Ayurveda has given Supreme Significance to the human body as a abode of god.Ayurveda is the only ancient science which says Purusham Purusham Veekshya which means characters of one person is different from other. In brief the need is to know about:
Importance of Kala, Importance of Anupana, Importance of Mathra.
And its necessity in Todays practice????
Dosage depends on:
• Tridoshas
• Saptha dooshyaas
• Desha
• Kaala
• Bala
• Prakruthi
• Vaya
• Saathmya
• Avastha
• Vyaadi
• Dravya
• Linga
Times of drug administration:
• Important b’coz they are dependant upon the diurnal variations in doshas both in physiological and pathological state.
• Charaka mentioned 10 kalas(chi.30)
• Sushrutha mentioned 10 kalas(su.ut.64)
• Vruddha vagbhata ---11 kalas (as.san.su.23)
• Vagbhata---10 kalas(as.hr.su.13)
• Sharanghadhara—5 kalas (sha san poo.2)
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mÉÑÂwÉÇ mÉÑÂwÉÇ uÉϤrÉ xÉ¥ÉårÉÉå ÍpÉzÉaÉѨÉqÉ: ||
(cÉ.xÉÔ .1/121)
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qÉɧÉÉ MüÉsÉÌ¢ürÉÉpÉÔÍqÉSåWûSÉåwÉaÉÑhÉÉliÉUqÉç |
mÉëÉmrÉ iɨÉή SìÓzrÉliÉå iÉå iÉå pÉÉuÉxiÉjÉÉ iÉjÉÉ ||
(cÉ.xÉÔ.11)
The Bhava and Prayojana of any drugs is depended on its mathra.
lÉ qÉÉlÉålÉÌuÉlÉÉ rÉÑÌ£üSìïurÉÉhÉÉÇ eÉÉrÉiÉå YuÉÍcÉiÉç |
AiÉ: mÉërÉÉåaÉ MüÉrÉÉïjÉï qÉÉlÉqÉɧÉÉåcrÉiÉå qÉrÉÉ ||
AsmÉ qÉɧÉÉåÅmÉrÉÉåÌaÉiuÉÉiÉç AÂcÉåUmÉëxÉ…¡ûiÉ: |
ͤÉmÉëqÉÉUÉåarÉSÉÌrÉiuÉÉiÉç AÉæwÉkÉåprÉÉåÅÍkÉMüÉåUxÉWû ||
The yogas which have been mentioned may not be advised in the same way it can be according to intellect of a physician according to the necessity.
rÉiÉÉå qÉlSÉalÉrÉÉå ¾ûxuÉÉ WûÏlÉ xÉiuÉÉ lÉUÉ: MüsÉÉæ |
AiÉxiÉÑ qÉÉ§É iɱÉåarÉÉ mÉëÉåcrÉiÉå xÉÑ¥É xÉqqÉiÉÉ ||
ÎxjÉÌiÉlÉÉïxirÉåuÉ qÉɧÉÉrÉÉWû MüÉsÉqÉÎalÉ uÉrÉÉå oÉsÉqÉç |
mÉëM×üÌiÉÇ SÉåwÉ SåzÉÉæ cÉ SØwOèuÉÉ qÉɧÉÉÇ mÉëMüsmÉrÉåiÉç
zÉÏbÉëÇ EmÉrÉÉÌiÉ oÉsÉÇ lÉ ÌWûqxrÉS³ÉÉÎluÉiÉqÉç lÉ cÉ qÉÑWÒûuÉïSlÉÉͳÉUåÌiÉ |
mÉëÉaÉçpÉ£ü xÉåÌuÉiÉqÉjÉÉæwÉkÉqÉåiÉSåuÉ S±ÉŠ uÉëÑήÍzÉzÉÑpÉÏiÉuÉUÉÇaÉlÉÉprÉWû ||
iÉxqÉÉiÉç xuÉpÉÉuÉÉå ÌlÉÌSï¹U¨ÉjÉÉ qÉɧÉÉÌSUÉ´ÉrÉWû |
iÉSèmÉå¤ÉrÉÉåÂprÉÇ MüqÉï mÉërÉÉåerÉÇ ÍxÉήÍqÉdcÉiÉÉ ||
Dravya kala and mathra vichara should be done well and i.e the base of any successive treatment.Yukthi jnatha is shreshta than dravyajnatha.
In modern science the following are also important to be considered in clinical practice.
• Individual resistance & incompatibilities.
• Acquired & habitual adaptation.
• Assimilation & excretion of administered medicine.
• Mental conditions of the patient.
• Country & habitat.
• Medicament used for the purpose of administering drugs.
• Age/sex criterion.
• Temperament.
Both for Social and Scientific reason dose is very important.
Dose response relationship:
This describes the change in effect on an organism caused by differing levels exposure (or doses) to the stressor (a chemical).This may apply to individual in particular. Studying dose response and developing the safe and hazardous levels and dosages of drugs.
Dravya grahana vidhaana:
AÉSìïÇ lÉuÉÏlÉÇ rÉSìurÉÇ rÉÉåerÉÇ xÉMüsÉMüqÉïxÉÑ |
ÌuÉlÉÉ ÌuÉQû…¡û M×üwhÉÉprÉÉÇ aÉÑQû kÉÉlrÉ AÉerÉ qÉÉͤÉMæü:||
mÉÑUÉhÉÉ: xrÉÑaÉÑïhÉærÉÑï£üÉ AÉxÉuÉÉ kÉÉiÉuÉÉå UxÉW |
As all drugs are directed to be used in wet form except vidanga,pippali,guda,dhanya,ghrutha and madhu.in the same way asava arishta ,dhathu bhasma and parada yuktha rasa prayoga is the best as it is older.
qÉÉ§É ÌlÉÃmÉhÉqÉç
xÉxÉWûxÉëÉrÉÑiÉ sɤÉMümÉ©ÉoÉÑïS ZÉoÉïaÉÑÍhÉiÉ kÉÉiÉÑÍpÉSÉqÉç |
qÉWûÉUxÉÉlÉÉÇ UÉeÉÏ ÍxÉ®ÉjÉï qÉɧÉÉ xrÉÉiÉç || (U MüÉ)
ÍxÉ®ÉjÉïMüxrÉ rÉÑaqȨ́ÉiÉrÉɱqÉç xrÉÉή pÉåÌSÌuÉwÉå |
rÉuÉ aÉÑgeÉɱkÉÉïkÉïÇ xÉuÉåïwÉÉqÉÌmÉ kÉÉiÉÑuÉaÉåïwÉÑ || (U.MüÉ)
qÉÉwÉxiÉÑ zÉsÉuÉÉå°uÉpÉxqÉlÉ: xrÉɨÉÉUxrÉ WåûqlÉÉåÅÌmÉ cÉ uÉssÉ LuÉ| AlrÉåwÉÑ xÉuÉåïwuÉÌmÉ kÉÉiÉÑwÉÑ xrÉÉlqÉɧÉÉ Ì§ÉqÉÉwÉmÉëÍqÉiÉ mÉëqÉÉhÉqÉç|| (U.Mü)
Example:1::Shankhavisha matra:
• It is 1/120-1/30th part of ratti.
• 1/10th -1/3rd of sarshapa.
• In the context of matra nirmana vidhi adding malla-1 gunja with maricha churna 15 mashakas---mardana with ardraka swarasa & make a pill of 1 ratti.admn dose:bid.
• WARNING: 1 RATTI PURE SHODHITHA MALLA IS LETHAL DOSE TO HUMANS
Example 2: UxÉ xÉåuÉlÉ MüÉsÉ
mÉëirÉÔwÉå pɤÉrÉåiÉç xÉÔiÉÇ mÉjrÉÇ rÉÉqÉå iÉSÉÌSqÉå |
̲iÉÏrÉ rÉÉqÉå qÉÌiÉqÉÉlÉzlÉÏrÉÉSè pÉÉåeÉlÉÇ ÌWûiÉqÉç ||(U ÍcÉ)
- Swarna jaarita parada---- 1 ratti
- Rajatha jaarita parada---2 ratti
- Tamra jaarita parada----3 ratti
- Teekshna loha/abhraka satva jeerna parada---------------1 masha
- Vajra jaarita-------------1 sarshapa.
Importance of a drug:
• Basis-vyadhi,agni,rogibala
• Excessive drug/highly potent—less severe patho state ---original disease eradicates----drug remains complications.
• Dormant enzymatic activity---incomplete metabolism----reduction of appetite/digestion constipation.
• Potent drug---weak person---intolerance------complications mada murcha.
Defining acute exposure guidelines:
1- Dose above which and individual might experience discomfort or irritation. These effects are transient and should be reversible upon cessation of exposure.
2- Dose above which an individual would be expected to experience irreversible or serious long lasting adverse health effects, or inability to escape.
3- Dose above which an individual might experience life-threatening health effects or death.
THERAPEUTIC INDEX:
• SAFETY OF A DRUG depends on this factor.
• Dose of desirable effect is separated from dose eliciting toxic effects.
• Median lethal dose and median efficient dose is the criteria.
• TI = LD50/ED50
• For a safe drug the index should be at least more than one & hence a drug having larger value for LD50 but smaller for ED50 is considered safer.
Even modern research do mention some of concepts regarding time of drugs.
Chronobiology:
• Study of biological rhythms.
• Predictable variations in bodily functions take place during the day,week,months & years.
• Alters the severity of diseases.
• Doses in time improves the treatment outcomes.
• Delivering right drug in right time.
• “Chronobiotics” are smart drugs.
Chronotherapeutics:
• Observation that every metabolic event undergoes rhythmic change.
• Composition of rhythms vary in frequencies and seasons.
• Circadian rhythm(circadian rhythm)—a name given to the “internal body clock” that regulates the (approximately) 24-hour cycle of biological processes in animals and plants. The term circadian comes from Latin words that literally mean “around the day.” –chronobiologic frequency.
• Invivo drug availability is timed in relation to the repetitive rhythms of drug.
AlÉÑmÉÉlÉ:
· AlÉÑmÉÉlÉÇ ÌWûiÉÇ rÉÑ£Çü iÉmrÉïirÉÉzÉÑ qÉÉlÉuÉqÉç |
· AlÉÑ mɶÉÉiÉç mÉÉlÉqÉç |
· AÉæwÉkÉÉ…¡û mÉårÉ ÌuÉzÉåwÉ |iÉŠ AÉæwÉkÉmÉÉlÉÉlÉliÉUÇ ÌuÉsÉqorÉ mÉërÉÉåerÉÇ,UɨÉÉæ mÉÑlÉ: mÉÉcÉlÉqÉåuÉ urÉuÉxiÉårÉÇ| ÌuÉsÉqorÉ cÉ ¢üqÉÉhÉqÉåiÉSÏËUiÉÇ UɧÉÉæ mÉÑlÉ: mÉÉcÉlÉqÉåiɲÍcÉUå|| (UÉ.ÌlÉ)
· AlÉliÉUå UxÉÇ SårÉÇ YuÉÉjÉÇ uÉÉ SìurÉÉå ÎeÉiÉÉå|
· AlÉÑmÉÉlÉ: qÉiÉ: ÌuÉ¥lÉ: UxÉÇ zÉÌ£ü ÌuÉuÉkÉïlÉqÉç || (mÉ.ÌuÉ.̲)
· eÉsÉÉlÉÑmÉÉlÉqÉç ´Éå¹qÉç | (AÉ.qÉ zÉÉU…¡ûkÉU )
· rÉjÉÉ iÉæsÉå eÉsÉå ͤÉmiÉÇ ¤ÉhÉålÉæuÉ mÉëxÉmÉïÌiÉ |
· AlÉÑmÉÉlÉoÉsÉÉSlÉÑmÉÉlÉzÉÌ£ü: |
· qÉWåûlSì eÉsÉ ´ÉåwOû AlÉÑmÉÉlÉ|
Anupana should not be Dhathu Virodhi.
AlÉÑmÉÉlÉ aÉÑhÉ
Ø rÉiÉç ÌMügÍcÉSÉæwÉkÉæSåïrÉÇ UÉåaÉÉlÉÑmÉÉlÉiÉ:|
iɨÉSè aÉÑhÉMüUÇ elÉårÉqÉlÉÑmÉÉlÉ oÉsÉÉÌSWû ||
The drug given anupana according to diseases enhances the property of the active ingredient and thus eradicates disease.
Ø AlÉÑmÉÉlÉÇ kÉÉiÉÔlÉÉÇ SìÓ¹Ç rÉ³É ÌuÉUÉåÍkÉ cÉ |
Anupana should not be dhathu virodhis.
Tarpana,preenana,oorjha,brumhana,mrudu,jarayati and sukha parinaama.
xÉWûmÉÉlÉ:
AÉæwÉkÉÇ zÉÉx§É xÉÇrÉÑ£üÉ SìurÉÇ rÉÉåaÉuÉɽÉÎeÉiÉÉå |
zÉÑwMÇü SìuÉ: UxÉ: SÒakÉÉ xÉWûmÉÉlÉÇ lÉÉqlÉÉ oÉÑkÉWèû ||
aÉÑhÉ---rÉjÉÉ iÉæsÉÇ eÉsÉÇ mÉëÉmiÉÇ ¤ÉhÉålÉæuÉ ÌuÉxÉmÉïÌiÉ |
xÉWûmÉÉlÉÇ oÉsÉÉSÇaÉå iÉjÉÉ xÉmÉïÌiÉ pÉåwÉeÉqÉç |
Doshaanusaara anupana:
• Vataja vyadhi------snigdha ushna
• Pittaja vyadhi------snigdha sheetha
• Kaphaja vyadhi---- ruksha ushna
• Snehapana-----asheetha jala.
• Bhallathaka----sheetha jala.
UÉåaÉÉlÉÑxÉÉU AlÉÑmÉÉlÉ:
- Grahani---------------------takra
- Kshaya---------------------shilaajathu
- Paandu---------------------mandoora
- Shosha ,mandagni------madira
- Arshas---------------------bhallathaka
- Vatavyadhi---------------shuddha guggulu
- Amavatha-----------------gomuthra
- Visha dosha----------swarnabhasma.
xÉuÉåïwÉÉÇ qÉiÉqÉåiÉSåuÉ ÍpÉwÉçeÉÉÇ rɨÉÉUxÉÏxÉÉåSèpÉuÉqÉç |
mÉÉjÉïYrÉålÉ aÉÑhÉÉuÉWÇû lÉ pÉÍxÉiÉÇ mÉëÉå£üÉåmÉsÉÉåWûxrÉ ||
Bhasmas like naga,rajatha isnt given alone.Also upaloha bhasmas like pittala,kansya,varthaloha bhasmas should not be administered alone.It is nishiddha.
Some of them below are rationality given to the concept of anupana.
Adjuvants
• Adjuvants are pharmacological or immunological agents that modify the effect of other agents (e.g., drugs, vaccines) while having few if any direct effects when given by themselves. In this sense, they are roughly analogous to chemical catalysts. Types of adjuvants include:
SYNERGISTS:
• A drug,food additive or other chemical substance that interacts with another substance and their combined effect is SYNERGY.
• Performs the same set of motion as the agonists.
• Help cancel or neutralize extra motion from agonists.
• Works only within the desired plane.
PRODRUGS:
• Pharmacological substance that’s administered in an inactive or significantly less active form.
• Metabolised invivo into an active metabolite.
• ADME optimization.
• Improve oral bioavailability.
• Selectivity of a drug to its intended target.
• Rational drug design.
In systems biology
• Modulation of immune system through different approaches.
• May be stimulatives,suppressives or regulators.
• Modulating single/multiple pathways or targets as needed.
• Cocktails of immuno drugs.
CHELATORS /DETOXIFYING AGENTS:
• Chelate is a water-soluble complex between a metal ion and a complexing agent.
• It usually does not dissociate easily in solution, but forms an inert complex.
• Encircles a mineral or metal ion and carries it from the body via the urine and feces.
• Chelating agents yielding soluble metal complexes are also called sequestering agents.
Would anupanas also act as….
• Drug carriers to facilitate drug transfer?
• Disintegration agents?
• Diluents?
• Granulating agents?
• Wetting agents?
• Lubricants?
• Sustained releasers for the controlled release mechanism.?
Concept of BMR & RMR:
• Body surface area is not only the criteria.
• Increase in metabolism.
• Increase in enzymatic induction.
• The range of dosages and dose rates effective for achieving the desired modulation of metabolism
Summarizing.
AsmÉxrÉÉÌmÉ qÉWûiuÉÉjÉï mÉëpÉÔiÉxrÉsmÉ MüqÉïiÉÉqÉç |
MÑürÉÉïiÉç xÉqzsÉåwÉ ÌuÉzsÉåwÉ MüÉsÉ xÉqxMüÉU rÉÑÌ£üÍpÉÌWû ||
AjÉÉå AÍpÉrÉÑ£ü xÉiÉiÉqÉç xÉuÉïqÉÉsÉÉåcrÉ xÉuÉïkÉÉ |
iÉjÉÉ rÉÑgeÉÏiÉ pÉæwÉerÉqÉÉUÉåarÉÉrÉ rÉjÉÉ kÉëÑuÉqÉç ||
(A.¾Òû.xÉÔ.22)
The drug must be administered to an individual only after careful evaluation of timing and condition of the disease. Then only drug restores complete health.
To discuss…
Ø What might be the criteria & method of fixing a dose of rasoushadies though general statement is alpamathra?
Ø Are rasoushadies applicable in all shat kriya kalas ?
Ø Are we applying the principles of circadian rhythms when selecting the time of administration!
Ø Dose depending on BMR how can we interpret?
Ø Anupanas belong to which category-synergists,adjuvants,prodrugs or any others?
Ø Do anupanas have such a component which might reduce / enhance the toxicity for some endpoints?
Ø Drug cost & availability for anupanas as and when needed in today's practice.
Ø Is mathra,parihara & upachara viruddha concepts applicable in rasashastra?
Ø Are patent drug combinations which contain rasaushadies out of these principles?
Ø Is kala anupanas mathra applicable in emergency conditions?
BIBLIOGRAPHY:
1) Agnivesa,The Charaka Samhitha,with Cakrapanidatta’s Ayurveda deepika and Vidyothini Hindi Commentary,Edited by Dr.Gangashaya Pandeya ,Seventh Edition,2002,Varanasi,Chaukambha Sanskrith Bhavan.Part -1.
2) Pandith Sharangadharacharya,Sharangadhara Samhitha ,Edited by Pandith Parashuram Shastri,Sixth Edition,2005,Varanasi,Chaukambha Orientalia.
3) Dr.J.L.N.Shastry, Dravyaguna Vijnana,First Edition 2006,Varanasi,Charu Printers,Chaukambha Orientalia.
4) http// www.personal medicine.com.
5) http// www.wikipedia.com
6) http// google search .