A REVIEW ON DESCRIPTION OF HERBAL MANAGEMENT OF BALAATISAAR I.E. CHILDHOOD DIARRHEA AS PER AYURVEDA

1. “A REVIEW ON
PHYTOPHARMACOLOGICAL
STUDY OF PATHA IN GLOBAL HEALTH
ISSUE W.S.R. TO
BALATISAR(CHILDHOOD DIARRHEA)”
-DR.ARJUN GROVER
PG SCHOLAR (DRAVYAGUNA VIGYANA)
DAYANAND AYURVEDIC COLLEGE,JALANDHAR

2. INTRODUCTION-:
 CHILDHOOD DIARRHEA/ACUTE DIARRHEA may be defined as a change in consistency and frequency of
stools/normal bowel habit i.e. of loose/watery nature that occurs more then 03 times in 24 hours which subside within
07 days. s
 If it is asso. Along with bleeding then it is termed as DYSENTRY.
 Around 05-15% cases of AD may persists for more then 14 days which is termed as PERSISTANT DIARRHEA.
 If it is along with insidious onest and duration more then 14 days then it is termed as CHRONIC DIARRHEA.
 In Ayurveda,it can be co-related with Balatisar, which is first found in Harita Samhita in context of its treatment.
 Aa.Dalhana, stated that “passing of watery stool in increased quantity is characterstic feature of ATISAR.”
 Whereas, Aa. Vijayarakshiata, defined it as “Excessive passage of drava from gudd marga (per anal).”
 DIARRHEA is the second leading cause of death in children under 05 years of age group.
 Globally there are around 1.7 billion cases of childhood diarrhea/yr. which is a leading cause of MALNUTRITION .
 Huge prevalence of this is found in rural area rather then urban area, as per findings of NATIONAL FAMILY
HEATH SURVEY(NFHS)- 8.3% of slum based children under 05 yrs. were suffering from it.
 Surveys and various Researches are also suggestive of fact that PREMATURE WEAING due to LACTATIONAL
MASTITS and LOWER SOCIO-ECO. STATUS among slum areas directly predisposes for CHILDHOOD
DIARRHEA.

3. ETIEOLOGY & RISK FACTORS-:
MALNUTRTIO
N & PRE
MATURE
WEANING,
8.2
INTESTIN
AL
INFECTIO
NS (1.
ROTA
VIRUS
2.ENTE…
DRUG
INDUCED,
1.4
SYSTEMIC
INFECTIONS
like- UTI
,OTITIS
MEDIA
commonly,
1.2
DIARRHEA
MALNUTRTION & PRE
MATURE WEANING
INTESTINAL
INFECTIONS (1. ROTA
VIRUS 2.ENTEROTOXIC
E.COLI)
DRUG INDUCED
SYSTEMIC INFECTIONS
like- UTI ,OTITIS
MEDIA commonly
SURGICAL
CONDITIONS like
Appendicitis
KSHEER
DOSHAJ
58%
DANTODBHED
JNYA
23%
KSHEERALSAK
10%
BALGREHAJ
9%
BALATISAR
KSHEER DOSHAJ
DANTODBHEDJNYA
KSHEERALSAK
BALGREHAJ

4. ROOPA-:
Aa. KASHYAP
(MENTIONED IN VEDANA ADHYAY)
Aa.MADHAVKARA
DISCOLOURATION OF BODY VATAJ-
BLACKISH, FROATHY,ROUGH, ABD. PAIN WHILE
DEFECATION, IN SMALLAMOUNT PRAVRUTI
UNEASINESS IN MOUTH PITTAJ-
YELLOW,GREEN,BLACK,FOUL SMELLY DRAVA MALA,
DAHA,MURCHA,TRUSHNA
FATIGUE KAPHAJ-
SNIGDH,SHVETA,PICHHIL,GURU DRAVA MALA
PRAVRUTI, WITH KAPHA MALA,NAUSEA, TENESMUS
INSOMNIA SANIPATA-
ALL DOSHAS SYMPTOMS
NIVRUTI/ABSENCE OF VAYU KARMA SHOKAJ-
SIMILAR TO VATATISARA
SAMANYA LAKSHANA- ATI DRAVA MAL PRAVRUTI AAMAJ-
STOOL OF VARIOUS COLORS WITH ABD.PAIN

5. -IN TODAY’S ERA OF MULTIPLE DRUG RESISTANCE OF MICROBES AND THEIR ASSOCIATED SIDE
EFFECTS ESPECIALLY TO OUR PEDIATRIC GROUP.
-TREATMENT DIRECTLY FROM DRUGS OF NATURAL ORIGIN HAS A VERY SIGNIFICANT ROLE IN
MANAGEMENT OF THESE GLOBAL HEALTH ISSUES.
-PATHA ONE OF THE WIDELY USED MEDICINAL PLANT SINCE VEDIC PERIOD PROVENS TO BE VERY
SCIENTIFIC IN MANAGEMENT OF BALATISAR.
PATHA DVYA
1.Cissampelos pareira (Laghu Patha)
2.Cyclea peltata (Raj Patha)

6. MORPHOLOGICAL DESCRIPTION-:
CISSAMPELOS PAREIRA(LAGHU PATHA)
Belonging to MENISPERMACEAE Family,
Laghu Patha is a sub-erect or climbing herb,very
variable, lofty,slender,dioecious,perennial climber,
root stock is woody,
leaves usually peltate,orbicular-reniform, or ovate-sub
reniforem,
Base is truncate-cordate,glabrous or hairy above,
PETIOLE BEGINS FROM 1/3RD BENATH FROM
THE BASE,
Flowers are greenish yellow,
Seeds are horse shoe shaped.
This plant is common in orchards,hedges,parks and
gardens on moist soils,either creeping or twining around
other plants.
Distribution – Tropical & Sub-tropical regions like-
Himachal, Punjab, West Bengal, Rajasthan,Tamilnadu.

7. CYCLEA PELTATA (RAJ PATHA)
CYCLEA PELTATA belongs to MENISPERMACEAE
family which know as Rajpatha .
- A much branched climbing shrub found through out
South and East India Andaman and Nicobar Islands.
- Roots tuberous;
- Leaves are peltate, deltoid or ovate, acute ,truncate
or slightly sinuate at the base with rounded angles,
mucronate,
. more or less hairy on the nerves and veins, margin
often ciliate;
- flower in axillary panicles.

8. GANNA/GROUP-:
AA.CHARAK AA.SHUSHRUTA
STANYA SHODHANA
JWARHARA
SANDHANIYA
AARAGWADHADI
PIPPALYADI
BRUHATYADI
MUSTADI
PATOLADI
AMBASTHADI

9. RAS PANCHAK-:
PATHA DVYA BHAV PRAKASH
NIGHANTU
(guduchyadi varga)
NIGHANTU
AADARSH
(guducyadi varga)
DHANVANTAR
NIGHANTU
(guduchyadi
varga)
KAIYDEVA
NIGHANTU
(oushadha
Varga)
RAJ
NIGHANTU
(pipplayadi
Varga)
MADANPAL
NIGHANTU
(abhyadi varga)
RASA Katu Katu ,Tikta Tikta Katu Tikta Katu
GUNA Laghu,tikshna Laghu - Laghu, Tikshna Guru Laghu ,tikshna
VIRYA Ushna Ushan - Ushna Ushna Ushna
VIPAKA Katu Katu - Katu Katu Katu
PRABHAVA/
DOSHGHNTA
VAAT
SHLESHMHARI
TRIDOSHARA TRIDOSH
SHAMNI (KAPH
PITTA JWARV
-APHA)
TRIDOSHARA VAATPITTA
JWAR
-APHA
VAAT SHLESHM
HARA

10. PHYTOCHEMICAL CONSTITUENTS-:
Cissampelos pariera Cyclea peltata
ROOT
ALKALOIDS-
hayatine,hayatinine,hayatidine.
SOME BISBENZYLISOQUINOLINE
ALKALOIDS.
NITROGENOUS COMPOUNDS-
quercitol, sterol
ROOT & ROOT BARK
cyclanoline chlorides,seepeerine,berberine,
cissampeline,pelosine,1-curine,d-
isochondrodendrine with a saponin,d-
quercitol,cycleamine,menismin
iodide,cissamine chloride, cissampareine
LEAVES
1-berberine,cycleanine,hayatidine
hayatin,1-quercitol
ROOT
Bisbenzylisoquinoline alkaloids,
cycleapeltine,cycleadrine,cycleacuine,
cycleanorine & cycleahomine chloride.
LEAVES
ALKALOIDS-
cycleanine,berberine,hayatinin,hayatin,
hayatidin.

11. ACC. TO AA. CHARAK
 “PATHA SHAKAM TU GRAHI TRIDOSHJAM…….” (C.S.SU.CH.27/87-88)

12. ||श्रीभावमिश्रमवरमित||
||भावप्रकाशमिघण्टु||
भावप्रकाश-पूववखण्ड-मिश्रप्रकरण - ४. गुड
ू च्यामिवगव
पाठा
पाठाम्बष्ठाम्बष्ठकी च प्राचीना पापचेमिका |
एकाष्ठीिा रसा प्रोक्ता पामठका वरमिक्तक्तका ||१६३||
पाठोष्णा कटुका िीक्ष्णा वािश्लेष्महरी िघुुः |
हक्ति शूिज्वरच्छमिवक
ु ष्ठािीसारहृद्रुजुः |
िाहकण्ड
ू मवषश्वासक
ृ मिगुल्मगरव्रणान् ||१६४||

13. ||धन्वन्तररमिघण्टु||
धन्विररमनघण्टु - १. गुड
ू च्यामिवगव
पाठा
पाठाऽम्बष्ठाऽम्बष्ठकी च प्राचीना पापचेमिका |
वरमिक्ता बृहमिक्ता पामठका स्थापनी वृकी ||७८||
िाििी च वरा िेवी मिवृिाऽन्या शुभा ििा |
पाठा मिक्तरसा वृष्या मवषघ्नी क
ु ष्ठकण्डुनुि् ||७९||
छमिवहृद्रोगज्वरमजि् मििोषशिनी परा |
पाठाऽमिसारशूिघ्नी कफमपिज्वरापहा ||८०||

14. ||श्रीवैद्यक
ै यदेवपण्डितमवरमित||
||क
ै यदेवमिघण्टु||
क
ै यिेवमनघण्टु - १. ओषमधवगव
पाठा
पाठा क
ु चेिा स्थपनी िु वृद्धा चाश्मसुिी वरा ||६७६||
अम्बष्ठाऽम्बष्ठकी यूथा प्राचीनाऽमवद्धकमणवका |
एकीशा मििशािेवी बृहसरा ||६७७||
बृहमिक्ता पापचेिी िाििी वृकिन्त्यमप |
पाठा िु कटुका िीक्ष्णा िघुरुष्णा मििोषहा ||६७८||
हरेि् क
ु ष्ठज्वरच्छमिविाहािीसारद्रुजुः |
गुल्मकण्ड
ू मवषश्वासव्रणशूिगरक
ृ िीन् ||६७९||
पाठाफिं मपिहरं च शीिं कषायिाधुयवयुिं गुरु स्याि् |
िस्यैव पिं त्वथ शीिवीयव रूक्षं गुरु ग्रामह मनहक्ति िेहि् ||
६८०||

15. ||श्रीिरहररपण्डितमवरमित||
||राजमिघण्टु||
राजमनघण्टु - ६. मपप्पल्यामिवगव
पाठा
पाठाऽम्बष्ठाऽम्बमष्ठका स्याि् प्राचीना पापचेमिका |
पामठका स्थापनी चैव श्रेयसी वृक्तद्धकमणवका ||११९||
एकाष्ठीिा क
ु चैिी च िीपनी वरमिक्तका |
मिक्तपुष्प वरामिक्ता िीपनी मिमशरा वृकी |
िािवी च वरा िेवी वृिपणी मिदृमििा ||१२०||
पाठा मिक्ता गुरूष्णा च वािमपिज्वरापहा |
भग्नसन्धानक
ृ क्तिििाहािीसारशूिहृि् ||१२१||

16. |िृपिदिपालमवरमित||
||िदिपालमिघण्टु||
ििनपािमनघण्टु - १. अभयामिवगव
पाठा
पाठाऽम्बष्ठा बृहमिक्ता प्राचीनाऽम्बष्ठका सरा |
वरमिक्ता पापचेिी श्रेयसी वृद्धकमणवका ||२२२||
पाठोष्णा कटुका िीक्ष्णा वािश्लेष्महरा िघुुः |
हक्ति शूिज्वरच्छमिवक
ु ष्ठािीसारहृद्रुजुः |
िाहकण्ड
ू मवषश्वासक
ृ मिगुल्मोिरव्रणान् ||२२३||

17. USEFUL PART-;
 ROOT
 ROOT BARK
 LEAVES
 BHAUMIK KAAND/RHIZOME(P.V. SHARMA JI)

18. TOXICITY-:
 In the acute and sub-acute toxicity test, oral administration of drug, did not
produce any changes in behaviour and physiological activities on experimental
animals.
 Biochemical and Haematological analysis did not show any changes.
(Amresh et al.,2008)

19. MATERIALS-:
 This study is a review mainly based upon -:
1.SAMHITAS
2.LEXICONS
3.THESIS WORK
4.RESEARCH PAPERS
5. PHYTOPHARMACOLOGICAL STUDIES ON CONCERNED PLANT
6.ARTICLES
7.MODERN TEXTS
8.INTERNET SOURCES

20. RESULT & DISCUSSION-:
 AS PER THE CLASSICAL REFERENCES AVAILABLE-
We know, BALATISAAR is a disorder involving aanveha & purishveh srotas with an atipravruti kind of
sroto dushti ; being an aamj with samaan & apaan vayu,pachak pitta & jala dhatu (dosha-dushya).
-So line of treatment must include drugs which are - aam pachak,
grahi,
stambhan kari,
drav shoshak.
-Also samprapti vighatan & nidaan parivarjan are the main pillars of any treatment….So concern should be
made on main etieologies of BALATISAR which are-
 PREMATURE WEANING due to stanya dushti (bacteriogenic lactational mastitis)
 MALNUTRITION (WHICH IS PREDISPOSED BY LATER CAUSE).
-Hence, PATHA DVYA (Cissampelos pareira & Cyclea peltata) is an effective drug of choice against
“Balatisar/Childhood Diarrhea” having necessary properties and action required.

21.  As we know , PATHA having raspanchank-
Guna- LAGHU,TEEKSHNA
Rasa- TIKTA, KATU
Vipaka-KATUPAKI
Veerya-USHNA
TRIDOSHNASHAK (esp. K-P nashak)
Hence, .does aam pachan
.pacifying vitiated saman –apana vayu, pachak pitta & drava dushya.
“ATISARAGHNA KRMA of patha has been mentioned in various samhitas
& lexicons”
As per Aa.Charak,
“PATHA SHAKAM TU GRAHI TRIDOSHJAM…….” (C.S.SU.CH.27/87-88)

22. Anti-Diarrheal Action as per Modern
Research Parameters-:
 The hydro-ethanolic extract of C.pareira exhibit a dose dependent decrease in the total
no. of faecal droppings & 29.2-60.0% inhibition in castor oil induced diarrhea.
-It reduced the intestinal fluid accumulation & GI-Transit.11
 Also as we know, Childhood Diarrhea by E.coli is the second most common variety
(Rota-virus being the first).So Anti-Microbial acitivity of patha against this notorious
agent is the most appropriate action.
 There are some research work which proves this anti-bacterial action.
 In an in-vitro study anti-bacterial activity of ethanolic extract of Cyclea peltata has
shown maximum zone of inhibition against E.coli i.e. 32mm
& chloroform extract shown 17 mm against E.coli. 12

23.  This action was justified again by the fact of steroid presence and along with
amino acids could accountable to its higher anti-microbial activity shown
against E.coli.12

24. “PATHA in STANYA DUSHTI (one of
predominant cause of c.diarrhea)”-:
 Also As per Aa.Charak & Aa.Kashyap-:
who mentioned patha in stanyashodhan mahakashyay/group(group that
detoxifies the impure/infected stanya).
-which leads to its purification hence avoid premature-weaning…giving proper
feeding nutrition to children for building immunity.
-beneficial to both dhatri as well as shishu.
 Roots and stem have shown anti-bacterial against K.pnuemonae,P.aeruginosa,
S.aureus.
Leaf extract against E.coli(methanolic extract)
Anti-inflammatory,Analgesic,anti-pyretic,Immunomodulatory,anti-oxidant,anti-
diarrheal. (kamal etal. 2k17).

25. CONCLUSION-:
 Childhood Diarrhea is one of the concerned GLOBAL HEALTH ISSUE in today’s era.
 Defined as change in frequency & consistency of stool more then 03 in 24 hours usually subside
within 07 days if it is more then that duration with insidious onset k/a-chronic.
 Complications of DEHYDRATION & MALNUTRTION are common post diarrhea which can
lead to fatal condition even death.
 PATHA DVYA (Cissampelos pareira & Cyclea peltata) is the best drug of choice for this case.
 Stanya dushti among lactating mothers is also one of the cause for c.diarrhea due to pre-mature
weaning & malnutrition.
 Various Samhitas and lexicons support the fact of STANYASHODHAK & ATISARGHNA property
of patha.
 Researches proved the anti-bacterial action of patha(Cyclea peltata) against E.coli which is the
second most prevalent cause of childhood diarrhea.
 Patha having steroidal and amino acid content which accounts to rectify its anti-microbial
property against DIEC (DIARRHEA INDUCING E.COLI.).
 Also Cyclea peltata is proven more effective then Cissampelos pareira by proving its anti-
microbial efficacy.
 Yet there almost negligible evidences against toxicity caused by patha.
 Pediatric Dosage of patha with suitable anupana is as per genral rules of aushadh sewan for kumar
 e.g.- patha moola churan with madhu or tandulodak etc.

26. References-:
1. Charak Samhita-Agnivesh kruta revised by Aa. Charak & Aa. Drurbala-Vidyotini teeka by commented by - Dr.Gorakhnath
Chaturvedi,Pt.Kashinath Samgandi-Chaukhamba Publications.
2. Kashyap Samhita(Vrudh Jivikiya Tantra)-by Dr.PremVati Tiwari Ji
3. Madhav Nidan-Sri Madhavkara virachitam Madhukosh teeka Commented by- Aayurvedaacharya Yadunandan Upadhyaya.
4. Dravya guna Vigyana by- Aa. Priyavrata Sharma Ji
5. BhavPrakash Nighantu-Aa.BhavMishra Commented By-PadmaShri Proff. Krishna Chandra Chunekar.
6. RajNighantu-Sri Narhari Virachitam-Abhidhan Chudamani Edited by-Dr.Ashok Bishnoi & Dr.Amritpal Singh.
7. Kaiydev Nighantu-PathyaApathya Vibhodhak By-Aa.PriyaVrat Sharma & Dr.Guru Prasad SHARMA
8. MadanPal Nighantu-NrupMadanpal virachit –Khemraj Krushan Das Prakashan Bambai.
9. Nighantu Aadarsh-by Bappalal G. Vaidya printed by-Chaukhamba Bharat Academy
10. Text Book of PEDIATRICS by- Dr. O.P. Ghai.
11. Suman S.,Nishteswar K. – Review on Cissampelos pareira & Cyclea peltata (PATHA DVYA)
PhtoPharmacological Prespective.International Journal of Ayurvedic Medicene.
12. Maniarasan U.,Keerthiga M., Nagarajan N.-Comparetive investigation on anti-microbial and phytochemical profiling of Cyclea
peltate and Tiliocora acuminate
Journal of Applied Biology & Biotechnology.
13. Bhardwaj R, Panwar S, Verma D, Kumar A “A Critical Analysis Of
Bacteriogenic Lactational Mastitis (Stanyadushti) And Its Management w.s.r To Kashyapa Samhita”
International journal of Ayurveda & Yog.
14.World Health Organisation
15.UNICEF.