GJRMI - Volume 4, Issue 8, August 2015 by Dr. Hari Venkatesh.K.Rajaraman

Indexing links of GJRMI GJRMI has been indexed in the Following International Databases

Google Scholar, ProQuest, DHARA online; DOAJ; Index Copernicus; NewJour; ScienceCentral; getCITED; RoMEO; Geneva Foundation for Medical Education & Research ; Catalog ebiblioteca; Ayurbhishak; Medicinal plants (Dravya Guna); Indianscience.in; Necker; Hong Kong University of Science and Technology Library; University of Zurich; University of Kansas; Western Theological Seminary; CaRLO; Mercyhurst University; University Library of Regensberg; WZB; Jadoun science; University of California, San Fransisco (UCSF Library); University of Washington; University of Saskatchewan; University of Winnipeg; Universal Impact Factor; Global Impact factor, Ulrich’s Periodicals Directory, New York Public Library, WISE, Cite factor, DRJI, Miami University Libraries, AYUSH RESEARCH PORTAL - Department of AYUSH, Ministry of Health & Family welfare, Govt. of India -

Chakradatta Ayurveda Chikitsalaya, Mysore. (Panchakarma & Netra Roga Chikitsa Kendra)

Get treated through Ayurveda, at our Hospital. (Exclusive Panchakarma Therapy available with accommodation) Address: Beside Vikram Jyothi Hospital, Temple Road, V V Mohalla, Mysore – 12, Karnataka, India.

Contact: Mobile: +919980952358, +919035087999 E- mail: raviamrita.kumar9@gmail.com

Consultant Physician: Dr. Ravi Kumar. M. (Specialized in different types of Keraliya Ayurvedic treatments especially in ENT & Eye diseases)

Arudra Ayurveda, Bangalore (A PANCHAKARMA TREATMENT CENTRE)

All types of Keraliya Ayurvedic treatments available for all the diseases) Ayurvedic Treatments in the following diseases: Eye diseases, Asthma, Skin diseases, Joint diseases, Diseases of the nervous system, Gynaecological & Obstetric diseases, Obesity, Asthma, Stress, Anxiety, Insomnia, Depression, Loss of Memory & Concentration, Piles, digestive tract diseases, Infertility etc. Address: No. 40, IInd cross, KV Pai Layout, Konanakunte, Near Silicon city school, Bangalore – 62, Karnataka, India.

Contact: Mobile: +919480748861

An International, Peer Reviewed, Open access, Monthly E-Journal

ISSN 2277 â&#x20AC;&#x201C; 4289 www.gjrmi.com Editor-in-chief Dr Hari Venkatesh K Rajaraman

Managing Editor Dr. Shwetha Hari

Administrator & Associate Editor Miss. Shyamala Rupavahini

Advisory Board Prof. Rabinarayan Acharya Dr. Dinesh Katoch Dr. S.N.Murthy Dr. Mathew Dan Mr. Tanay Bose Dr. Nagaraja T. M.

Editorial board Dr. Nithin Ujjaliya Mr. Sriram Sridharan Dr. Ashok B.K. Dr. Madhu .K.P Dr. Sushrutha .C.K Dr. Vidhya Priya Dharshini. K. R.

Honorary Members - Editorial Board Dr Farhad Mirzaei Dr. Sabarinath Subramaniam Dr. Yogitha Bali

INDEX – GJRMI - Volume 4, Issue 8, August 2015 INDIGENOUS MEDICINE Ayurveda – Agada Tantra A CLINICAL STUDY ON THE EFFICACY OF KARANJA BEEJA TAILA ALONG WITH DOOSHIVISHARI AGADA IN THE MANAGEMENT OF PSORIASIS Ittoop J Ancheril*, Ashwin Kumar Bharati, Sailekha P, Niveditha PN, Deepthi Ittoop

162–171

Review Article – Ayurveda – Moulika Siddhanta HEPATOPROTECTIVE PROPERTY OF VARNYA MAHAKASHAYA – AN INNOVATIVE INSIGHT Sapna Narasanagi*, Sujnana VS, Jyoti Devangamath, Shreevathsa

172–181

COVER PAGE PHOTOGRAPHY: DR. HARI VENKATESH K R, PLANT ID – IMMATURE FRUITS OF SHRI TAALA – CARYOTA URENS L.* OF THE FAMILY ARECACEAE PLACE – KOPPA, CHIKKAMAGALUR DISTRICT, KARNATAKA, INDIA *BOTANICAL NAME VALIDATED FROM www.theplantlist.org AS ON 10/09/2015

Research article A CLINICAL STUDY ON THE EFFICACY OF KARANJA BEEJA TAILA ALONG WITH DOOSHIVISHARI AGADA IN THE MANAGEMENT OF PSORIASIS Ittoop J Ancheril1*, Ashwin Kumar Bharati2, Sailekha P3, Niveditha PN4, Deepthi Ittoop5 1, 3, 4

Final year Postgraduate Scholar, Department of Agada tantra, SDM College of Ayurveda, Hassan, Karnataka, India 2 Professor and H.O.D.- Department of Agada tantra, SDM College of Ayurveda, Hassan, Karnataka, India 5 Resident Medical Officer, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India *Corresponding Author: Email: ittoopjancheril@gmail.com

Received: 22/06/2015; Revised: 20/07/2015; Accepted: 10/08/2015

ABSTRACT Psoriasis is one of the oldest recorded skin diseases. The prevalence of psoriasis in our society is increasing day by day.Because of its un-known etiology, recurrence and unsuccessful treatment; it is still a challenge to the medical fraternity. Here an effort is made to see the efficacy of Karanjabeejataila (seed oil of Pongamia pinnata) along with dooshivishariagada tablet in psoriasis. This is a single group study with a sample size of 30 patients. Diagnosed cases of psoriasis were selected and were administered karanjabeejataila for external application along with dooshivishariagada administered internally for 14 days. All the results were analyzed statistically for comparing the net effects before and after treatment. Follow up was done on 7th& 14th day. The overall result was that the therapy got highly significant results in reducing main parameters like scaling by 84 % and thickness of lesions by 57 %. It was concluded that the combination of Karanjabeejataila along with dooshivishariagada showed significant results in reducing parameters like scaling, erythema, thickness of lesions, degree of involvement of the lesions and in reducing the total PASI score of psoriatic cases. KEY WORDS: Psoriasis, Karanjabeejataila, DooshivishariAgada, PASI score, Pongamia pinnata

Cite this article: Ittoop J Ancheril, Ashwin Kumar Bharati, Sailekha P, Niveditha PN, Deepthi Ittoop (2015), A CLINICAL STUDY ON THE EFFICACY OF KARANJA BEEJA TAILA ALONG WITHDOOSHIVISHARI AGADA IN THE MANAGEMENT OF PSORIASIS, Global J Res. Med. Plants & Indigen. Med., Volume 4(8): 162â&#x20AC;&#x201C;171

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162â&#x20AC;&#x201C;171

INTRODUCTION: Psoriasis is a non-infectious chronic skin disease. The precise cause of psoriasis is still unknown. The prevalence of psoriasis in our society is increasing day by day. It varies from 0% to 11.8% in different populations around the world. In India the prevalence of psoriasis patients among total skin patients is 2.3% & male to female ratio is 2.46:1 (Dogra S, 2010). The cause of psoriasis is generally believed to be due to damage in factors of immune system & enzymes that control skin cell division. Abnormal immune response causes rapid production of immature skin cells and inflammation.Weather, stress, injury, infection,incomplete protein digestion, bowel toxemia, immunological factors and certain medicationtriggers the disease process leading to the onset and worsening of psoriasis.Various food,environmental & cosmetic factors have been suggested as causing & aggravating psoriasis- environmental pollutants & toxicants, chemical cosmetics like deodorants, shampoos, gels, sprays, conditioners, colors& hair dye etc.Role of drugs such as beta blockers, NSAIDs, synthetic anti-malarial drugs,tetracycline& lithium in the induction & exacerbation of psoriasis have also been studied (Tsankov N, Angelova I, Kazandjieva J, 2000). Withdrawal of corticosteroids (topical steroid cream) can aggravate the condition due to so called 'rebound effect'.Simple sugars in soft drinks,cakes and candies,caffeine containing foods and saturated fats in red meat and eggs are some other aggravating factors (August McLaughlin, 2013) of psoriasis. Because of its unknown etiology, recurrence and unsuccessful treatment, it is still an untackled challenge to the medical fraternity. The existing pattern of Ayurvedic approach to psoriasis is through the principles of treatment of kushta (skin diseases) according to nidana (etiology) and samprapti (pathogenesis), but still recurrences are not infrequent. In Ayurvedic dermatology, normal skin complexion and pathological lesions of skin are attributed to diet & regimens of the individual. Kushta is the banner which is used

to explain almost all dermatological ailments in Ayurveda with utmost clarity. Even though kushta (skin disease) is considered as a disease of bahyarogamarga (external route of disease causation) (Srikantamurthy K.R, 2000), the initiation of pathogenesis is within the gastrointestinal tract. Acharya Charaka emphasizes the unparalleled influence of diet in the etiopathogenesis of all diseases. At the present context people are frequently exposed to various kinds of toxins in food as well as the environment which in turn leads to accumulation of toxins in our body.This state is considered under the concept of dooshivisha (cumulative toxicity) which could be manifested as various skin disorders (Srikanthamurthy K.R 2005; Sharma P.V., 2000). Acharyas mentions rakthadushti (vitiated blood) (Srikantamurthy K.R, 1997) and kushta (skin diseases) as manifestations of dooshivisha. Dooshivishajanyakushtaroga (skin diseases caused by cumulative toxicity) cannot be treated effectively with common kushta (dermatological) treatment only, whereas it can be more effectively managed with vishahara (anti-toxic) drugs. It is the need of the hour to develop economic, easily available and an efficacious medicine for psoriasis. Use of agada (anti-toxic drugs) in chronic kushtaroga (skin diseases) have been mentioned in classics (Sharma P.V, 2000),In this regard, karanjabeeja (seed of Pongamia pinnata) which is a potent vishashamana (anti-toxic) and kushtagna (curing skin disease) drug (Ayurvedic pharmacopoeia of India, 1999; Pandey G,2001;Srikantamurthy.K.R, 2004) has been taken for the study to analyze the efficacy of its taila (oil) applied externally along with Dooshivishariagada (Srikantamurthy K.R, 1997), a potent anti-toxic formulation for internal administration in the management of psoriasis. MATERIALS AND METHODS Data were collected from patients attending OPD of SDM College of Ayurveda and Hospital, Hassan, Karnataka, India fulfilling the clinical criteria. Patients were randomly

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

selected irrespective of their socio-economic, educational or religious status. Ethical clearance Number SDMCAH/IEC/50/13–14 was granted from the institution for the study. Preparation of drug Karanjabeejatailam:

and 20 liters of oil was obtained from it. The oil was bottled into 200 ml air tight amber colored bottles. The drug was checked with the criteria mentioned in the classical Ayurvedic texts and modern botanical parameters with experts before using them in the study.

Karanjabeeja (seeds of Pongamiapinnata) was collected from Sidhvaidyasramam, kerala Table 1: Ingredients of DooshivishariAgada: Sl No

DRUG

BOTANICAL NAME

Part used

Form

Pippali

Piper longum Linn.

Fruit

Powder

Dhyamaka

Leaves

Powder

Jatamamsi

Root

Powder

Lodra

Cymbopogon martinii (Roxb.)Wats. Nardostachys jatamamsi DC.(N. grandiflora) Symplocos racemosa Roxb.

Stem bark

Powder

5 6

Ela Suvarchika

Elettaria cardamomum Maton Tribulus terrestris Linn.

Fruit Fruit

Powder Powder

Kutannatum

Root bark

Powder

Natam

Oroxylum indicumLinn. (Benth. ExKurz. Valeriana wallichii D.C

Root

Powder

Kusta

Saussurea lappa C.B. Clarke.

Root

Powder

Yastimadhu

Glycyrrhiza glabra Linn.

Root

Powder

Chandana

Santalum album Linn.

Heart wood

Powder

Gairika

Red ochre

Collection of drug: Raw drugs were collected from Sidhavaidyasramam, Thrissur district, Kerala, India Preparation: All the drugs were taken in equal quantity. They were made into powder separately. Then they were mixed together and sufficient quantity of water was added. Bhavana (ticturation) was done for 3 days until vatipaka (pill form) was obtained. Then they were made into vati (pills) and kept for drying. Dried pills were used for the clinical study.the drugs were send to S.D.M. centre for research in ayurveda and allied sciences, Udupi, for analysis - 266/13070101 Diagnostic criteria Diagnosed cases of Psoriasis

Powder Inclusion criteria: 1. Psoriasis patients which were diagnosed as per the criteria. 2. Patients within the age limit of 16-60 years. Exclusion criteria: 1. Subjects with uncontrolled metabolic disorders like diabetic dermopathy pretibial myxedema that may interfere with the course of treatment. 2. Pregnant women & lactating women Assessment criteria: PASI Scoring: The current gold standard score for assessment of Psoriasis (Carlin CS, 2004). • Erythema • Thickness • Scaling • Degree of involvement

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

Table 2: Scoring pattern Sl.No. 1.

Domain Erythema

Criteria none light red red,but not deep red very red extremely red Scaling none Scaling is visible by scratching skin moderate powderiness with small lifting scales heavy powderiness with cracking & lifting scales heavy cracking & lifting scales, scaling falls without rubbing Thickness none barely palpable elevation slight elevation moderate elevation marked ridge Degree of none Involvement 1–9 % 10–29 % 30–49 % 50–69 % 70–89 % 90–100 %

Overall assessment Overall assessment of the results was made by considering the collective effect on all the parameters and total PASI score. Medicines used in the study are: 1. Karanjabeejatailam-For external application 2. DooshivishariAgada- For internal administration

Score 0 1 2 3 4 0 1 2 3 4 0 1 2 3 4 0 1 2 3 4 5 6

application and DooshivishariAgada tablet internally daily for 14 days. The patients were assessed before and after treatment. Follow up Study- The changes with the treatment were tobe observed & recorded on 7th& 14thday in the proforma of case sheet prepared for the study.

Sampling methods: Convenient sampling method was adopted. 30 psoriasis patients were selected from OPD according to the criteria.

Assessment of results:

Study design: A clinical survey of patients attending OPD of SDMCA, Hassan, Karnataka, India was made and patients fulfilling the criteria as per the proforma were selected for the study. A clinical evaluation of patients wasdone by collection of data through information obtained by detailed history & physical examination. The study was an open label clinical study in a single group at OPD level in 30 patients. They were given Karanjabeejataila for external

RESULTS

The parameters of base line data to the follow up and post medication status were compared for assessment of the results. All the result analysis was done by using SPSS ver.20 software, and obtained results were interpreted statistically for „p‟ value.

Erythema of head: The results were compared before treatment and after treatment and overall result of treatment for variable erythema of head with

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

Wilcoxon‟s test, significant results were obtained with Z vaue of −2.449 and P value 0.014. Erythema of upper limb The results were compared before treatment and after treatment and overall result of treatment for variable erythema of upper limb with Wilcoxon‟s test, significant results were obtained with Z vaue of −2.449 and P value 0.014. Erythema of trunk The results were compared before treatment and after treatment and overall result of treatment for variable erythema of trunk with Wilcoxon‟s test, significant results were obtained with Z vaue of −2.646 and P value 0.008. Erythema of lower limb The results were compared before treatment and after treatment and overall result of treatment for variable erythema of lower limb with Wilcoxon‟s test, significant results were obtained with Z vaue of −2.828 and P value 0.005. Thickness at head The results were compared before treatment and after treatment and overall result of treatment for variable thickness at head with Wilcoxon‟stest, highly significant results were obtained with Z vaue of −3.357 and P value 0.001. Thickness at upper limb

The results were compared before treatment and after treatment and overall result of treatment for variable thickness at upper limb with Wilcoxon‟stest, highly significant results were obtained with Z vaue of −3.873 and P value 0.000. Thickness at trunk The results were compared before treatment and after treatment and overall result of treatment for variable thickness at trunk with Wilcoxon‟stest, highly significant results were

obtained with Z vaue of −3.357 and P value 0.001. Thickness at lower limb

The results were compared before treatment and after treatment and overall result of treatment for variable thickness at lower limb with Wilcoxon‟stest, highly significant results were obtained with Z vaue of −3.945 and P value 0.000. Scaling at head The results were compared before treatment and after treatment and overall result of treatment for variable scaling at head with Wilcoxon‟s test, highly significant results were obtained with Z vaue of −4.065 and P value 0.000. Scaling at upper limb

The results were compared before treatment and after treatment and overall result of treatment for variable scaling at upper limb with Wilcoxon‟stest, highly significant results were obtained with Z vaue of −4.021 and P value 0.000. Scaling at trunk The results were compared before treatment and after treatment and overall result of treatment for variable scaling at trunk with Wilcoxon‟stest, highly significant results were obtained with Z vaue of −3.666 and P value 0.000. Scaling at lower limb The results were compared before treatment and after treatment and overall result of treatment for variable scaling at lower limb with Wilcoxon‟stest, highly significant results were obtained with Z vaue of −4.914 and P value 0.000. Degree of involvement at head The results were compared before treatment and after treatment and overall result of treatment for variable degree of involvement at head with Wilcoxon‟s test, significant results

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

were obtained with Z vaue of −2.646 and P value 0.008.

Degree of involvement at upper limb

Degree of involvement at lower limb

The results were compared before treatment and after treatment and overall result of treatment for variable degree of involvement at upper limb with Wilcoxon‟stest, significant results were obtained with Z vaue of −2.828 and P value 0.005.

The results were compared before treatment and after treatment and overall result of treatment for variable degree of involvement at lower limb with Wilcoxon‟stest, significant results were obtained with Z vaue of −2.887 and P value 0.004.

Degree of involvement at trunk

Total pasi score

The results were compared before treatment and after treatment and overall result of treatment for variable degree of involvement at trunk with Wilcoxon‟stest, significant results

When the total PASI score results were analysed using repeated anova test, highly significant results were obtained in all pair wise comparisons with P value of 0.000.

Table no. 3: Results-Wilcoxon’s signed rank test: Parameter Erythema head Erythema-upper limb

Negative ranks N MR SR 6 3.50 21.0 6 3.50 21.0

Positive ranks N MR SR 0 .00 0.00 0 .00 0.00

Ties Total Z Value 24 30 -2.449 24 30 -2.449

P Remark value 0.01 S 0.01 S

Erythema-trunk

4.00

28.00

.00

0.00

-2.646

0.008

Erythema-lower limb

4.50

36.00

.00

0.00

-2.828

0.005

Thickness-Head

12 6.50

78.00

.00

0.00

-3.357

0.001

Thickness-Upper Limb

15 8.00

120.00

.00

0.00

-3.873

0.000

Thickness-trunk

12 6.50

78.00

.00

0.00

-3.357

0.001

Thickness-Lower Limb

17 9.00

153.00

.00

0.00

-3.945

0.000

Scaling-head

19 10.00

190.00

.00

0.00

-4.065

0.000

Scaling-Upper Limb

19 10.00

190.00

.00

0.00

-4.021

0.000

Scaling-trunk

16 8.50

136.00

.00

0.00

-3.666

0.000

Scaling-Lower Limb

25 13.00

325.00

.00

0.00

-4.914

0.000

Degree-of involvementhead Degree-of involvementUpper Limb Degree-of involvementtrunk Degree-of involvementLower Limb

4.00

28.00

.00

0.00

-2.646

0.008

4.50

36.00

.00

0.00

-2.828

0.005

4.00

28.00

.00

0.00

-2.646

0.008

5.00

45.00

.00

0.00

-2.887

0.004

N- Number of samples, MR- Mean ranks, SR- Sum of Ranks, S- Significant, HS- Highly significant

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

Table 4: Repeated ANOVA Test- PASI Score Parameter

PASI 1st day PASI 7th day th

PASI 14 day

Mean

F value

P value

Size Green effect house geisser error df

Remark

1.194

46.715

0.000

0.617

12.290 30

9.980

46.323

7.157 N- number of samples, Df- Degrees of Freedom

DISCUSSION There is no single variety of kushta, which can be rightly correlated to psoriasis.Psoriasis can be chiefly divided into four types on the basis of its appearance namely- plaque, guttate, erythrodermic and pustular. Plaque psoriasis is characterized by well defined, noninflammatory lesions covered with uniform scales, while guttate is characterized by multiple, small, oval, drop like lesions with scaling (Roxanna Gunter, 2011). Here, an effort has been taken to correlate plaque and guttate types with features of ekakushtha (a type of skin disease). In ekakushtha, the characteristics are aswedanam (absence of sweat), mahavastum (larger extent) and matsyashakalopamam (fishy scales) (R.K Sharma et al., 1988). The lesions of plaque type is also found all over the body and though small and drop like, guttate psoriasis is also found all over the body which can be correlated with ekakushtha. Other striking similarity found was, scaling with characteristic shiny appearance found both in ekakushtha and plaque –guttate types of psoriasis. The lesions of plaque and guttate type are dry and rough which can be correlated to ekakushtha. Also, other symptoms pertaining to vata (humour) and kaphadosha (humour) are present in both types. E.g- rukshata (dry skin –vata) and bahalatva (macules and papules- kaphadosha), kandu (Itching-kaphadosha) etc. Also Bhavamishra has mentioned “chakrakara” (round) appearance of ekakushtha which is similar to drop-like lesion of the guttate psoriasis. Thus we can find striking similarity between plaque – guttate psoriasis and ekakushtha in Ayurveda.

In kitibha (another variety of skin disease) the lesions are usually sukshma (small in size) and sravi (exudation) (R.K Sharma et al., 1988). But in psoriasis, the lesions are large and dry in nature. In sidhma (another variety of skin disease), the lesions are mostly found in urdhvakaya (upper portion of body) but in psoriasis the lesions are distributed all over the body. In sidhma, there will be scaling which is like raja (dust particles) &kandu (itching) is also present but in psoriasis there is scale formation andkanduis usually absent. Thus kitibha & sidhma cannot be exactly correlated with psoriasis. Description and characteristic features of ekakushtha very closely resemble the descriptions of psoriasis has been tabulated (Table 4): Probable mode of action of drug: As rightly said by all acharyas, some drugs may act through rasa (taste), some through guna (attributes), veerya (potency), vipaka (post-digestive effect) or prabhava (dominant function) or it may be the combined effect of all the ingredients (P.V.Sharma, 1998). Hence, to understand the mode of action of medicines, it is necessary to understand the pharmacodynamics by understanding dominant properties. Karanjabeeja is having katuvipaka (pungent- post digestive effect), katutikta rasa (pungent- bitter taste), laghurukshaguna (easily digestable and dry), ushnaveerya (hot potency), vatakaphashamaka (pacify vata and kapha humours) property and kushthaghna karma (skin disease curing property). Though kushtha (skin disease) is tridosha (involvement of three humours) dominant disease, the predominance of vata and kapha is found in psoriasis.

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

Table 5: Comparison of Ekakushta and Psoriasis Ekakushtha

Psoriasis

Aswedanam

The lesions of this disease are dry and rough

Mahavastum

Lesions are found all over body. The Un-involved skin is also abnormal. Well defined raised macules, papules & plaques of erythema found which are covered with silvery scales. The lesions are raised & erythematous, thick Non-indurated lesion becomes black in colour.

Matsyashakalopam Krishna –Aruna Varna (black- red colour)

Katu rasa (pungent taste)-One property of katu rasa described by acharyacharakais “Marganvivrunoti” which means it dilates the srotas (channels) and thus acts on cellular level and stops the uncontrolled production of cells which causes hyperkertanization. Other properties of katu rasa described by acharyacharaka are vishaghna (anti-toxic), kandughna (anti-itching) and vranaprasadana (improves skin complexion).

Ushnaveerya (hot potency)-According to Ashtangasangraha, ushnaveerya has vatakaphashamaka (pacifies vata and kapha) property and according to AshtangaHrudaya, it has ashupaka (sudden ation) property through which it acts quickly at minute channels. Looking to the karmas, it is clear that the drug is having kushthaghna, kandughna and vrunaghna (wound healing) properties which clearly explains its mode of action in kushta.

Tikta rasa (bitter taste) has the property of raktaprasadana (blood purification), vishaghna, kushthaghna, kandughna (antiitching). It also has kaphaghna (pacifies kapha humour) property. Laghuguna (easy to digest) possess kaphashamaka (pacifies kapha humour) property. By its srotoshodhaka (clearing the channels) property, it acts on minute channels and removes the amavisha (indigested food). Acharyasushruta has described lekhana (scraping) and ropana (wound healing) properties of laghuguna. Lekhana property might help in management of hyperkertanization which leads to scaling.

DooshivishariAgada: It is indicated in all types of visha, i.e. Dooshivishari Agada is effective in sthavara, jangama (inanimate and animate) and also garavisha (poison). The properties of Dooshivishariagada are raktashodhaka (blood purifying) and vishaghna (antitoxic). Raktashodhaka property corrects the vitiated raktadhatu (blood) and helps in maintaining normal functions of raktadhatu. Vishaghna (anti toxic) property helps in detoxifying the garavisha, which is having alpavirya (mild potency) and is deep seated in raktadhatu.

Acharya Hemadri has given shoshana (shrinking) property of ruksha (dry) guna. It also has kaphashamaka property. Acharya Hemadri has described shodhana (cleansing) property of tikshna (intense) guna. Acharya Madhava has described kaphavatahara (pacifies kapha and vata) and lekhana (scraping) property of tikshna (intense) guna.

The drug profile shows that the general properties are predominant of madhurakashaya rasa, (sweet-astringent taste) laghurookshaguna (easy to digest and dry), sheethaveerya (cold potency) and katuvipaka(pungent post digestive effect). Being a combination of drugs bearing similar qualities, a synergistic drug action can be assumed. Due to the above-mentioned properties, Dooshivishariagada is tridoshahara (pacifies three humours), twakdoshahara (cures

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162â&#x20AC;&#x201C;171

skin diseases) and rakthasodhaka. Almost all the drugs of this yoga are seethaveerya (cold potency) in nature, capable of antagonizing the adverse effect of visha. Drugs of this yoga (recipe) are fairly met within many agada (antitoxic) preparations, some of these drugs are individually vishagna (anti-toxic) and again certain combination of drugs would bring about miraculous effects apart from their total effects (Yoga Samyogajam Phalam).

The drugs are prominent in the rasas (tastes) which are said to beantitoxic ie madhura (sweet), tikta(bitter), katu (pungent) and kashaya (astringent). Almost all the drugs are laghu (easy to digest) and rooksha (dry). Thus the combination itself is highly potent and can cure Dooshivisha with signs and symptoms of kushta (skin disease) which is a kaphavata prominent disorder.

Table no. 6: Properties of individual drugs of DooshivishariAgada Drug

Rasa

Guna

Veerya

Vipaka

Karma

Pippali

Madhura, Katu, Tikta

Laghu, Snigdha

Anushna

Madhura

Tridoshakara

Dhyamaka

Katu, Tikta

Ushna

Katu

Pittahara

Jatamansi

Tikta, Kashaya Kashaya

Laghu, Rooksha, Teekshna Laghu

Sheeta

Katu

Tridoshahara

Laghu

Sheeta

Katu

Kaphapittanut

Sheeta

Madhura

Kaphavatahara

Sheeta

Madhura

Vatanut

Sheeta

Katu

Ushna

Katu

Ushna

Katu

Kapha-pitta Shamaka Kapha-vata Hara Vata-kapha Hara

Sheeta

Madhura

Vata-pittajit

Sheeta

Katu

Sheeta

Madhura

Kaphapittahara Pittanasaka, Kaphajit

Lodhra

Laghu, Rooksha Madhura, Guru, Gokshura Katu Snigdha Tiktha, Laghu, Syonaka Kashaya Rooksha Tikta, Katu, Laghu, Tagara Kashaya Snigdha Tikta, Katu, Laghu, Kushta Madhura Rooksha, Teekshna Guru, YashtiMadhu Madhura Snigdha Madhura, Laghu, Chandana Tikta Rooksha Madhura, Snigdha, Gairika Kashaya Vishada Ela

Madhura

CONCLUSION The present day polluted environment, unhealthy and unwholesome foods& stressful regimencan trigger accumulation of toxins in the body. Certain drugs, virudhahara (incompatible food), mental stress are

aggravating factors in psoriasis. Virudhavihara (incompatible life style) will also contribute in the causation and exacerbation of kushta. Addiction to tobacco, non-vegetarian diet, virudhahara and even injudicious vegetarian diet has relationship with psoriasis

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 162–171

manifestations. The symptoms of psoriasis can be compared with features of ekakushta. Karanjabeejataila has got potent kushtagna properties. Karanjabeejataila for external application along with dooshivishariagada is effective in reducing the main symptoms of psoriasis. The combination is highly effective

in reducing scaling upto 84% and thickness of lesions upto 57 %. It is also effective in reducing erythema upto 20 % & degree of involvement of lesions upto 30 %. Hence, agadayogas (anti-toxic formulations) can be effectively tried in kushta and other related complications of dooshivisha.

REFERENCES

Sharma P.V. (1998) Charakasamhitha vol.1, 5thedition.Varanasi:Chaukhambhaorien talia publications.

August McLaughlin, (2013), Foods That Make Psoriasis Worse. [Online] Available from: http://www.livestrong.com/article/337096foods-that-aggravate-psoriasis/ (accessedon 18/5/2015)

Sharma P.V. (2000) Charakasamhitha vol.2, 5thedition.Varanasi:Chaukhambhaorien talia publications.

Carlin CS, Feldman SR, Krueger JG, Menter A, Krueger GG. (2004) A 50% reduction in the Psoriasis Area and Severity Index (PASI 50) is a clinically significant endpoint in the assessment of psoriasis. J Am AcadDermatol. Jun; 50 (6):859– 66.

Sharma R.K (1988) Carakasamhita vol.3, first edition. Varanasi: Chowkhamba Sanskrit series office.

Dogra S, Yadav S. (2010) Psoriasis in India: Prevalence and pattern. Indian J DermatolVenereolLeprol;76:595–601.

Srikantamurthy K.R (2000), rd Ashtangasangrahavol.1.3 edition.Vara nasi: Chaukhambhaorientalia publications.

Government of India, (1999) Ministry Of Health And Family Welfare. Ayurvedic pharmacopoeia of India. part 1,vol.2 Department Of Indian Systems of Medicine publications.

Srikantamurthy. K.R. (2004), Susruthasamhitha.vol.1.2ndedition.Vara nasi:Chaukhambhaorientalia publications.

Pandey.G. (2001) DravyaGunaVijnan part21stedition .Varanasi: Krishnadas Academy publications.

Srikanthamurthy K.R (2005), Susruthasamhitha, vol.2,2ndedition.Varanasi:Chaukhambh aorientalia publications.

Roxanna Gunter (2011), The effect of a homeopathic complex in psoriasis https://ujdigispace.uj.ac.za/bitstream/h andle/10210/7888/Gunter.pdf?sequenc e=1

Source of Support: NIL

Srikantamurthy K.R (1997), Ashtanga Hridaya of vagbhata vol.3.2nd edition. Varanasi: Krishnadas Academy publications.

Tsankov N, Angelova I, Kazandjieva J. (2000), Drug-induced psoriasis. Recognition and management. [online] Available from:http://www.ncbi.nlm.nih.gov/pub med/11702297(accessed on 13/3/2015)

Conflict of Interest: None Declared

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Review Article HEPATOPROTECTIVE PROPERTY OF VARNYA MAHAKASHAYA – AN INNOVATIVE INSIGHT Sapna Narasanagi1*, Sujnana VS2, Jyoti Devangamath3, Shreevathsa4 1, 2, 3

P.G. scholar, Department of PG studies in Ayurveda Siddhanta, Government Ayurveda Medical College, Mysuru, Karnataka, India 4 HOD and Professor (I/C) Department of PG studies in Ayurveda Siddhanta, Government Ayurveda Medical College, Mysuru, Karnataka, India *Corresponding Author: E-mail: narasanagi.sapna4@gmail.com; Mob: 7795409892

Received: 24/05/2015; Revised: 15/07/2015; Accepted: 31/07/2015

ABSTRACT Liver is considered to be one of the vital organs which help in maintaining the health of the human body. Not many of the physicians relate the outer glow of complexion to the liver health. After critical analysis it can be understood that there is a tremendous importance of liver function to one’s appearance. Modern lifestyles can overstress the liver and make it malfunctioning. No significant and safe hepato-protective drugs are available in existing contemporary therapeutics. Liver is the metabolic factory of the body producing energy to sustain the thousands of functions performed every minute by all body’s cells. Skin cells require energy to eliminate toxins, repair and regenerate. Nature has bestowed some plants with the property to prevent, treat and cure hepatic disturbances. The focus of this review is to elucidate the importance of liver in maintenance of Varna and also the probable mode of action of Varnya mahakashaya gana dravyas on yakrit (liver) based upon Ayurvedic aspects. As varnya gana helps in detoxification of blood in Raktapradoshaja vikaras (disorders due to vitiated blood) and yakrit is the moola Sthana (root site) for raktavaha Srotas (channels of blood circulation). KEYWORDS: Yakrit, Varna, Varnyamahakashaya gana.

Cite this article: Sapna Narasanagi, Sujnana VS, Jyoti Devangamath, Shreevathsa (2015), HEPATOPROTECTIVE PROPERTY OF VARNYA MAHAKASHAYA – AN INNOVATIVE INSIGHT, Global J Res. Med. Plants & Indigen. Med., Volume 4(7): 172–181

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

INTRODUCTION Liver The liver is the largest glandular organ in the body which works all the time to keep the body healthy. The liver is important because a person’s nutritional level is not only determined by what he or she eats, but by what the liver processes. Liver is considered to be one of the most vital organs that functions as a centre of metabolism of nutrients such as carbohydrates, proteins and lipids and excretion of waste metabolites. Additionally, it is also handling the metabolism and excretion of drugs and other xenobiotic from the body thereby providing protection against foreign substances by detoxifying and eliminating them (Sembulingam. K, 2006). Skin cells require energy to eliminate toxins, repair and regenerate. Nature has bestowed some plants with the property to prevent, treat and cure hepatic disturbances. The focus of this review is to elucidate the importance of liver in maintenance of Varna and also the probable mode of action of Varnya mahakashaya gana dravyas on yakrit (liver) based upon Ayurvedic aspects. Hence here an attempt is made to create a hypothesis that varnya mahakashayaa dravyas can be a drug of choice in case of skin disorders associated with liver dysfunction Role of liver in healthy skin As per Ayurveda: In Ayurvedic literature, Bhavamisra (16th Century) has described that it is situated right and below to the hridaya (heart) and is the sthana of pitta and sonitha (blood). Susrutha (500 BC) mentioned yakrit as the abode of ranjaka pitta and describes it as the sthana of rakta (blood). Charaka (1000 BC) while describing the Srotas (channels), mentioned yakrit and pleeha (spleen) as the moola of raktavaha Srotas (Giby abraham et al., 2014). Vagbhata holds the opinion that the twak (skin) is formed from the rakta. After the paka of rakta by its dhatwagni, it gets dried up to from the skin, like the deposition of cream on the surface of boiling milk (Hari Sadashiva Shastri

Paradakara, 2002). Hence liver is directly related to the skin. As per Contemporary medicine: “Healthy Liver Can Mean Healthy Skin” – said by Jody Smith Liver is the metabolic factory of the body producing energy to sustain the thousands of functions performed every minute by all body’s cells. Hair follicles need energy to grow strong shiny hair and skin cells require energy to eliminate toxins and repair and regenerate them. Heart requires energy to pump blood efficiently to skin to maintain collagen production and oxygenate the cells to protect them from aging (Liver Doctor, 2015), thereby Based on the physiology of liver, there is a relation between the outer glows of complexion to liver health. Role of liver in skin diseases: As per Ayurveda: In Ayurveda it can be understood in relation with Shonita, Raktavaha Srotas, and yakrit. In shonitaja rogas (disorders due to vitiated blood), Vaivarnya (skin discoloration) is mentioned (CS, vimana stana 5/8, pp. 250) (Acharya Y.T, 2006), Prasanna varnendriyaartha (bright skin tone and texture etc) are the lakshanas of vishuddha rakta purusha (characteristics of a person having pure and detoxified blood) (CS, Sutrasthana 24/13&24, pp.124&125) (Acharya Y.T., 2006), snigdha rakta Varna in rakta sara purusha (CS, Vimanasthana 8/104, pp.278) (Acharya Y.T, 2006) and liver is said to be the moola of shonitavaha/ raktavaha srotas. This shows that liver is the karana (cause) for vaivarnya, prasanna Varna and other disorders of skin. As per Contemporary medicine: The kidney-bladder system, liver system, lung system, and heart system are the creators of the structure of human protein. It is the direct result of the cooperation of these four organic systems. So any functional disorders will bring about disorders in protein formation which can appear as various kinds of symptoms, and also

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

as skin diseases. If this indication is taken as a working hypothesis, then the connections between particular skin diseases and the four protein-forming organs mentioned could be studied (Alla Selawry, 2004–2009). Hence here the focus is laid on liver system wherein if liver is not doing its function of breaking down toxins efficiently then they must be eliminated from the body by other means – in many cases they come out through the skin. When excessive toxins build up in the deeper layers of the skin this causes inflammation to occur and this can manifest as: Dermatitis, Eczema, Premature aging and wrinkling of the skin etc. (Liver Doctor, 2015). Treatment of dermatological conditions where liver is involved: Ayurvedic view In dealing with problems of the liver, the primary goal is to enhance liver detoxification processes and to protect against further liver damage. Significant and safe hepato-protective agents are unavailable in contemporary therapeutics. Therefore, due importance has been given globally to develop plant-based hepato-protective drugs effective against a variety of liver disorders. So in this review the

important herbs in varnya mahakashaya gana used to treat (vaivarnya) skin discolouration associated with liver disorders have been described. Varnya mahakashaya dravyas: (CS, Sutrasthana 4/10, pp.32) (Acharya Y.T., 2006) Varnya mahakashaya dravyas are the group of drugs which are used to treat and prevent the Vaivarnya (skin discoloration) related conditions, to maintain and enhance the complexion in healthy. These can be administered both internally and externally. According to Charaka Samhita Sutra Sthana 4th chapter Varnya mahakashaya dravyas includes – Acc to Charaka Samhita Sutra Sthana 4th chapter Varnya mahakashaya dravyas mainly includes - Chandana (Santalum Album), Tunga (Calophyllum inophyllum), Padmaka (Prunus cerasoides), Ushira (Vetveria zizanoides), Madhuka (Glycyrrhiza glabra), Manjishta (Rubia cordifolia), Sariva (Hemidesmus indicus), Payasya (Pureaeria tuberosa), Sita (Cynodon dactylon), Lata (Cynodon linearis). A brief drug review of Varnya Mahakashaya dravyas is show in table no.1.

Table no 1: Varnya Mahakashaya dravyas (Pallavi. G et al., 2012)

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

DISCUSSION From the above review it is understood that liver is one of the important component in maintaining the Varna, and varnya mahakashya dravyas possess both hepato protective and varnya property. Thus the link is found between the liver and the skin, wherein varnya mahakashya can be used; as both these

conditions are checked by it. Some of the examples of Varnya mahakashaya dravyas used in Yakrit vikaras mentioned in classics have been shown in table no.2, and References of research and review articles on hepatoprotective action of each varnya gana dravyas in Table no. 3.

Table no.2 References of Varnya mahakashaya dravyas used in Yakrit vikaras mentioned in classics. 1.

Chandana

Ex: In kamala (jaundice) – Katukaadhya ghrutam (CS, Chikitsasthana 16/47. pp.529.)(Acharya Y.T, 2006), It is also mentioned in vishagna, kandughna (CS, Sutrasthana 4/11.pp.33) (Acharya Y.T, 2006)

Punnaga (Nagakesara)

Ushira

Manjishta

Madhuka

Payasya (Vidari)

Ex: in Mrutbhakshana nivarana vidhi (CS. Chikitsasthana 16/108. pp. 531) (Acharya YT et al., 2006). Ex: in kamala – Bijakarishta (CS. Chikitsasthana 16/121. pp. 532.) (Acharya Y.T, 2006), Blood purifier (PV Sharma, 2006). Ex: in kamala – Gaudoarishta (CS. Chikitsasthana 16/121. pp. 532.) (Acharya Y.T, 2006) (Acharya Y.T, 2006), It is also mentioned in vishagna gana Ex: in kamala – Haidari ghruta, Dhatryaavalehya, Bijakarishta, Gaudoarishta (CS. Chikitsasthana 16/121. pp. 532.) (Acharya Y.T, 2006), It is also mentioned in jeevaneeya, kandugna, mutravirajaneeya, shonitasthapanaani gana (CS, Sutrasthana 4/9, 11, 15, and 18) (Acharya Y.T, 2006). It is also mentioned in balya, (CS, Sutrasthana 4/10 pp.32) (Acharya Y.T, 2006). Purishavirajaneeya gana (CS, Sutrasthana 4/15 pp.33) (Acharya Y.T, 2006). in hepatosplenomegaly (PV Sharma, 2006) Ex: in Mrutbhakshana nivarana vidhi (CS. Chikitsasthana 16/121 chakrapani. pp. 532.) (Acharya Y.T, 2006),

7,8 Sita & Lata

These varnya mahakashaya dravyas can be administered both internally and externally.

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

Table no. 3 References of research and review articles on hepatoprotective action of each varnya gana dravyas: 1.

6. 7. 8.

9. 10.

11.

12.

Santalum album 1. Hepatoprotective Potential of Hydro alcoholic Extract of Santalum album Linn. Leaves. 2. International Journal of Pharmaceutical Sciences and Drug Research 2014; 6(3):pp. 224–228 3. Hepatoprotective activity of Vetiveria zizanioides Linn.against ethanolVetiveria induced liver damage in rats. zizanioides 4. Pharmacognosy Magazine, Vol 4, Issue 16 (Suppl.), Oct-Dec, 2008, pp 216. 5. Hepatoprotective potential of methanolic extract of vetiveria zizanioides vetiveria roots against carbon tetrachloride induced acute liver damage in rats. zizanioides 6. Digest Journal of Nanomaterials and Biostructures, Vol. 8, No. 2, April June 2013, pp. 835–844. Prunus puddum 1. Ethnopharmaco-Botanical Review of Padmaka – Prunus puddum Roxb. 2. International Journal of Ayurvedic and Herbal Medicine 1:3 (2011) pp. 87:99. 1. Antibacterial and Analgesic Effects of the Stem Barks of Calophyllum Calophyllum inophyllum inophyllum. 2. International Journal of ChemTech Research, Vol.2, No.2, April-June 2010, pp 973–979. Rubia cordifolia. Hepatoprotective activity of Rubia cordifolia. Pharmacologyonline (2007)3: pp. 73–79. 1. Glycyrrhiza glabra (Liquorice) - a potent medicinal herb. Glycyrrhiza 2. International Journal of Herbal Medicine 2014; 2(2):pp. 132–136. glabra 1. Pharmacological Perspectives of Cynodon dactylon. Cynodon 2. Research Journal of Pharmaceutical, Biological and Chemical Sciences, dactylon April – June 2012, Volume 3 Issue 2 pp.1135. Hemidesmus 3. Hepatoprotective activity of Hemidesmus indicus R.Br. in rats. 4. Indian journal of experimental biology, vol .44, May 2006, pp.399–402. indicus Mesua ferrea 1. Evaluation of Hepatoprotective Activity of Isolated Mesuol from Mesua Ferrea L. In Paracetamol Induced Hepatotoxicity in Rats. 2. International journal of research article pharmaceutical innovations, sept ₋ oct 2013, volume 3, issue 5, pp. 42. Mesua ferrea 3. Evaluation of antioxidant and hepatoprotective efficacy of methanolic extract of Mesua ferrea linn leaves in experimentally challenged mice. 4. International Journal of PharmTech Research, Oct-Dec 2009, Vol.1, No.4, pp. 1692–1696. Mesua ferrea 5. Hepatoprotective Effect of Stamen Extracts of Mesua ferrea L. against Oxidative Stress induced by CCl4 in Liver Slice Culture Model. 6. Natural Product Sciences, (2012), 18(2):pp. 76–82.

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

Ayurvedic pharmacology Varnyamahakashaya dravyas:

Before understanding the Ayurvedic pharmacology of varnya mahakashaya understanding of factors involved in formation of varna (skin complexion) is very essential which would in turn help to analyse the effect of varnya mahakashaya dravyas on varna and the yakrit. Hence Factors involved in the process of formation of Varna are as follows: (Pallavi. G et al., 2012) 1) Dosha (functional entities of the body): a) Vata- Udana vata & vyana vata. b) Pitta- Bhrajaka pitta & Ranjaka pitta.

2) Dhatu (tissue elements): Rasa & Rakta Dhatu. 3) Agni (digestive fire/enzymes): Jatharagni, Bhutagni, & Dhatwagni. 4) Srotas (channels): Rasavaha Srotas & Raktavaha Srotas.’ In figure no. 1 Schematic representation of mode of action of varnya mahakashaya dravyas on Twacha (skin) internally have been shown and in table no.4 the relation between the factors for formation of Varna and the varnya kara bhavas present in the varnya mahakashayaa dravyas have been shown.

Figure 1: Schematic representation on mode of action of varnya mahakashaya dravyas on Twacha (skin)

Intake of Aushadha  Rasa Dhatu  Rakta Dhatwagni and Ranjaka Pitta  Rakta Dhatu  Through vyana vayu Circulates Throughout the Body  Increase in Ojas  Reflects in Twacha (skin)

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Yakrit is involved

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

Table.no 4: Varnya dravyas: Varnya Kara bhavas Varnya Kara Bhavas of Varnya Mahakashaya dravyas 1.

6. 7.

Rasa Dhatu tissue)

(lymph Rasa (taste) - Madhura rasa (sweet taste), Guna (quality) - guru (difficult to digest) & snigdha guna (unctuous quality) Vipaka (post metabolic effect) - Madhura (sweet) vipaka, Virya (potency) - sheeta virya (cold potency). Rakta Dhatu (blood Vipaka (post metabolic effect) - Katu (pungent) vipaka, tissue) Virya (potency) - Ushna (hot) virya, Guna (quality) - laghu (easily digestible) & snigdha guna (unctuous quality). Twacha (skin) Among panchmahabhuta (5essential elements)Vayu mahabhuta (air element) for sensitivity Prithvi (earth element) as gross form. Vata (Qualities Rasa (taste) – Kashaya (astringent) & Tikta (bitter) reflecting elements of Guna (Quality) – laghu & Ruksha (dry) guna space and air Vipaka (Post metabolic effect) – Katu (Pungent) vipaka, Virya (potency) – Sheeta virya Pitta (qualities Vipaka (post metabolic effect) - Katu vipaka, reflecting the elements Virya (potency) – ushna virya of fire and water) Agni (digestive fire) Virya (potency) – ushna virya Vipaka (post metabolic effect) - Katu vipaka Ojas (prime energy) Rasa (taste) – Madhura rasa, Guna (quality) – guru & snigdha guna, Vipaka (post metabolic effect) - madhura vipaka, Virya (potency) – sheeta virya.

Discussion on Probable mode of action of varnya mahakashayaa dravyas on yakrit To understand the probable mode of action, Etio-pathogenesis of yakrit roga should be understood, which is as follows- in Figure 2. The main aim of treatment is to purify the blood and to regain the normal functions of the liver for which the Cikitsa siddhanta (Line of treatment) in Ayurveda is (Hari Sadashiva Shastri Paradakara, 2002). A. Sodhana (Purificatory therapy) - virechana B. Sanshamana (Palliative therapy) - Kapha pitta hara cikitsa

Shodana is done by the respective line of treatments and samshamana can be done by administrating the supportive drugs of varnya mahakashaya dravyas such as madhuka, chandana, ushira, punnaga (Nagakesara), payasya (vidari) possessing hepatoprotective property as single drugs or compounded drugs. Toxins and Yakrit: Garavisha, a type of toxin described in Ayurveda affects liver & hepatomegaly may also take place. The reason for hepatomegaly is that the blood has special affinity towards toxins. The toxins immediately get spread in the body through blood (Hari Sadashiva Shastri Paradakara, 2010) and hence treatment is given

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

to pitta dosha, thereby purification of rakta dhatu takes place. According to pharmacology, the main mechanism involved in the protection of liver could be associated with the strong capability of hepato-protective drugs to reduce the

intracellular levels of reactive oxygen species by enhancing the level of both enzymatic and non-enzymatic antioxidants. These drugs protect liver tissues against oxidative damage and help in stimulating the repair mechanism of liver (Giby Abraham et al., 2014).

Figure 2: Etio-pathogenesis of yakrit roga (liver disease) Vidahi annapanam (food and drinking that cause burning sensation, Madhya sevana (alcohol intake), Teekshna padartha (strong/ sharp substance) ▼ Pitta prakopa (aggrevation of pitta) ▼ Dushita rakta dhatu (Vitiated blood tissue) ▼ Rakta pradoshaja roga (disease caused by vitiated blood tissue) ▼ Yakrit rogas

Analysis based on Rasapanchakas: Rasapanchakas means rasa, guna, virya, vipaka and karma (functions), which are the base for pharmacology of varnya mahakashaya dravyas. Analysis of these present in the individual drugs reveals that maximum number of drugs have Madhura, Tikta and Kashaya rasa, laghu guna, Madhura katu Vipaka and Sheeta Virya. Madura rasa: Its snigdha (unctuous) sheeta (cold in nature) and guru (heavy to digest) guna does dhatuposhana (nourishment to all essential body tissues) function thereby increasing the immunity, strength and stability in the body and protect liver tissues against oxidative damage. Due to its pittaghna (destroying the excess of qualities reflecting the elements of fire and water) and vishaghna (destroying of toxins) functions helps in removing the obstruction and toxins from the rakta vaha channels and yakrit (CS, sutrasthana 26/42-43)(Acharya Y.T, 2006).

Tikta rasa: Its Laghu guna (easy to digest quality) helps in increasing jatharagni as they are easily digestible and they form less nitrogenous waste products, Arochakaghna (treat loss of appetite), Agnidipana (increases metabolism) Aharapachana (helps in digestion) (Sharma Dinesh Chandra et al., 2014) helps in proper metabolism (by enhancing the catabolism) thereby these herbs help in digestion of nitrogenous waste products collected in body, due to disturbed metabolism. kashaya rasa have Ropana property (Healing property) helps in stimulating the repair mechanism of liver . Vipaka: Madhura and Katu Vipaka that cause catabolism in our body and removes obstruction of Rakta Vaha Channels. (Sharma Dinesh Chandra et al., 2014) Virya: varnya mahakashayaa is chiefly of Sheeta Virya and by virtue of its pitta and

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

Rakta alleviating property it pacifies the pitta dosha and thereby purifies/detoxifies the rakta dhatu in twak rogas associated with yakrit vikaras. Sheetavirya also act as diuretics and antioxidant thus reduce the intracellular levels of reactive oxygen species (Giby Abraham et al., 2014).

Acharya Sushruta mentioned the composition of rakta (blood) on the basis of Pancha- mahabhuta (five elements), in the same way modern physiology illustrated. (Table. 5)

Tables no. 5 the composition of blood on the basis of Pancha- mahabhuta Panchamahabuta composition According to contemporary science Rakta Blood Visrata (Prthvi mahabhuta),

serum protein, glucose etc,

Dravta (Jala mahabhuta),

plasma, lipids etc,

Raga (Agni mahabhuta),

haemoglobin, potassium, magnesium, iodine, chloride, acid phosphate, lipase, insulin etc.

Spandana (Vayu mahabhuta) Colloidal substances in the blood, blood pressure. and laghuta (Akasha mahabhuta). Oxygen, carbon di oxide, nitrogen gases contributes to laghu guna of rakta. Thus, in Ayurveda Panchamahabhutas (five basic elements of the body) is the base for all the body components and these are the bridges which links all the body tissues. These are the base for creating such hypothesis. CONCLUSION On the basis of above study it can be concluded that in skin disorders associated with liver involvement varnya mahakashayaa can be used as a supporting tool along with the main treatment; because conventional skin creams or drugs can suppress the condition but ultimately there may be side effects because the main challenge which contemporary science facing is how to ensure effective metabolism of the drugs that have been prescribed since the liver itself is in disorder. So in a natural approach for the health of the liver, Ayurveda sages have

used their intellect, to formulate such herbal formulations that can be metabolized even by a sluggish liver. The logic behind how such formulations work is that they first heal and strengthen the liver and then contribute to the restoration of its normal functions that may reduce inflammation and does detoxification of blood. “Preserving health of the liver means adding more complexion to the skin.” ACKNOWLEDGEMENT Author is thankful to Dr. Shreevathsa, HOD and Professor (I/C), Dr. Sujnana V.S and Dr. Jyoti Devangamath B.A.M.S., P.G. scholar, MD (Ayu), Department of PG studies in Ayurveda Siddhanta,GAMC, Mysuru for all the help and guidance in writing this article.

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 8 | August 2015 | 172–181

REFERENCES: Acharya YT (Ed) (2006) Charaka Samhita with Chakrapanidatta and Ayurveda Dipika, Commentary, Varanasi: Chaukhambha Surabharati Prakashana.

Liver Doctor, (2015) your skin reflects your liver, Retrieved on 8/11/2014, from http://www.liverdoctor.com/your-skinreflects-your-liver

Alla Selawry (2004–2009) Anthroposophic Medicine | 'Connections Between Skin Diseases and Organ Dysfunctions'.Retrieved on 8/11/2014, from http:// www.anthromed.org/Article.

Pallavi. G (2012), A Study on the concept of varnya vis-vis clinical evaluation of efficacy of varnya gana lepa in vyanga.

Giby abraham (2014), A Review on Hepatoprotective Herbs used in Ayurveda, global j res. Med. Plants & indigen. Med., volume 3(7): 303–311 Hari Sadashiva Shastri Paradakara (Ed) (2002) Ashtanga Hridaya, 6th Ed, Sharirasthana 3/8, Chikitsasthana16/39, Uttarasthana 35/60Varanasi: Chaukhamba Surbharati prakashan; pp. 386, 703, 906.

Source of Support: NIL

PV Sharma (2006) Dravyaguna vijnana. Reprint ed. Varanasi: chaukhambha bharati academy; Vol-2.pp.115, pp.739. Sembulingam K, Sembulimgam Prema (2006) Essentials of Medical Physiology, 4th Ed. New Delhi: Jaypee Brother Medical Publishers, pp.222, 228 Sharma Dinesh Chandra (2014), a scientific study on rakta dhatu and its related disorder and effect of varnya mahakashaya ghanvati and Chandra prabha lepa in the management of yuvan pidika (acne vulgaris), Int. J. Ayur. Pharma Research; Volume 2(2): pp.33–39.

Conflict of Interest: None Declared

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

Call for Papers â&#x20AC;&#x201C; Vol. 4, Issue 10, October 2015 Submit your manuscripts (Research articles, Review articles, Short Communications, Letters to the Editor, Book Reviews) to Global Journal of Research on Medicinal plants & Indigenous medicine â&#x20AC;&#x201C; GJRMI Submit it online through www.gjrmi.com or mail it to submitarticle@gjrmi.com on or before September 10th 2015.

To advertise on the Flip book Cover page freely, write to chiefeditor@gjrmi.com or editorinchief@gjrmi.com Or Call - +919590574495