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EXPERIMENTAL STUDY OF SANDHYA RAGA (MIRABILIS JALAPA. LINN) IN COMPARISON WITH MADHUSNUHI (SMILAX CHINA .LINN) WITH SPECIAL REFERENCE TO ITS VRANAROPANA PROPERTY-SHEHNA.S.R., Department of P.G.Studies ...

EXPERIMENTAL STUDY OF SANDHYA RAGA (MIRABILIS JALAPA. LINN) IN COMPARISON WITH MADHUSNUHI (SMILAX CHINA .LINN) WITH SPECIAL REFERENCE TO ITS VRANAROPANA PROPERTY-SHEHNA.S.R., Department of P.G.Studies in Dravyaguna Vijnana, Alva’s Ayurveda Medical College, Moodbidri, Karnataka - 574 227

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    Madusnuhi vrana#dg06 mdb Madusnuhi vrana#dg06 mdb Document Transcript

    • EXPERIMENTAL STUDY OF SANDHYA RAGA (MIRABILIS JALAPA. LINN) IN COMPARISON WITHMADHUSNUHI (SMILAX CHINA .LINN) WITH SPECIALREFERENCE TO ITS VRANAROPANA PROPERTY ’ DISSERTATION SUBMITTED TO RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKAAS PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR AWARDING THE DEGREE OF AYURVEDA VACHASPATI [M.D (Ay)] IN Dravyaguna Vijnana BY SHEHNA.S.R. UNDER THE SUPERVISION OF Prof.Dr.N.Viswanathan M.D. (Ay) Dr.Subrahmanya P. M.D.(Ay) Guide & H.O.D Co-Guide & Assistant Professor Dept. of P.G.Studies in Dravyaguna Vijnana, Dept. of P.G.Studies in Dravyaguna Vijnana, Alva’s Āyurveda Medical College, Alva’s Āyurveda Medical College, Moodbidri, Moodbidri, Karnataka. Karnataka. Department of P.G.Studies in Dravyaguna Vijnana Alva’s Ayurveda Medical College Moodbidri, Karnataka - 574 227
    • DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA VIJNANA MOODBIDRI, KARNATAKA This is to certify that the dissertation entitled ‘EXPERIMENTALSTUDY OF SANDHYA RAGA (MIRABILIS JALAPA.LINN) INCOMPARISON WITH MADHUSNUHI (SMILAX CHINA.LINN) WITHSPECIAL REFERENCE TO ITS VRANAROPANA PROPERTY’” is abonafide research work done by SHEHNA S.R., in partial fulfilment ofthe requirement for the degree of Ayurveda Vachaspati - M.D. (Ay) inDravyaguna Vijnana of Rajiv Gandhi University of Health Sciences,Bangalore, Karnataka. Prof.Dr.N.Viswanathan M.D. (Ay) H.O.D., Dept. of P.G.Studies in Dravyaguna Vijnana, Alva’s Āyurveda Medical College,Moodbidri Moodbidri
    • EXPERIMENTAL STUDY OF SANDHYA RAGA (MIRABILIS JALAPA. LINN) IN COMPARISON WITHMADHUSNUHI (SMILAX CHINA .LINN) WITH SPECIALREFERENCE TO ITS VRANAROPANA PROPERTY DISSERTATION SUBMITTED TO RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKAAS PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR AWARDING THE DEGREE OF AYURVEDA VACHASPATI [M.D (Ay)] IN Dravyaguna Vijnana BY SHEHNA S.R. UNDER THE SUPERVISION OF Prof.Dr.N.Viswanathan M.D. (Ay) Dr.Subrahmanya P. M.D.(Ay) Guide & H.O.D Co-Guide & Assistant Professor Dept. of P.G.Studies in Dravyaguna Vijnana, Dept. of P.G.Studies in Dravyaguna Vijnana, Alva’s Āyurveda Medical College, Alva’s Āyurveda Medical College, Moodbidri Moodbidri Department of P.G.Studies in Dravyaguna Vijnana Alva’s Ayurveda Medical College Moodbidri, Karnataka - 574 227 2009
    • DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA VIJNANA MOODBIDRI, KARNATAKA This is to certify that the dissertation titled ‘EXPERIMENTAL STUDY of SANDHYA RAGA (MIRABILIS JALAPA.LINN) IN COMPARISON WITH MADHUSNUHI (SMILAX CHINA.LINN) WITH SPECIAL REFERENCE TO ITS VRANAROPANA PROPERTY’ submitted by SHEHNA.S.R., in partial fulfillment for the degree of Ayurveda Vachaspati - M.D. (Ay) in Dravyaguna Vijnana, of the Rajiv Gandhi University of Health Sciences, Bangalore, is a record of research work done by her during the period of her study in this institute, under our guidance and supervision and the dissertation has not previously formed basis to the award of any degree, diploma, fellowship or other similar titles. We recommend this dissertation for the above degree to the University for approval.Prof.Dr.N.Viswanathan M.D. (Ay) Dr.Subrahmanya P. M.D.(Ay)H.O.D., Assistant Professor,Dept. of P.G.Studies in Dravyaguna Vijnana, Dept. of P.G.Studies in Dravyaguna Vijnana,Alva’s Āyurveda Medical College, Alva’s Āyurveda Medical College,Moodbidri MoodbidriMoodbidri
    • DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA VIJNANA MOODBIDRI, KARNATAKA I hereby declare that this dissertation titled ‘EXPERIMENTAL STUDY OF SANDHYA RAGA (MIRABILIS JALAPA.LINN) IN COMPARISON WITH MADHUSNUHI (SMILAX CHINA.LINN) WITH SPECIAL REFERENCE TO ITS VRANAROPANA PROPERTY’ is a bonafide and genuine research work carried out by me under the guidance of Prof.Dr.N.Viswanathan M.D. (Ay) and Dr.Subrahmanya P. M.D.(Ay), Dept. of P.G. Studies in Dravyaguna Vijnana, Alva’s Āyurveda Medical College, Moodbidri, Karnataka.Moodbidri SHEHNA.S.R. P.G.Scholar Dept. of P.G.Studies in Dravyaguna Vijnana, Alva’s Āyurveda Medical College, Moodbidri.
    • DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA VIJNANA MOODBIDRI, KARNATAKA This is to certify that the dissertation titled ‘EXPERIMENTAL STUDY OFSANDHYA RAGA (MIRABILIS JALAPA.LINN) IN COMPARISON WITHMADHUSNUHI (SMILAX CHINA.LINN) WITH SPECIAL REFERENCETO ITS VRANAROPANA PROPERTY’ is a bonafide research work done bySHEHNA S.R. under the guidance of Prof.Dr.N.Viswanathan M.D. (Ay) andDr.Subrahmanya P. M.D.(Ay), Dept. of P.G.Studies in Dravyaguna Vijnana,Alva’s Āyurveda Medical College, Moodbidri, Karnataka. Prof. Suresh Negalaguli M.D. (Ay.) Prof.Lakshmeesh Upadhya M.D.(Ay.) Dean Principal, Post Graduate.Studies Alva’s Āyurveda Medical College, Alva’s Āyurveda Medical College, Moodbidri. Moodbidri. Moodbidri
    • COPYRIGHT I hereby declare that the Rajiv Gandhi University of HealthSciences, Karnataka shall have all rights to preserve, use anddisseminate this dissertation in print or electronic format for academic/ research purposes. Moodbidri SHEHNA.S.R P.G.Scholar Dept. of P.G.Studies in Dravyaguna Vijnana, Alva’s Ayurveda Medical College, Moodbidri, Karnataka – 574 227 © Rajiv Gandhi University of Health Sciences, Karnataka
    • ACKNOWLEDGEMENT I solicit my deep and profound sense of respect to my rewarded guideProf. Dr.N.Viswanathan,M.D(Ay), H.O.D, Department of P.G.Studies in Dravyaguna Vjnana for his advise, motivational inspiration and ever encouraging constantindefeasible guidance extended towards me through out this dissertation work I sincerely express my deep sense of gratitude to my teacher and co-guide,Dr.Subrahmanya P. M.D(Ay), Asst. Professor, Department of P.G.Studies inDravya guna for the magnitude of his dynamic and untiresome guidancethroughout the study. I express my sincere gratitude to Prof.Dr. A.P.Haridasan., Dept. ofP.G.studies in Dravyaguna Vijnana , for his constructive suggestions andmeticulous guidance given from time to time while carrying out dissertation work I offer my special thanks to Dr.Mohan Alva, Chairman, Alvas EducationFoundation for providing me an opportunity in his esteemed institution for PostGraduation studies. I wish to offer my sincere thanks to Prof. Dr. Suresh Negalaguli, Dean ofPost Graduation studies , and Prof. Dr. Lakshmeeesh Upadhya, , Principal ,AlvasAyuveda Medical College ,for their encouragement and support. I acknowledge with sincere thanks for the valuable guidance and kind co–operation of Prof. Dr.Sethumadhava Murthy H.O.D, and Dr.Srikanth, LecturerDepartment of P.G.Studies in Dravya guna Vijnana , and authorities of S.D.M.Educational Society for providing me all the requisite facilities to carry out theanimal experimentation work.
    • I express my sincere gratitude to Prof. Radhakrishna Rao MSc. PhD.Visiting Professor, Dept. of Dravyaguna for his valuable guidance in thepharmacognostical aspect and drug authentication of this work. I express my sincere gratitude to Dr.T.S.Mahesh, Dr. Ravi Rao,Dr.Vinod Joshi, and Dr.Sridevi, teaching staff , Dept. of Dravyaguna, for theirconstructive suggestions and guidance given from time to time while carrying outdissertation work. I here acknowledge the valuble help and suggestions I have had discussingmy dissertation with Dr.Krishna Murthy and Dr.Prashanth.B.K Lecturers ,Department of Bhaishajya kalpana. I offer my special thanks to Mrs.Reshma, Statistician, Managalore, for hervaluable assistance during statistical analysis of result. It is beyond the reach of my language as it is very difficult to findappropriate words to express my sincere and hearty gratitude to my husband,batch mate Dr.Suchith.M.S and my friend, classmate Dr.Subhasree.G.H forbeing with me any time I needed help, moral support, during the miseries I facedduring the work and suggestions which helped me to pull through. I am indebted to my other batch mates and my juniors and every one whohave helped me directly and indirectly during my dissertation work. I am thankful to my parents, in laws and my brother for their love, blessingsand never ending support through out the span of my work and for being there forme. I am ever indebted to the God almighty for showering his blessings upon meand for making my hurdles lighter so that I could complete my work satisfactorily.Moodbidri Shehna.S.R.
    • CONTENTS ABBREVATIONS LIST OF TABLES LIST OF DIAGRAMS LIST OF GRAPHS LIST OF IMAGES ABSTRACTCHAPTER. 1 INTRODUCTION 1-5CHAPTER. 2 REVIEW OF LITERATURE 6-81 DRUG REVIEW- Madhusnuhi Sandhyaraga DISEASE REVIEW VranaCHAPTER. 3 DRUG ANALYSIS 82-93CHAPTER.4 EXPERIMENTAL STUDY 94-98 Materials Methods GroupingCHAPTER.5 OBSERVATION AND RESULTS 99-148CHAPTER.6 DISCUSSION 149-159CHAPTER.7 CONCLUSION 160-161CHAPTER.8 SUMMARY 162-163 LIST OF REFERENCES BIBLIOGRAPHY ANNEXURE
    • ABBREVATIONSA.H -Astanga HridayaA.P.I -Ayurvedic Pharmacopia of India.A.S -Astanga Sangraha.B.P.N -Bhavaprakasha Nighantu.C -Control group.C&C - Conservation and consumption, A study on crude drug trade in threatened medicinal plants in Trivandrum districtCh. -Charaka SamhitaChi - Chikitsa sthana.D.G.V -Dravya Guna Vinjana.Eg/eg -Example.EM -External MadhusnuhiES - External Sandhyaragagms -Grams.i.e -That is.I.M.P.K&B-Indian Medicinal Plants by Keerthikar and BasuI.M.P.O.L - Indian Medicinal Plants, Published by Orient LongmanIEM -Internal external madhusnuhiIES -Internal External sandhyaragaIM -Internal MadhusnuhiIS -Internal SandhyaragaM.M.P - Materia Medica of Local Health Traditions of PayyannurM.Ni -Madhava Nidana.mg -MilliGramsml -milli litre.mm2 -Millimeter Square.Ni. -Nidana Sthana.Pg -PageR -RatS.D -Standard Deviation.S.E -Standard Error.S.Y -Sahasra Yogam
    • Sa.Ka.Dru -Shabda kalpa druma.Sam. -Samhita.Sl.No. -Serial Number.Su .Chi -Susrutha samhitha .ChikitsasthanaSu -SuthrasthanaSu.Sam - Susrutha samhithaU -Uttarathantraviz. - NamelyVol -VolumeY..R -Yoga Ratnakara.% -Percentage.& -And
    • LIST OF TABLESTable Topic PageNo. No.2.B.1 Classifications of NijaVrana 382.B.2 Classification of Vrana based on prognosis and treatment 412.B.3 Types of Agantuja Vrana 422.B.4 Vrana Adhishtanas 462.B.5 Vrana Lakshanas as per Susrutha Samhita 472.B.6 Vrana Lakshanas as per Charaka Samhita 49 3.1 Results of phytochemical analysis 89 4.1 Physical attributes 964.2. Group, Drug and Mode of Administration 98 5.1 Percentage of closure in original excision wound area (sq.mm) on 99 4th post wounding day of Control and Trial drug A (Madhusnuhi) 5.2 Interpretation of statistical analysis on the comparative percentage 100 of closure in excision wound area of Control and Trial drug A (Madhusnuhi) groups on 4th post wounding day 5.3 Percentage of closure in original excision wound area (sq.mm) on 100 th 8 post wounding day of Control and Trial drug A (Madhusnuhi) 5.4 Interpretation of statistical analysis on the comparative percentage 101 of closure in excision wound area of Control and Trial drug A (Madhusnuhi)groupson 8th post wounding day 5.5 Percentage of closure in original excision wound area (sq.mm) on 101 th 12 post wounding day of Control and Trial drug A (Madhusnuhi) 5.6 Interpretation of statistical analysis on the comparative percentage 102 of closure in excision wound area of Control and Trial drug A (Madhusnuhi)groups on 12th post wounding day
    • 5.7 Percentage of closure in original excision wound area (sq.mm) on 102 16th post wounding day of Control and Trial drug A (Madhusnuhi)5.8 Interpretation of statistical analysis on the comparative percentage 103 of closure in excision wound area of Control and Trial drug A (Madhusnuhi)groups on 16th post wounding day.5.9 Percentage of closure in original excision wound area (sq.mm) on 103 4th post wounding day of Control and Trial drug B ( Sandhyaraga)5.10 Interpretation of statistical analysis on the comparative percentage 104 of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 4th post wounding day5.11 Percentage of closure in original excision wound area (sq.mm) on 104 th 8 post wounding day of Control and Trial drug B ( Sandhyaraga)5.12 Interpretation of statistical analysis on the comparative percentage 105 of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 8th post wounding day5.13 Percentage of closure in original excision wound area (sq.mm) on 105 th 12 post wounding day of Control and Trial drug B (Sandhyaraga)5.14 Interpretation of statistical analysis on the comparative percentage 106 of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 12th post wounding day5.15 Percentage of closure in original excision wound area (sq.mm) 106 on16th post wounding day of Control and Trial drug B (Sandhyaraga)5.16 Interpretation of statistical analysis on the comparative percentage 107 of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 16th post wounding d5.17 Percentage of closure in original excision wound area (sq.mm) on 107 4th post wounding day of Control and Internal administration groups of both Trial drug5.18 Interpretation of statistical analysis on the comparative percentage 108 of closure in excision wound area of Control and Internal administration groups of both Trial drugs on 4th post wounding day
    • 5.19 Percentage of closure in original excision wound area (sq.mm) on8th 108 post wounding day of Control and Internal administration groups of both Trial drugs5.20 Interpretation of statistical analysis on the comparative percentage 108 of closure in excision wound area of Control and Internal administration groups of both Trial drugs on 8th post wounding day.5.21 Percentage of closure in original excision wound area (sq.mm) on 109 th 12 post wounding day of Control and Internal administration groups of both Trial drugs:5.22 Interpretation of statistical analysis on the comparative percentage 109 of closure in excision wound area of Control and Internal administration groups of both Trial drugs on 12th post wounding day5.23 Percentage of closure in original excision wound area (sq.mm) on 109 16th post wounding day of Control and Internal administration groups of both Trial drugs5.24 Interpretation of statistical analysis on the comparative percentage 110 of closure in excision wound area of Control and Internal administration groups of both Trial drugs on 16th post wounding day5.25 Percentage of closure in original excision wound area (sq.mm) on 110 4th post wounding day of Control and External administration groups of both Trial drugs:5.26 Interpretation of statistical analysis on the comparative percentage 111 of closure in excision wound area of Control and External administration groups of both Trial drugs 4th post wounding day5.27 Percentage of closure in original excision wound area (sq.mm) on 111 8th post wounding day of Control and External administration groups of both Trial drugs5.28 Interpretation of statistical analysis on the comparative percentage 112 of closure in excision wound area of Control and External th administration groups of both Trial drugs 8 post wounding day
    • 5.29 Percentage of closure in original excision wound area (sq.mm) on 112 12th post wounding day of Control and External administration groups of both Trial drugs5.30 Interpretation of statistical analysis on the comparative percentage 112 of closure in excision wound area of Control and External administration groups of both Trial drugs 12th post wounding day.5.31 Percentage of closure in original excision wound area (sq.mm) on 113 th 16 post wounding day of Control and External administration groups of both Trial drugs:5.32 Interpretation of statistical analysis on the comparative percentage 113 of closure in excision wound area of Control and External administration groups of both Trial drugs 16th post wounding day.5.33 Percentage of closure in original excision wound area (sq.mm) on 114 4th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.34 Interpretation of statistical analysis on the comparative percentage 114 of closure in excision wound area of Control and Combined Internal and External administration groups of both Trial drugs 4th post wounding day5.35 Percentage of closure in original excision wound area (sq.mm) on 115 8th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.36 Interpretation of statistical analysis on the comparative percentage 115 of closure in excision wound area of Control and Combined Internal and External administration groups of both Trial drugs 8th post wounding day5.37 Percentage of closure in original excision wound area (sq.mm) on 116 12th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.38 Interpretation of statistical analysis on the percentage of closure in 116 excision wound area of Control and Combined Internal and External administration groups of both Trial drugs 12th post wounding day
    • 5.39 Percentage of closure in original excision wound area (sq.mm) 117 on16th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.40 Interpretation of statistical analysis on the comparative percentage 117 of closure in excision wound area of Control and Combined Internal and External administration groups of both Trial drugs 16th post wounding day5.41 Percentage of closure in original excision wound area (sq.mm) on 118 4th post wounding day of Control and all groups of Trial drugs5.42 Interpretation of statistical analysis on the percentage of closure in 118 excision wound area of Control and all groups of Trial drugs on on 4th post wounding day of Control and all groups of Trial drugs5.43 Percentage of closure in original excision wound area (sq.mm) on8th 119 post wounding day of Control and all groups of Trial drugs5.44 Interpretation of statistical analysis on the percentage of closure in 120 excision wound area of Control and all groups of Trial drugs on 8th post wounding day5.45 Percentage of closure in original excision wound area (sq.mm) 121 on12th post wounding day of Control and all groups of Trial drugs5.46 Interpretation of statistical analysis on the comparative percentage 121 of closure in excision wound area of Control and all groups of Trial drugs on 12th post wounding day5.47 Percentage of closure in original excision wound area (sq.mm) on 123 16th post wounding day of Control and all groups of Trial drugs5.48 interpretation of statistical analysis on the comparative percentage 123 of closure in excision wound area of Control and all groups of Trial drugs on 16th post wounding day5.49 Comparison of period of epithelialization (in no. of days) between 125 Control and Trial drug A (Madhusnuhi)5.50 Interpretation of statistical analysis on the comparative period of 125 epithelialization (in no. of days) of Control and Trial drug A (Madhusnuhi)
    • 5.51 Comparison of period of epithelialization (in no. of days) between o 126 Control and Trial drug B (Sandhyaraga)5.52 Interpretation of statistical analysis on the comparative period of 126 epithelialization (in no. of days) of Control and Trial drug B (Sandhyaraga)5.53 Comparison of period of epithelialization (in no. of days) between 127 Control and Trial drugs internal administration groups5.54 Interpretation of statistical analysis on the comparative period of 127 epithelialization (in no. of days) of Control and Trial drugs internal administration groups :5.55 Comparison of period of epithelialization (in no. of days) between 128 Control and Trial drugs external administration groups5.56 Interpretation of statistical analysis on the comparative period of 128 epithelialization (in no. of days) of Control and Trial drugs External administration groups:5.57 Comparison of period of epithelialization (in no. of days) between 129 Control and Trial drugs combined internal and external mode of administration groups5.58 Interpretation of statistical analysis on the comparative period of 129 epithelialization (in no. of days) of Control and Trial drugs combined internal and external mode of administration groups5.59 Comparison of period of epithelialization (in no. of days) between o 130 Control and all groups of both Trial drugs5.60 Interpretation of statistical analysis on the comparative period of 130 epithelialization (in no. of days) of Control and all groups of both Trial drugs
    • LIST OF DIAGRAMS No. Topic Page No. List of Graphs5.1 Mean percentage of closure of original excision wound area 132 (sq.mm) on 4h post wounding day of Control and Trial drug A (Madhusnuhi)5.2 Mean percentage of closure of original excision wound area 132 (sq.mm) on 8h post wounding day of Control and Trial drug A (Madhusnuhi)5.3 Mean percentage of closure of original excision wound area 133 th (sq.mm) on 12 post wounding day of Control and Trial drug A (Madhusnuhi)5.4 Mean percentage of closure of original excision wound area 133 (sq.mm) on 16h post wounding day of Control and Trial drug A (Madhusnuhi)5.5 Mean percentage of closure of original excision wound area 134 (sq.mm) on 4th post wounding day of Control and Trial drug B ( Sandhyaraga)5.6 Mean percentage closure of original excision wound area 134 (sq.mm) on 8th post wounding day of Control and Trial drug B ( Sandhyaraga)5.7 Mean percentage closure of original excision wound area 135 (sq.mm) on 12th post wounding day of Control and Trial drug B ( Sandhyaraga)5.8 Mean percentage closure of original excision wound area 135 (sq.mm) on 16th post wounding day of Control and Trial drug B ( Sandhyaraga)5.9 Mean percentage closure of original excision wound area 136 (sq.mm) on 4th post wounding day of Control and Internal administration groups of both Trial drugs
    • 5.10 Mean percentage closure of original excision wound area 136 (sq.mm) on 8th post wounding day of Control and Internal administration groups of both Trial drugs5.11 Mean percentage of closure of original excision wound area 137 (sq.mm) on 12th post wounding day of Control and Internal administration groups of both Trial drugs5.12 Mean percentage wounding day of Control and Internal 137 administration groups of both Trial drugs5.13 Mean percentage of closure of original excision wound area 138 (sq.mm) on 4th post wounding day of Control and External administration groups of both Trial drugs5.14 Mean percentage of closure of original excision wound area 138 (sq.mm) on 8h post wounding day of Control and External administration groups of both Trial drugs:5.15 Mean percentage of closure of original excision wound area 139 (sq.mm) on 12h post wounding day of Control and External administration groups of both Trial drugs:5.16 Mean percentage of closure of original excision wound area 139 (sq.mm) on 16h post wounding day of Control and External administration groups of both Trial drugs:5.17 Mean percentage of closure of original excision wound area 140 th (sq.mm) on 4 post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.18 Mean percentage of closure of original excision wound area 140 (sq.mm) on 8th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.19 Mean percentage of closure of original excision wound area 141 (sq.mm) on12th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs
    • 5.20 Mean percentage of closure of original excision wound area 141 (sq.mm) on 16th post wounding day of Control and Combined Internal and External administration groups of both Trial drugs5.21 Mean percentage of closure of original excision wound area 142 (sq.mm) on 4th post wounding day of Control and all groups of Trial drug A and B5.22 Mean percentage of closure of original excision wound area 142 (sq.mm) on 8th post wounding day of Control and all groups of Trial drug A and B5.23 Mean percentage of closure of original excision wound area 143 (sq.mm) on 12th post wounding day of Control and all groups of Trial drug A and B5.24 Mean percentage of closure of original excision wound area 143 (sq.mm) on 16th post wounding day of Control and all groups ofTrial drug A and B5.25 Mean percentage of closure of original excision wound area 144 (sq.mm) on every fourth day of Control and all groups of Trial drug A and B5.26 Mean period of epithelialization (in no. of days) of Control 144 and Trial drug A (Madhusnuhi)5.27 Mean period of epithelialization (in no. of days) of Control 145 and Trial drug B (Sandhyaraga)5.28 Mean period of epithelialization (in no. of days) of Control 145 and Trial drugs internal administration groups5.29 Mean period of epithelialization (in no. of days) of Control 146 and Trial drugs external administration groups5.30 Mean period of epithelialization (in no. of days) of Control 146 and Trial drugs combined internal and external mode of administration groups5.31 Mean period of epithelialization (in no. of days) of Control 147 and all groups of both Trial drugs
    • List of Images2.1 Madhusnuhi. 352.2 Madhusnuhi-Inflorescence 352.3 Sandhyaraga 352.4 Sandhyaraga Inflorscence and fruit 352.5 Dry specimen of Madhusnuhi tuber 352.6 Dry specimen of Sandhyaraga tuber 353.1 Tuber of Sandhyaraga 843.2 T.S of Sandhyaraga tuber 843.3 Outer cork cells of Sandhyaraga tuber 843.4 Xylem bundles of Sandhyaraga tuber 844.1 Madhusnuhi Churna 974.2 Sandhyaraga Churna 975.1 Stages of Excision Wound Healing 148
    • ABSTRACTTitle:‘Experimental study of Sandhyaraga (Mirabilis jalapa.Linn) incomparison with Madhusnuhi (Smilax china.Linn) with special reference to itsVranaropana property’ Sandhyaraga, (Mirabilis jalapa Linn) is a common herb, tubers of whichhave been sold in the market as an adulterant of Madhusnuhi (Smilax chinaLinn.). On literary review it is seen that both drugs possess wound healingproperty. So an investigation to bring out the wound healing property of theplant Sandhyaraga and to compare its efficacy with that of Madhusnuhi issought. The objectives of the study are to conduct scientific investigations onSandhyaraga viz; Pharmacognostical study ,Phytochemical studies ,study onPharmacological property (Rasa estimation) amd to evaluate the Vranaropana(wound healing) property of Sandhyaraga in comparison with Madhusnuhi inexperimental animals(Morton and Malone -1972 methodology) and thus to findout the most effective route of administration of both trial drugs .Albino ratswere the experimental model. 42 albino rats were selected and divided into 7groups of 6 rats each. 3 groups were used for trial drug A and 3 for trial drug Bwhere one group being served as the control. Trial drug groups wereadministered by the respective drugs internally, externally and in combinedinternal and external form. Albino rats were wounded under aseptic conditionsusing wound techniques suggested by Marton and Malone [1972]. Wound areawas measured by planimetry contraction percentage calculated and day of fallingof eschar was noted.The statistical values of three groups of both trial drugs werecompared with Control group. The results conclude that the trial drugs Sandhyaraga and Madhusnuhi areeffective, safe and well tolerated in the treatment of excision wound and thedrugs can be used for human trial.Key words: Madhusnuhi, Sandhyaraga, Adulteration, Comparison, Albino rats,Excision wound, Planimetry, Wound healing.
    • Chapter-1 Introduction INTRODUCTION Ayurveda originated long back in pre-vedic period. Rigveda and Atharva-veda(5000 years B.C.), the earliest documented knowledge have references on health anddiseases. Ayurveda is the science based up on principles like Panchamahabhuta,Tridosha and Trisutras. Ayurveda considers every Dravya in the nature as Aushadhi. Dravyaguna vijnana is a branch of Ayurveda, in which numerous herbal drugshave been discussed in detail regarding their pharmacological & therapeutic aspects.As the tradition of it spreads through out the country, various plants have beenmentioned for maintaining health and curing ailments. Medicinal plants constitute a source of raw materials for both traditionalsystems of medicine (e.g. Ayurveda, Chinese, Unani and Siddha) and modernmedicine. Most rural populations, especially in the under developed and developingcountries, depend on medicinal herbs as their main source of primary healthcare. Mostmedicinal herbs are not fit for administration as such. Hence, preparations suitable foradministration are made according to the pharmacopeial directions known asKalpanas. Some factors, which have led to the increased usage of plant materials as asource of medicines for a wide variety of human ailments are – increased population,inadequate supply of drugs, prohibitive cost of treatments, side effects anddevelopment of resistance to isolated principles and their synthetic versions. In Ayurvedic system, the crude plants are used in the preparation of medicinesby which the undesired side effects and resistance are not developed. But the isolationand identification of the active principles and elucidation of the mechanism of actionDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 1
    • Chapter-1 Introductionof a drug is of paramount importance as far as the standardization point of view ofAyurvedic drugs is concerned. A drug is said to be adulterated if it does not meet the quality and puritycharacteristics it is represented to possess or if sold under the name, which pertains toanother drug, or if it is imitation or a substitute for the other drug or resemblinganother drug in a manner likely to deceive. Different methods adopted for adulteration may be grouped as follows:Substitution with inferior commercial varieties adulteration by artificiallymanufactured substitutes, substitution by exhausted drugs, substitution bysuperficially similar but cheaper natural substances, adulteration by addition ofworthless heavy materials, addition of synthetic principles and usage of vegetativematter from the same plant. Sandhyaraga, (Mirabilis jalapa Linn) is a common herb seen in western ghats andcoastal areas of Karnataka and Kerala. It has been noted that the tubers of the planthave been sold in the crude drug market as an adulterant of Madhusnuhi (Smilaxchina Linn.). The drug Madhusnuhi (Dweepantharavacha) has been mentioned inBhavaprakasa nighantu by Bhavamisra in Hareethakyadi varga as beneficial inPhiranga roga . 1 Being a non classical drug Sandhyaraga is not found in ancient classical texts ofAyurveda. References regarding Mirabilis jalapa Linn. as adulterant is obtained fromthe research work viz‘Materia Medica of Local Health Traditions of Payyannur’ by E.Unnikrishnan2 and ‘Conservation and consumption, A study on crude drug trade inthreatened medicinal plants in Trivandrum district’ by Parvathi Menon3. SeveralDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 2
    • Chapter-1 Introductionreferences regarding ethnomedical practices of Sandhyaaga is mentioned in websiteswhich shows its medical importance. So an investigation to bring out the medicinal property of the plant Sandhyaragaif any, and to compare its efficacy with that of Madhusnuhi has become the need ofthe day. References regarding medicinal property of Mirabilis jalapa Linn. especiallyits wound healing property is mentioned in the text books – ‘Indian Materia Medica’by K.M.Nadkarni and ‘Indian Medicinal Plants Vol. – III’ by Kirthikar.K.R. andBasu.B.D. The references regarding its ethno medical practice in the disease Syphilisand as a remedy for wound is also available. The common property which was found to be claimed in both the drugs isVranaropana. In Ayurveda classical use of Madhusnuhi is mentioned inPhirangaroga where Vrana is a symptom. Hence Vranaropana is the criteria selectedto compare the medicinal property of trial drugs. Aims and objectives of the study are: 1. To conduct scientific studies on Sandhyaraga viz a) Pharmacognostical study(.Both macroscopically and microscopically) b) Phytochemical studies (test for alkaloids, tannins, saponins etc) c) Study on Pharmacological property (Rasa estimation) 2. To evaluate the Vranaropana (wound healing) property of Sandhyaraga in comparison with Madhusnuhi in experimental animals(Morton and Malone [1972]methodology). 3. To find out the most effective mode of administration of both trial drugs .Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 3
    • Chapter-1 Introduction Susuruta Samhita has explained Vrana, its complications and management indetail. In the Vranitopasaneeya adhyaya4, he has explained that, “If the RakshaKarma of Vrana is proper then the Nishachara’s leave the patient, same as theMrugaas (deer) run away from the jungle terrified by a lion.” Sandhyaraga is a drug which was not described in Ayurvedic classics. Henceit is a need to postulate Rasadi Gunas of the drug. So an attempt is made in thepresent study to evaluate the Rasa of the drug Sandhyaraga. A vast scope of research exists in the field of Ayurveda for the benefit of thescience and humanity at large. Hopefully, a number of scientists and experts workingin this field may help in achieving this goal.Plan of the studyChapter 1. Introduction part gives a general view on, Ayurveda Dravyaguna Vijnana, need of the study and a brief outline of trial drugs , disease , and experimental studyChapter 2. Review of literature:An extensive collection regarding trial drugs and disease is mentioned in this chapterChapter 3. Drug analysis part is where the pharmacognostical, phytochemical and pharmacological analysis (regarding Rasa estimation)of drug Sandhyaraga is explained.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 4
    • Chapter-1 IntroductionChapter 4. Experimental study is the chapter where materials and methods, experimental procedure, grouping of experimental animals are explainedChapter 5. Result: This section deals with the analysis of observation and interpretations of statistical analysis.Chapter 6. Discussion: Major findings and probable mode of action of drugs are discussed here.Chapter 7. Conclusion: The dissertation concludes with highlighting important findings, further scope, limitations and recommendations of the study.Chapter 8. Summary part summarises the study in a nutshellDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 5
    • Chapter-2 Review of Literature REVIEW OF LITERATURE In Ayurveda, Dravya is one among the Padachatustaya. Dravya isvery important as the instrument for Chikitsa Siddhi. It has been told by Acharyas thatthere is no Dravya which cannot be used as medicine because of itsPanchabhoutikatva. But in classical texts of Ayurveda only a limited number of plantsare considerd for the management of diseases. Even though plants possessingmedicinal properties are abundantly seen around us they are not being used asmedicine because they are not recommended by classical texts. The present trial drugs are Madhusnuhi and Sandhyaraga.Madhusnuhi is a drug mentioned in Bhavaprakasa samhita by Acharya Bhava Misraaround 15th century A.D. It is used effectively by the practitioners of Ayurveda for thetreatment of Phiranga, the outstanding symptom of which is Vrana. Hence it has beendecided to study for its Vranaropana (wound healing) property. Sandhyaraga is a plant which is not mentioned in any Ayurvedicclassical texts.It is commonly found all over India especially in the valleys of WesternGhats. Many crude drug sellers are using the tuber of this plant as an adulterant ofMadhusnuhi because of similar therapeutic property. It also possesses enormousethnomedical importance in the treatment of skin ailments and wound. Theinformations received from traditional physicians this plant is having good curativeeffect on ulcers, wounds, skin disease etc. Hence to verify the claims of traditionalDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 6
    • Chapter-2 Review of Literaturephysicians and drug sellers and with the informations received from world wideethnomedical uses of the plant5, this study has been undertaken to evaluate thecomparative efficacy of Madhusnuhi and Sandhyaraga for their Vranaropanaproperty in experimental animals and analyze it statistically. PART-A DRUG REVIEWMADHUSNUHI (SMILAX CHINA.LINN)Ayurvedic Review of the Plant The drug Madhusnuhi is commonly known as Chopacini. It is grown in China andJapan. Probably this plant might have been brought to India during 15th century A.Din order to treat syphilis (Phiranga). Hence there is no much reference about the drugin the ancient classical texts. This drug is first found mentioned and explained inBhavaprakshanighantu. It is not found in earlier nighantus like Astanga nighantu,Dhanvanthari nighantu, Raja nighanu etc. But it is found explained extensively intext books of later period.SYNONYMS 6,7,8 The description about medicinal plants in Ayurvedic texts is in a simple andinformative pattern, i.e. through the synonyms. The ancient Taxonomy is designed forcommunicating about the plant both morphologically and pharmacologically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 7
    • Chapter-2 Review of Literature Madhusnuhi- Snuhivat thekshnasodhanadigunayukthamapi madhuram. (It possess aall the pharmacological properties of snuhi,but it is madhura rasa) 9 Dveepantharavaca- Dweepantharath aagatham idam vacha sadrusham kandham. (The rhizome was first brought from Java nd Sumatra islands to india) Susnuhi Subhachini Chopachini Sumuulika Dwipautra VacaROOPA VIJNANA10 It is a tuber possessing nodes on them yellowish white colored, taut, possessingMadhura rasa and leaves like Aswagandha.GANA /VARGABhavaprakasa nighantu - Haritakyadi vargaNighantu Adarsa - Lashunadi vargaSaligrama nighantu - Haritakyadi vargaPriya nighantu - Satapushpadi vargaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 8
    • Chapter-2 Review of LiteratureGUNA-KARMA11,12,13Rasa : TikthaGuna : Laghu,RukshaVirya : UshnaVipaka : KatuDoshaghnatha : Vataharam ,TridosaharaKarma : Sothahara,Sukrasodhaka, Deepana, Mutrala,Raktasodhaka,Rasayana Tridosahara, Varnya, Vedanasthapana, ,Nadeebalya, Anulomana, Svedajanana. Tarunyatha, Poushtiki, GarbhapradaVyadhighnatha:Angagraha,Upadamsha, Kateegraha, Urustambha, Rajayaksma, Vrana, Gandamaala,Netraroga,SarvangavaataKampavaata, Kubjavaata, Rakta vikara,Rakta dushti, Phiranga, Shodha, Klaibya, Sukra vikara, Agni mandya, Adhmana, Udarashoola, Krimiroga, Mootravikara,Pooyamootra, Sandhivikara, Sandhishodha, Jadya, Kushta, Dourbalya, Unmaada, Apasmara,VaatavyadhiPakshaghatha, AmavaataPRAYOGA In Upadamshaja sandhigatavaata, decoction of Ushava and Copacini is mixedwith honey and taken internally.14 In Phiranga, powder of Copacini with honey shall be taken while keeping on saltfree diet.15 Decoction of fresh roots is used in veneral complaints and sores.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 9
    • Chapter-2 Review of Literature It is used in India like sarsaparilla as a depurative, alterative, antisyphilitic andaphrodisiac in the form of decoction which is prepared by boiling 2 ounces of root inone pint of water till the water is reduced to ten ounce. It is useful in rheumatism,epilepsy, insanity and syphilis.16 17MATHRA (DOSE): Dose of a drug is an important factor for achieving desired therapeutic effect. Thedose is decided or fixed according to the condition of the disease with respect to itsstage, the age of the patient, the structure of the patient, the body weight, etc. It alsodepends on the potency of the drug, mode of action and also the form of applicationlike Churna, Kwatha, etc. The usual dose of this drug is 3-6 gms of Churna as perAyurvedic Pharmacopeae of India.VISISHTA YOGAS Chukkuthippalyadi Kashayam18 Pavukashayam18 Madhusnuhi rasayana18 Chopachini paka19 20FORMULATIONS IN OTHER SYSTEMS Parangi pattai choornam Parangi rasayanam Parangipattai pathangamDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 10
    • Chapter-2 Review of LiteratureNISHEDHA One should abstain from Madya, Taila, Kanjika, Shaaka, Kshara, Amla,Lavana and Tikta Bhojana.21REVIEW OF MODERN LITERATURE OF SMILAX CHINA.LINN 22History The drug Smilax china was introduced into Goa from China aboutA.D.1535.Previous to this date it was not noticed by any of the Mahometanphysicians. The Portugese, how ever, appear to have lost no time in carrying it to theirfactories in Persia, as it was mentioned, a few years after its introduction into Goa, byMir –Immad_ed-din Mahmud of Shiraz, Mirza Kazi of Yezd, andMir MuhMMeadHashim of Teheran. In 1669 it was described as a well known drug in the Tuhfat-el-muminin under the name of Chub-chini (Chinese wood) in Arabic Khasab -es –sini.The author of theMahzan el Adwiya has a long article upon its medicinalvirtues. He also notices particularly the variable appearances of different samples ofthe drug, and directs that what is heavy, of a rosy colour, free from knots is to beselected. He tells us that fresh root is some times brought to India; some of this heplanted at Moorshedabad (A.H.1178); it produced a climbing stem with smallelongated leaves, not unlike bamboo; after a years time he dug it up , but found thatthe roots degenerated and did not retain the qualities of the China article. Chubchini isconsidered by these writers to be anti-rheumatic anti-syphilitic, aphrodisiacal, anddemulcent. Loureiro says of it, “valet in quibusquunque doloribus vagis, veneris, autrheumaticis”Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 11
    • Chapter-2 Review of Literature Ainslie (Mat.Ind.,i.,70)notices its use in southern India as an anti-syphilitic and asa remedy of much repute in a disease called maygum vaivoo, in which the limbs arestiff and contracted. He also states on the authority of the AbbeRochon (voyage toMadagascar and East indies, London, 1792) that “the Chinese often eat the rootinstead of rice, and that it contributes to make them lusty.” Roxburgh states that theSmilax glabra ,a native of Sylhet and of the adjacent Garrow country, where it iscalled Hurina -shook- China , has large tuberous roots, not to be distinguished by theeye from the China root and that the natives of the country use a decoction of thefresh root for the cure of sores and venereal complaints(Flora Indica). This plant alsogrows in China and affords some of the china-root of commerce. (Trimen’s Journ.ofBot.,i.,102) The reported good effects of China root on the Emperor Charles.V. who wassuffering from gout acquired for the drug a great celebrity in Europe, and severalworks were written in praise of its virtues. But though its powers were soon found tobe over-rated, it still retained some reputation as a sudorific and alternative, and wasmuch used at the end of the 17th century in the same way as sarsaparilla. It still retainsits place in some pharmacopoeias. (Pharmacographia).In the East the Chub-chini isstill as highly esteemed as it ever was , and the China trade Returns show a steadyyealy increase in the quantity shipped from Southern ChinaTaxonomyKingdom - Plantae – PlantsSubkingdom - Tracheobionta – Vascular plantsSuperdivision - Spermatophyta – Seed plantsDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 12
    • Chapter-2 Review of LiteratureDivision - Magnoliophyta – Flowering plantsClass - Liliopsida – MonocotyledonsSubclass - LiliidaeOrder - LilialesFamily - Smilacaceae – Catbrier familyGenus - Smilax L. – greenbrierSpecies - china L. – China rootVernacular names 23Arab -Kasbussini,Kashabchinae, AslussiniBengali -Thopchini, Kumarika, Harna shukhochinaChinese -Too-fup,English -China-root,Bamboo Briar rootGujarathi -ChopchiniHindi -Chobchini,ThopchiniJapanese -Too-PufKannada -Chinipavu,Neerubetta balliMalayalam -Chenapavu,Cheenapairu,Marathi -ChobchiniPersian -Chob-chinaePunjabi -ChobchiniSanskrit -Dveepantharavaca,Chopchini,MadhusnuhiSinhala -China allaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 13
    • Chapter-2 Review of LiteratureTamil -Parankichekkai, Parankipatte, Shukchina, ParingayTelugu -Pirangichekka,Gali-chekkaFAMILY CHARACTER23LILIACEAE Herbs (very rarely shrubs or small trees) with fibrous roots, or a creeping rootstock, or a bulb or corm. Leaves various. Flowers usually hermaphrodite, axillary orterminal, solitary, or twin, or umbellate, spicate, racemose, paniculate, or fasciculate ;bracts usually small, scarious, sometimes, whwn the flowersa are umbellate, spathelike. Perianth herbaceous or petaloid, usually 6-merous in two series, imbricate (rarelyvalvate) in bud. Stamens 6 (rarely 3 or fewer), hypogynous or adnate to the perianth ;filaments free or connate ; anthers oblong or linear, often dorsifixed, usually dehiscinglongitudinally. Ovary 3 celled ; ovules 2 or more from the inner angles of the cells,anatropous (rarely orthotropus) ; style usually simple, often long (rarely short or 0), orstyles 3. Fruit a capsule or berry, usually 3 – (rarely 1- ) celled. Seeds 1 or more,globose or flattened ; albumin horny or fleshy ; embryo small, terete. Genera 250.Species 2,700. Cosmopolitan.GENUS CHARACTERSMILAX.Linn Climbing shrubs (rarely erect herbs). Leaves alternate (rarely opposite), persistent,3-7 nerved, reticulately veined ; petiole usually with 2 tendrils above its base. Flowersmall, umbellate, dioecious. Perianth of 6 free, usually incurved or recurved, subequalsegments. Male flowers : stamens 6 or more, inserted at the base of the perianth ;Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 14
    • Chapter-2 Review of Literaturefilaments erect, free long or short ; anthers oblong, 2 celled, didymous, withcontiguous cells or with cells discrete by a forking of the connective. Pistillode 0.Female flowers: staminodes 3 or 6, filiform. Ovary 3 celled, 3-gonous ; ovules 1-3 ineach cell;, orthotropous, pendulous ; style short or 0 ; stigmas 3, stout, recurved. Fruita globose berry. Seed solitary, or more often 2. , hemispheric, rarely 3; albumenhorny; embryo small, Species 210, Tropics and subtropics.HABIT , HABITAT and DISTRIBUTIONHabit It is a thorny climbing shrub with good vegetation with tendrils. It ia havingsmallwhite flowers whichIt is in flowers in May, and the seeds ripen in October. Theplant is not self-fertile.Habitat Forests, thickets, hillsides, grassy slopes, shaded places along valleys or streamsfrom near sea level to 2000 metres. The plant prefers light (sandy), medium (loamy)and heavy (clay) soils. The plant prefers acid, neutral and basic (alkaline) soils. It cangrow in semi-shade (light woodland) or no shade. It requires moist soil.DistributionAssam, Khasi and Garo hills, Japan,ChinaMORPHOLOGICAL CHARACTERS OF SMILAX CHINA.LINNRoot : The tubers which are formed on the fibrous root of the plant, are of shape andsize of an elongated kidney potato, some what flattened, knotty, covered with a rustyDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 15
    • Chapter-2 Review of Literaturecoloured bark, some times smooth and shining, sometimes rough, internally theirsubstance is of a pinkish white colour ,hard and farinaceous, insipid, mucilaginousand inodorousStem: It is a climbing shrub with slender branchlets,Leaf: Terete smooth unarmed leaves rather than 7.5 to 15cm by3.2 to 5.7cm ,ellipticor ovate lanceolate, acuminate,3 costate to the rounded or cuneate base ,petiole 13.5to17mm,narrowly sheathing, unarmed sheath 8 to17mm.longaxillary;cirrhi veryslender.FlowersUmbels subsessile,many flowerd;peduncle ebractat;pedcels t8 mm;bracteolessubulat;flowrs very small, white,buds depressed globose,deeply 6lobed from thegoove on the back othe obovate cucullate cornaceous sepals;minute petalsstamensvery short;staminoids in female flowers.MICROSCOPIC CHARACTER OF TUBERS OF SMILAX CHINA.LINN24 The bark consists of thick walled dark brown brick shaped cells, which containsbundles of crystalline needles and resinous matter. The bulk of the tuber is made up ofa parenchyma, the cells of which are large and have a radiate hilum .The vascularsystem is scalariform and is associated with porous wood cells.CULTIVATION & PROPAGATION25Seed – sown on March in a warm greenhouse. This method probably refers to thetropical members of the genus, seeds of plants from cooler areas seem to require aperiod of cold stratification, some species taking 2 or more years to germinate. Seedsof temperate species are sown in a cold frame as soon as they are received . Seeds areDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 16
    • Chapter-2 Review of Literatureobtained as soon as they are ripe .When the seedlings eventually germinate, they arepricked out into individual pots when they are large enough to handle and grow themon in the greenhouse for at least their first year, though normally in pots for 2 years.They shall be planted out into their permanent positions in early summer. Division inearly spring as new growth begins. Larger divisions can be planted out direct intotheir permanent positions. It is found out best to pot up the smaller divisions andgrow them on in a lightly shaded position in a cold frame, planting them out once theyare well established in the summer. The flowers are dioeciou, so both male and femaleplants must be grown if seed is requiredPHYTOCHEMISTRY26 Root contain fat ,sugar glucoside, colouring matter, saponin, gum and starch.Aproximate analysis the air dried drug afforded :Ether extract (fat) …………………… 0.33Alchoholic extract(sugar, glucoside)……… 1.72Aqueous extract (sugar, gum )……..… 6.79Crude fibre……………………………… 13.79Ash………………………………………….1.47Moisture……………………………………. 6.10Starch (by difference)…………………… 69.80 100.00 The root contained no alkaloid, but the alcoholic extract contained a glucoside anda colouring matter which gave an olive-green tint with ferric chloride, but noprecipitate with gelatine. With soda it afforded a deep red colour, and was precipitatedfrom the solution by neutral plumbic acetate. The sugar present abundantly reducedFehling’s test without previous inversion. The amount of ash, consisting of allalkaline salts is very small.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 17
    • Chapter-2 Review of LiteratureIDENTITY, PURITY AND STRENGTH27Foreign matter -Not more than 2 per cent,.Total Ash -Not more than 0.6 per cent.Acid-insoluble ash -Not more than 0.006per centAlcohol-soluble extractive -Not less than 0.8 per centWater-soluble extractive -Not less than 5 per centTHIN LAYER CHROMATOGRAPHY (T.L.C.) T.L.C. of the alcoholic extract on precoated Silica gel G plate (0.2 mm thick)using Toluene : Ethyl acetate : Methanol (10 : 10 : 4) as mobile phase and on sprayingwith Anisaldehyde-Sulphuric acid reagent and heating the plate at 1050C for tenminutes ten spots appear at Rf. 0.09 (dark green), 0.17 (violet), 0.21 (dirty yellow),0.26 (grey), 0.32 (yellow), 0.48, 0.55 and 0.58 (all violet), 0.73 (greenish blue) and0.77 (violet).THERAPEUTIC USES28 Apart from the classical texts the other valuable sources for Dravya GunaVignana like Indian medicinal plants ,The Indian Materia Medica, etc have given theelaborate usage of Smilax china as follows Aphrodisiac in the form of decoction (1 in 10 or 2 ounces in a pinch of water andboiled down and reduced to 5) dose- 1 ounce thrice daily. It is boiled with milk to which Mastaki, cardamoms and cinnamons are added andtaken internally, in Rheumatism, gout, epilepsy, Chronic nervous disease, Cachexia,Seminal weakness and Constitutional Syphilis.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 18
    • Chapter-2 Review of Literature It is used along with Anathamool, and other drugs of reputed efficacy in syphilisand rheumatism. In Unani system it is indicated in syphilis, leprosy, kidney and bladder diseases,paralysis, headache, convulsions etcADULTERATION China root is used in India to some extent like sarasaparilla.28 Tubers of Mirabilis jalapa, (naalumani) are used as an adulterant of Smilax china ( Cheenappavu).29,30 Smilax china is adulterated with Smilax pseudochina and Pachyma cocos. 31SANDHYARAGA(MIRABILIS JALAPA.LINN) Traditional use of medicinal plant is very important to researchers. If a plant hasbeen used in a specific way for a specific purpose for many years and in manydifferent geographical areas, there is probably a reason for it. Science that deals withthe study of such traditionally used plants is called Ethnobotany. This branch ofscience help scientist to do research and study them scientifically. All indigenoussystems have originally discovered the medicinal uses of plant derived drugs fromsuch traditional practice and experience. Sandhyaraga is such a drug which has verymuch ethnobotanical relevance.AYURVEDIC REVIEW OF THE PLANT Sandhyaraga is a drug which is not mentioned in classical texts of ayurveda.According to some authors a reference is seen in Rajanighantu32 in KaraveeradiDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 19
    • Chapter-2 Review of Literaturevarga about a plant called Trisandhya33 Gosh (probably the name is due to the reasonthat it flowers in the evening). But in later text books such references are not seen. InBhavaprakasha Nighantu the plant Trisandhya has been equated to Japapushpa34.PARYAYA Krishnakeli35 Sandhyaraga 36 (Sandhyaya iva rago asya) Sandhyakali Trisondi 37 Krishnakali ‘Swanaama khyate pushpa pradhane vrukshe’38REVIEW OF MODERN LITERATURE OF MIRABILIS JALAPA. LINNHISTORY39 Five varieties of the plant , Mirabilis jalapa, with white red ,yellow ,red& white,red and yellow flowers were introduced from West Indies in 1596 and must havebeen carried by the Portuguese to the east shortly afterwards , as the plant is said tohave been introduced into Persia in the reign of Shah Abbas the first , and wasestablished on the Malabar coast Van Rheede.It was at time supposed to produce theJalap of commerce. M.Jalapa has been given the Sanskrit name Sandhyakali,or“evening flower “ but is best known by its Persian name Gul A’bbas or “flower ofAbbas”; it is a favorite flower or Persians, who cultivate it in ornamental flower pots.The Arabs call it Shab-el-leili which is evidently a translation of the French “belle denuit”; it is the “Fula quodrahoras” or “four o’clock” flower of the Portuguese as itsflower open at the hour in the after noon.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 20
    • Chapter-2 Review of LiteratureBIOLOGICAL ACTIVITIES AND CLINICAL RESEARCH40 The plant and root have demonstrated other biological activities in addition to theantiviral actions of the Mirabilis Anti-viral Protiens. In 2001, researchers found newphenolic compounds in clavillia which demonstrated in vitro action against the yeastCandida albicans. A hot water extract of the flower, leaf, and root of clavillia hasshown antifungal activity in another in vitro study. Other research on the leaf andbranches of clavillia did not confirm any antimicrobial actions; therefore, theseproperties are probably attributed only to the root of the plant. In early research, theroot of the plant (in water and ethanol extracts) also demonstrated mild uterinestimulant actions in rats, and antispasmodic actions in guinea pigs.TAXONOMYKingdom - Plantae -- Planta, plantes, plants, VegetalSubkingdom - Tracheobionta -- vascular plantDivision - Magnoliophyta , Angiospermes, angiosperms, flowering plants, phanérogames, plantes à fleurs, plantes à fruitsClass - Magnoliopsida -- dicots, dicotylédones, dicotyledonsSubclass - CaryophyllidaeOrder - CaryophyllalesFamily - Nyctaginaceae (four oclocks, nyctaginacées)Genus - Mirabilis L. ( four oclock, four-oclockSpecies - Mirabilis jalapa L. -- common four oclock, common four-oclock, marvel of Peru, marvel-of-PeruDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 21
    • Chapter-2 Review of LiteratureCOMMON NAMES:40 Clavillia, Four-o’clocks Marvel of peruVERNACULAR NAMES 40,41,42,43.Africans -VieruurbomArabic -Shahelleilli, ZahrulajlAssamese -GodhuligopalBengal -Gulabas, Krishnakeli, KrishnokeliBombay -Gubhaji, GulabbasBurma -Mizubin, MyoezuCanarese -Chandramallige, Gulamaji, Madhyahnamallige, Sanjamallige, SanjimalligeCatalan -Diego de noche, Don Diego de noche, Juan de noche, Don Juan de nocheChinese -Tche Kia HoaDeccan -GulabashEnglish -Four o’clock flower, Marvel of peru, ClavilliaFanti -Guaamboroba,SankaniFrench -Belle de nuit, Fleur admirable, Herbe triste, Faux jalap, Jasmin rouge, Merveille du Perou, Nyctage, Nyctage fauxjalap,French Guiana -Belle de nuit, Herbe de quatre heuresDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 22
    • Chapter-2 Review of LiteratureGa -Dmaidzi edzwai forforiGerman -AbendblumeGujarathi -GubbajiHindi -Gulabbas, Gulabash, GuleaabbasHova -Vanimpolera, Voampoleri, VonimpoleraKonkani -AkasamugriLareunion -Belle de nuitMalayalam -Anthimalari, AnthimantharamNorthwestern provinces -GulbansaOriya -RangaiPersian -Guleabbas, GuliaabbasPhilippines -Diego de noche, Maravillas, Oricion, SuspirosPunjab -Abasi , GulabbasSanskrit -Krishnakeli, SandhyakaliSinhalese -Sendrikka, SindrikagahaSpanish -Don diego de noche, Don juan de noche, Maravilla de noche, TrompetillaSynd -AbhasieTagalog -Gilalas, GuilalasTamil -Andhimalligai, Pattarachi,PattarashuTelugu -Batharachi, Bhadrakshi, Chandrakantha, Chandramallige,Twi -NnonnannhwiranUrudu -GuleabbasDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 23
    • Chapter-2 Review of LiteratureFAMILY CHARACTER44NYCTAGINACEAE Herbs, shrubs, or trees. Leaves usually opposite, entire; stipules 0. Flowershermaphrodite (rarely unisexual), regular, sometimes dimorphous ; inflorescencevarious; bracts often involucrate, free or connate. Perianth monosepalous, usuallysmall, petaloid; tube persistent, enveloping the fruit ; limb 3-5 lobed, persistent ordecidous, the lobes plicate in bud. Stamens 1-30, hypogynous, sometimes unilateral ;filaments small, unequal, inflexed in bud ; anthers included or exserted, dorsifixed,didymous. Ovary one celled, free, ovule solitary, basal, erect; style filiform, involutein bud,; stigma small; simple or multifid. Fruit membranous, indehiscent,, enclosed ina coriacceous perianth tube . seed erect; testa adherent; albumin soft or foury; embryostraight with convolute cotyledons or incurved; radicle inferior. Genera-20. Species-160. Mostly tropical and especially in America.GENUS CHARACTERMIRABILIS .Linn Herbs often with tuberous roots and medium sized or somewhat large flowersclustered on the branches of large leafy panicles, each or clusters of 2-10 surroundedby a calyx like involucre of 4-5 connate bracts. Perianth brightly colored, salver –shaped to campanulate. Stamens 3-5, rarely 6 somewhat exserted. Nut ellipsoid orobpyramidal, often ribbed or rugose. Cotyledons large sub orbicular on germination.Species 25. tropical American. Mirabilis jalapa Linn. Is used medicinally inPhilippine islands, La Reunion, Guiana ; Mirabilis dichotoma Linn. in Brazil ;Mirabilis dichotoma Linn. and Mirabilis longiflora Linn in tropical America.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 24
    • Chapter-2 Review of LiteratureHABIT, HABITAT and DISTRIBUTION OF MIRABILIS JALAPA. LINN45HABITIt is a perennial herb growing upto 0.6m. It flowers from July to Oct, and the fruitsripen from August to October. The scented flowers are hermaphrodites. Four o’clocks are grown as annuals in cool regions.HABITATCulture – Fast growing four o’ clocks are easy to grow and essentially trouble free,thriving mostly in any soil.Light - four o’ clocks do best in full sun but also perform well in partial shade.Moisture - regular garden moisture, reduced watering in winter. It is planted forornamental purposes in gardens, houses, and along railway lines, exotic, cultivated forbeautiful flowers of variegated colors.DISTRIBUTION46 It was officially botanically recorded in 1753 although it already had beendistributed as an ornamental plant throughout the tropics of the world. There is somedisagreement about where it came from originally: Mexico, Chile, or India. Today,clavillia is naturalized throughout the tropics of South America, Latin America,France, and India. In Brazil the plant is known as clavillia, maravilha, or bonina; inPeru it is known as jalapa or maravilla. Hybrids of clavillia can be found in nurseriesthroughout the U.S. where they are sold as ornamental landscape plants.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 25
    • Chapter-2 Review of LiteratureMORPHOLOGICAL CHARECTERS OF MIRABILIS JALAPA. LINN A well known herbaceous dichotomous plant 1 metre high with largeperennial tuberous roots, rather fleshy stems and cordate leaves.Root of young plants is cylindrical above and tapering below, but in old plants, itbecomes napiform or subrotund. The external surface is dark brown and marked withnumerous circular rings. Internally it is dirtywhite or grayish in transverse sectionpresenting concentrate rings of a darker color, it shows numerous acicular crystalswhen magnified. When dry, very old roots become hard, compact and heavy anddeepen in color, but younger roots are of a leathery consistence.47Stem: dichotomous branching,Fleshy stems,purplish coloured,which thickens at thenode48Leaves -Simple,opposite, reticulate venation, entire margin,acute and cordate, ovatewith acuminate tip, smooth and of dark green color leaf blade 5.1-6.3cm longpetiolate, petiole 2.5-3.8cm long and exstipulate.Flowers usually purple but very numerous colors (white, yellow to crimson, oftenstriped or blotched )are found and the perianth is sometimes variegated. There is onlyone flower (Solitary)to the involucre in this species, which latter therefore is apt to bemistaken for a calyx.49 Flowers brilliant, elongate, fragrant, long tubular flowersopening in the evening borne in clusters among the leaves at the end of branches.Slender tube 4 to 5 cm, widening abruptly to a wide limit with rounded petal likelobes spreading 3-4cm across, perianth –undivided terminally incised.Fruits –Achenes, black, muricated rough resembling black pepper.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 26
    • Chapter-2 Review of LiteratureCULTIVATION & PROPAGATION They succeed in almost any ordinary garden soil, prefers a fertile well-drained soilin full sun or part day shade. Plant seeds in early spring or divide tubers any time. Iflarge black seeds are soaked in water overnight before planting they will germinatequicker. tuber can also be dug up at the end of the season and replant it next spring.Four oclocks will self seed.PHYTOCHEMISTRY50,51,52 This plant contains alanine, alpha amyrins, arabinose, beta amyrines, campesterol,daucosterol and dopamine. (ref. from – Antibacterial activity of some selected Indianmedicinal flora) The roots are collected in July, cut into slices, exposed to warm air, and thenreduced to powder and desiccation completed at 100o C. the fresh roots dried oversulphuric acid lost 81.136 % in wweight ; the ash amounted to 6.135% and was freefrom manganese. The proximate analysis was made with the powdered roots dried at 100 0 C andwas conducted according to Dragendroff’s plan with the following results. Light petroleum ether extract - 0.580% Ether extract, soluble in water - 0.09% Ether extract, soluble in alcohol - 0.222% Residue insoluble in water or alcohol - 0.02% - 0.340% Absolute alcohol extract - 3.040% Aqueous extract containing glucose - 1.6% Saccharose or allied carbohydrate - 7.97%....30.62%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 27
    • Chapter-2 Review of Literature The petroleum ether extract was soft and pale yellowish in color, not crystallineand without any special odour. It consisted of wax and pale yellow oil soluble inabsolute alcohol with neutral reaction. The ethereal extract was soft and yellowish. The portion soluble in water had anacid reaction but gave no coloration with ferric chloride. Acidulated with sulphuricacid, a slight precipitate was afforded with Mayer’s reagent. The residue of theethereal extract soluble in alcohol was also yellowish, soft and on standing becameindistinctly crystalline. Treated with water acidulated with Sulphuric acid, it gave noalkaloidal reactions; with alkalies on gently warming, it was slightly soluble withpale yellow coloration, the color being destroyed by acids and whitish flocksprecipitated. The alcoholic tincture of the roots was of a port wine color and the extract of adeep orange tint. In water part was soluble with acid reaction and afforded aprecipitate with alkaloidal reagents. The extract was treated with ammonia in whichthe greater part dissolved affording a dirty brownish red solution and the solutionagitated with ether- the ethereal extract amounted to 0.384% and contained a smallamount of alkaloid with much coloring matter. An attempt was made to purify thealkaloid by reagitating this extract from an acid solution with ether, and thenneutralizing and again agitating with ether; an unweighable amount of alkaloid was,however obtained. No special color reactions of the alkaloid were observed. Analkaline solution of the alcoholic extract was only slightly precipitated by acids,solution remaining dark colored. The aqueous extract contained 1.6% of glucosecalculated on the roots dried at 1000 C. after boiling with dilute sulphuric acid, aDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 28
    • Chapter-2 Review of Literaturesecond determination with Fehling’s solution was made, and the result calculated asSaccharose which was equivalent to 7.97%. In order to determine whether the plant had any injurious properties, the alcoholicextract from 10gms of the dried and pounded roots was mixed with a few drops ofammonia and water and injected into a cat’s stomach; the cat vomited once but wasnot otherwise inconvenienced. Four new miraxanthins- I,II,III and IV isolated from flowers and charectarised;Indica xanthin and Vulga xanthin – I also isolated. As recorded in Rainforest Database chemical analysis of clavillia shows that it isrich in many active compounds including triterpenes, proteins, flavonoids, alkaloids,and steroids. Of particular interest to researchers is a group of amino acid-basedproteins, called mirabilis antiviral proteins (MAPs). These chemicals have shownspecific antiviral and antifungal actions. They are produced in the seeds, roots, andyoung shoots, and help the plant protect against various plant viruses and soil-bornefungi. In 1994, a Japanese tobacco company was awarded a U.S. patent on the MAPsin clavillia as being effective in protecting economically-important crops (such astobacco, corn, and potatoes) from a large variety of plant viruses (such as tobaccomosaic virus, spotted leaf virus and root rot virus). Researchers in Hong Kongisolated another MAP in the roots of clavillia with the same antiviral actions, and alsonoted, "The MAP demonstrated to possess abortifacient [abortion-causing] activity inpregnant mice, inhibitory effects on cell-free protein synthesis, and antiproliferativeeffects on tumor cells." The MAPs found in clavillia have shown to inhibit cellularprocesses in viral cells.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 29
    • Chapter-2 Review of Literature The highest concentration of MAPs is found in the seeds of the plant, followed bythe roots, then leaves. The seeds, however, are a significant source of other peptidechemicals with actions similar to the neurotoxic peptides found in spider venom. These peptides are in the same classification as (and act similarly to) anotherplant-derived toxic peptide, ricin (now being employed as a biological weapon). Ascompared with ricin, though, clavillias peptides are only about 1/30th as toxic.Because of this toxicity, though, the seeds are not generally used in herbal medicinesystems (despite researchers documentation of the significant antimicrobial actionsattributed to them). Clavillias main chemicals include: alanine, alpha-amyrins, arabinose, betaamyrins, betalamic acid, betanin, brassicasterol, beta-sitosterols, 2-carbosyarabinitol,campesterol, daucosterol, d-glucan, dopamine, hexacosan-1-ol, indicaxanthin,isobetanin, 6-methoxyboeravinone C, methylabronisoflavone, mirabilis antiviralproteins, mirabilis peptides, miraxanthins, n-dotriacontane, n-hentriacontane, n-heptacosane, n-hexacosane, n-nonacosane, n-octacosane, n-pentacosane, n-pentatriacontane, n-tetracosane, n-tetratriacontane, n-triacontane, n-tricosane, n-tritriacontane, oleanolic acid, stigmasterol, tartaric acid, trigonelline, tryptophan,ursolic acid, and vulgaxanthin I.PHARMACOLOGICAL PROPERTIES The leaves have a sharp taste; maturant;lessen inflammations. The root isaphrodisiac; good for syphilitic sores (Yunani). Its roots are known as aphrodisiac and mild purgative.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 30
    • Chapter-2 Review of Literature Mirabilis jalapa was screened for its antibacterial activity and is proved to possessantifungal, antimicrobial, antiviral, antispasmodic, antibacterial, diuretic, carminative,cathartic, hydrogogue, purgative, stomachic, tonic, and Vermifuge propertiesLeavesare tonic & antiseptic.53.Root, in powder form, possess a distinct odour and a slightlyacrid taste followed by a tingling warm and numbing sensation stimulating the flow ofsaliva. Moistant powder is irritant to skin and mucus membrane..It also cures woundsand Bruises.INDICATIONS 52 Sandhyaraga is indicated in several diseases and is practiced world wide .It isindicated mainly in skin related ailments and for intestinal parasites. Brazil :for candida, chagas disease, colic, constipation, contusions, diarrhea,dysentery, earache, edema, eczema, freckles, herpes, hives, itch, intestinal parasites,liver problems, pain, skin problems, skin infections, syphilis, vaginal discharge,urinary insufficiency, wounds, worms Cuba: for herpes, intestinal parasites Guatemala: for abscesses, aches, boils, bruises, conjunctivitis, dermatitis, fungalinfections, gonorrhea, inflammation, mucosal lesions, ringworm, scrofula, skinproblems, sores, ulcers (skin), vaginal discharge, vaginitis, wounds India: for conjunctivitis, edema, fungal infections, inflammation, pain, swellings Mexico:for bee stings, dysentery, scorpion stings, vaginal discharge, wounds Peru:for constipation, dermatitis, earaches, herpes, urinary insufficiency U.S.A.: for abortions, bone fractures, childbirth, mumpsDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 31
    • Chapter-2 Review of Literature Elsewhere for abscesses, arthritis, boils, bowel cleansing, burns, bruises, colic,constipation, diabetes, digestion stimulation, dropsy, dyspepsia, fungal infections,gonorrhea, hepatitis, herpes, hypochondria, intestinal gas, intestinal parasites, libidostimulation, liver problems, menstrual irregularities, muscle pains, piles, pimples,sores, splenitis, strains, syphilis, thrush, tonic, tumors, urinary insufficiency,urogenital inflammation, urticaria, woundsTHERAPEUTIC USESThe root is used as a purgative in La Reunion and the Philippine islands. The leavesare applied to boils, phlegmons and whitlow, as a maturant.55 The fresh juice of its leaves is considered as demulsant and found useful inUrticaria. Also cures the inflammation and bruises. Its roots after rubbing with waterare applied externally in contusions.56 Tuber is used as a poultice on carbuncles, fresh leaf juice is very soothing andallays the heat and itching when applied to the body in urticaria. It also cures woundsand bruises. Powdered and fried in ghee with spices, it is given in milk as nourishingor strengthening medicine. Rubbed with water, it is applied as lepa in contusions. Theleaves bruised and heated and applied as poultice to boils and abscesses hasten thesuppurative process.57 Dr. P.S.Mootooswamy states that in Thanjavur, the roots boiled and made intocurry are considered beneficial to those who suffer from piles and that a powder andconfection are also in use. according to Thunberg, the Japanese prepare a kind ofwhite paint for their complexion from the seeds58.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 32
    • Chapter-2 Review of Literature Tender twigs extract taken in stomach pain, flatulence, and gastritis by villagers inNorth India. There are lots of indigenous practices which have impelled clavillias presence inherbal medicine systems around the world59 The indigenous people of the Amazon enjoy the beauty of clavillias flowers asmuch as city dwellers, and often plant it in their gardens. They employ the plantmedicinally as well. Indigenous Peruvian people use a root decoction as a diuretic. The Shipibo-Conibo Indians put the flowers in baths to treat colds and flu. In Brazil, the Kayapo Indians inhale the powdered, dried flowers as a snuff forheadaches, and use a root decoction to wash wounds and to treat such skin afflictionsas leprosy. The Assuraní Indians in Brazil crush the seeds to use as a peppery condiment onfoods, and grate the tuberous root into cold water and drink it for intestinal parasites. The tribal people of Orissa, India grind the roots of the plant into a paste withblack pepper and take it orally for conjunctivitis. They also apply the juice of theleaves to fungal infections of the skin. In Peru, the plant and/or tuber is used as a diuretic, laxative, and bowel cleanser. The juice of the flower is used to clear herpes lesions and for earaches. InBrazilian herbal medicine, a paste is made of the leaf and flower and applied toaffections of the skin such as itchiness, eczema, herpes, skin spots, and skininfections.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 33
    • Chapter-2 Review of Literature The juice of the root is dropped into the ear for earaches. Brazilians also use theroot to combat worms, intestinal parasites, leucorrhea, edema, diarrhea, dysentery,abdominal colic, syphilis, and liver affections. In Mexico, the entire plant is decocted and used for dysentery, vaginal discharge,infected wounds, and bee and scorpion stings. In the United States, the plant is used for mumps, bone fractures, and as an uterinestimulant to hasten childbirth.DOSE59The standard dose of the drug is mentioned in Rainforest data baseStandard DosagePowdered drug : 1 g twice dailyTincture : 1-2 ml twice dailyInfusion : 1/2 cup twice dailyAS AN ADULTERANT The seeds are used to adulterate black pepper.60 Root is a substitute or adulterant of true jalapa. (Exogonium purga)61 Tubers of Mirabilis jalapa, (naalumani) are used as an adulterant of Smilax china(Cheenappavu) 62,63Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 34
    • Chapter-2 Review of LiteratureImage2.1 Madhusnuhi. Image 2.2 Madhusnuhi-InflorescenceImage2.3.Sandhyaraga Image 2.4.Sandhyaraga-Inflorescence and fruitImage2.5 Dry specimen of Image2.6 Dry specimen ofMadhusnuhi tuber Sandhyaraga tuberDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 35
    • Chapter-2 Review of Literature PART B. REVIEW OF LITERATURE ON VRANAHistory of the disease Vrana (wound) is as old as mankind. Large number ofreferences pertaining to the wound and wound healing was found in ancient Indianliterature. For better insight about the disease, apart from knowledge of types ofwounds and the process of wound healing, history of wounds is also of utmostimportance. Much reference regarding Vrana and its management is not found during prevedicperiod we get references in Vedic period. Rigveda and Atharva Veda are c the texts ofwhich have given importance to medical and treatment aspect during Vedic period.These texts contribute to us with some references regarding Vrana.References inRigveda include Sandhaan karma done by Ashwini Kumaaras in case of severedhead of Yajnya (Daksha)and joining the limb of Vishpala the daughter of Khela.Enumeration of Sadhyo Vranas and references regarding healing medicines are got inAtharva veda. Indirect references about Vrana were got Puranas like Agnipurana andin Epics like Ramayana & Mahabharata.AYURVEDIC LITERARY REVIEW OF VRANA A vast and elaborate description regarding Vrana is available in Ayurvedic textbooks. Vrana is a topic which is dealt in detail by all the basic Samhitha-s ofayurveda.According to Acharya Charaka diseases are grouped into four, out of whichthree are caused by innate factors and fourth is caused by exogenous factors. Adetailed description of skin i.e. about its formation, layers, disease afflicting it and itsphysiological as well as anatomical significance are mentioned in our classics.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 36
    • Chapter-2 Review of LiteratureEtymology:Vrana has the meaning to recover, which is further suffixed by ‘Ach’, is the sense ofBhava. The ‘Ch’ sound is elided and the form remains Vrana + ‘A’ in the sense ofGatra vicurnane.64DEFINITION ‘Vrunoti Yasmat Roodeapi Vranavastu Na Nashyathi Adeha Dharanat Tasmat Vrana Ityuchyathey Budhaihi’65 As the scar of a wound never disappears even after complete healing and itsimprint persists for long time, this lesion is called Vrana by wise. “Vranagathra vicurnane Vranayatiti Vrana:” 66 Gathra Vicurnana has a grammatical meaning i.e., a particular type of rogawhich creats a feeling of cutting the body in to small pieces. Word Vicurnane has theother meaning with reference to this disease like destruction, break, rupture,discontinuation etc. Therefore, Vrana gatra vicurnane means phenomenon complexcausing destruction, rupture, or discontinuation of tissue in a particular part of thebody leading to discolouration. Dalhana in his commentary mentions that, “Vrana Gathra Vaivarnyam Karotiiti”67.Vivarnyata is the prime feature i.e., there is discoloration of the affected part.According to Ashtanga Sangraha68 “Yavadayurvraneete Vivrunoti Va ShareeramitiVrana” i.e., Vrana is one that produces a distortion of the affected part whichremaines through out the life.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 37
    • Chapter-2 Review of Literature CLASSIFICATION OF WOUNDS: Ayurvedic treaties classified the Vrana mainly in to two category, i.e, 1) Nija and 2) Agantuja Ashtanga samgrahakara tells about another classification 1) Suddha and 2) Dushta Nija Vrana Based on dosa predominance NijaVrana is classified into Ekadosaja, Dwidosaja, Sannipataja and Raktaja as per different Acharyas: Table 2.B.1 showing classifications of NijaVranaNo Of Acharya Susrutha Acharya Charaka Acharya Vagbhatatypes 3 - Vataja, Pittaja and Kaphaja - Vataja, Pittaja 5 Kaphaja,Raktaja & - - Sannipataja Vataja, Pittaja, Kaphaja,VataPittaja, 7 - - VataKaphaja,PittaKaphaja, VataPittaKaphaja Vataja, Pithaja, Vataja, Pittaja, Sleshmaja, Sleshmaja, Sonitaja, Sonitaja, VataPittaja, VataPittaja, VataSleshmaja, VataSleshmaja, PittaSleshmaja, PittaSleshmaja, VataSonitaja, PittaSonitaja, VataSonitaja, 15 SleshmaSonitaja, - PittaSonitaja, VataPittaSonitaja, SleshmaSonitaja, VatasleshmaSonitaja, VataPittaSonitaja, PittasleshmaSonitaja, VatasleshmaSonitaja, VataPittaSleshmaja, PittasleshmaSonitaja, VataPittaKaphaSonitaja VataPittaSleshmaja, VataPittaKaphaSonitaja Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 38
    • Chapter-2 Review of LiteratureAccording to Acharya Sushruta: 69 Sushruta had quoted sixteen types of nija-Vranas, including Suddha-Vrana, thatare given below: 1. Vataja Vrana – Vrana caused by Vata is dark and reddish, thin, cold, slimy,with little discharge, rough, cracking, having pain of twitching, stretching, prickingand tearing nature and devoid of muscle occurs mainly in Adhah Kaya Predominanlyon Basthi.70 2. Pittaja Vrana – Vrana caused by Pitta emerges quickly, is yellow and blue incolour, discharges white liquid resembling washing of kimsuka flowers, attended withburning, suppuration and redness and covered with yellow boils. 3. Kaphaja Vrana – Vrana caused by Kapha has extensive and severe itching,thick margins, covered with net of stiff veins and ligaments, hard, pale, with mild painand exuding white, cold, thick and slimy discharge and is heavy. 4. Raktaja Vrana –Vrana caused by Rakta looks like collection of coral pieces,is covered with network of black eruptive boils and pustules, smells likes stable, ispainful, fuming, bleeding and having signs and symptoms of Pitta. 5. VataPittaja Vrana – Vrana caused by Vata and Pitta has pricking pain,burning and fuming, yellow and reddish in colour and with discharge of the samecolour. 6. VataKaphaja Vrana – Vrana caused by Vata and Kapha has excessiveitching, pricking pain, is rough, Guru, hard, occasionaly discharging cold, slimy andlittle fluid. 7. PittaKaphaja Vrana – Vrana caused by Pitta and Kapha is Guru, withburning sensation, and warm discharge as yellow and pale.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 39
    • Chapter-2 Review of Literature 8. VataRaktaja Vrana – Vrana caused by Vata and Rakta is rough, thin, hasintense pricking pain, numbness, red and reddish colours and discharge also of thesame colour. 9. PittaRaktaja Vrana – Vrana caused by Pitta and Rakta, looks like ghee-scum,smells like washing of fish, soft, spreading and discharging hot and black fluid. 10. KaphaRaktaja Vrana – Vrana caused by Kapha and Rakta is red, heavy,glossy, slimy, itching, firm and with discharge as red and pale. 11. VataPittaRaktaja Vrana – Vrana caused by Vata, Pitta and Rakta hastwitchings, pricking, burning and fuming with discharge as yellow, thin and red. 12. VataKaphaRaktaja Vrana – Vrana caused by Vata, Kapha and Rakta hasitching, twitching and tingling with discharge as pale, thick and red. 13. PittaKaphaRaktaja Vrana – Vrana caused by Pitta, Kapha and Rakta haspredominance of heat, suppuration, redness and itching with discharge as pale, thickand red. 14. VataPittaKaphaja Vrana – Vrana caused by Vata, Pitta and Kapha hascolour, pain and discharge of all the three types. 15. VataPittaKaphaRaktaja Vrana – Vrana caused by Vata, Pitta, Kapha andRakta, has burning (as making ash), churning, twitching, pricking, heat, suppuration,redness, itching and numbness and attended with various colours, pain and discharge. Apart from these 15 one more named shuddhaVrana is also mentioned 16. Shuddha Vrana - The clean wound resembles lower surface of the tongue, issoft, unctuous, smooth, painless, well-formed and free from discharge.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 40
    • Chapter-2 Review of LiteratureAccording to Acharya Charaka 71Acharya Charaka had mentioned nija wound as of three types.1. Vataja Vrana – Vrana caused by Vata is stiff, hard on touching, with slowexudation,excruciating pain, piercing pain, throbbing and blackishness.2. Pittaja Vrana – it is known from the thirst, confusion (Moha), fever, sweating,burning sensation, impurity, tearing, foul smell and discharge.3. Kaphaja Vrana – it has much slimness, is heavy, unctuous, wet with mild pain,paleness in colour, little fluid and chronicity. Vrana caused by Vata, Pitta, Kapha andRakta, has burning (as making ash), churning, twitching, pricking, heat, suppuration,redness, itching and numbness and attended with various colours, pain and discharge.According to Acharya Vagbhata: 72 Acharya Vagbhata had followed the same classification of NijaVrana as inSusrutha samhitha. He had divided nija Vrana into fifteen types. Table2.B.2 showing classification of Vrana based on prognosis and treatmentSamhitha Classification Subtypes and name 73Susrutha 2 Su-upacara (4) Ayata, Caturasra, Vritta, Triputaka. types Durupacara (10) Sukti, Dwaja, Ratha, Kunta, Jaji, Vrana, Gho, Vrisha, Prasadakritya, Curnita. 4 Sukhasadhya, Krichra sadhya, types Yapya, Asadhya 74Charaka 20 Kritya, Akritya, Dushta, Adushta, - types Marmasritha,Marmanasritha, Samvrita, vivrita, Daruna, Mridu, Sravi, Asravi, Savisha, Nirvisha, Vishama, Sama, Utsangi, Anutsangi, Utsanna, Anutsanna. 3 Asadhya, Sukhasadhya, Krichra - sadhyaAshtanga 4 Sukharopaniya, Krichraropanya, -samgraha Yapya and AsadhyaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 41
    • Chapter-2 Review of LiteratureAGANTUJA VRANA / SADHYOVRANA SushruthaAcharya has mentioned that Agantuja Vrana is caused by the bites ofmen, beasts, birds, ferocious animal, reptiles/lizards, or by fall, pressure and blow orby fire, alkali, poison or irritant drugs, or through injuries inflicted by pointed wood,skeletal bones, horns, discus, arrows, axes, tridents or such other weapons. 76Agantuja Vrana is classified into, 6 types 3 types 8 typesClassification of Agantuja Vrana77,78,79. Table2.B.3 showing types of Agantuja VranaSusrutha 6 types Chinna, .Bhinna, Vidda, .Kshata, Piccita, GrishtaSamhithaAshtanga 3types Chinna(5) Grishta, Avakrita,ViccinnaVilambhi,Patita.Samgraha Vidda (8) Anuvidda, Uttundita, Ativida, Nividda, Anubhinna, Bhinnothundita, Atibhinna, Nirbhinna. Piccita(2) 1.Savarna,2.AvarnaAshtanga 8 types Ghrishta, Avakrita, Viccinna, Pravalambita, Patita, Vidda, Bhinna,Hrudaya Vidalita.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 42
    • Chapter-2 Review of LiteratureCharacters of Agantuja Vrana based on shape and severity of injury: 80,81. Acharyas have described accidental (exogenous) wound having various shapesbriefly and with features as of six types These are- Chinna (severed), .Bhinna (ruptured), Vidda (punctured), .Kshata(lacerated), Piccita( crushed) and Grishta (abraded). The first two are caused by edged weapons, punctured by pointed ones whileothers are caused by trauma with stone, stick etc.Chinna- The wound which is broad, either oblique or straight and cause falling offof any of the limbs is known Chinna (severed)Bhinna- When a viscus injured by the pointed spear, trident, double-edged orsimple sword and also by horn (of animals) etc, exudes some discharge fromrespective Ashaya, is known as Bhinna. (ruptured).For example, disharge may be blood, urine and stool from respective viscera. Kostha Bhinna lakshana:If kostha is ruptured and filled with blood, fever andburning sensation appear, blood comes out of urethra, rectum, mouth and nose alongwith the following symptoms-fainting, dyspnoea, thirst, flatulence, anorexia, retentionof faeces, urine and flatus, perspiration, redness of eyes, metallic smell in mouth, foulsmell in body pain in cardiac region and sides. Amasaya bhinna lakshana:If blood is situated with in stomach, hematemesestakes place along with excessive flatulence and severe colic. Pakvasayabhinna lakshana: In case bleeding is in intestines, there are pain,heaviness and coldness, blood being discharged from the passages (Srotas) belowumbilicus (Nabhi).Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 43
    • Chapter-2 Review of LiteratureViddha - The body part, except viscera injured with splinter having fine tip andeither protrude or gone out is known as Viddha (punctured).Kshata- The uneven wound neither excessively cut nor severely torn but havingfeature of both is known as Kshata (lacerated)Piccita- The part which is swollen along with bone by striking and pressing andaffecting marrow and blood is known as Piccita (crushed).Ghrista- When skin is removed by rubbing or any other cause associated withburning sensation and discharge, it is known as Ghrista (abraded).AetiopathogenisisIn Ayurvedic classics it is mentioned that aetiopathogenesis helps in defining theprocess of the diseases as well as its treatment.Classification based on healing Acharyas have also mentioned the signs and symptoms of the Vrana that are givenbelow.Characters of Sudda Vrana 82,83,84,85,86:According to Acharya Susruta Vrana that is of recent origin, unaffected by threevitiated doshas, edge with a slight blackish colour, having granulation tissue, absenceof pain and secretion with an even/equal elevation of the surface through out itslength. According to Acharya Charaka, wound which is neither reddish nor whitish/blackwithout much pain and elevation or depression is Suddha Vrana.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 44
    • Chapter-2 Review of Literature According to Ashtanga hridaya, wound resembling like surface of tongue, soft,unctuous, smooth with normal surface, absence of pain and secretion is SuddhaVrana.Characters of Ruhyamana Vrana 87 Wound with margin of grey cololur like pigeon’s colour without moisture, firmand scaly should be known as healing ulcer.Characters of Ruda Vrana 88 Wound which had ground matrix healing up; knotless; unswollen; painless; withcolour similar to that of skin and even should be known as well healed ulcer.Aetiopathogenisis of VranaIn Ayurvedic classics it is mentioned that aetiopathologenesis helps in defining theprocess of the diseases as well as its treatment.Nidana:, 89,90, 91, 92 93The word nidana refers to the root cause of all ailments. All causes can be classifiedinto Ayoga, Hinayoga, and Atiyoga of Asatmendriyartha, which are three main factorsto produce a disease. All the etiological factors of Vrana belong to extrinsic orintrinsic forces.Intrinsic causes: 94VataAhara - intake of non-unctuous, light and food.Vihara -over administration of vamana, virechana, rakthamokshana, physicalexercise, suppression of natural urges, fasting assault, sexual indulgence, anxiety,grief and vigil during night etc.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 45
    • Chapter-2 Review of LiteraturePittaAhara- Excessive intake of ushna, amla, lavana, kshara, katu.Food intake at time of from indigestion.Vihara- exposure to sun, fire, exhaustion, anger.KaphaAhara- excessive intake of unctuous, heavy, sweet, slimy, sita and lavana food.Vihara- Sleeping during daytime and lack of exercise.Extrinsic causes: By the bites of men, beasts, birds, ferocious animal, reptiles/lizards, or by fall,pressure and blow or by fire, alkali, poison or irritant drugs, or through injuriesinflicted by pointed wood, skeletal bones, horns, discus, arrows, axes, tridents or suchother weapons. 95Samprapti: Acharya Charaka has explained the samprapti of Nija Vrana as the Vatadi Doshasaggravated due to their own etiological factors produce Nija Vrana by thepredisposing Bahya marga.Vrana moolas : 96 Vataja, Pittaja, Sleshmaja, Sonitaja, Sannipataja,Aganthuja.Table 2.B.4 showing Vrana AdhishtanasSushrutha 97 8 Twak Mamsa sira ,Snayu, Sandhi, Asthi,Koshta,Marma 98Charaka 8 Twak, Sira, Mamsa, Meda, Asthi, Snayu, Marma, Antarasraya 99Vagbhata 8 Twak, Mamsa, Sira, Snayu, Sandhi, Asthi, Koshta, MarmaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 46
    • Chapter-2 Review of LiteratureTable 2.B.5 showing Vrana Lakshanas as per Susrutha Samhita100,101,102,103,104 100Sabdha Ksveda, Ghurgura, Jvalantiva, Pavana sashabdam visrujyanthi. Prakrutha - Katu, Tikshna, Visra, Loha Gandha, Mishra Gandha, Laja, Atasi taila,Gandha Vaikrutha – Madya, Agaru, Aagya, Sumana, Padma, Chandana, Champaka, Divya Gandha, Swana, Vaji, Mooshika, Dhwanksha, Puti, Valloora, Matkuna, Panka. Dahyante antharathyartha bahihi seetascha orSparsha Dahyante bahirathyartham bhavanthi anthascha seetala Twak Salila, Visra, Pithavabhasa. Mamsa Sarpi, Sandra, Swetha, Pichila. Rakta, Puya, Tanu, Vichinna, Pichila, Avalambi, Sira Shyava, Avasyaya Snayu Snigdha, Ghana, Singhanaka, Rakta Sukti Dhouta, Majja misra, Rakta, Snigdha, Asthi Sandhigata, Pichila, Avalambi Koshta Mutra, Pureesha, Puya, Udaka Marma As above Parushya, Shyava, Avashyaya, Dahi, Mastu, Vata in TwakSrava Ksharodaka, Mamsadhavana pulakodaka Gomeda, Gomutra, Bhasma, Shanka, Kashaya, Pitta in Twak Udaka, Madweeka, Taila Navaneetha. Kaseesa, Majja, Pishta, Tila, Kapha in Twak Nalikerodaka, Varaha Vasa. Nalikerodaka, Ervaruka rasa, Kanjikaprasada, Sannipata in Twak Arukodaka, Priyangu phala, Yakrut, Mudga yusha. Pakwashaya (Asadhya) Pulakodaka, Raktashaya (Asadhya) Ksharodaka Amashaya & Kalayaambha Trikasandhi (Asadhya)Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 47
    • Chapter-2 Review of Literature Toda, Bheda, Tadana, Chedana, Ayamana, Mandhana, Vikshepana, Chumuchumayana, Nirdahana, Avabhanjana, Sphotana, Vidarana, Vata Utpatana, Kampana, Vividha shoola, Vikirana, Stambhana, Poorana, Swapna, Aakunchana, AnkushikaVedana Osha, Chosha, Paridaha, Dhumayana, Pitta Angaramavakirnamiva, Ushmabhivrudhi, Ksharavasikta Rakta Same like Pitta Kandu, Gurutwa, Suptatwa, Upadehtwa, Alpa Kapha vedana, Stambha, Shaitya Sannipata All the aboveAkruthi Ayata, Caturasra, Tryasra, Mandala, Ardacandrapratikasa, Visala, Kutila,Sarvasadrsa, Yugmadhya. Vata Bhasma, Kapotasti, parusha, Aruna, Krishna Neela, Peeta, Harita, Shyava, Krishna Rakta,Varna Pitta & Rakta Pingala, and Kapila Kapha Swetha, Snigdha, PanduTable 2.B.6 showing Vrana Lakshanas as per Charaka Samhita105 Sveta, Avasannavartma, Athisulavartma, Atipinjara,Nila,Akruthi (12) Syava, Atipidaka, Rakta, Krishna, Atiputika, Ropya, Kumbhimukha.Gandha Sarpi, Taila, Vasa, Puya, Rakta, Syava, Amla, Puti.Srava (14) Lasika, Jala, Puya, Asruk, Haridra, Aruna, Pinjara, Kashaya, Neela, Haritha, Snigdha, Ruksha, Sita, Asita.Sadhyasadhyata The prognosis is based on a number of conditions and various types of wounds.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 48
    • Chapter-2 Review of LiteratureCharacteristics of Sukhasadya Vrana106,107,108,109,110 Vrana arising in only Tvak Adhishtana. Patient who is having good Satva, good strength, equilibrium of Agni, woundwhich is circular/elliptical/triangular /rectangular in shape and not at the site ofbuttock, anus, penis, lips, back, inner side of buccal cavity, throat . Vrana which is rectangular, square, circular and triangular in shape Patient of Vrana who follows the pathyapathya sincerely. Early age of patients, strength of body, mental power, vitality of dhatus. Vrana situated at such a place where dressing, application of medicaments etc areeasier and availability of healing tissue is better . Wound occurring in the skin and the flesh, in the region which is easy toapproach, which is of recent in origin, which occurs in favorable season also inyoung. Vrana having Kapota Varna, edges dry and stable.Characteristics of Krichra Sadhya Vrana 111,112 Vrana of bone, teeth, nose, lateral angle of eye, srotas, umbilicus, stomach,suture, buttock, flanks, abdomen, thorax, breast, joints,etc, those secreting frothyblood /pus with a gurgling sound or containing any foreign matter embedded inside. A wound appearing in the neither region of the body and pointing upward or at theroot of the hair or about the end of the nails or in any of the vulnerable parts of thebody, on the tibio-fibular joint, pelvis, and Bhagandara which has got the openinginwardDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 49
    • Chapter-2 Review of Literature Wound of leprotic, diabetes mellitus, tubercular, poisonous one, and reoccurrenceof pre-existing wound. Vrana which is having smell, 16 complication and 24 Vrana Dosha. Lacking the lakshanas told for Sukhasadya Vrana .Characteristic features of Yapya Vrana: 113,114. Characteristics of Yapya Vrana is explained as Avapatita, Niruda Prakasa,Sanniruda Guda, Jatara Granthi, Krimi, Pratishyaya, Koshtagata Krimi, SarkaraMeha, Sikata Meha, Vatakundalika, Ashtila, Dantasarkara, Upakusha, Kanthasaluka,Dushita gums, Visarpa, Bhagna, Urakshata, and Vrana Granti. With out treatment inproper time, curable wound can be converted in to Yapya.Characteristic features of Asadya Vrana115,116,117,118,119Wound without takingtreatment Wound which grows like a fleshy mass, painful, containing pus copious secretionwith its edges raised like genitals of mare, horn of a cow which are soft/ hard,elevated at its base, exudates, blood/thin slimy secretion/fat/marrow/coagulatedblood/brain matter embossed / heaped up at center, dipped at its extremity, coveredwith shreds of ligaments, bad appearance, Koshtagata Vrana having yellow/blackdischarge/urine/faces/air exudation from mouth anus and wound itself, multispreading narrow mouthed wound of an emaciated patient, narrow mouthed fromwhere air bubbles come out, passing air with sound from a head/neck wound, pus andblood discharge from wounds of emaciated patients wound, wound with complicationDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 50
    • Chapter-2 Review of Literaturesuch as anorexia, indigestion, cough and dyspneoa, brain injury from which brainmatter exudates and all doshas are vitiated. Wound which exudates fat, marrow, or cerebrospinal fluid, may prove incurableto medical treatment. If a wound does not heal, even without involvement of vein/joint/bone / vital partsof body. Shape of wounds other than those explained in Sukha Sadya Llakshanas. Wound having secretion like Pulakodaka from large intestine, discharge likealkaline water from Raktasaya, peya yusha like exudates from stomach and sacraljoint. Lacking of all conditions of Sukasadhya Vrana. Wound associated with the diseases like erysepales, fever, diarrhea, cough, thirst,insomnia, dyspnoea, indigestion. Wound produced by dosha vitiation and having exudes of musclefat, marrow,cerebrospinal fluids. Wound which having smell of wine /agar /ghee/chameli /red lotus / Champa/Divya /extra ordinary smell. Wound becomes squire, painful even without involvement of vital parts, which ishot externally and cold internally, “wound of patients who have emaciation,dyspnoea, cough, anorexia, which exudes too much muco-purulent blood staineddischarges and wound of vital parts is incurable even after taking treatment. Wounds of patient whose Koshta is filled with blood, having coldnessof hands,legs, mouth and respiration,eyes become red and having Anaha.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 51
    • Chapter-2 Review of LiteratureVrana upadrava Acc to Acharya Susrutha there are many complications of wound and thewounded patient. Out of them complication of wound are five sense subjects relatingto smell etc. while those of wounded are Jwara,Atisara, Moorcha, Hikka, Chardhi,Arochaka, Swasa, Kasa, Avipaka and Thrushna.120 Acc to Acharya Charaka Vrana Upadravas are 16 in number.They are Visarpa ,Pakshaghata, Sirastambha, Apatanaka, Moha, Unmada, Ruja,Jwara, Hrushna, Hanugraha, Kasa, Chardi, Atisara, Hikka, Swasa and Vepadhu.121Vrana Upadrava Hetu-s 1221. Snayu kleda 9. Nagha prabheda 17. Atibhuktha2. Sirakleda 10. Kashtaprabhedt 18. Virudhdha bhojana3. Gambhirya 11. Charma athikattana 19. Asathmya bhojana4. Krumi bhakshana 12. Loma athikattana 20. Soka5. Asthibheda 13. Midhyabandha 21. Krodha6. Sasalyatva 14. Atisneha 22. Divaswapna7. Savishatva 15. Atibhaishajya karshana 23. Vyayama8. Sarpana 16. Ajirna 24. MaidhunaVRANA ROPANAEtymology:Root “ruh” adding the suffix “Ana”, na-ruh-nic-hasya yah-lyut in the meaning ofJanane or to regenerate.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 52
    • Chapter-2 Review of LiteratureDefinition:Vrana is so named by the scholars because it covers the site and the scar thus formeddoes not disappear, even after healing, and persists until the person lives.Vrana ChikitsaThe entire course of treatment in Vrana is classified under,1. Poorvakarma,2. Pradhana karma,3. Paschatkarma. Classical texts have mentioned that if the aganatuja Vrana does not heal even afterseven days, has to be considered as sharirika and the treatment is to be done like thatof Doshaja Vrana123,124..Susruthacharya has adviced Saptopakramas as the basic treatment principles forVrana where he has incorporated various procedures viz.Shashti upakramas inthem.125Saptopakramas are1. Vimlaapana2. Avasecana3. Upanaaha4. Patana Kriya5. Sodhana6. Ropana and7. VaikrutaapaharanaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 53
    • Chapter-2 Review of LiteratureSashti upakramas are1. Apatarpana 21. Seevana 41. Krushnakarma2. Aalepa 22. Sandhana 42. Paandukarma3. Parisheka 23. Peedana 43. Pratisaarana4. Abhyanga 24. Sonita sthaapana 44. Romasanjanana5. Sweda 25. Nirvaapana 45. Lomaapaharana6. Vimlaapana 26. Utkaarikaa 46. Bastikarma7. Upanaaha 27. Kashaaya 47. Uttarabastikarma8. Paacana 28. Varti 48. Bandha9. Visraavana 29. Kalka 49. Patraadaana10. Sneha 30. Sarpi 50. Krumighna11. Vamana 31. Taila 51. Bramhana12. Virecana 32. Rasakriyaa 52. Vishaghna13. Chedana 33. Avacoornana 53. Sirovirecana14. Bhedana 34. Vranadhoopana 54. Nasya15. Daarana 35. Utsaadana 55. Kavaladhaarana16. Lekhana 36. Avasaadana 56. Dhooma17. Eshana 37. Mrudukarma 57. Madhu18. Aaharana 38. Daarunakarma 58. Sarpi19. Vyadhana 39. Kshaarakarma 59. Yantra20. Vidraavana 40. Agnikarma 60. AahaaraThe Upakramas incorporated in Vimlapana are: Apatarpana, Alepa, Parisheka, Abhyanga, Sveda, VimlapanaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 54
    • Chapter-2 Review of LiteratureThe Upakramas incorporated in Avasechana are Visravana Snehana Vamana. Virechana.The Upakramas incorporated in Upanaha are Upanaha PacanaThe Upakramas incorporated in Patana Chedana Bhedana Darana Lekhana Eshana Aharana Vyadhana Visravana SivanaThe Upakramas incorporated in Shodana and Ropana Sandhana Pidana Sonithasthapana Nirvapana UtkartikaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 55
    • Chapter-2 Review of Literature Kashaya Varti Kalka Sarpi Taila Rasakriya Avacurnana Dhupana.The Upakramas incorporated in Vaikrutapaharana are 26 cosmetic measures.As per Charakacharya126Charaka has mentioned thirty-six therapeutic measures for the treatment of wound.1. Sophaghna 13. Sodhana kasaya 25. Utsadana2. Patana 14. Sodhana pralepa 26. Avasadana3. Vyadhana 15. Ropana kasaya 27. Agni Daha4. Chedana 16. Ropana pralepa 28. Kshara daha5. Lekhana 17. Sodhana taila ghrita 29. Kathinyakara dhupana6. Prachchana 18. Ropana taila ghrita 30. Mardavakara dhupana7. Avapidana 19. Patra 31. Kathinyakara – alepa8. Nirvapana 20. Bahya Chadana 32. Mardavakara – alepa9. Sandhana 21. Antah Chadana 33. Avacurnana10. Swedana 22. Bandana 34. Ropana11. Samana 23. Upabandhana 35. Varnya12. Eshana 24. Pathya Bhojya 36. LomarohanaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 56
    • Chapter-2 Review of LiteratureAs per Ashtanga Sangraha1. Vamana 10. Upanaaha 19. Kshaarakarma2. Virecana 11. Daarana 20. Agnikarma3. Upacaara 12. Peedana 21. Vranaropana Lepa4. Raktamokshana 13. Prakshaalana 22. Vranaropana Ghruta5. Seka 14. Vranasodhana Lepa 23. Vranaropana Taila6. Abhyanga 15. Varti 24. Avacooranana7. Sophahara Lepa 16. Dhoopa 25. Svarnakarana8. Swedana 17. Utsaadana 26. Romasan`janana9. Sthirasophahara 18. AvasaadanaLepaTreatment of Sadyovrana:128,1291. Immediate general treatment is done for pacifying the heat released at the site ofinjury due to Pitta aggravation by special cooling measures.2. Sneha – processed by Vatahara drugs are advised for loss of blood due to vitiationof Vata following by sudation.3. Irrigation of drugs having Seeta Veerya (cold properties) for excessive burningsensation followed by suppuration.4. Vamana, Virecana, Langhana, Pathya, repeated blood letting are indicated for redand inflamed Vrana.5. Specific treatment:A) Ghrushta Vrana: Dusting of powder after Subsiding of pain.B) Avakruta Vrana: Use of Kalka, Kashaaya.C) Vicchinna and Pravilambita: Bandaging and Avapeedana after suturing.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 57
    • Chapter-2 Review of LiteratureD) Viddha Vrana: Salya Harana.E) Vidaalita Vrana: Like Bhagnapratishedha. Recurrence of Vrana occurs due to Dosha Prakopa, Vyaayaama, Abhighaata,Ajeerna, Harsha, Krodha and Bhaya.PATHYAAPATHYA130,131 Charaka had mentioned Pathya-apathya for the patient suffering from Vrana. Hehad quoted that such a patient should abstain from salt, sour, pungent, hot, burningheavy food-drinks and also sexual intercourse. Food and drinks not too cold, heavyand fatty, non-burning, according to the nature of the wound and day sleep arebeneficial. According to Sushruta, if the wound, in spite of being situated in location not nearthe vital spots and free from vessels, joints and bones; spreads all over the body. Healso suggested avoiding physical exercise and intercourse for a year. According to Vagbhata, he who takes old rice (Shali dhanya) cooked well andadded with fats (ghee etc) in small quantity along with meat of animal of arid land(Jangala) followed by drinking warm water gets cured of the ulcer quickly.REVIEW OF MODERN LITERATURE OF WOUNDDEFINITION OF WOUND “A wound is a break in the integrity of the skin or tissues often ,which may beassociated with disruption of structure and function”.132SYNONYMS: 133 Wound, sore, ulcer, abscess, tumour, cancer, boil, scar, cicatrix, crack, fistula,injury.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 58
    • Chapter-2 Review of LiteratureDEFINITION OF ULCER: An ulcer is a break in the continuity of the covering epithelium, either skin ormucus membrane due to molecular death 134CLASSIFICATION OF WOUNDS135 A wound can be caused by almost any injurious agent and can involve any tissueor structure. Rank and Wake field classify wounds mainly into two viz; tidy anduntidy.Tidy wounds They are afflicted by sharp instruments and contain a devitalized tissue,where theyget closed primarily with the expectation of quiet primary healing .Eg: Surgicalincisions, cuts from glass and knife wounds .Untidy wounds They result from crushing, avulsion, vascular injury or burns and containdevitalized tissue. Skin wounds will often be multiple and irregular. Such woundsdoesnot heal primarily and usually heal with complications.Other types of wounds are bruise, contusion and haematoma A closed blunt injury may result in a bruise or contusion. There is bleeding intothe tissues and visible discoloration. Where the amount of bleeding is sufficient tocreate a localized collection in the tissues, this is described as a haematoma.Puncture wounds and bites A puncture wound is an open injury in which foreign material and organisms arelikely to be carried deeply into the underlying tissues. Common causes are standingon a nail or other sharp object. There may be little to see on the surface,Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 59
    • Chapter-2 Review of LiteratureRadiological examination may detect metal fragments or glass.Abrasions and friction burns An abrasion is a shearing injury of skin in which the surface is rubbed off. Mostare superficial and will heal by epithelialisation, but some may result in full-thicknessskin loss. Abrasions may be dirt ingrained and if this dirt is not removed at the timeof primary treatment permanent, tattooing of the skin will result.Laceration A laceration or cut is the result of contact with a sharp object (the surgicalequivalent is an incised wound). Once the suting implement has gone deep to thedermis, there is less resistance in the subcutaneous tissues and the cut may thereforepenetrate to a considerable depth.Traction and avulsion Avulsion injuries are open injuries where there has been severe degree of tissuedamage. Such injuries occur when hands or limbs are trapped in moving machinery,such as is rollers, producing a degloving injury. Degloving is caused by shearingforces that separate tissue planes, rupturing their vascular interconnections andcausing tissue ischaemia. This most frequently occurs between the subcutaneous fatand deep fascia. Degloving injuries can be open or closed. Degloving can belocalized or circumferential. It can occur only in the single, subcutaneous plane, butwhere present in multiple planes, such as between muscles and fascia and betweenmuscles and bone, is an indication of a severe high energy injury with a limitedpotential for primary healing.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 60
    • Chapter-2 Review of LiteratureCrush Crush injuries are a further variant of blunt injury and are often accompanied bydegloving and compartment syndrome. Injury to tissues within a closed fascialcompartment leads to bleeding, exudate and swelling of these tissues, and increasedinterstitial pressure. As the interstitial pressure rises above capillary perfusionpressure thje blood supply to the viable tissues is reduced, resulting in furtherischaemic tissue injury and swelling. This cycle causes a worsening compartmentsyndrome with muscle ischaemia and nerve ischemia progressing to muscle necrosis,skin necrosis and limb loss. Muscle necrosis may result in renal failure. This processcan be arrested by early recognition and decompression of the affected compartmentsby fasciotomy.Injury to Internal organs Wound such as stab wounds may be associated with damage to internal organs.Treatment of penetrating abdominal or thoracic wound has been discussed elsewhere.The possibility of blunt or sharp abdominal trauma must not be overlooked whentreating extensive injuries else where, particularly in an unconscious patient.War wounds and gunshot injuries Gunshot injuries are associated with different severity of tissue damage dependingupon whether the injury is of low or high velocity. Low-velocity injuries, such asfrom a hand gun, result in an entry and exit wound, the latter being the large, anddamage along the tract of the missile, Such injuries are often assoiated with servertissue contamination from clothing, dirt or other foreign materials. High-velocityinjuries from modern assault rifles) cause explosive pressure and decom pressioneffect, such that there is widespread tissue damage, with injury to major limb vesselsDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 61
    • Chapter-2 Review of Literatureand nerves situated some distance from the tract of the missile. Where a high-velocitymissile strikes bone, the high-energy exchange result in fragmentation of the bone.Injuries to bone and joints Fractures may be closed where the skin is intact or open where there is a wound.Open fractures may have a skin wound due to penetration from the outside or, morefrequently, due to bursting of the skin from within by bone fragments. The bonedisplacement is worst at the very moment of injury and bone fragments partiallyreduce spontaneously thereafter.Injury to nerves -usually seen in open wounds and presented with impaired nervefunction.Injuries to arteries and veins - wound is presented with very much bleeding.Chronic wounds Several conditions are classified as varieties of chronic wounds, although theymay not clearly follow mechamical trauma.Ulcers All ulcer is any breach in an epithelial surface. Chronic ulcers are wounds thatfail to heal. In generally, they have a fibrotic margin and a bed of granulation tissuewhich may include areas of slough (necrotic tissue).Pressure sores These are chronic wounds following tissue necrosis from pressure. They occurover bony prominences. There pathogenesis is identical to compartment syndrome intheat they ariose where there is unrelieved pressure in the soft tissues overlying boneDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 62
    • Chapter-2 Review of Literaturesuch that the external pressure exceeds capillary perfusion pressure and ischaemicnecrosis occurs.WOUND HEALING 136The word ‘healing’ means replacement of destroyed tissue by living tissue.Wounds may be caused by-i) Trauma-either accidental or surgical.ii) Physical, chemical and microbial agents, which give rise to inflammation and maylead to necrosis or destruction of living tissue.iii) Ischaemia, which leads to infraction. Regeneration and repair are two important factors to be understood in the contextof wound healing . Regeneration, which means replacement of lost tissue by tissue similar in type.This occurs due to proliferation of surrounding undamaged specialized cells. Repair, which means replacement of lost tissue by granulation tissue, followed byfibrosis and scar tissue formation. This occurs when the surrounding specialized cellsdo not possess the capacity to proliferate e.g. neurons and muscle or destruction oftissue to such an extent that proliferation of the surrounding undamaged cells cannotmake good the loss.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 63
    • Chapter-2 Review of LiteratureTwo types of healing are: Healing by first intention-When a wound is sutured primarily with clips, suturesor adhesive materials, the wound healing occurs with minimum scarring and it isknown as healing by first intention. Healing by second intention-When there is irreparable skin loss or the woundbecomes infected and breaks open, primary suturing is not possible. So the woundheals with more scar tissue and taken longer time to heal. This is known as healing bysecondary intention. An ulcer also heals in the same way.The four basic processes which take place in wound healing are:-A. Inflammation.B. Wound contraction.C. Epithelialization.D. Granulation tissue formation.Although all wounds heal by the same basic process, yet their application is differentin closed wounds and open wounds.A. Inflammation- Immediately after disruption of tissue integrity either byaccidental trauma or by surgeon’s knife, inflammation starts. Platelets becomeadherent and with clotting factors form a haemostatic plug to stop bleeding from thesmaller vessels. The blood vessels undergo transient vasoconstriction followed byvasodilation. Histamine is considered to be the primary mediator of inflammatoryvascular responses. This is liberated by platelets, mast cell and granulocytes.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 64
    • Chapter-2 Review of LiteratureHistamine produces local vasodilatation and increases permeability of small vessels.With increase of permeability, proteins and plasma leak out of the vessels. The actionof histamine is short lasting and local sources are depleted rapidly. Soon the kinins, aseries of biologically active peptides and the prostaglanins, principally PEG1 andPEG2 take over the job of implicating local inflammatory vascular responses fromhistamine. Kallikrein, and enzyme found in plasma and in gametocytes, releasebradykinin and kallidin. In the presence of kinins, the local cells produce a varity ofprostaglandin’s. These prostaglandin’s seem to be the final mediators of acuteinflammation and may play a chemotactic role for white cells and fibroblasts. In theearly stages of inflammation, actively motile white cells migrate into the wound andstart engulfing and removing cellular debris and injured tissue fragments. At first,polymorph nuclear leucocytes dominate. This stage has also chemical mediators.Leukotaxine, a peptide formed in damaged tissues by the enzymatic destruction ofalbumin, is though to be the chemotactic agent-attracting leucocytes into the wound. As the transient phase of white cell migration ends, the granulocytes with shorterlife die and release acid hydrolases into the local environment. Previously theproportion of granulocytes and monocytes in the wound area were in the same ratio asthey are in the blood. As the granulocytes are dying, the proportion of monocytesincreases significantly and these monocytes continue their scavenging activity forweeks. Monocytes become the dominant cell type by the 5th day. They arephagocytic and ingest cellular debris. It has been found out experimentally thatwound healing may proceed normally in the absence of granulocytes andDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 65
    • Chapter-2 Review of Literaturelymphocytes, but monocyte must be present to create normal fibroblasts production.Depression of monocytes will delay wound healing. Clinically, inflammation is presented by redness, tenderness, heat, swelling andloss of function. B. Wound contraction- Wound contraction has been noticed in open woundswith tissue loss for centuries. Only recently however, the mechanisms responsible forwound contraction have been investigated extensively.This wound contraction doesnot begin immediately and that about 3 to 4 days elapse before movement of theedges become measurable. This period, when no wound contraction is noticed, iscalled the initial ‘Lag period”. After this period there is a period of rapid contraction,which is completed by the 14 the day. At this time the wound is reduced toapproximately 80% of its original size. The magnitude of contraction varies with thespecies of animal and with the shape, size and site of the wound.CAUSES OF WOUND CONTRACTION Over the years a great deal of research work has been performed to know themechanism of wound contraction, but yet it is not known with certainty.1. Removal of fluid by drying has been suggested as a cause of diminution in thesize of wound. But this has not been substantiated, as water content of central woundtissue at the beginning of wound contraction has not changed significantly as at theend of contraction.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 66
    • Chapter-2 Review of Literature2. Contraction of collagen has also been incriminated as the cause of woundcontraction. Although collagen increases markedly between the 5th and 8th day ofhealing, yet the total collagen in the wound falls significantly after this period, so itdoes not correlate with the period of wound contraction. Moreover the rate of woundcontraction is not affected by suppressing collagen synthesis. In scorbutic animals,although granulation tissue is formed, collagen production is inhibited and yet woundcontraction proceeds normally.3. Contraction of granulation tissue: - That contraction occurs at a time whengranulation tissue is actively being formed has laid many workers to regard thegranulation tissue as forming an organ of contraction. But curiously excision ofcentral granulation tissue did not agent the rate of wound contraction. It was furthernoticed that although wound contraction was not inhibited by excising the centralmass of granulation tissue, it could be stopped decisively by excising a very limitedzone of tissue just beneath the advancing dermal edge.So this indicated that thecontracting mechanism is located in margins of the wound, the so called picture-framearea. This histological area of this ‘picture-frame area reveals a collection of large,stellate, pale staining cells which have been thought to be the cells responsible formoving the overlying dermis. These are myofibroblasts. These cells showcharacteristics of fibroblasts and smooth muscle cells including a rough endoplasmicreticulum and microfilament bundles similar to smooth muscles.FACTORS INHIBITING WOUND CONTRACTION1. Corticosteroid administration has inhibitory effect on wound contraction.2. Contraction does not occur normally in burns.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 67
    • Chapter-2 Review of Literature3. Immediate skin grafting prevents wound contraction.4. X-irradiation, if applied on the wound, causes delay in wound contraction.5. Trocinate, which is a smooth muscle inhibitor, acts on actin which is thecontractile protien of fibrous contractures in human beings.6. Colchicine and vinblastin also inhibit wound contraction, as they are inhibitors ofmicrotubule formation in the myofibroblasts. In fact colchicines is presently used inthe control of fibrous contractures in human beings.7. Cytotoxic agents particularly the cytochrome poisons in non-lethal doses inhibitwound contraction.C. Epithelialisation:- In skin wounds, the epidermis immediately adjacent to thewound edge begins thickening on the first day. Marginal basal cells lose their firmattachment to the underlying dermis, enlarge and begin to migrate into the wound.The fixed basal cells in a zone near the wound edge undergo rapid mitotic divisions(proliferate) and the daugher cells migrate. Within 48 hours, the entire wound surfaceis re-epithelialised. After bridging the wound defect, the migrating epithelial cellslose their flattened appearance and become more columnar in shape. Layering of theepithelium starts and surface cells keratinise. The epithelial cells also migrate downthe suture tracts. Subsequent epithelial thickening and keratinisation may producemarked foreign body reaction and formation of sterile abscess. Epithelialisation ofthe wound mainly occurs by proliferation and migration of the marginal basal cellslying close to the wound margin.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 68
    • Chapter-2 Review of LiteratureD. Granulation tissue formation:- The haematoma within the wound is soonreplaced by granulation tissue, which consists of new capillaries and fibroblasts. Thisformation of granulation is preceded by two phases- (i) phase of traumaticinflammation and (ii) phase of demolition.1. PHASE OF TRAUMATIC INFLAMMATION:- The details of this traumaticinflammation has been discussed in the context of wound inflammation.2. PHASE OF DEMOLITION:- The dead tissue cells liberate their autolyticanzymes. Similalry disintegrating polymorphs liberate proteolytic enzymes. Themononuclear cells along with lage phagocytic macrophages infiltrate and ingestparticulate matters. They either digest or remove them. Fusion of these macrophagesresults in the formation of foreign body gaint cells.3. GRANULATION TISSUE FORMATION:- The granulation tissue is mainlyformed by proliferation and migration of the surrounding connective tissue elements.It is in fact composed of in the first instance by capillary loops and fibroblasts with avariable number of inflammatory cells. So initially it is highly vascular tissue, whichgradually turns into an avascular scar tissue. The two stages are considered in thisprocess- (a) stage of vascularisation and (b) stage of devascularisation.a) Stage of vascularisation-As mentioned above the wound clot is invaded bymacrophages, which with their phagocytic activities remove the particulate mattersand move towards the center of the wound. This process is followed by capillaryloops and fibroblasts. The ingrowth of capillary loops and fibroblasts which help toform living granulation tissue is known as organization.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 69
    • Chapter-2 Review of Literature Solid buds of endothelial cells grow out of the existing damaged blood vessels atthe surface of the wound. These undergo canalization by anastomosis with theirneighbours form a series of vascular arcades. Under the electron microscope gaps areseen between the endothelial cells and the basement membrane is poorly formed.These newly formed capillary loops leak protein and thus the tissue fluid which isformed is a very suitable medium for fibroblastic growth. Gradually these capillaryloops differentiate, a few acquire muscle coat and become arterioles, whereas othersenlarge to form thin walled venules. A few disappear or persist as part of thecapillary bed. The source of smooth muscle fibres to form arterioles is either cellmigration or differentiation of existing primitive mesenchymal cells. Directarteriovenous shunts are also formed. The fibroblasts, which accompany the capillary loop, gradually become larger tobecome elongated fibrocytes. During this process of fibrogenesis, pH becomesalkaline. From these fibroblasts ultimately collagen is formed. Collagen is anextracelllar secretion from specialized fibroblasts and the basis molecules whichfibroblasts synthesise are frequently called tropocollagen. This tropocollagencondenses in the mucopolysaccharide extracellular space to form fibrils. These fibrilsare grouped together to form the reticulin fibres. These fribrils when condensedtogether form the collagen fibres. This collagen is not inert and it undergoes constantturnover under the influence of tissue collagenase. More thicker collagen fibres arelaid down haphazardly.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 70
    • Chapter-2 Review of Literature These are several types of collagen which differ in the amino acid sequence of theconstituent chains, though hydroxyproline, proline and glycin dominate. Type Icollagen is found in the tendon, ligament, skin and bone Type II collagen is found incartilage, mainly in articular and costal cartilages. Type III collagen is found infoetal dermis and later on is replaced by type I collagen at birth. Type III collagenappears to be an important component of tissues with unusual degree of elasticitysuch as aorta, oesophagus and uterus. The aminocids found in collagen arehydroxyproline and hydroxylysine. Other fibrous tissues such as elastin do not containsignificant amount of hydroxyproline. Fibroblasts are also though to be responsible for the production ofmucopolysaccharide ground substance.b) Stage of devascularisation- In this stage fibroplasia proceeds and some vesselsundergo atrophy, whereas others show endarteritis obliterans, that means their lumensbecome obliterated due to intimal proliferation. So the granulation tissue looks pale atthis stage, which is known as devascularisation. At the beginning of this stage, nerve fibres and lymphatics form, with theingrowth of nerve fibres, the arterioles exhibits rhythmic contraction. The newlymphatics develop from existing lymphatics in the same way as do the capillaryloops. Mast cells also make their appearance and their granules are derived from theground substance. At later stage these mast cells disappear and hyalinisation occurs.Ther is also formation of scar tissue. This process is known as cicatrisation. Collagenturn over and remodeling in the scar never stops. In fact the turn over of collagen inDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 71
    • Chapter-2 Review of Literaturescar tissue is faster than in other tissues. The phenomenon of scar remodeling is thebasic function of injured tissues. The gross appearance of remodeling scars suggeststhat collagen fibres are altered and rewoven into different architectural patterns withtime.Factors affecting granulation tissue formation1. Cortisone administration- Excess corticosteriod administration inhibitsgranulation tissue formation.2. Scurvy- Maturation to collagen does not occur in the absence of vitamin C.3. Protein starvation- also causes delayed formation of collagen. There remainsexcessive accumulation of poorly sulphated ground substance.Healing of Skin WoundsHealing of a clean incised wound, the edges of which are closed (closed wound)-takesplace by a process known as healing by first intention. The following changes takeplace- i. Initial haemorrhage results in the formation of a fibrin-rich haematoma. ii. Acute inflammatory process occurs and the fibrinous exudates help to cement the cut margins of the wound together. iii. Minimum granulation tissue is formed, which can be called organization. iv. Regeneration of epithelium- The process of epithelialisation has been discussed above. In the first 24 hours basal cells mobilize from the undersurface of the epidermis. By 48 hours the advancing epithelial edge undergoes cellular hypertrophy and mitosis. Epithelial cells gradually line the wound deep to the fibrin clot and it also lines the suture tracks. Implantation epidermoid cyst mayDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 72
    • Chapter-2 Review of Literature develop from epithelial remnants. There may be formation of ugly punctuate scars from sutures which are left in position for longer period. The use of adhesive tapes instead of sutures for closing wounds avoids these marks and gives better cosmetic results.Healing of open wounds- If delayed closure is not performed and if there skin loss, aremarkable change in the physical dimension of the wound occurs. Healing of suchwound is known as healing by secondary intention. The main bulk of tissue withperforms the healing process is the granulation tissue and that is why this type ofhealing is also called healing by granulation. But this does not mean that granulationsare not formed in the simple incised wounds. The difference is quantitative and notqualitative. The followings are that various important processes of this type of woundhealing.i) Initial inflammatory phase affects the surrounding tissues and the wound is filledwith coagulum. This coagulum dies and forms a scab.ii) The most important feature of healing of this type of wound is wound contraction.The skin wound contracts by stretching the surrounding skin to close the defect andnot by the production of new skin. After a dealy of ‘lag period’ of 2 or 3 days, thedermal edges begin moving towards each other. Between 5 and 10 days, the woundedges move rapidly and after 2 weeks it becomes slowed down again.iii) The exposed wound gradually becomes completely covered with granulationtissue. This granulation tissue forms a temporary protective layer against infectionuntil the surface is covered by epithelium.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 73
    • Chapter-2 Review of Literatureiv) The epithelium gradually grows over the granulation tissue, but beneath the scabto complete the healing process. Specialized epithelial structures like interpapillaryprocesses, hair follicles and sebaceous gland are not reformed. The epithelial cells in fact slide into the wound forming a thin tongue ofcells between the granulation tissue and the clot. Gradually as the epithelialisationcontinues, there is also remodeling of the granulation tissue and scar, so that thewounded area which was at first depressed, ultimately forms a flat scar.Complications of wound healing: i) Implantation cysts. ii) Painful scars. iii) Cicatrisation- It often produces various deformities. iv) Keloid formation v) NeoplasiaFactors influencing wound healing - The various factors which influence woundhealing can be divided into two groups-general factors and local factors.General factors:-1. Age- Wound healing is fast in the young, but it is normal in old age unlessassociated with debilitating diseases or ischaemia or diabetes etc.2. Nutrition- (i) Protein deficiency- As mentioned above, protein depletion causesimpairment of granulation tissue and collagen formation. It should be noted that it isDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 74
    • Chapter-2 Review of Literaturenot always due to inadequate intake, but may be due to excessive loss e.g. nephroticsyndrome, cirrhosis, chronic inflammatory conditions etc. ii) Vitamin C deficiencyiii) Vitamin A is required for proper epithelialisation, which may be hampered due toits deficiency.Zinc, Calcium, Copper and Manganese deficiency- Zinc is an essential component ofmany enzymes which are involved in protein synthesis. There is some failure ofgranulation tissue formation in case of zinc deficiency. Others are essential mineralswhich are also required for proper wound healing. These may be depleted inintestinal fistulas and burns.3. Hormones- (A) Corticosteroids- The effects of this hormone on granulation tissueformation and wound contraction have been discussed above.b) Desoxycorticosterone acetate and anabolic steroids like testosterone are alsoconcerned with increase in the speed of wound healing.The following conditions delay or hamper the quality of wound healing. These are:-4. Anaemia.5. Uraemia6. Jaudice.7. Diabetes.8. Blood dyscrasias9. Malignant disease.10. Cytotoxic drugs.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 75
    • Chapter-2 Review of LiteratureLocal factors:- 1. Position of skin wound- When the skin wounds are parallel to the lines of langer, they heal faster and wounds right angle to these lines tend to gape and the healing is delayed. 2. Blood Supply- Wounds with poor blood supply heal slowly 3. Tension-If the wound is in tension, its healing will be jeopardized. Haematoma and infection increase tension. 4. Infection-Once infection occurs in a wound, healing is always delayed. Due to infection, fibroblasts face tough time to persist as they have to complete with inflammatory cells and bacteria for oxygen and nutrients. So proper granulation tissue formation and collagen formation become affected. This has been often the sause of burst wound which requires secondary sutures. 5. Movement- it delays wound healing, so rest is very essential. The delicate capillary lopps of the granulation tissue and the delicate epithelium are damaged due to movement. 6. Exposure to ionizing radiation-Previous X-irradiation may affect vascularity of the part. It also causes delay in the formation of granulations tissue. But most important is that it inhibits wound contraction. 7. Foreign bodies- These include tissue reaction and inflammation. 8. Adhesions to bony surfaces cause delay in wound heating probably by preventing proper wound contraction. 9. Necrosis- This obviously retards healing.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 76
    • Chapter-2 Review of Literature 10. Lymph drainage- Impairment of lymph drainage, which causes oedema of the part, jeopardizes the process of wound healing. 11. Ultraviolet light is well known clinically to increase the rate of healing. This has been confirmed experimentally. 12. Faulty technique of wound closure is obviously responsible for delay in wound healing in many cases.SCARS 137 The most superficial wound such as superficial burns and abrasions will heal byepithelialisation alone without scar formation. In these circumstances adnexalstructures are preserved and the epithelium regenerates from these structures. Thismay leave alterations in keratinisation, texture or pigmentation of the healed area, butnot scarring as such. A scar is the inevitable consequence of wound repair. The finalphase of wound repair is the process of remodeling and scar maturation. Thefibroblasts, capillaries, glycosaminoglycans, and immature collagen of granulationtissue and the newly healed wound are replaced by relatively acellular, avascular scartissue composed of mature collages with scattered fibroblasts. This biological processis manifested by a change in appearance of the scar from a red, raised, firm,contracting, and perhaps itchy nodule to a pale, flat softer, static, symptomless plaqueof mature scar. The rate at which any given scar passes though this process can varywidely depending on the age of the individual, the site of the wound, the time thewound took to heal, the direction of the scar and the tension across it. In general,scars in younger patients with wounds on the trunk that heal slowly, perhaps withDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 77
    • Chapter-2 Review of Literatureinfection or dehiscence, and scars that have a lot of tension across them will takemuch longerto mature than scars in older people, in thin-skinned areas, that healrapidly by first intention and that have minimal tension across them.Adverse scars.There are many types of adverse scar many of which can be avoided or prevented bycorrect incision planning and adequare wound manangement. Some types, however,cannot be prevented and are unpredicatable in their occurrence.Wrong Direction Incisions that passs along ideal lines are more likely to leave acceptable scars.Poor Alignment of features Mal-alignments result in conspicuous adverse scars.Stretched scar Scars from excisional wounds on the trunk and limbs often stretch.Contracted scar Where a linear scar crosses a flexor surface shortening may result in a scarcontracture which may prevent full extension of that part.Pigment alteration The new epidermis of a scar will often not have the same degree of pigmentationas surrounding unscarred areas mosly hypopigmented, but hyperpigmentation canalso occur.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 78
    • Chapter-2 Review of LiteratureContour deformity Where would edges are not anatomically aligned in the vertical plane or where abeveled cut is not repaired accurately there is a risk of contour irregularity in thehealed scar.Tattooing Grit, dirt or soot become implanted in the wound as it heals result in tattonedscars.Stitch marks If skin sutures are left in place for more than 7 days then scars from the stitchmarks will usually result.Hypertrophic scars Hypertrophic scars typically occur in wounds where healing was delayed, perhapswere complications such as infection or dehiscence occurred.Keloid scars In some situations there is an extreme overgrowth of scartissue that grows beyondthe limits of the original wound and shows no tendency to resolve.MANAGEMENT OF WOUNDS138 1. Wound is inspected and classified as per the type of wounds. 2. If it is in the vital area then The airway should be maintained. The bleeding, if present, should be controlled. Intravenous fluids are started.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 79
    • Chapter-2 Review of Literature Oxygen, if required, may be given. Deeper communicating injuries and fractures etc. should be looked for. 3. If it is an incised wound then primary suturing is done after through cleaning. 4. If it is lacerated wound then the wound is excised and primary suturing is done. 5. If it is a crushed or devitalized wound there will be oedema and tension in the wound. So after wound debridement or wound debridement or wound excision by excising all devitalized tissue, the oedema is allowed to subside for 2-6 days. Then delayed primary suturing is done. 6. If it is a deep devitalized wound, after wound debridement it is allowed to granulate completely. Later, if the wound is large a split skin graft (Thiersch graft) is used t cover the defect. 7. In a wound with tension, fasciotomy is done so as to prevent the development of compartment syndrome. 8. Vascular or nerve injuries are dealt with accordingly. Vessels are sutured with 6-zero polypropylene no absorbable suture material. If the nerves are having clean cur wounds it can be sutured primarily with polyprolelene 6-zero or 7-zero suture material. If there is difficulty in identifying the nerve ends or if there is difficulty in identifying the nerve ends or if there are crushed cut ends of nerves then marker stitches are placed using silk at the site and later secondary repair of the nerve is done.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 80
    • Chapter-2 Review of Literature 9. Internal injuries (intracranial by cranioromy, intrathoracic by intercostals tube drainage, intraabdominal by laparotomy) has to be dealt with accordingly. Fractured bone is also identified and properly dealt with. 10. Antibiotics, fluid and electrolyte balance, blood trasfusion, tetanus toxoid, or antitetanus globulin (ARG) injection.Wound debridement (wound toilet, or wound excision) is liberal excision of alldevitalized tissue at regular intervals (of 48-72 hours) until healthy, bleeding vasculartidy wound is created.Primary suturing means suturing the wound immediately within 6 hours. It is done inclean insides wounds.Delayed primary suturing means suturing the wound in 48 hoours to 10 days. It isdone in lacerated wounds. This time is allowed for the oedema to subside.Secondary suturing means suturing the wound in 10-14 days or later. It is done ininfected wounds. After the control of infection, once healthy granulation tissueappears, secondary suturing is done.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri 81
    • Chapter-3 Drug Analysis DRUG ANALYSIS The drug Sandhyaraga is not mentioned in Ayurvedic classical texts and notincluded in Ayurvedic Pharmacopeia of India. The tuber of this drug is being used asa traditional medicine in many parts of the country.It has been claimed very effectivefor intestinal parasites, wounds, ulcers and such other clinical conditions.This drughas not been studied scientifically for curative properties for its pharmacologicalactions so far by anybody. Hence here an attempt is made to analyze the drug for itsPharmacognostical, Phytochemical and Pharmacological nature. The tuber has beenselected for the detailed analytical study.PHARMACOGNOSY OF SANDHYARAGA TUBERMacroscopic features: It is fleshy with cylindrical oblong appearance, tapering to the end, dark brownto deep black in colour.Microscopic features:Transverse section (T.S) of outer portion of older root of Sandhyaraga (Mirabilisjalapa Linn).The outer cork consists of about 15-20 layers of laterally elongated compactlyarranged radial rows of cells. This forms the outer cork which is dark brown or blackin color.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 82
    • Chapter-3 Drug Analysis Inner to this portion, there are 2 bands of thick walled sclerenchyma which arerectangular shaped. Few layers of larger thin walled polygonal cells separate thebands of Sclerenchyma. Most of the cells contain dark coloured crystals of calciumoxalate raphids. Inner to the second layer of transverse band of sclerenchyma, largethin walled radially arranged parenchymatous cells which are found filled withenormous amount of starch grains.T.S of the terminal portion of the root of Sandhyaraga (Mirabilis jalapa Linn). Anatomy of the root of Sandhyaraga shows an atypical character whencompared with that of a typical dicot root. During secondary growth, the primarythickening meristem differentiates in the pericycle outside the vascular tissue.Histology of the section shows very small central pith with compactly arranged thinwalled cells. Four patches of xylem bundles surround pith with metaxylem facingtowards center and protoxylem towards periphery. Outer to the layer of xylembundles, few layers of thin walled lighter colored cells are found which probablyinclude the cells of primary phloem between the arms of xylem and the conjunctivetissue. Outside this, a patch of secondary xylem vessels is found scattered here andthere. Secondary xylem vessels were interrupted by radially arranged rectangularcells which contain starch grains. The layer of secondary xylem is surrounded by alayer of polygonal thin walled cells, which may include the region of secondaryphloem and inner cortex. Some of the polygonal cells contain dark coloured contentsin them. The outer cortex contains a layer of sclerenchyma which is followed by aband of sclerenchymatous cells which is followed by the cork on the periphery. Thecork cells are arranged radially, rectangular shaped and arranged in 10 to 15 rows.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 83
    • Chapter-3 Drug Analysis Image3.1. Tuber of Sandhyaraga Image 3.2. T.S of Sandhyaraga tuberImage 3.3Outer cork cells of Image.3.4Xylem bundles ofSandhyaraga tuber Sandhyaraga tuberDept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 84
    • Chapter-3 Drug AnalysisPHYTOCHEMICAL ANALYSIS OF SANDHYARAGA TUBER139Extracts of drug in different solvents viz,Water,Alchohol,and Ether, were made andused for phytochemical analysis.DETERMINATION OF PETROLEUM ETHER EXTRACT.5 gm of the air dried drug was macerated, coarsely powdered, with 100 ml ofpetroleum ether of the specified strength in a closed flask for 24 hours, and shook itfrequently for 6 hours and allowed to stand for 18 hours. After that it was filteredrapidly, taking precautions against loss of solvent, evaporate 25 ml of the filtrate todryness in tared flat bottomed shallow disc, and dry at 1050, to constant weight andweigh. The percentage of the petroleum ether soluble extractive was calculated withreference to air dried drug.DETERMINATION OF ALCHOHOL SOLUBLE EXTRACT5 gm of the air dried drug was macerated, coarsely powdered, with 100 ml of alcoholof the specified strength in a closed flask for 24 hours, and shook it frequently for 6hours and allowed to stand for 18 hours. After that it was filtered rapidly, takingprecautions against loss of solvent, evaporate 25 ml of the filtrate to dryness in taredflat bottomed shallow disc, and dry at 1050, to constant weight and weigh. Thepercentage of the alcohol soluble extractive was calculated with reference to air drieddrug.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 85
    • Chapter-3 Drug AnalysisDETERMINATION OF WATER SOLUBLE EXTRACT5 gm of the air dried drug was macerated, coarsely powdered, with 100 ml of water ofthe specified strength in a closed flask for 24 hours, and shook it frequently for 6hours and allowed to stand for 18 hours. After that it was filtered rapidly,, takingprecautions against loss of solvent, evaporate 25 ml of the filtrate to dryness in taredflat bottomed shallow disc, and dry at 1050C, to constant weight and weigh. Calculatethe percentage of the water soluble extractive with reference to air dried drug.DETERMINATION OF TOTAL ASHIncinerate about 2 to 3 gm accurately weighed, of the ground drug in a tared platinumor silica disc at a temperature not exceeding 4500 until free from Carbon, cool andweigh. If a Carbon free ash cannot be obtained in this way, exhaust the charred masswith hot water, collect the residue on a ash less filter paper, incinerate the residue andfilter paper, add the filtrate, evaporate to dryness, and ignite at a temperature notexceeding 4500. Calculate the percentage of ash with the reference to the air drieddrug.DETERMINTION OF pH VALUE The pH value of a liquid is determined by means of a glass electrode and a pHmeter. Suitable glass electrode and pH meters of both the potentiometric anddeflection type are available.Method: - Operate the pH meter and the electrode system according to themanufacturer’s instructions. Standardize the meter and the electrodes with 0.05 Mpotassium hydrogen phthalate (pH 4.0) when measuring a acid solution or with 0.05M sodium borate when measuring in alkaline solution. At the end of a set ofDept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 86
    • Chapter-3 Drug Analysismeasurements, take a reading of the solution used to standardize the meter andelectrodes. This reading should not differ by more than 0.02 from the original value atwhich the apparatus was standardized.Preparation of solutions: - A10% w/v solution in water filtered through a dry filter andused.TEST FOR CARBOHYDRATESBenedict’s test: To 0.5 ml of aqueous extract of drug add 5 ml of Benedict’s solution and boilfor 5 minutes. Formation of a coloured precipitate is due to the presence ofCarbohydrate.TEST FOR PROTIENS:Biuret’s test: To 1 ml of hot aqueous extract of the drug, add 5- 8 drops of 10% w/v Sodiumhydroxide solution followed by 1 or 2 drops of 3% w/v Copper sulphate solution. Ared or Violet colour is obtained.TEST FOR SAPONINS: In a test tube containing about 5 ml of aqueous extract of the drug, add a dropof Sodium bicarbonate solution, shake the mixture vigorousely, and leave for 3minutes .Honeycomb like froath is formed and the froath remains for 3 minutes.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 87
    • Chapter-3 Drug AnalysisTEST FOR FLAVONOIDS: In a test tube containing 0.5 ml of alcoholic extract of the drug, add 5- 10drops of diluted Hydrochloric acid followed by a small piece of Magnesium. In thepresence ofFlavonoids presence of pink, reddish pink or Brown colour is produced.TEST FOR ALKALOIDS Dissolve a few milligram of alcoholic or aqueous extract of the drug in 5 ml of distilled water, added 2 M hydrochloric acid until an acid reaction occurs, then add 1 ml of Dragendorff’s reagent, an orange or orange red precipitate is produced immediately.Mayer’s test Add a few drops of Mayor’s reagent to 1 ml of acidic aqueous extract of the drug. White or pale yellow precipitate is formed.TEST FOR TANNINS:To 1- 2 ml of alcohol extract of the drug add a few drops of 5% FeCl3 solution .Agreen colour indicates the presence of gallotannins while a brown colour Tannins.TEST FOR STEROIDS Liebermann – Burchard’s test Add 2 ml of acetic anhydride solution to 1 ml of petroleum ether extract of the drug in chloroform followed by 1 ml of concentrated sulphuric acid. A greenish colour is developed which turns to blue.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 88
    • Chapter-3 Drug Analysis Table3.1 showing results of phytochemical analysisSl No Test Result 1. Petroleum Ether soluble extract 0.76% 2. Alchohol soluble extract 3.6% 3. Water soluble extract 1.8% 4. pH value 5.2 5. Ash value 6.2% 6. Test for Carbohydrates Positive 7. Test for Proteins Negative 8. Test for Saponins Positive 9. Test for Flavonoids Negative 10. Test for Alkaloids ( Mayer’s test) Mildly positive 11. Test for Alkaloids (Dragendorff’s test) Positive 12. Test for Tannins Negative 13. Test for Steroids (Liebermann – Burchard’s Negative test)PHARMACOLOGICAL STUDY OF SANDHYARAGA TUBER140 A drug performs its action by the virtue of its the pharmacological properties, viz, Rasa, Guna, Veerya Vipaka, and Prabhava. But generally it is considered that the prime factor of drug action is its potency. Acharya Charaka describes it as ‘Yena Kurvanti tat Veeryam’. The potency is obtained by a drug on the basis of the Bhautik combination and the resultant Rasa and Guna. So in order to study the drug action in detail the knowledge about Dravya’s Bhautik composition and the embedded Gunas are to be investigated. In Samhitas and Nighantus, the properties like Rasa, Guna, Veerya etc of many drugs have been described. In the case of non classical drugs Charakacharya in Suthrasthana 26thchapter 66th sloka has given specific directiveDept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 89
    • Chapter-3 Drug Analysisto examine their Gunas as mentioned that Raso Nipate Dravyanam, Vipakam Karmanishtaya I, Veeryam Yavad Adhivasat nipatachopalabhyathey.II On the basis of this direction the pharmacological properties of the Dravya can be made out Rasa- On contact with tongue Veerayam-by long contactand or by means of external contact with body Vipakam-By the Karma performed The drugs for the present study are Madhusnuhi and Sandhyaraga as stated in theprevious chapters. Of them Madhusnuhi is a known drug for its pharmacologicalproperties and pharmacological properties of Sandhyaraga is not mentioned. So tohave a clear idea about the pharmacological properties of Sandhyaraga, investigationsinto the pharmacological nature of the drug is highly necessitated .At this juncture themethod adopted and suggested by Dr.S.C. Dhyani is sought for the purpose. Rasa and Vipaka indicate the chemical structure of drugs, and Guna andVeerya indicate the physico-pharmacological properties of drugs. Different drugshave got different arrangements of the five Mahabhutas in terms of weight, numberand configuration in their composition. The specific arrangement of any two of theMahabhuta gives rise to a particular taste of a drug are inferred from it’s taste. Thespecific taste inherits the specific qualities from its predominant proto-elementalconstituents. Rasa have certain local and systemic actions on account of theirqualities. Hence study of the first pharmacological property, Rasa has been done.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 90
    • Chapter-3 Drug AnalysisNeed for Rasa determinationThere are several problems faced by the practitioners regarding the confusion in rasaof a drug. The first problem is that different texts have described different Rasas to adrug. The reasons for this difference of opinion may be: 1. Different plants being used under one name. 2. Different parts of drugs being used. 3. Different place and season of collection and storage. 4. Taste of drug in a green and dry form. 5. Not only by the method of ‘Taste with the tongue’ but also by inference on the basis of the actions the drug produces. The second problem is that some texts have two or more Rasas to a drug and havenot generally mentioned as to which of those Rasas is the principal taste and which isthe secondary taste (Pradhana Rasa and Anurasa)The third problem is the drugs of aparticular Rasa may have varying intensity of taste. For example Tara-tama Bhava ofa Rasa.The fourth problem is the assessment of the effect of storage on the taste ofdrugs. The crude drug powders are said to retain their potency for two months only.Definition of Rasa That, which is recognized or perceived first after the contact of the substancewith the tongue, is the Pradhana Rasa ( main taste), and that, which is subsequentlyperceived, is called Anu-rasa or Uparasa( Secondary taste). The Rasa is gustatoryappeal caused by the substance after coming in contact with the tongue. Therefore,Rasa has been defined as taste with tongue.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 91
    • Chapter-3 Drug Analysis The drug or dietic substances may give different Rasa in immature and maturestates. In other words, Rasas in a drug may vary when it is green and when dried up.Charaka, therefore, observed; that savour, which becomes patent on the first contactof dry substance with the tongue, is declared to be its Rasa. What is otherwiseapprehended is its latent or after-taste (Anurasa or Uparasa).Sandhyaraga is a non classical drug whose Rasadi properties are not yet known.Hence an attempt was made to estimate the taste and determine the taste threshold.Estimation of tasteTaste with tongue is the criterion for determining the Rasa or Anurasa of a drug. Thefollowing procedures for taste with tongue were adopted. The drug was collected , and dried up and made into fine powder fine powder by grinder. 25 healthy volunteers were selected from first year PG scholars so that nochance of mistakes in expressing the Rasa they perceive is there. They were asked to them to wash their mouth. Five minutes gap was maintained between washing of mouth and tasting drug. 5 gms of fine powder of drug was served to these volunteers. They were given pieces of paper and requested to record the Rasa and Anurasa they perceived. The volunteers were not told about the sample (Blind method).Papers were collected and the results were recorded.Result : All the volunteers expressed unanimous opinion about the taste of the drugthat it was Kashaya rasa .Hence it was accepted as the Pradhana Rasa of that drug.The volunteers could mention the Anurasa as Katu.Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 92
    • Chapter-3 Drug AnalysisDetemination of the Taste-threshold 5 gms of drug powder was taken and put it in 100ml. of water and stirred for30 minutes. Then it was filtered with the filter paper. 1 ml of that filtered solutionwas taken and diluted with distilled water gradually. Few drops of this solution wastasted between different dilutions. The point at which the taste is last perceived wastaken as the Taste threshold of that taste in that drug. Any further dilution of thesolution did not reveal any taste.ResultTaste threshold of Kashayarasa ;385mlThreshold of Katurasa: 472ml,(Katutama)Dept. of P.G, Studies in Dravyaguna Vijnana, AAMC, Moodbidri 93
    • Chapter-4 Experimental Study EXPERIMENTAL STUDYMATERIALS AND METHODSMATERIALS Materials utilized for the present study are: Albino rats Trial drugs (Tubers of Madhusnuhi & Sandhyaraga) Surgical instruments like scalpel with blade, forceps.Selection of Animals: 42 healthy Albino rats of both sex with an average body weight of 175gmwere selected for the experiment. They were grouped into seven, containing sixanimals in each group and were kept in separate cages after weighing and labelingwith potassium permanganate stain for their individual identity. All these cages werenumbered serially from 1 to 7. The animals were fed with standard laboratory diet anddrinking water.Selection of Trial Drugs - Tubers of Madhusnuhi and Sandhyaraga were used astrial drugs for the experiment. The first drug Madhusnuhi was collected from Alva’sAyurveda College Pharmacy, Mijar. The tubers of Sandhyaraga were collecteddirectly from the farm of the Trivandrum district. The above drugs were officiallyidentified in the department of Dravyaguna Vijnana, Alva’s Ayurveda College,Moodbidri.Preparation of Trial Drugs The collected drug samples were washed and cleaned with water, initiallydried in shadow and thereafter dried in an electric drier.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 94
    • Chapter-4 Experimental StudyPreparation of Powder 1kg of properly dried tubers of each drug was initially crushed in adisintegrator and then powdered using a pulverizer at a mesh size of 80 to get a finepowder. Drugs were then stored in air tight, separate containers. These samples wereused for the entire experiment. Mode of Administration of the Drug: 1. Internal - Dose was calculated using the formula Rat dose= Human dose x 0.018 x 5/kg body wt.141 Madhusnuhi - The drug was administered at a dose of 108mg/200g body wt in solution form. Sandhyaraga - The drug was administered at a dose of 36mg/200g body wt in solution form. 2. External - Trial drug powders were used for dusting, in a quantity sufficient to cover the wound area. 3. Combined- Internal & External together done in this groupMETHODSPreparation of Wounds:- Excision Wound Healing method The wound model chosen for present study was excision wound techniquesuggested by Morton and Malone142. (A slight modification was made in themethodology by reducing the wound size from 500mm2 to 200mm2 as per thesuggestion of the ethical committee.) Full aseptic measures were carried out andanimals did not receive either local are systematic chemotherapeutics. The groups ofanimals were housed separately. Selected animals were starved twelve hours prior to wounding. Animals wereanaesthetized using Ketamin anesthesia in semi-aseptic conditions. A circular patch offull thickness of skin measuring 200 mm2 was cut away from a pre-determined areaon the depilated dorsal thoracic region of all the rats in each group. After making thewounds, the wound margins were traced on thin, transparent sheet which is againretraced on millimeters scale graph paper on the day of wounding (0 day) and this wasDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 95
    • Chapter-4 Experimental Studyfollowed periodically until complete wound healing. The observation of percentagewound closure was made on 4th, 8th, 12th, 16th and 18th post wounding day and alsothe wound was observed for complete Epithelialization. Wound healing can be assessed by monitoring Physical attributesPhysical Attribute: Physical attributes like contraction, Epithelialization and scarremolding was monitored by measuring the total wound area. Table 4.1 showing Physical attributesWound Model Attribute Parameter studied Method used a) Percentage of contraction Excision Physical Planimetry b) Period of EpithelializationExperimental parameters:- The study of excision wound heals by contraction andEpithelialization. The parameters include wound contraction and period ofEpithelialization.Percentage of wound contraction – Contraction which mainly contributes woundclosure was studied by tracing the raw wound area on tracing sheet every day, untilwounds were completely covered by epithelium. These wound tracings were retracedon a millimeter scale graph paper to determine wounded area. The wound closurewas expressed as a percentage original wound size (200 mm2) for a group. And groupmean on a particular day was taken for final analysis of the result.Period of Epithelialization it was measured in terms of days required for falling ofscar. Falling of scar, leaving no raw area, was taken as an end point of completeEpithelialization and the time was noted in all of the animals.Administration of Drugs As the procedure of the experiment, the trial drugs were administered to sixgroups (Group2 to Group7) keeping the first group labeled as control group. The trialdrugs were administered as follows:Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 96
    • Chapter-4 Experimental StudyGroup 1 (Control). No administration of the drug was done in this group for theassessment of natural healing process. With the values of this group, values offollowing six groups were compared.Group 2 - The external application of trial drug Madhusnuhi was done on Groups 2.The application of the churna was done daily once in the morning, after cleaning thewounded area with distilled water using sterile gauze piece. Wounded area wastraced using tracing sheet.Group 3 - To this group, trail drug Madhusnuhi was given in the form of solution andadministered internally and wounded area was traced.Group 4 - Area of wound was estimated and the combined internal and externalapplication of trial drug Madhusnuhi was applied on Groups 4. Wounded area wasstraced using transparent sheet.Group 5 - To this group the external application of trial drug Sandhyaraga churnawas done and wounded area was traced using tracing sheet.Group 6 - To this group, trail drug Sandhyaraga Churna was given in the form ofsolution and administered internally and wounded area was traced.Group 7 - Combined internal and external application of trial drug Sandhyaragachurna was applied on Groups 7. Wounded area was traced using transparent sheet. To assess the efficacy of wound healing properties of trial drugs, Sandhyaragaand Madhusnuhi used in the form of powder externally and internaly in woundmodels. For statistical analysis, the groups are made into seven i.e. Groups 1 to 7.Each group contains six animals each. Image 4.1 Madhusnuhi Churna Image 4.2 Sandhyaraga ChurnaDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 97
    • Chapter-4 Experimental Study Table 4.2. showing Group, Drug and Mode of Administration.Group Drug used DoseGroup – 1 No medicine -(control) Trial drug AGroup – 2 (Trial Madhusnuhi churna Sufficient quantity to cover the excised areadrug A) externallyGroup – 3 (Trial Trial drug Adrug A) Madhusnuhi churna 108mg/200gm bodyweight internally internallyGroup – 4 (Trial Trial drug A 108mg//200gm bodyweight internally anddrug A) Madhusnuhi churna sufficient quantity to cover the excised area externally & internally Trial drug BGroup - 5 (Trial Sandhyaraga churna Sufficient quantity to cover the excised areadrug B) externally Trial drugGroup – 6 (Trial Sandhyaraga churna 36mg//200gm bodyweight internallydrug B) internally Trial drugGroup - 7 (Trial Sandhyaraga churna 36mg//200gm bodyweight internally& sufficientdrug B) externally & quantity to cover the excised area internally.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 98
    • Chapter-5 Observation & Results OBSERVATION AND RESULTS The method selected for conducting the experimental study is Morton andMalone excisional wounding technique with modification in the wound size. Theobservation were made and are subjected for statistical analysis. The results thusobtained can be better understood if interpreted in different steps. Hence, theinterpretation is done as follows: 1. Control with Trial Drug-A groups 2. Control with Trial Drug-B groups 3. Control with Internal medication groups of both Trial drugs 4. Control with External medication groups of both Trial drugs 5. Control with combined Internal & External medication groups of both Trial drugs 6. Control with all groups of trial drugs.PERCENTAGE OF CONTRACTION Control with Trial Drug-A groupsTable 5.1 showing Percentage of closure in original excision wound area (sq.mm) on 4th post wounding day of Control and Trial drug A (Madhusnuhi) C IM EM IEM R1 21.98 24.5 62.43 35.86 R2 19.79 25.13 61.22 36.02 R3 22.34 22.4 66.32 37.5 R4 20.63 22.75 67.19 34.24 R5 22.16 23.2 64.43 34.57 R6 21.05 22.05 61.29 36.73 MEAN 21.33 23.33 63.81 35.82 SD 1.01 1.22 2.57 1.25 SE 0.41 0.49 1.05 0.51 t-value 17.38 49.28 62.62 43.12 RESULT P<0.001 P<0.001 P<0.001 P<0.001 The mean contraction seen on the 4th post wounding day: Control group - 21.33±1.01% Madhusnuhi Internal -23.33±1.22% Madhusnuhi External -63.81±2.57% Madhusnuhi Internal External -35.82 ±1.25%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 99
    • Chapter-5 Observation & Results Table-5.2 showing interpretation of statistical analysis on the comparative percentage of closure in excision wound area of Control and Trial drug A (Madhusnuhi) groups on 4th post wounding day GROUPS COMPARED T- P- RESULT INTERPRETATION VALUE VALUEControl group& 3.11 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal group is better than control groupControl group&Madhusnuhi 37.71 P<0.001 Madhusnuhi External Highly significantExternal group group is better than control groupControl group& 22.17 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Madhusnuhi Internal and 34.85 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group group is better than Madhusnuhi Internal groupMadhusnuhi Internal and 17.53 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than Madhusnuhi Internal groupMadhusnuhi External group 24.05 P<0.001 Madhusnuhi External Highly significantand Madhusnuhi Internal group is better thanExternal group Madhusnuhi Internal External groupTable 5.3 showing percentage of closure in original excision wound area (sq.mm) on 8th post wounding day of Control and Trial drug A (Madhusnuhi) C IM EM IEM R1 39.75 69.39 92.27 67.17 R2 36.67 64.71 94.9 68.28 R3 41.49 65.63 91.05 66.15 R4 38.1 67.72 92.19 66.85 R5 36.76 67.53 93.81 67.55 R6 44.21 63.59 93.55 68.37 MEAN 39.49 66.43 92.96 67.39 SD 2.96 2.16 1.38 0.86 SE 1.21 0.88 0.56 0.35 t-value 10.09 17.917 63.81 75.24 RESULT P<0.001 P<0.001 P<0.001 P<0.001 The mean contraction seen on the 8th post wounding day Control group - 39.49 ±2.96% Madhusnuhi Internal - 66.43±2.16% Madhusnuhi External - 92.96±1.38% Madhusnuhi Internal External - 67.39±0.86%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 100
    • Chapter-5 Observation & ResultsTable-5.4 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Trial drug A(Madhusnuhi)groupson 8th post wounding day GROUPS COMPARED T- P- RESULT INTERPRETATION VALUE VALUEControl group& 18.01 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal group is better than control groupControl 40.1 P<0.001 Madhusnuhi External Highly significantgroup&Madhusnuhi group is better thanExternal group control groupControl group& 22.2 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Madhusnuhi Internal and 25.35 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group is better thangroup Madhusnuhi InternalMadhusnuhi Internal and 1.02 P>0.05 Madhusnuhi Internal No significanceMadhusnuhi Internal and MadhusnuhiExternal group Internal External group provided the same result.Madhusnuhi External 38.56 P<0.001 Madhusnuhi External Highly significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External groupTable 5.5showing percentage of closure in original excision wound area (sq.mm)on 12th post wounding day of Control and Trial drug A (Madhusnuhi) C IM EM IEM R1 90.1 96.43 98.34 95.96 R2 91.15 95.72 98.98 93.01 R3 89.89 93.75 98.95 95.31 R4 86.24 93.65 98.96 92.39 R5 87.56 95.36 98.97 95.74 R6 87.89 96.41 97.85 94.90 MEAN 88.81 95.22 98.67 94.55 SD 1.86 1.25 0.48 1.49 SE 0.76 0.51 0.19 0.61 t-value 84.28 89.30 74.57 72.28 RESULT P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the12th post wounding day:Control group -88.81 ±1.86Madhusnuhi Internal - 95.22±1.25Madhusnuhi External - 98.67±0.48Madhusnuhi Internal External - 94.55±1.49Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 101
    • Chapter-5 Observation & Results Table-5.6 showing interpretation of statistical analysis on the comparative percentage of closure in excision wound area of Control and Trial drug A (Madhusnuhi)groups on 12th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 7.02 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal group is better than control groupControl 12.59 P<0.001 Madhusnuhi External Highly significantgroup&Madhusnuhi group is better thanExternal group control groupControl group& 5.90 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Madhusnuhi Internal and 6.34 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group is better thangroup Madhusnuhi Internal group.Madhusnuhi Internal and 0.83 P>0.05 Madhusnuhi Internal and No significanceMadhusnuhi Internal Madhusnuhi InternalExternal group External group provided the same result.Madhusnuhi External 6.45 P<0.001 Madhusnuhi External Highly significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External groupTable 5.7 showing percentage of closure in original excision wound area (sq.mm)on 16th post wounding day of Control and Trial drug A (Madhusnuhi) C IM EM IEM R1 96.7 99.49 100 100 R2 96.35 98.93 99.49 98.92 R3 95.74 95.31 100 97.40 R4 92.06 98.94 100 98.37 R5 95.14 99.48 100 100 R6 93.68 98.47 100 96.43 MEAN 94.95 98.44 99.92 98.52 SD 1.77 1.58 0.21 1.43 SE 0.72 0.65 0.09 0.58 t-value 111.33 93.37 87.38 79.65 RESULT P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the16th post wounding day:Control group - 94.95 ±1.77%Madhusnuhi Internal - 98.44±1.58%Madhusnuhi External - 99.92±0.21%Madhusnuhi Internal External - 98.52±1.43%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 102
    • Chapter-5 Observation & ResultsTable-5.8showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Trial drug A(Madhusnuhi)groups on 16th post wounding day. GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 3.60 P<0.01 Madhusnuhi Internal SignificantMadhusnuhi Internal group is better than control group.Control group & 6.83 P<0.001 Madhusnuhi External Highly SignificantMadhusnuhi External group is better than controlgroup group.Control group& 3.84 P<0.01 Madhusnuhi Internal SignificantMadhusnuhi Internal External group is betterExternal group than control group.Madhusnuhi Internal and 2.29 P<0.05 Madhusnuhi External Moderatly significantMadhusnuhi External group is better thangroup Madhusnuhi Internal IM<EMMadhusnuhi Internal and 0.09 P>0.05 Madhusnuhi Internal and No significanceMadhusnuhi Internal Madhusnuhi InternalExternal group External group provided the same result.Madhusnuhi External 2.39 P<0.05 Madhusnuhi External Moderatly significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External group.Control with Trial Drug-B groupsTable 5.9 showing percentage of closure in original excision wound area (sq.mm)on 4th post wounding day of Control and Trial drug B ( Sandhyaraga) C IS ES IES R1 21.98 57.61 59.57 45.92 R2 19.79 61.14 60.7 44.68 R3 22.34 59.14 55.21 43.55 R4 20.63 59.04 60.10 46.91 R5 22.16 60.40 56.08 46.32 R6 21.05 58.82 56.68 46.56 MEAN 21.33 59.36 58.06 45.66 SD 1.01 1.25 2.34 1.29 SE 0.41 0.51 0.96 0.53 t-value 17.38 10.49 42.76 56.16 RESULT P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the 4th post wounding day:Control group - 21.33±1.01%Sandhyaraga internal - 59.36±1.25%Sandhyaraga External -58.06±2.34%Sandhyaraga Internal External -45.66±1.29%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 103
    • Chapter-5 Observation & ResultsTable-5.10 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 4th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group & 58.17 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better thangroup control group.Control group and 35.33 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group Madhusnuhigroup External group control group.Control group and 36.47 P<0.001 Sandhyaraga Internal Highly significantSandhyaraga Internal External group is betterExternal group than control group.Sandhyaraga Internal 1.20 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga ExternalExternal group group provided the same result.Sandhyaraga Internal 18.74 P<0.001 Sandhyaraga Internal is Highly significantand Sandhyaraga better than SandhyaragaInternal External group Internal External groupSandhyaraga External 11.38 P<0.001 Sandhyaraga External Highly significantgroup and Sandhyaraga group is better thanInternal External group Sandhyaraga Internal External groupTable 5.11 showing percentage of closure in original excision wound area(sq.mm) on 8th post wounding day of Control and Trial drug B ( Sandhyaraga) C IS ES IES R1 39.75 75.54 84.04 79.08 R2 36.67 75.13 85.71 78.19 R3 41.49 77.42 84.90 77.42 R4 38.10 75 86.87 76.29 R5 36.76 76.80 86.24 75.26 R6 44.21 77.01 83.42 75.13 MEAN 39.49 76.15 85.20 76.90 SD 2.96 1.05 1.32 1.61 SE 1.21 0.43 0.54 0.66 t-value 10.09 102.15 66.80 75.35 RESULT P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the 8th post wounding day:Control group - 39.49 ±2.96%Sandhyaraga internal - 76.15±1.05%Sandhyaraga External - 85.20±1.32%Sandhyaraga Internal External - 76.90±1.61%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 104
    • Chapter-5 Observation & ResultsTable-5.12showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Trial drug B(Sandhyaraga) groups on 8th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group & 28.6 P<0.001 Sandhyaraga internal group Highly significantSandhyaraga internal is better than control group.groupControl group and 34.6 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group Madhusnuhi Externalgroup group control group.Control group and 27.22 P<0.001 Sandhyaraga Internal Highly significantSandhyaraga Internal External group is better thanExternal group control group.Sandhyaraga Internal 13.1 P<0.001 Sandhyaraga External Highly significantand Sandhyaraga group is better thanExternal group- Sandhyaraga Internal groupSandhyaraga Internal 0.95 P>0.05 Sandhyaraga Internal group No significanceand Sandhyaraga and Sandhyaraga InternalInternal External External group provided thegroup same result.Sandhyaraga External 9.8 P<0.001 Sandhyaraga External Highly significantgroup and group is better thanSandhyaraga Internal Sandhyaraga InternalExternal group External groupTable 5.13 showing percentage of closure in original excision wound area(sq.mm) on 12th post wounding day of Control and Trial drug B (Sandhyaraga) C IS ES IES R1 90.1 94.57 96.28 87.24 R2 91.15 96.89 98.47 87.23 R3 89.89 96.77 96.88 91.40 R4 86.24 95.21 98.48 93.81 R5 87.56 95.88 96.83 87.89 R6 87.89 94.65 96.26 94.71 MEAN 88.81 95.66 97.20 90.38 SD 1.86 1.02 1.025 3.39 SE 0.76 0.42 0.42 1.38 t-value 84.28 86.87 57.67 57.13 RESULT P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the 12th post wounding day.Control group -88.81 ±1.86Sandhyaraga internal - 95.66±1.02Sandhyaraga External - 97.20±1.025Sandhyaraga Internal External -90.38 ±3.39Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 105
    • Chapter-5 Observation & ResultsTable-5.14 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 12th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group & 7.91 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better thangroup control group.Control group and 9.68 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group is better thangroup control group.Control group and 0.99 P>0.05 Control group and No significanceSandhyaraga Internal Sandhyaraga InternalExternal group External group provided the same result.Sandhyaraga Internal 2.60 P<0.05 Sandhyaraga External Moderately significantand Sandhyaraga group is better thanExternal group- Sandhyaraga Internal group.Sandhyaraga Internal 3.65 P<0.01 Sandhyaraga Internal Significantand Sandhyaraga group is better thanInternal External group Sandhyaraga Internal External groupSandhyaraga External 4.71 P<0.001 Sandhyaraga External Highly significantgroup and Sandhyaraga group is better thanInternal External group Sandhyaraga Internal External group.Table 5.15 showing percentage of closure in original excision wound area(sq.mm) on16th post wounding day of Control and Trial drug B ( Sandhyaraga) C IS ES IES R1 96.7 97.83 98.94 100 R2 96.35 98.96 98.98 97.87 R3 95.74 98.92 98.44 97.31 R4 92.06 96.28 99.50 100 R5 95.14 98.97 97.88 98.42 R6 93.68 98.93 99.46 100 MEAN 94.95 98.31 98.86 98.93 SD 1.79 1.09 0.62 1.22 SE 0.72 0.45 0.25 0.49 t-value 111.33 90.69 94.16 80.26 RESULT P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the 16th post wounding dayControl group - 94.95 ±1.77%Sandhyaraga internal - 98.31±1.09%Sandhyaraga External - 98.86±0.62%Sandhyaraga Internal External -98.93 ±1.22%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 106
    • Chapter-5 Observation & ResultsTable-5.16 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Trial drug B (Sandhyaraga) groups on 16th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group & 3.96 P<0.01 Sandhyaraga internal SignificantSandhyaraga internal group is better than controlgroup group.Control group and 5.12 P<0.001 Sandhyaraga External Highly SignificantSandhyaraga External group is better than controlgroup group.Control group and 4.54 P<0.01 Sandhyaraga Internal SignificantSandhyaraga Internal External group is betterExternal group than control groupSandhyaraga Internal 1.07 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga ExternalExternal group- group provided the same result.Sandhyaraga Internal 0.93 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga InternalInternal External group External group provided the same result.Sandhyaraga External 0.12 P>0.05 Sandhyaraga External and No significancegroup and Sandhyaraga Sandhyaraga InternalInternal External group External group provided the same result.Control with Internal medication groups of both Trial drugsTable 5.17 showing percentage of closure in original excision wound area(sq.mm) on 4th post wounding day of Control and Internal administration groupsof both Trial drugs C IM IS R1 21.98 24.5 57.61 R2 19.79 25.13 61.14 R3 22.34 22.4 59.14 R4 20.63 22.8 59.04 R5 22.16 23.19 60.40 R6 21.05 22.05 58.82 MEAN 21.33 23.33 59.36 SD 1.01 1.22 1.25 SE 0.41 0.49 0.51 t-value 17.38 49.28 10.49 RESULT P<0.001 P<0.001 P<0.001 The mean contraction seen on the 4th post wounding day: Control group - 21.33±1.01% Madhusnuhi Internal -23.33±1.22% Sandhyaraga internal - 59.36±1.25%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 107
    • Chapter-5 Observation & ResultsTable-5.18 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Internaladministration groups of both Trial drugs on 4th post wounding day GROUPS COMPARED T- P- RESULT INTERPRETATION VALUE VALUEControl group& 18.01 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal group is better than control groupControl group & 28.6 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better thangroup control group.Madhusnuhi Internal, and 9.92 P<0.05 IM<IS Moderately significantSandhyaraga internalTable 5.19 showing percentage of closure in original excision wound area(sq.mm) on8th post wounding day of Control and Internal administration groupsof both Trial drugs C IM IS R1 39.75 69.39 75.54 R2 36.67 64.71 75.13 R3 41.49 65.63 77.42 R4 38.10 67.72 75 R5 36.76 67.53 76.81 R6 44.21 63.59 77.01 MEAN 39.49 66.43 76.15 SD 2.96 2.16 1.05 SE 1.21 0.88 0.43 t-value 10.09 17.92 102.15 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 8th post wounding day:Control group - 39.49 ±2.96%Madhusnuhi Internal - 66.43±2.16%Sandhyaraga internal - 76.15±1.05%Table-5.20 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Internaladministration groups of both Trial drugs on 8th post wounding day. GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 18.01 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal group is better than control groupControl group & 28.6 P<0.001 Sandhyaraga internal Highly significantSandhyaraga group is better thaninternal group control group.Madhusnuhi 9.92 P<0.05 IM<IS Moderately significantInternal, andSandhyaragainternalDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 108
    • Chapter-5 Observation & ResultsTable 5.21 showing percentage of closure in original excision wound area(sq.mm) on 12th post wounding day of Control and Internal administrationgroups of both Trial drugs: C IM IS R1 90.1 96.43 94.57 R2 91.15 95.72 96.89 R3 89.89 93.75 96.77 R4 86.24 93.65 95.21 R5 87.56 95.36 95.88 R6 87.89 96.41 94.65 MEAN 88.81 95.22 95.66 SD 1.86 1.25 1.02 SE 0.76 0.51 0.42 t-value 84.28 89.30 86.87 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 12th post wounding day:Control group -88.81 ±1.86Madhusnuhi Internal - 95.22±1.25Sandhyaraga internal - 95.66±1.02Table-5.22 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Internaladministration groups of both Trial drugs on 12th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 7.02 P<0.001 Madhusnuhi Internal group Highly significantMadhusnuhi Internal is better than control groupControl group & 7.91 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better than controlgroup group.Madhusnuhi Internal, 0.67 P>0.05 Sandhyaraga internal No significanceand Sandhyaraga group and Madhusnuhiinternal Internal group provided the same result.Table 5.23 showing percentage of closure in original excision wound area(sq.mm) on 16th post wounding day of Control and Internal administrationgroups of both Trial drugs C IM IS R1 96.7 99.49 97.83 R2 96.35 98.93 98.96 R3 95.74 95.31 98.92 R4 92.06 98.94 96.28 R5 95.14 99.48 98.97 R6 93.68 98.47 98.93 MEAN 94.95 98.44 98.31 SD 1.77 1.58 1.10 SE 0.72 0.65 0.45 t-value 111.33 93.37 90.69 RESULT P<0.001 P<0.001 P<0.001Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 109
    • Chapter-5 Observation & ResultsThe mean contraction seen on the16th post wounding day:Control group - 94.95 ±1.77%Madhusnuhi Internal - 98.44±1.58%Sandhyaraga internal - 98.31±1.10%Table-5.24 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Internaladministration groups of both Trial drugs on 16th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 3.60 P<0.01 Madhusnuhi Internal SignificantMadhusnuhi Internal group is better than control group.Control group & 3.96 P<0.01 Sandhyaraga internal SignificantSandhyaraga internal group is better thangroup control group.Madhusnuhi Internal, 0.16 P>0.05 Madhusnuhi Internal, and No significanceand Sandhyaraga Sandhyaraga internalinternal group provided the same result.Control with External medication groups of both Trial drugsTable 5.25 showing percentage of closure in original excision wound area(sq.mm) on 4th post wounding day of Control and External administrationgroups of both Trial drugs: C EM ES R1 21.98 62.43 59.57 R2 19.79 61.22 60.7 R3 22.34 66.32 55.21 R4 20.63 67.19 60.10 R5 22.16 64.43 56.08 R6 21.05 61.29 56.68 MEAN 21.33 63.81 58.06 SD 1.01 2.57 2.34 SE 0.41 1.05 0.96 t-value 17.38 62.62 42.76 RESULT P<0.001 P<0.001 P<0.001Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 110
    • Chapter-5 Observation & Results The mean contraction seen on the 4th post wounding day: Control group - 21.33±1.01% Madhusnuhi External -63.81±2.57% Sandhyaraga External -58.06±2.34%Table-5.26showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Externaladministration groups of both Trial drugs 4th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 37.71 P<0.001 Madhusnuhi External group Highly significantMadhusnuhi External is better than control groupgroupControl group and 35.33 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group Madhusnuhi Externalgroup group control group.Madhusnuhi External 4.06 P<0.01 Madhusnuhi External is Significantand Sandhyaraga better than SandhyaragaExternal External groupTable 5.27 showing percentage of closure in original excision wound area(sq.mm) on 8th post wounding day of Control and External administrationgroups of both Trial drugs C EM ES R1 39.75 92.27 84.04 R2 36.67 94.90 85.71 R3 41.49 91.05 84.90 R4 38.10 92.19 86.87 R5 36.76 93.81 86.24 R6 44.21 93.55 83.42 MEAN 39.49 92.96 85.20 SD 2.96 1.38 1.32 SE 1.21 0.56 0.54 t-value 10.09 63.81 66.80 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 8th post wounding day:Control group - 39.49 ±2.96%Madhusnuhi External - 92.96±1.38%Sandhyaraga External - 85.20±1.32%Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 111
    • Chapter-5 Observation & ResultsTable-5.28 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Externaladministration groups of both Trial drugs 8th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 40.1 P<0.001 Madhusnuhi External group Highly significantMadhusnuhi External is better than control groupgroupControl group and 34.6 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group Madhusnuhi Externalgroup group control group.Madhusnuhi External 9.95 P<0.001 EM>ES Highly significantand SandhyaragaExternalTable 5.29 showing percentage of closure in original excision wound area(sq.mm) on 12th post wounding day of Control and External administrationgroups of both Trial drugs C EM ES R1 90.1 98.34 96.28 R2 91.15 98.98 98.47 R3 89.89 98.95 96.88 R4 86.24 98.96 98.48 R5 87.56 98.97 96.83 R6 87.89 97.85 96.26 MEAN 88.81 98.67 97.20 SD 1.86 0.48 1.03 SE 0.76 0.19 0.42 t-value 84.28 74.57 57.67 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 12th post wounding day:Control group -88.81 ±1.86Madhusnuhi External - 98.67±0.48Sandhyaraga External - 97.20±1.03Table-5.30 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Externaladministration groups of both Trial drugs 12th post wounding day: GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 12.59 P<0.001 Madhusnuhi External group Highly significantMadhusnuhi External is better than control groupgroupControl group and 9.68 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group is better than controlgroup group.Madhusnuhi External 3.20 P<0.01 Madhusnuhi External group Significantand Sandhyaraga is better than SandhyaragaExternal External groupDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 112
    • Chapter-5 Observation & ResultsTable 5.31 showing percentage of closure in original excision wound area(sq.mm) on 16th post wounding day of Control and External administrationgroups of both Trial drugs: C EM ES R1 96.7 100 98.94 R2 96.35 99.49 98.98 R3 95.74 100 98.44 R4 92.06 100 99.49 R5 95.14 100 97.88 R6 93.68 100 99.46 MEAN 94.95 99.92 98.86 SD 1.77 0.21 0.62 SE 0.72 0.09 0.25 t-value 111.33 93.37 87.38 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the16th post wounding day:Control group - 94.95 ±1.77%Madhusnuhi External - 99.92±0.21%Sandhyaraga External - 98.86±0.62%Table-5.32 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Externaladministration groups of both Trial drugs 16th post wounding day: GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 6.83 P<0.001 Madhusnuhi External Highly SignificantMadhusnuhi External group is better than controlgroup group.Control group and 5.12 P<0.001 Sandhyaraga External Highly SignificantSandhyaraga External group is better than controlgroup group.Madhusnuhi External 3.94 P<0.01 Madhusnuhi External Significantand Sandhyaraga group is better thanExternal Sandhyaraga ExternalDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 113
    • Chapter-5 Observation & ResultsControl with combined Internal & External medication groups ofboth Trial drugsTable 5.33 showing percentage of closure in original excision wound area(sq.mm) on 4th post wounding day of Control and Combined Internal andExternal administration groups of both Trial drugs C IEM IES R1 21.98 35.86 45.92 R2 19.79 36.02 44.68 R3 22.34 37.5 43.55 R4 20.63 34.24 46.91 R5 22.16 34.57 46.32 R6 21.05 36.73 46.56 MEAN 21.33 35.82 45.66 SD 1.01 1.25 1.29 SE 0.41 0.51 0.53 t-value 17.38 43.12 56.16 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 4th post wounding day:Control group - 21.33±1.01%Madhusnuhi Internal External -35.82 ±1.25%Sandhyaraga Internal External -45.66±1.29%Table-5.34 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Combined Internaland External administration groups of both Trial drugs 4th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 22.17 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Control group and 36.47 P<0.001 Sandhyaraga Internal Highly significantSandhyaraga Internal External group is betterExternal group than control group.Madhusnuhi Internal 13.45 P<0.001 Madhusnuhi Internal Highly significantExternal and External is better thanSandhyaraga Internal Sandhyaraga InternalExternal External groupDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 114
    • Chapter-5 Observation & ResultsTable 5.35 showing percentage of closure in original excision wound area(sq.mm) on 8th post wounding day of Control and Combined Internal andExternal administration groups of both Trial drugs C IEM IES R1 39.75 67.17 79.08 R2 36.67 68.28 78.19 R3 41.49 66.15 77.42 R4 38.10 66.85 76.29 R5 36.76 67.55 75.26 R6 44.21 68.37 75.13 MEAN 39.49 67.39 76.90 SD 2.96 0.86 1.61 SE 1.21 0.35 0.66 t-value 10.09 75.24 75.35 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 8h post wounding day:Control group - 39.49 ±2.96%Madhusnuhi Internal External - 67.39±0.86%Sandhyaraga Internal External - 76.90±1.61%Table-5.36 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Combined Internaland External administration groups of both Trial drugs 8th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 22.2 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Control group and 27.22 P<0.001 Sandhyaraga Internal Highly significantSandhyaraga Internal External group is betterExternal group than control group.Madhusnuhi Internal 12.79 P<0.001 IEM<IES Highly significantExternal andSandhyaraga InternalExternalDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 115
    • Chapter-5 Observation & ResultsTable 5.37 showing percentage of closure in original excision wound area(sq.mm) on 12th post wounding day of Control and Combined Internal andExternal administration groups of both Trial drugs C IEM IES R1 90.1 95.96 87.24 R2 91.1 5 93.01 87.23 R3 89.90 95.31 91.40 R4 86.24 92.39 93.81 R5 87.56 95.74 87.89 R6 87.89 94.90 94.71 MEAN 88.81 94.55 90.38 SD 1.86 1.49 3.39 SE 0.76 0.61 1.38 t-value 84.28 72.28 57.13 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the 12th post wounding day:Control group -88.81 ±1.86Madhusnuhi Internal External - 94.55±1.49Sandhyaraga Internal External -90.38 ±3.39Table-5.38 showing interpretation of statistical analysis on the percentage ofclosure in excision wound area of Control and Combined Internal and Externaladministration groups of both Trial drugs 12th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 5.90 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Control group and 0.99 P>0.05 Control group and No significanceSandhyaraga Internal Sandhyaraga InternalExternal group External group provided the same result.Madhusnuhi Internal 2.75 P<0.05 Madhusnuhi Internal Moderately significantExternal and External group is betterSandhyaraga Internal than Sandhyaraga InternalExternal External group.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 116
    • Chapter-5 Observation & ResultsTable 5.39 showing percentage of closure in original excision wound area(sq.mm) on16th post wounding day of Control and Combined Internal andExternal administration groups of both Trial drugs C IEM IES R1 96.7 100 100 R2 96.35 98.92 97.87 R3 95.74 97.40 97.31 R4 92.06 98.37 100 R5 95.14 100 98.42 R6 93.68 96.43 100 MEAN 94.95 98.52 98.93 SD 1.77 1.43 1.22 SE 0.72 0.58 0.50 t-value 111.33 79.65 80.26 RESULT P<0.001 P<0.001 P<0.001The mean contraction seen on the16th post wounding day:Control group - 94.95 ±1.77%Madhusnuhi Internal External - 98.52±1.43%Sandhyaraga Internal External -98.93 ±1.22%Table-5.40 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and Combined Internaland External administration groups of both Trial drugs 16th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 3.84 P<0.01 Madhusnuhi Internal SignificantMadhusnuhi Internal External group is betterExternal group than control group.Control group and 4.54 P<0.01 Sandhyaraga Internal SignificantSandhyaraga Internal External group is betterExternal group than control groupMadhusnuhi Internal 0.54 P>0.05 Madhusnuhi Internal No significanceExternal and External and SandhyaragaSandhyaraga Internal Internal External providedExternal the same result.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 117
    • Chapter-5 Observation & ResultsControl with all groups of trial drugs.Table 5.41 showing percentage of closure in original excision wound area(sq.mm) on 4th post wounding day of Control and all groups of Trial drugs C IM EM IEM IS ES IES R1 21.98 24.49 62.43 35.86 57.61 59.57 45.92 R2 19.79 25.13 61.22 36.02 61.14 60.7 44.68 R3 22.34 22.40 66.32 37.5 59.14 55.21 43.55 R4 20.63 22.75 67.19 34.24 59.04 60.10 46.91 R5 22.16 23.20 64.43 34.57 60.40 56.08 46.31 R6 21.05 22.05 61.29 36.73 58.82 56.68 46.56 MEAN 21.33 23.33 63.81 35.82 59.36 58.06 45.66 SD 1.01 1.22 2.57 1.25 1.25 2.34 1.29 SE 0.41 0.50 1.05 0.51 0.51 0.96 0.53 t-value 17.38 49.28 62.62 43.12 10.49 42.76 56.16 RESULT P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the 4th post wounding day:Control group - 21.33±1.01%Madhusnuhi Internal -23.33±1.22%Madhusnuhi External -63.81±2.57%Madhusnuhi Internal External -35.82 ±1.25%Sandhyaraga internal - 59.36±1.25%Sandhyaraga External -58.06±2.34%Sandhyaraga Internal External -45.66±1.29%Table-5.42 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and all groups of Trialdrugs on 4th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 3.11 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal group is better than control groupControl group& 37.71 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group is better thangroup control groupControl group& 22.17 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Control group & 58.17 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better thangroup control group.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 118
    • Chapter-5 Observation & ResultsControl group and 35.33 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group Madhusnuhigroup External group control group.Control group and 36.47 P<0.001 Sandhyaraga Internal Highly significantSandhyaraga Internal External group is betterExternal group than control group.Madhusnuhi Internal and 34.85 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group is better thangroup Madhusnuhi Internal group.Madhusnuhi Internal and 17.53 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than Madhusnuhi Internal group.Madhusnuhi External 24.05 P<0.001 Madhusnuhi External Highly significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External groupSandhyaraga Internal 1.20 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga ExternalExternal group group provided the same result.Sandhyaraga Internal 18.74 P<0.001 Sandhyaraga Internal is Highly significantand Sandhyaraga better than SandhyaragaInternal External group Internal External groupSandhyaraga External 11.38 P<0.001 Sandhyaraga External Highly significantgroup and Sandhyaraga group is better thanInternal External group Sandhyaraga Internal External groupMadhusnuhi Internal, 50.58 P<0.001 Madhusnuhi Internal is Highly significantand Sandhyaraga better than Sandhyaragainternal Internal groupMadhusnuhi External 4.06 P<0.01 Madhusnuhi External is Significantand Sandhyaraga better than SandhyaragaExternal External groupMadhusnuhi Internal 13.45 P<0.001 Madhusnuhi Internal Highly significantExternal and External is better thanSandhyaraga Internal Sandhyaraga InternalExternal External groupTable 5.43 showing percentage of closure in original excision wound area(sq.mm) on8th post wounding day of Control and all groups of Trial drugs C IM EM IEM IS ES IES R1 39.75 69.39 92.27 67.17 75.54 84.04 79.08 R2 36.67 64.71 94.90 68.28 75.13 85.71 78.19 R3 41.49 65.63 91.05 66.15 77.42 84.90 77.42 R4 38.10 67.72 92.19 66.85 75 86.87 76.29 R5 36.76 67.53 93.81 67.55 76.80 86.24 75.26 R6 44.21 63.59 93.55 68.37 77.01 83.42 75.13 MEAN 39.49 66.43 92.96 67.39 76.15 85.20 76.90 SD 2.96 2.16 1.38 0.86 1.05 1.32 1.61 SE 1.21 0.88 0.56 0.35 0.43 0.54 0.66 t-value 10.09 17.92 63.81 75.24 102.15 66.80 75.35 RESULT P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 119
    • Chapter-5 Observation & ResultsThe mean contraction seen on the 8th post wounding day:Control group - 39.49 ±2.96%Madhusnuhi Internal - 66.43±2.16%Madhusnuhi External - 92.96±1.38%Madhusnuhi Internal External - 67.39±0.86%Sandhyaraga internal - 76.15±1.05%Sandhyaraga External - 85.20±1.32%Sandhyaraga Internal External - 76.90±1.60%Table-5.44 showing interpretation of statistical analysis on the percentage ofclosure in excision wound area of Control and all groups of Trial drugs on 8thpost wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 18.01 P<0.001 Madhusnuhi Internal group Highly significantMadhusnuhi Internal is better than control groupControl group& 40.1 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group is better than controlgroup groupControl group& 22.2 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Control group & 28.6 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better than controlgroup group.Control group and 34.6 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group Madhusnuhigroup External group control group.Control group and 27.22 P<0.001 Sandhyaraga Internal Highly significantSandhyaraga Internal External group is betterExternal group than control group.Madhusnuhi Internal 25.35 P<0.001 Madhusnuhi External Highly significantand Madhusnuhi group is better thanExternal group Madhusnuhi InternalMadhusnuhi Internal 1.02 P>0.05 Madhusnuhi Internal and No significanceand Madhusnuhi Madhusnuhi InternalInternal External group External group provided the same result.Madhusnuhi External 38.56 P<0.001 Madhusnuhi External Highly significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External groupSandhyaraga Internal 13.1 P<0.001 Sandhyaraga External Highly significantand Sandhyaraga group is better thanExternal group- Sandhyaraga Internal groupSandhyaraga Internal 0.95 P>0.05 Sandhyaraga Internal No significanceand Sandhyaraga group and SandhyaragaInternal External group Internal External group provided the same result.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 120
    • Chapter-5 Observation & Results Sandhyaraga External 9.8 P<0.001 Sandhyaraga External Highly significant group and Sandhyaraga group is better than Internal External group Sandhyaraga Internal External group Madhusnuhi Internal, 9.92 P<0.05 Sandhyaraga Internal Moderately significant and Sandhyaraga group is better than internal Madhusnuhi Internal Madhusnuhi External 9.95 P<0.001 Madhusnuhi External is Highly significant and Sandhyaraga better than Sandhyaraga External External group Madhusnuhi Internal 12.79 P<0.001 Sandhyaraga Internal Highly significant External and External group is better Sandhyaraga Internal than Madhusnuhi Internal External External group. Table 5.45 showing percentage of closure in original excision wound area (sq.mm) on12th post wounding day of Control and all groups of Trial drugs C IM EM IEM IS ES IESR1 90.1 96.43 98.34 95.96 94.57 96.28 87.244R2 91.15 95.72 98.98 93.01 96.90 98.47 87.234R3 89.89 93.75 98.95 95.31 96.77 96.88 91.397R4 86.24 93.65 98.96 92.39 95.21 98.48 93.814R5 87.56 95.36 98.97 95.74 95.88 96.83 87.894R6 87.89 96.41 97.85 94.90 94.65 96.26 94.708MEAN 90.38183 88.81 95.22 98.67 94.55 95.66 97.20 333SD 1.86 1.25 0.47 1.50 1.02 1.03 3.39028SE 0.76 0.51 0.19 0.61 0.42 0.42 1.38407t-value 84.28 89.30 74.57 72.28 86.87 57.67 57.13RESULT P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 The mean contraction seen on the 12th post wounding day: Control group -88.805 ±1.859 Madhusnuhi Internal - 95.219±1.246 Madhusnuhi External - 98.674±0.47457 Madhusnuhi Internal External - 94.55±1.492 Sandhyaraga internal - 95.661±1.0216 Sandhyaraga External - 97.1975±1.02470 Sandhyaraga Internal External -90.38183333 ±3.39028 Table-5.46 showing interpretation of statistical analysis on the comparative percentage of closure in excision wound area of Control and all groups of Trial drugs on 12th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUE Control group& 7.019 P<0.001 Madhusnuhi Internal Highly significant Madhusnuhi Internal group is better than control group Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 121
    • Chapter-5 Observation & ResultsControl group& 12.59 P<0.001 Madhusnuhi External Highly significantMadhusnuhi External group is better thangroup control groupControl group& 5.90 P<0.001 Madhusnuhi Internal Highly significantMadhusnuhi Internal External group is betterExternal group than control group.Control group & 7.91 P<0.001 Sandhyaraga internal Highly significantSandhyaraga internal group is better thangroup control group.Control group and 9.68 P<0.001 Sandhyaraga External Highly significantSandhyaraga External group is better thangroup control group.Control group and 0.998 P>0.05 Control group and No significanceSandhyaraga Internal Sandhyaraga InternalExternal group External group provided the same result.Madhusnuhi Internal 6.34 P<0.001 Madhusnuhi External Highly significantand Madhusnuhi group is better thanExternal group Madhusnuhi Internal group.Madhusnuhi Internal 0.83 P>0.05 Madhusnuhi Internal and No significanceand Madhusnuhi Madhusnuhi InternalInternal External group External group provided the same result.Madhusnuhi External 6.45 P<0.001 Madhusnuhi External Highly significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External groupSandhyaraga Internal 2.60 P<0.05 Sandhyaraga External Moderately significantand Sandhyaraga group is better thanExternal group- Sandhyaraga Internal group.Sandhyaraga Internal 3.65 P<0.01 Sandhyaraga Internal Significantand Sandhyaraga group is better thanInternal External group Sandhyaraga Internal External groupSandhyaraga External 4.71 P<0.001 Sandhyaraga External Highly significantgroup and Sandhyaraga group is better thanInternal External group Sandhyaraga Internal External group.Madhusnuhi Internal, 0.67 P>0.05 Sandhyaraga internal No significanceand Sandhyaraga group and Madhusnuhiinternal Internal group provided the same result.Madhusnuhi External 3.20 P<0.01 Madhusnuhi External Significantand Sandhyaraga group is better thanExternal Sandhyaraga External groupMadhusnuhi Internal 2.75 P<0.05 Madhusnuhi Internal Moderately significantExternal and ExternalSandhyaraga Internal group is better thanExternal Sandhyaraga Internal External group.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 122
    • Chapter-5 Observation & ResultsTable 5.47 showing percentage of closure in original excision wound area(sq.mm) on 16th post wounding day of Control and all groups of Trial drugs C IM EM IEM IS ES IESR1 96.7 99.49 100 100 97.83 98.95 100R2 96.35 98.93 99.49 98.92 98.96 98.97 97.87R3 95.74 95.31 100 97.4 98.92 98.44 97.31R4 92.06 98.94 100 98.37 96.28 99.49 100R5 95.14 99.48 100 100 98.97 97.88 98.42R6 93.68 98.47 100 96.43 98.93 99.46 100MEAN 94.95 98.44 99.92 98.52 98.31 98.86 98.93SD 1.77 1.58 0.21 1.43 1.09 0.619 1.22SE 0.72 0.65 0.09 0.58 0.45 0.25 0.49t-value 111.33 93.37 87.38 79.65 90.69 94.16 80.255RESULT P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001The mean contraction seen on the16th post wounding day:Control group - 94.946 ±1.768%Madhusnuhi Internal - 98.44±1.58%Madhusnuhi External - 99.91±0.21%Madhusnuhi Internal External - 98.52±1.43%Sandhyaraga internal - 98.31±1.09%Sandhyaraga External - 98.86±0.62%Sandhyaraga Internal External -98.93 ±1.22%Table-5.48 showing interpretation of statistical analysis on the comparativepercentage of closure in excision wound area of Control and all groups of Trialdrugs on 16th post wounding day GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 3.60 P<0.01 Madhusnuhi Internal SignificantMadhusnuhi Internal group is better than control group.Control group& 6.83 P<0.001 Madhusnuhi External Highly SignificantMadhusnuhi External group is better than controlgroup group.Control group& 3.84 P<0.01 Madhusnuhi Internal SignificantMadhusnuhi Internal External group is betterExternal group than control group.Control group & 3.96 P<0.01 Sandhyaraga internal SignificantSandhyaraga internal group is better than controlgroup group.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 123
    • Chapter-5 Observation & ResultsControl group and 5.12 P<0.001 Sandhyaraga External Highly SignificantSandhyaraga External group is better than controlgroup group.Control group and 4.54 P<0.01 Sandhyaraga Internal SignificantSandhyaraga Internal External group is betterExternal group than control groupMadhusnuhi Internal 2.29 P<0.05 Madhusnuhi External Moderately significantand Madhusnuhi group is better thanExternal group Madhusnuhi InternalMadhusnuhi Internal 0.09 P>0.05 Madhusnuhi Internal and No significanceand Madhusnuhi Madhusnuhi InternalInternal External group External group provided the same result.Madhusnuhi External 2.39 P<0.05 Madhusnuhi External Moderately significantgroup and Madhusnuhi group is better thanInternal External group Madhusnuhi Internal External group.Sandhyaraga Internal 1.07 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga ExternalExternal group- group provided the same result.Sandhyaraga Internal 0.93 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga InternalInternal External group External group provided the same result.Sandhyaraga External 0.12 P>0.05 Sandhyaraga External and No significancegroup and Sandhyaraga Sandhyaraga InternalInternal External group External group provided the same result.Madhusnuhi Internal, 0.16 P>0.05 Madhusnuhi Internal, and No significanceand Sandhyaraga Sandhyaraga internalinternal group provided the same result.Madhusnuhi External 3.94 P<0.01 Madhusnuhi External Significantand Sandhyaraga group is better thanExternal Sandhyaraga ExternalMadhusnuhi Internal 0.54 P>0.05 Madhusnuhi Internal No significanceExternal and External and SandhyaragaSandhyaraga Internal Internal External providedExternal the same result.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 124
    • Chapter-5 Observation & ResultsPERIOD OF EPITHELIALIZATIONTable 5.49 showing comparison of period of epithelialization (in no. of days)between Control and Trial drug A (Madhusnuhi): C IM EM IEM R1 18 17 15 16 R2 21 18 17 18 R3 17 19 14 20 R4 22 17 14 18 R5 19 17 14 16 R6 21 18 16 19 MEAN 19.66 17.67 15 17.83 SD 1.96 0.82 1.26 1.60 SE 0.80 0.33 0.52 0.65 t-value 24.51 53.05 29.06 27.26 RESULT P<0.001 P<0.001 P<0.001 P<0.001Average period of Epithelialization seen wasControl group - 19.66±1.96%Madhusnuhi Internal -17.67±0.82%Madhusnuhi External - 15±1.26%Madhusnuhi Internal External - 17.83±1.60%Table-5.50 showing interpretation of statistical analysis on the comparativeperiod of epithelialization (in no. of days) of Control and Trial drug A(Madhusnuhi) GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 2.30 P<0.05 Madhusnuhi Internal group Moderately significantMadhusnuhi Internal is showing better result than Control group by showing least mean.Control 4.88 P<0.001 Madhusnuhi external group Highly Significantgroup&Madhusnuhi is showing better result thanExternal group Control group by showing least mean.Control group& 1.77 P>0.05 Control group& No significanceMadhusnuhi Internal Madhusnuhi InternalExternal group External group provided the same result statistically.Madhusnuhi Internal 4.33 P<0.01 Madhusnuhi external group Significantand Madhusnuhi is showing better result thanExternal group Madhusnuhi Internal by showing least mean.Madhusnuhi Internal 0.23 P>0.05 Madhusnuhi Internal and No significanceand Madhusnuhi Madhusnuhi InternalInternal External group External group provided the same result statistically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 125
    • Chapter-5 Observation & ResultsMadhusnuhi External 3.4 P<0.01 Madhusnuhi Significantgroup and Madhusnuhi external group isInternal External group showing better result than Madhusnuhi Internal External group by presenting least mean.Table-5.51 showing comparison of period of epithelialization (in no. of days)between o Control and Trial drug B (Sandhyaraga) C IS ES IES R1 18 18 17 16 R2 21 18 17 19 R3 17 17 19 19 R4 22 20 17 16 R5 19 17 20 18 R6 21 18 17 15 MEAN 19.66 18 17.83 17.17 SD 1.96 1.10 1.33 1.72 SE 0.80 0.45 0.54 0.70 t-value 24.51 40.25 32.80 49.83 RESULT P<0.001 P<0.001 P<0.001 P<0.001Average period of Epithelialization seen was Control group - 19.66±1.96% Sandhyaraga internal -18 ±1.10% Sandhyaraga External -17.83 ±1.33% Sandhyaraga Internal External -17.17 ±1.72%Table-5.52 showing interpretation of statistical analysis on the comparativeperiod of epithelialization (in no. of days) of Control and Trial drug B(Sandhyaraga) GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group & 1.81 P>0.05 Control group & No significanceSandhyaraga internal Sandhyaraga internal groupgroup provided the same result statistically.Control group and 1.89 P>0.05 Control group and No significanceSandhyaraga External Sandhyaraga Externalgroup group provided the same result statistically.Control group and 2.34 P<0.05 Sandhyaraga Internal Moderately significantSandhyaraga Internal External group shows betterExternal group result than Control group by presenting least mean.Sandhyaraga Internal 0.24 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga ExternalExternal group- group- provided the same result statistically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 126
    • Chapter-5 Observation & ResultsSandhyaraga Internal 1.00 P>0.05 Sandhyaraga Internal and No significanceand Sandhyaraga Sandhyaraga InternalInternal External group External group provided the same result statistically.Sandhyaraga External 0.76 P>0.05 Sandhyaraga External No significancegroup and group and SandhyaragaSandhyaraga Internal Internal External groupExternal group provided the same result statistically.Table-5.53 showing comparison of period of epithelialization (in no. of days)between Control and Trial drugs internal administration groups C IM IS R1 18 17 18 R2 21 18 18 R3 17 19 17 R4 22 17 20 R5 19 17 17 R6 21 18 18 MEAN 19.66 17.67 18 SD 1.96 0.82 1.10 SE 0.80 0.33 0.45 t-value 24.51 53.05 40.25 RESULT P<0.001 P<0.001 P<0.001Average period of Epithelialization seen wasControl group - 19.66±1.96%Madhusnuhi Internal -17.67 ±0.82%Sandhyaraga internal -18 ±1.10%Table-5.54 showing interpretation of statistical analysis on the comparativeperiod of epithelialization (in no. of days) of Control and Trial drugs internaladministration groups : GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 2.30 P<0.05 Madhusnuhi Internal group is Moderately significantMadhusnuhi Internal showing better result than Control group by showing least mean.Control group & 1.81 P>0.05 Control group & No significanceSandhyaraga Sandhyaraga internal groupinternal group provided the same result statistically.Madhusnuhi Internal, 0.60 P>0.05 Madhusnuhi Internal, and No significanceand Sandhyaraga Sandhyaraga internalinternal provided the same result statistically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 127
    • Chapter-5 Observation & ResultsTable 5.55- showing period of epithelialization (in no. of days) of Control andTrial drugs external administration groups C EM ES R1 18 15 17 R2 21 17 17 R3 17 14 19 R4 22 14 17 R5 19 14 20 R6 21 16 17 MEAN 19.66 15 17.83 SD 1.96 1.26 1.33 SE 0.80 0.52 0.54 t-value 24.51 29.06 32.80 RESULT P<0.001 P<0.001 P<0.001Average period of Epithelialization seen wasControl group - 19.66±1.96%Madhusnuhi External - 15±1.26%Sandhyaraga External -17.83 ±1.33%Table-5.56 showing interpretation of statistical analysis on the comparativeperiod of epithelialization (in no. of days) of Control and Trial drugs Externaladministration groups: GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group & 4.88 P<0.001 Madhusnuhi external group is Highly SignificantMadhusnuhi showing better result thanExternal group Control group by showing least mean.Control group and 1.89 P>0.05 Control group and No significanceSandhyaraga Sandhyaraga External groupExternal group provided the same result statistically.Madhusnuhi 3.78 P<0.01 Madhusnuhi external group is SignificantExternal and showing better result thanSandhyaraga Sandhyaraga External groupExternal by presenting least mean.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 128
    • Chapter-5 Observation & ResultsTable-5.57 showing comparison of period of epithelialization (in no. of days)between Control and Trial drugs combined internal and external mode ofadministration groups C IEM IES R1 18 16 16 R2 21 18 19 R3 17 20 19 R4 22 18 16 R5 19 16 18 R6 21 19 15 MEAN 19.66 17.83 17.17 SD 1.96 1.60 1.72 SE 0.80 0.65 0.70 t-value 24.51 27.26 49.83 RESULT P<0.001 P<0.001 P<0.001Average period of Epithelialization seen wasControl group - 19.66±1.96%Madhusnuhi Internal External - 17.83±1.60%Sandhyaraga Internal External -17.17 ±1.720%Table-5.58 showing interpretation of statistical analysis on the comparativeperiod of epithelialization (in no. of days) of Control and Trial drugs combinedinternal and external mode of administration groups: GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 1.77 P>0.05 Control group& No significanceMadhusnuhi Internal Madhusnuhi InternalExternal group External group provided the same result statistically.Control group and 2.34 P<0.05 Sandhyaraga Internal Moderately significantSandhyaraga Internal External group shows betterExternal group result than Control group by presenting least mean.Madhusnuhi Internal 0.69 P>0.05 Madhusnuhi Internal No significanceExternal and External and SandhyaragaSandhyaraga Internal Internal External providedExternal the same result statistically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 129
    • Chapter-5 Observation & ResultsTable-5.59 showing comparison of period of epithelialization (in no. of days) between oControl and all groups of both Trial drugs C IM EM IEM IS ES IES R1 18 17 15 16 18 17 16 R2 21 18 17 18 18 17 19 R3 17 19 14 20 17 19 19 R4 22 17 14 18 20 17 16 R5 19 17 14 16 17 20 18 R6 21 18 16 19 18 17 15 MEAN 19.66 17.67 15 17.83 18 17.83 17.17 SD 1.96 0.82 1.26 1.60 10 1.33 1.72 SE 0.80 0.33 0.52 0.65 0.45 0.54 0.70 t-value 24.51 53.05 29.06 27.26 40.25 32.80 49.83 RESULT P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001 P<0.001Average period of Epithelialization seen wasControl group - 19.66±1.96%Madhusnuhi Internal -17.67 ±0.82%Madhusnuhi External - 15±1.26%Madhusnuhi Internal External - 17.83±1.60%Sandhyaraga internal -18 ±1.10%Sandhyaraga External -17.83 ±1.33%Sandhyaraga Internal External -17.17 ±1.720%Table-5.60 showing interpretation of statistical analysis on the comparativeperiod of epithelialization (in no. of days) of Control and all groups of both Trialdrugs GROUPS T- P- RESULT INTERPRETATION COMPARED VALUE VALUEControl group& 2.30 P<0.05 Madhusnuhi Internal group is Moderately significantMadhusnuhi showing better result thanInternal Control group by showing least mean.Control group& 4.88 P<0.001 Madhusnuhi external group is Highly SignificantMadhusnuhi showing better result thanExternal group Control group by showing least mean.Control group& 1.77 P>0.05 Control group& Madhusnuhi No significanceMadhusnuhi Internal External groupInternal External provided the same resultgroup statistically.Control group & 1.81 P>0.05 Control group & Sandhyaraga No significanceSandhyaraga internal group provided theinternal group same result statistically.Control group and 1.89 P>0.05 Control group and No significanceSandhyaraga Sandhyaraga External groupExternal group provided the same result statistically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 130
    • Chapter-5 Observation & ResultsControl group and 2.34 P<0.05 Sandhyaraga Internal External Moderately significantSandhyaraga group shows better result thanInternal External Control group by presentinggroup least mean.Madhusnuhi 4.33 P<0.01 Madhusnuhi external SignificantInternal and group is showingMadhusnuhi better result thanExternal group Madhusnuhi Internal by showing least mean.Madhusnuhi 0.23 P>0.05 Madhusnuhi Internal and No significanceInternal and Madhusnuhi Internal ExternalMadhusnuhi group provided the same resultInternal External statistically.groupMadhusnuhi 3.4 P<0.01 Madhusnuhi external SignificantExternal group and group is showingMadhusnuhi better result thanInternal External Madhusnuhi Internalgroup External group by presenting least mean.Sandhyaraga 0.24 P>0.05 Sandhyaraga Internal and No significanceInternal and Sandhyaraga External group-Sandhyaraga provided the same resultExternal group- statistically.Sandhyaraga 1.00 P>0.05 Sandhyaraga Internal and No significanceInternal and Sandhyaraga Internal ExternalSandhyaraga group provided the same resultInternal External statistically.groupSandhyaraga 0.76 P>0.05 Sandhyaraga External group No significanceExternal group and and Sandhyaraga InternalSandhyaraga External group provided theInternal External same result statistically.groupMadhusnuhi 0.60 P>0.05 Madhusnuhi Internal, and No significanceInternal, and Sandhyaraga internal providedSandhyaraga the same result statistically.internalMadhusnuhi 3.78 P<0.01 Madhusnuhi external group is SignificantExternal and showing better result thanSandhyaraga Sandhyaraga External group byExternal presenting least mean.Madhusnuhi 0.69 P>0.05 Madhusnuhi Internal External No significanceInternal External and Sandhyaraga Internaland Sandhyaraga External provided the sameInternal External result statistically.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 131
    • Chapter-5 Observation & ResultsDIAGRAMS SHOWING PERCENTAGE OF CONTRACTIONDIAGRAMS OF COMPARISON OF CONTROL WITH TRIAL DRUG-A(Madhusnuhi)Diagram 5.1 showing mean percentage of closure of original excision wound area(sq.mm) on 4h post wounding day of Control and Trial drug A (Madhusnuhi) 70 63.81 60 Mean Percentage 50 40 35.82 30 21.33 23.33 20 10 0 C IM EM IEMDiagram 5.2 showing percentage of closure of original excision wound area(sq.mm) on 8h post wounding day of Control and Trial drug A (Madhusnuhi) 100 92.96 80 Mean Percentage 66.42 67.39 60 40 39.49 20 0 C IM EM IEMDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 132
    • Chapter-5 Observation & ResultsDiagram 5.3 showing mean percentage of closure of original excision wound area(sq.mm) on 12th post wounding day of Control and Trial drug A (Madhusnuhi) 100 98.67 98 96 95.22 Mean Percentage 94.55 94 92 90 88.81 88 86 84 82 C IM EM IEM Diagram 5.4 showing mean percentage of closure of original excision woundarea (sq.mm) on 16h post wounding day of Control and Trial drug A(Madhusnuhi) 100 99.92 99 98.44 98.52 98 Mean Percentage 97 96 95 94.95 94 93 92 C IM EM IEMDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 133
    • Chapter-5 Observation & ResultsDIAGRAMS OF COMPARISON OF CONTROL WITH TRIAL DRUG B(Sandhyaraga)Diagram 5.5 showing mean % of closure of original excision wound area (sq.mm)on 4th post wounding day of Control and Trial drug B ( Sandhyaraga) 60 59.36 58.06 50 45.66 Mean Percentage 40 30 21.33 20 10 0 C IS ES IESDiagram 5.6 showing mean% closure of original excision wound area (sq.mm) on8th post wounding day of Control and Trial drug B ( Sandhyaraga) 90 85.2 80 76.15 76.9 70 Mean Percentage 60 50 39.49 40 30 20 10 0 C IS ES IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 134
    • Chapter-5 Observation & ResultsDiagram 5.7 showing mean% closure of original excision wound area (sq.mm) on12th post wounding day of Control and Trial drug B (Sandhyaraga) 98 97.2 96 95.66 Mean Percentage 94 92 90.38 90 88.81 88 86 84 C IS ES IESDiagram 5.8 showing mean% closure of original excision wound area (sq.mm)on 16th post wounding day of Control and Trial drug B ( Sandhyaraga) 99 98.86 98.93 98.31 98 Mean Percentage 97 96 95 94.95 94 93 92 C IS ES IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 135
    • Chapter-5 Observation & ResultsDIAGRAMS OF COMPARISON OF CONTROL WITH BOTH TRIAL DRUGINTERNAL GROUPSDiagram 5.9 showing mean% closure of original excision wound area (sq.mm) on4th post wounding day of Control and Internal administration groups of bothTrial drugs 59.36 60 50 Mean Percentage 40 30 21.33 23.33 20 10 0 C IM ISDiagram 5.10 showing mean% closure of original excision wound area (sq.mm)on 8th post wounding day of Control and Internal administration groups of bothTrial drugs 80 76.15 70 66.43 Mean Percentage 60 50 39.49 40 30 20 10 0 C IM ISDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 136
    • Chapter-5 Observation & ResultsDiagram 5.11 showing mean% of closure of original excision wound area(sq.mm) on 12th post wounding day of Control and Internal administrationgroups of both Trial drugs 96 95.22 95.66 94 Mean Percentage 92 90 88.81 88 86 84 C IM ISDiagram 5.12showing mean% closure of original excision wound area (sq.mm)on 16th post wounding day of Control and Internal administration groups of bothTrial drugs 99 98.44 98.31 98 Mean Percentage 97 96 94.95 95 94 93 C IM ISDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 137
    • Chapter-5 Observation & ResultsDIAGRAMS OF COMPARISON OF CONTROL WITH BOTH TRIAL DRUGEXTERNAL GROUPSDiagram 5.13 showing mean% of closure of original excision wound area(sq.mm) on 4th post wounding day of Control and External administrationgroups of both Trial drugs: 70 63.81 60 58.06 Mean Percentage 50 40 30 21.33 20 10 0 C EM ESDiagram 5.14 showing mean% of closure of original excision wound area(sq.mm) on 8h post wounding day of Control and External administration groupsof both Trial drugs: 100 92.96 85.2 80 Mean Percentage 60 39.49 40 20 0 C EM ESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 138
    • Chapter-5 Observation & ResultsDiagram 5.15 showing mean % of closure of original excision wound area(sq.mm) on 12h post wounding day of Control and External administrationgroups of both Trial drugs: 100 98.67 98 97.2 96 Mean Percentage 94 92 90 88.81 88 86 84 82 C EM ESDiagram 5.16 showing % closure of original excision wound area (sq.mm) on 16hpost wounding day of Control and External administration groups of both Trialdrugs: 99.92 100 99 98.86 Mean Percentage 98 97 96 94.95 95 94 93 92 C EM ESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 139
    • Chapter-5 Observation & ResultsDIAGRAMS OF COMPARISON OF CONTROL WITH BOTH TRIAL DRUGINTERNAL-EXTERNAL GROUPSDiagram 5.17 showing mean% closure of original excision wound area (sq.mm)on 4th post wounding day of Control and Combined Internal and Externaladministration groups of both Trial drugs 50 45.66 40 35.82 Mean Percentage 30 21.33 20 10 0 C IEM IESDiagram 5.18 showing mean % closure of original excision wound area (sq.mm)on 8th post wounding day of Control and Combined Internal and Externaladministration groups of both Trial drugs 80 76.9 70 67.39 Mean Percentage 60 50 39.49 40 30 20 10 0 C IEM IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 140
    • Chapter-5 Observation & ResultsDiagram 5.19 showing mean % closure of original excision wound area (sq.mm)on12th post wounding day of Control and Combined Internal and Externaladministration groups of both Trial drugs 95 94.55 94 93 Mean Percentage 92 91 90.38 90 89 88.81 88 87 86 85 C IEM IESDiagram 5.20 showing mean% of closure of original excision wound area(sq.mm) on 16th post wounding day of Control and Combined Internal andExternal administration groups of both Trial drugs 98.93 99 98.52 98 Mean Percentage 97 96 94.95 95 94 93 92 C IEM IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 141
    • Chapter-5 Observation & ResultsDIAGRAMS OF COMPARISON OF CONTROL WITH ALL GROUPS OFTRIAL DRUGSDiagram 5.21 showing mean% closure of original excision wound area (sq.mm)on 4th post wounding day of Control and all groups ofTrial drug A and B 70 63.81 60 59.36 58.06 Mean Percentage 50 45.66 40 35.82 30 21.33 23.33 20 10 0 C IM EM IEM IS ES IESDiagram 5.22 showing mean % closure of original excision wound area (sq.mm)on 8th post wounding day of Control and all groups ofTrial drug A and B 100 92.96 90 85.2 80 76.15 76.9 Mean Percentage 70 66.43 67.39 60 50 40 39.49 30 20 10 0 C IM EM IEM IS ES IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 142
    • Chapter-5 Observation & ResultsDiagram 5.23 showing mean% of closure of original excision wound area(sq.mm) on 12th post wounding day of Control and all groups ofTrial drug Aand B 100 98.67 98 97.2 96 95.22 95.66 Mean Percentage 94.55 94 92 90.38 90 88.81 88 86 84 82 C IM EM IEM IS ES IESDiagram 5.24 showing mean% of closure of original excision wound area(sq.mm) on 16th post wounding day of Control and all groups ofTrial drug Aand B 100 99.92 99 98.86 98.93 98.44 98.52 98.31 98 Mean Percentage 97 96 95 94.95 94 93 92 C IM EM IEM IS ES IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 143
    • Chapter-5 Observation & ResultsDiagram 5.25 showing % closure of original excision wound area (sq.mm) onevery fourth day of Control and all groups of Trial drug A and B 120 100 80 60 40 20 0 C IM EM IEM IS ES IESDIAGRAMS SHOWING PERIOD OF EPITHELIALIZATIONDiagram-5.26 showing mean period of epithelialization (in no. of days) ofControl and Trial drug A (Madhusnuhi) 20 19.66 17.67 17.83 15 15 Days 10 5 0 C IM EM IEMDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 144
    • Chapter-5 Observation & ResultsDiagram-5.27 showing mean period of epithelialization (in no. of days) ofControl and Trial drug B (Sandhyaraga) 20 19.66 19.5 19 18.5 18 17.83 18 Days 17.5 17.17 17 16.5 16 15.5 C IS ES IESDiagram 5.28 showing meanperiod of epithelialization (in no. of days) of Controland Trial drugs internal administration groups 20 19.66 19.5 19 18.5 Days 18 18 17.67 17.5 17 16.5 C IM ISDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 145
    • Chapter-5 Observation & ResultsDiagram 5.29- showing mean period of epithelialization (in no. of days) ofControl and Trial drugs external administration groups 20 19.66 17.83 15 15 Days 10 5 0 C EM ESDiagram-5.30 showing mean period of epithelialization (in no. of days) ofControl and Trial drugs combined internal and external mode of administrationgroups 20 19.66 19.5 19 18.5 18 17.83 Days 17.5 17.17 17 16.5 16 15.5 C IEM IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 146
    • Chapter-5 Observation & ResultsDiagram-5.31 showing period of epithelialization (in no. of days) of Control andall groups of both Trial drugs 20 19.66 18 17.67 17.83 18 17.83 17.17 16 15 14 12 Days 10 8 6 4 2 0 C IM EM IEM IS ES IESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 147
    • Chapter-5 Observation & ResultsImage 5.1Stages of Excision Wound Healing 0th day 4th day 8th day 12th day 16th dayCEMIMIEMESISIESDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 148
    • Chapter-6 Discussion DISCUSSION Adulteration in crude drugs includes substitution of the original crude drugspartially or fully with other substances which is either free from or inferior intherapeutic and chemical properties. The premise of the study conducted isadulteration where an adulterant is compared with the genuine drug to analyze therationality behind it.Trial drug selection There are several drugs though non-classical, which do have high medicinalvalue but still bearing the abuse as adulterants. It is the need of the day to explore themedicinal properties if any, of such drugs and to adopt them into the pharmacopoeiaso that the science of Dravyaguna Vijnana. Ayurveda and human kind are totallybenefited. The present experimental study was carried out in such an out look on twodrugs, Madhusnuhi and Sandhyaraga, the latter being used as adulterant of theformer.Literary review Literary analysis revealed that Madhusnuhi was introduced into theAyurvedic system of medicine around 15th century AD, by Acharya Bhavamisrawhich is widely practiced . Sandhyaraga a non-classical drug with high ethnomedicalimportance and used as an adulterant of Madhusnuhi. As per Ayurvedoktha Paryaya Niruktha Mala by Vaidhya J.L.N.Shasthri,Madhusnuhi is Madhura Rasa .But as per Bhavaprakasha nighantu the Rasa of -Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 149
    • Chapter-6 Discussion-Madhusnuhi is Tikta, Vipaka is Katu. But it is felt that Madhusnuhi is havingSodhana-Ropana property like Madhu (honey). So it could be on the basis of thoseproperties China root was named as Madhusnuhi.Pharmacognostical study :143 An atypical character presented by the root tubers of Sandhyaraga during thesecondary thickening could be appreciated in the microscopy which is itsdistinguishing feature. During secondary growth, the primary thickening meristemdifferentiates in the pericycle outside the vascular tissue on an arc between thevascular bundles of outer bundle ring. This feature contributes a lot in theidentification of the tuber from other dicot members. The section contained abundantstarch grains.Phytochemical analysis: Preliminary Phytochemical analysis of Sandhyaraga revealed the presence ofsaponins, alkaloids, carbohydrates,etc which promote wound healing process. Thedrug Sandhyaraga is said to have purgative property along with which it is also foundto be effective in Intestinal parasites .These could be due to presence of saponins.Analysis of Pharmocological properties:Pharmocological analysis of Sandhyaraga revealed that it is Kashaya RasaPradhana. It is an established fact that Kashaya Rasa promotes the process ofwoundhealing. So the wound healing property of Sandhyaraga can be attributed toKashayarasa of the drug.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 150
    • Chapter-6 DiscussionDiscussion on Animal experimentation:Disease selectionBoth the drugs were found to be practiced in the disease Syphilis where Vrana is aclassical symptom. Hence Vranaropana property was the criteria selected to seewhether both the drugs show any similarity in the action.Findings of the study The aim of the present study was to evaluate, Vranaropana (wound healing)property of the two trial drugs Madhusnuhi and Sandhyaraga in different routes ofadministration and to find out effective one among these. Trial drug groups werecompared with the Control group (natural healing) and among themselves. Thegrouping was done as follows. Group 1 Control Group 2- Trial Drug A - Madhusnuhi Churna Externally Group 3- Trial Drug A - Madhusnuhi Churna Internally Group 4- Trial Drug A - Madhusnuhi Churna combined Internal & External Group 5- Trial Drug B - Sandhyaraga Churna Externally Group 6- Trial Drug B - Sandhyaraga Churna Internally Group 7- Trial Drug B - Sandhyaraga Churna combined Internal & ExternalThe result shows that both the trial drugs have wound healing properties whencompared with control group and have shown moderate to high significance.In this method two parameters were assessed,1. Percentage contraction of original wound area2. Period of epithelialization.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 151
    • Chapter-6 DiscussionPercentage contraction of original wound area Whenever a breach occurs in the continuity of tissue, the surroundingconnective tissue and capillaries grows to cover up the area damaged, and achievesthe contraction of wound. To prove any drug as a wound-healing agent, it should have significant effecton rate of contraction. In this experiment, the wound was measured once in four daysi.e., 4th, 8th, 12th, 16th day. All trial drug groups have shown better result than control group. It was found that from 0thday to 4thday, i.e. in first reading in Group 2 i.e.external group of Trial drug A (Madhusnuhi), there was a remarkable reduction inwound area with greater percentage of contraction compared to other groups. It hasshown a mean percentage of 63.81. Both Internal and external administration of Trialdrug B have shown 58.06% and 59.36% with no much significance differencebetween them. From 0thday to 8thday i.e. in 2nd reading, Group 2(external group of Trial drugA - Madhusnuhi) has shown a greater contraction percentage mean of 92% precededby Group 5 (external group of Trial drug B-Sandhyaraga). There is no significantdifference between the internal groups and Internal and external combined groups ofboth Trial drugs. From 0thday to 12thday i.e. in 3rd reading, it is observed that Group 2 (externalgroup of Trial drug A-Madhusnuhi) has shown 98.67% of wound contraction andGroup 5 (external group of Trial drug B-Sandhyaraga) has shown 97.2% contraction.Group 3 (Trial drug A-Madhusnuhi Internal) and Group 4 (Trial drug A Madhusnuhicombined internal and external group) though better than Group 1 (control), have-Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 152
    • Chapter-6 Discussion-shown no much significant difference in the percentage of contraction amongthemselves. Group 6(Trial drug B-Sandhyaraga Internal) has shown better result thanGroup 7 (Trial drug B- Sandhyaraga combined Internal and external group). Group 7(Trial drug B- Sandhyaraga combined Internal and external group) has shown nosignificant difference with Group 1-Control. From 0th day to16th day i.e., in the 4th reading, Group 2 (Trial drug A-Madhusnuhi external) has shown complete healing with a mean wound contractionpercentage of 99.91% and has shown better result when compared with all othergroups . All other Trial drug groups, are showing better result when compared withGroup 1-Control group and with no significant difference among themselves. Group 2and Group 5 the External administration group of both drugs have shown a highlysignificant difference when compared with Group 1-Control group.In a nutshell: All groups are showing better result than control group in majority of the observations. Group 2 where Madhusnuhi is dusted externally has shown better result when compared to all other groups . While comparing the different mode of administration of both drugs it is clear that external mode of administration is showing comparatively better result. Internal and combined (internal and external) groups are not showing significant difference among themselves, which suggest a hindering factor (could be psychological factor) in the process of wound healing in spite of good results of external application.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 153
    • Chapter-6 DiscussionPeriod of epithelialization. The second parameter is the period of epithelialization. It is recorded as theday on which the scar falls off leaving no raw area. Once there is a break in theepithelium, it will proliferate and grow from the surrounding tissue. Before that, dueto the clotting and other factors, a scar tissue is formed on the wound. Initially the scarcovers the whole area of the wound, and as the new epithelium grows, the scarreduces in size and will falls off. Earlier falling of the scar, faster is the healing. In the trial groups complete closure was achieved from 14th to 20th day, but inthe Control group closure was achieved from 18th to 22nd day. Among trial druggroups, Group 2 (Madhusnuhi externally ) was showing comparatively earlierepithelialization by producing a result with least mean of complete epithelialization. Group 2 (Madhusnuhi externally) is showing a result with high significancewhen compared with Group1 (control group). The result obtained when Group 2 iscompared with other modes of same drug (Group 3 and Group 4) and same mode ofother drug (Group 5) is of significant difference proving Group 2 is better with lessermean. Group 3 (Madhusnuhi internally ) and Group 7 (Sandhyraga internal andexternal combined group ) are showing a result with moderate significance whencompare with the Group1 (control group) There is no considerable difference in the mean of period of epithelializationin other groups and show no statistical significance.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 154
    • Chapter-6 DiscussionIn a nutshell Even though all trial groups were showing better contraction percentage , only Group2 Group3 and Group7 have shown earlier epithelialization in comparison with control groups. Madhusnuhi external group can be considered best among the trial drug groups when period of complete epithelialization is considered. Considering the raw data regarding mean period of complete epithelialization all other groups have shown earlier epithelialization compared with Group 1 (control) The over all assessment shows that all trial drug groups are better than the groupsubjected for natural healing. Thus it is seen that both the trial drugs have woundhealing property. Both the drugs were acting in a better manner when administeredexternally than internally or in combined form.Probable mode of action: I. Probable mode of action of Madhusnuhi Tiktarasa: The drug is Krumihara and Kleda shoshana by the virtue of its Rasa and hence it must have promoted Vranaropanakarma. According to Ayurvedic Pharmacodynamics the drug can perform its Karma by its various properties like Rasa- Guna- Veerya- Vipaka and Prabhava. Here in Madhusnuhi we can se that it doesnot bear Guna, Veerya or Vipaka which promotes Vranaropana But it is a very potent Ropana Dravya. There fore the Vranaropana Karma of Madhusnuhi can certainly be attributed to its Tikta Rasa.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 155
    • Chapter-6 Discussion Promoting angiogenesis: βsitosterol and Diosgenine (Sapogenine)144,145 present in Madhusnuhi have angiogenic effect and thus hastens the wound healing process. Angiogenesis called neovascularization, the process of angiogenesis occurs concurrently with fibroblast proliferation when endothelial cells migrate to the area of the wound. Because the activity of fibroblasts and epithelial cells requires oxygen, angiogenesis is imperative for other stages in wound healing, like epidermal and fibroblast migration.. Quercitin,146,147,148,149,150: It is a biofalvonoid present in Madhusnuhi which improves circulation, repairs nerve damage and speed up wound healing. It also has anti-oxidant, anti-inflammatory and anti viral properties. Wounds with poor blood supply are found to heal slowly where the Quercitin promotes circulation and favours the healing processs. A previous study shows that Quercitin along with collagen has shown faster wound healing. It was also proved that Quercitin prevents the formation of hypertrophied scars. Anti microbial property: Wound infecton is considered as the most important factor that delays healing where Madhusnuhi is a drug which possess anti microbial property and prevents infection which facilitates wound healing. Free radical scavenging property151: Free radicals are the bi-products of oxygen metabolism. Chemically they are extremely reactive but under controlled circumstances form part of normal metabolic processes. They are produced from mitochondrial metabolism, prostaglandin synthesis and a variety of other enzymatic or auto-oxidation processes. Damage to the endothelia in the microcirculation attracts neutrophils which adhere to theDept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 156
    • Chapter-6 Discussion endothelium, block the capillaries and produce more free radicals. Destruction of the micro-circulation occurs and results in subsequent cell death. Madhusnuhi is a drug screened for its free radical scavenging property. Beta- sitosterol present in Madhusnuhi reduces the level of free radical in cells and increases the level of typical antioxidant enzymes. II. Probable mode of action of Sandhyaraga Kashayarasa : Rasa determination and estimation of taste threshold of the drug revealed that it is Kashaya rasa pradhana. Kashaya rasa is mainly Vrana Sodhana Ropana and Kleda Visoshana, hence it must have acted as Vranaropaka. Anti microbial 152: Sandhyaraga has antifungal, , antiviral and antibacterial properties which helps in providing a micotic free atmosphere for wound healing . A group of amino acid-based proteins, called mirabilis antiviral proteins (MAPs) have shown specific antiviral and antifungal actions. Saponins153: Immunity booster& anti oxidant. Plants produce saponins to fight infections by parasites. When ingested, saponins also seem to help immune system and to protect against virusand bacteria. The non-sugar part of saponins have also direct antioxidant activity. These factors facilitate wound healing property. Trigonelline154: It is an alkaloid with chemical formula C7H7NO2. It is an inner salt formed by the addition of a methyl group to the nitrogen atom of niacin. Trigonelline is a product of the metabolism of niacin (vitamin B3) which is excreted through the urine. Trigonelline is believed to prevent the bacteria Streptococcus mutans .Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 157
    • Chapter-6 Discussion Stigmasterol155is one of a group of phytosterols, that includes beta-sitosterol, campesterol etc . Sandhyaraga contains stigmaterols. Beta-sitosterol is an antioxidant, which is able to reduce DNA damage, reduce the level of free radical in cells and to increase the level of typical antioxidant enzymes. Thus Sandhyaraga possess free radical scavenging property. Alanine156: They are building blocks of proteins. Protein is required for all the phases of wound healing, particularly important for collagen synthesis. Hence, presence of this constituent in Sandhyaraga favors wound healing. Carbohydrate157s: Sugar is also considered as another factor for the wound healing. It is one of the factors for the binding and activation of the fibroblast growth factor. A study was done on the action of sugarcompound viz; Topical Sucralfate on ulcers .The study shows that this sugar compound has regenerative, anti microbial and anti-inflammatory effects.III. Mode of Administration. Avachurnana: it is one among Shashtyupakrama-s mentioned in Vrana Chikitsa. It is specifically told for Ghrishta Vrana, (with only skin loss) in the context of SadyoVrana Chikitsa in Ashtanga Samgraha. In this experiment the method selected is excision wound method in which only the skin portion is removed with out damaging any deep tissues. The result obtained in the experiment gives a positive stress on Acharya’s advice.IV. Involvement of Psychological factors Stress158,159 : Recent studies have proved that stress can affect the process of wound healing. Individuals subjected to stress are categorized as slow healers i.e one with stress control exhibits higher cortisol reactivity. This enhanced cortisol -Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 158
    • Chapter-6 Discussion -secretion in turn results in longer healing period. These findings suggest that the ability to regulate the expression of ones anger has a clinically relevant impact on wound healing. The rats which have shown lower healing rate in trial drugs had some common factors like stress resulted forceful internal administration of medicine and physical handling during wound agony. The act of internal feeding and pain of wounded area on handling might have increased the stress and temper of the rats and must have affected their healing rate in a negative manner. V. Involvement of physical factors Wound stress: Mechanical Stress affects quantity, aggregation and orientation of collagen fibers. Hence physical stress caused due to the internal feeding of medicine might have affected the healing. Thus both the Trial drugs proved to have wound healing property, hence it can besuggested that they can be taken for human trials. Out of the two trial drugs, Madhusnuhi is a classical drug and is being used inthe treatment in various Kalpana-s. The other test drug Sandhyaraga is not a classical one and not officially usedfor medicinal purpose in Ayurveda. But it is used widely as an adulterant ofMadhusnuhi. It is obvious from the results that Sandhyaraga also possess goodwound healing property in experimental animals and can be taken for clinical trialsthereby enriching Ayurvedic Pharmacopeae.Dept. of P.G.Studies in Dravyaguna Vijnana, AAMC, Moodbidri. 159
    • Chapter 7 Conclusion CONCLUSION The experimental study was conducted to see whether Sandhyaraga possesssimilar action of Madhusnuhi. It would be a great contribution to the field ofAyurvedic Dravyaguna Vijnana if a new drug with similar effect is explored. The following conclusions could be drawn from the study: Experimental evaluation, prove that both trial drugs Sandhyaraga and Madhusnuhi are having significant action on wound healing process. Both trial drug groups provided better result than control group in percentage closure of excision wound area. External application of both trial drugs shown better result than when they were administered internally and in combined form. Madhusnuhi external group was best among the trial drug groups when period of complete epithelialization is considered. Considering the raw data regarding mean period of complete epithelialization, all groups of both trial drugs have shown earlier epithelialization compared with Control group. Hence Sandhyaraga can be considerd as a drug of choice in Vranaropana(wound healing) because it is very commonly available, cost effective for the condition.Further scope ,Limitations and Recommendations: The efficacy of these trial drugs needs further exploration to identify the exact mode of action. As both trial drugs proved to have wound healing property they can be can be taken for clinical trials.Dept of P.G.Studies in Dravyaguna Vijnana,AAMC,Moodbidri 160
    • Chapter 7 Conclusion As Sandhyaraga is found to possess similar action as that of Madhusnuhi, it can be used as a substitute after conducting clinical trials and advanced scientific studies. Dose: The study shall be proceeded with different dosage of the drug so that the optimum dose can be found out.Dept of P.G.Studies in Dravyaguna Vijnana,AAMC,Moodbidri 161
    • Chapter- 8 Summary SUMMARY The dissertation titled ‘Experimental study of Sandhyaraga (Mirabilisjalapa.Linn) in comparison with Madhusnuhi (Smilax china.Linn) w.s.r to itsVranaropana property’ consists of different topics discussed under the followingheadings: Introduction gives a general glimpse on Ayurveda, Dravyaguna vijnana,importance of herbal drugs and preparations, adulteration, trial drugs selection, andmethodology of wound healing action. In Review of literature, an exhaustive collection of literature pertaining totrial drugs and disease Vrana is done. It revealed that Madhusnuhi was introduced toAyurvedic system of medicine in 15th century by Bhavamisra. It was used forUpadamsarogas, Phirangajavrana, and such other clinical condition. Thepharmacognostical, phytochemical and pharmacological studies on Madhusnuhi havealready been done. Sandhyaraga is not mentioned in any classical texts. It has gotonly ethnic background. It is being used by some traditional physicians for wounds,boils, inflammation, and many other clinical conditions. The pharmacognosticalfeatures, phytochemical and pharmacological investigations are also been verified.Under, disease review, both Ayurvedic and modern aspects are dealt with. In the Chapter Drug analysis, pharmacognostical, phytochemical andpharmacological analysis (regarding Rasa estimation) of Sandhyaraga is done. Onthis investigation on, phytochemical and pharmacological analysis of Sandhyaraga, ithas been observed on that the tuber of the plant contains saponins, carbohydrates,Dept of P.G.Studies in Dravyaguna Vijnana,AAMC.Moodbidri 162
    • Chapter- 8 Summaryalkaloids, proteins and the study on the nature of rasa of Sandhyaraga Moola(tuber)revealed that it has Kashaya pradhana rasa and Katu Anurasa. In the context of Animal experimentation details regarding evaluation ofVranaropana property of Sandhyaraga in comparison with Madhusnuhi is dealt with.The powder of tubers of Madhusnuhi and Sandhyaraga were selected as the test drugsfor the experiments. Excision wound method suggested by Morton and Malone (1972)has been chosen as the procedure for the experiment. Materials and methods,experimental procedure, grouping of experimental animals, explanation regarding theexecution of wounding technique and drug administration was done under thisheading. .Group1 among seven groups was kept as Control. Each drug wasadministered for 3 groups in remaining animal groups as per the methodology .Thepowders of each drugs were administered externally, internally and in combined form.Result: After 18 days of study, the results were analyzed statistically, considering thepercentage of wound contraction and epithelalization. It revealed that al drug receivedgroups have shown better result than control group. Discussion deals with major results obtained and major trends found in results.This chapter also contains the discussion regarding probable mode of action of thedrugs and factors which must have influenced the study. It can be concluded that the drug Madhusnuhi and Sandhyaraga are havingstatistically significant effects w.s.r to their wound healing property on experimentallycreated wounds in albino rats.Dept of P.G.Studies in Dravyaguna Vijnana,AAMC.Moodbidri 163
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    • ANNEXURESl no Body wt in Drug And Area of wound measured by Graph sheet gms Dose (No: of Days)Control 0 4 8 12 16 18R1R2R3R4R5R6Trial drug A (External)R1R2R3R4R5R6Trial drug A (Internal)R1R2R3R4R5R6Trial drug A(External&nternal)R1R2R3R4R5R6Trial drug B (External)R1R2R3R4R5R6Trial drug B(Internal)R1R2R3R4R5R6Trial drugB(External&nternal)R1R2R3R4R5R6
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