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==Preamble of Kalpa Sthana of the [[Charaka Samhita]] ==
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{{CiteButton}}
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{{#seo:
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|title=Kalpa Sthana
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|titlemode=append
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|keywords=Kalpa Sthana, Madanakalpa Adhyaya, Jimutaka Kalpa Adhyaya, Ikshvaku Kalpa Adhyaya, Dhamargava Kalpa Adhyaya, Vatsaka Kalpa Adhyaya, Kritavedhana Kalpa Adhyaya, Shyamatrivrita Kalpa Adhyaya, Chaturangula Kalpa Adhyaya, Tilvaka Kalpa Adhyaya, Sudha Kalpa Adhyaya, Saptalashankhini Kalpa Adhyaya, Dantidravanti Kalpa Adhyaya
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|description=Kalpa Sthana deals with the study of formulations used in therapeutic purification procedures
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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{{Infobox
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|title = [[Charak Samhita]] Kalpa Sthana-Preamble
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|label1 = Section/Chapter
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|data1 = [[Kalpa Sthana]] Section 7/ Preamble
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|label2 = Preceding section
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|data2 = [[Chikitsa Sthana]]
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|label3 = Succeeding section
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|data3 = [[Siddhi Sthana]]
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|label4 = Other Sections
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|data4 = [[Sutra Sthana]], [[Nidana Sthana]],[[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]]
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|label5 = Author
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|data5 = Nishteswar K.
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|label6 = Reviewer
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|data6  = [[Gopal Basisht|Basisht G.]]
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|label7 = Editors
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|data7  = [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
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|label8 = Year of publication
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|data8 = 2020
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|label9 = DOI
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|data9  = [https://doi.org/10.47468/CSNE.2020.e01.s07.001 10.47468/CSNE.2020.e01.s07.001]
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|header10 = Chapters
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|label11 =
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|data11 = 1. [[Madanakalpa Adhyaya]], 2. [[Jimutaka Kalpa Adhyaya]], 3. [[Ikshvaku Kalpa Adhyaya]], 4. [[Dhamargava Kalpa Adhyaya]], 5. [[Vatsaka Kalpa Adhyaya]], 6. [[Kritavedhana Kalpa Adhyaya]], 7. [[Shyamatrivrita Kalpa Adhyaya]], 8. [[Chaturangula Kalpa Adhyaya]], 9. [[Tilvaka Kalpa Adhyaya]], 10. [[Sudha Kalpa Adhyaya]], 11. [[Saptalashankhini Kalpa Adhyaya]], 12. [[Dantidravanti Kalpa Adhyaya]] }}
  
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A healthy individual is an asset to any society (and contributes to making a healthy society), while a sick individual will be a liability to the family and society. To keep oneself healthy, Ayurveda laid down the principles of various lifestyles with regard to daily regimen (''dinacharya''), seasonal regimen (''ritucharya'') and modified lifestyles to cure the diseases. Physical exercise for the preservation of health begins with the adaptation of purification of body and mind along with intake of ''rasayana'' drugs (rejuvenating agents). Accumulation of ''malas'' (metabolic waste) at the level of cell, tissue or organ should be expunged out to facilitate the restoration of normal functioning of the body by five purificatory procedures (''shodhana karma'') often referred as ''panchakarma'', namely ''vamana'' (emesis), ''virechana'' (purgation), ''asthapana basti'' (evacuative enema), ''anuvasana basti'' (restorative enema), and ''shirovirechana'' (errhines) are indicated for healthy as well as diseased. If ''malas'' are not taken out of the body, they cause diseases and decay (ageing) of the body. After purification procedures, ''jatharagni'' (gastro-intestinal digestive juices) becomes weak and may not digest the food normally.  For restoration of this function, the food that is easily digestible is introduced and increased gradually over a period of time and this procedure is called ''samsarjana karma''. Details of pharmaceutical process of drugs employed in ''vamana'' and ''virechana'' procedures are given in this section and detailed therapeutic implications of all the ''shodhana'' karma in [[Siddhi Sthana]].
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'''<big>Preamble of Kalpa Sthana</big>'''
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''Vamana'' and ''virechana'' therapies should be administered before administering ''basti'' (medicated enema therapy). Therefore, ''vamana'' and ''virechana'' drugs are first described in Kalpa Sthana before the description of therapy, which is described in detail under [[Siddhi Sthana]]. Generally, purgation therapy is administered only after the administration of emetic therapy and keeping this view the first six chapters are allocated for description of emetic drugs.
 
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Six drugs are described for emesis and nine others are described for purgation. Six hundred recipes prepared from these drugs (Total 15 drugs) are for the use of physician of low caliber and intelligent physician can formulate many other recipes to suit the exact requirement of his patient. The formulations are prescribed according to disease in different dosage forms like ''kashaya'' (decoction), ''svarasa'' (juice), ''kalka'' (paste), ''churna'' (powder), ''peya'' (drinks), ''lehya'' (lickable), and ''bhojya'' (foods).
 
  
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==== Table no 1: Kalpa Sthana Contents at a Glance====
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Kalpa Sthana deals with the study of formulations used in therapeutic purification procedures.
 +
 
 +
<div style="text-align:justify;">
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=== Fundamental principles===
 +
A healthy individual is an asset to any society, while a sick individual will be a liability to his family in particular and the society at large. To keep oneself healthy, [[Ayurveda]] lays down the principles of various lifestyles in terms of daily regimen ([[dinacharya]]), seasonal regimen ([[ritucharya]]) and modified lifestyles to cure the diseases. Physical exercise for the preservation of health begins with adapting techniques for purification of the body and the mind along with an intake of [[rasayana]] drugs (rejuvenatives). Accumulated [[mala]] (metabolic waste) at the level of cell, tissue or organ should be expunged out to facilitate the restoration of normal functioning of the body by five purification procedures ([[shodhana karma]]) often referred as [[Panchakarma]], namely [[vamana]] (emesis), [[virechana]] (purgation), [[asthapana basti]] (evacuative enema), [[anuvasana basti]] (restorative enema), and [[shirovirechana]] (errhines) are indicated for healthy as well as diseased persons. If ''malas'' are not taken out of the body, they cause diseases and decay (ageing) of the body. After purification procedures, ''jatharagni'' (gastro-intestinal digestive juices) becomes weak and may not digest the food normally.  For restoration of this function, the food that is easily digestible is introduced and increased gradually over a period of time and this procedure is called ''samsarjana karma''. Details of pharmaceutical process of drugs employed in [[vamana]] and [[virechana]] procedures are given in this section and detailed therapeutic implications of all the [[shodhana]] karma in [[Siddhi Sthana]].
 +
[[Vamana]] and [[virechana]] therapies should be administered before administering [[basti]] (medicated enema therapy). Therefore, [[vamana]] and [[virechana]] drugs are first described in [[Kalpa Sthana]] before the description of [[basti]] therapy, which is described in detail under [[Siddhi Sthana]]. Generally, purgation therapy is administered only after the administration of emetic therapy and keeping this view the first six chapters are allocated for description of emetic drugs.
 +
 
 +
Six drugs have been described for emesis and nine others are described for purgation. Six hundred recipes prepared from these drugs (Total 15 drugs) are for the use of physician of low caliber and intelligent physician can formulate many other recipes to suit the exact requirement of his patient. The formulations are prescribed according to disease in different dosage forms like ''kashaya'' (decoction), ''svarasa'' (juice), ''kalka'' (paste), ''churna'' (powder), ''peya'' (drinks), ''lehya'' (lickable), and ''bhojya'' (foods).
 +
 
 +
==== [[Kalpa Sthana]] Contents at a glance====
  
 
{| class="wikitable"
 
{| class="wikitable"
Line 15: Line 54:
 
! scope="col"| No. of Recipes
 
! scope="col"| No. of Recipes
 
! scope="col"| Part Used
 
! scope="col"| Part Used
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! scope="col"| Botanical identification<ref>Thakur Balvant Sing and Chunekar K. C., Glossary of Vegetable Drugs in Brihattrayi, Chaukhamba Amarabharati Prakashan, Varanasi, Ed. (2015)</ref>
 
|-
 
|-
 
| 1
 
| 1
−
| [[Madanakalpa]]
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| [[Madanakalpa Adhyaya]]
 
| 30
 
| 30
 
| ''Madanaphala''
 
| ''Madanaphala''
 
| 133
 
| 133
 
| Fruit and Flower
 
| Fruit and Flower
 +
| ''Randia dumetorum''
 
|-
 
|-
 
| 2
 
| 2
−
| [[Jimutaka Kalpa]]
+
| [[Jimutaka Kalpa Adhyaya]]
 
| 15
 
| 15
 
| ''Jimutaka''
 
| ''Jimutaka''
 
| 39
 
| 39
 
| Fruit and Flower
 
| Fruit and Flower
 +
| ''Luffa echinata'' Roxb.
 
|-
 
|-
 
| 3
 
| 3
−
| [[Ikshavaku Kalpa]]
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| [[Ikshvaku Kalpa Adhyaya]]
 
| 23
 
| 23
−
| ''Ikshavaku''
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| ''Ikshvaku''
 
| 45
 
| 45
 
| Leaf, Fruit, Seed
 
| Leaf, Fruit, Seed
 +
| ''Lagenaria siceraria'' Standl.
 
|-
 
|-
 
| 4
 
| 4
−
| [[Dhamargava Kalpa]]
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| [[Dhamargava Kalpa Adhyaya]]
 
| 20
 
| 20
 
| ''Dhamargava''
 
| ''Dhamargava''
 
| 60
 
| 60
 
| Fruit, Flower, Tender Leaves
 
| Fruit, Flower, Tender Leaves
 +
| ''Luffa cylindrica'' (Linn.) M. Roem.
 
|-
 
|-
 
| 5
 
| 5
−
| [[Vatsaka Kalpa]]
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| [[Vatsaka Kalpa Adhyaya]]
−
| 12
+
| 13
 
| ''Vatsaka''
 
| ''Vatsaka''
 
| 18
 
| 18
 
| Fruit
 
| Fruit
 +
| ''Holarrhena antidysenterica'' Wall.(male ''Kutaja'')and ''Wrightia tinctoria'' R.Br.(or W. tomentosa Roem. & Schult.)(female ''Kutaja'')
 
|-
 
|-
 
| 6
 
| 6
−
| [[Kritavedhana Kalpa]]
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| [[Kritavedhana Kalpa Adhyaya]]
 
| 14
 
| 14
 
| ''Kritavedhana''
 
| ''Kritavedhana''
 
| 60
 
| 60
 
| Flower, Fruit
 
| Flower, Fruit
 +
| ''Luffa acutangula'' (Linn.)
 
|-
 
|-
 
| 7
 
| 7
−
| [[Shyamatrivrita Kalpa]]
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| [[Shyamatrivrita Kalpa Adhyaya]]
 
| 80
 
| 80
 
| ''Shyama'', ''Trivrita''
 
| ''Shyama'', ''Trivrita''
 
| 110
 
| 110
 
| Root
 
| Root
 +
| ''Ipomoea petaloidea'' Chois.(Shyama trivrita),Operculina turpethum (Arun trivrita)
 
|-
 
|-
 
| 8
 
| 8
−
| [[Chaturangula Kalpa]]
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| [[Chaturangula Kalpa Adhyaya]]
 
| 18
 
| 18
 
| ''Araghvadha''
 
| ''Araghvadha''
 
| 12
 
| 12
 
| Fruit
 
| Fruit
 +
| ''Cassia fistula'' Linn.
 
|-
 
|-
 
| 9
 
| 9
−
| [[Tilvaka Kalpa]]
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| [[Tilvaka Kalpa Adhyaya]]
 
| 18
 
| 18
 
| ''Tilvaka''
 
| ''Tilvaka''
 
| 16
 
| 16
 
| Root, Bark
 
| Root, Bark
 +
| ''Viburnum nervosum''(According to Thakur Balavant Singh)
 
|-
 
|-
 
| 10
 
| 10
−
| [[Sudha Kalpa]]
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| [[Sudha Kalpa Adhyaya]]
 
| 22
 
| 22
 
| ''Sudha''
 
| ''Sudha''
 
| 20
 
| 20
 
| Milky Latex
 
| Milky Latex
 +
| ''Euphorbia neriifolia'' Linn.
 
|-
 
|-
 
| 11
 
| 11
−
| [[Saptalashankhini Kalpa]]
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| [[Saptalashankhini Kalpa Adhyaya]]
 
| 19
 
| 19
 
| ''Saptala'', ''Shankhini''
 
| ''Saptala'', ''Shankhini''
 
| 36
 
| 36
−
| Root (of Saptala), Fruit (of Shankhini)
+
| Root (of ''Saptala''), Fruit (of ''Shankhini'')
 +
| ''Euphorbia dracunculoides'' Lam. and ''Colonyction muricatum'' G Don.
 
|-
 
|-
 
| 12
 
| 12
−
| [[Dantidravanti Kalpa]]
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| [[Dantidravanti Kalpa Adhyaya]]
 
| 107
 
| 107
 
| ''Danti'', ''Dravanti''
 
| ''Danti'', ''Dravanti''
 
| 49
 
| 49
 +
| Root
 +
| ''Baliospermum montanum'' Muell.-Arg.
 
|-
 
|-
 
! scope="row"|Total
 
! scope="row"|Total
 
|  
 
|  
−
| 378
+
| 379
 
|  
 
|  
 
| 600
 
| 600
 +
|
 +
|
 
|}
 
|}
  
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=== Salient features of Kalpa Sthana ===
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[[Madanakalpa Adhyaya]] (pharmaceutical preparations)is the very first chapter of [[Kalpa Sthana]] of [[Charak Samhita]]. In all, there are twelve chapters in this section, of which the first six including ''Madanakalpa'' describe the various pharmaceutical formulations for emesis while the remaining six describe various purgative pharmaceutical preparations. Each chapter is named after a plant drug and in every chapter many compound formulations with suitable plant drugs are also given. Grossly, all twelve chapters can be divided into [[Vamana]] and [[Virechana]] ''Kalpa''. The literal meaning of [[Vamana]] is to eliminate the [[dosha]](impurities) from gastro-oral route whereas  from lower tract- through anus it is known as purgative. Since impurities are eliminated in both the cases, it is known as [[Madanakalpa Adhyaya#Vamana(therapeutic emesis) and Virechana(therapeutic purgation)|''Virechana sanjna''  (evacuative) [Cha. Sa. [[Kalpa Sthana]] 1/4] ]]
  
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Charaka discussed the general information about Pharmaco-kinetics of drugs, dosage forms and weights and measures. Drugs useful for ''vamana'' and ''virechana'' are discussed with their synonyms, varieties, pharmacological actions, and various modes of application in different dosage forms.  
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=== Salient features of [[Kalpa Sthana]] ===
 +
 
 +
Charak detailed the Pharmacokinetics of drugs, dosage forms and weights and measures in this section. Drugs useful for [[vamana]] and [[virechana]] are discussed with their synonyms, varieties, pharmacological actions, and various modes of application in different dosage forms.  
  
 
==== Factors responsible for therapeutic efficacy ====
 
==== Factors responsible for therapeutic efficacy ====
  
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Four important factors for producing maximum therapeutic efficacy of these drugs are identified. ''Deshasampat'' (collecting the plant from appropriate habitat), ''kalasampat'' (collecting the drugs in the appropriate season), ''gunasampat'' (collecting the plants when they are enriched with excellent attributes like ''rasa'', ''guna'', ''virya'', etc.) and ''bhajanasampat'' (storage of drugs in appropriate container).
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Four important factors for producing maximum therapeutic efficacy of these drugs are identified. ''Deshasampat'' (collecting the plant from appropriate habitat), ''kalasampat'' (collecting the drugs in the appropriate season), ''gunasampat'' (collecting the plants when they are enriched with excellent attributes like ''rasa'', [[guna]], [[virya]], etc.) and ''bhajanasampat'' (storage of drugs in appropriate container).
 +
 
 +
==== Pharmacokinetics of Drugs ====
 +
 
 +
Drugs (used for emesis and purgation) which are ''ushna'' (hot), ''tikshna'' (sharp), ''sukshma'' (subtle), ''vyavayi'' (those pervading the entire body before getting digested) and ''vikasi'' (those causing looseness of joints), by virtue of their own potency, reach the heart and circulate through the vessels. Because of their ''agneya'' nature (predominance of [[agni mahabhuta]], or fire element), they liquefy the compact form of (adhered) [[dosha]] (morbid material), and because of their sharpness (''tikshna'' attribute) they separate the adhered [[dosha]] located in the gross and subtle channels of the entire body.  Like honey kept in the pot smeared with fat, the morbid material, after separation, moves floating without adhesion in the body which has been oleated (by the administration of oleation therapy). Because of its nature to move through subtle channels and to flow (towards the gastrointestinal tract), this morbid material reaches the stomach, and gets propelled by ''udana vayu''. Because of the predominance of [[agni mahabhuta]] and [[vayu mahabhuta]] in these (emetic) drugs, and because of their specific action to move upwards, the morbid material gets expelled through the upward tract (mouth). On the other hand, purgative drugs, because of the predominance of [[prithvi]] and [[jala mahabhuta]], and because of their specific action, (''prabhavajanya'') move downwards to expel the morbid material through the downward tract (anus). Combination of both these attributes result in the expulsion of the morbid material through both the upward and downward tracts.
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 +
==== Similarities/ Dissimilarities of ''virya'' ====
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 +
Sometimes, the drugs of secondary nature (mixed with main drug) have antagonistic property. Even then they do not contradict the effects of the principal drug. If these drugs of secondary nature are similar in potency as that of the principal drugs, then the recipe becomes all the more effective therapeutically. Trituration, boiling etc. are considered ''samskaras'' which bring in chemical changes in the chemical structure of the drug resulting in the modification of the drug activity.
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 +
==== Modification of drug activity ====
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 +
Ingredients of a recipe should be impregnated with the juice or decoction of other ingredients having identical potency. By virtue of appropriate ''samyoga'' (addition of ingredients), ''vishlesha'' (elimination of ingredients), ''kala'' (appropriate time of administration) and ''samskara'' (processing) even a small quantity of a drug may produce more powerful effects, and otherwise even a recipe in large quantity may produce very mild effects.
 +
 
 +
==== Weight and measures ====
 +
 
 +
Two traditions for ''mana'' (weight and measures) are mentioned in [[Kalpa Sthana]], namely, ''Kalinga'' (part of present Orissa) and ''Magadha'' (part of present Bihar). Charak opines that Magadha is better than former. Chakrapani considers this statement as unauthentic. It is also suggested that when weight of ingredients in a recipe is not specified, then all the ingredients are to be taken in equal quantity.
 +
 
 +
==== ''Snehapaka'' (preparation of medicated oil or ghee) ====
 +
 
 +
[[Charak Samhita]] does not specify the liquid medium to be used in formulation of the medications. However, the use of certain liquids has been known through practice and other sources. In the process of ''snehakalpana'', for example, water has to be used invariably. ''Snehapaka'' (preparation of medicated oil or ghee) is categorized into three types i.e. ''mridupaka'' (mild boiling), ''madhayamapaka'' (moderate boiling) and ''kharapaka'' (full boiling). ''Sneha'' processed by ''kharapaka'' is indicated for massage purpose, ''mridupaka sneha'' is recommended to be used for [[nasya]] (inhalation) and moderately processed oil or ghee for internal use including for [[basti]] karma.
 +
 
 +
==== Purification of drugs ====
 +
 
 +
To reduce the toxicity (''vikasi guna'') of ''Danti'' and ''Dravanti'', Charak evolved a process using ''Pippali'' and honey paste which is to be besmeared over the roots and once again to be smeared with mud and fomented with steam after drying up in sun. Chakrapani observes that heat of fire and sunrays makes the root free from adverse effects. This could be quoted as a best example of purification process employed for the removal of toxicity - a novel concept mentioned by Charak. In the medieval ages, ''Rasashastra'' texts adopted several purificatory procedures for various herbal and metallic drugs.
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 +
==== Sushruta's perspective of Kalpa sthana ====
 +
 
 +
The subject matter of Kalpasthana in Sushruta samhita  is entirely different and deals with one of the Ashtangas of [[Ayurveda]] known as Damshtrachikitsa (Toxicology). Sushruta furnished the details of [[vamana]] and [[virechana]] drugs in Sutra sthana (43 and 44th chapter). Among [[vamana]] dravyas madanaphala, jimutaka pushpa, kutaja phala, ikshvaku pushpa, kritavedhana beeja and dhamargava phala are enumerated. Sushruta identified best virechaneeya drugs based on part used like, trivrit among root purgatives and amongst bark, fruits, oil, juice and latex, the drugs namely tilvaka, haritaki, erandataila (Castor oil), karavellaka and snuhi are considered as best respectively. Trivrit, danti, dravanti, tilvaka, haritaki, chaturangula, erandataila, snuhiksheera, saptala, and shankhini are enumerated under virechaneeya drugs. There is not much difference among the drugs enumerated in Charak and Sushruta, but Sushruta included triphala, erandataila under virechana drugs.
 +
 
 +
Charak suggested root bark of tilvaka while Sushruta instructed to use bark of tilvaka. A purgative recipe is suggested for children, old people, delicate and patients suffering from dhatukshaya (weight loss/wasting condition) by Sushruta which includes erandataila (Castor oil) mixed with triphala kwatha and milk or meat soup. He also suggested chaturangula for children up to age 12. It appears that Sushruta suggested easily available purgatives.<ref>Sushruta. Sutra Sthana, Cha.44 Virechanadravyavikalpaneeya Adhyaya verse 72-77. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>
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 +
=== Relevance of the concepts of [[Kalpa Sthana]] in the current clinical practices ===
 +
 
 +
''Vamana karma'' (emesis) and ''virechana karma'' (purgation) are mandatory before performing ''basti karma'' (enema), in order to promote health (i.e., for the patient to gain weight). Keeping this in view, the details about drugs employed in ''vamana'' and ''virechana karma'' are described in this section and the details about ''basti karma'' in the subsequent section, [[Siddhi Sthana]].
 +
 
 +
For ''vamana karma'', ''Madanaphala'' is the main drug employed in the current clinical practice. But the rest of five drugs (i.e., ''Jimutaka'', ''Ikshvaku'', ''Dhamargava'', ''Vatsaka'', and ''Kritavedhana'') are not being prescribed. Charak suggested the period of collection and procedure for extracting seed from the ''Madanaphala''. These procedures are not being followed currently.
 +
 
 +
In the purgative therapy the drug ''Trivrita'' is prescribed currently in the various dosage forms and ''Aragwadha'' and ''Danti'' are infrequently prescribed. Charak suggested a procedure for extracting the pulp from the fruit of ''Aragwada''. He also described a process to reduce ''vikasi guna'' (causes looseness of tissues) of ''Danti'' root. Both these procedures are not in vogue. Sushruta suggested ''Triphala'' (three fruits, namely ''Haritaki'', ''Vibitaka'', and ''Amalaki'') and ''Eranda Taila'' (Castor oil) as purgatives and are prescribed in the current clinical practice.
 +
 
 +
''Tilvaka'', ''Saptala'', ''Sankhini'', and ''Dravanti'' are the purgative drugs suggested by Charak which are controversial and not being preferred in current practice.
 +
 
 +
The procedures described by Charak with regard to ''vamana'' and ''virechana karma'' are being followed religiously by Ayurvedic physicians of current times.
 +
 
 +
Ayurvedic classics have advocated to collect the medicinal plants according to part used and seasons in order to get desired pharmacological action and therapeutic benefits. Sushruta, Charak and other acharyas advocate the collection of various parts of medicinal plants based on the seasons. The logic behind such recommendations has been validated by recent modern scientific research.
 +
 
 +
In a study the variations in the phytoconstituents of ''Ashwagandha'' root  was evaluated according to lunar cycles with regard to ''grishma'' and ''shishira ritu'' (summer and late winter season). In this study, total phenolic, flavonide and carbohydrate content of ''Ashwagandha'' root were found more in ''poornima'' (full moon day) samples. GAP (''Grishma Ashadha Poornima'', or the full moon night occurring in the ''Grishma-Ashadha'' season) samples showed maximum differentiation from rest of the samples with regards to TCA, TCW, TFW, MEx, WEX, pH etc. parameters. The ''Grishma-Jyeshtha Poornima'' (GJP) and GAP samples were found to be superior than ''Amavasya'' (new moon day) samples with regard to  functional groups and with anoloid content respectively. <ref>Tavhare SD, Nishteswar K, Shukla VJ. Effect of seasonal variations on the phytoconstituents of Aśvagandhā w.r. to lunar cycles. Ancient Sci Life. 2016;35((3)):150–8 available online https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850775/</ref> <ref>Tavhare SD, Nishteswar K, Shukla VJ. Influence of lunar cycles on growth of Ashwagandha(Withania somnifera [L.] Dunal). AYU [serial online] 2015 [cited 2019 Jan 22];36:258-64. Available from: http://www.ayujournal.org/text.asp?2015/36/3/258/182763 </ref> Such type of studies validate the concept of seasonal collection of drug delineated in [[Ayurveda]] classics like [[Charak Samhita]] and ''Sushruta Samhita''.
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 +
=== Contemporary perspective ===
 +
 
 +
Modern phytochemistry suggests that Saponin containing drugs act like irritants due to their foam producing action. Through this mechanism, drugs like madana, ikshvaku, jimutaka, kritvedhana may produce emesis. Till date there is no research work carried out on biological activity of kurchine regarding emesis. Drugs containing anthroquinone derivatives tend to be good laxatives. Therefore anthraqinone containing drugs like argvadha act as good virechaka drugs.
 +
Ayurvedic classical texts atributed anti-diarrhoel activity to kutaja (Stem bark & seeds). Charak included kutaja under emetics. It may be interpreted that kutaja in emetic doses induces vomiting, while in sub-emetic or therapeutic doses controls diarrhea. According to modern pharmacology “the emetic drugs in sub-emetic doses acts as bronchodilators”  indicates that alteration of the dose of the drug can produce different pharmacological actions.<ref>Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmaco- therapeutics. Revised 16th edn. Popular Prakashan Private Limited. Mumbai; 1999.</ref> It can be presumed that kutaja in emetic doses produces vomiting at the level of upper gastrointestinal tract, while the therapeutic dose of the drug controls diarrhea at the level of lower gastrointestinal tract.
 +
''Vamanopaga'' drugs (synergistic drugs to [[vamana]] karma) like kovidara, karbudara, shanapushpi, pratyakpushpi possess [[agni]] and [[ vayu mahabhuta ]] dominance can support main [[vamana]] dravya for emetic action, while drugs like draksha, kashmariphala, parushaka, badara, kuvala, peelu, karkandhu are [[prithvi]] and [[jala mahabhuta]] dominant drugs, which can support the main ''virechaka'' drugs for inducing purgative action.
 +
 
 +
To summarize the content of ''Kalpa sthana'' of Charak samhita it appears that the information about most popular emetic and purgative drugs with various dosage forms is furnished. And more research is required to explain modus operandii of emetic and purgative drugs and their therapeutic applicability through evidence based clinical trials which were in vogue during those times.
 +
 
 +
=== Important concepts in Kalpa Sthana ===
 +
* Mode of action of [[Vamana]] and [[Virechana]] [Cha. Sa. [[Kalpa Sthana]] 1 / 5]
 +
* Factors responsible for potency of drug [Cha. Sa. [[Kalpa Sthana]] 1 / 7]
 +
* Selection of soil and desha classification for collecting good quality medicinal plants [Cha. Sa. [[Kalpa Sthana]] 1 / 7-8]
 +
* Ideal and forbidden areas for collecting medicinal plants [Cha. Sa. [[Kalpa Sthana]] 1 / 9]
 +
* Time period of collection and harvesting herbs[Cha. Sa. [[Kalpa Sthana]] 1 / 10]
 +
* Storage of herbs [Cha. Sa. [[Kalpa Sthana]] 1 / 11]
 +
* Concept of [[Anupana]] (vehicle) [Cha. Sa. [[Kalpa Sthana]] 1 / 12]
 +
* Nasal drug delivery of herbs [Cha. Sa. [[Kalpa Sthana]] 1 / 19], [Cha. Sa. [[Kalpa Sthana]] 3 / 11-12],[Cha. Sa. [[Kalpa Sthana]] 4 / 10],[Cha. Sa. [[Kalpa Sthana]] 10 / 17]
 +
* Concept of ascending dosage schedule (vardhamana matra)[Cha. Sa. [[Kalpa Sthana]] 3 / 13]
 +
* Development of different dosage forms of purgatives according to constitution [Cha. Sa. [[Kalpa Sthana]] 7 / 28]
 +
* Formulation of purgative drugs according to seasons[Cha. Sa. [[Kalpa Sthana]] 7 / 56-59]
 +
* Formulation designing according to koshtha[Cha. Sa. [[Kalpa Sthana]] 10 / 17] 
 +
* Principles of indicating nomenclature of formulation [Cha. Sa. [[Kalpa Sthana]] 12 / 44]
 +
* Concept of potentiation of drugs including the theory of antogonism and synergism [Cha. Sa. [[Kalpa Sthana]] 12 / 45-48]
 +
* Categorization or classification of therapeutic response into mild, moderate and severe categories [Cha. Sa. [[Kalpa Sthana]] 12 / 50-56]
 +
* Importance of assessment of roga bala and rogi bala ( severity of disease and strength of patient) for prescribing purification procedures[Cha. Sa. [[Kalpa Sthana]] 12 / 60]
 +
* Management of residual [[dosha]] with food and medicated decoctions after purification therapies.[Cha. Sa. [[Kalpa Sthana]] 12 / 66]
 +
* Concept of examination of koshtha (status of gastrointestinal tract) while administering [[vamana]] and [[virechana]] drugs.[Cha. Sa. [[Kalpa Sthana]] 12 /67]
 +
* Concept of sneha and ruksha [[virechana]] [Cha. Sa. [[Kalpa Sthana]] 12 / 82-83]
 +
* Inhibiting factors fro prevention of purgative actions.[Cha. Sa. [[Kalpa Sthana]] 12 / 80]
 +
* Concept of posology based upon koshtha(status of gastro intestinal tract), vaya(age) and bala(strength)[Cha. Sa. [[Kalpa Sthana]] 12 / 86]
 +
 
 +
=== Important areas of research and its clinical applications ===
 +
 
 +
* Standardization of procedure of [[vamana]] and [[virechana]] karma
 +
* Standardization of processes of different dosage forms
 +
* Studies on procedures and processing of different [[anupana]] like Kwatha, Yavagu, Ksheerapaka, Swarasa, Shashkuli, Shadava, Raga, Shukta, Suramanda, Asava, Sura, Varit, Krishara, Panaka, Sauvira, Tushodaka, Avaleha, Shritapaka, Seedhu, Utkarika
  
−
==== Pharmacokinetic of Drug ====
 
  
−
Drugs (used for emesis and purgation) which are ''ushna'' (hot), ''tikshna'' (sharp), ''sukshma'' (subtle), ''vyavayi'' (those pervading the entire body before getting digested) and ''vikasi'' (those causing looseness of joints), by virtue of their own potency, reach the heart and circulate through the vessels. Because of their ''agneya'' nature (predominance of ''agni mahabhuta'', or fire element), they liquefy the compact form of (adhered) ''doshas'' (morbid material), and because of their sharpness (''tikshna'' attribute) they separate the adhered ''doshas'' located in the gross and subtle channels of the entire body.  Like honey kept in the pot smeared with fat, the morbid material, after separation, moves floating without adhesion in the body which has been oleated (by the administration of oleation therapy). Because of its nature to move through subtle channels and to flow (towards the gastro-intestinal tract), this morbid material reaches the stomach, and gets propelled by ''udana vayu''. Because of the predominance of agni and vayu mahabhutas in these (emetic) drugs, and because of their specific action (prabhavajanya) to move upwards, the morbid material gets expelled through the upward tract (mouth). On the other hand, purgative drugs, because of the predominance of prithvi and jala mahabhutas, and because of their specific action, (prabhavajanya) move downwards to expel the morbid material through the downward tract (anus). Combination of both these attributes result in the expulsion of the morbid material through both the upward and downward tracts.
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<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
−
3. Similarity - dissimilarity of virya
 
−
Sometimes, the drugs of secondary nature (mixed with main drug) have antagonistic property. Even then they do not contradict the effects of the principal drug. If these drugs of secondary nature are similar in potency as that of the principal drugs, then the recipe becomes all the more effective therapeutically. Trituration, boiling etc. are considered samskaras which bring in chemical changes in the chemical structure of the drug which results in potentiation or neutralization of the drug activity.
 
−
4. Modification of drug activity
 
−
Ingredients of a recipe should be impregnated with the juice or decoction of other ingredients having identical potency. By virtue of appropriate samyoga (addition of ingredients), vishlesha (elimination of ingredients), kala (appropriate time of administration) and samskara (processing) even a small quantity of a drug may produce more powerful effects, and otherwise even a recipe in large quantity may produce very mild effects.
 
−
5. Weight and measures: Two traditions for mana (weight and measures) are mentioned in Kalpasthana namely Kalinga (part of present Orissa) and Magadha (part of present Bihar) and Charaka opines that Magadha is better than former. Chakrapani considers that this statement as unauthentic. It is also suggested that when weight of ingredients in a recipe is not specified, then all the ingredients are to be taken in equal quantity.
 
−
6. Snehapaka (Dosage form): In the formulation processing the liquid is not specified; in the process of snehakalpana invariably water has to be used. Snehapaka (preparation of medicated oil or ghee) is categorized into three types i.e. mridupaka (mild boiling), madhayamapaka (moderate boiling) and kharapaka (full boiling). Sneha processed by kharapaka is indicated for massage purpose, mridupaka sneha for nasya (inhalation) and moderately processed oil or ghee for internal use including basti karma.
 
−
7. Purification of drugs: To reduce the toxicity (vikasi guna) of Danti and Dravanti, Charaka evolved a process with Pippali and honey paste which is to be besmeared over the roots and once again to be smeared with mud and fomented with steam after drying up in sun. Chakrapani observes that heat of fire and sunrays makes the root free from adverse effects. This would be quoted as a best example for purification to remove toxicity, a novel concept for the first time quoted by Charaka. In medieval period, Rasashastra texts adopted several purificatory procedures for various herbal and metallic drugs.
 
  
−
Relevance of the concepts of Kalpasthana in the current clinical practises
+
</div>
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Vamana karma (emesis) and virechana karma (purgation) are mandatory before performing bastikarma (enema) in the health promoting regimen. Keeping this in view the details about drugs employed in vamana and virechana karma are described in this section and the details about bastikarma in the subsequent section, Sidhisthana.
+
<div id="BackToTop"  class="noprint" style="background-color:#DDEFDD; position:fixed;
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For vamana karma, Madanaphala is the main drug employed in the current clinical practice. But the rest of five drugs namely Jimutaka, Ikshvaku, Dhamargava, Vatsaka and Kritavedhana are not being prescribed. Charaka suggested the period of collection and procedure for extracting seed from the Madanaphala. These procedures are not being followed currently.
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bottom:32px; left:2%; z-index:9999; padding:0; margin:0;"><span style="color:blue;
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In the purgative therapy the drug Trivrit is prescribed currently in the various dosage forms and Aragwadha and Danti are infrequently prescribed. Charaka suggested a procedure for extracting the pulp from the fruit of Aragwada. He also described a process to reduce vikasi guna (causes looseness of tissues) of Danti root. Both these procedures are not in vogue. Susrutha suggested Triphala (3 Fruits namely Haritaki, Vibitaka and Amalaki) and Eranda Thaila (Castor oil) as purgatives and are prescribed in the current clinical practise.  
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font-size:8pt; font-face:verdana,sans-serif;  border:0.2em outset #ceebf7;
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Tilvaka, Saptala, Sankhini and Dravanti are the purgative drugs suggested by Charak which are controversial and not being preferred in current practise.
+
padding:0.1em; font-weight:bolder; -moz-border-radius:8px; ">
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The procedures described by Charak with regard to vamana and virechana karma are being followed religiously by Ayurvedic physicians of current times
+
[[#top| Back to the Top ]]</span></div>
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Ayurvedic classics have advocated to collect the medicinal plants according to part used and seasons in order to get desired pharmacological action and therapeutic benefits. Sushruta, Charaka and other ācāryas advocate the collection of various parts of medicinal plants in different seasons. The logic behind such recommendations  has been validated by recent modern scientific research.
 
  
−
In a study the variations in the phytoconstituents of Ashwagandha root  was evaluated according to lunar cycles with regard to greeshma and sisira ritu (summer and late winter season). In this study, total phenolic, flavonide and carbohydrate content of Ashwagandha Root were found more in pournima (full moon day) samples. GAP (greeshma rithu) samples showed maximum differentiation from rest of the samples with regards to TCA, TCW, TFW, MEx, WEX, pH etc. parameters. The Grīṣṃa Jyeṣṭha Paurṇimā (GJP) and Āṣāḍha Paurṇimā (GAP) samples were found to be superior than amāvāsyā (new moon day) samples with regard to  functional groups and withanoloid content respectively (Ref. 2016 Ancient Science of Life) . Such type of studies validate the concept of seasonal collection of drug delineated in ayurvedic classics like Charkasamhita and Sushruthasamhita.
+
==References==

Latest revision as of 10:59, 23 February 2024

Cite.png
Charak Samhita Kalpa Sthana-Preamble
Section/Chapter Kalpa Sthana Section 7/ Preamble
Preceding section Chikitsa Sthana
Succeeding section Siddhi Sthana
Other Sections Sutra Sthana, Nidana Sthana,Vimana Sthana, Sharira Sthana, Indriya Sthana
Author Nishteswar K.
Reviewer Basisht G.
Editors Deole Y.S., Basisht G.
Year of publication 2020
DOI 10.47468/CSNE.2020.e01.s07.001
Chapters
1. Madanakalpa Adhyaya, 2. Jimutaka Kalpa Adhyaya, 3. Ikshvaku Kalpa Adhyaya, 4. Dhamargava Kalpa Adhyaya, 5. Vatsaka Kalpa Adhyaya, 6. Kritavedhana Kalpa Adhyaya, 7. Shyamatrivrita Kalpa Adhyaya, 8. Chaturangula Kalpa Adhyaya, 9. Tilvaka Kalpa Adhyaya, 10. Sudha Kalpa Adhyaya, 11. Saptalashankhini Kalpa Adhyaya, 12. Dantidravanti Kalpa Adhyaya

Preamble of Kalpa Sthana

Kalpa Sthana deals with the study of formulations used in therapeutic purification procedures.

Fundamental principles

A healthy individual is an asset to any society, while a sick individual will be a liability to his family in particular and the society at large. To keep oneself healthy, Ayurveda lays down the principles of various lifestyles in terms of daily regimen (dinacharya), seasonal regimen (ritucharya) and modified lifestyles to cure the diseases. Physical exercise for the preservation of health begins with adapting techniques for purification of the body and the mind along with an intake of rasayana drugs (rejuvenatives). Accumulated mala (metabolic waste) at the level of cell, tissue or organ should be expunged out to facilitate the restoration of normal functioning of the body by five purification procedures (shodhana karma) often referred as Panchakarma, namely vamana (emesis), virechana (purgation), asthapana basti (evacuative enema), anuvasana basti (restorative enema), and shirovirechana (errhines) are indicated for healthy as well as diseased persons. If malas are not taken out of the body, they cause diseases and decay (ageing) of the body. After purification procedures, jatharagni (gastro-intestinal digestive juices) becomes weak and may not digest the food normally. For restoration of this function, the food that is easily digestible is introduced and increased gradually over a period of time and this procedure is called samsarjana karma. Details of pharmaceutical process of drugs employed in vamana and virechana procedures are given in this section and detailed therapeutic implications of all the shodhana karma in Siddhi Sthana. Vamana and virechana therapies should be administered before administering basti (medicated enema therapy). Therefore, vamana and virechana drugs are first described in Kalpa Sthana before the description of basti therapy, which is described in detail under Siddhi Sthana. Generally, purgation therapy is administered only after the administration of emetic therapy and keeping this view the first six chapters are allocated for description of emetic drugs.

Six drugs have been described for emesis and nine others are described for purgation. Six hundred recipes prepared from these drugs (Total 15 drugs) are for the use of physician of low caliber and intelligent physician can formulate many other recipes to suit the exact requirement of his patient. The formulations are prescribed according to disease in different dosage forms like kashaya (decoction), svarasa (juice), kalka (paste), churna (powder), peya (drinks), lehya (lickable), and bhojya (foods).

Kalpa Sthana Contents at a glance

Chapter No. Chapter Name No. of Shlokas Name of the drug No. of Recipes Part Used Botanical identification[1]
1 Madanakalpa Adhyaya 30 Madanaphala 133 Fruit and Flower Randia dumetorum
2 Jimutaka Kalpa Adhyaya 15 Jimutaka 39 Fruit and Flower Luffa echinata Roxb.
3 Ikshvaku Kalpa Adhyaya 23 Ikshvaku 45 Leaf, Fruit, Seed Lagenaria siceraria Standl.
4 Dhamargava Kalpa Adhyaya 20 Dhamargava 60 Fruit, Flower, Tender Leaves Luffa cylindrica (Linn.) M. Roem.
5 Vatsaka Kalpa Adhyaya 13 Vatsaka 18 Fruit Holarrhena antidysenterica Wall.(male Kutaja)and Wrightia tinctoria R.Br.(or W. tomentosa Roem. & Schult.)(female Kutaja)
6 Kritavedhana Kalpa Adhyaya 14 Kritavedhana 60 Flower, Fruit Luffa acutangula (Linn.)
7 Shyamatrivrita Kalpa Adhyaya 80 Shyama, Trivrita 110 Root Ipomoea petaloidea Chois.(Shyama trivrita),Operculina turpethum (Arun trivrita)
8 Chaturangula Kalpa Adhyaya 18 Araghvadha 12 Fruit Cassia fistula Linn.
9 Tilvaka Kalpa Adhyaya 18 Tilvaka 16 Root, Bark Viburnum nervosum(According to Thakur Balavant Singh)
10 Sudha Kalpa Adhyaya 22 Sudha 20 Milky Latex Euphorbia neriifolia Linn.
11 Saptalashankhini Kalpa Adhyaya 19 Saptala, Shankhini 36 Root (of Saptala), Fruit (of Shankhini) Euphorbia dracunculoides Lam. and Colonyction muricatum G Don.
12 Dantidravanti Kalpa Adhyaya 107 Danti, Dravanti 49 Root Baliospermum montanum Muell.-Arg.
Total 379 600

Madanakalpa Adhyaya (pharmaceutical preparations)is the very first chapter of Kalpa Sthana of Charak Samhita. In all, there are twelve chapters in this section, of which the first six including Madanakalpa describe the various pharmaceutical formulations for emesis while the remaining six describe various purgative pharmaceutical preparations. Each chapter is named after a plant drug and in every chapter many compound formulations with suitable plant drugs are also given. Grossly, all twelve chapters can be divided into Vamana and Virechana Kalpa. The literal meaning of Vamana is to eliminate the dosha(impurities) from gastro-oral route whereas from lower tract- through anus it is known as purgative. Since impurities are eliminated in both the cases, it is known as [[Madanakalpa Adhyaya#Vamana(therapeutic emesis) and Virechana(therapeutic purgation)|Virechana sanjna (evacuative) [Cha. Sa. Kalpa Sthana 1/4] ]]

Salient features of Kalpa Sthana

Charak detailed the Pharmacokinetics of drugs, dosage forms and weights and measures in this section. Drugs useful for vamana and virechana are discussed with their synonyms, varieties, pharmacological actions, and various modes of application in different dosage forms.

Factors responsible for therapeutic efficacy

Four important factors for producing maximum therapeutic efficacy of these drugs are identified. Deshasampat (collecting the plant from appropriate habitat), kalasampat (collecting the drugs in the appropriate season), gunasampat (collecting the plants when they are enriched with excellent attributes like rasa, guna, virya, etc.) and bhajanasampat (storage of drugs in appropriate container).

Pharmacokinetics of Drugs

Drugs (used for emesis and purgation) which are ushna (hot), tikshna (sharp), sukshma (subtle), vyavayi (those pervading the entire body before getting digested) and vikasi (those causing looseness of joints), by virtue of their own potency, reach the heart and circulate through the vessels. Because of their agneya nature (predominance of agni mahabhuta, or fire element), they liquefy the compact form of (adhered) dosha (morbid material), and because of their sharpness (tikshna attribute) they separate the adhered dosha located in the gross and subtle channels of the entire body. Like honey kept in the pot smeared with fat, the morbid material, after separation, moves floating without adhesion in the body which has been oleated (by the administration of oleation therapy). Because of its nature to move through subtle channels and to flow (towards the gastrointestinal tract), this morbid material reaches the stomach, and gets propelled by udana vayu. Because of the predominance of agni mahabhuta and vayu mahabhuta in these (emetic) drugs, and because of their specific action to move upwards, the morbid material gets expelled through the upward tract (mouth). On the other hand, purgative drugs, because of the predominance of prithvi and jala mahabhuta, and because of their specific action, (prabhavajanya) move downwards to expel the morbid material through the downward tract (anus). Combination of both these attributes result in the expulsion of the morbid material through both the upward and downward tracts.

Similarities/ Dissimilarities of virya

Sometimes, the drugs of secondary nature (mixed with main drug) have antagonistic property. Even then they do not contradict the effects of the principal drug. If these drugs of secondary nature are similar in potency as that of the principal drugs, then the recipe becomes all the more effective therapeutically. Trituration, boiling etc. are considered samskaras which bring in chemical changes in the chemical structure of the drug resulting in the modification of the drug activity.

Modification of drug activity

Ingredients of a recipe should be impregnated with the juice or decoction of other ingredients having identical potency. By virtue of appropriate samyoga (addition of ingredients), vishlesha (elimination of ingredients), kala (appropriate time of administration) and samskara (processing) even a small quantity of a drug may produce more powerful effects, and otherwise even a recipe in large quantity may produce very mild effects.

Weight and measures

Two traditions for mana (weight and measures) are mentioned in Kalpa Sthana, namely, Kalinga (part of present Orissa) and Magadha (part of present Bihar). Charak opines that Magadha is better than former. Chakrapani considers this statement as unauthentic. It is also suggested that when weight of ingredients in a recipe is not specified, then all the ingredients are to be taken in equal quantity.

Snehapaka (preparation of medicated oil or ghee)

Charak Samhita does not specify the liquid medium to be used in formulation of the medications. However, the use of certain liquids has been known through practice and other sources. In the process of snehakalpana, for example, water has to be used invariably. Snehapaka (preparation of medicated oil or ghee) is categorized into three types i.e. mridupaka (mild boiling), madhayamapaka (moderate boiling) and kharapaka (full boiling). Sneha processed by kharapaka is indicated for massage purpose, mridupaka sneha is recommended to be used for nasya (inhalation) and moderately processed oil or ghee for internal use including for basti karma.

Purification of drugs

To reduce the toxicity (vikasi guna) of Danti and Dravanti, Charak evolved a process using Pippali and honey paste which is to be besmeared over the roots and once again to be smeared with mud and fomented with steam after drying up in sun. Chakrapani observes that heat of fire and sunrays makes the root free from adverse effects. This could be quoted as a best example of purification process employed for the removal of toxicity - a novel concept mentioned by Charak. In the medieval ages, Rasashastra texts adopted several purificatory procedures for various herbal and metallic drugs.

Sushruta's perspective of Kalpa sthana

The subject matter of Kalpasthana in Sushruta samhita is entirely different and deals with one of the Ashtangas of Ayurveda known as Damshtrachikitsa (Toxicology). Sushruta furnished the details of vamana and virechana drugs in Sutra sthana (43 and 44th chapter). Among vamana dravyas madanaphala, jimutaka pushpa, kutaja phala, ikshvaku pushpa, kritavedhana beeja and dhamargava phala are enumerated. Sushruta identified best virechaneeya drugs based on part used like, trivrit among root purgatives and amongst bark, fruits, oil, juice and latex, the drugs namely tilvaka, haritaki, erandataila (Castor oil), karavellaka and snuhi are considered as best respectively. Trivrit, danti, dravanti, tilvaka, haritaki, chaturangula, erandataila, snuhiksheera, saptala, and shankhini are enumerated under virechaneeya drugs. There is not much difference among the drugs enumerated in Charak and Sushruta, but Sushruta included triphala, erandataila under virechana drugs.

Charak suggested root bark of tilvaka while Sushruta instructed to use bark of tilvaka. A purgative recipe is suggested for children, old people, delicate and patients suffering from dhatukshaya (weight loss/wasting condition) by Sushruta which includes erandataila (Castor oil) mixed with triphala kwatha and milk or meat soup. He also suggested chaturangula for children up to age 12. It appears that Sushruta suggested easily available purgatives.[2]

Relevance of the concepts of Kalpa Sthana in the current clinical practices

Vamana karma (emesis) and virechana karma (purgation) are mandatory before performing basti karma (enema), in order to promote health (i.e., for the patient to gain weight). Keeping this in view, the details about drugs employed in vamana and virechana karma are described in this section and the details about basti karma in the subsequent section, Siddhi Sthana.

For vamana karma, Madanaphala is the main drug employed in the current clinical practice. But the rest of five drugs (i.e., Jimutaka, Ikshvaku, Dhamargava, Vatsaka, and Kritavedhana) are not being prescribed. Charak suggested the period of collection and procedure for extracting seed from the Madanaphala. These procedures are not being followed currently.

In the purgative therapy the drug Trivrita is prescribed currently in the various dosage forms and Aragwadha and Danti are infrequently prescribed. Charak suggested a procedure for extracting the pulp from the fruit of Aragwada. He also described a process to reduce vikasi guna (causes looseness of tissues) of Danti root. Both these procedures are not in vogue. Sushruta suggested Triphala (three fruits, namely Haritaki, Vibitaka, and Amalaki) and Eranda Taila (Castor oil) as purgatives and are prescribed in the current clinical practice.

Tilvaka, Saptala, Sankhini, and Dravanti are the purgative drugs suggested by Charak which are controversial and not being preferred in current practice.

The procedures described by Charak with regard to vamana and virechana karma are being followed religiously by Ayurvedic physicians of current times.

Ayurvedic classics have advocated to collect the medicinal plants according to part used and seasons in order to get desired pharmacological action and therapeutic benefits. Sushruta, Charak and other acharyas advocate the collection of various parts of medicinal plants based on the seasons. The logic behind such recommendations has been validated by recent modern scientific research.

In a study the variations in the phytoconstituents of Ashwagandha root was evaluated according to lunar cycles with regard to grishma and shishira ritu (summer and late winter season). In this study, total phenolic, flavonide and carbohydrate content of Ashwagandha root were found more in poornima (full moon day) samples. GAP (Grishma Ashadha Poornima, or the full moon night occurring in the Grishma-Ashadha season) samples showed maximum differentiation from rest of the samples with regards to TCA, TCW, TFW, MEx, WEX, pH etc. parameters. The Grishma-Jyeshtha Poornima (GJP) and GAP samples were found to be superior than Amavasya (new moon day) samples with regard to functional groups and with anoloid content respectively. [3] [4] Such type of studies validate the concept of seasonal collection of drug delineated in Ayurveda classics like Charak Samhita and Sushruta Samhita.

Contemporary perspective

Modern phytochemistry suggests that Saponin containing drugs act like irritants due to their foam producing action. Through this mechanism, drugs like madana, ikshvaku, jimutaka, kritvedhana may produce emesis. Till date there is no research work carried out on biological activity of kurchine regarding emesis. Drugs containing anthroquinone derivatives tend to be good laxatives. Therefore anthraqinone containing drugs like argvadha act as good virechaka drugs. Ayurvedic classical texts atributed anti-diarrhoel activity to kutaja (Stem bark & seeds). Charak included kutaja under emetics. It may be interpreted that kutaja in emetic doses induces vomiting, while in sub-emetic or therapeutic doses controls diarrhea. According to modern pharmacology “the emetic drugs in sub-emetic doses acts as bronchodilators” indicates that alteration of the dose of the drug can produce different pharmacological actions.[5] It can be presumed that kutaja in emetic doses produces vomiting at the level of upper gastrointestinal tract, while the therapeutic dose of the drug controls diarrhea at the level of lower gastrointestinal tract. Vamanopaga drugs (synergistic drugs to vamana karma) like kovidara, karbudara, shanapushpi, pratyakpushpi possess agni and vayu mahabhuta dominance can support main vamana dravya for emetic action, while drugs like draksha, kashmariphala, parushaka, badara, kuvala, peelu, karkandhu are prithvi and jala mahabhuta dominant drugs, which can support the main virechaka drugs for inducing purgative action.

To summarize the content of Kalpa sthana of Charak samhita it appears that the information about most popular emetic and purgative drugs with various dosage forms is furnished. And more research is required to explain modus operandii of emetic and purgative drugs and their therapeutic applicability through evidence based clinical trials which were in vogue during those times.

Important concepts in Kalpa Sthana

  • Mode of action of Vamana and Virechana [Cha. Sa. Kalpa Sthana 1 / 5]
  • Factors responsible for potency of drug [Cha. Sa. Kalpa Sthana 1 / 7]
  • Selection of soil and desha classification for collecting good quality medicinal plants [Cha. Sa. Kalpa Sthana 1 / 7-8]
  • Ideal and forbidden areas for collecting medicinal plants [Cha. Sa. Kalpa Sthana 1 / 9]
  • Time period of collection and harvesting herbs[Cha. Sa. Kalpa Sthana 1 / 10]
  • Storage of herbs [Cha. Sa. Kalpa Sthana 1 / 11]
  • Concept of Anupana (vehicle) [Cha. Sa. Kalpa Sthana 1 / 12]
  • Nasal drug delivery of herbs [Cha. Sa. Kalpa Sthana 1 / 19], [Cha. Sa. Kalpa Sthana 3 / 11-12],[Cha. Sa. Kalpa Sthana 4 / 10],[Cha. Sa. Kalpa Sthana 10 / 17]
  • Concept of ascending dosage schedule (vardhamana matra)[Cha. Sa. Kalpa Sthana 3 / 13]
  • Development of different dosage forms of purgatives according to constitution [Cha. Sa. Kalpa Sthana 7 / 28]
  • Formulation of purgative drugs according to seasons[Cha. Sa. Kalpa Sthana 7 / 56-59]
  • Formulation designing according to koshtha[Cha. Sa. Kalpa Sthana 10 / 17]
  • Principles of indicating nomenclature of formulation [Cha. Sa. Kalpa Sthana 12 / 44]
  • Concept of potentiation of drugs including the theory of antogonism and synergism [Cha. Sa. Kalpa Sthana 12 / 45-48]
  • Categorization or classification of therapeutic response into mild, moderate and severe categories [Cha. Sa. Kalpa Sthana 12 / 50-56]
  • Importance of assessment of roga bala and rogi bala ( severity of disease and strength of patient) for prescribing purification procedures[Cha. Sa. Kalpa Sthana 12 / 60]
  • Management of residual dosha with food and medicated decoctions after purification therapies.[Cha. Sa. Kalpa Sthana 12 / 66]
  • Concept of examination of koshtha (status of gastrointestinal tract) while administering vamana and virechana drugs.[Cha. Sa. Kalpa Sthana 12 /67]
  • Concept of sneha and ruksha virechana [Cha. Sa. Kalpa Sthana 12 / 82-83]
  • Inhibiting factors fro prevention of purgative actions.[Cha. Sa. Kalpa Sthana 12 / 80]
  • Concept of posology based upon koshtha(status of gastro intestinal tract), vaya(age) and bala(strength)[Cha. Sa. Kalpa Sthana 12 / 86]

Important areas of research and its clinical applications

  • Standardization of procedure of vamana and virechana karma
  • Standardization of processes of different dosage forms
  • Studies on procedures and processing of different anupana like Kwatha, Yavagu, Ksheerapaka, Swarasa, Shashkuli, Shadava, Raga, Shukta, Suramanda, Asava, Sura, Varit, Krishara, Panaka, Sauvira, Tushodaka, Avaleha, Shritapaka, Seedhu, Utkarika


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References

  1. ↑ Thakur Balvant Sing and Chunekar K. C., Glossary of Vegetable Drugs in Brihattrayi, Chaukhamba Amarabharati Prakashan, Varanasi, Ed. (2015)
  2. ↑ Sushruta. Sutra Sthana, Cha.44 Virechanadravyavikalpaneeya Adhyaya verse 72-77. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.
  3. ↑ Tavhare SD, Nishteswar K, Shukla VJ. Effect of seasonal variations on the phytoconstituents of Aśvagandhā w.r. to lunar cycles. Ancient Sci Life. 2016;35((3)):150–8 available online https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850775/
  4. ↑ Tavhare SD, Nishteswar K, Shukla VJ. Influence of lunar cycles on growth of Ashwagandha(Withania somnifera [L.] Dunal). AYU [serial online] 2015 [cited 2019 Jan 22];36:258-64. Available from: http://www.ayujournal.org/text.asp?2015/36/3/258/182763
  5. ↑ Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmaco- therapeutics. Revised 16th edn. Popular Prakashan Private Limited. Mumbai; 1999.
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