried immature fruit and root in the form of decoction were extensively usedin acute and chronic bronchitis attended with cough and were found to give gradual reliefin all such cases (Koman).      
  • 82.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha GudaSanskrit - GudaHindi - GudEnglish - Trade,JaggaryKannada - BellaSynonyms - Guda, Ikshusara, Madhura, Rasapakaja Shishupriya, SitadiUtpatti - Well – Cooked sugarcane juice when solidifies and becomes hard like stone is known as gudaPropertiesRasa - MadhuraGuna - Laghu, SnigdhaVeerya - UshnaDoshaghanata - Vata Pitta ShamakaPurana guda is said to be best because of its action over all dhatuvaha samstana. It isagnivardhaka,ruchya. There by easily digests and nourishes the jatharagni. It is vrushyaand also claimed as sadya shukrala puranaguda is mainly pitta and vayunashaka,ruchikaraka hridya,tridoshanashaka pandu,pramehanashaka,sharamhara and pathya.118      
  • 83.                                                         Efficacy of Marichapatra & Pippalimoola in Nidranasha      
  • 84.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  METHODOLOGYMATERIALSSource of DataLiterary Source - Literary aspect of study is collected from classical Ayurvedic texts,Modern texts and from internet.Drug- MarichaPatra(leaves) –piper nigrum. Linn Pippalimoola(Root)- piper longum. Linn are taken for the clinical trail.Collection of Raw Materials- Botonically identified Marichapatra were collected from Koppa.Good quality of Pippalimoola was purchased from the local market of Hubli.Method of Preperation-The method of preparation of vati given in Sharangadhara Samhita was adopted179.Marichapatra Vati- 1. 1 KG of Maricha leaves are collected and they are dried in shade and made into vastragalita choorna with the help of khalva yantra.
  • 85.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  2. Double quantity of puranaguda to that of choorna is taken and made into Gudapaka by adding suffecient quantity of water and giving mild heat and then added fine powder of maricha to the Gudapaka and mixed well. 3. After this vati is made by the hands with the uniform size of weight ie 1gm each. 4. After the vati preparation they are dried in shade and kept in air tight bottles 5. Vati was given for consumption. Pippalimoola vati- 1. 1 KG fine powder of Pippalimoola taken in clean stainless steel vessel. 2. Similarly double the quantity of puranaguda is taken to that of pippalimoola in the stainless steel vessel and placed the container on the stove and allow to form gudapaka by adding suffecient quantity water and giving mild heat on mild fire. 3. Fine powder of pippalimoola was added and mixed thoroughly. 4. And made vati by the hands of the weight bearing 1gm each 5. Vatis were collected preserved in the air tight bottles. 6. Vatis were given for consumption. Place of preparation of Medicine- The preparation of Medicine was done in Post Graduation Research Studies Department of Dravya guna. D.G.M.Ayurvedic Medical College. Gadag. Form of Medicine- The Medicine was administered in the form of vati
  • 86.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  METHODS Selection of Samples- Patients suffering from Nidranaasha were selected from OPD, Department of Dravya guna. Post Graduation Studies and Research center, D.G. Melmalgi Ayurvedic Medical College and Hospital by present inclusion and exclusion criteria. Criteria for sellection of patient- Patients diagnosed as Nidra nasha as per the classics. Irrespective of sex [Both male and female patients were considered]. Patients in between age group of 18-60 years. Exclusion criterea-♦ Patients with complications and other systemic disorders.♦ Patients with Nidranasha due to other conditions like madatya, abhigata etc. Inclusion criteria-• Patients complainig of reduction in sleep time, difficulty in initiating sleep, wakefulness during normal sleep any of these or all of these will be included.• Along with the Nidranasha patients complaining of angamarda shirogourava, jrumbha, jadya, glani,bhama and apakti.• Patients already diagnosed as Primary Insomia with the duration of one month to 5 years will be included.
  • 87.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Lab investigations The laborotary investigations done only to rule out any other disorders. Blood- Haemoglobin(Hb %) percentage Total count of W.B.C [T.C] Differential leukocyte count [D.L.C] Erythrocyte sedimentation Rate [E.S.R] Urine- Albumin Sugar Microscopic examination Criteria of Diagnosis• Symptoms mentioned in Ayurvedic texts.• I.C.D 10 of criteria for primary Insomia.• Blood investigations and urine investigations are not considered as diagnostic criteria. Classical signs and symptoms are included in this study. Study design Phrospective comparitive clinical study. Sample size A minimum of 30 patients equally distributed in each group. Groups♦ Group A- Marichapatra choorna with guda in the form of vati.♦ Group B- Pippalimoola choorna with guda in the form of vati
  • 88.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Posology 1. Marichapatra vati 1gm 1 B.D after food. 2. Pippalimoola vati 1gm 1 B.D after food. Study duration Duration of the study was 30 days.fallow up 15 days. The patients were instructed to report every 15 days. 1st Assessment - Before treatment 2nd Assessment - 15th day after treatment 3rd Assessment - 30th day after treatment [After treatment] These assessments were made for the progressive signs and symptoms after the medication. But the 1st and 3rd [last] assesment were taken for the assessment of results. Assessments of Results Results of the treatment were assessed on difference between the before and after treatment. Data of the subjective parameters by using unpaired and paired ‘t’ test. Subjective parameters As designated in classical Ayurvedic and Modern texts . 1. Reduction in sleep time. 2. Difficulty in initiating sleep. 3. Wakefulness during normal sleep. 4. Angamarda [ Bodyachae]. 5. Shirogourava [ Heaviness of the head ]. 6. Jrumbha [ Yawning ].
  • 89.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Objective parameters 1. Routine haematological and urological investigations are taken only to rule out any other disorders. They are not taken for the assesments of results. Grades of Subjective Parameters 1. Reduction in sleep time – 0-No reduction in sleep time. 1 - 5-4 hours sleep. 2 - 3-2 hours sleep. 3 - Less than two hour sleep. 2. Difficulty in initiating normal sleep- 0 – Sleep immediately after go to bed. 1 – One hour late sleep after go to bed. 2 – Two hours late sleep after go to bed. 3 – Three hour or above three hour late sleep after go to bed. 3. Wakefulness during normal sleep – 0 – No wakefulness. 1 – One to two times wakefulness in between sleep. 2 – Three to four times wakefulness in between sleep. 3 – More than 4 times wakefulness.
  • 90.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  4. Anagamarda(Bodyachae) – 0 – No body pain. 1 – Mild body pain. 2 – Moderate body pain. 3 – Severe body pain. 5. Shirogourava – 0 – No shirogourava. 1 – Mild shirogourava. 2 – Moderate shirogourava. 3 – Severe shirogourava. 6. Jrumbha – 0 – No Yawning(Jrumbha). 1 – One to two times yawning. 2 – Three to four times yawning. 3 – More than four times yawning.
  • 91.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha  Overall assesment of results. As the objective parameters are not suggesting any role in the assessment of results in the study, so here assesment of results is made only with subjective parameters. The overall assesment of results in the present study were grouped in to the following categories. 1. Complete Remission – Complete subsidence of all the subjective symptoms irrespective of any degree before the inititation of treatment. 2. Major Improvement – Complete subsidence of 2 or 3 subjective symptoms irrespective of any degree before the initiation of treatment. 3. Minor Improvement – Reduction of 2 or less than 2 degree of subjective symptoms or subsidence of only one symptom.Not Responded – No reduction of degrees of subjective symptoms.
  • 92.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha 
  • 93. Efficacy of Marichapatra & Pippalimoola in Nidranasha  Research Profile1)Antibacterial constituents from the berries of Piper nigrum.Piper nigrum finds an extensive application in antibacterial preparations belonging toAyurvedic system of medicine. A bioguided extraction and fractionation of thepetroleum ether extract of the berries of P. nigrum afforded 2E, 4E, 8Z-N-isobutyleicosatrienamide (1), pellitorine (2), trachyone (3), pergumidiene (4) andisopiperolein B (5). Pergumidiene and trachyone are isolated for the first time from P.nigrum. All the isolated compounds were active against Bacillus subtilis, Bacillussphaericus, and Staphylococcus aureus amongst Gram + ve bacteria, and Klebsiellaaerogenes and Chromobacterium violaceum among Gram -ve bacterial strains.2) Nigramides A-S, dimeric amide alkaloids from the roots of Piper nigrum.3)Melanogenesis stimulation in murine B16 melanoma cells by Piper nigrum leafextract and its lignan constituents.School of Pharmaceutical Sciences, Kinki University, Higashiosaka, Osaka, Japan.matsuda@phar.kindai.ac.jpA methanolic extract from the leaves of Piper nigrum L. showed a significantstimulatory effect on melanogenesis in cultured murine B16 melanoma cells. Activity-guided fractionation of the methanolic extract led to the isolation of two known lignans,(-)-cubebin (1) and (-)-3,4-dimethoxy-3,4-desmethylenedioxycubebin (2), together witha new lignan, (-)-3-desmethoxycubebinin (3). Among these lignans, 1 and 2 showed asignificant stimulatory activity of melanogenesis without any significant effects on cellproliferation.                                 
  • 94. Efficacy of Marichapatra & Pippalimoola in Nidranasha 4) Antioxidant efficacy of black pepper (Piper nigrum L.) and piperine in rats withhigh fat diet induced oxidative stress.5) Effect of storage on the essential oil composition of Piper nigrum L. fruits ofdifferent ripening states.6) Evaluation of the modulatory influence of black pepper (Piper nigrum, L.) on thehepatic detoxication system.Cancer Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, NewDelhi, India.The present paper assesses the modifying potential of black pepper on the hepaticbiotransformation system in mice. The modulatory effect was assessed on glutathione S-transferase (GST), cytochrome b5 (cyt. b5), cytochrome P-450 (cyt. P-450), acid-solublesulfhydryl (-SH) content and malondialdehyde (MDA) level. Swiss albino mice of eithersex (eight weeks old) were fed on a diet containing 0.5%, 1% and 2% black pepper(w/w) for 10 and 20 days. The findings revealed a significant and dose-dependentincrease in GST and -SH content in the experimental groups except the one maintainedon 0.5% black pepper diet for 10 days. Elevated levels of cyt. b5 and cyt. P-450 werealso statistically significant and dose-dependent. The level of MDA was lowered in thegroup fed on 2% black pepper diet for 20 days. Being a potential inducer of detoxicationsystem, the possible chemopreventive role of black pepper in chemical carcinogenesis issuggested.7)Protective effects of Piper nigrum and Vinca rosea in alloxan induced diabeticrats.8) Insecticidal amides from fruits of Piper nigrum Linn.References : WWW.PUBMED.COM.PMID: [ PubMed – Indexed for MEDLINE]                                 
  • 95. Efficacy of Marichapatra & Pippalimoola in Nidranasha Research Profile1) Dehydropipernonaline, an amide possessing coronary vasodilating activity,isolated from Piper longum L.An amide (dehydropipernonaline) that has coronary vasorelaxant activity was isolatedfrom the fruit of Piper longum L. This substance was characterized on the basis ofspectroscopic data.2) Antigiardial and immunostimulatory effect of Piper longum on giardiasis due to Giardia lambliaPiper longum fruit, used in traditional remedies as well as in the Ayurvedic system ofmedicine against intestinal disorders, was tested for its efficacy against experimentalinfection of Giardia lamblia in mice. On in vitro test, an aqueous extract of P. longumfruit powder (PF) at 250 µg/mL and its ethanol extract at 125 µg/mL showed 100%giardicidal activity. A low order activity was found in the n-butanol extract. Furtherfractionation in hexane and chloroform resulted in a total loss of activity. The survivaloftrophozoites in mice at 900 mg/kg body weight was 11.12 in PF, 8.54 in aqueousextract, 5.81 in ethanol extract. The antigiardial activity of PF in hexane, chloroform andn-butanol soluble fractions was comparable to the drug-untreated control (47.63). Piperlongum possessed a demonstrable immunostimulatory activity, both specific andnonspecific, as evident from the standard test parameters such as haemagglutination titre(HA), plaque forming cell (PFC) counts, macrophage migration index (MMI) andphagocytic index (PI). A maximum effect was found at 225 mg/kg body weight in mice.The effect was marginally reduced at higher doses of 450 and 900 mg/kg or the lowerdose of 112.5 mg/kg. Copyright © 1999 John Wiley & Sons, Ltd.     
  • 96. Efficacy of Marichapatra & Pippalimoola in Nidranasha3) Antifertility activity of Piper longum Linn. in female rats.The crude extract, its different fractions and the major pure compound from theactive fraction of the powdered fruits of Piper longum were studied for theantifertility effect in female rats. The crude extract and its hexane fractionexhibited 100 and 86% efficacy respectively (days 1-7 post-coitum (p.c.)schedule). On the other hand, 1-butanol soluble, 1-butanol insoluble andchloroform fractions were inactive.4) Inhibition of CCl(4)-induced liver fibrosis by Piper longum Linn.?5) Antioxidant activity of a salt-spice-herbal mixture against free radicalinduction.6) Novel aromatic ester from Piper longum and its analogues inhibit expression ofcell adhesion molecules on endothelial cells.7) Effect of piperine on the epididymis of adult male rats.8) Study on proliferation effect of extracts of Piper longum on mesenchymal stemcells of rat bone marrow and the relationship to chemical functional groups9) Protective effect of Piper longum fruit ethanolic extract on radiation induceddamages in mice: a preliminary study.10) Alteration of pharmacokinetics of oxytetracycline following oral administrationof Piper longum in hens.References : WWW.PUBMED.COM.PMID: [ PubMed – Indexed for MEDLINE]     
  • 97. Efficacy of Marichapatra & Pippalimoola in Nidranasha     
  • 98. Grades of subjective parameters1. Reduction in sleep time - 0 - No reduction in sleep time 1 - 5 to 4 houws sleep 2 - 3-2 Hours sleep2. Difficulty in initiating normal - 0 - Sleep immediately after go to bed Sleep 1 - One hour late sleep after go to bed 2 - Two hours late sleep after go to bed 3 - Three hours or above three hour late sleep after go to bed3. Wakefulness during normal - Sleep 0 - No wake fulness 1 - One to two times wakefulness 2 - 3 to 4 times wakefulness 0 - No body pain4. Angamarda - 1 - Mild vody pain 2 - Moderate body pain 3 - Severe body pain5. Shirogourava - 0 - No Shirogourava 1 - Mild Shirogourava 2 - Moderate Shirogourava 3 - Severe Shirogourava6. Jrumbha - 0 - No Yawning 1 - One to two times yawning 2 - Three to four times yawning 3 - More than four times yawning    Annexure 137 
  • 99.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha OBSERVATION AND RESULTSThe present comparative clinical study was ment for Evaluation of efficacy ofMarichapatra and Pippali mula in the management of Nidranasha.(Primary Insomnia)Total 30 patients were taken randomly for above mentioned study assessed before andafter treatment subjective changes were recorded according to the proforma of the casesheet.The data was collected as fallowes.Section “A” – Demographic data.Section “B” - Data related to disease Nidranasha.Section “C”- Data related to response to the treatment.
  • 100.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha SECTION “A” DEMOGRAPHIC DATA1) Age incidence present study of Evaluation of efficacy of Maricha Patra and Pippali moola in themanagement of Nidranasha (Primary Insomnia) – A comparitive clinical study has thefallowing age incidences.It suggests that much of the Patients fall under the age group between 41-50 yrs i.e11(36.67%) 9 and (30%)patients fall under the age group 31.40, 6(20%) patients fallunder the age group in between 51-60 yrs. Very few patients i.e 4(13.33%) fall under theage group in between 20-30.Table 4.1 Age distribution of 30 Patients. Sl.No Age group No of Patients Percentage 1 20-30 04 13.33% 2 31-40 09 30% 3 41-50 11 36.67% 4 51-60 06 20% 5 Total 30 100% 12 11 10 9 8 6 6 No of Patients 4 4 2 0 20-30 31-40 41-50 51-60 Graph number 1 Age distribution of 30 patients
  • 101.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha2) Sex Incidence Evaluation of efficacy of Marichapatra and Pippali moola in the management ofNidranasha (Primary Insomnia). A comparative clinical study has the fallowing data inSex Incidence. From the available data we can draw a conclusion that the incidence ofNidranasha is more in female’s i.e., 18 (60%). Where as males are of only 12(40%). Theratio reveals in the study is as 2:3 for male and female respectively Table 4.2 sex distribution of 30 Patients Sl.No Sex No of Patients Percentage 1 Male 12 40% 2 Female 18 60% 3 Total 30 100% 40% Male Female 60% Graph number 2 Sex Distribution of 30 Patients
  • 102.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha3) Incidence of Religion : An attempt was made to understand the religious influence in thisdisease.Hindu,Muslim and Christian were included in this study. There was no anydescrimination of religion in this study. In this study maximum Patients 27 (90%) were Hindus and only 3(10%) Patientswere Muslim. There were no any patients other than these communities were reportedTable 4.3 Distribution of religion of 30 Patients Sl.No Cataegory No of Patients Percentage 1 Hindu 27 90% 2 Muslim 03 10% 3 Christian 00 00.00% 4 Otheres 00 00.00% 5 Total 30 100% 30 25 20 15 10 5 0 Hindu Muslim Christian Otheres NO of Patients 27 3 0 0 Graph number 3 Distribution of Religion of 30 Patients
  • 103.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha4) Occupation incidence Study suggests that the patients out of housewives occupational group were moreprone to get the Nidranasha. Out of 30 cases studied 12(40%) Patients were housewivescategory. 7(22.33) were Labour group of occupatinal category. 6(20%) patients were inservice group of occupational category and only 4 (13.33%)patients are other group ofoccupational category & only 1(3.33%) is student occupational category.Table 4.4 Distribution of Patients According to the Occupation. Sl.No Categories No of Patients Perecntage 1 Service 06 20% 2 Labour 07 23.33% 3 Housewife 12 40% 4 Student 1 3.33% 5 Other 4 13.33% 6 Total 30 100% Other Service 13% 20% Student 3% Labour 23% Housewife 41% Graph number 4 Distribution of patients according to the occupation
  • 104.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha5) Economical Status. Data collected in the study shows that more values of percentage i.e. 70% (21)patients fall under middle class economical status category 8(26.67%) patients fall under poorclass economical status categoryAnd only 1(3.33%) patients fall under higher class economical status category.Table 4.5 Distribution of Patients according to the Economical status. Sl.No Economical Status No of Patients Percentage 1 Poor class 08 26.67% 2 Middle class 21 70.00% 3 Higher class 01 3.33% 4 Total 30 100% Higher class Middle class Poor class 0 5 10 15 20 25 No of Patients Graph number 5 Distribution of patients according to the Economical status
  • 105.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha6) Diet [ Food Habits ] Distribution of patients according to the Diet habit. The food habit distribution inthe locality of research has more percentage of vagetarians in comparisions mixed dietdependents. The ratio of percentage between vegetarian and mixed diet is 20:10 i.e. 66.67%:33.33% respectivelyTable 4.6 Distribution of patients according to the Diet habit. Sl.No Category No of Patients Percentage 1 Vegetarian 20 66.67% 2 Mixed diet 10 33.33% 3 Total 30 100% Mixed diet 33% Vegetarian Mixed diet Vegetarian 67% Graph number 6 Distribution of patients according to the Diet { Food Habits }
  • 106.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha SECTION ‘B’ DATA RELATED TO DISEASE7) Complanits presented by treated thirty patients:- In this study all of the 30(100 %) patients were complained about Reduction insleep, time difficulty in initiating sleep, wakefullness during normal sleep, Angamarda,Shirogourava and Jrumbha. Most of the patients 18(60%) were presented the complainedjadyata. 15(50%) patients complained apakti (Indigestion). 10(33.33%) patientscomplains of Glani and 8(26.67%) patients complain Bharma.Table 4.7: Presenting symptoms of thirty patients. Sl.No Complaints No of Patients Percentatge 1 Reduction in sleep time 30 100% 2 Difficulty in initiating sleep 30 100% 3 Wakefulness during normal sleep 30 100% 4 Angamarda 30 100% 5 Shirogourava 30 100% 6 Jrumbha 30 100% 7 Jadya 18 60% 8 Glani 10 33.33% 9 Bhrama 08 26.67% 10 Apakti 15 50%
  • 107.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Apakti Bhrama Reduction in sleep time 6% 3% 14% Glani 4% Jadya Difficulty in initiating 8% sleep 13% Jrumbha 13% Wakefulness during normal sleep 13% Shirogourava 13% Angamarda 13% Graph No 7 Presenting Symptoms of thirty patients
  • 108.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha8)DurationThe duration which patients had their illness ranged from 1 month to more than 2 years.Maximum patients 16(53.33%) were suffered in this disease in between 7-12 monthsduration followed by 8(26.67%) patients were suffered in between 1-6 months duration.3(10%)patients suffered in this disease more than duration 19-24 months.Patients2(6.67%)suffered in this disease in between the duration 13-18 months Patients1(3.33%) were suffered in between of duration more than 2 years.Table 4.8: Duration of the patients in the present study. Sl.No Duration No. of Patients Percentage 1 1-6 Months 08 26.67% 2 7-12 Months 16 53.33% 3 13-18 Months 02 6.67% 4 19-24 Months 03 10% 5 More than 2 years 01 3.33% 6 Total 30 100% 18 16 16 14 12 10 8 8 6 4 3 2 2 1 0 1-6 Months 7-12 Months 13-18 Months 19-24 Months More than 2 years Graph number 8 Duration of the patients in the present study
  • 109.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha9)Agnibala of 30 patientsIn this present study a systemic correlation between Agni and Kosta was made out. Maximum 15 (50.00%) had Vishamagni and 13(43.33%) patients hadTeekshnagni and 2(6.67%) Patients had mandagni. there were no any patients reportedabout samagni. Table 4.9- Agnibala of 30 patients Sl.No Agni No of Patients Percentage 1 Manda 02 6.67% 2 Teekshnagni 13 43.33% 3 Vishmagni 15 50.00% 4 Samagni 00 00 5 Total 30 100% 16 14 12 Manda 10 Teekshnagni 8 Vishmagni 6 Samagni 4 2 0 No of Patients Graph number 9 Agnibala of 30 patients
  • 110.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha10) Prakruti – Prakruti of thirty patients. In Ayurveda prakruti is the fundamental entity in disease process. In this studymaximum patients 14(46.67%) screened as Vata prakruti followed by 12(40%) Vatapitta prakruti, 2(6.67%) Pitta prakruti patients and 2(6.67%) Vata kapha prakrutipatients. Table 4.10: Prakruti of thirty patients. Sl.No Prakruti No.of Patients Percentage 1 Vata 14 46.67% 2 Pitta 02 6.67% 3 Kapha 00 00.00% 4 Vata pitta 12 40% 5 Vata kapha 02 6.67% 6 Kapha pitta 00 00.00% 7 Vata pitta kapha 00 00.00% 8 Total 30 100% 14 12 10 8 6 4 2 0 Vata Vata Kapha Vata Vata Pitta Kapha pitta kapha pitta pitta No of Patients 14 2 0 12 2 0 0 Graph number 10 Prakruti of thirty patients
  • 111.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaSection C : Data related to Response to the treatmentTable 4.11 showing Grades of Reduction in sleep time Before Treatment in GroupA and B.No of Patients Group Grades 3 % 2 % 1 % 0 %15 A 3 20 11 73.33% 1 6.67 - -15 B 4 26.67 10 66.67 1 6.67 - -3= Less than 2 hours sleep,2= Two to three hours sleep1= Four to five hours sleep,0= Normal sleep (6-8 hours)Table 4.12 showing Grades of Reduction in sleep time After Treatment in GroupA and B.No of Patients Group Grades 0 % 1 % 2 % 3 % 15 A 1 6.67 8 53.33% 6 40% - - 15 B 7 46.67 8 53.33% 0 0% - -0 = Normal sleep,1 = Four to five hours sleep,2 = Two to three hours sleep3 = Less than two hours sleep
  • 112.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.13 showing Grades of Difficulty in initiating sleep in Before Treatment inGroup A and B.No of Patients Group Grades 3 % 2 % 1 % 0 % 15 A 2 13.33 9 60% 4 26.67 - - 15 B 6 40% 8 53.33 1 6.67 - -3 = Three or above three hours late sleep immideatly after going to bed.2 = Two hours late sleep immideatly after going to bed.1 = One hour late sleep immideatly after going to bed.0 = Sleep immideatly after going to bed.Table 4.14 showing Grades of Difficulty in initiating sleep in After Treatment inGroup A and B.No of Patients Group Grades 0 % 1 % 2 % 3 % 15 A 3 20% 9 60% 3 20% - - 15 B 8 53.33% 7 446.67% 0 0% - -0 = Sleep immideatly after going to bed.1 = One hour late sleep immideatly after going to bed.2 = Two hours late sleep immideatly after going to bed.3 = Three or above three hours late sleep immideatly after going to bed.
  • 113.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.15 showing Grades of Wakefullness during Normal sleep Before Treatmentin Group A& BNo of Patients Group Grades 3 % 2 % 1 % 0 % 15 A 6 40% 7 46.67 2 13.33 - - 15 B 3 20% 12 80% 0 0 - -3 = More than four times wakefulness2 = Four to three times wakefulness1 = One or two times wakefulness0 = No wakefulnessTable 4.16 showing Grades of Wakefullness during Normal sleep After Treatmentin Group A& BNo of Patients Group Grades 0 % 1 % 2 % 3 % 15 A 1 6.67 6 40 8 53.33 - - 15 B 7 46.67 8 53.33% - - - -0 = No wakefulness1 = One or two times wakefulness2 = Three to four times wakefulness3 = More than four times wakefulness
  • 114.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.17 showing Grades of Angamarda Before Treatment in Group A and B.No of Patients Group Grades 3 % 2 % 1 % 0 % 15 A 6 40% 5 33.33% 4 26.67 - - 15 B 6 40% 5 33.33% 4 26.67 - -3 = Severe Angamarda2 = Moderate Angamarda1 = Mild Angamarda0 = No AngamardaTable 4.18 showing Grades of Angamarda After Treatment in Group A and B.No of Patients Group Grades 0 % 1 % 2 % 3 % 15 A 3 20% 8 53.3 4 26.62 - - 15 B 8 53.33 6 40% 1 6.67 - -0 = No Angamarda1 = Mild Angamarda2 = Moderate Angamarda3 = Severe Angamarda
  • 115.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.19 showing Grades of Shirogourava Before Treatment in Group A and B.No of Patients Group Grades 3 % 2 % 1 % 0 % 15 A 4 26.67% 7 46.67 4 26.6 - - 7 15 B 6 40% 8 53.33% 1 6.67 - -3 = Severe Shirogourava2 = Moderate Shirogourava1 = Mild Shirogourava0 = No ShirogouravaTable 4.20 showing Grades of Shirogourava After Treatment in Group A and B.No of Patients Group Grades 0 % 1 % 2 % 3 % 15 A 2 13.33% 7 46.67% 4 26.67% 2 13% - - 15 B 8 53.33% 7 46.67% 0 0 - - - -0 = No Shirogourava1 = Mild Shirogourava2 = Moderate Shirogourava3 = Severe Shirogourava
  • 116.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.21 showing Grades of Jrubha Before Treatment in Group A and B.No of Patients Group Grades 3 % 2 % 1 % 0 % 15 A 3 20% 8 53.33 4 26.67 - - 15 B 2 13.33% 11 73.33 2 13.33 - -3 = More than four times yawning2 = Three to four times yawning1 = One to two times yawning0 = No yawnings.Table 4.22 showing Grades of Jrubha After Treatment in Group A and B.No of Patients Group Grades 0 % 1 % 2 % 3 % 15 A 4 26.67% 7 46.67% 4 26.67% - - 15 B 7 46.67% 7 46.67% 1 6.67% - -0 = No yawnings1 = One to two times yawning2 = Three to four times yawning3 = More than four times yawning.
  • 117.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTABLE 4.23 COMPARATIVE RESULTS OF GROUP A AND B WITHREDUCTION IN SLEEP TIME. Group Before Treatment Percentage After Treatment Percentage Total No.of patients No. of patients Relieved A 15 150% 01 6.67% B 15 150% 07 46.67%Graph No 11 SHOWING COMPARATIVE RESULTS OF GROUP A AND BWITH REDUCTION IN SLEEP TIME. 15 10 5 0 A B Before Treatment Total 15 15 No.of patients After Treatment No. of 1 7 patients Relived In the present study all the patients (30) from 2 groups have presented thesubjective symptoms reduction in sleep time with varying degrees. After the treatmentthe study reveals that effect of all the two groups have consistent convinced results overreduction in sleep time. In group A 1 patient (6.67%) has major improvement with reduction insleeptime. In the same way group B only 7 patients (46.67%) has major improvementwith reduction in sleep time
  • 118.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.24 : COMPARATIVE RESULTS OF GROUP A & B WITHDIFFICULTY IN INITIATING SLEEP. Group Before Percentage After Treatment Percentage Treatment No of patients No of patients Relieved A 15 150% 3 20% B 15 150% 8 53.33%Graph No 12 : SHOWING COMPARATIVE RESULTS OF GROUP A & B WITHDIFFICULTY IN INITIATING SLEEP 15 10 5 0 A B Before Treatment No of 15 15 patients Relived After Treatment No of 3 8 patients Relived All the patients from all the groups have presented the subjective Symptomdifficulty in initiating sleep before the treatment with varying degrees. After the treatment in group A 3(20%) patients have shown complete relief fromdifficulty in initiating sleep. In the same way group B 8(53.33%) patients relievedcompletely from difficulity in initiating sleep.
  • 119.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.25 : COMPARATIVE RESULTS OF GROUP A & B WAKEFULLNESSDURING NORMAL SLEEP Group Before Treatment Percentage After Treatment Percentage No of parients No of patient relieved A 15 150% 1 6.67% B 15 150% 7 46.67%Graph No 13 : SHOWING COMPARATIVE RESULTS OF GROUP A & B WITHWAKEFULLNESS DURING NORMAL SLEEP 15 10 5 0 A B Before Treatment No of 15 15 parients After Treatment No of 1 7 patient relieved All the patients from all the groups have presented the subjective symptomwakefullness during normal sleep before the treatment with varying degrees aftertreatment most of the patients relieved with wakefullness during normal sleep that is inGroup A (6.67%) patients group B7(46.67%) patients
  • 120.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.26 COMPARATIVE RESULTS OF GROUP A & B WITHANGAMARDA Group Before Treatment Perecentage AfterTreatmen Percentage No of patients No of Patient relieved A 15 150% 3 20% B 15 150% 8 53.33%Graph No 14 :SHOWING COMPARTIVE RESULTS OF GROUP A & B WITHANGAMARDA 15 10 5 0 A B Before Treatment No of 15 15 patients AfterTreatmen No of 3 8 Patient relieved All the patients from all the groups have presented the subjective symptomangamarda before treatment with varying degrees. After treatment in group A 3 patients (20%).In group B 8 (53.33%) patients hasmajor improvement from Angamarda.
  • 121.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.27 COMPARATIVE RESULTS OF GROUP A & B WITHSHIROGOURAVA. Group Before Treatment Percentage After Treatment Percentage No of Patients No of patients relieved A 15 150% 2 13.33% B 15 150% 8 53.33%Graph No 15 : SHOWING COMPARATIVE RESULTS OF GROUP A & B WITHSHIROGURAVA 15 10 5 0 A B Before Treatment No of 15 15 Patients After Treatment No of 2 8 patients relieved All the patients from all the groups have presented the subjective symptomshirogourava before treatment with varying degrees After treatment in Group A 2(13.33%) patients. In Group B 8(53.33%) patients hasmajor improvement from shirogourava.
  • 122.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable 4.28 : COMPARATIVE RESULTS OFF GROUP A & B WITH JRUMBHAGroup Before Treatment Percentage After Treatment Percantage No of Patients No of patients Relieved A 15 150% 4 26.67% B 15 150% 7 46.67%Graph No 14 : SHOWING COMPARATIVE RESULTS OF GROUP A & B WITH JRUMBHA 15 10 5 0 A B Before Treatment No 15 15 of Patients After Treatment No of 4 7 patients Relieved All the patients from all the groups have presented the subjective symptomJrumbha before treatment with varying degrees. After treatment in group A 4(26.67%) patients. In group B 7 patients (46.67) hasmajor improvement from Jrumbha
  • 123.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha RESULTS30 patients were studied in two groups with 15 patients in each. Group A patients weretreated with Marichapatra Vati,Group B patients were treated with Pippalimoola Vati.The results obtained in the two groups were assessed on the basis of reduction in sleeptime,difficulty in initiating sleep, wakefulness during normal sleep, Angamarda,Shirogourava and Jrumbha. Table 4.29 : Statistical Analysis of Subjective Parameters in group A Parameter Mean S.D S.E ‘t’value P value RemarksReduction in sleep 0.8 0.560 0.144 5.55 <0.001 H.S time Difficulty in 0.866 0.351 0.0908 9.62 <0.001 H.S initiating sleepWake fulness during 0.89 0.676 0.174 4.59 <0.001 H.S normal sleep Angamarda 1.066 0.457 0.118 9.033 <0.001 H.S Shirogourava 0.6 0.632 0.163 3.68 <0.02 H.S Jrumbha 0.866 0.516 0.133 6.496 <0.001 H.S Subjective parameters in Group A Statistical analysis showed highly significant.
  • 124.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Table 4.30: Statistical Analysis of Subjective Parameters in Group B Parameter Mean S.D S.E t-value P-value RemarksReduction in sleep 1.733 0.457 0.118 14.686 <0.001 H.S time Difficulty in 1.8 0.5606 0.144 12.5 <0.001 H.S initiating sleepWakefulness during 1.6 0.507 0.1309 12.22 <0.001 H.S normal sleep Angamarda 1.533 0.639 0.165 9.29 <0.001 H.S Shirogourava 1.866 0.351 0.09 20.87 <0.001 H.S Jrumbha 1.4 0.507 0.1309 10.69 <0.001 H.S Subjective Parameters in Group B Statistical analysis showed highly significant Table 4.31: Statistical analysis of Comparative study treatment in Group A & B Parameters Groups Mean S.D S.E P.SE t-value P-value Remarks Reduction in A 1.333 0.617 0.159 sleep time B 0.533 0.516 0.133 0.207 3.864 <0.001 H.S Difficulty in A 1.00 0.654 0.169 initaiting sleep B 0.466 0.516 0.133 0.215 2.48 <0.05 H.S Wakefulness A 1.466 0.639 0.165 during normal B 0.533 0.516 0.133 0.212 4.4 <0.001 H.S sleep A 1.066 0.703 0.182 Angamarda B 0.533 0.639 0.165 0.245 2.174 <0.05 H.S A 1.4 0.91 0235 Shirogourava B 0.466 0.516 0.133 0.27 3.459 <0.01 H.S A 1.00 0.755 0.195 Jrumbha 0.254 1.574 >0.05 N.S B 0.6 0.632 0.163
  • 125.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha RESULTS From the comparative study except the parameter Jrumbha all the other parameters shows highly significant as ( P < 0.05) after the treatment. The parameter wakefulness during normal sleep and Reduction in sleep time shows more highly significant after the treatment as (p<0.001) In group B reduction in sleep time, wakefulness during normal sleep,Angamarda having the same mean glect with same variation The parameter Jrumbha shows more mean effect with more variation and shirogourava and difficulty in initiating sleep having same mean effect (After the treatment) In group A the parameter wakefulness during normal sleep shows more mean effect but shirogourava shows more variation Two know the effect of the drug before and after the treatment the analysis is done by using paired “t” test. The Group B shows more significant than Group A ( by comparing P & T value). In group B the parameter shirogourava,Reduction in sleep time, wakefulness during normal sleep & difficulties in initiating sleep shows more highly significant as ( P <0.001). In group A parameter difficulty in sleep and Angamarda shows more highly significant. But shirogourava shows less highly significant ( By comparing P & T values).
  • 126.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaTable no. 4.32 Comparative overall Assessment of Therapeutic Response of GroupA&BThe overall effect of the therapies were assessed as complete reonission, MajorImprovement, minor improvement and not respondedTypes of Response Group A Percentage Group B Perecentage Complete 00 0 00 0 Remission Major 04 26.67% 14 93.33% Improvement Minor 11 73.33% 1 7.3% Improvement Not responded 0 0 0 0 Discontinued 0 0 0 0Graph no 15 Showing Comparative over all Assessment of therapentic Response ofGroup A & B 15 10 5 0 No. of Patients in No. of Patients in Group A Group B Complete Remission 0 0 Major Improvement 4 14 Minor Improvement 11 1
  • 127.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha The overall effect of the therapies were as mentioned in this Graph no 15,No patients have got complete remission in Group A & B Major improvement was shown maximum 14(140%) patients in Group B comparedwith group A with 4 (40%) patients. Minor improvement was shown in 11(110%). Patients in Group A as compared withGroup B with only 1(10%) patient. There were no patients, which falls under not responded category of assessment, so itspeaks that all the patients of both the groups were responded well.
  • 128.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Master Chart 1 Demographic Dara of “ Evaluation of Efficacy of Maricha Patra and Pippalimoola in the management of Nidranasha (Primary Insomia) – A Comparative Clinical StudySl.No O.P.D Age Sex Religion Occupation Econimical Status Food No M F H M C O L S Hw St O P M H V M 1 36.65 21 + - + - - - - - - + - + - - + 2 3574 49 - + + - - - - - + - - - + - + - 3 3651 40 - + + - - - - - + - - - + - + - 4 3436 55 - + + - - - - - + - - - + - + - 5 3936 58 - + + - - - - - + - - + - - - + 6 3938 40 - + + - - - + - - - - + - - - + 7 3935 48 - + + - - - + - - - - + - - - + 8 3939 37 + - + - - - - + - - - - + - - + 9 3940 32 - + + - - - - - + - - - + - + - 10 3937 38 + - + - - - - + - - - - + - + - 11 3942 49 - + + - - - - - + - - + - + - 12 3954 48 + - - + - - - + - - - - + - - - 13 3941 30 - + + - - - + - - - - + - - + + 14 3955 48 - + + - - - - - + - - - + - + - 15 3956 42 - + + - - - - - + - - - + - + - 16 3572 58 + - + - - - - - - - + - + + + - 17 5584 42 - + + - - - - - + - - - + - - + 18 2911 49 + - - + - - - + - - - - + - - + 19 1114 40 - + + - - - - - + - - - + - + - 20 3943 60 + - + - - - + - - - - + - - - + 21 3944 48 + - + - - - - - - - + - + - + - 22 3945 58 - + + - - - - - + - - - + - + - 23 3946 50 - + + - - - - - - - + - + - + - 24 3947 29 - + - + - - - - + - - - + - - + 25 3948 55 + - + - - - + - - - - + - - + - 26 3949 38 + - + - - - - + - - - - + - + + 27 3950 40 + - + - - - - - - - + - + - + - 28 3951 30 - + + - - - + - - - - + - - + - 29 3953 49 + - + - - - - + - - - - - - + - 30 3955 38 - + + - - - + - - - - + - - + - M = Male, F = Female, H = Hindu , M = Muslim, C = Christian, L = Labour, S = Service, HW = Housewife, ST = Student O = Others,P = Poor, M = Middle, H = High, V = Vegetarian, M = Mixed diet Group, Group A – No 1 to 15, Group B No – 16 to 30.
  • 129.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha Master chart 2 ASSESSMENT OF SUBJECTIVE PARAMETERS OF GROUP A AND BNO O.P.D Reduction in Diffculty in Wakefulness sleep time initiating sleep during normal Angamarda Shirogourava Jrumba sleep B.T A.T B.T A.T B.T A.T B.T A.T B.T A.T B.T A.T 1 3565 2 1 1 1 1 0 1 1 1 0 2 2 2 3574 3 2 2 2 3 2 1 0 3 3 1 0 3 3651 2 2 3 2 3 2 3 2 3 3 2 1 4 3436 2 2 2 1 2 2 3 2 1 1 3 2 5 3936 2 1 2 1 3 2 2 1 2 1 2 1 6 3938 3 2 1 0 2 2 3 1 2 1 3 2 7 3935 2 1 2 1 2 1 2 1 2 1 2 2 8 3939 3 1 3 2 3 2 3 2 3 2 3 1 9 3940 2 2 2 1 2 1 1 0 2 2 2 110 3937 2 1 2 1 2 2 3 2 3 1 2 011 3942 2 2 2 1 3 1 2 1 2 2 2 112 3954 2 1 2 1 2 2 1 0 2 2 1 113 3941 2 1 1 0 1 1 2 1 1 0 2 114 3955 2 1 2 1 3 1 2 1 1 1 1 015 3956 1 0 1 0 2 1 3 1 2 1 1 016 3572 3 1 2 0 3 1 2 0 2 0 1 017 2584 1 0 1 0 2 1 2 0 2 0 2 018 2911 2 0 2 0 3 1 3 1 3 1 2 119 2580 2 1 3 0 3 0 3 1 3 1 2 120 2680 2 1 3 1 2 0 3 0 3 1 3 121 2579 2 0 3 1 2 0 2 1 3 1 3 122 2659 2 0 2 0 2 1 1 0 1 0 2 023 2537 2 0 2 1 2 0 1 0 1 0 2 024 3947 3 1 2 0 2 1 1 0 2 0 2 125 3948 3 1 2 1 2 0 3 1 2 0 2 026 2546 2 0 3 0 2 0 3 1 2 0 2 027 1114 2 1 3 1 2 1 3 2 3 1 2 128 3951 2 1 3 1 2 0 2 1 2 0 2 129 3953 3 1 2 0 2 1 2 0 2 0 3 230 3955 2 0 2 1 2 1 1 0 2 1 1 0 Group A. No. 1 to 15, Group B. No.16 to 30 BT – Before treatment, AT – After treatment
  • 130.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha
  • 131.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranasha Discussion The science of life Ayurveda believes the treatment of the disease by.Oushadha,Ahara and Manasa chikitsa. Even the major account of the treatment is by thedrug only. They used to say “ Jagateva Vanoushadham ” i.e the each dragvya in theuniverse acts as a medicine. So the every drugs can be used in any kind of a disorders.“Anenopadeshena Nanoushdhi bhutam jagati kinchid dravya mupalabhyete” that’swhy the drugs with a similar properties can be used in a perticular disease effectivly. Toful fill that purpus a comparative trail can be conducted one drug which is having knownaction and the drug with similar properties without any references of using that drug asthe previous one. There by a comparative clinical study on Nidranasha is to be conductedwith Pippalimoola and Maricha patra. As per Vangasena Pippali moola is one of the choice of the drug in Nidranasha alongwith guda. It has Laghu,Rooksha guna,Katu tikta rasa,Katu vipaka,Ushna veerya,Kaphavata shamaka. There by it acts as Medhya,Rasayan,Shoola hara. Vruyshya,Deepanapachana,Nidranasha hara etc. Maricha is having the properties similar to thePippalimoola i.e Laghu rooksha guna, Katu tikta rasa, Katu vipaka,Ushna veerya andKapha vata shamaka, there fore it acts as shoolahara, Agni deepaka, Shirovirechaka.Medhya etc . Shweta Maricha the other form of Maricha act with a similar properties actsas a Rasayana, Maricha can be used as a anjana in Nidranasha ( As per Vangasena).Someexperimental studies carried out over the Maricha patra as a Nidrajanaka. Nidrajanakaaction of Maricha patra on albino rats and Hypnotic activity of petroleum extract ofMaricha patra insist that the Maricha patra.                   
  • 132.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranashahaving similar property as Pippalimoola that acting as Nidrajanaka suggest the Marichapatra can also be used as Nidrajanaka. Ayurveda upholds the Trayopasthamba. Which supports the life both in health andsickness i.e Ahara,Nidra & Brahmachrya. Physiology of Nidra in Ayurveda is considerd to because of the influence of Kaphaand Tamoguna which results in dissociation of the sensory organs. It appears to be truethat the aggrevated Vayu becomes responsilbe for increased alertness (Anidra) similartyaggrevated pitta has the tendency to relieve Tamoguna which is cause for Nidranasha. In Nidranasha both Vata and Mana plays an important role. Hata yoga Pradipikahigh lighted the interrelation ship of Vata and Mana by saying “Chale Vate chalamchittam Nischale Nischalan Bhavet” As Vata and Mana are interdependent so if one isvitiated it also affects the other adversly, So pacyfication of Vata is needed. In this comparitive clinical trial selected both the drugs are having Shoolaharaproperties which indirectly implies its effect on central nervous system. The Nervoussystem has an active role in generating & maintaing sleep. Both the drug are havingUshna veerya there by acts as Vata shamaka,Shoolahara. There by we can use the boththe drus as a Nidrajanaka.                   
  • 133.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranasha In the present clinical trial the Maricha patra & Pippalimoola are used forcomparative study on Nidranasha. In this comparative clinical study totally 30 patientswere randomly selected & treated with Maricha patra and Pippalimoola. In postgraduation and research centre ( Dravya guna ) of shri DGM Ayurvedic Medical collegeGadag. The disease was diagnosed as Nidranasha based on the signs & symptomsdescribed in our classics with only subjective parameters because objective parametersnot taking any role in the assessment. The study is carried out in two groups A and B i.e15 patients in each.Group A – Maricha patra with Guda in the form of Vati.Group B - Pippalimoola witg Guda in the form of Vati.Observations1) Age : Out of 30 patients of Nidranasha studied in this trail maximum 11 patients(36.67%) of were in the age group of 41-50 years in that 7 patients are female they aremore worried about poor economical condition and family problems and their childrenseducation.9 patients (30%) were in the age group of 31-40 years in that 5 are housewives and 2 are male they get Insomnia because of their altered diet and stressful life andhabbits, 4 patients of the age 22-30 years in that 3 are female and one is student femalesare worried about their marriage.                   
  • 134.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranasha2)Sex : The number of female patients 18 (60%). Shows maximum Nidranasha. It seemsto be true with available data.in this 2nd decade to 3rd decade patients, are worried abouttheir education, marriage etc. 3rd to 4th decade patients are worried about not getting theconception and some are due to economical conditions, 4th to 5th decade people weresuffers because of poor economical condition, females due to menopausal condition, Inthis 4th to 6th decade suffers from insomnia because of oldage lifespan is decreased Vatais increased.3) Religion : Here 27 patients were Hindu and 3 were Muslim, Hindus get insomnia dueto their food habbits like Lagu,Rooksha,Ahara, and Muslim takes more Kapha VaradakaAhara. So they less porne to insomnia.4) Occupation : Occupation incidence suggests maximum 12 patients (40%) arehousewives and 7 patients (23.33%) are labour . when the occupation incidence is relatedwith sex incidence we found similarity i.e the females are more prone for Nidranashabecause of family mentainance, As per history labours have ill economic.5) Diet Habbit : 20 patients are vegetarian and that to taking Lagu,Rooksha Katu dietcause for Insomnia, Muslims take Kapha Vruddikara Ahara less porne to Nidranasha.                   
  • 135.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranasha6)Data related to the disease :- Among the datas of disease all the 30 patients shows thecomplaints as Reduction in sleep time, difficulty in initating sleep, wakefullness duringnormal sleep, Angamarda. Shirogourava, Jrumbha are the diagnostic features of theNidranasha.7)Duration: Maximum number of patients (53.33%) in this study had come for treatmentafter the duration of 7 months to 1 year. It may be due to they were taking alternativesystem of medicine.8) Prakruti : In this series 14 (46.67%) patients were having vataja prakruti which ishaving Rajoadhika manasika prakruti, vata,pitta prakriti people are of 12 patients (40%)generally have less sleep Raja is called as pravartaka so causitive factors of Nidranashaeasily provokes the vata,pitta and Rajadosha.9)Satva : In this series maximum number of patients were having Avara satva. Avarastava persons have unsteady mind for which they have no control over Krodha chinta etcwhich leads to Nidranasha condition.10) Agni and Kosta: In the present study maximum number of patients (43.33% and46.67%) belonged to Vishamagni and Krura Kostha, which highlights the predisposingfactor for vata.11) Habbits: An investigation to the addiction of patients showed the maximum numberof patients were addicted to Tea/Coffee (73.33%) followed by 30% / to smoking, 26.67%                   
  • 136.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranashato Alcohol whereas 13.33% patients were having no addiction. It has been reported thatcofleine nicotine alcohol all can alter sleep patterns. Though they provide sleep initiallybut fall in blood concentration leads increased arousal due to sympathetic stimulation.11) Hetus : Manasika Nidranasha reported by the patient in this study were chinta(76.24%) Udvega (63.38%) Vishada (53.84%). Family problem (50%) Krodha (42.3%)etc. All these are said to be the direct cause for Nidranasha as they provokes Raja, Vataand decreases Stava, Tama and Kapha. These causitive factors independently or inconjugation causes Nidranasha.12) Disscussion on Results : All the 30 patients presented with subjective symptomReduction in sleep with varying degree before the treatment (Table no 4.11) After thetreatment group B has shown a marked result compared with Group A. i.e 7 (46.67%)Patients has major improvement shown with Reduction in sleep time. In Group A 1(6.67%) patients has major improvment (Table 4.12 ) Even statistically is proved thatReduction in sleep time highly significant in Group B than A ( Table No 4.12 ). Thesubjective parameter difficulty in initiating sleep has major imporvement in Group B with8 patients (53.33%) than Group A. 3 patients 20% has major imporvement with thiscomplaint ( Table 4.14). The subjective parameter wakefulness during normal sleep is present in both theGroups with varying degree which is responded well in both the groups. But major                   
  • 137.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranashaimprovement in Group B with 7 patients (46.67%) ( Table 4.16) In Group A 1 patients(6.67%) has a major improvement and 6 patients (40%) has miner improvement. The major improvement of symptom Angamanda is noticed in the patients 8(53.33%) of Group B (Table 4.18 ) than Group A which is also has major improvementshown in 3 patients (20%). The parameter shirogourava shows highly impressive of patient 8 (53.33%) ofgroup B (Table 4.20) than Group A with 2 patients (13.33%). The parameter Jrumbha shows major improvement in Group B 7 patients (46.67%)(Table 2.22) and in Group A 4 patients (26.67%). The overall effect of the therapies were assessed as complete remission, majorimprovement, minor improvement and not responded (Table 4.32 ) From this clinicalstudy it is quite obvious that the treatment provided in group B (Pippali moola churnaGuda in the form of Vati) has major improvement compared to group A.As the results is found group B showed 14 patients (93.33%) of patients has majorimprovement as compared with group A i.e 4 patients(26.67%) and in Group Amaximum 11 patients (73.33%) has shown minor improvement.Individually the Group Bperformance is more than in all the parameters than the Group A.Over all the comparative study of both the group shows efficaceous. But the Group BPippalimoola is more efficaceous than Group A the Marichapatra.                   
  • 138.                                                 Efficacy of Marichapatra & Pippalimoola in NidranashaProbable Mode of Action of the Drugs :Here both the drugs Maricha and Pippalimoola are having the similar properties like KatuTikta Rasa, Ushna Veerya and Kapha Vatashamaka properties. In Nidranasha there isincrease of Vata and Pitta and decrease of Kapha is found, here Ushna Veerya propertyhelps to pacify the increased Vata and Tikta Rasa also pacify the increased Pitta which isalso one of the cause for Nidranasha and the Rasayana action of Pippalimoola andMedhya,Shoolahara and Vrushya actions of both the durgs are helpful in Nidranasha asthey pacifies Vata and Pitta so that both Rajo and Satva guna decreases automatically theTamoguna Pradurbhavata increases and causes Nidra.When we assess the chemical compositions of both the drugs the Pippalimoola is havingPiperine which is one of CNS depressent. But the TLC carried out on the Marichapatradoes not contain Piperine. Thus the Hypontic activity of Pippalimoola can be predictedwith presency of piperine but the action of the Marichapatra cant be explained on thebases of chemical composition when we go through the properites both are similar andthe actions are same. The comparative study carried out in this trial shows theMarichapara is less efficaceous than the Pippalimoola. Thus the Acharyas opinionnregarding the action of Pippalimoola is true when compared with the Maricha patra.                   
  • 139.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha CONCLUSION• 1. Pippalimoola with Guda is indicated in nidranasha by vangasena and Bhava prakasha• 2. Maricha and Pippali is an economical effective drug in Nidranasha without any Substantial obverse effect• 3. Animal experiments on Albino rats proven the Nidra janaka action of Maricha patra.• 4. Nidranasha is a Nanatmaja vata Vyadhi and also a Symptom of some diseases are to classics• 5. Nidranasha can be correlated with insomnia of contemporary science by observing the similarity in pathophysiology as well as clinical manifestation• 6. Two preparations of vati selected here for the study are found to be selective in nidranasha. This has been proved here clinically with two individual groups• 7. Pippali mula churna guda (Group B) showed better response in nidranasha with the subjective parameters except Jrumbha are highly significant after the treatment• 8. Maricha Patra churna with guda also showed good response in Nidranasha with the subjective parameters (Group A) the treatment is less effective.• 9. Individually the group B performance is more in all the parameters than the group A.• 10.Comparing two groups individually group B Pippali moola churna with guda showed much response than Group A maricha patra churna with guda by using paired and unpaired ‘t’ test as P value is <0.001 and ‘t’ values in both the groups.     
  • 140.                                                Efficacy of Marichapatra & Pippalimoola in NidranashaFUTURE PROSPECTIVEThough this work maximum efforts put to fulfill the subject and achieve the aims andobjectives of the present project work. There is still a wide scope to greatest distance ofstudies as fallow.♦ Similar study carried with largest sample.♦ Similar study carried with more duration of treatment.♦ Comparative clinical trial should be carried along with sedative drugs.    Conclusion 121 
  • 141.                                                 Efficacy of Marichapatra & Pippalimoola in Nidranasha SUMMARY This study was formulated to evaluate the efficacy of Maricha and Pippali in themanagement of Nidranasha (primary Insomnia) – A comparative clinical study. The aims and objectives of the present study has been discussed. The drug Maricha and Pippali were reviewed discussed and elaborated explained from the Ayurvedic and Modern literatures. The definition , History,Etiology,Sumprapti,Laxana and treatment of Nidranasha according to classics and also definition,Physiology, types of sleep, and clinical features of Insomnia were reviewed in this clinical trial. The study was conducted on 30 patients with equally distributed in 2 groups A and B. In group A – Maricha patra Churna with Guda in the form of Vati was administered . In group B pippali Moola Churnawith guda in the form vati was administered. Dose was 2gm B.D same for two groups. In this study incidence of age, sex, occupation, religion, economical status and diet incidents were highlighted in the observations. Almost all the symptoms of Nidranasha reported in this study and showed response with both the groups. Comparing 2 groups individually Group B (Pippali Moola Churna with guda) showed better response than Group A (Maricha patra churna with Guda) by using paired and unpaired ‘t’ test P value is <0.001 and ‘t’ values.
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  • 146.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha98. Bhavamisra, Bhavaprakasha Nighantu Aradrakadi varga sloka 65. G.S. Pandey editor. 7th ed. Varanasi: Chowkhamba Bharati Academy; 1984. Pg 19.99. Pandit Aryadasa kumar singh, Mahaushadha Nighantu mahaushadha varga 1 sloka 14. Shri Indradeva Tripathi editor. 1st ed. Varanasi: Chowkhamba Vidyabhavan; 1971. Pg 15.100. P.V.Sharma, Dravyaguna vijnana Vol-II 7th ed Varanasi : Chaukhamba Bharati Acadeny ; 1987 Pg 363.101. Pandit Narahari, Raj Nighantu Pippalyadi varga sloka 23. Indradeo Tripathi editor. 2nd ed. Varanasi: Krishnadas Academy; 1998. Pg 138.102. Bhavamisra, Bhavaprakasha Nighantu Haritakyadi varga sloka 65. G.S. Pandey editor. 7th ed. Varanasi: Chowkhamba Bharati Academy; 1984. Pg 19.103. Bapala G. Vaidya, Nighantu Adarsa purvardha Aradrakadi varga 92 28.1st ed. Varanasi; Chowkhamba Vidya Bhawana; 1968. Pg 346.104. .Y.T. Acharya, Dravyaguna Vijnana Vol-II. Pippalyadi varga 22. 3rd ed. Varanasi: Sharma Ayurveda Mandir; 1978. Pg 122-23.105. P.V. Sharma, Dravyaguna vijnana Vol-II. 7th ed. Varanasi: Chaukhambha Bharati Academy; 1987. Pg 278.106. Vaidya Vishnu Mahadeva Gogte, Ayurvedic Pharmacology And Therapeutic uses of Medicinal Plants (Dravyaguna Vijnyan). 1st English ed. Mumbai: Bharatiya vidya Bhavana; 2000. Pg 424.107. K.R. Kirtikar B.D. Basu, Indian Medicinal Plants Vol-III. 2nd ed. Dehra Dun: InternationalBook Distributors; 1999. Pg 2130.108. K.R. Kirtikar B.D. Basu, Indian Medicinal Plants Vol-III. 2nd ed. Dehra Dun: International Book Distributors; 1999. Pg 2130.109. Ibid110. Ibid111. The Ayurvedic Pharmacopiea of India Vol-I. 1st ed. New Delhi: Published by Government of India. Ministry of Health and Family welfare. Department of Health. 1989. Pg 118.112. Vaidya Vishnu Mahadeva Gogte, Ayurvedic Pharmacology And Therapeutic uses of Medicinal Plants (Dravyaguna Vijnyan). 1st English ed. Mumbai: Bharatiya vidya Bhavana; 2000. Pg 425.113. G Gopalan, nutrative value of Indian Foods, B S Nagarajarao editor.National Institute of Nutrition, ICMR, Hyderabad.pg 53,63.114. The Ayurvedic Pharmacopiea of India Vol-I. 1st ed. New Delhi: Published by Government of India. Ministry of Health and Family welfare. Department of Health. 1989. Pg 134.115. Bapalal Vaidya, Some controversial drugs in Indian Medicine P V Sharma editor 1st ed.1982,Pg 335-336.116. K.M. Nadakarni’s Indian Materia Medica Vol-I. A.K. Nadakarni editor. 3rd ed. Bombay:Popular Prakashana; 1982. Pg 966.967.117. K.R. Kirtikar and B.D. Basu, Indian Medicianl Plants. Vol-III. 2nd ed. Dehra Dun:International Book Distributors; 1999. Pg 2128,2129.118. Yogaratanakarah, Yogaratnakara vidyotini Hindi commentary by Laksmipati sastri Purvarda sloka 1 . Bhisgratna Brahmasankar sastri editor. 2nd ed. Varanasi : Chowkhamba Sanskrit series office, 1973. Pg 111.     
  • 147.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha DISEASE REVIEW119. Raja Radha Kantadeva, Shabda Kalpa Druma. Part – II, 3rd ed. Varanasi : Chowkhamba Sanskrit Series ; 1967 Pg 881.120. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Sutrasthanam Chapter 7 Sloka 52. Priyavrat Sharma editor. 1st ed. Varanasi: Chaukhambha orientalia; 1978. Pg 119.121. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 7 sloka 3-4. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 150.122. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 36. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 418.123. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 58,59. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 422.124. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 32, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 34.125. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 51. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 420.126. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 33, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 34127. Bhavamishra,Bhavaprakasha,Vidyotini Hindi Commentry,poorvardha,Chapter 3rd Sholka 317,Shri Brhama Shankar Shastri editor, 5th ed. Chowkhamba Sanskrit Series office,Varanasi ; 1969,Pg 99.128. Pandita Sharangadhara,Sharangadhara Samhita Madya Khada,Chapter 3rd Sloka 317, Dr.Brahmanand Tripathi editor. 1st ed.Varansi : Chaukhambha Surbharati Prakasha : 1990. Pg 99.129. Pandita Sharangadhara,Sharangadhara Samhita Purva Khada,Chapter 3rd Sloka 317, Dr.Brahmanand Tripathi editor. 1st ed.Varansi : Chaukhambha Surbharati Prakasha : 1990. Pg 99130. Raja Radha Kantadeva, Shabda Kalpa Druma. Part – 1, 3rd ed. Varanasi : Chowkhamba Sanskrit Series ; 1967 Pg 68.131. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 34, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 34.132. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Sutrasthanam Chapter 9 Sloka 20. K.R.Shrikantamurthy editor. 1st ed. Varanasi: Chaukhambha orientalia; 1978. Pg 203.133. Vriddha Jiraka- Kashyapa Samhita Sutra Stana,Chapter 28th,Pandit Hemaraja sarma with the Vidyotini Hindi Commentry, editor 4 ed, Chaukhambha,Sanskrit Sansthan, Varanasi ; 1977 Pg 54134. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 6, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 34135. Vagbhata,Astanga Sangraha with Sarvanga Sundari Commentry Part 1 Sutrastana, Chapter 9,Sloka 39.Pandit Lalchandra Shastri Vaidya editor. 2nd ed,Nagapur : Shri Baidhyanatha Ayurveda Bhavan limited ; 1981 Pg 197.136. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Sutrasthanam Chapter 9 Sloka 19. K.R.Shrikantamurthy editor. 1st ed. Varanasi: Chaukhambha orientalia ; 1978. Pg 203.137. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 35. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 416.138. Vagbhata,Astanga Sangraha with Sarvanga Sundari Commentry Part 1 Sutrastana, Chapter 9,Sloka 7.Pandit Lalchandra Shastri Vaidya editor. 2nd ed,Nagapur : Shri Baidhyanatha Ayurveda Bhavan limited ; 1981 Pg 203.     
  • 148.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha139. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 58,59. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 422.140. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 33,34, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 34141. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 58. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 422.142. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 32, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 34143. Vagbhata,Astanga Sangraha with Sarvanga Sundari Commentry Part 1 Sutrastana, Chapter 9,Sloka 67.Pandit Lalchandra Shastri Vaidya editor. 2nd ed,Nagapur : Shri Baidhyanatha Ayurveda Bhavan limited ; 1981 Pg 201.144. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 36. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 418.145. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 38. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 418.146. Sushruta,Sushruta Samhita,Shareera Stana, 4th chapter Shloka 40, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 35.147. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 36. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 418.148. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 20, sloka 14. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 403.149. Vagbhata,Astanga Sangraha with Sarvanga Sundari Commentry Part 1 Sutrastana, Chapter 9,Sloka 38,39,40,41,42,43,44.Pandit Lalchandra Shastri Vaidya editor. 2nd ed,Nagapur : Shri Baidhyanatha Ayurveda Bhavan limited ; 1981 Pg 197-200.150. Raja Radha Kantadeva, Shabda Kalpa Druma. Part – II, 3rd ed. Varanasi : Chowkhamba Sanskrit Series ; 1967 Pg 881.151. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21st sloka 36,38,50,52. Sri satya narayana sastri editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 418-421.152. Sushruta,Sushruta Samhita,Shareera Stana, 4 chapter, Shloka 41,47, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 35,36.153. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Sutrasthanam Chapter 7, Sloka 55,64. K.R.Shrikantamurthy editor. 1st ed. Varanasi: Chaukhambha orientalia ; 1978. Pg 119,120.154. Sushruta,Sushruta Samhita,Shareera Stana, 4 chapter Shloka 41, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 35.155. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 3 , 24 sloka 28,85,91 Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 116,139,818.156. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Nidana Stana Vol II Chapter 2,6 , Sloka 16,27,16 K.R.Shrikantamurthy editor. 1st ed. Varanasi: Chaukhambha orientalia ; 1978. Pg 13,16,60.157. Agnivesha, Charaka samhita purva bhaga Chikitsa stana Vol II chapter 24,29 sloka 6,91Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 818,984.158. Sushruta,Sushruta Samhita,Chikitsa Stana, chapter 1 Shloka 40,41, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan : Pg 231.159. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Chikitsa Stana Vol II Chapter 13 Sloka 26 K.R.Shrikantamurthy editor. Reprint . Varanasi: Chaukhambha orientalia ; 1978. Pg 550.     
  • 149.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha160. Agnivesha, Charaka samhita purva bhaga Chikitsa stana Vol II chapter 3, sloka 28Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 116.161. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Chikitsa Stana Vol II Chapter 2 Sloka 27 K.R.Shrikantamurthy editor. Reprint. Varanasi: Chaukhambha orientalia ; 1978. Pg 451162. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21, sloka 55,56,Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 421.163. Sushruta,Sushruta Samhita,Shareera Stana, 4 chapter, Shloka 41, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan ; Pg 35164. Vagbhata,Astanga Sangraha with Sarvanga Sundari Commentry Part 1 Sutrastana, Chapter 9,Sloka 54.Pandit Lalchandra Shastri Vaidya editor. 2nd ed,Nagapur : Shri Baidhyanatha Ayurveda Bhavan limited ; 1981 Pg 199.165. Vagbhata, Astanga Hradayam with sarvanga sundara commentary by Arunadatta and the vidyotini Hindi commentary by Artideva Gupta. Chikitsa Stana Vol II Chapter ?? Sloka 64 K.R.Shrikantamurthy editor. 1st ed. Varanasi: Chaukhambha orientalia ; 1978. Pg 121.166. Vagbhata,Astanga Sangraha with Sarvanga Sundari Commentry Part 1 Sutrastana, Chapter 9,Sloka 54.Pandit Lalchandra Shastri Vaidya editor. 2nd ed,Nagapur : Shri Baidhyanatha Ayurveda Bhavan limited ; 1981 Pg 199.167. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21, sloka 56,Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 421.168. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21, sloka 56,Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 421.169. Sushruta,Sushruta Samhita,Shareera Stana, 4 chapter, Shloka 34, Kaviraj Ambhika datta Shastri editor 8th ed. Varansi : Chowkhamba Sanskrit Samstan ; Pg 34170. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21, sloka 52,Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy ;1996. Pg 421.171. Agnivesha, Charaka samhita purva bhaga sutra stana chapter 21, sloka 53,Bhrmanand Tripati editor.22nd ed. Varanasi: Chaukhambha Bharati Academy; 1996. Pg 421.172. Arthur C. Guyton – Text book of Medical Physiology,Chapter 59, Elsevier,Editor. 10th ed, New Delhi.Published by Elsevier,a division of Reed Elsevier India Pvt Ltd ; 2000. Pg 688.173. Arthur C. Guyton – Text book of Medical Physiology,Chapter 59, Elsevier,Editor. 10th ed,New Delhi.Published by Elsevier,a division of Reed Elsevier India Pvt Ltd ; 2000. Pg 688-690.174. Harrison’s Principles of International Medicine Vol II, Chapter 328. Fouci,Drauwald,Isslbachr, Wilson,Martin,Kasper etal editor. Singapore ; Mc Graw Hill ; 1998 Pg 1988.175. A.P.I Text book of Medicine,Section XII ,Gs Sainani,Philip Abraham,F.D Dastur,V.R.Joshi,R.D.Lele,Late P.J.Mehta . et al.editor 6th ed.Mumbai : Association of Physian of India. 1999 Pg 743,744.176. Arthur C. Guylon – Text book of Medical Physiology,Chapter 59, Elsevier,Editor. 10th ed, New Delhi.Published by Elsevier,a division of Reed Elsevier India Pvt Ltd ; 2000. Pg 591.177. A.P.I Text book of Medicine,Section XII ,Gs Sainani,Philip Abraham,F.D Dastur,V.R.Joshi,R.D.Lele,Late P.J.Mehta . et al.editor 6th ed.Mumbai : Association of Physian of India. 1999 Pg 744.178. Kaplan and Sadak – Sunopsis of Psychiatry, Behavioural sciences/clinical psychiatry,New delhi 8th ed. Pg 744.     
  • 150.                                                Efficacy of Marichapatra & Pippalimoola in Nidranasha     
  • 151.                                                                    Efficacy of Marichapatra & Pippalimoola in Nidranasha pDroval No : TL-2/2004 dated: 14.06.2004 Format No. BTH/QF/7A BANGALORE TEST HOUSE 09001"<a ~ 65, 20th Main, Marenahalli, Vijayanagar, Bangalore - 560 040. Ph.: 23356415, 23388895, 23502689 Fax: 080- 23385979 e-mail: testhouse@satyam.net.in website: www.bthindia.com .!!? ~fb , . TEST CERTIFICATE The Drugs & Cosmetics Act 1940 and the Rules thereunder FORM 43 [See Rule 160.. F] 1 of 1 IWs. Dr.SunItha Gaddlgoudar Final M.D., Report No : 1257 Departmd or Dravyaguna, P.G.Studies & Date : 20.12.2005 Researd1 Center, D.G.MAyurvecic MedIcal Reference No : letter Collage, Kalasapur Road, Dated : 14.12.2005 GADAG. Date or receipt: 14.12.2005 Job Order No. :AUI2OO5I12/029 Nrg Ucence No: NA Sample : Marlchapatra Churna Batch No : NA DIM: NA DIE : NA Lot Stze: NA Sample Qy : 100gms IVIanufactunM;I {SUpplied by: NA NA- Not Available TESTS RESULTS PROTOCOL Description Dark green co loured fine powder. Ayurvedlc Pharmacopoeia of India. Test for Presence of Piperine Absent f.~~~ .. A~ AUTHORISED SIGNATORY ~OTE: 1. The result listed refer only to the tested samples & applicable parameters. Endorsement of products is neither inferred nor implied. 2. Samples will be destroyed after one month from the date of issue of test certificate unless otherwise specified. 3. This report is not to be reproduced wholly or in part & cannot be used as an evidence in the Court of law & should not be used in any advertising media without our special permission in writing.. 4. Sample (s) not drawn by us unless otherwise stated. 5. Total liability of our laboratory is limited to the invoiced amount. Any dispute arising out of this report is subject to Bangalore Jurisdiction only.               Methodology 73 
  • 152. SPECIAL CASE SHEET FOR EVALUATION OF EFFICACY OF MARICHA PATRA & PIPPALI MOOLA IN THE MANAGEMENT Department of Dravya guna Vignana Post graduate studies and reasearch center Shri D G M Ayurvedic Medical College Gadag.Guide : Dr. T.R. Bhagyalaxmi M.D (Ayu)Co-guide : Dr. Kuber Sankh M.D (Ayu) Scholar: Sunitha 01. Name : 02. Fathers/Husband’s Name: 03. Age : 04. Sex : 05. Religion : Hindu Muslim Christian Others 06. Occupation : Service Labour House Wife Student Others 07. Economical Status Poor Class Middle Class Higher Class 08. Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ________ ___________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Telephone No : _ _ _ _ _ _ 09.Type of Medication : Group A Maricha Patra Vati B Pippali Moola Vati 10.Results : Complete Remission Major Improvement Minor Imorvement Discontinued 11. Consent : I ---------------------------------------------------------------------------- here by giving myconsent to be included as a subject in the above study. I have been informed to my satisfaction,by the investigator about the Purpose of the Clinical trial, nature of the drug treatment and its Signature of the Investigator Signature of the Patient       
  • 153. fallow up. I am also aware of my right to quite the trial at any time during the course of the trialwithout having to reasons for doing so. 13. PRADHANA VEDANA: Sl.No Symptoms Y/N Duration 1 Difficulty in initiating sleep 2 Disturbance during sleep 3 Reduction in sleep time 4 Angamarda 5 Jrumbha 14. ANUBANDHA VEDANA : Sl.No Symptoms Y/N Duration 1 Jadya 2 Glani 3 Bhrama 4 Apakti 5 Tandra 6 Other 15. VEDANAVRUTTANTA 16. POORVA VYADHI VRITTANTA: A. Nature of Problem/Character/Severity B. Onset of Symptoms Sudden Gradual ? C. Factor/events responsible.Compalints due to Sl.No Altered Notaltered Could not be elicoted 1 Impairment of social activity 2 Impairment in occupational activity 3 Other functionilty areas 4 Environmental changs       
  • 154. 5 Familial and other Relationships 6 Sexyal relationship 17. POORVA VYADHI VRITTANTA : A) Psychiatric history : I. Date : Complications Yes/No II. H/O Injuries : Suicidal thought/Attempt Yes/No III.Treatment : History of drug abuse B) Medical History : I. Chronic Medical illness : Present/Absent II. H/O Injuries : Present/Absent III. Operations : Yes/No 18. TREATMENT HISTORY : A) G.P/Ayurveda/Homeo/Religious/Other B) Dose/Duration of any Psychotropic Medicine : C) Nature of Psychological/Physical treatment given : D) Antidepressant drugs/Sedatives/Tranquilizers/Hypnotic drugs. E) Counseling / Cognitive therapy/ Psychotherapy/Meditation 19. KULA VARITTANTA :- A) Same complaint present in Family Yes/No B) Extended/Joints/Hostel/With relatives/Others. C) No of persons in the family _ _ _ _ _ Adults _ _ _ _ Children_ _ _ _ _ D) F/H/O Alcoholism/Suicide/Epilepsy/Psycholpathy/Drug Addiction. Mental retardation/Emotional disorders/ Others 20. VAIYANKTIKA VRITTANTA : AHARA: Vegetarian Non-Vegetarian Habit of eating in the evening       
  • 155. VIHARA : Vyasama : Vyasana : Sl.No Habit before sleep Yes No 1 With soft music? 2 Applying perfume at bed time? 3 Bath before going to bed? 4 Light massage? 5 Habit of passing urine? 6 Habit of passing stool? 7 Habit of masturbation? 8 Habit of exercise/Prayer/Smoking? 9 Habit of thinking/Sexual intercourse 10 Habit of consuming alcohol?HISTORY OF SLEEPSl.No Yes No1 Sleep attack during day?2 Do you have trouble falling a sleep? When you first go to bed?3 Do you awaken during night?4 Do you awake more than once?5 Do you awake too early in the morning?6 How long have you had trouble sleeping?7 How would you describe your usual night sleep?8 Do others live at home, who interrupt your sleep?9 Does your job requires shift changes or travels?10 Do you drink coffee, tea or soft drink?11 What sleep medication do you take (Prescription/dose/duration)12 Have you suffered from depression/anxiety       
  • 156. 21) SAMANYA PAREEKSHA (GENARAL EXAMINATION) Nadi - Shabda - Shareerabhara - Mala - Sparsha - Shareera Dairgya - Mutra - Druk - Raktachapa - Jiwha - Akriti - Others -22) VISHESHA PAREEKSHA (SYSTEMIC EXAMINATION) C.V.S - R.S - C.N.S - P/A -23) DASHAVIDHA PAREEKSHAPRAKRITI : Vataja/Pittaja/Kaphaja/Dwandwaja/SannipatajaSARATA : T/R/M/M/A/M/SSAMHANA : Pravara Madhyama AvaraPRAMANA : Pravara Madhyama AvaraSATMYA : Pravara Madhyama AvaraSATVA : Pravara Madhyama AvaraVYAYAMSHAKTI : Pravara Madhyama AvaraVAYA : Balya Madhyama VruddaAHARASHAKTI : Abhyavaranashakti P/M/A       
  • 157. 24) PRAYOGIKA PAREEKSHA: Blood : Hb% Urine-Sugar -TC -Albumin -DC -E.S.R Microscopic examination25) TREATMENT :25) ASSESMENT OF RESULT :Subjective symptoms Complaints Before treatment 15th day After treatment 45th day after 0th day 30th day treatment followup1 Reduction in sleep time2 Difficulty in initiating sleep3 Wakefulness during normal sleep4 Angamarda5 Shirogourava6 JrumbhaINVESTGATORS NOTE : Signature of the ScholarSignatue of Co-guide Signature of Guide       
  • 158. HISTORY OF SLEEPSl.No Yes No1 Sleep attack during day?2 Do you have trouble falling a sleep? When you first go to bed?3 Do you awaken during night?4 Do you awake more than once?5 Do you awake too early in the morning?6 How long have you had trouble sleeping?7 How would you describe your usual night sleep?8 Do others live at home, who interrupt your sleep?9 Does your job requires shift changes or travels?10 Do you drink coffee, tea or soft drink?11 What sleep medication do you take (Prescription/dose/duration)12 Have you suffered from depression/anxiety21) SAMANYA PAREEKSHA (GENARAL EXAMINATION) Nadi - Shabda - Shareerabhara - Mala - Sparsha - Shareera Dairgya - Mutra - Druk - Raktachapa - Jiwha - Akriti - Others -22) VISHESHA PAREEKSHA (SYSTEMIC EXAMINATION) C.V.S - R.S - C.N.S - P/A -       
  • 159. 23) DASHAVIDHA PAREEKSHAPRAKRITI : Vataja/Pittaja/Kaphaja/Dwandwaja/SannipatajaSARATA : T/R/M/M/A/M/SSAMHANA : Pravara Madhyama AvaraPRAMANA : Pravara Madhyama AvaraSATMYA : Pravara Madhyama AvaraSATVA : Pravara Madhyama AvaraVYAYAMSHAKTI : Pravara Madhyama Avara VAYA : Balya Madhyama VruddaAHARASHAKTI : Abhyavaranashakti P/M/A Jaranashakti P/M/A24) PRAYOGIKA PAREEKSHA: Blood : Hb% Urine-Sugar -TC -Albumin -DC -E.S.R Microscopic examination25) TREATMENT:Medicine Dosage Started on Completed       
  • 160. 25) ASSESMENT OF RESULT :Subjective symptoms Complaints Before treatment 15th day After treatment 45th day after 0th day 30th day treatment followup1 Reduction in sleep time2 Difficulty in initiating sleep3 Wakefulness during normal sleep4 Angamarda5 Shirogourava6 JrumbhaINVESTGATORS NOTE : Signature of the Scholar       
  • 161. Signature of the co-guide Signature of the guide       

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