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Shyamatrivrita Kalpa Adhyaya (view source)

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The seventh Chapter of [[Kalpa Sthana]] deals with the pharmaceutical preparations for ''virechana karma'' (purgative therapy) using ''Shyama'' and ''Trivrita''. ''Trivrita'', is considered best purgative because of its effectiveness and minimal side effects. The chapter describes synonyms of the plant, its morphology, pharmacological properties, the varieties of plant with their different indications and untoward effects, the method of collection of the plant part used i.e. the root and its storage are also described. Then, one hundred and ten preparations using ''Trivrita'' or ''Shyama'' or combination of these two drugs are enlisted. Proportions of different drugs that are to be used along with the main drug are discussed and the dosage to different individuals is also presented. Recipes made of ''Trivrita'' or ''Shyama'' are formulated in such a way to suit any individual depending upon the seasons and climatic conditions.

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'''Keywords''': ''Shyama, Trivrita, Virechana,'' Operculana turpenthum Linn., purgation.

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'''Keywords''': Shyama, Trivrita, [[Virechana]], Operculana turpenthum Linn., purgation.

</div>

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== Introduction ==

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The first six chapters of this section dealt with preparations used for ''Vamana Karma'' (therapeutic emesis). The preparations aimed at ''Virechana Karma'' (therapeutic purgation) begin with this chapter and are extended in five more chapters. ''Trivrita'' is considered the best as it causes very little side effects and less spasmodic pain during the process of purgation, that is the reason many recipes of this drug are being described.

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The first six chapters of this section dealt with preparations used for [[Vamana]] Karma (therapeutic emesis). The preparations aimed at [[Virechana]] Karma (therapeutic purgation) begin with this chapter and are extended in five more chapters. ''Trivrita'' is considered the best as it causes very little side effects and less spasmodic pain during the process of purgation, that is the reason many recipes of this drug are being described.

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The action of ''Virechana'' drugs known as laxatives or purgatives or cathartics varies depending upon the drug used. The different varieties of drugs used in modern medicine act according to their structure and chemical composition. The latency and effect of all laxatives vary with dosage. In sufficiently high dosage, many laxatives promote catharsis, which implies purgation with more fluid evacuation. Generally many of the drugs used in [[Ayurveda]] for catharsis or laxative action are stimulant laxatives. These drugs stimulate accumulation of water and electrolytes in the colonic lumen and they also enhance intestinal motility. Anthraquinones that are present in many of the Ayurvedic drugs like ''Haritaki, Aragvadha'' or ''Trivrita'' exert their action similarly. They reduce net absorption of electrolytes and water and also increase the permeability of the mucosa, possibly by making tight junctions leaky. This persistent action allows fats to secrete through the intestinal mucosa there by reducing the overall levels of triglycerides in the body. Many of the laxatives of this type increase the synthesis of prostaglandins and this action may contribute to increased secretion of water and electrolytes and is a factor for the spasmodic pain during the process of catharsis. In the present chapter, purgative preparations of ''Trivrita'' are described.

+

The action of [[Virechana]] drugs known as laxatives or purgatives or cathartics varies depending upon the drug used. The different varieties of drugs used in modern medicine act according to their structure and chemical composition. The latency and effect of all laxatives vary with dosage. In sufficiently high dosage, many laxatives promote catharsis, which implies purgation with more fluid evacuation. Generally many of the drugs used in [[Ayurveda]] for catharsis or laxative action are stimulant laxatives. These drugs stimulate accumulation of water and electrolytes in the colonic lumen and they also enhance intestinal motility. Anthraquinones that are present in many of the Ayurvedic drugs like ''Haritaki, Aragvadha'' or ''Trivrita'' exert their action similarly. They reduce net absorption of electrolytes and water and also increase the permeability of the mucosa, possibly by making tight junctions leaky. This persistent action allows fats to secrete through the intestinal mucosa there by reducing the overall levels of triglycerides in the body. Many of the laxatives of this type increase the synthesis of prostaglandins and this action may contribute to increased secretion of water and electrolytes and is a factor for the spasmodic pain during the process of catharsis. In the present chapter, purgative preparations of ''Trivrita'' are described.

== Sanskrit Text, Transliteration with English Translation ==

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kalpavaisheshyamasadya [1] sarvarogahara bhavet||6|| <br />

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''Trivrita'' is astringent and sweet in taste, dry (not oily or creamy) and pungent in ''vipaka'' (post digestive effect). Due to its dry property it pacifies ''kapha'' and ''pitta'' and aggravates ''vata''. Even then, when utilized along with drugs which pacify ''vata, pitta'' and ''kapha'' and also depending upon the combinations used in various pharmaceutical preparations, this drug attains the capacity of curing all types of diseases. [5-6]

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''Trivrita'' is astringent and sweet in taste, dry (not oily or creamy) and pungent in ''vipaka'' (post digestive effect). Due to its dry property it pacifies [[kapha]] and [[pitta]] and aggravates [[vata]]. Even then, when utilized along with drugs which pacify [[vata]], [[pitta]] and [[kapha]] and also depending upon the combinations used in various pharmaceutical preparations, this drug attains the capacity of curing all types of diseases. [5-6]

=== Types of ''Trivrita'' ===

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shasyate bahudoshanam krurakoshthashcha ye narah||9||

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The root of the ''Trivrita'' having black colour, when used for purgative action, due to its instantaneous action, leads to unconsciousness, loss (of tissue elements or in another sense, electrolytes) and fainting. Due to its rapid action, it causes spasmodic pain (torment) in the cardiac region and throat. It eliminates the morbid (accumulated) material instantaneously. Hence, this variety is highly useful in persons having excessively aggravated ''dosha'' and highly constipated bowel (''Krura koshtha'') [7 ½ -9]

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The root of the ''Trivrita'' having black colour, when used for purgative action, due to its instantaneous action, leads to unconsciousness, loss (of tissue elements or in another sense, electrolytes) and fainting. Due to its rapid action, it causes spasmodic pain (torment) in the cardiac region and throat. It eliminates the morbid (accumulated) material instantaneously. Hence, this variety is highly useful in persons having excessively aggravated [[dosha]] and highly constipated bowel (''Krura koshtha'') [7 ½ -9]

=== Method of collection ===

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vatapittahitanyetanyanyani tu kaphanile|20| <br />

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The powder of ''Trivrita'' can be taken along with the powder of either, ''Jivaka, Rhushbhaka, Meda, Shravani (Mundi), Karkatashringi, Mudgaparni, Mashaparni, Maha-shravani, Kakoli, Kshirakakoli, Indra (Indravaruni), Chinna riha (Guduchi), Kshirashukla (Kshiravidari)'' or ''Payasya (Arka-puspha)'' for purgation. Similarly, the powder of ''Trivrita'' root can be taken along with ''Yashtimadhu (Madhuka)'' for purgation. The above mentioned preparations are useful for diseases caused by ''vata'' and ''pitta''. The preparations that will be useful for the diseases caused by ''vata'' and ''pitta'' will be described later. [18 –19½]

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The powder of ''Trivrita'' can be taken along with the powder of either, ''Jivaka, Rhushbhaka, Meda, Shravani (Mundi), Karkatashringi, Mudgaparni, Mashaparni, Maha-shravani, Kakoli, Kshirakakoli, Indra (Indravaruni), Chinna riha (Guduchi), Kshirashukla (Kshiravidari)'' or ''Payasya (Arka-puspha)'' for purgation. Similarly, the powder of ''Trivrita'' root can be taken along with ''Yashtimadhu (Madhuka)'' for purgation. The above mentioned preparations are useful for diseases caused by[[vata]] and [[pitta]]. The preparations that will be useful for the diseases caused by [[vata]] and [[pitta]] will be described later. [18 –19½]

=== Preparations of Trivrita, to be taken along with liquids ===

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anena vidhina kuryat paittikanam virechanam||28|| <br />

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Following the same method (as mentioned in the above verses) preparations may be done in the form of ''Sharkara modaka'' (round, ball like sweets made of sugar), ''Sharkara varti'' (rolls made of sugar), ''Sharkaragulika'' (Pills made with sugar) and ''Sharkara mamsapupaka'' (Cake prepared with sugar and meat). These preparations are useful as purgatives for those persons, suffering from diseases caused by ''pitta dosha'' [28]

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Following the same method (as mentioned in the above verses) preparations may be done in the form of ''Sharkara modaka'' (round, ball like sweets made of sugar), ''Sharkara varti'' (rolls made of sugar), ''Sharkaragulika'' (Pills made with sugar) and ''Sharkara mamsapupaka'' (Cake prepared with sugar and meat). These preparations are useful as purgatives for those persons, suffering from diseases caused by [[pitta]] [[dosha]] [28]

=== Preparations of ''Trivrita'' in the form of linctus (No. 6) ===

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The powder of ''Trivrita'' (having pink roots) may be added with powders of ''Pippali, Nagara, Kshara'' (an alkali preparation) and ''Shyama'' (the variety having black roots).

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To this mixed powder, honey may be added and can be taken in, in the form of linctus for purgation for those having ''kapha'' type of constitution or for those persons suffering from disease due to the aggravation of ''kapha''.

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To this mixed powder, honey may be added and can be taken in, in the form of linctus for purgation for those having [[kapha]] type of constitution or for those persons suffering from disease due to the aggravation of [[kapha]].

=== Preparation of ''Trivrita'' in the form of linctus (No. 7) ===

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anena vidhina kuryadvirekartham kaphadhike||33|| <br />

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Similar to the above mentioned procedure, the preparations (of ''Trivrita'') are to be made in the forms of ''Panak'' (syrup), ''Rasa'' (meat soup), ''Yusha'' (pulse-soup), ''Modaka'' (sweet-meat), and ''Raga'' – ''shadava'' (sour drinks with and pungent taste). These preparations can be administered for purgation to persons having aggravated ''kapha''. [33]

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Similar to the above mentioned procedure, the preparations (of ''Trivrita'') are to be made in the forms of ''Panak'' (syrup), ''Rasa'' (meat soup), ''Yusha'' (pulse-soup), ''Modaka'' (sweet-meat), and ''Raga'' – ''shadava'' (sour drinks with and pungent taste). These preparations can be administered for purgation to persons having aggravated [[kapha]]. [33]

=== Preparations of ''Trivrita'' in the form of ''Tarpana'' (soothing drink) ===

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nareshu sukumareshu nirapayam virechanam||35|| <br />

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A ''Tarpana'' or soothing drink should be prepared by adding the powder of one part of ''Bhringa'', one part of ''Ela'' (Cinnamon bark), two parts of ''Nili'', three parts of ''Trivrita'' and seven parts of sugar to the juice of ''Dadima'', honey and powder of pop-rice or barley. This is a very safe purgative preparation for the patients suffering from diseases due to ''vata, pitta'' and ''kapha'', for persons having low digestive fire and for persons who are very much tender or delicate. [34-35]

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A ''Tarpana'' or soothing drink should be prepared by adding the powder of one part of ''Bhringa'', one part of ''Ela'' (Cinnamon bark), two parts of ''Nili'', three parts of ''Trivrita'' and seven parts of sugar to the juice of ''Dadima'', honey and powder of pop-rice or barley. This is a very safe purgative preparation for the patients suffering from diseases due to [[vata]], [[pitta]] and [[kapha]], for persons having low digestive fire and for persons who are very much tender or delicate. [34-35]

=== Preparation of ''Trivrita'' in the form of ''Modaka'' ===

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modakah sannipatordhvaraktapittajvarapahah||36|| <br />

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A ''Modaka'' (large sized round sweet-meat) may be prepared using sugar, ''Haritaki, Vibhitaki, and Amalaki'', black variety of ''Trivrita'' roots, ''Pippali'' and honey. Intake of this preparation cures ''Sannipata'' (simultaneous aggravation of all the three ~~''doshas''~~ and diseases caused there upon), ''Urdhva Raktapitta'' (bleeding from the opening of the upper parts of the body like mouth or nose) and fever. [36]

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A ''Modaka'' (large sized round sweet-meat) may be prepared using sugar, ''Haritaki, Vibhitaki, and Amalaki'', black variety of ''Trivrita'' roots, ''Pippali'' and honey. Intake of this preparation cures ''Sannipata'' (simultaneous aggravation of all the three [[dosha]] and diseases caused there upon), ''Urdhva Raktapitta'' (bleeding from the opening of the upper parts of the body like mouth or nose) and fever. [36]

=== Preparation of ''Trivrita'' in the form of linctus (No. 8) ===

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kaphavatakrutamshchanyan vyadhinetahyapohati||39||<br />

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Three ''shanas'' of ''Trivrita'' powder is to be added with one ''shana'' rind powders of ''Haritaki, Vibhitaki, Amalaki,'' ''Vidanga'', ''Pippali'' and ''Kshara'' (an alkali preparation). This compounded powder may be mixed with ghee and honey and made to linctus or to an ''Modaka'' (round large sized sweet meat) using jaggery. This is considered as a good purgative and a person using it need not follow any dietary or any other restrictions. If this preparation is taken in, it can cure ''gulma'' (benign tumors of intestines), ''Plihodara'' (splenomegaly), ''Shvasa'' (broncho-spasm), ''Halimaka'' (chronic hepatitis), ''Arochaka'' (anorexia) and other such diseases caused by the aggravation of ''kapha'' and ''vata'' [37-39]

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Three ''shanas'' of ''Trivrita'' powder is to be added with one ''shana'' rind powders of ''Haritaki, Vibhitaki, Amalaki,'' ''Vidanga'', ''Pippali'' and ''Kshara'' (an alkali preparation). This compounded powder may be mixed with ghee and honey and made to linctus or to an ''Modaka'' (round large sized sweet meat) using jaggery. This is considered as a good purgative and a person using it need not follow any dietary or any other restrictions. If this preparation is taken in, it can cure ''gulma'' (benign tumors of intestines), ''Plihodara'' (splenomegaly), ''Shvasa'' (broncho-spasm), ''Halimaka'' (chronic hepatitis), ''Arochaka'' (anorexia) and other such diseases caused by the aggravation of [[kapha]] and [[vata]] [37-39]

=== Preparation of ''Trivrita'' in the form of ''Modaka'' (No. 2) ===

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*''Trivrita'' is ''kashaya''(astringent), ''madhura''(sweet) ''rasa, katu''(pungent), ''vipaka''(product after digestion), and ''ruksha''(dry) properties. These properties do not support the purgative action, in spite of this ''Trivrita'' is best among purgative drug.

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*It pacifies ''kapha'' and ''pitta'' and aggravates ''vata'' due to its ''ruksha''(dry) property.

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*It pacifies [[kapha]] and [[pitta]] and aggravates [[vata]] due to its ''ruksha''(dry) property.

*Roots of ''Trivrita'' are used in pharmaceutical processing. These are of two types: black (''Shyama'') and the other having Blackish red. The latter are more useful between them.

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*The blackish red root of ''Trivrita'' can be safely used as mild purgative in tender persons, children, old aged people and those with laxed bowel. The blackish variety is strong purgative and can cause untoward effects. It is used in more aggravation of ''dosha'' and hard bowel persons.

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*The blackish red root of ''Trivrita'' can be safely used as mild purgative in tender persons, children, old aged people and those with laxed bowel. The blackish variety is strong purgative and can cause untoward effects. It is used in more aggravation of [[dosha]] and hard bowel persons.

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*After combining with respective ''dosha'' pacifying drugs, ''Trivrita'' can be used in treatment of all diseases due to any ''dosha'' vitiation. It can also be used in all seasons in combination with various drugs.

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*After combining with respective [[dosha]] pacifying drugs, ''Trivrita'' can be used in treatment of all diseases due to any [[dosha]] vitiation. It can also be used in all seasons in combination with various drugs.

== Vidhi Vimarsha (Applied Inferences ) ==

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=== Properties ===

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Some drugs have got inborn tendency to act in some pathological conditions. Similarly, ''Trivrita'' has the natural property to aggravate ''vata'' and pacify ''pitta'' and ''kapha''. But when prepared with ''vata'' pacifying drugs, it cures diseases caused by ''vata''. Similarly, when prepared with ''pitta'' and ''kapha'' pacifying drugs, it can be capable of curing diseases caused by ''pitta'', and ''kapha'' respectively. This property of modulating the pharmacological action depending upon the preparation is known as ''Samskarabhivartana; Ghuta'' or clarified butter is also said to possess the similar property.

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Some drugs have got inborn tendency to act in some pathological conditions. Similarly, ''Trivrita'' has the natural property to aggravate [[vata]] and pacify [[pitta]] and [[kapha]]. But when prepared with [[vata]] pacifying drugs, it cures diseases caused by [[vata]]. Similarly, when prepared with [[pitta]] and [[kapha]] pacifying drugs, it can be capable of curing diseases caused by [[pitta]], and [[kapha]] respectively. This property of modulating the pharmacological action depending upon the preparation is known as ''Samskarabhivartana; Ghuta'' or clarified butter is also said to possess the similar property.

Pharmacological Properties of a drug are described in any context to gain full length knowledge about its therapeutic actions. But at times, there may not be exact concordance between these two. The Ayurvedic parameters like ''rasa, guna'', etc.; generally show or exhibit the same therapeutic actions, attributed to them. But some drugs that are strong emetics, purgatives and antitoxic, do not imbibe themselves to the theoretical parameters and exert their individualized action. So, ''Trivrita'' also can be considered as a drug with individualized action. (Verse 5-6)

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Administration of thin gruel, in the previous night is an exception to the general rule to the purgation process, as stated in Sutra 13:18. There, it is said that the person who is to be purgated is to be given a liquid diet along with meat-soup which is unctuous (''Snehavat'') and hot, continuously for three days. But when, purgation with ''trivrita'' is being done, this rule need not be followed and a single semi liquid diet in the previous night is sufficient. Anyhow, it is to be given when hot and is prepared with meat soup, adding ghee. The reason for this exception is that, ''trivrita'' is such a drug which can cause purgation with ease, causing less or little complications.

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In total, 110 preparations of ''trivrita'' are described in this chapter, utilizing different vehicles and different forms that are suitable for each individual. Out of them nine preparations are counted here. Fermented liquids or urine of different animals are used. Though, the secondary purpose of liquid is to swallow the drug easily, the main purpose is to facilitate the action of the drug.i.e ''trivrita''. In general, the fermented liquids can expel out the hard ''feces'' (''bhedi''), palatable and control reversed peristalsis there by reducing the spasm generated during the administration of purgatives. The person suffers from less colicky pain by using them. The use of urine of different animals helps to pacify ''kapha'' and alleviate colicky pain. Thus, the use of vehicles, enhance the desired action of the main drug and reduce the undesired actions.

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In total, 110 preparations of ''trivrita'' are described in this chapter, utilizing different vehicles and different forms that are suitable for each individual. Out of them nine preparations are counted here. Fermented liquids or urine of different animals are used. Though, the secondary purpose of liquid is to swallow the drug easily, the main purpose is to facilitate the action of the drug.i.e ''trivrita''. In general, the fermented liquids can expel out the hard ''feces'' (''bhedi''), palatable and control reversed peristalsis there by reducing the spasm generated during the administration of purgatives. The person suffers from less colicky pain by using them. The use of urine of different animals helps to pacify [[kapha]] and alleviate colicky pain. Thus, the use of vehicles, enhance the desired action of the main drug and reduce the undesired actions.

=== Twelve preparations ===

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=== Yashtimadhu combination ===

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One preparation, along with ''yashtimadhu'' is described. In the index at the end of this chapter, two preparations, using the same drug are enlisted. The other one is narrated in the verse no. 19. This preparation is very much palatable and is specifically useful for those persons having ''pitta'' type of constitution who are suffering from symptoms like throat burn.

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One preparation, along with ''yashtimadhu'' is described. In the index at the end of this chapter, two preparations, using the same drug are enlisted. The other one is narrated in the verse no. 19. This preparation is very much palatable and is specifically useful for those persons having [[pitta]] type of constitution who are suffering from symptoms like throat burn.

=== Fourteen preparations ===

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Fourteen preparations using ''trivrita'' along with fourteen different drugs like ''jivaka'' are narrated. Additionally, one more preparation, using ''yashtimadhu'' is also described. These preparations are very much palatable as most of the drugs are sweet in taste. Though, some of them are bitter, their ''vipaka'' or post digestive effect is sweet. So, apart from causing purgation, they relieve many diseases caused by ''vata'' and ''pitta'' and act as rejuvenatives (''rasayana'') as well.

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Fourteen preparations using ''trivrita'' along with fourteen different drugs like ''jivaka'' are narrated. Additionally, one more preparation, using ''yashtimadhu'' is also described. These preparations are very much palatable as most of the drugs are sweet in taste. Though, some of them are bitter, their ''vipaka'' or post digestive effect is sweet. So, apart from causing purgation, they relieve many diseases caused by [[vata]] and [[pitta]] and act as rejuvenatives ([[rasayana]]) as well.

=== Seven preparations ===

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Total number of seven preparations, of ''trivrita'' are prescribed, using seven different ingredients. Many of them are having sweet taste and are able to control ''vata'' potentially. Milk and meat soup are highly palatable and can be given to individuals with their choice. The third one is sugar cane juice, accepted by all and is an addition to the laxative action. The next three recipes are fruit juices and have got pure sweet taste with mild laxative action. The seventh one is ghee which alleviates ''vata'' and reduces the drastic action of any purgative drug. ''Haritaki'' is added half the quantity to the main drug to enhance the purgative action of ''trivrita'' very safely and in a sustained manner.

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Total number of seven preparations, of ''trivrita'' are prescribed, using seven different ingredients. Many of them are having sweet taste and are able to control [[vata]] potentially. Milk and meat soup are highly palatable and can be given to individuals with their choice. The third one is sugar cane juice, accepted by all and is an addition to the laxative action. The next three recipes are fruit juices and have got pure sweet taste with mild laxative action. The seventh one is ghee which alleviates [[vata]] and reduces the drastic action of any purgative drug. ''Haritaki'' is added half the quantity to the main drug to enhance the purgative action of ''trivrita'' very safely and in a sustained manner.

=== Avaleha (linctus) ===

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This preparation (Verse 23 ½ - 25) is intended for rich people and whose physique is tender. As they usually consume high fat diet regularly, they need not undergo oleation therapy as a prerequisite to purgation. This linctus can cause purgation even in them, with ease.

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Though, the quantity of ''trivrita'' to be added is not mentioned here, as a common rule, one-fourth quantity to the liquids may be added. The fruit juices in general and juices of grapes and ''pilu'' specifically cause mild laxation and expel out the stagnated ''pitta dosha'' from the body effectively. The honey that is heated also can act as a ''pitta'' aggravating factor to mobilize it from the existing place and move it out. Similar preparation is found also in Sushruta Samhita and Ashtanga Hridaya. (Verse 26-27)

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Though, the quantity of ''trivrita'' to be added is not mentioned here, as a common rule, one-fourth quantity to the liquids may be added. The fruit juices in general and juices of grapes and ''pilu'' specifically cause mild laxation and expel out the stagnated [[pitta]] [[dosha]] from the body effectively. The honey that is heated also can act as a [[pitta]] aggravating factor to mobilize it from the existing place and move it out. Similar preparation is found also in Sushruta Samhita and Ashtanga Hridaya. (Verse 26-27)

These preparations (Verse 28) are made in the similar process as that of linctus. For making these preparations, sugarcane juice etc; as described in the verses 26-27 are to be utilized accordingly.

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In this preparation (Verse 29), both the varieties of ''trivrita'' roots are used for their synergistic action. Though, the propositions are not mentioned, they can be taken in equal quantity. The other drugs are also able to check the status of ''kapha'' and help to expel out the stagnated ''kapha'' from the body. ''Kshara'' mentioned here is an alkali preparation that is prepared synthetically, using grasses and herbs.

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In this preparation (Verse 29), both the varieties of ''trivrita'' roots are used for their synergistic action. Though, the propositions are not mentioned, they can be taken in equal quantity. The other drugs are also able to check the status of [[kapha]] and help to expel out the stagnated [[kapha]] from the body. ''Kshara'' mentioned here is an alkali preparation that is prepared synthetically, using grasses and herbs.

This preparation (Verse 30-32) can be made as per the method mentioned in verses 26-27. Quantity of the ingredients individually is not mentioned here. But for all practical purposes, the juice of ''Matulunga'', etc; are to be taken in the quantity of one ''kudava'' each. This is as per the suggestions made by Chakrapani.

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This (Verse 36) is one of the five preparations of ''trivrita'' in the form of ''modaka''. The taste of this is good and causes less hazardous effects on the body while curing the disease proper.

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This (Verse 37-39) is the eighth and the last one of the preparations in the form of linctus. Measurement of ''modaka'' used here is one ''shana'' which measures approximately 3.0 grams. Because this contains many drugs which pacify ''kapha'', the preparation is indicated in upper abdominal diseases including bronchitis. Though it is said that no restrictions of any type are required here, they are to be followed cautiously and judiciously so that unexpected complications do not arise.

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This (Verse 37-39) is the eighth and the last one of the preparations in the form of linctus. Measurement of ''modaka'' used here is one ''shana'' which measures approximately 3.0 grams. Because this contains many drugs which pacify [[kapha]], the preparation is indicated in upper abdominal diseases including bronchitis. Though it is said that no restrictions of any type are required here, they are to be followed cautiously and judiciously so that unexpected complications do not arise.

=== Kalyanaka guda ===

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This (Verse 49½ - 50½) is the fourth formulation of ''trivrita'' in the form of ''modaka''. Here, Charaka has used the word ''urubuka'' (castor plant) but did not mention the part of the plant to be used. Ancient commentators on any of the verse too did not give their opinion. Some modern commentators advised to take powdered seed which does not appear to be correct since the powder is highly toxic and can kill a person in that dose. Hence, it is ideal to use the root bark of castor plant which is not toxic but causes purgation without causing intestinal spasm.

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The fifth type of trivrita formulation (Verse 50½ -55) in the form of modaka is prepared by dividing it into two parts - while the first one is preparation of large sized pills, the second part consists of application of medicated powders over it to make it more effective and palatable. There is a debate regarding the part of ''dadima'' to be used for preparations. In the similar compound, as mentioned in Ashtanga Hridaya, the preparation of ''modaka'' and its ingredients are to certain extent similar but the rolling (''veshtana'') process is not present. The seed powder of ''dadima'' is not effective therapeutically when dried and hence, the powder of the stem bark, which has got many potent actions against the diseases of colon that, can be used. Due to the addition of drugs like ''vacha, chitraka'' and ''tumburu'', diseases due to ''kapha'' are definitely alleviated.

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The fifth type of trivrita formulation (Verse 50½ -55) in the form of modaka is prepared by dividing it into two parts - while the first one is preparation of large sized pills, the second part consists of application of medicated powders over it to make it more effective and palatable. There is a debate regarding the part of ''dadima'' to be used for preparations. In the similar compound, as mentioned in Ashtanga Hridaya, the preparation of ''modaka'' and its ingredients are to certain extent similar but the rolling (''veshtana'') process is not present. The seed powder of ''dadima'' is not effective therapeutically when dried and hence, the powder of the stem bark, which has got many potent actions against the diseases of colon that, can be used. Due to the addition of drugs like ''vacha, chitraka'' and ''tumburu'', diseases due to [[kapha]] are definitely alleviated.

=== Importance of Trivrita ===

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To make this drug more safe and more effective surpassing these climatic changes, Charaka has given four different preparations, useful for four seasons - summer, rainy/monsoon, autumn and winter. Apart from these four, he has also formulated two preparations that are useful for all seasons. Though it is stated that, for a healthy person, purgation therapy is to be employed in post rainy season, it has to be administered as and when an emergency state occurs in any season. There, this preparation helps a physician and the patient to cope up with the situation safely. In rainy season, there is a dominance of ''vata'' and the addition of ''shunthi'', honey and grape juice help to overcome this problem.

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In this purgative preparation (Verse 57) that is useful in post rainy season, two drugs of plant origin appear to be confusing. They are ''duralabha'' and ''udichya''. ''Duralabha'' can be better equated with Fagonia cretica Linn. As some sweet resionous substance is prepared from this plant and marketed which pacifies Pitta. So the other plant ''udichya'' can be equated with some Valeriana sp. which acts against ''pitta''.

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In this purgative preparation (Verse 57) that is useful in post rainy season, two drugs of plant origin appear to be confusing. They are ''duralabha'' and ''udichya''. ''Duralabha'' can be better equated with Fagonia cretica Linn. As some sweet resionous substance is prepared from this plant and marketed which pacifies [[Pitta]]. So the other plant ''udichya'' can be equated with some Valeriana sp. which acts against [[pitta]].

The word ''drakshambu'' is different from the juice of grapes. Grape juice is a direct extraction of the fruits through compression. But for grape water, dry grapes are to be soaked in water over night, thoroughly squeezed and filtered. The difference between them is that the first one is more concentrated and the latter is more diluted.

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=== Contraindication of purgation therapy and seasons affecting its efficacy ===

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Purgation therapy is not indicated during winter season due to the likely development of intestinal spasm because of the cold wave. Even then, in case of emergency or in a particular disease where ''kapha'' is causing problem or obstructing the lower parts of the colon, this purgation therapy is indicated. The powders mixed together can be ground well with hot water, so that the actual compound acts upon the system with ease.

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Purgation therapy is not indicated during winter season due to the likely development of intestinal spasm because of the cold wave. Even then, in case of emergency or in a particular disease where [[kapha]] is causing problem or obstructing the lower parts of the colon, this purgation therapy is indicated. The powders mixed together can be ground well with hot water, so that the actual compound acts upon the system with ease.

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During hot summer, purgation therapy is not at all advised due to the fear of developing dehydration or electrolyte imbalance. Even during that season, if need arises, ''trivrita'' can be utilized without any complication. To avoid any unexpected problem Charaka suggested using it with sugar which can prevent gastritis due to ''pitta''.

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During hot summer, purgation therapy is not at all advised due to the fear of developing dehydration or electrolyte imbalance. Even during that season, if need arises, ''trivrita'' can be utilized without any complication. To avoid any unexpected problem Charaka suggested using it with sugar which can prevent gastritis due to [[pitta]].

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