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<div style='text-align:justify;'>Aushadha means medicine or drug. It is used for the preservation of health and the treatment of [[Vyadhi|diseases]]. Aushadha is used for regaining [[Health|health]], and its appropriate use is as beneficial as nector, whereas inappropriate use makes it a poison.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 4. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 363.</ref> The aushadha may be used either in combination or as a single drug. In the context of using a single aushadha, a description of agrya prakarana (superior aushadha) with 152 entities is found in [[Charak Samhita New Edition|Charak Samhita]] [Cha. Sa. Sutra Sthana 25/40] and 155 entitites in Ashtanga sangraha.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Agryasangraha Adhyaya: Chapter 13, Verse 3. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 269-271.</ref> Ashtanga Hridaya described 55 entities.<ref>Murthy K.R.S., editor, (8th ed.). Vagbhata’s Ashtanga Hridayam, Uttar Tantra: Vajikaranavidhi Adhyaya: Chapter 40, Verse 48-58. Varanasi: Chowkhamba Krishnadas Academy, 2011; 420.</ref> [A. Hri. Uttar Tantra 40/48-58] Aushadha is among the four aspects of the healthcare system with the physician, attendant, and patient. [Cha. Sa. Sutra Sthana 9/3] All [[Dravya|dravya]] in the world are derived from [[Pancha mahabhuta|five mahabhutas]] ([[Prithvi mahabhuta|prithvi]], [[Jala mahabhuta|apa]], [[agni|agni]], [[Vayu mahabhuta|vayu]] and [[Akasha mahabhuta|akasha]]). The sharira is a constitution of panchamahabhuta in variable proportion. Any imbalance in this proportion can alter homeostasis and cause disorders. Dravya of a particular panchamahabhautika composition is required to normalize the composition of panchamahabhuta in sharira. For example, if a disease originated due to insufficiency of apa mahabhuta, then dravya rich in apa mahabhuta is administered to patient to increase the quantity of apa mahabhuta back to normal. Since all dravyas have a specific panchamahabhautika constitution, they can be used to establish normal homeostasis of panchamahabhutas of sharira and treat disease. Since aushadhi too is a dravya and similarly treats the disease, thus all the dravyas are aushadhi<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Sutra Sthana; Dravyavisheshavigyaniya Adhyaya: Chapter 41, Verse 9. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 199.</ref> [Cha. Sa. Sutra Sthana 26/12] [Su. Sa. Sutra Sthana 41/9] Effectively managing a disease requires correct identification, dosage and time of administration of aushadha. Selection of the right aushadha requires understanding its mode of action. To prevent the untoward effects of aushadha, it’s essential to know that the aushadha are patient-specific, location-specific, and season specific. Examination of aushadha must not be missed prior to its use. This chapter describes various aspects of aushadha. </div>

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<div style='text-align:justify;'>Aushadha means medicine or drug. It is used for the preservation of health and the treatment of [[Vyadhi|diseases]]. Aushadha is used for regaining [[Health|health]], and its appropriate use is as beneficial as nector, whereas inappropriate use makes it a poison.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 4. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 363.</ref> The aushadha may be used either in combination or as a single drug. In the context of using a single aushadha, a description of agrya prakarana (superior aushadha) with 152 entities is found in [[Charak Samhita New Edition|Charak Samhita]] [Cha. Sa. Sutra Sthana 25/40] and 155 entitites in Ashtanga sangraha.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Agryasangraha Adhyaya: Chapter 13, Verse 3. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 269-271.</ref> Ashtanga Hridaya described 55 entities.<ref>Murthy K.R.S., editor, (8th ed.). Vagbhata’s Ashtanga Hridayam, Uttar Tantra: Vajikaranavidhi Adhyaya: Chapter 40, Verse 48-58. Varanasi: Chowkhamba Krishnadas Academy, 2011; 420.</ref> [A. Hri. Uttar Tantra 40/48-58] Aushadha is among the four aspects of the healthcare system with the physician, attendant, and patient. [Cha. Sa. Sutra Sthana 9/3] All [[Dravya|dravya]] in the world are derived from [[Pancha mahabhuta|five mahabhutas]] ([[Prithvi mahabhuta|prithvi]], [[Jala mahabhuta|apa]], [[agni|agni]], [[Vayu mahabhuta|vayu]] and [[Akasha mahabhuta|akasha]]). The [[Sharira|sharira]] is a constitution of [[Pancha mahabhuta|panchamahabhuta]] in variable proportion. Any imbalance in this proportion can alter homeostasis and cause disorders. [[Dravya|Dravya]] of a particular panchamahabhautika composition is required to normalize the composition of [[Pancha mahabhuta|panchamahabhuta]] in [[Sharira|sharira]]. For example, if a [[Vyadhi|disease]] originated due to insufficiency of [[Jala mahabhuta|apa mahabhuta]], then [[Dravya|dravya]] rich in [[Jala mahabhuta|apa mahabhuta]] is administered to patient to increase the quantity of [[Jala mahabhuta|apa mahabhuta]] back to normal. Since all [[Dravya|dravyas]] have a specific panchamahabhautika constitution, they can be used to establish normal homeostasis of [[Pancha mahabhuta|panchamahabhutas]] of [[Sharira|sharira]] and treat [[Vyadhi|disease]]. Since [[Aushadhi|aushadhi]] too is a [[Dravya|dravya]] and similarly treats the [[Vyadhi|disease]], thus all the [[Dravya|dravyas]] are [[Aushadhi|aushadhi]]<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Sutra Sthana; Dravyavisheshavigyaniya Adhyaya: Chapter 41, Verse 9. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 199.</ref> [Cha. Sa. Sutra Sthana 26/12] [Su. Sa. Sutra Sthana 41/9] Effectively managing a [[Vyadhi|disease]] requires correct identification, dosage and time of administration of aushadha. Selection of the right aushadha requires understanding its mode of action. To prevent the untoward effects of aushadha, it’s essential to know that the aushadha are patient-specific, location-specific, and season specific. Examination of aushadha must not be missed prior to its use. This chapter describes various aspects of aushadha. </div>

{{Infobox

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== Etymology and derivation ==

* The vegetations that die when their fruits mature are called ‘aushadhi’. Example, the plants of banana and grain.<ref>Dev R.R.K., editor, (1st ed.). Shabdakalpadrum, Kand 1. Delhi: Amar Publications, 2018; 303.</ref>

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The rasa (essence) is called osa. Entity that contains this rasa is called ‘aushadhi’. As disease-free state is obtained through rasa, so the entity that contains rasa is called aushadha.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 27. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 366.</ref>

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The [[Rasa|rasa]] (essence) is called osa. Entity that contains this rasa is called ‘aushadhi’. As disease-free state is obtained through [[Rasa|rasa]], so the entity that contains [[Rasa|rasa]] is called aushadha.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 27. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 366.</ref>

* Aushadha is the plant which perish after fruits mature. [Cha. Sa. Sutra Sthana 1/73].

'''Synonyms''' [Cha. Sa. Chikitsa Sthana 1/1/3]

* Chikitsita: That which alleviates disorders.

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* Vyadhihara: destroyer of diseases.

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* Vyadhihara: destroyer of [[Vyadhi|diseases]].

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* Pathya: beneficial for the channels in body.

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* Pathya: beneficial for the channels in [[Sharira|body]].

* Sadhana: that which is an instrument for performance.

* Prayaschitta: expiation.

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* Prashamana: pacification.

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* [[Prashamana|Prashamana]]: pacification.

* Prakritisthapana: that which helps recovery.

* Hita: wholesome.

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<li>That which alleviates disorders.</li></ol>

<li>Aushadha can also be classified as-<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 6. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref></li>

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<ol><li>Shamana aushadha: Shamana therapy is a palliative approach that normalizes the vitiated dosha at the seat of aggravation.</li>

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<ol><li>Shamana aushadha: Shamana therapy is a palliative approach that normalizes the vitiated [[Dosha|dosha]] at the seat of aggravation.</li>

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<li>Shodhana aushadha: Shodhana (purification) is a therapy in which the aggravated dosha is expelled from the body, thereby eliminating the internal causative factors of the disease.</br>Shodhan aushadha is again of two types:</li>

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<li>[[Shodhana|Shodhana]] aushadha: [[Shodhana|Shodhana]] (purification) is a therapy in which the aggravated [[Dosha|dosha]] is expelled from the [[Sharira|body]], thereby eliminating the internal causative factors of the [[Vyadhi|disease]].</br>Shodhan aushadha is again of two types:</li>

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<ol type="a"><li>Agneya aushadha: Aushadha that are predominant in agni and vayu mahabhuta.</li>

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<ol type="a"><li>[[Agneya|Agneya]] aushadha: Aushadha that are predominant in [[Agni mahabhuta|agni]] and [[Vayu mahabhuta|vayu mahabhuta]].</li>

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<li>Soumya aushadha: Aushadha predominant in apa, akash and prithvi mahabhuta.</li></ol></ol>

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<li>Soumya aushadha: Aushadha predominant in [[Jala mahabhuta|apa]], [[Akasha mahabhuta|akash]] and [[Prithvi mahabhuta|prithvi mahabhuta]].</li></ol></ol>

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<li>Sushruta mentioned that all dravya is aushadha, and then classified aushadha into two:</li>

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<li>Sushruta mentioned that all [[Dravya|dravya]] is aushadha, and then classified aushadha into two:</li>

<ol><li>Sthavara: Entities of plant origin are called sthavara. The sthavara are of four types:</li>

<ol type="a"><li>Vanaspati: Those bearing fruits without being preceded by flowers.</li>

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<ol type="A"><li>Matravat aushadha: When aushadha is administered in optimum dose.</li>

<li>Amatravat aushadha: When aushadha is administered in improper dose. Amatravat aushadha can be divided into</li>

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<ol><li>Heena matra (insufficient dose): The quantity of administered aushadha less than its optimum dose is its heena matra. Heena matra is unable to treat disease and does not bring about the homeostasis of dhatu.</li>

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<ol><li>Heena matra (insufficient dose): The quantity of administered aushadha less than its optimum dose is its heena matra. Heena matra is unable to treat [[Vyadhi|disease]] and does not bring about the homeostasis of [[Dhatu|dhatu]].</li>

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<li>Ati matra (excess dose): The quantity of administered aushadha more than its optimum dose is its ati matra. The ati matra causes the vitiation of tridoshas leading to other undesired results. The ati matra of aushadha is excreted out of the body without being absorbed. It can lead to complications.</li></ol></ol>

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<li>Ati matra (excess dose): The quantity of administered aushadha more than its optimum dose is its ati matra. The ati matra causes the vitiation of [[Tridosha|tridoshas]] leading to other undesired results. The ati matra of aushadha is excreted out of the body without being absorbed. It can lead to complications.</li></ol></ol>

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<li>Aushadha matra (particularly in context to aushadha of snehapana i.e., oral administration of medicated ghee or oil) can also be classified into:<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Snehavidhi Adhyaya: Chapter 25, Verse 22. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 452.</ref><ref>Murthy K.R.S., editor, (8th ed.). Vagbhata’s Ashtanga Hridayam, Sutra Sthana; Snehavidhi Adhyaya: Chapter 16, Verse 17-18. Varanasi: Chowkhamba Krishnadas Academy, 2011; 212.</ref> [Ast. Hri. Sutra Sthana 16/17-18]</li>

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<li>Aushadha matra (particularly in context to aushadha of snehapana i.e., oral administration of medicated [[Ghee|ghee]] or oil) can also be classified into:<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Snehavidhi Adhyaya: Chapter 25, Verse 22. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 452.</ref><ref>Murthy K.R.S., editor, (8th ed.). Vagbhata’s Ashtanga Hridayam, Sutra Sthana; Snehavidhi Adhyaya: Chapter 16, Verse 17-18. Varanasi: Chowkhamba Krishnadas Academy, 2011; 212.</ref> [Ast. Hri. Sutra Sthana 16/17-18]</li>

<ol type="A"><li>Laghu or hriswa matra: The quantity of aushadha that gets digested in 6 hours.</li>

<li>Madhyam matra: The quantity of aushadha that gets digested in 12 hours.</li>

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<ul><li>Vardhamana matra (increasing dose gradually): It is a dose which is progressively increased for a few days until the dose of aushadha reaches its optimum quantity. Then this dose is decreased gradually. This phenomenon avoids the dependency and withdrawl symptoms of aushadha. It protects the patient from an abrupt increase in the dose of aushadha in a short period. Aushadha administered in this way are vardhamana pippali rasayana, bhallataka kalpa, etc.</li>

<li>Hrasiyasi matra (minimum dose): This dose of aushadha is smaller than the hriswa or laghu matra and thus gets digested before 6 hours. This dose is used as a test dose when the strength of the digestive system in unknown.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Snehavidhi Adhyaya: Chapter 25, Verse 23. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 452.</ref></li></ul></ul>

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There is no specific common matra of aushadhi for everyone. The matra of aushadha of individual depends on time (kala), digestive capacity (agni), age (vaya), strength (bala), body constitution (prakriti), dosha and habitat (desha).<ref>Sharangdhar purvakhand 1/37 Tripathi B, editor, (1st ed.). Commentary Dipika on Sharangadhar Samhita of Sharangadhar, Purva Khanda; Adhyaya: Chapter 1, Verse 37. Varanasi: Chaukhamba Surbharti Prakashan, 2011; 10.</ref> [Cha. Sa. Kalpa Sthana 12/86].

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There is no specific common matra of aushadhi for everyone. The matra of aushadha of individual depends on time (kala), digestive capacity ([[Agni|agni]]), age (vaya), [[Bala|strength (bala)]], [[Sharira|body]] [[Prakriti|constitution (prakriti)]], [[Dosha|dosha]] and [[Desha|habitat (desha)]].<ref>Sharangdhar purvakhand 1/37 Tripathi B, editor, (1st ed.). Commentary Dipika on Sharangadhar Samhita of Sharangadhar, Purva Khanda; Adhyaya: Chapter 1, Verse 37. Varanasi: Chaukhamba Surbharti Prakashan, 2011; 10.</ref> [Cha. Sa. Kalpa Sthana 12/86].

=== Time of consumption of aushadha ===

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<div style='text-align:justify;'>The pharmacokinetics of aushadha is dependent on the biological rhythm of the body. Thus, to obtain maximum health benefits, aushadha must be administered at proper time depending on the patient's disease, strength, and age. Bheshaj kala (or aushadha sevana kala or aushadha apeksha kala) is the proper time for administration of aushadha. Ashtang Sangraha mentioned eleven<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 12. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 428.</ref>; Charak [Cha. Sa. Chikitsa Sthana 30/298], Sushruta<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Uttar Tantra; Swasthavrittam Adhyaya: Chapter 64, Verse 67. Varanasi: Chaukhamba Sanskrit Sansthan, 2016; 624.</ref> [Su. Sa. Uttara Tantra 64/67], Ashtangh Hridaya<ref>Murthy K.R.S., editor, (8th ed.). Vagbhata’s Ashtanga Hridayam, Sutra Sthana; Doshopakramaniya Adhyaya: Chapter 13, Verse 37. Varanasi: Chowkhamba Krishnadas Academy, 2011; 190.</ref> [A. Hri. Sutra Sthana 13/37] and Kashyap<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 52. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 369.</ref> mentioned ten aushadha sevan kala. Sharangadhara<ref>Tripathi B, editor, (1st ed.). Commentary Dipika on Sharangadhar Samhita of Pandita Sharangadharacharya, Purva Khanda; Bhaishajyakhyan: Chapter 2, Verse 2-3. Varanasi: Chaukhamba Surbharti Prakashan, 2011; 24.</ref> mentioned five suitable periods of administration of aushadha (aushadha kala). The aushadha kala are as below: [Cha. Sa. Chikitsa Sthana 30/298]

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<div style='text-align:justify;'>The pharmacokinetics of aushadha is dependent on the biological rhythm of the [[Sharira|body]]. Thus, to obtain maximum health benefits, aushadha must be administered at proper time depending on the patient's [[Vyadhi|disease]], strength, and age. Bheshaj kala (or aushadha sevana kala or aushadha apeksha kala) is the proper time for administration of aushadha. Ashtang Sangraha mentioned eleven<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 12. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 428.</ref>; Charak [Cha. Sa. Chikitsa Sthana 30/298], Sushruta<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Uttar Tantra; Swasthavrittam Adhyaya: Chapter 64, Verse 67. Varanasi: Chaukhamba Sanskrit Sansthan, 2016; 624.</ref> [Su. Sa. Uttara Tantra 64/67], Ashtangh Hridaya<ref>Murthy K.R.S., editor, (8th ed.). Vagbhata’s Ashtanga Hridayam, Sutra Sthana; Doshopakramaniya Adhyaya: Chapter 13, Verse 37. Varanasi: Chowkhamba Krishnadas Academy, 2011; 190.</ref> [A. Hri. Sutra Sthana 13/37] and Kashyap<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 52. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 369.</ref> mentioned ten aushadha sevan kala. Sharangadhara<ref>Tripathi B, editor, (1st ed.). Commentary Dipika on Sharangadhar Samhita of Pandita Sharangadharacharya, Purva Khanda; Bhaishajyakhyan: Chapter 2, Verse 2-3. Varanasi: Chaukhamba Surbharti Prakashan, 2011; 24.</ref> mentioned five suitable periods of administration of aushadha (aushadha kala). The aushadha kala are as below: [Cha. Sa. Chikitsa Sthana 30/298]

<ol><li>A strong patient must consume aushadha empty stomach in the morning</li>

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=== Mode of action of aushadha ===

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<div style='text-align:justify;'>The action of the aushadha depends upon its potency.<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Sutra Sthana; Dravyarasagunaviryavipakavigyaniya Adhyaya: Chapter 40, Verse 5. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 195.</ref> [Su. Sa. Sutra Sthana 40/5] Some scholars believed the potency to be of two types (hot and cold) while others believed it to be of eight types (cold, hot, oily, dry, clear, slimy, mild and sharp). For example, mahatpanchamula (combination of roots of ''Aegle marmelos, Clerodendrum phlomidis, Oroxylum indicum, Stereospermum suaveolens'' and ''Gmelina arborea'') alleviate vata dosha due to their hot potency (since vata dosha is cold in property). Kulattha (''Dolichos biflorus'') and onion (''Allium cepa'') alleviate vata due to oily character (since vata is dry in property). Cane sugar (''Saccharum officinarum'') increases vata due to its cold potency. </div>

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<div style='text-align:justify;'>The action of the aushadha depends upon its potency.<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Sutra Sthana; Dravyarasagunaviryavipakavigyaniya Adhyaya: Chapter 40, Verse 5. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 195.</ref> [Su. Sa. Sutra Sthana 40/5] Some scholars believed the potency to be of two types (hot and cold) while others believed it to be of eight types (cold, hot, oily, dry, clear, slimy, mild and sharp). For example, mahatpanchamula (combination of roots of ''[https://en.wikipedia.org/wiki/Aegle_marmelos Aegle marmelos], [https://en.wikipedia.org/wiki/Clerodendrum_phlomidis Clerodendrum phlomidis], [https://en.wikipedia.org/wiki/Oroxylum_indicum Oroxylum indicum], [https://en.wikipedia.org/wiki/Stereospermum_chelonoides Stereospermum suaveolens]'' and ''[https://en.wikipedia.org/wiki/Gmelina_arborea Gmelina arborea]'') alleviate [[Vata dosha|vata dosha]] due to their hot potency (since [[Vata dosha|vata dosha]] is cold in property). Kulattha (''Dolichos biflorus'') and onion (''Allium cepa'') alleviate [[Vata dosha|vata]] due to oily character (since [[Vata dosha|vata]] is dry in property). Cane sugar (''Saccharum officinarum'') increases [[Vata dosha|vata]] due to its cold potency. </div>

=== The action of aushadha is location specific ===

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<div style='text-align:justify;'>The aushadha that is effective at one site in the body might not be as effective at other site.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 4. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref> The location of dosha in the body is specific and the diseases are most probably caused by aggravation of dosha at their native sites. Particular aushadha acts on particular dosha, hence the site of action of aushadha must be specific. Thus the site of aggravated dosha must be determined first. Reason of aushadha being location specific may be presence of specific receptors at specific sites. For example, beta-blockers act on the heart and reduce blood pressure as the receptors on which beta blockers acts (B1 receptors) are found in the heart.<ref>Arcangelo VP, Peterson AM (2006). Pharmacotherapeutics for advanced practice: a practical approach. Lippincott Williams & Wilkins. p. 205. ISBN 978-0-7817-5784-3. Retrieved September 7, 2010</ref><ref>James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E (February 2014). "2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.</ref><ref>Frishman WH, Cheng-Lai A, Nawarskas J (2005). Current Cardiovascular Drugs. Current Science Group. p. 152. ISBN 978-1-57340-221-7. Retrieved September 7, 2010.</ref></div>

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<div style='text-align:justify;'>The aushadha that is effective at one site in the [[Sharira|body]] might not be as effective at other site.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 4. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref> The location of [[Dosha|dosha]] in the [[Sharira|body]] is specific and the [[Vyadhi|diseases]] are most probably caused by aggravation of [[Dosha|dosha]] at their native sites. Particular aushadha acts on particular [[Dosha|dosha]], hence the site of action of aushadha must be specific. Thus the site of aggravated [[Dosha|dosha]] must be determined first. Reason of aushadha being location specific may be presence of specific receptors at specific sites. For example, beta-blockers act on the heart and reduce blood pressure as the receptors on which beta blockers acts (B1 receptors) are found in the heart.<ref>Arcangelo VP, Peterson AM (2006). Pharmacotherapeutics for advanced practice: a practical approach. Lippincott Williams & Wilkins. p. 205. ISBN 978-0-7817-5784-3. Retrieved September 7, 2010</ref><ref>James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E (February 2014). "2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.</ref><ref>Frishman WH, Cheng-Lai A, Nawarskas J (2005). Current Cardiovascular Drugs. Current Science Group. p. 152. ISBN 978-1-57340-221-7. Retrieved September 7, 2010.</ref></div>

=== The action of aushadha is individual specific<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 5. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref> ===

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<div style='text-align:justify;'>The individuals who are obese, very lean, whose muscles, blood, bones and other body parts are of unsteady mass, whose digestive fire is weak, who take less quantity of food or unwholesome food, are emaciated or exhausted of essence, cannot tolerate and bear the strong medicines. Hence such persons are to be treated with aushadha, that are soft and pleasant, gradually strong and heavy, and which do not create unhappiness due to exhaustion or disturb the dosha. Women, tender individuals and children are to be treated like this due to less endurance. <br/>In the same way, aushadha in low dose or of less efficacy administered in severe diseases or strong persons will be of little use and further disturb and aggravate the dosha and the disease.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 7. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424-425.</ref><br/>Ayurveda scholars quoted that children under 12 years should not be advised aushadha alone as the children are delicate. The use of aushadha alone may destroy their strength and longetivity. Use of aushadha alone should also be avoided in emaciated, old and short-tempered individuals suffering from loss of dhatu, indriya and ojas. This aushadha may destroy them in a way the sun desiccates small amount of water.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 58-59. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 369.</ref><br/>These treatment protocols are practiced by ayurveda practitioners. The medicines that contains metals or are required in small doses like rasaushadhi, rasamanikya, etc. are avoided in very old, very young and emaciated individuals. The chidren are almost always administered the aushadha with anupana (liquid taken soon after medicine), bal chaturbhadra churna is administered to children along with honey. Customized or a person specific medicine, form, dose is a thrust area for research. </div>

+

<div style='text-align:justify;'>The individuals who are obese, very lean, whose muscles, blood, bones and other [[Sharira|body]] parts are of unsteady mass, whose digestive fire is weak, who take less quantity of food or unwholesome food, are emaciated or exhausted of essence, cannot tolerate and bear the strong medicines. Hence such persons are to be treated with aushadha, that are soft and pleasant, gradually strong and heavy, and which do not create unhappiness due to exhaustion or disturb the [[Dosha|dosha]]. Women, tender individuals and children are to be treated like this due to less endurance. <br/>In the same way, aushadha in low dose or of less efficacy administered in severe [[Vyadhi|diseases]] or strong persons will be of little use and further disturb and aggravate the [[Dosha|dosha]] and the [[Vyadhi|disease]].<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 7. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424-425.</ref><br/>Ayurveda scholars quoted that children under 12 years should not be advised aushadha alone as the children are delicate. The use of aushadha alone may destroy their strength and longetivity. Use of aushadha alone should also be avoided in emaciated, old and short-tempered individuals suffering from loss of [[Dhatu|dhatu]], [[Indriya|indriya]] and [[Ojas|ojas]]. This aushadha may destroy them in a way the sun desiccates small amount of water.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 58-59. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 369.</ref><br/>These treatment protocols are practiced by [[Ayurveda|ayurveda]] practitioners. The medicines that contains metals or are required in small doses like rasaushadhi, rasamanikya, etc. are avoided in very old, very young and emaciated individuals. The chidren are almost always administered the aushadha with anupana (liquid taken soon after medicine), bal chaturbhadra churna is administered to children along with honey. Customized or a person specific medicine, form, dose is a thrust area for research. </div>

=== Untoward effects of aushadha consumed in inappropriate doses ===

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<div style='text-align:justify;'>The aushadha, its potency and doses should be determined after evaluating dosha, the strength of the disease, and the person. Even the use of emergency aushadha, or the aushadha with mild properties in greater doses, or treatments such as use of alkali or surgical instruments, may cause harm to patients of poor physical strength and stamina. When aushadha with doses or potency greater than the strength of disease are used, this aushadha may relieve the patient from the existing disease, but soon may generate diseases of opposite qualities. These aushadha may cause exhaustion, fainting, toxicity, delusion, and a decrease in strength; those more potent than the digestive capacity will produce exhaustion and poor digestion.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 6. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref></br>The drug induced toxicity can be due to either of the four causes: hypersensitivity and related immunological reactions; off-target pharmacology; biological activation to toxic metabolites; and idiosyncratic toxicities.<ref>Liebler, D., Guengerich, F. Elucidating mechanisms of drug-induced toxicity. Nat Rev Drug Discov 4, 410–420 (2005). https://doi.org/10.1038/nrd1720</ref> For example, drug toxicity by drugs administered in high doses was observed in a study in which Lauha Bhasma and Mandura Bhasma were given five times (55 mg/kg) more than therapeutic dose (11 mg/kg) for a long duration (60 days) in albino rats. The signs observed in the rats were increase in body weight, blood sugar level, serum urea level, serum creatinine level, SGOT and serum alakaline phosphatase. Moderate fatty degenerative changes, diffuse necrosis, periportal necrosis, central vein congestion and sinusoidal dilatation was observed in Lauha bhasma treated group. Mild fatty changes and sinusoidal dilatation was observed in Mandur Bhasma treated group.<ref>Sarkar, Prasanta Kumar & Prajapati, Pradeep & Shukla, Vinay & Ravishankar, Basavaiah & Chaudhary, Anand. (2009). Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian journal of experimental biology. 47. 987-92.</ref></div>

+

<div style='text-align:justify;'>The aushadha, its potency and doses should be determined after evaluating [[Dosha|dosha]], the strength of the [[Vyadhi|disease]], and the person. Even the use of emergency aushadha, or the aushadha with mild properties in greater doses, or treatments such as use of alkali or surgical instruments, may cause harm to patients of poor physical strength and stamina. When aushadha with doses or potency greater than the strength of [[Vyadhi|disease]] are used, this aushadha may relieve the patient from the existing [[Vyadhi|disease]], but soon may generate [[Vyadhi|diseases]] of opposite qualities. These aushadha may cause exhaustion, fainting, toxicity, delusion, and a decrease in strength; those more potent than the digestive capacity will produce exhaustion and poor digestion.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 6. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref></br>The drug induced toxicity can be due to either of the four causes: hypersensitivity and related immunological reactions; off-target pharmacology; biological activation to toxic metabolites; and idiosyncratic toxicities.<ref>Liebler, D., Guengerich, F. Elucidating mechanisms of drug-induced toxicity. Nat Rev Drug Discov 4, 410–420 (2005). https://doi.org/10.1038/nrd1720</ref> For example, drug toxicity by drugs administered in high doses was observed in a study in which Lauha Bhasma and Mandura Bhasma were given five times (55 mg/kg) more than therapeutic dose (11 mg/kg) for a long duration (60 days) in albino rats. The signs observed in the rats were increase in [[Sharira|body]] weight, blood sugar level, serum urea level, serum creatinine level, SGOT and serum alakaline phosphatase. Moderate fatty degenerative changes, diffuse necrosis, periportal necrosis, central vein congestion and sinusoidal dilatation was observed in Lauha bhasma treated group. Mild fatty changes and sinusoidal dilatation was observed in Mandur Bhasma treated group.<ref>Sarkar, Prasanta Kumar & Prajapati, Pradeep & Shukla, Vinay & Ravishankar, Basavaiah & Chaudhary, Anand. (2009). Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian journal of experimental biology. 47. 987-92.</ref></div>

=== Examination of aushadha ===

−

<div style='text-align:justify;'>Even if one aushadha is known to mitigate the existing disease, it should still be examined to compare its taste, potency, taste after digestion, qualities, nature of the substance, actions, special effects, place of growth, season of collection, method of preservation, correct method of using, prohibited mode of use, methods of processing combinations, procedure of use, dosage, the type of patient for whom its meant, time of use, the actions on dosha. The best aushadha should be selected for management of the disease.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 8. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 425.</ref></div>

+

<div style='text-align:justify;'>Even if one aushadha is known to mitigate the existing [[Vyadhi|disease]], it should still be examined to compare its taste, potency, taste after digestion, qualities, nature of the substance, actions, special effects, place of growth, season of collection, method of preservation, correct method of using, prohibited mode of use, methods of processing combinations, procedure of use, dosage, the type of patient for whom its meant, time of use, the actions on [[Dosha|dosha]]. The best aushadha should be selected for management of the [[Vyadhi|disease]].<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 8. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 425.</ref></div>

=== Features of undesirable aushadha ===

−

<div style='text-align:justify;'>The aushadha, whose potency is either less or more in regards to disease, dosha, strength and digestive capacity, which is new or not known, which is devoid of described properties, is not mitigating the diseases, have aversion towards mind that do not completely suppresses the aggravated dosha and do not subsides the disease completely should be avoided.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 61-62. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 370.</ref> These are disqualifying criteria for medicines. </div>

+

<div style='text-align:justify;'>The aushadha, whose potency is either less or more in regards to [[Vyadhi|disease]], [[Dosha|dosha]], strength and digestive capacity, which is new or not known, which is devoid of described properties, is not mitigating the [[Vyadhi|diseases]], have aversion towards mind that do not completely suppresses the aggravated [[Dosha|dosha]] and do not subsides the [[Vyadhi|disease]] completely should be avoided.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 61-62. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 370.</ref> These are disqualifying criteria for medicines. </div>

=== Features of desirable aushadha ===

−

<div style='text-align:justify;'>Ideal aushadha for a person is the one that is grown locally in same climatic conditions or land as that of the patient.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 35. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 433.</ref> The aushadha growing in a region has the properties similar to that specific place. When the aushadha and the person are of same region, then the aushadha is nearly homogenous to the constitution of the persons. Hence the chances that the body of person being considered, the aushadha as foreign matter is more, so are the chances of immune reactions against the aushadha. The aushadha of hot regions like vindhya and shaila mountains have hot potency, whereas the aushadha of cold regions like mountain ranges of Himalayas have cold potency. Moreover the aushadha that does not destroy the strength of the patient but destroys the potency of the disease is the desirable aushadha.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 63. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 370.</ref><br/>In current scenario, the ideal criteria for selecting a medicine are:<ref>WHO criteria for the selection of essential drugs, adopted by the forty-first World Health Assembly, Geneva, Switzerland, 2-13 May 1986, in resolution WHA39.27 https://healthydocuments.org/public/healthydocuments-doc21.pdf</ref>

+

<div style='text-align:justify;'>Ideal aushadha for a person is the one that is grown locally in same climatic conditions or land as that of the patient.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 35. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 433.</ref> The aushadha growing in a region has the properties similar to that specific place. When the aushadha and the person are of same region, then the aushadha is nearly homogenous to the constitution of the persons. Hence the chances that the [[Sharira|body]] of person being considered, the aushadha as foreign matter is more, so are the chances of immune reactions against the aushadha. The aushadha of hot regions like vindhya and shaila mountains have hot potency, whereas the aushadha of cold regions like mountain ranges of Himalayas have cold potency. Moreover the aushadha that does not destroy the strength of the patient but destroys the potency of the [[Vyadhi|disease]] is the desirable aushadha.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 63. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 370.</ref><br/>In current scenario, the ideal criteria for selecting a medicine are:<ref>WHO criteria for the selection of essential drugs, adopted by the forty-first World Health Assembly, Geneva, Switzerland, 2-13 May 1986, in resolution WHA39.27 https://healthydocuments.org/public/healthydocuments-doc21.pdf</ref>

<ul><li>Only those drugs for which adequate scientific data are available from controlled studies should be selected.</li>

<li>Each selected pharmaceutical product must meet adequate standards of quality, including bioavailability.</li>

Line 138: Line 138:

<li>Cost represents a major selection criterion. In cost comparisons between drugs, the cost of the total treatment, and not only the unit cost, must be considered. In addition, the cost of non-pharmaceutical therapeutic modalities should be taken into account.</li>

<li>Local health authorities should decide the level of expertise required to prescribe single drugs or a group of drugs in a therapeutic category.</li>

−

<li>The influence of local diseases or condition on pharmackinetic and pharmacodynamic parameters should be considered in making the selection e.g. malnutrition, liver disease.</li>

+

<li>The influence of local [[Vyadhi|diseases]] or condition on pharmackinetic and pharmacodynamic parameters should be considered in making the selection e.g. malnutrition, liver [[Vyadhi|disease]].</li>

<li>When several drugs are available for the same indication, then such a medicine must be selected which provides the highest benefit/ risk ratio.</li>

<li>When two or more drugs are therapeutically equivalent, preference should be given to:</li>

Line 158: Line 158:

=== Variation of potency of aushadha with season ===

−

<div style='text-align:justify;'>The potency of aushadha varies with season, which consequently causes variation in the dose.During rainy season, the body becomes weak due to the effect of season (aadana kala). The naturally available aushadha is also poor in potency, their roots being submerged in water, the water being contaminated with cadavers, tissues, urine and excreta of birds and animals. Thus administration of aushadha in rainy season is unsuitable for the health of the person.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 10. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 426-427.</ref><br/>In hot season, the body remains weak due to the effect of season (aadana kala), dry and hot wind, and excessive perspiration. This increases the fluidity of the dosha, and they penetrate more in the channels of the body. In these conditions, even if an aushadha of slightly hot potency is administered, it also produces excessive heat in the body due to hot temperature. Thus more effect of aushadha is observed even at lower doses of aushadha in hot season.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 11. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 427.</ref></div>

+

<div style='text-align:justify;'>The potency of aushadha varies with season, which consequently causes variation in the dose. During rainy season, the [[Sharira|body]] becomes weak due to the effect of season (aadana kala). The naturally available aushadha is also poor in potency, their roots being submerged in water, the water being contaminated with cadavers, tissues, urine and excreta of birds and animals. Thus administration of aushadha in rainy season is unsuitable for the health of the person.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 10. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 426-427.</ref><br/>In hot season, the body remains weak due to the effect of season (aadana kala), dry and hot wind, and excessive perspiration. This increases the fluidity of the [[Dosha|dosha]], and they penetrate more in the channels of the [[Sharira|body]]. In these conditions, even if an aushadha of slightly hot potency is administered, it also produces excessive heat in the body due to hot temperature. Thus more effect of aushadha is observed even at lower doses of aushadha in hot season.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 11. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 427.</ref></div>

=== Instant acting aushadha ===

−

<div style='text-align:justify;'>The people have less time for therapies. The aushadha shall be effective in a short course of time. The ideal aushadha is to be used in specific doses, is light in digestion, palatable, causes evacuation of dosha, is to be consumed in small quantity, possesses high potency, is satisfying, protects strength. It shall be with minimal untoward effects and produce mild languor if inevitable. It shall have all good qualities and prove to be efficacious.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 33-34. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 432.</ref></div>

+

<div style='text-align:justify;'>The people have less time for therapies. The aushadha shall be effective in a short course of time. The ideal aushadha is to be used in specific doses, is light in digestion, palatable, causes evacuation of [[Dosha|dosha]], is to be consumed in small quantity, possesses high potency, is satisfying, protects strength. It shall be with minimal untoward effects and produce mild languor if inevitable. It shall have all good qualities and prove to be efficacious.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 33-34. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 432.</ref></div>

=== Pharmaceutical forms of aushadha ===

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