Amlapitta#dg15 gdg

“EVALUATION OF EFFICACY OF KALAMEGHA (ANDROGRAPHIS

PANICULATA NEES.) IN THE MANAGEMENT OF AMLAPITTA

A CLINICAL STUDY”

By

Dr. JAYA. MALAGOUDAR

Dissertation submitted to the

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

In partial fulfillment of the degree of

Ayurveda Vachaspati M.D.

In Dravya Guna

Under the Guidance of

Prof Dr. G.V.Mulagund M.D. (Ayu)

And Co-guidance of

Dr. Shashikant.B. Nidagundi M.D. (Ayu)

Department of Dravya Guna Post Graduate Studies & Research Centre

D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG 2006-2009

Ayurmitra

TAyComprehended

D.G.M.AYURVEDIC MEDICAL COLLEGE

POST GRADUATE STUDIES AND RESEARCH CENTRE

GADAG - 582 103

This is to certify that the dissertation entitled “Evaluation of Efficacy of

Kalamegha (Andrographis paniculata Nees.) In the Management of Amlapitta A

Clinical Study” is a bonofide reseach work done by Dr. Jaya. Malagoudar in partial

fulfillment of the requirement for the post graduation degree of “Ayurveda

Vachaspati” M.D. (Dravya Guna). Under Rajiv Gandhi University of Health

Sciences, Bangalore, Karnataka.

Dr. G.V.Mulagund. M.D. (Ayu)

Guide, Professor & HOD

Dept. of Dravya Guna

DGMAMC, PGS&RC, GADAG

Date:

Place: Gadag

Dr. Shashikanth.B. Nidagundi. M.D. (Ayu)

Co- Guide, Lecturer

Dept. of Dravya Guna

DGMAMC, PGS&RC, GADAG

Date:

Place: Gadag

J.S.V.V. SAMSTHE’S

D.G.M.AYURVEDIC MEDICAL COLLEGE

POST GRADUATE STUDIES AND RESEARCH CENTRE

GADAG, 582 103

Endorsement by the H.O.D, Principal/ head of the institution

This is to certify that the dissertation entitled “Evaluation of Efficacy of

Kalamegha (Andrographis Paniculata Nees.) In the Management of Amlapitta A

Clinical Study” is a bonofide reseach work done by Dr. Jaya.Malagoudar under the

guidance of Dr. G. V. Mulagund, M.D. (Ayu), Professor & H.O.D. Dept of Dravya

Guna in partial fulfillment of the requirement for the post graduation degree of

“Ayurveda Vachaspati M.D. (Dravya Guna)” Under Rajiv Gandhi University of

Health Sciences, Bangalore, Karnataka.

.

Dr. G. B. Patil

Principal,

DGM Ayurvedic Medical College, Gadag

Date:

Place: Gadag

Dr. G. V. Mulagund. M.D. (Ayu)

Professor & HOD,

Dept. of Dravya Guna.

Date:

Place: Gadag

Declaration by the candidate

I here by declare that this dissertation / thesis entitled “Evaluation of Efficacy

of Kalamegha (Andrographis Paniculata Nees.) In the Management of Amlapitta A

Clinical Study” is a bonafide and genuine research work carried out by me under the

guidance of Dr. G.V. Mulagund M.D.(Ayu) Professor and Dr. Shashikanth.B.

Nidagundi, M.D.(Ayu), Lecturer in Dept. of Dravya Guna, DGMAMC, PGS&RC,

Gadag.

Date :

Place : Gadag (DR. JAYA.MALAGOUDAR)

© Copy right

Declaration by the candidate

I here by declare that the Rajiv Gandhi University of Health Sciences,

Karnataka shall have the rights to preserve, use and disseminate this

dissertation / thesis in print or electronic format for the academic /

research purpose.

Date :

Place : Gadag (DR.JAYA.MALAGOUDAR)

© Rajiv Gandhi University of Health Sciences, Karnataka

i

ACKNOWLEDGEMENT

This is a moment of great pleasure and contentment for me as writing

acknowledgment is the last phase in completion of this research work. At the onset

my devotional pranamas to His Holiness Sri Jagadguru Abhinava Shivananda

Swamiji, Shivananda math, Gadag.

I take this glorious opportunity to acknowledge with deep sense of gratitude to my

guide Dr .G.V. Mulagund MD (Ayu), Professor, Head of the Dept, Department of post

graduate studies and research center (Dravyaguna), D.G.M.A.M.C, Gadag for his

valuable guidance and close supervision during the entire phase of the study.

I take this opportunity to acknowledge with the deep sense and gratitude to

Dr. Kuber. Sankh. MD (Ayu), Asst. Professor, Department of post graduate studies and

research center(Dravyaguna),D.G.M.A.M.C,.Gadag for their valuable guidance and

critical suggestions during the entire phase of the study.

My profound gratitude to my co-guide Dr. Shashikanth. B. Nidagundi MD (Ayu),

Lecturer, Department of Post graduate studies and research center (Dravyaguna)

D.G.M.A.M.C, Gadag for their good and valuable guidance through out this

dissertation work.

With profound sense of gratitude, I express my sincere thanks to Dr. G.B. Patil,

Principal, D.G.M.A.M.C. Gadag. I thank Sri. S.B. Saunshi, Chairman and all the

committee members for their constant encouragement, facilities and moral support

during my post graduate study.

I offer my sincere thanks to Dr. G.S Hiremath M.D (Ayu) Professor and HOD, Dept of

Dravyaguna D.G.M.A.M.C.Gadag.

I express my gratitude to the principal, Professor Dr. S.S. Hiremath.M.D (Ayu),

management committee and my colleagues, of B.V.V.S Ayurvedic medical college,

Bagalkot, for their encouragement and support.

ii

I render my sincere thanks to Principal, Professar Dr. I. S. Muchchandi,

Professor, Y. Shrinivas, Dept of pharmacognosy and phytochemistry,

V.M. Chandrashaker Asst. Professor, Dept of pharmacology and M. pharma P.G

Scholars of Hanagal Shri Kumareshwar college of pharmacy, Bagalkot for their

valuable guidance and timely help I have been able to complete this work.

I am extremely thankful to my teacher Dr. A.M. Goudar, and other U.G teachers of

S.V.M Ayurvedic Medical College Ilkal, for their encouragement and support during

my study.

I wish to add my warmest thanks to my PG teaching faculty, Dr.K.S. Paraddi,

Dr. B.G. Swamy, Dr.M.C. Patil, Dr.K.S.R. Prasad, Dr. Shashidhar Doddamani,

Dr. Santosh Belavadi, Dr. Jagadish Mitti, Dr. Raghavendra Shettar, Dr. Girish.N.

Danappagoudar Dr. Samudri, Dr. Yasmin, Dr. Mulki Patil, Dr.Veena Kori, and

Dr. Ashok Patil, for their valuable suggestions and timely help made me to complete

this dissertation work successfully.

I am very much grateful to Dr. Yerigeri, R.M.O. DGMAMC, Gadag and to all the

lecturers, house surgeons, hospital staff and non teaching staff for their timely

assistance in completion of this work.

I sincere thank P.M. Nandakumar, statistician and Sri. V.M. Mundinamani,

Librarian, Smt. P.K. Belavadi and other office staff for their timely help during my

study.

Special thanks to my senior friends Dr. Shivaleela, Dr. Ashwini, Dr. Shalini, and

Dr. Kataraki for their help and co-operation during the study.

I extend my gratefulness and sincere heart felt gratitude to my colleagues

Dr. Kalavati, Dr. Savita, Dr. Mukta, Dr. Kavita, Dr, Sarvamangala, Dr. Anupama,

Dr. Veena, Dr. Vijayalaxmi, Dr. Mukta Hiremath, Dr. P.V.Joshi, Dr. Ravi, for their

timely support and encouragement got during the course. I am very thankful to my

junior friends Dr. Asha, Dr. Sevantika, Dr. C.C.Hiremath, Dr. Bupesh, Dr. Pushpa,

Dr. Triveni, Dr. Shrikant, for their help and co-operation during the study.

iii

I wish to thank Principals of Rajeev Gandhi D.Ed College, Anglo Urdu D.Ed

College and Parshwanath D.Ed. College, Gadag and all my patients and their

assistants for their co-operation during my clinical study.

I pick up this precious moment for appreciation of my mother and sisters; they are the

cause for me to take this noble profession and shaped me into what I am today. I have

not been able to find words enough, to express my sentiments of love, respect and

gratitude to my parent in-laws and all my near and dear one.

My special thanks to Dr. R.R.Kulkarni M.D (Ayu) and his family for their

co-operation, moral support and valuable suggestions during my documentation work.

I am also thankful to librarian, Smt. Seema Somashekhar and her family for their

co -operation during this work.

I never forget the fragrance of love and sacrifice shown by my husband

Dr. Rajkumar M.D (Ayu) for his kind advice, help and moral support. Cheerful face of

my lovely son chi. Dhanvantari (Preetam), Ananya, Rani and Rutu made me to reach

the destiny of the course.

I in this special moment should be very thankful to Dr.Raghu, and all my family

members, Dr Budihal, Mr.Santosh. M.Y. Mr.Gangadhar, and Mr.Basu.K their help

not only in this work, also through out my P.G. Studies.

I thank to all my senior, junior colleagues for their timely suggestions and help.

And also my friend late Dr. Shivakumar for his help to this valuable project.

Lastly I acknowledge my thanks to those who have directly or indirectly extended

their support for the completion of my work.

Place: Gadag Dr. Jaya. Malagoudar.

Date:

v

ABSTRACT Title: Evaluation of efficacy of Kalamegha (Andrographis paniculata Nees.) in the

management of Amlapitta- a clinical study.

Introduction: Kalamegha one among the controversial drugs coming under the study of Dravya

Guna Vijnana, possessing tikta rasa pradhanata and claimed to have a beneficial effect

in pittaja and kaphaja vikaras, was studied under the light of the previous scholarly

works and the controversy was been settled and the drug Andrographis paniculata

Nees. was considered for the present study to assess its efficacy in the management of

Amlapitta, which can be supported by the presence of a bitter principle

Andrographolide; the active principle of the drug a potent component having

antiulcer, antiinflammatory, analgesic, hepatoprotective etc, activities.

Objectives:

1) Pharmacognostical evaluation of Kalamegha. Preliminary phytochemical

study, macroscopical evaluation, microscopical evaluation, standardization

and validation of Kalamegha.

2) To evaluate the efficacy of Kalamegha panchanga churna in Amlapitta.

Materials and Methods: The genuine drug Kalamegha (Andrographis paniculata Nees.) was collected and its

powder was prepared and was subjected for priliminary phytochemical study,

macroscopial and microscopial study for its standardisition and validation. The

panchanga churna was administered to 30 patients diagnosed as suffering from

Amlapitta in a dosage of 2gms bid for 30 days with sukhoshna jala, to assess the

efficacy of Kalamegha in the management of Amlapitta.

vi

Observation and Results: It was noticed that in some cases chemical constituents fail to answer their presence in

preliminary tests due to other reasons. However The Rf value of Andrographis

paniculata Nees. for flovonoids was found to be 0.641. The drug proved to possess

statistically significant response in managing the Amlapitta, while it was reported

from all the patients regarding poor palatability due to its bitter taste.

Conclusion:

From the present study it was concluded, that Andrographis paniculata Nees. can be

considered as the authentic botanical source for Kalamegha that helps in decreasing

the Amlapitta by its properties and actions like tiktarasa, deepana, ruchikara, pittahara

and rechana. And is effective in reducing the symptoms which are statistically

significant.

Key Words:

Kalamegha, Amlapitta, Andrographis paniculata Nees. and Andrographolide.

iv

ABBREVIATION A.P.V.M.G - Ayurvedic Pharmacology by V.M.Gogte

B.P - Bhavaprakasha Nighantu

D.G.G.P - Dravyaguna Vignana by Dr Gyanendra Pandey

D.G.H - Dravyaguna Hastamalaka

D.G.J.L.N.S - Dravyaguna Vignana by Dr J.L.N.Sastri

D.G.P.V.S - Dravyaguna Vignana by P.V.Sharma

I.M.M - Illustrated Manual of Herbal Drugs

I.M.P - Indian Medicinal Plants

K.S - Kashyapa Samhita

M.N - Madhava Nidhana

P.N - Priya Nighantu

T.W.I - The Wealth of India

Y.R - Yoga Ratnakar

vii

LIST OF TABLES

Table No.

Title of the Table

Page No

1. Synonyms according to recent authors 7

2. Classification of the drug Kalamegha 8

3. Rasa panchaka according to different authors 15

4. Doshaghnata according to different authors 15

5. Karmas according to different authors 16

6. Rogaghnata according to different authors 16

7. Prayojya anga according to different authors 20

8. Matra according to different authors 20

9. Vishistha yogas 20

10. Showing the nidana of Amlapitta 39

11. Showing the symptoms of Amlapitta 40

12. Rasa of Kalamegha perceived by 25 volunteers 75

13. Organoleptic studies of physical and sensory characteristics of

successive solvent extraction of Andrographis paniculata Nees.

75

14. Preliminary tests for primary and secondary metabolites 78

15. Distribution of patients based on Age 82

16. Distribution of patients based on Sex 83

17. Distribution of patients based on Religion 84

18. Distribution of patients based on Occupation 85

19. Distribution of patients based on Economical status 86

20. Distribution of patients based on Diet 87

21. Showing the Chief Complaints of 30 treated cases 88

22. Showing the Response to Avipaka at the end of Treatment 90

23. Showing the Response to Avipaka at the end of Follow-Up 90

24. Showing the Response to Klama at the end of Treatment 91

25. Showing the Response to Klama at the end of Follow-Up 91

26. Showing the Response to Utklesha at the end of Treatment 92

27. Showing the Response to Utklesha at the end of Follow-Up 92

viii

28. Showing the Response to Tiktodgara at the end of Treatment 93

29. Showing the Response to Tiktodgara at the end of Follow-Up 93

30. Showing the Response to Amlodgara at the end of Treatment 94

31. Showing the Response to Amlodgara at the end of Follow-Up 94

32. Showing the Response to Gourava at the end of Treatment 95

33. Showing the Response to Gourava at the end of Follow-Up 95

34. Showing the Response to Hritdaha at the end of Treatment 96

35. Showing the Response to Hritdaha at the end of Follow-Up 96

36. Showing the Response to Kanthadaha at the end of Treatment 97

37. Showing the Response to Kanthadaha at the end of Follow-Up 97

38. Showing the Response to Aruchi at the end of Treatment 98

39. Showing the Response to Aruchi at the end of Follow-Up 98

40. Showing the Response to Chardi at the end of Treatment 99

41. Showing the Response to Chardi at the end of Follow-Up 99

42. Showing the Response to Over all at the end of Treatment 100

43. Showing the Response to Over all at the end of Follow-Up 100

44. Showing Number of Patients with Degree of severity Before

Treatment, After Treatment and at the End of Follow-up for individual

variables and over-all severity of the disease.

101

45. Showing Statistical analysis for individual variables and over-all

severity of the disease

102

46. Showing response to the individual variables and overall status of the

disease after treatment and at the end of the follow up

103

ix

LIST OF CHARTS Chart No.

Title of the Chart

Page No

1. Distribution of patients based on Age 82

2. Distribution of patients based on Sex 83

3. Distribution of patients based on Religion 84

4. Distribution of patients based on Occupation 85

5. Distribution of patients based on Economical status 86

6. Distribution of patients based on Diet 87

7. Showing the Chief Complaints of 30 treated cases 89

8. Showing the Response to Avipaka at the end of Treatment 90

9. Showing the Response to Avipaka at the end of Follow-Up 90

10. Showing the Response to Klama at the end of Treatment 91

11. Showing the Response to Klama at the end of Follow-Up 91

12. Showing the Response to Utklesha at the end of Treatment 92

13. Showing the Response to Utklesha at the end of Follow-Up 92

14. Showing the Response to Tiktodgara at the end of Treatment 93

15. Showing the Response to Tiktodgara at the end of Follow-Up 93

16. Showing the Response to Amlodgara at the end of Treatment 94

17. Showing the Response to Amlodgara at the end of Follow-Up 94

18. Showing the Response to Gourava at the end of Treatment 95

19. Showing the Response to Gourava at the end of Follow-Up 95

20. Showing the Response to Hritdaha at the end of Treatment 96

21. Showing the Response to Hritdaha at the end of Follow-Up 96

22. Showing the Response to Kanthadaha at the end of Treatment 97

23. Showing the Response to Kanthadaha at the end of Follow-Up 97

24. Showing the Response to Aruchi at the end of Treatment 98

25. Showing the Response to Aruchi at the end of Follow-Up 98

26. Showing the Response to Chardi at the end of Treatment 99

27. Showing the Response to Chardi at the end of Follow-Up 99

28. Showing the Response to Over all at the end of Treatment 100

29. Showing the Response to Over all at the end of Follow-Up 100

x

LIST OF PHOTOGRAPHS

Plate No. Fig No Title

1. Habit

2. Leaf

3. Stem

4. Inflorescence

5. Flower

1 Description of plant

6. Fruit

7. TS of Stem

8. TS of Stem Enlarged

9. TS of Root

10. TS of Root Enlarged

11. TS of Leaf

2 Pharmacognostic Studies

12. TS of Leaf Enlarged

13. Soxhlet Extractor

14. Petroleum Ether Extract

15. Benzene Extract

16. Chloroform Extract

17. Ethanol Extract

3 Preliminary Phytochemical Studies

Successive Solvent Extraction

18. Aqueous Extract

19. Powder Microscopy

20. Solute System

21. Silica Plate

22. Solvent Systems

23. Flovanoid

4 Standardization and Validation

24. Alkaloid and Flavanoid

5 Kalamegha Panchanga Churna 25. Kalamegha Panchanga Churna

CONTENTS Page Numbers

Acknowledgement. i - iii

Abbreviations iv

Abstract v - vi

List of Tables vii - viii

List of Charts ix

List of Photographs x

Introduction 1 - 3

Objective 4

Drug review 5 - 29

Disease review 30 - 50

Methodology 51 - 74

Observation and results (Pharmacognostic) 75 - 80

Observation and results (Clinical Study) 81 - 103

Discussion 104 – 115

Conclusion 116

Future prospects 117

Summary 118 – 119

Bibliography 120 - 136

ANNEXURE

Table No I Demographic data

Table No II Chief complaints

Table No III Associated complaints

Table No IV Nidana (Etiology)

Master Chart

Table No V Chief complaints with Gradings

Clinical Proforma

Shloka

Introduction

“Evaluation of efficacy of Kalamegha (Andrographis paniculata Nees.) in the management of Amlapitta- a clinical study. ”

1

INTRODUCTION

Man has been using vegetal materials for medicinal purposes since hoary past. It may be

difficult to determine how and where this aspect of man-plant relationship started, but it

is undeniable that on the basis of empirical experience of generations, human societies

developed certain systems of herbal medicines.

The world of plants is not evolved spontaneously. Through centuries, the science has

gradually developed with new experience getting incorporated and old principles which

could not stand the test of authenticity being discarded.

On the basis of “Jagathyevamanaushadam” (Vagbhata) i.e., every material substance

existing in the universe is composed of medicine.

Health is considered to be the moolam for achieving Chaturvidha Purushartha, namely,

dharma, artha, kama and moksha.

The ahara has got major role in the nourishment of the body and also causing the disease.

Greater significance is given to pathya that is hitaahara sevana which not only nourishes

the dhatus but also maintain the equilibrium of doshas. It has been also explained that the

apathya that is ahitaahara sevana is the causative factor for the vitiation of dosha, dhatu

resulting in the menifestation of diseases.

Introduction


2

The main cause for several diseases, which we are witnessing today, is considered to

ahitaahara sevana. The disease Amlapitta is no exception to this condition.

Life style in modern era has rendered lot of stress on human being and modern

mechanical lifestyle may not permit all the people to adopt a systematic diet, which

ultimately results in several gastrointestinal disorders. Excessive consumption of amla,

katu, teekshna ahara that is faulty dietary habits, addictions like alcohol, smoking,

tobacco chewing and other psychological factors like stress, strain also contributes in

causing the Amlapitta disease. Annavaha srotas in general, Amashaya in particular being

the principle site of the disorder.

Most of the diseases arrised from the abnormal functioning of agni, especially by its

mandagni state. “Rogasarvepi mandagnou.” Because of mandagni, the ingested food

will not digest properly and becomes apakwa and leads to the formation of ama, which is

the basic factor for the manifestation of several disorders.

The chikitsa sutra for Amlapitta explained in the Ayurvedic classics includes Vamana

and Virechana for urdvagati and adhogati of doshas respectively. The basic principles of

the treatment namely nidana parivarjana and samprapti vighatana are also applicable in

the treatment of Amlapitta.

There are abundant herbal and herbo mineral preparations available in the market for

early relief of Amlapitta, but drugs have not yet been developed properly for the

complete cure of the disease. Usually most of the cases treated by shamana chikitsa with

Introduction


3

different formulations, where chances of recurrence are more, so first priority is to treat

the underlying cause of the disease. Treatment should be aimed at restoring and

maintenance of good health without any artificial aids and, relief from the discomfort

associated with Amlapitta.

Keeping this view in mind an attempt was made to search an ideal drug having the

properties of pittahara, acting on agni and which should be easily available and

economic. Hence, the drug Kalamegha (Andrographis paniculata Nees.) has been

selected for the study.

Objectives

“Evaluation of efficacy of Kalamegha (Andrographis paniculat Nees.) in the management of Amlapitta- a clinical study. ”

4

OBJECTIVES

1) Pharmacognostical evaluation of Kalamegha. Preliminary phytochemical

study, macroscopical evaluation, microscopical evaluation, standardization

and validation of Kalamegha.

2) To evaluate the efficacy of Kalamegha panchanga churna in Amlapitta.

Review of Literature (Drug Review)


5

A) DRUG REVIEW:

THE PLANT KALAMEGHA:

The plant is indigenous to India and has been used in Indian systems of medicine

since time immemorial. It is also known as ‘Rice bitters’ in West Indies and ‘King of

bitters’ or Chiretta in England.1

The fresh and dried leaves of the herb and the juice extracted from this are official

drugs in Indian Pharmacopoeia and Chinese Pharmacopoeia.2

The herb is the well known drug Kalamegha or green chiretta, and forms the principal

ingredient of a reputed household medicine, used as a bitter tonic and febrifuge.3

HISTORICAL ASPECT OF THE DRUG:

Vedic Kala (2000-1000BC): No particular reference is available.

Samhita Kala (1000BC-500AD):

Caraka Samhita – It is not mentioned in Caraka samhita.

Sushruta Samhita – It is not mentioned in Sushruta samhita.

Asthanga Sangraha – No particular reference is available.

Asthanga Hridayam – The word Kalamegha is not mentioned.

Sharangadhara Samhita – It is not described in Sharangadhara samhita.

Madhava Nidana – Not found any references.



6

Nighantu Kala:

Dhanvantari Nighantu (11th century AD) -No particular reference is available.

Madanapal Nighantu (1374 AD) - No particular reference is available.

Raja Nighantu (14th century AD) - No particular reference is available.

Kaiyadeva Nighantu (1425 A.D.) - No particular reference is available.

Bhavaprakasha Nighantu (16th century AD) - No particular reference is

available

Shaligrama Nighantu (19th centuryAD) - No particular reference is available.

Nigantu Adarsha (1928A.D.) - No particular reference is available.

Priya Nighantu (1983 A.D.): Here the word Kalamegha has been mentioned

under the heading Shatapushpadi varga. Different synonyms, properties,

actions and rogaghnata are also mentioned. The source plant is Andrographis

paniculata Nees.4

Adhunika Kala :

It has been noted that Andrographis paniculata Nees. is popularly known as

Bhunimba in MP and Nagpur area and as Chirayata in the Bihar forests.5

KALAMEGHA NIRUKTI:6

The word Kalamegha is derived from “Vangeeya Sampradaya”. From distance it

appears like a cloud of sky blue colour, hence it is called as Kalamegha.

Fruits of Kalamegha are like yava (barley) and very bitter.



7

Table No 1 - SYNONYMS ACCORDING TO RECENT AUTHORS

SYNONYMS P.N7 D.G.H8 D.G P.V.S9

A.P V.M.G10

D.G G.P11

D.G. J.L.N.S12 I.M.P13 I.M.M14 T.W.I15

Bhunimba + - + - + + + + + Kalamegha + + + + + + + + + Kalpanatha + + - + + - - - - Kirata - - - - - - + + + Mahatikta - - - - - - - + - Yavakaraphala + - - - - + - - - Yavatikta - + - + + + - - - Shankhini - - - - + - - - -

EXPOSITION OF THE SYNONYMS:

Bhunimba –It is very small shrub, very bitter in taste like nimba.

Kalamegha –Appears like cloud of blue sky.

Kirata –It is called as kirata in some areas of India.

Mahatikta –Plant very bitter in taste.

Yavatikta –Fruits are yava in shape and very bitter.

Yavaakaraphala –Fruits are like indrayava or yavas.

BOTANICAL NAME: 16

Andrographis paniculata Nees.

ETYMOLOGICAL DERIVATION:

Andrographis = denoting male, andro = male, paniculata = having an

inflorescence the axis of which is divided into branches bearing two or more

flowers.

Panicula = tuft, a loose cluster of flowers.17



8

FAMILY: ACANTHACEAE

(akanthos – thorn)

KULA: VASAKULA 18

CLASSIFICATION OF THE DRUG KALAMEGHA:

The ancient authors classified the drugs on the basis of their morphological

characters, properties, pharmacodynamics as well as therapeutic values. The

classification goes as follows,

Table No 2- CLASSIFICATION OF THE DRUG KALAMEGHA:

Text Varga Name

Priya Nighantu19 Shatapushpadi varga Kalamegha

In the botanical floras and glossaries, the Kalamegha is identified as Andrographis

panicalata Nees.

Indian materia medica, Indian medicinal plants, Flora of presidency of Madras,

Flora of Chikkamangalur district, Wealth of India, Materia Medica of Hindus,etc in

all text Andrographis paniculata Nees. is included in the Acanthaceae family.

VARIETIES:

No particular varieties are available in Classics and Nighantus.According to Indian

medicinal plants, vol-2 and there are 4 genuses of Andrographis Wall. available.

1) Andrographis altata Nees.

2) Andrographis echioides Nees.

3) Andrographis lineata Nees.

4) Andrographis paniculata Nees. 20



9

VERNACULAR NAMES: 21

Arabic : Qasabhuva, Qasebazzarirah.

Bengal : Kalamegh, Mahatita.

Canarese : Kreata, Nelabevinagida.

Deccan : Charayetah, Kalaphnath.

English : Creat.

Gujarati : Kariyatu, Kiryata, Kiriyati, Olikiriyat.

Hasada : Kalameg .

Hindi : Charayetah, Kiryat, Mahatika.

Java : Sadilata.

Malayalam : Kiriyattu, Nalaveppu.

Marathi : Olenkirayat.

Persian : Nainehavandi.

Sadani : Bhuinim.

Sanskrit : Bhunimba, Kirata.

Sinhalese : Hinbinkohomba, Ninbinkohomba.

Tamil : Nelavembu, Shiratkuchi.

Telagu : Nelavemu.

Uanadi : Creat.

TAXONOMICAL CLASSIFICATION: 22

Kingdom - Plantae.

Divisions - Angiospermeae.

Class - Dicotyledoneae.

Subclass - Gamopetalae.

Series - Bicarpellatae.

Cohort - Personales.

Family - Acanthaceae.

Genus - Andrographis.

Species - Paniculata .



10

FAMILY FEATURES: 23, 24, 25

Habit

Plants are herbs, shrubs and sometimes climbers. Cystoliths are often present in the

stem and leaf.

Leaves

These are simple, opposite and exstipulate.

Inflorescence

This is a spike or a cyme, or sometimes a raceme. In some species, the flowers are in

axillary clusters. They are rarely solitary.

Flowers

These are zygomorphic, bilabiate or oblique, bisexual and hypogynous. They often

have conspicuous bracts and bracteoles, the latter often large and sometimes spiny.

Calyx

The sepals are (5), rarely (4), and united.

Corolla

The petals are (5) connate in a two lipped or oblique corolla, and are twisted or

imbricate in the bud.

Androecium

The stamens are 2 or 4 (didynamous) and if epipetalous disc, is often conspicuous.

Gynoecium

This is syncarpous, the carpels being (2). The ovary is 2 celled, superior, with 2 to

many ovules in each cell. The placentation is axile. There are 2 stigmas.

Fruit

The fruit is a 2 valved capsule.



11

Seeds

In most cases, these are supported on curved hooks (jaculators). These press the fruit

from inside, which bursts with a sudden jerk and scatters the seeds.

Floral formula – %♀ K (5) C (5) A2 or 4 G(2)

Floral Diagram -

Acanthaceae is related to scrophulariaceae, but is distinguished from it by the

presence of copious bracts and bracteoles, often unequal posterior sepal, loculicidal

capsule dehiscing to the very base, the presence of jaculators, the absence of

endosperm, frequent presence of cystolith etc. It is also related to labiatae and

verbenaceae.

MORPHOLOGY: 26, 27

Habit

An erect, branched annual herb 0.3 – 0.9m. high, branches sharply quandrangular.

Leaves

5 – 7.5 by 1.2 – 2.5cm, lanceolate, acute, glabrous, slightly undulate, pale beneath,

base tapering, main nerves 4 – 6 pairs, slender, petioles 0 – 6mm long.

Inflorescence

Panicles.



12

Flowers

Small, solitary, distant, in lax spreading axillary and terminal racemes or panicles, the

whole forming large pyramidal paniculate inflorescence, bracts 2.5mm, long,

lanceolate, bracteoles similar or 0, pedicels 0.8 – 4mm. long, glandular pubescent.

Calyx

3mm. long, sepals equal 5 in numbers, linear-lanceolate, glandular pubescent.

Corolla

Rose coloured, 1cm. long hairy outside, 2 lipped rather more than half way down,

tube 5mm. long, slightly enlarged below the limb upper lip 4mm. long, oblong, 2-

toothed at the apex, lower lip equal in length, deeply 3 lobed, the lobes 2.5mm. long,

linear oblong, sub obtuse.

Androecium

Filaments flattened, hairy in the upper part, stamens 5 in numbers, anthers bared at the

base.

Gynoecium

Ovary glabrous, style slightly pubescent.

Fruit

Capsules 20 by 3mm. linear – oblong, acute at both ends.

Seeds

Numerous, subquadrate, osseous rugosely pitted, glabrous yellowish brown.

PHARMACOGNOSTIC FEATURES ANDROGRAPHIS PANICULATA: 28

MACROSCOPIC:

Habit

An erect, glabrous, annual, much branched herb up to 90cm high, branches sharply

quadrangular; often narrowly winged in the upper part.



13

Leaves

Simple, opposite, short petioled, 2-7cm. long and 1-3cm. wide, lanceolate, glabrous,

slightly undulate, pale beneath; base tapering; main nerves 4-6 pairs, slender; petioles

0-6mm. long.

Inflorescence

Panicles

Flowers

Flowers pink in solitary, axillary and terminal panicles.

Fruits

Capsules erect, linear-oblong, compressed, longitudinally furrowed on the broad

faces, thinly glandular hairy.

Seeds

Numerous, sub-quadrate.

MICROSCOPIC:

Stem

Microscopically it is characterized by the presence of glandular and non glandular

hairs, collenchyma located at the corners, secondary phloem with mainly acicular

fibres, xylem fibres elongated and thickened vessels with scalariform and spiral

thickenings, pith composed of parenchyma cells containing small acicular crystals of

calcium oxalate.



14

Leaf

In transverse section of the leaf shows a dorsiventral structure with cuticularised

upper epidermis, rarely having stomata. Hairs are glandular, disc shaped, multicellular

with vertical walls. Stomata are abundant on lower epidermis and are of

caryophyllaceous type. Both the epidermis show presence of cystolith of various

forms which are round and elongated or blunt at both ends. Palisade is single layered,

spongy mesophyll 4-6 layered. Midrib appears triangular to oblong in cross section

and its vascular strand shows phloem located on dorsal side and xylem on ventral

side.

QUANTITATIVE STANDARDS: 29

Physical constants are, foreign organic matter: not more than 2.0%, ash: not more than

15.0%, acid insoluble ash: not more than 3.0 %, Alcohol soluble extractive: not less

than 8.0 %, Alcohol (60%) soluble extractive: not less than 24.0 %, water soluble

extractive: not less than 20.0 %.

HABITAT: 30, 31

Plant is found throughout Ceylon and India, in plantal or in wild state, especially in

West Bengal. It is abundantly scattered in rural areas. Generally it is found in gardens

and waste places, Central India, Kerala, Assam, Andhra Pradesh, Bihar, West Bengal

and other provinces in India.

RASAPANCHAKA OF KALAMEGHA:

The action of a drug is inevitably based on the Rasapanchaka of that drug.

Charaka and Sushruta opines that the drugs execute their actions some with

rasas, some with gunas, some with virya and some with vipaka and prabhava.

Vagbhata stated that though rasadi are antagonist to each other, they acts on different

doshas and dushyas without interfering the other properties.



15

The ‘Rasa-panchaka’ of Kalamegha according to different lexicons is as follows,

Table No 3 – RASA PANCHAKA ACCORDING TO DIFFERENT AUTHORS

REF RASA GUNA VIRYA VIPAKA

P.N 32 Tikta Laghu Ruksha

Ushna -

D.G.H 33 Tikta Laghu Ruksha

Ushna Katu

D.G. P.V.S 34 Tikta Laghu Ruksha

Ushna Katu

A.P V.M.G35 Tikta Laghu Ruksha

Ushna Katu

D.G. G.P 36 Tikta Laghu Ruksha

Ushna Katu

D.G J.L.N.S37 Tikta Laghu Ruksha

Ushna Katu

DOSHA KARMA OF KALAMEGHA:

Action of Kalamegha on doshas.

Table No 4 – DOSHAGHNATA ACCORDING TO DIFFERENT AUTHORS

REF. PITTAHARA KAPHAHARA P.N38 + + D.G.H 39 + + D.G .P.V.S 40 + + A.P. V.M.G 41 + + D.G .G.P 42 + + D.G. J.L.N.S43 + +

SAMANYA KARMAS OF THE PLANT KALAMEGHA:

The dravyas perform certain actions in the body by virtue of their qualities.

The plant Kalamegha has several actions when it is either administered alone or

in combination with other drugs.



16

The different actions mentioned by different authors are tabulated below:

Table No 5 – KARMAS ACCORDING TO DIFFERENT AUTHORS

ROGAGHNATA OF THE PLANT KALAMEGHA:

Success in treatment signifies the correct application of all therapeutic majors.

To select the right medicine which is made for health and to relieve the

disease, the knowledge of therapeutic action of the drug has an important role.

We can observe that Kalamegha is mainly used in Agnimandya, Udararoga,

Kamala,Yakruttaroga.

Table No 6 – ROGAGHNATA ACCORDING TO DIFFERENT AUTHORS

ROGAS P.N 50 D.G.H 51 D.G.

P.V.S 52 A.P.

V.M.G 53 D.G. G.P 54

D.G. J.L.N.S 55

Aamadosha - - - - - - Agnimandya - - + - - - Gulma - - - - + - Jwara + - - - - + Kamalaa - - - + - + Krimiroga + - + + - + Kushtaroga + - - + + + Pandu - - - - - + Raktavikara - - + - - - Shotha - - - - - + Udararoga - - - - - + Vibanda - - + - - - Vishajanya - - - - - - Vishama jwarahara

- - + - - -

Vrana - - - - - + Yakruttaroga + - + + - -

KARMAS P.N44 D.G.H45 D.G.

P.V.S46 A.P.

V.M.G47 D.G. G.P48

D.G. J.L.N.S49

Deepana + + + + + + Pitta shamaka - - + - - - Rakta shodhaka - - + - - - Rechana - - + + + - Ruchikara - - - - - - Swedana + + - - - - Vishodhani - - - - - - Yakruttejaka - - + + + -



17

PHYTOCHEMISTRY:

Major – 0.5 – 0.9% andrographolide, a diterpene lactone. Minor – Include diterpene

lactones viz, andrograpanin, deoxyoxoandrographolide. Glycosides viz,

neoandrographolide and andrographiside. Flavonols viz, oroxylin, wogonin,

andrographidines A, B, C, D, E & F. 56

Analysis of the whole plant gave the following lactones (dry basis):

Andrographolide, 0.6, 14-deoxy-11-oxo-andro-grapholide [ C20H28O5 , mp 98-100˚),

0-12; 14 – deoxy – 11, 12 – didehydroandrographolide [ C20H30O4, mp 203-04˚ ),

0,06, 14-deoxyandrographolide [ C20H30O4, mp 175˚ ), 0.02%, and a non bitter

constituent, neoandrographolide [ C26H40O8, mp 167-168˚] , 0.005 %.

The leaves contain andrographolide (yield, 1%). From the petroleum ether extract of

the leaves from Bangladesh, the following have been isolated: -, -unsaturated

lactone, homoandrographalide [C22H32O3, mp 115˚], andrographosterol [C23H38O, mp

135˚],andrographane [C40H82, mp 67-68˚],andrographone [C32H64O, mp 85˚], a war,

two esters containing hydroxyl groups.

The roots gave apigenin-7, 4-di-o-methyl ether, andrographolide and a new natural

flavone, 5-hydroxy 7, 8, 2, 3-tetra methoxyflavone [C19H18O7, mp 150-51˚, yield

0.006%]]. They also contain a monohydroxytrimethyflavone,andrographin C18H16O6,

mp 190-91˚ and a dihyroxy-di-methoxyflavone, panicalin[C17H14O6, mp 263-64˚].

The presence of -sistosterol is also reported. 57



18

THERAPEUTIC USES:

1. The expressed juice of the leaves, together with certain spices, such as

Cardamoms, cloves, cinnamon etc, is dried in the sun and made into little

globules, which are prescribed for infants to relieve griping irregular stools and

loss of appetite, flatulence, and diarrhea. 58, 59

2. A decoction of the plant is a blood purifier. It is used as a cure for torpidity of

Liver and jaundice, neuralgia and constipation. It forms the major constituent of

the Ayurvedic drug.60

3. Switradilepa, which is effective in treating vitilago- a dermatological disease. 61

4. A decoction or infusion of the leaves is useful in general debility, dyspepsia.

5. The leaves and roots are also used as febrifuge, stomachic, cholagogue,

anathematic.

6. A tincture of the root is stimulant and aperients.

7. The decoction of the plant is used in high blood pressure and anemia.

8. The hot water extracts of leaf stem are used as a powerful tonic. 62, 63

USES OF KALAMEGHA IN DIFFERENT SYSTEMS:

Unani: 64, 65

The plant is used in Unani system of medicine as blood purifier.

Homeopathy: 66

It is also used in homeopathy system of medicine as a febrifuge and hepatoprotective

medicine.



19

FOLK USES:

1. It is bitter shrub, well known under the name Kalamegha, and forms the principal

ingredient of a household medicine called Alvi, which is extensively used in

Bengal. 67,68

2. A paste of its dried roots with haridra into equal proportions is made with water,

Which is applied for itching and on skin rashes.

3. Its leaves are much used in flatulence by the Nat and Musher people in Uttar

Pradesh (Ahmed, 1995).

4. In central India, half cup of the plant decoction is taken in the morning and

evening for 7-8 days to cure malaria (Saini, 1996).

5. A decoction of entire plant is also given to children as a house-hold remedy to

cure the worms.

6. The juice extracted from its leaves, is mixed with coconut water and given orally

in Kerala also for worms (Augustin and Shivadasan, 2004).

7. According to Barthakuret. Et al, 2004, in Assam. People take a decoction of its

shoots in about 10 gms quantity twice daily for 4-5 days in acute jaundice due to

hepatitis associated with hepatomegaly. For children honey or sugar is added to

mask the bitter taste of the recipe.

8. Besides in Chattisgarh state, about 250 leaves of the plant are boiled with water

and one glassful is taken twice a day for 3 days in intermittent fever (Tirkey,

2004). 69

9. The Yanaders, a wonder gipsy tribe in the Madras Presidency, constantly carry a

supply of pills made of creat fresh leaves, and the pulp of the ripe tamarind,

which they consider antidotal to the venom of the Cobra. A pill made into a paste



20

with water is applied to the bitten part and some of it is put into the eyes, two

pills are given for a dose every hour or two internally.

10. A saturated infusion of the whole plant in a dose of about half a pint is

administered to fever patients by the Mundas of chota Nagapur. It is considered

as a specific. (Encyclopedia Mundarica)

11. Green leaves with the leaves of Indian birthwort (Aristolochia indica) and the

fresh inner root bark of country Sarsaparilla, made into an electuary, is used by

Hakims as a tonic and alterative in Syphilitic cachexia and foul Syphilitic

ulcers.70

Table No 7 – PRAYOJYA ANGA ACCORDING TO DIFFERENT AUTHORS

PRAYOJYA ANGA

D.G.H71 D.G. P.V.S72

D.G. G.P73 D.G.

J.L.N.S74 A.P. V.M.G75

Panchanga + + + + +

Table No 8 – MATRA ACCORDING TO DIFFERENT AUTHORS

MATRA D.G.H76 D.G. P.V.S77

D.G. G.P78 D.G.

J.L.N.S79 A.P.

V.M.G80 Churna (gms) 0.5-1 1-3 1-3 1-3 1-3 Swarasa (ml) 2-5 5-10 5-10 5-10 5-10 Kwatha (ml) 20-40 20-40 20-40 20-40 20-40 Tarala Satva (ml) -- 0.5-1 0.5 0.5 0.5 Ghana Satva (gm) -- -- -- -- --

Table No -9 VISHISTHA YOGAS:

SL NO YOGAS 1 Shvitradilepa 2 Kalamegha tarala satva 3 Kalamegha navayasachurna 4 Kalameghasava 5 Kalamegha swarasa 6 Kalamegha kwatha 7 Kalamegha panchanga churna 8 Kalamegha vati



21

COLLECTION:

The whole plant is used for medicinal purpose. At the end of the rainy season and

before winter, the plant is collected and dried in shade, before use.

CULTIVATION:

It grows throughout India in moist and shaded places in the plains. It is an annual herb

cultivated to some extent in Assam and Bengal.81

It prefers sunny situations. The seeds are sown in May-June. The seedlings are

transplanted at a distance of 60 X 30 cm. 2 or 3 irrigations are given during dry

period. Flowering occurs during August-November, followed by fruiting. The crop is

harvested during February-March by uprooting the whole plant. The plants are dried

in shade. 82

MODE OF PROPAGATION:

It can be propagated by seeds or cuttings. 83

PEST AND DISEASES:

It is hardy plant and is not attacked by any pests and diseases of a serious nature. 84

HARVESTING AND STORAGE:

The crop is ready for the first harvest after about 90 to 120 days of sowing when the

plants start flowering. At this stage they are harvested by cutting the plants at the

base, leaving about 10-15 cm of the stem for regeneration. The regenerated plants are

ready for harvest in about 60 days of the previous harvest. Totally 2 to 3 harvests can

be made in a year. As a perennial crop, one in August and second in November /

December. Crop remains dormant during winter. At the flower initiation, active

principle andrographolide is high in leaves. Sometimes, the whole plant is also

harvested after about 6 months. After harvesting the plants are dried under shade for

3-4 days before storage. 85



22

PRODUCTION AND YIELD:

The average yield is about 2 to 2.5 tonnes/ ha of dry herb86

MARKETING AND TRADE:

According to estimation, the demand of kalamegh by herbal industries and ayurvedic

drug producer of Maharashtra is nearly 16-18 tonnes in 2001-2002. The natural

remedies (P) Ltd., Bangalore is required nearly 11.5 t Kalamegh as crude drug in

1999-2000. Annual production of kalmegh is nearly 5000 Mts vis-à-vis their 20%

consumption by Indian ayurvedic pharmaceutical industries in 1999 (Source ADMA,

Mumbai. The current market price of herbage is Rs. 15-20 per kg. 87

ECONOMICS OF CULTIVATION:

The markets of kalamegh and their products are highly volatile. The economics (per

ha) worked out here are subject to fluctuations, depending upon time and place. 88

ADULTERANTS:

Andrographis paniculata is also adulterated with Andrographis echioides Nees, found

in tropical India and in dry districts of Maharashtra, Rajasthan and Tamil Nadu.

However, both Sweritia chirayita and Andrographis echioides are devoid of

andrographolide, the major bioactive constituent of Andrographis paniculata. 89

SUBSTITUTES:

The drug is often substituted for or mixed with the genuine ‘Chirata’ Swertia chirayita

but can be distinguished from the latter easily by the green colour of its stem,

numerous erect, slender, opposite branches and its lanceolate green leaves. 90



23

CONTROVERSY STUDY: Points to rule out the controversy:

1. Bhunimba is said to be the synonym of Kiratatikta and Kalamegha in samhita kala

and nighantu kala.

2. According to Bapalal Vaidya, while explaining the controversy of Kalamegha, he

has considered bhunimba is Andrographis paniculata. Nees. (Fam-Acanthaceae).

And is the kalamegha.of Bengal and kirayata of Gujarat it can’t be identified as

kiratatikta (Swertia chirayita, Fam Gentianaceae).

3. Bhunimba is accepted as a synonym of kiratatikta (chirayata – Swertia species)

and Andrographis paniculata is sold in the market as its substitute or adulterant or

by the name of Deshi-chiraaitaa and kalamegha also. A. paniculata is locally

known as bhunimba in Madhya Pradesh and bhunimo in Orissa.

4. According to Dhanvantari Nighantu, Madanapala Nighantu, Kaiyadeva Nighantu,

Raja Nighantu, Shaligrama Nighantu, the word yavatikta is mentioned. Bhunimba,

yavakaraphala, and kirata are synonyms mentioned to it.

5. There is one word saptalika Sushruta samhita but the commentator has treated

saptalika as yavatikta, (Andrographis paniculata -kalamegha). Personally Bapalal

Vaidya & P.V Sharma would like it as a diminutive form of saptala.

6. Other bitter species of swertia may also be used. Mostly are found in high

himalayan regions so called kirata tikta apart from this certain other bitter plants

of other genera are also used. The common name is Deshi chirayita (Andrographis

paniculata Nees. ) designated as separate drug bhunimba.



24

By considering the above points it can be concluded that,

1. Bhunimba which is mentioned in Samhita kala, Nighanta kala is not

Kalamegha. Bhanimba and Kalamegha are two separate plants.

2. According to Bapalal Vaidya, bhunimba is Adrographis paniculate Nees. This

is the regional language variation.

3. The Deshiya- Chirayata (A. Panicalata Nees) can be sold in the market as a

Substitute and adulterant to the kiratatikta. Due to this region bhunimba is

called As Kalamegha, but both are different plants.

4. Yavatikta can be considered as one of the synonyms of Kalamegha that is due

to yavakara phala. So yavatikta and Kalamegha are two different plants.

5. Yavatikta, Saptala, which are mentioned by Bapalala Vaidya and P.V.Sharma

are not Kalamegha (Adrographis paniculate Nees.).

6. Finally it can be concluded that Kalamegha which is mentioned in Ayurvedic

texts can be considered as Andrographis paniculata Nees, which belongs to

the family Acanthaceac.



25

RESEARCH PROFILE: 91

Pharmacognostic studies:

The macro and microscopic characteristics of the stem, leaves and floral parts of the

plant have been described. The quantitative microscopic studies of the leaves with

respect to palisade ration, stomatal index and vein-islet number have also been

conducted (Prasad and Gupta. 1957).

Ethno botanical studies: The plant is used as

1. Stomachic, blood purifier and liver tonic. (Chandra et al., 1985, 1987).

2. Jaundice (Reddy, 1986, 1988).

3. Fever, anemia and scabies (Singh and Singh, 1992 ;).

4. Infective hepatitis (Vedavathy and Rao, 1995).

5. Used as a tonic, febrifuge, antidysenteric, antipyretic, anthelmintic, wormicidal and

dyspepsia (Jha et al. 1997).

6. Flatulence (Ahmad, 1995).

7. Wound healing (Borthakur et al., 1996).

8. Oedema (Reddy et al., 1991) etc.

Chemical studies:

Andrographolide, a trihydroxy lactone and the bitter principle of the plant was

isolated as early as 1911. The plant was later investigated by Moktader andGuha-

Sircar (1939) who reported a structure not consistent with earlier report. It was later

established that andrographolide was a trihydroxy lactone with one tertiary hydroxy

group (Chakravarti and Chakravarti, 1952). Structure of andrographolide was finally

confirmed as a bicyclic diterpenoid lactone (Cava et al., 1965).

Four diterpenes, andrgrapholide, neoandrgrapholide, deoxyandrgrapholide and

andrgraphiside were isolated from the n-butanol fraction of the alcoholic extract of the

plant (Gupta et al., 1990). The methanol soluble portion of the benzene extract of the

plant yielded carvacrol and eugenol along with myristic acid, hentriacontane and

tritriacontane(Ojha., 1983).



26

The polyphenols obtained from the mother liquor after removal of andrographolide

from the leaves were identified as caffeic, chlorogenic and a mixture of dicaffeol and

quinic acids (Satyanarayana et al., 1978).

The root yielded a new flavone (5-hydroxy-7,8.2’3- tetramethoxyflavone) found to be

identical with mono-0-methylwightin along with apigenin-7,4’-di-0-methyl ether

andandrgrapholide (Govindachari et mal., 1969); two new flavonoids, 5-hydroxy-7.8-

dimethoxyflavonone and 5-hydroxy-3.7.8.2’-tetramethoxyflavonone in addition to the

known flavonoid. 5-hydroxy-7.8-dimethoxyflavone (7-0-methylwogonin) (Gupta et

al., 1983): a new glycoside. 2’, 5-dihydroxy-7.8-dimethoxyflavone-2’-0-β-D-

glucoside, 3β-hydroxy-5-stigmasta-9(11).22(23)-diene (Gupta et al.,1996). Bhardwaj

et al., (1981.1990) reported the synthesis of 5-hydroxy-7.8.2’-trimethoxyflavone:

5.2’-dihydroxy-7.8-dimethoxyflavone and 3.7.8.2’-tetramethoxy-5-hydroxyflavone

isolated by foreign workers (Biswas and Chowdhury, 1972: Jalal et al., 1979).

Toxicology:

Leaves and stem extracts may cause gastric discomfort, vomiting and loss of appetite

when given orally in large doses. Injection of the crude drug (extract of leaves and

stem) extract may lead to anaphylactic shock.

Andrographolide showed reproductive toxic effects in male albino rats. Leaves, when

fed to male albino rats, andrographolide present in it, because the arrest of

spermatogenesis by preventing cytokinesis of the dividing spermatogenic cell lines.

Pharmacological studies: Antihepatotoxic, hepatoprotective, antimalarial, cholinergic, cardiovascular,

Anti-inflammatory,antialergic,antimicrobial, antipyretic, immunostimulant, anti-HIV,

antiulcer,antispermatogenic,antidiarrhoeal,filaricidal,antifertility,hypotensive,

choleretic,antiphoid,anti-fungal,anti-biotic,antioxidant, antihyperglycaemic, analgesic.



27

Plant extract increased biliary flow and liver weight in rat and decreased hexobarbital

induced sleeping time.

Hepatoprotective

The aqueous extract of the plant [each 5 ml of the extract contained ‘Kalamegh’ I.P.

containing 5 percent andrographolide (1 ml) in a dose of 3.75 ml/kgp.o. once a day for

5d was studied on the biliary flow, liver weight and hexobarbital-induced sleeping

time in rats. The extract was reported to increase biliary flow and liver weight and

decreased the duration of action of the hexobarbital. When compared with

Phenobarbital it was less potent at the dose employed (Chaudhuri, 1978).

The crude aqueous extract (2 per cent) of the plant showed inactivation of HBsAg

positive serum samples in in vitro studies in 48-120h at 37°C which was tested by

counter immunoelectrophoresis and latex agglutination methods (Jayaram et al.,

1989). However, Mehrotra et al., (1990) could not detect any anti-HBsAg activity in

andrographolide in in vitro studies.

Antiulcer

Apigenin 7, 4’-di-O-methyl ether, the flavone isolated from the root was tested for its

antigastric ulcer property in various animal models. The animals received a

suspension of the compound orally in doses of 5, 10 and 50 mg/kg. The flavone

produced a significant dose-dependent antiulcer activity in Shay rats, histamine-

induced ulcer in guinea pigs and in aspirin-induced ulcers in rats. It was suggested

that the antisecretory activity and a protective effect on the gastric mucosa might be

responsible for the antiulcer action of the flavone (Viswanathan et al., 1981).

Andrographolide possessed significant (p<0.05) antiulcerogenic activity at doses of

100 and 300 mg/kg bw administered orally in aspirin-induced ulceration in rats

(Madav et al., 1994).

Anti-inflammatory

The aqueous extract of the plant at a dose of 20 mg/ 100 gm bw orally in rats inhibited

carrageenin-induced oedema (65.3 per cent) after three hours as compared to the

control rats. The percentage of inhibition of the inflammation in the group treated



28

with pheylbutazone (Standard) in the dose of 10 mg /100 g bw orally was 76.5 per

cent (Tajuddin et al., 1983).

Antipyretic

The plant juice (2 ml/100g bw orally) showed antipyretic activity in yeast-induced

pyrexia in rats. The extract administered even after 5h of yeast also reduced pyrexia.

The control rats were fed saline (Kanniappan et al., 1991). In another study, the

watery solution of the ethanolic extract of the plant (500 mg/kg bw) produced

antipyretic activity against yeast-induced pyrexia. The results were comparable in

efficacy to that of 200 mg/kg of aspirin (Vedavathy and Rao, 1991).

Andrographolide (100 and 300 mg/kg bw orally) produced a significant (p<0.05)

antipyretic effect 3h of administration in Brewers yeast-induced pyrexia in rats

(Madav et al., 1994).

Analgesic

Andrographolide at 300 mg/kg dose administered orally showed significant (p<0.05)

analgesic activity in acetic acid-induced writhing in mice and Randall Selitto’s test in

rats. It was devoid of any analgesic activity (at 30, 100 and 300 mg/kg, administered

orally) in hot plate test in mice (Madav et al., 1994).

Antidiarrhoeal

The alcoholic extract of the plant exhibited significant antidiarrhoeal activity against

Escherichia coli enterotoxins in animal models. The activity was further located in n-

butanol fraction, which contained four diterpenes, andrographolide,

neoandrographolide, deoxyandrographolide and andrographiside. Among the four

diterpenes andrographolide, neoandrographolide showed similar activity to

loperamide against Escherichia coli enterotoxins. Andrographolide was found to be

superior against ST enterotoxins, the most common cause of epidemics of neonatal

diarrhoea (Gupta et al., 1990).

In another study, the alcoholic, hexane, chloroform, butanol and aqueous extract of

the plant showed significant antisecretory activity against Escherichia coli enter toxin

induced secretory response in rabbit and guinea pig ileal loop models at a dose of 300

mg/loop (Gupta et al., 1993).



29

Antihelmintic

The aqueous extract of the plant showed nematicidal activity against the root knot

nematode Meloidogyne incognita on tomato both in vitro and in pot (Mukherjee and

Sukul, 1978: Goswami and Vijayalakshmi, 1986).

The crude extract of the leaves revealed 100 per cent mortality of soil nematodes

within 12h of treatment. The other parts of the plant also had some activity

(Bandyopadhyay et al., 1986).

General studies

The aqueous extract of the powdered stems and root were found to be devoid of any

blood anticoagulant principle (Pillai et al., 1957).

The effect of the alcoholic extract of the plant (at dose of 100 mg/25 g i.p. and 50

mg/25 g i.p) on cobra venom-induced death in mice was studied. The extract

prolonged the life time of venom injected animals as compared to the controls

(saline). The extract prolonged the life time of cobra victims by an unknown

mechanism (Nazimudeen et al., 1978)

Clinical studies:

Vitiligo

A. paniculata is one of the constituents of Ayush-57, an Ayurvedic drug containing

the plants Plumbago rosea, Terminalia belerica, T. chebula, Emblica officinalis and

other constituents, which has been reported to be beneficial in some cases of vitiligo

(Rao et al 1980).

Review of Literature (Disease Review)


30

B. DISEASE REVIEW:

HISTORICAL REVIEW:

VEDIC PERIOD:

There are no references of Amlapitta in Vedic period.

SAMHITA PERIOD:

In Samhita kala there are few references about Amlapitta which are available.

In the context of Brahatrayee, Amlapitta has not been mentioned as separate disease.

Few scattered references are available.

Lagutrayee and other text, have described this disease in separate chapters.

In Charaka Samhita, while explaining about qualities of dugda, it has been mentioned

as pathya in Pandu roga, Amlapitta etc diseases.92

There is also a reference that the excessive use of kulattha causes Amlapitta. 93

While mentioning the ill effects caused due to excessive use of lavana rasa, there is a

statement that it provokes pitta, lohita pitta, Amlapitta and similar other conditions. 94

Amlapitta also mentioned in the context of ill effects of the vidhi viruddha ahara

sevana. 95 There is also a reference available regarding it. Rajamasha is more

beneficial in Amlapitta disorder. 96

There is also a reference that when gora anna visha combines with pitta, it produces

daha, trishna, mukhamaya, Amlapitta and other pittaja disorders. 97

In Sushruta Samhita we get a reference that is “Vidagdham chamlamevacha”

Commentary on Dalhana teeka by Gayadas says,

“Vidagdham pittamamla pittamiti rogavishesha kare. Chinmanyantae.”

Vagbhata has mentioned that excessive use of kulattha causes Amlapitta. 98



31

In Kashyapa Samhita Khila sthana 16th chapter, detailed description about Amlapitta

is available. He deals with the nidana, laxana, chikitsa, upadrava and sadhyasadhyata

of Amlapitta.

In Madhava Nidana of Madhavakara, he mentioned nidana, swarupa, laxana, bheda,

sadhyasadhyata and dosha samsarga of Amlapitta in 51st chapter.

In 10th chapter of Bhavaprakasha, Bhavamisra deals in detail about the nidana, laxana,

bheda, sadhyasadhyata of Amlapitta along with its treatments.

Types of Amlapitta and few yogas useful in Amlapitta are seen to be explained by

Sharangadhara.

In Amlapittadhikara of Bhaishajyaratnavali and 52nd chapter of Chakradatta, detailed

description about chikitsa and pathyapathya of Amlapitta is seen.

In Yogaratnakara description of nidana, samprapti, rupa, prakara, sadhyasadhyata,

chikitsa and pathyapathya of Amlapitta is available in Amlapitta nidana chapter.

Vanga sena explained nidana, laxana, bheda, sadhyasadhyata, chikitsa of Amlapitta in

his Chikitsasara sangraha.

6th Chapter of Siddhanta Nidana by Gananath Sen, brief explaination about nirukti,

nidana, samprapti, laxanas, upadravas and sadhyasadhyata of Amlapitta is available.

Basavarajeeyam deals about nidana panchaka and treatment aspects of Amlapitta in

saptama prakarana.

Harita deals with nidana and chikitsa of Amlapitta in 24th chapter of Tritiya sthana.



32

NIGHANTU KALA:

Nighantu Ratnakara, a description about nidana, laxana, bheda, sadhyasadhyata and

chikitsa of Amlapitta is available.

Gadanigraha of Shodala deals with nidana, lakshana, prakara, sadhyasadhyata,

chikitsa aspects of Amlapitta in the 38th chapter of Kaya chikitsa khanda.

NIRUKTI:

Amlapitta comprises of two components that is Amla and Pitta.

These two conjoined term which conveys the idea of the disease Amlapitta.

Amla is derived from: Am+Kla+Ach pratyaya.

The word Amla is commonly been used to express one among Shadrasas.

Second component of the term pitta is derived from the Dhatu,

“Tap” to heat or to burn. This term is seen to have three meanings; namely;

Tap-santape, refers to the generation of heat. 99

Tap-dahe, refers to the act of burning of the nutrition consumed.

Tap-aishwarye, refers to that factor which is responsible to make one achieve the

eight kinds of benefits.

These references are obtained from Siddhanta Kaumudi.

Pitta : Api + Do + Kla Ape A kara lopa.



33

PARIBHASHA:

Chakrapanidatta in his commentator on Charaka Samhita defines Amlapitta as

“Amlapittam cheti amlagounodriktam pittam”. 100

Means the pitta acquiring more of amla guna is known as Amlapitta.

Acharya Kashyapa explains that the Vidagdha anna rasa turns to shukta, and this

retained in amashaya and produces Amlapitta.

Srikanthadatta and Vijayarakshita, the famous commentator of Madhava Nidana said

that

“Vidahyadamlagunodriktam pittam Amlapittam.” 101

Means the condition of pitta in which the udriktata of amla guna along with vidaha is

noticed, should be called as Amlapitta

In Madhava Nidana of Madhavakara, it is defined as,

“Avipakaklamotkleshatikthamlodgaragauravaihi

HruthkanthadaharuchibhischAmlapittamvadedbhishak.” 102

A particular disease in which there is avipaka, klama, utklesha, tiktodgara, amlodgar,

gaurava, hriddaha, kanthadaha and aruchi are seen is suppose to be Amlapitta.

According to Nirukta Shastra, a particular disease in which the amla property of pitta

is increased along with pitta itself is defined as Amlapitta.

Vachaspati has described that, Amlapitta is a disease where pitta leads to sour taste

and in such state what ever is eaten is transferred into amla rasa.

“Amlamvidagdham cha tat pittam Amlapittam.” 103

When the definition of Amlapitta is summarised, it can said that a particular

pathological condition in which the pitta exceeds its normal level in terms of amlatha,

is Amlapitta.



34

PARYAYAS (SYNONYMS) The commentator of Asthanga Sangraha Indu affirms the paryayas of Amlapitta as,

1. Prameelakam

2. Amlapitta

3. Pitta visuchika

Yogaratnakara and Kashyapa104 have used the terms Pittamla and the suktata as the

synonyms of Amlapitta though they have not directly described Amlapitta.

The following terms can be taken as important synonyms of Amlapitta. They are

1. Prameelakam

2. Amlapitta

3. Pitta vishoochikam

4. Pittamla

5. Shuktaka

6. Amlaka

7. Amleeka

Prameelakam:

This pachyamana vidagdha annarasa immediately provokes Pittadi Doshas and

consequently in its turn vitiates Rakta etc., there by producing mukha vairasya,

hritshula, sadana. Continuous lavana tiktamla chardi, daha, atinidra, malabaddhata,

vivarnata, shosha, aruchi, restlessness as uneasiness and watering in the mouth

(praseka). All the symptoms stated in prameelakam. In Asthanga sangraha, we find

this term under kaphaja vyadhis and some authors read and term atinimitya as

prameelaka.

Amlapitta:

The implication of the term Amlapitta signifies the abnormal state of Pitta especially

by its Amla guna.

Pitta visoochikam:

This may pertain to both the types of Amlapitta urdwaga and adhoga Amlapitta,

where their respective cardinal features are urdhwapravritti (vamana) and

Adhapravrutti (atisara) of Pitta discordance associated with burning sensation.



35

Pittamla:

This term would imply the sense of the term Amlapitta.

Shuktaka:

Means amlodgar (acid or sour eructation)

Amlaka:

Refers to one of the nanatmaja vyadhi of Pitta. This produce antardaha (kostha daha)

Hridaya shula and amlodgar.

Amleeka:

Means Amlodgar and would refer to one of the lakshanas of saama pitta, the factor

from which Amlapitta is produced.

BHEDAS (CLASSIFICATION) :

Amlapitta has been classified under the distinct heading viz.-

CLASSIFICATION OF AMLAPITTA:

Based on gati 105, 106, 107 Based on Doshasamsarga Based on Dosha’s

Urdhwaga Adhoga M.N108 & B.P109 Y.R110 Kashyapa111 Sharangadhara112

Sanila Sanila

Sanilakapha Sanilakapha Vataja Vataja

Sakapha Sakapha Pittaja Shleshmaja

Kapha pittaja Kaphaja Shleshmajavataja



36

In the process of genesis of Amlapitta pathology it is necessary to consider the organs

in concern. Specifically stomach and intestine have its impact on the genesis of

Amlapitta. Here a stretch has been given towards Amashaya

AMASHAYA:

Chakrapani has commented that Amashaya is divided into two parts as upper and

lower. The upper part is the seat of kapha and the lower part is for the pitta. 113

Sushruta says upper connection to the Anna Nadi as Argala or Amashaya Dwara. This

latter is also known as Grahani Sushruta has very clearly stated that Amashaya is seat

of Kapha.

ANNAVAHA SROTAS: 114

It may be recalled that the terms are mahasrotas, kostha, Amashaya, Pakwashaya,

Kshudrantra, Brihadantra etc., were used to designate the gastrointestinal tract with

which the Pachakapitta is immediately concerned.

Charakacharya’s opinion about the moolas of Annavaha Srotas has relevance here.

According to him its moolas are,

1. Vama Parshwa

2. Amashaya

With out going to a detailed anatomical substation on Annanalika or esophagus and

the urdwa amashaya (stomach) may be taken in this connection of the reference made

by Charaka in 2nd chapter of his vimansthana.

PITTADHARAKALA: 115

The inner layer of the Amashaya called (relatively present more in Grahani) as

Pittadharakala also known as Grahani. It separates sara, kitta and activity of it

depends upon Agni. The Pachakapitta produced by Pittadharakala, which is situated

nearer to amashaya.

AGNI: 116, 117

The Agni otherwise Kayagni described as Pitta by Sushruta. Even Charaka has

mentioned Pitta is the form of Agni. Human body is made by Pancha mahabootas but

Pitta is having more qualities of Ap and prithvi mahabootas. This agni or Pitta digests

food ingested and it is said Bhagwan. Agni has the qualities as Rooksha, neither drava

or Ghana and moves upwards. There are four functional types of Agni. They are

Mandagni, Teekshnagni, Vishamagni and Samagni .



37

AHARA PACHANA

Chiefly Pachakapitta digests indigested food. And the seven Dhatwagnies are also

takes parts in intermediate metabolism. The food mainly undergoes three stages or

avasthas. They are:

1. Prathamana Avastha or Madhura Avastha

2. Dviteeyavastha or Amlavastha

3. Triteeyavastha or Katu avastha.

The non-homologous foods indigested subjected for mastication in mouth and

physical constitutions of food is vigorously changed in stomach because of its

movements in stomach Pachakapitta or Acchapitta (Hydrochloric Acid) changes

further its constitution chemically and starts the non homologous food transformation

into homologous.

Lavana Rasa in malaroopa Kapha is subjected for madhura vipaka118 in due course. In

pachchamanavastha, the partly digested food being propelled from urdwa amashaya

into the Adhoamashaya enters into amlapaka due to the predominance of Pitta. These

stages include two important stages as amlarasa. Padharthas gets digested and

secretion of digestive juices in to Amashaya takes places. The outcome of this stage

of digestion in the production of Vidagdha Ahara. 119

The word “Vidagdha” is interpreted as pakwapakwam the partly or not fully digested.

The implication here is that the food in this state is not yet fit for absorption and

utilization in metabolic process to dhatwagni paka.

The Amlabhava stage:

In this stage the digestive juices are acidic in nature due to the presence of

Hydrochloric acid. Whereas the bile , pancreatic juice act in an alkaline medium only.

Amlavastha in the digestive process indicates three important aspects.

1. The partly digested food, which moves down into the Adhoamashaya, is capable

of stimulating abundant production of clear Pitta of Amla states.

2. The dietary articles whose constitutes are Amla in taste are digested in this stage.

3. The Rasa of the end products in this stage are Amla.



38

PACHAKAPITTA: 120, 121

Ayurveda Acharyas affirmed every state of disease, which is developed because of

impaired Agni. There fore treating Agni it self said as treating the whole body.

The Pachakapitta is said to be located in the interior of the Amashaya and

Pakwashayas. These two Ashayas are separated by Argalam. Inner layer of these two

Ashayas is said as Pittadharakala by which produce Pachakapitta. This is

Pittadharakala known as Grahani as it retains food till the time of completion.

FUNCTIONS OF PACHAKAPITTA: 122, 123

Kosthagni is the leader of all the factors is consideration to that of digestion in living

beings. 68 It gives life span, complexion, vitality, vital essence, good health, glow,

luster, plumpness, enthusiasm, heat and life breaths are developed from dehagni, it is

added that who maintain antaragni good he never be victim of disease. Sushruta stated

that the integrity of Grahani depends upon Agni, therefore Agni or the Pachakapitta

is said as one of the major component in maintenance of health in living beings.

SAMANA VATA: 124,125,126

Samanavata is located nearer to the Agni (Pachakapitta) and Amashaya. Capable of

digesting all the varieties of food ingested by man. It helps in dividing to sara and

kitta then it propels kitta later parts of annavaha srotas .

KLEDAKA KAPHA: 127

Kledakakapha is located in the Amashaya. It disintegrates breaks and liquefies the

food kledakakapha it is said to be one of the protective mechanisms against

Hydrochloric acid secreted in to stomach.

NIDANA PANCHAKA:

Even though some disease may be diagnosed by a single among these five (nidana,

poorvarupa, rupa, upashayanupashaya and samprapti.), it is better to go through all the

five. Not only for diagnostic purpose, it even helpful in the treatment aspect,

“Sanskepathaha kriyayogo nidanaparivarjanam128 and “Samprapti vigatanameva



39

chikitsa”, which are fundamental principles of chikitsakarma. And even helpful in

knowing the sadhyasadhyata of the disease.

NIDANA: 129,130,131

The general causes which are responsible for provoking pitta are also responsible for

causing the disease Amlapitta. Because the vitiated dosha here is pitta. So generally

food and habits which are responsible for the vitiation of pitta are responsible for the

Amlapitta disease.

Along with these, vata and kapha are also having a role in the causation of Amlapitta,

particularly in the vataja, kaphaja, vatakaphaja types of Amlapitta, where these doshas

are in the anubandha or samsarga state.

By going through the classics the nidana of Amlapitta disease may be classified

under,

Ahara sambhandi

Viharasambhandi

Anya, which includes kala, desha, manasika vikaras etc.

The causative factors responsible for Amlapitta related to the food articles that is,

annapana are considered under ahara sambandhi and others regarding the non-

congenial activities like diwaswapna, vegadharana, atisnana etc are considered under

vihara sambandhi nidana.

Anya includes kala like Varsha-Sharad rutu, desha like Anupadesha, manasika vikaras

like krodha, irsha etc. which are generally pittaprakopaka in nature.



40

Table No- 10 SHOWING THE NIDANA OF AMLAPITTA

Sl.No NIDANA 1. Abhishyandi. 2. Adhika dravapadartha sevanam. 3. Adhyasana. 4. Ajeerna. 5. Ama. 6. Amla bhojanam. 7. Amlapadartha sevanam. 8. Antarodakapanam. 9. Apakwa madhyam. 10. Apakwa ksheeram. 11. Atiavagaham. 12. Atiruksha bhojanam. 13. Atisnanam. 14. Atisnigdha bhojanam. 15. Atiushna bhojana. 16. Brustha dhanyam. 17. Divaswapna. 18. Dusthanna bhojanam. 19. Guru bhojanam. 20. Ikshu vikaras. 21. Kulutham. 22. Paryushita bhojanam. 23. Phanitham. 24. Pisthannabhojana. 25. Pitta prakopa anna pana. 26. Pruthuka. 27. Pulaka (tusha). 28. Vegadharanam. 29. Vidahi padartha sevanam. 30. Viruddhashana.

Charaka stated that kulattha sevana, lavana rasa adhika sevana and viruddha

(unwholesome) aharasevana are the causative factors for Amlapitta.

There is no specific commentary of sannikristha and viprakristha karanas for

Amlapitta. Viruddha, dustha, amla, vidahi, pittaprakopaka anna pana etc may be

sannikristha karana and Varsha rutu may be considered as viprakristha karana.



41

POORVA RUPA:

Before dealing with rupa of Amlapitta, it is necessary to deal with the poorvarupa of

that disease.

There are supposed to be the symptoms which indicates or forecast the probable

development of Amlapitta in near further. These symptoms occur during the

sthanasamshraya stage of the pathogenesis. 132 Infact, the Ayurvedic classics do not

mentioned the poorvarupa of Amlapitta. Still however the lower intensity of the

symptoms may be considered here as the poorvarupa of Amlapitta.

RUPA: 133,134

The rupas of Amlapitta has been separately mentioned in the classics.

GENERAL SYMPTOMS (SAMANYARUPA):

These are the symptoms, which develop during the vyakta stage of pathogenesis of

Amlapitta and these indicate the onset of the disease.

Table No-11 SHOWING THE SYMPTOMS OF AMLAPITTA.

No. LAXANAS K.S135 M.N136 B.P137 Y.R138

1. Amlodgara. + + + +2. Amlotklesha. + - - -3. Angasada. + - - -4. Antrakujana. + - - -5. Aruchi. - + + +6. Atisara. - + + +7. Avipaka. - + + +8. Chardi. - + + +9. Gourava. - + + +10. Gurukosthata. + - - -11. Hrid daha. - + + +12. Hrid shula. + - - -13. Kanthavidaha. + + + +14. Klama. - + + +15. Romaharsha. + - - -16. Shiroruk. + - - -17. Tiktodgara. - + + +18. Udgaradmana. + - - -19. Urovidaha. + - - -20. Utklesha. - + + +21. Vidbheda. + - - -



42

SPECIAL SYMPTOMS (VISHISTHA RUPA):

These are also the symptoms which develop during the vyakta stage of Amlapitta. But

they differ from the general symptoms in the sense that these show the relationship

with particular individual dosha or combined doshas, where as the general symptoms

do not do so. More ever, by means of these symptoms Amlapitta can be differentiated

from the other disease, which is having the similar type of symptoms.

UPASHAYANUPASHAYA: 139,140

Here in case of Amlapitta, Kashyapa explained about upashaya for vataja, pittaja,

kaphaja Amlapitta. In vataja Amlapitta snigdha ahara, in pittja Amlapitta sheeta ahara

and in kaphaja Amlapitta ruksha ahara are said to be as upashaya. 141 The anupashaya

of Amlapitta are not mentioned in texts. But however the causative factors and

aggravating factors themselves may be taken as anupashaya.

SAMPRAPTI OF AMLAPITTA: 142,143,144

According to Charaka: Even though the detailed description of Amlapitta is not

available regarding Amlapitta in Charaka Samhita, but while describing the Grahani

chikitsa explained that the pitta which gets amlatva in its quality can be taken as

Amlapitta. And also while going through it, Acharya explained that the pachakagni

gets vitiated due to its own vitiating factors. This dushitagni looses its capacity to

digest even a small amount of food, (Laghu ahara). The ahara being undigested gets

shuktatwam and acts like visha. This amavisha causes the ajeerna. The undigested

food which is in the form of amavisha, when combines with vitiated pitta then daha,

trishna, diseases of mouth, Amlapitta and other pittavikaras will occurs. 145

Acharya Kashyapa explained the samprapti of Amlapitta in detail. Due to nidana

sevana doshas become aggravated and affects the agni to produce jatharagnimandya,

and hence the ahara, which is consumed, becomes attaining the state of vidagdhata.



43

This vidagdha amarasa later undergoes shuktapaka in amashaya. In this condition

whatever the food consumed is converted into vidagdhata by dushitapitta (vidagdha

pitta). This condition is known as Amlapitta.146

Kashyapa explained the samprapti of Amlapitta by giving an example. i.e, when curd

is in vessel if we pour milk in that, soon after it gets converted into curd. In the same

way when Rasadhatu is amlayukta if consumed anything then it converts itself into

vidagdha and shuktata. 147

According to Madhavanidana, Madhavakara explains the samprapti of Amlapitta.

That is the pitta which is already sanchita (accumulated) due to its self aggravating

factors further attains vidagdhata due to consuming the viruddha, dustha, amla,

vidahi, pitta prakopaka ahara pana and kala etc and produces the symptoms like

hritkanthadaha, avipaka, klama, utklesha, tikta amlodgara, gourava, aruchi, chardi etc.

148 When dushita dosha traveling shukta ahara towards urdhvabhaga i.e., amashaya,

the condition said to be Urdhvaga Amlapitta and if traveling towards adhobhaga, the

condition said to be Adhoga Amlapitta.

In terms of Kriyakala the samprapti has got its stages and it attains these stages for a

complete manifestation of the disease. They are chaya, prakopa, prasara,

sthanasamshraya (which leads to Dosha-Dushya Sammurchana) and further

vyaktavastha and finally Bhedavastha.

The reason for their settlement at a particular site i.e., sthanasamshraya has been

explained as “Khavaigunya”, which acts as obstruction in the spreading of the vitiated

doshas.

The process of the production of disease by, spreading vitiated doshas is called

pathogenesis or samprapti. That pathogenesis is discussed on the basis of Sankhya,

Vidhi, Vikalpa, Pradhanya and Bala Kala vishesha.



44

SAMPRAPTI GHATAKA OF AMLAPITTA: 149

Dosha Pittapradhana kapha

Dushya Rasadhatu

Agni Pachakagnimandyata

Srotas Annavaha, rasavaha and raktavaha

Srotodusthi Sanga, vimargagamana

Udbhavasthana Amashaya

Sancharasthana Mahasrotas (Annavaha srotas)

Vyaktasthana Amashaya

Samutthana Amashaya samuttha

Avastha Sama

Rogamarga Abhyantara

Adhisthana Shareera



45

PATHOGENESIS OF AMLAPITTA:

By going through the etiological factors of Amlapitta, it will be quite evident that

Amlapitta may be produced by different factors. These factors if initialized

individually or collectively in both the conditions, Amlapitta may be produced and on

the basis of the definition of samprapti according to Ayurveda the pathogenesis of

Amlapitta may be presented in adiagrammatic scheme as under.

DIAGRAMATIC PRESENTATION OF AMLAPITTA SAMPRAPTI:

Pittaprakopaka nidana sevana vata and Kaphakaraka nidana

Pittasya amlaguna vriddhi vata and kapha vriddhi

Pittasya vidagdhavastha jatharagnimandya

Vidhagdha anna

Shuktapaka in amashaya

Aruchi, avipaka, utklesha,chardi

Tikta – amlodgaradi laxana utpatti

Amlapitta



46

UPADRAVA: 150

Kashyapa explained upadravas of Amlapitta, namely jwara, atisara, pandutwa, shula,

shotha, aruchi and bhrama.

The occurance of these in Amlapitta, and in case of ksheena dhatu made the latter

asadhya or incurable.

In sidhanta nidana, they mentioned eleven upadravas of Amlapitta. Namely

sheetapitta, udarda, kotha, kandu, mandala, vicharchika, visphota, peedaka, urdhvaga

raktapitta, adhoga raktapitta and grahani.

SADHYASADHYATA: 151

In case of Amlapitta, Navotthita (early stage) is curable with efforts. When it will

becomes chronic and continuous, considered to be yapya or curable with difficulty in

a person who adopts wholesome diets and controlling the self. If Amlapitta

accompanied with complications then it becomes yapya or asadhya.

CHIKITSA VIVECHANA: 152,153

The first obvious requirement before proceeding to the treatment is the diagnosis of

the clinical variety to which a given case of Amlapitta belongs. That is,

“Rogamadou pareekshet tatonantharamoushadam.”

A careful enquires has to be made to ascertain the cause or causes responsible for the

disease. So that to adopt a principle “Nidana parivarjana meva chikitsa”. 154 Which

is applicable to every disease.

The primary importance of chikitsa lies in breaking up of Samprapti and the integrate

factors of it. There is a general principle in Ayurveda i.e.,

“Samprapti Vighatanameva chikitsa”.

It means separating the components of factors of pathogenesis.

Chikitsa Karma of a disease is adopted according to Rogibalam and Rogabalam.



47

The below mentioned general principles should be taken in to consideration for

treating any disease.

“Samshodhanam Samshamanam, Nidanasya Cha varjanam l Etavat Bhishaje

Karayam Roge roge yatha vidhi” 155

Hence it is stated that Samshodhana, Samshamana and Nidana parivarjana have to be

applied based on suitability in all the diseases and Amlapitta cannot be an exception

to this principle.

NIDANA PARIVARJANA:

Whatever might be the chikitsakrama either Shodhana karma or Shamankarma,

nidana parivarjana is outstanding here. In the context of Amlapitta chikitsa, Acharya

Kashyapa explained about nidana varjana, texts have laid greater significance to this.

To be more prices amla, ushna, vidhagdha, teekshna, katu, padartha should be

avoided in Amlapitta.

SAMSHAMANA CHIKITSA: 156,157

It includes Langhana, Laghubhojana and usage of various dravyas, which possess the

properties of pachana, deepana have to be administered. Apart from this all the

pittashamaka dravyas specifically acting on annavaha srotas like amalaki, shatavari

yasthimadhu, guduchi, shukti, shanka etc. have to be administered. In all Ayurvedic

texts, there is explaination to take tikta rasa pradhana ahara, aoushadha and pana in

Amlapitta. Madhura ahara and madhura takrapanam also help in relieving Amlapitta.



48

SAMSHODHANA CHIKITSA:

In order to dislodge ama, shamana have to be used only after shodhana in the

treatment of Amlapitta.

The shodhana procedures indicated in the treatment of Amlapitta are, Vamana,

Virechana, Asthapana basti and Raktamokshana. These are adopted by considering

the doshanubhanda, rogibala, rogabalam etc.

In Amlapitta chikitsa, Acharya Kashyapa, Bhavamishra and Yogaratnakara have

mentioned the line of the treatment as vamana, virechana and shamana therapy.

In Bhaishajya ratnavali and Chakradatta there is a mention of vamana, virechana,

anuvasana and asthapana basti in the context of Amlapitta chikitsa. 158

Raktamokshana is explained in Yogaratnakara and by Vangasena.

In case of Bahudoshavastha and depending upon rogibalam doshanubandhata. The

general principle is to do vamana, if the doshas are sited in urdhva amashaya and to

adopt virechana karma if the doshas are sited in adho amashaya. 159 Because the main

objective of treatment in amashayottha vyadhis including Amlapitta is to expel the

doshas from nearest route i.e., by vamana and virechana karma. According to this

principle Acharyas mentioned vamana karma in urdhvaga Amlapitta and virechana

karma in adoga Amlapitta.

After the vamana virechana, bastikarma has to be done to cleanse the residual morbid

matters. Whenever vata is predominant dosha anuvasana basti is usual procedure

followed before giving asthapana basti.

When the doshas do not subside by above-mentioned procedures, Acharya Vangasena

advised to adopt raktamokshana procedure. This procedure is beneficial in Amlapitta

associated with kotha, mandala laxanas that synchronizing raktadusthi.



49

PATHYAPATHYA:

The ancient acharyas have given much more importance to patyapathya of each and

every disease.

The term pathya means, the one, which is compatible to health, and the one, which is

not conductive to health,160 is called apathya.

The pathya can be merely correlates with upashaya and sathmya.

Only adopting pathya or wholesome regimen can cure diseases. But without following

pathya, which comprises of wholesome ahara, vihara and charya, any amount of

medicine may not help in curing the disease.

So pathya plays an important role in curing the disease.

The following are pathyas mentioned in Amlapitta.

Laghu bhojana, purana shali, purana yava, purana godhuma, mudgayusha, lajasaktu.

The jangala mamsarasa, kalaya shaka, karanja rasa, goghrita, and other than these the

drugs which are having tikta rasa pradhana and laghu in property.

Tikta rasa pradhana ahara and paneeya are more beneficial in Amlapitta. 161

The drugs, which are not having vidahi property and the foods, which are sathmya to

the body, are considered as pathya. 162

Karkota, karavella, patola, nimba, kushmanda, kapittha, dadima, all sorts of food and

drinks having the property of pacifying kapha and pitta are considered as pathya. 163

The drugs, which provokes pitta dosha and kapha dosha as well as vitiates the agni are

considered as apathya for Amlapitta. Navadhanya, pittaprakopaka ahara,

vegavarodha, tila, masha, kulatta, amla katu padartha sevana, danyamla, atilavana,

barjitha padartha, dadhi, dhoomapana, and madhya sevana are considered to be

apathya for Amlapitta

The responsible factors of Amlapitta are also acts as apathya.



50

Kashyapa suggests change of place or environment and rehabilitation in new to

protect life for four fold achievements. 164

NIDANARTHAKARA ROGA:

However there is no any direct explanation regarding the nidanarthakara roga for

Amlapitta. But still some diseases like ajeerna, vidagdajeerna, shleshmaja krimi roga,

may be considered as nidanarthakara roga for Amlapitta.

Methodology


51

PHARMACOGNOSTIC STUDIES:

Due to vast gap in the development of Ayurvedic system in the country and non

availability of original literature proper descriptions and gradual decline of expert in

the system itself, the identification of drug has become an enigma. The traditional

system of medicine in the third world are confronted with problems like establishing

standard appropriate references for fixing specifications, identity, purity, strength,

good manufacturing etc. Hence, it is necessary to adopt some methods available in

other sciences to assess this crude drug, they are taxonomic, phytochemistry,

pharmacognosy, pharmacology etc.

The previous observation concentrates on evaluation of macroscopic and microscopic

characteristic features of stem, root and leaf of Andrographis paniculata Nees.

Macroscopic study: Observations are,

Leaves – Simple, opposite, short petioled.

Stem - Quadrangular.

Inflorescence – Panicles.

Flowers – Racemes or panicles.

Fruits – Capsules erect, compressed, thinly glandular hairy.

Seeds – Numerous, sub-quadrate.

Methodology


52

Microscopic study:

Materials:165

Napkin, watch glass, test tubes, painting brush, a sharp razor blade, micro slides,

cover slips, a beaker full of water, a dropper, filter paper/blotting paper, stains, drug

sample, forceps, needles etc.

Method: 166

For the stem/root of the drug, cut a cylindrical portion which is almost straight and cut

off both edges so as to make the edge surface smooth. This sample is ready for section

cutting. Hold the sample vertical between the first, second finger and the thumb and

move the blade back and forth from one to the other, obtaining fine slices. Take

sufficient number of sections, as all sections will not be very fine and uniform.

Transfer the sections to a watch glass containing water with the help of the brush.

Reject thick and oblique one.

Similarly, cut sections of the leaf in the block of pith which shall give sections of the

leaf when separated from pith. Transfer the sections to a watch glass with a brush.

Microscopic characteristic features of stem, root and leaf are,

Anatomy of stem:

Anatomy of young stem in ground plan reveals that, the stem is rectangular and

differentiated in to three regions; epidermis, cortex & stele.

Epidermis:

It is outermost layer of stem made up of single layered parenchyma tissue. The cells

are barrel shaped, compactly arranged without any intercellular space. Epidermis is

covered by thick cuticle.

Methodology


53

Cortex:

Epidermis is followed by cortex. In young stem it is differentiated into three regions;

hypodermis, general cortex and endodermis. Hypodermis is 2-3 layered,

collenchymatous. General cortex is parenchymatous. Endodermis is single layered,

parenchymatous.

Stele:

In young stem it is bounded by single layered parenchymatous pericycle. Vascular

bundles are conjoint, collateral and open. They are capped by multicellular

sclerenchymatous bundle cap. Metaxylem towards periphery and protoxylem towards

pith (Endarch). Phloem is towards pericycle. In between xylem and phloem there is

strip of cambium. Pith is large parenchymatous.

Matured stem shows secondary growth in the stelar region, hence xylem tissue

differentiated as secondary xylem, more in quantity. Phloem is crushed due to

pressure created in the stele due to addition of xylem elements.

Anatomy of root:

The root system is taproot system. Anatomy of young primary root reveals that,it is

differentiated into three regions; epiblema, cortex and stele.

Epiblema:

Is an outer most, single layered in thickness, cells are parenchymatous, thin walled

with unicellular hairs.

Cortex:

Cortex is differentiated in to multicellular parenchymatous general cortex and single

layered endodermis. The cells of endodermis having Casparian strips.

Methodology


54

Stele:

Stele is bounded by single layered parenchymatous pericycle. The xylem and phloem

tissue arranged in separate radii, hence known as radial type. Xylem is in tetrarch

condition, similar to typical to dicots. Metaxylem towards pith and protoxylem

towards pericycle (Exarch). Pith is small or absent.

Mature root shows a secondary growth as stem, because of this reason large amount

of xylem is seen in the stele. Epidermis is also ruptured due to same.

Anatomy of the leaf:

The anatomically as in typical dicots, leaf is dorsiventral, is differentiated into

epidermis and mesophyll tissue.

Epidermis:

As in typical dicots, the leaf covered by two epidermises, upper and lower. Both are

single layered, parenchymatous and covered with thick cuticle. Lower epidermis

having more stomata than upper epidermis.

Mesophyll tissue:

It is differentiated into palisade parenchyma towards upper half of the leaf and spongy

towards lower half. Both the cells having chloroplasts hence are photosynthetic in

function.

The vascular bundles are conjoint, collateral having xylem towards the upper side and

phloem towards the lower side. Vascular bundles are covered by parenchymatous

bundle sheath.

The midrib is prominent, the upper region is of pyramid shape, while the lower region

is bluntly rounded the leaf being dorsi-ventral, the midrib is covered on dorsal side by

an upper epidermis consisting of rectangular cells arranged continuously and covered

on outer side by a thin continuous layer of cuticle. The lower epidermis is

Methodology


55

discontinuous due to the presence of superficial stomata placed at a distance. Below

the epidermis there is a collenchymatous hypodermis.

DETERMINATION OF TASTE:

In almost all the texts, the taste of Kalamegha is mentioned as tikta. The taste by

tongue is the best method of identifying any taste. Hence, an experiment of volunteer

method determination of taste by tongue was followed. Twenty-five healthy

volunteers were selected and requested to clean and wash their mouth by cold water

and gave the panchanga powder of Kalamegha to examine the pradhana and anurasa.

The data obtained shows the determination of taste according to their priority.

PRELIMINARY PHYTOCHEMICAL SCREENING: 167

The plant may be considered a biosynthetic laboratory, not only for the chemical

compounds such as carbohydrates, proteins and lipids that are utilized as food by

man, but also for a multitude of compounds like glycosides, alkaloids, volatile oils,

tannins, etc., that exert a physiologic effect. The compounds that are responsible for

therapeutic effects are usually the secondary metabolites. A systematic study of a

crude drug embraces through consideration of both primary and secondary

metabolites derived as a result of plant metabolism. The plant material may be

subjected to preliminary phytochemical screening for the detection of various plant

constituents on the following lines.

Methodology


56

Successive solvent extraction:

1. Extract about 500 g of the air-dried powdered plant material successively with the

following solvents in a Soxhlet extractor.

a) Petroleum ether (60°C)

b) Benzene (80.1°C)

c) Chloroform (50°C)

d) Ethanol 99.9% (82.3°C)

Each time before extracting with the next solvent, dry the powdered material in air-

oven below 50°C.

2. Finally, macerate and homonize the drug with chloroform water for 24 hours to

obtain the aqueous extract.

3. Concentrate each extract by distilling off the solvent and then evaporating to

dryness on the water-bath.

4. Weight the extract obtained with each solvent and calculate its percentage in terms

of the air-dried weight of the plant material. Also note the weight and consistency

of the extract.

Weight of the extraction = extraction obtained X 100 / weight of the sample.

Methodology


57

Preliminary tests:

The preliminary tests were made by using the five different extracts of Andrographis

paniculata Nees. panchanga.

A. Proteins:

1. Biuret test:

2 ml of 10% copper sulphate solution was added to 2 ml. of test solution, mixed well

and 2 drops of 1% CuSO4 solution was added. Violet or pink colour indicates the

presence of two or more peptide bond of proteins.

2. Ninhydrin test:

1 ml. of 0.1% freshly prepared ninhydrin solution was added to 4 ml. of the test

solution, which should be neutral pH. The contents were mixed and boiled for a

minute and was allowed to cool. Violet or purple coloured solution indicates the

presence of aminoacids and proteins.

3. Xanthoproteic test:

1 ml. of conc. HNO3 was added to 5 ml. of the solution. The contents were boiled and

cooled. Appearance of yellow colour indicates the presence of nitro derivatives of

aromatic-aminoacids. To this solution 40% of NaOH was added. A deep orange

colour solution indicates the presence of sodium salts of nitro derivatives of aromatic

aminoacids.

4. Hopkins-Cole test:

Two ml of glacial acetic acid was added to 2 ml of the test solution and mixed well.

To this 2 ml conc. H2SO4 was added carefully along the sides of the test tube. The

formation of violet ring in the junction of two liquids indicates the presence of indole

group of tryptophan.

Methodology


58

5. Sulphur test:

Two ml of 40% NaOH solution and 10 drops of 2% lead acetate solution were added

to the 2 ml of solution and the contents were boiled for a minute and cooled back.

Precipitate indicates the presence of sulphur containing amino acids of proteins.

Carbohydrates test for starch:

a) Molisch’s test:

Two drops of Molisch’s reagent was added along the sides of the test tube. At the

junction of two liquids a red cum violet coloured ring indicates the presence of

carbohydrates.

b) Iodine test:

Fehling’s test:

One ml of Fehling’s solution “A” and one ml of Fehling’s solution “B” were

added to 1 ml of test solution. The contents were mixed well and boiled for a

minute. Yellow or brownish-red ppt indicates the presence of the reducing

sugars.

Benedict’s test:

Two ml of Benedict’s reagent was added to five drops of the test solution.

Boiled for a minute in a water bath and cooled, yellow, red or green colour

precipitate indicates the presence of reducing sugars.

Non-reduction sugar such as sucrose:

a) Benedict’s test:

Benedict’s test showing no characteristic colour formation indicates the presence of

non-reducing sugars in the test solutions.

Methodology


59

Tannins:

a) Gelatin test:

The solution was evaporated to dryness and the residue was dissolved in gelatin 2%.

To this, salt solution (10% NaCl) was added. A white precipitate was obtained which

indicates the presence of tannins.

Anthocyanins:

a) Aqueous NaOH test:

1 ml of aqueous NaOH solution was added to the 1 ml test solution, formation of blue

to violet colour indicates the presence of anthocyanins.

b) Conc H2SO4 test:

1 ml of Conc H2SO4 was added to the 1 ml test solution, formation of yellow to

orange colour indicates the presence of anthocyanins.

Glycosides:

a) Molisch’s test:

1 ml of Molisch’s reagent and 1 ml of Conc H2SO4 was added to the test solution,

formation of reddish violet colour ring at the junction of the two liquids indicates the

presence of glycosides.

b) Conc H2SO4 test:

1 ml of Conc H2SO4 solution was added to the 1 ml of solution and was allowed to

stand for 2 minutes. Formation of reddish colour indicates the presence of glycosides.

c) Keller-kiliani test:

The test solution was dissolved in glacial acetic acid boiled for a minute and cooled.

To this solution 2 drops of ferric chloride solution was added, the contents were

transferred to a test tube containing 2 ml. of concentrated sulphuric acid. A reddish

Methodology


60

brown colour ring was observed at the junction of two layers indicating the presence

of glycosides (Gokhale et al 1993).

Saponin:

a) Foam test:

Extract is shaken vigorously with distilled water in a test tube. Honey comb like foam

produced, persists for few minutes. It confirms the presence of Saponin.

Flavanoids:

a) Flavanoids test:

The presence of flavanoids is detected by the development of scarlet and cherry red

colour in alcoholic extract when a few drops of sulphuric acid with few magnesium

turnings were added to the test solution. These colours usually indicate flavanoids.

Scarlet colour indicates flavones deep cherry red colour indicates the presence of

flavanoids.

Pew’s test (Zn/Hcl) for dihydroflavonols:

A pinch of zinc powder and 5 drops of 5 NHcl were added to the test solution. It gives

a deep purple red (dihydroquercetin) or cherry red (dihydrokaemfeol) colours (Pew,

1948). Flavones, dihydrochalocones and other flavanoids gives at most pinkish or

brownish colour (Dey and Harborne, 1989).

Shinoda test (Mg/Hcl):

This test is applied in the same way as Zn/HCl, but magnesium powder was used

instead of Zinc. The development of a deep-red or magenta colour of the solution is

an indication for the presence of flavone dihydroflavanol. Dihydrochalcones and other

flavanoids do not react with the reagent (Dey and Harborne, 1989).

Methodology


61

Aqueous NaOH solution:

1 ml of aqueous NaOH solution was added to the 1 ml test solution. Formation of

yellow colour indicates the presence of flavanoids.

Conc H2SO4 test:

1 ml of Conc H2SO4 was added to 1 ml test solution, formation of red colour indicates

the presence of flavanoids.

Phenols:

a) Phenol test:

When 0.5 ml of Fecl3 solution was added to 2 ml of test solution, formation of an

intense colour indicates the presence of phenols.

Steroids:

a) Salkowski test:

A wine red colour was developed when chloroform H2SO4 were added to the test

solution, it indicates the presence of Steroidal nuclei.

b) Liberman and Burchard test:

The blue-green colour was developed in the test solution when treated with 50%

H2SO4 and acetic anhydride to the test solution indicates positive reaction for steroids.

Alkaloids:

The various extracts were mixed well with ammonia and then extracted with

chloroform, the chloroform solution is then extracted with 0.1N HCl and filtered. The

filtrate was used for further test.

a) Mayer’s test:

The filtrate when mixed with few drops of Meyer’s reagent gives creamy white

precipitate.

Methodology


62

b) Wagner’s test:

The filtrate when mixed with few drops of Wagner’s reagent gives reddish brown

coloured precipitate.

c) Dragendroff’s test:

The filtrate when added with few drops of Dragendroff’s reagent gives orange red

colour.

Estimation of Flavanol:

The total amount of flavanol was estimated by Swain and Hillis (1959 method).

Proceedure:

500 mg of plant material was extracted with 10 ml of methanol. 1 ml of plant extract

was taken in a test tube and diluted to 4 ml with distilled water within 10-15 secs. To

this ‘4 ml’ of vanillin reagent (freshly prepared) and 2 ml of distilled water were

added. Shake the contents of the test tube and keep the test tube in a water bath at a

temperature below 35oC for 20-30 minutes. The test tubes were kept at room

temperature, for exactly 15 minutes obtained a strong red colour. The observance was

measured at 500 nm and calculated the flavanoid contents by using a standard curve

prepared with phloroglucinol of different concentrations.

Estimation of total Tannin by Folin Denis method (Schanderi, 1970):

Proceedure:

0.5 gms of the powdered material was transferred to a 250 ml conical flask. 75 ml of

distilled water was added. The flask was heated gently and boiled for 30 minutes,

centrifuged at 2,000 rpm for 20 mins and collected the supernatant in 100 ml

volumetric flask and made up the volume.

Methodology


63

One ml of the sample extract was transferred to a 100 ml volumetric flask containing

75 ml of water, added 5 ml of Folin-Denis reagent, 10 ml of sodium carbonate

solution and diluted to 100 ml with distilled water and shaken well. The blue colour

intensity was measured in a spectrophotometer. Read the absorbance at 700 nm after

30 mins and make a 30 times dilution of the sample with distilled water and prepare a

standard graph by using 0-100 mg tannic acid. Calculate the tannin content of the

samples as tannic acid equivalents from the standard graph expressed as mg/100mg.

STANDARDISATION AND VALIDATION:

PHYSICO-CHEMICAL TESTS: 168

Determination of moisture content:

Materials:

Petri plates, Physical balance, Desiccators, Oven.

Method:

2 gms of the sample was taken in the previously weighed Petri plates. Petri plates

were kept in the oven maintained at 1100c for drying. After 3 hours Petri plates were

taken out and weight was noted down. This procedure was repeated for 4-5 times

until the constant weight is reached.

% Moisture = difference in weights X 100/ weights of the sample.

Methodology


64

Determination of ash content:

Materials:

Silica crucible, Physical balance, Desiccators, Bunsen burner.

Method:

Weight of the empty crucible was noted down. 2 gms of the sample was taken in the

previously weighed crucible and was heated on a Bunsen burner until it turned into

ash. It was then cooled in desiccators and weighed.

% Ash = difference in weights X 100/ weight of the sample.

Determination of water insoluble ash:

Materials:

Silica crucible, Hot water, Ash less filter paper (what Mann No.42), Desiccators.

Method:

The ash obtained from the above test was dissolved in H2O and filtered. The water

insoluble as collected on the filter paper was heated again on the Bunsen burner until

it turned into ash. The crucible was cooled in the desiccators and weighed.

% Water insoluble ash = difference in weights X 100 / weight of the sample.

Determination of acid insoluble ash:

Material:

Silica crucible, 25% Hcl, Ash less filter paper (what Mann no.42), Desiccators.

Method:

The water insoluble ash obtained is dissolved in 15ml of 25% HCL and then filtered.

The acid insoluble ash collected on the filter paper was heated again. The crucible

was cooled in the desiccators and weighed.

% Acid insoluble ash = difference in weights X 100 / weight of the sample.

Methodology


65

Determination of water soluble extractive:

Materials:

Volumetric flask, Distilled water, Chloroform, Filter paper, Evaporating dishwater

bath, Oven, Desiccators, Physical balance.

Method:

5 gms of the powder was taken in the volumetric flask. Few drops of chloroform were

added to avoid the fungal attack; subsequently 100 ml of distilled water was added. It

was kept for 24 hours, shaking frequently during the first six hours. The solution was

filtered the next day and 25 ml of this filtrate was evaporated in a previously weighed

evaporating dish on a water bath. Later it was dried in the oven at 1100c to remove the

traces of water. Weights were noted.

% Water soluble extractive = difference in weights X 100 / weight of the sample.

Determination of alcohol soluble extractive:

Materials:

Volumetric flask, Evaporating dishwater bath, Oven, Physical balance.

Method:

5 gms of the powder was taken in the volumetric flask. 100 ml of alcohol was added

to it, flask was kept for 24 hours, shaking frequently during the first six hours. The

solution was filtered the next day and 25 ml of this filtrate was evaporated in a

previously weighed evaporating dish on a water bath. Later it was dried in the oven at

1100c to remove the traces of alcohol. Constant weights were noted down.

% Alcohol soluble extractive = difference in weights X 100 / weight of the sample.

Methodology


66

Determination of foreign matter:

Materials:

Microscope, Thin paper.

Method:

2 gm. of plant material spread on a thin layer of paper. To sort into different groups of

foreign matters, it has to be examined by using a magnifying 10x and foreign matters

are picked out and the percentage is recorded.

Foreign matter = difference in weights X 100 / weight of the sample

Evaluation of powder drug by microscopy: 169

Procedure:

Take Kalamegha panchanga churna in the watch glass.

Add few ml of Chloral hydrate to clear the powder and boil for a minute to

remove Chloral hydrate.

Then add equal amount of Phloroglucinol and HCL acid & wait for 2 minutes.

Prepare glass smear of the sample.

Add a drop of glycerin & place a cover slip.

Observed under low power microscope 10 xs.

Methodology


67

Identification of Crude Drug by Thin Layer Chromatography A. For Alkaloids170 Sample: Andrographis paniculata Nees. (Crude powder)

1. Solvent system: Chloroform: Methanol 70 : 10

Detection : Sulfuric acid reagent, (heat at 100C for 3-5 min), visualized at normal light.

2. Solvent system: Acetone: Chloroform: Benzene.

4 : 4 : 1 Detection : Vanillin sulfuric acid reagent. 1% of Ethanolic vanillin - solution 1 10% of Ethanolic sulfuric acid – solution 2 The plates are sprayed with 100ml solution-1 and immediately followed by 10 ml of solution-2, heat at 110C for 5-10 min, evaluate in normal light. 3. Observation:

Solvent system

Rf value = Distance traveled by solute (a) Distance traveled by solvent (b)

B. For Flavonoids171 Preparation of the Extracts:

Powder drug (1gm) is extracted with 10ml methanol for 5 min on water bath at about

60C and then filtered; 20-30 µl is used for chromatography (flavonoid content 0.5%-

1.5%) These rapid methods extract both lipophilic and hydrophilic flavonoids.

Adsorbent: - Silica gel 60 F254 precoated TLC plate (Merck, Germany). Solvent system:

1. Ethyl acetate : formic acid : glacial acetic acid : water 100 : 11 : 11 : 26

Rf value = Distance traveled by solute (a) Distance traveled by solvent (b)

Methodology


68

PREPARATION OF MEDICINE:

Drug:

Kalamegha panchanga- Andrographis paniculata Nees. is taken for the clinical trial.

Collection of raw materials:

Botanically identified Kalamegha was collected from area surrounding Gadag,

Bagalkot and Dharwad.

Method of preparation:

The method of preparation of churna according to Sharangadhara Samhita

(6th chapter, Churna Kalpana) was adopted.

Kalamegh Panchang Churna:

1. Four Kgs of Kalamegha, taken in completely dry form.

2. It was pounded well in “Ulukhala Yantra” ( Pounding Machine)

3. Powdered well in Pulverisers.

4. Sieved through 120 no sieve.

5. Then it was stored in air tight container.

Place of preparation of medicine:

The churna was prepared in Post Graduation Research Studies Department of Dravya

Guna, D G M Ayurvedic Medical College Gadag.

Methodology


69

CLINICAL STUDY:

AIM OF THE STUDY:

The aim of the study was to evaluate the therapeutic effect of Kalamegha

(Andrographis paniculata Nees.) in patients suffering from Amlapitta.

MATERIALS AND METHODS

Source of data:

Thirty patients diagnosed as Amlapitta were taken for the study from the P.G.S &

R.C., O.P.D/I.P.D of DGM Ayurveda Medical College and Hospital, Gadag, and

patients attended the camp conducted at Anglo urdu D.Ed college, Parshwanath D.Ed

college and Rajiv Gandhi D.Ed college Gadag.

Method of collection of data:

It was a single blind clinical study with 30 patients diagnosed as Amlapitta of either

sex were be selected for the study randomly.

Inclusion criteria:

Classical signs and symptoms of Amlapitta.

Patients aged between 15-60 years of both sex.

Exclusion critera:

Associated with other systemic disorders.

Associated with Ama.

Methodology


70

Investigations:

Red blood cell count

Stool test

Bile test

Other relevant investigations if required

Intervention:

All the patients were treated with 4 gms. Kalamegha panchanga churna.

Anupana: Sukoshna Jala

Administration time: After food

Frequency: 2 gms. B.D.

Duration: 30 days.

Follow-up period: 15 days.

Subjective parameters

As designated in classical tests

Avipaka Klama

Utklesha Tiktodgara

Amlodgara Gourava

Hriddaha Kanthadaha

Aruchi Chardi

Objective parameters

Red blood cell count

Stool test

Bile test

Methodology


71

Method of evaluation:

A special proforma will be prepared with all the points of history taking and

examination based on the criteria mentioned in Ayurvedic classics and the

contemporary science. Relevant classical signs and symptoms will be adopted for

diagnosis to assess the improvement. The parameters of signs and symptoms will be

scored on the basis of standard method for statistical analysis. Following were the

criteria for assessment.

Assessment criteria:

Avipaka:

• Absent - 1

• Irregular digestion - 2

• Indigestion associated with nausea - 3

• Indigestion associated with chardi and bhakta dwesha - 4

Klama:

• Absent - 1

• Fatigue due to excretion and relieved by rest - 2

• Fatigue without excretion, more in the morning - 3

• Fatigue associated with heaviness - 4

Utklesa:

• Absent - 1

• In relation with specific food - 2

• In relation with normal food - 3

• Associated with chardi - 4

Methodology


72

Tiktodgara:

• Absent - 1

• Associated with avipaka - 2

• Associated with hrillasa - 3

• Associated with kanthadaha - 4

Amlodgara:

• Absent - 1


• Associated with hrillasa - 3

• Associated with kanthadaha - 4

Gourava:

• Absent - 1

• Feel of heaviness in the early morning - 2

• Feel of heaviness associated with avipaka - 3

• Feel of heaviness associated with klama - 4

Hritdaha:

• Absent - 1

• Retrosternal discomfort - 2

• Associated with pain - 3

• Associated with gastric regurgitation - 4

Kanthadaha:

• Absent - 1


• Associated with utklesha - 3

• Associated with gastric regurgitation - 4

Methodology


73

Aruci

• Absent - 1

• Loss of interest in intake of food - 2

• Aversion to the food - 3

• Nausea and sometimes vomiting after intake of food - 4

Chardi

• Absent - 1

• Vomiting of bilious contents - 2

• Excess mucous secretion along with undigested food - 3

• Vomiting of indigested food taken before 24 hours - 4

Statistical analysis:

Mean, S.D, P value, t value were calculated.

CRITERIA FOR OVERALL ASSESSMENT

As the objective parameters are not suggesting any crucial role in the assessment of

results in this study, so here assessment of results is made only with subjective

parameters. The results have been classified in following grades.

Individual variables: CI-1 Encouraging 1 degree reduction in the severity from initial severity. CI-2 Good 2 degree reduction in the severity from initial severity. CI-3 Excellent 3 degree reduction in the severity from initial severity. CS Stable No change in the severity from initial severity. CD Deteriorated Increase in the severity from initial severity

Methodology


74

Overall severity: CI-1 Encouraging 1-10 degree reduction in the severity from initial severity. CI-2 Good 11-20 degree reduction in the severity from initial severity. CI-3 Excellent 21-30 degree reduction in the severity from initial severity. CS Stable No change in the severity from initial severity. CD Deteriorated Increase in the severity from initial severity

Observation and Results (Pharmacognostic)


75

Determination of taste:

Table No-12 RASA OF KALAMEGHA PERCEIVED BY 25 VOLUNTEERS.

No. Volunteers Pradhanarasa Anurasa 1 10 Tikta Katu 2 10 Tikta Katu 3 5 Tikta Katu

The table exhibits the rasa of the drug Kalamegha by taste by tongue examination. It

was observed that tiktarasa as pradhana rasa and katu rasa as anurasa. The results

shows tikta is the pradhana rasa of Kalamegha.

Table No -13 ORGANOLEPTIC STUDIES OF PHYSICAL AND SENSORY

CHARACTERISTICS OF SUCCESSIVE SOLVENT EXTRACTION OF

ANDROGRAPHIS PANICULATA NEES.

Name of the solvent

Nature Colour Odour Wt. of extract

in %. Petroleum ether Sticky Green Characteristic 30 Benzene Sticky Dark green Characteristic 20 Chloroform Sticky Dark green Characteristic 20 Ethanol Non Sticky Light green Characteristic 20 Aqueous Non Sticky Dark green Characteristic 40

Preliminary tests for primary and secondary metabolites:

In the present study preliminary phytochemical observations were carried out on

panchanga part of Andrographis paniculata Nees. It was noticed that in some cases

chemical constituents fail to answer their presence in preliminary tests due to other

reasons. However, detail results are as under:



76

1) Proteins test:

Petroleum ether, benzene and ethanol extracts have showed positive result by

producing deep orange colour in xanthoprotic test. All five successive solvent extracts

have showed the formation of violet ring with Hopkin’s cole test and the formation of

precipitate with sulphur test.

2) Carbohydrates test for starch:

All five successive solvent extracts have showed the positive result by formation of

red cum violet ring with Molisch’s test, the formation of deep colour in iodine test and

yellow colour precipitate in Benedict’s test, petroleum ether and benzene extracts

have shown brownish red precipitate in Fehling’s test.

3) Benedict’s test for non reducing sugars:

Aqueous extract has shown positive result with Benedict’s test.

4) Tannin test:

The Tannins were absent in all the extracts.

5) Anthocyannin test:

Benzene, aqueous and chloroform extracts have shown positive result by producing

blue to violet colour with Aqueous NaOH test.

6) Glycoside test:

The petroleum ether and benzene extract gave reddish violet colour ring at junction

with Molisch’s test. All five successive solvent extracts gave reddish colour solution

with Conc H2SO4 test and reddish brown colour in Keller-kiliani test except benzene

extract.



77

7) Saponin test:

The foam test for saponin gave positive results for all extracts.

8) Flavanoid test:

Only ethanol extract has shown positive result by producing cherry red with flavonoid

test, aqueous extract has shown positive result by producing deep purple with Shinoda

test. Benzene and chloroform extracts have shown positive result by producing yellow

colour with aqueous NaoH test. Petroleum ether and benzene extracts have shown

positive result by producing red colour with Conc H2SO4 test.

9) Phenols:

All the extracts showed positive results by producing intense colour for phenol test.

10) Steroid test:

The petroleum ether, benzene, ethanol and aqueous extract have responded positively

by producing red colour by Salkowski test and Liberman Buchard test but the

chloroform extract has failed to respond positively.

11) Alkaloid test:

All the extracts showed positive results by producing reddish brown precipitate in

Wagner’s reagent and creamy white precipitate in Mayer’s reagent except aqueous

extract and all the extracts showed positive result by producing orange red colour

precipitation in Dragendroff’s reagent.



78

Table No-14 PRELIMINARY TESTS FOR PRIMARY AND SECONDARY

METABOLITES

Sl. No

Tests Pet ether

Benzene Chloroform Ethanol alcohol

Aqueous extract

1 Tests for proteins a) Biuret test b) Ninhydrin test c) Xanthoproteic test d) Hopkins-Cole test e) Sulphur test

-ve -ve +ve +ve +ve

-ve -ve +ve +ve +ve

-ve -ve -ve +ve +ve

-ve -ve +ve +ve +ve

-ve -ve -ve +ve +ve

2 Carbohydrates Test for starch a) Molisch’s test b) Iodine test c) Fehling’s test d) Benedict’s test

+ve +ve +ve +ve

+ve +ve +ve +ve

+ve +ve -ve +ve

+ve +ve -ve +ve

+ve +ve -ve +ve

3 Non-reduction sugar such as sucrose a) Benedict’s test

-ve

-ve

-ve

-ve

+ve

4 Tests for Tannins a) Gelatin test

-ve

-ve

-ve

-ve

-ve

5 Anthocyanins a) Aqueous NaOH test b) Conc H2SO4 test

-ve -ve

+ve -ve

+ve -ve

-ve -ve

+ve -ve

6 Glycosides a) Molisch’s test b) Conc H2SO4 test c) Keller-kiliani test

+ve +ve +ve

+ve +ve -ve

-ve +ve +ve

-ve +ve +ve

-ve +ve +ve

7 Saponin a) Foam test

+ve

+ve

+ve

+ve

+ve

8 Flavanoids a) Flavanoids test b) Pew’s test c) Shinoda test d) Aqueous NaOH sol e) Conc H2SO4 test

-ve -ve -ve -ve +ve

-ve -ve -ve +ve +ve

-ve -ve -ve +ve -ve

+ve -ve -ve -ve -ve

-ve +ve +ve +ve -ve

9 Phenols a) Phenol test

+ve

+ve

+ve

+ve

+ve

10 Steroids a) Salkowski test b) Libermann and Burchard test

+ve +ve

+ve +ve

-ve -ve

+ve +ve

+ve +ve

11 Alkaloids a) Mayer’s test b) Wagner’s test c) Dragendroff’s test

+ve +ve +ve

+ve +ve +ve

+ve +ve +ve

+ve +ve +ve

-ve +ve +ve



79

Standardization and validation:

Result:

Physico-chemical analysis:

Test Observation

Moisture content 6.55%

Total ash content 9.25%

Water insoluble ash 0.83%

Acid insoluble ash 1.00%

Successive extractive values:

Test Observation

Water soluble extractive value 14.4%

Alchol soluble extractive value 16.0%

Test for extraneous material:

Test Observation

Foreign matter 0.00

Evaluation of powder drug by macroscopy:

Observation Test

Colour Light greenish

Odour Characteristic

Taste Very bitter



80

Evaluation of powder drug by microscopy:

Observation- Vascular bundles are seen.

Identification of Crude Drug by Thin Layer Chromatography

A. For Alkaloids

Observation:

1. Solvent system:

Rf value = Distance traveled by solute (a) Distance traveled by solvent (b) = 3.2 = 0.711 4.5

2. Solvent system Rf value = Distance traveled by solute (a) Distance traveled by solvent (b) = 0.7 = 0.155 4.5

Result:

The Rf value of Andrographis paniculata for Chloroform : Methanol and Acetone :

Chloroform : Benzene. System was found to be 0.711 and 0.155 respectively

B. For Flavonoids

Observation: Solvent system:

Rf value = Distance traveled by solute (a) Distance traveled by solvent (b) = 3.4 = 0.641 5.3

Detection: Flavonoids

Result- The Rf value of Andrographis paniculata for flovonoids was found to be 0.641.

Observation and Results (Clinical Study)


81

CLINICAL STUDY: The present clinical study was meant for “Evaluation of efficacy of Kalamegha

(Andrographis paniculata Nees.) in the management of Amlapitta- a clinical

study.” Total 38 patients were diagnosed as Amlapitta, out of them only 30

patients were included. All the patients were assessed before and after treatment.

Both subjective and objective changes were recorded according to the case sheet.

The data was collected as follows,

Section- “A” - Demographic data Section- “B” - Data related to disease Amlapitta. Section- “C” – Data related to the treatment.



82

Section- “A” - Demographic data: In the present clinical study 30 patients of Amlapitta were included. The age group

was between 20 to 60 years.

Table No- 15 Distribution of patients based on Age:

AGE No of Patients % 20-29 13 43.33 30-39 8 26.66 40-49 8 26.66 50-59 1 3.33

Out of 30, 13 (43.33) were in the age group of 20-29 years, 08 (26.66) were in the age

group of 30-39 years, 08 (26.66) were in the age group of 40-49 years and 1 (3.33)

were in the age group of 50-59 years.

Chart No 1 Distribution of patients based on Age:

13

43.33

8

26.66

8

26.66

13.33

0

5

10

15

20

25

30

35

40

45

20-29 30-39 40-49 50-59

no

%



83

Table No. 16 Distribution of patients based on Sex:

SEX No of Patients % Male 14 46.66 Female 16 53.33

Female patients were predominated in this study i.e., 16 (53.33) with male 14 (46.66).

Chart No 2 Distribution of patients based on Sex:

14

46.66

16

53.33

0

10

20

30

40

50

60

male female

no

%



84

Table No-17 Distribution of patients based on Religion

RELIGION No of Patients % Hindu 17 56.66 Muslim 13 43.33 Christian 00 0 Other 00 0 An attempt was made to understand the religious influence in this disease. Hindu,

Muslim and Christian were included in this study. In this study maximum patients

17(56.66) are Hindu their followed by 13(43.33) are Muslims, there is no one

Christian and others.

Chart No 3 Distribution of patients based on Religion:

17

56.66

13

43.33

0 0 0 00

10

20

30

40

50

60

hindu muslim christian others

no

%



85

Table No-18 Distribution of patients based on Occupation:

OCCUPATION No of Patients % Sedentary 07 23.33 Active 13 43.33 Labor 10 33.33 Others 0 0 Occupation can give the idea of nature of work, out of treated 30 patients maximum

patients 13 (43.33) were active group followed by 10 (33.33) were labor group and

remaining 7 (23.33) sedentary group.

Chart No 4 Distribution of patients based on Occupation:

7

23.33

13

43.33

10

33.33

0 00

5

10

15

20

25

30

35

40

45

sedentary active labor Others

no

%



86

Table No-19 Distribution of patients based on Economical status:

ECONOMICAL STATUS No of Patients % Poor 13 43.33 Middle 17 56.66 Higher 0 00 This status had an impact over this disease process.In this study most of the patients

17 (56.66) in the middle class and 13 (43.33) patients are low economical status or

poor.

Chart No 5 Distribution of patients based on Economical status:

13

43.33

17

56.66

0 0

0

10

20

30

40

50

60

poor middle higher

no

%



87

Table No-20 Distribution of patients based on Diet:

DIET No of Patients % Vegetarian 16 53.33 Mixed 14 46.66 According to Ayurveda, diet is an important factor for the production of the disease in

this study, out of 30 treated patients 16 (53.33) were vegetarian compared to 14

(46.66) were mixed diet habits.

Chart No 6 Distribution of patients based on Diet:

16

53.33

14

46.66

0

10

20

30

40

50

60

vegeterian mixed

no

%



88

Section B: Data related to disease: Table No-21 Showing the Chief Complaints of 30 treated cases.

COMPLAINTS No of Patients % Avipaka 30 100 Klama 30 100 Utklesha 23 76.66 Tiktogdara 30 100 Amlodgara 21 70 Gourava 21 70 Hritdaha 28 93.33 Kanthadaha 29 96.66 Aruchi 30 100 Chardi 25 83.33 In this study all the 30 patients were complained about avipaka, klama, tiktogdara and

aruchi, 29 patients were complained about the kanthadaha, 28 patients were

complained about the hritdaha, 25 patients were complained about the chardi, 23

patients were complained about the utklesha and 21 patients were complained about

the amlodgara and gourava.



89

Chart No 7 Showing the Chief Complaints of 30 treated cases:

30

30

23

30

21

21

28

29

30

25

100

100

76.66

100

70

70

93.33

96.66

100

83.33

avipaka

klama

utklesha

tiktogdara

amlodgara

gourava

hritdaha

kanthadaha

aruchi

chardi

%

no



90

Section C: Data related to Response of Treatment Table No-22 Showing the Response to Avipaka at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 4 13.33 Encouraging 18 60.00 Stable 8 26.66 Deteriorated 0 0 Chart No 8. Showing the Response to Avipaka at the end of Treatment

0 0 413.33

18

60

8

26.66

0 00

1020

3040

5060

excellent good encouraging stable deteriorated

no

%

Table No-23 Showing the Response to Avipaka at the end of Follow-Up

RESPONSE No of Patients % Excellent 3 10 Good 10 33.33 Encouraging 14 46.66 Stable 3 10 Deteriorated 0 0 Chart No 9. Showing the Response to Avipaka at the end of Follow-Up

310 10

33.33

14

46.66

310

0 00

10

20

30

40

50


no

%



91

Table No-24 Showing the Response to Klama at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 11 36.66 Encouraging 11 36.66 Stable 8 26.66 Deteriorated 0 0 Chart No 10. Showing the Response to Klama at the end of Treatment

0 0

11

36.66

11

36.66

8

26.66

0 00

10

20

30

40


no

%

Table No-25 Showing the Response to Klama at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 12 40 Encouraging 12 40 Stable 6 20 Deteriorated 0 0 Chart No 11. Showing the Response to Klama at the end of Follow-Up

0 0

12

40

12

40

6

20

0 00

10

20

30

40


no

%



92

Table No-26 Showing the Response to Utklesha at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 12 40 Encouraging 10 33.33 Stable 8 26.66 Deteriorated 0 0 Chart No 12. Showing the Response to Utklesha at the end of Treatment

0 0

12

40

10

33.33

8

26.66

0 00

10

20

30

40


no

%

Table No-27 Showing the Response to Utklesha at the end of Follow-Up

RESPONSE No of Patients % Excellent 4 13.33 Good 11 36.66 Encouraging 8 26.66 Stable 7 23.33 Deteriorated 0 0 Chart No 13. Showing the Response to Utklesha at the end of Follow-Up

0 0

12

40

12

40

6

20

0 00

10

20

30

40


no

%



93

Table No-28 Showing the Response to Tiktodgara at the end of Treatment

RESPONSE No of Patients % Excellent 3 10 Good 6 20 Encouraging 9 30 Stable 12 40 Deteriorated 0 0 Chart No 14. Showing the Response to Tiktodgara at the end of Treatment

3

106

20

9

30

12

40

0 00

10

20

30

40


no

%

Table No-29 Showing the Response to Tiktodgara at the end of Follow-Up

RESPONSE No of Patients % Excellent 4 13.33 Good 8 26.66 Encouraging 10 33.33 Stable 8 26.66 Deteriorated 0 0 Chart No 15. Showing the Response to Tiktodgara at the end of Follow-Up

4

13.338

26.66

10

33.33

8

26.66

0 00

10

20

30

40


no

%



94

Table No-30 Showing the Response to Amlodgara at the end of Treatment

RESPONSE No of Patients % Excellent 2 6.66 Good 12 40 Encouraging 5 16.66 Stable 11 36.66 Deteriorated 0 0 Chart No 16. Showing the Response to Amlodgara at the end of Treatment

26.66

12

40

5

16.6611

36.66

0 00

10

20

30

40


no

%

Table No-31 Showing the Response to Amlodgara at the end of Follow-Up

RESPONSE No of Patients % Excellent 5 16.66 Good 10 33.33 Encouraging 6 20 Stable 9 30 Deteriorated 0 0 Chart No 17. Showing the Response to Amlodgara at the end of Follow-Up

5

16.66

10

33.33

6

20

9

30

0 00

10

20

30

40


no

%



95

Table No-32 Showing the Response to Gourava at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 8 26.66 Encouraging 12 40 Stable 9 30 Deteriorated 1 3.33 Chart No 18. Showing the Response to Gourava at the end of Treatment

0 0

8

26.6

12

40

9

30

1 3.330

10

20

30

40


no

%

Table No-33 Showing the Response to Gourava at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 12 40 Encouraging 8 26.66 Stable 10 33.33 Deteriorated 0 0 Chart No 19. Showing the Response to Gourava at the end of Follow-Up

0 0

12

40

8

26.66

10

33.33

0 00

10

20

30

40


no

%



96

Table No-34 Showing the Response to Hritdaha at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 2 6.66 Encouraging 17 56.66 Stable 11 36.66 Deteriorated 0 0 Chart No 20. Showing the Response to Hritdaha at the end of Treatment

0 0 26.66

17

56.66

11

36.66

0 00

10

20

30

40

50

60


no

%

Table No-35 Showing the Response to Hritdaha at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 7 23.33 Encouraging 18 60 Stable 5 16.66 Deteriorated 0 0 Chart No 21. Showing the Response to Hritdaha at the end of Follow-Up

0 07

23.3318

60

5

16.66

0 00

10

2030

40

50

60


no

%



97

Table No-36 Showing the Response to Kanthadaha at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 0 0 Encouraging 25 83.33 Stable 5 16.66 Deteriorated 0 0 Chart No 22 Showing the Response to Kanthadaha at the end of Treatment

0 0 0 0

25

83.33

516.66

0 00

20

40

60

80

100


no

%

Table No-37 Showing the Response to Kanthadaha at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 2 6.66 Encouraging 24 80 Stable 4 13.33 Deteriorated 0 0 Chart No 23. Showing the Response to Kanthadaha at the end of Follow-Up

0 0 2 6.66

24

80

413.33

00

20

40

60

80


no

%



98

Table No-38 Showing the Response to Aruchi at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 0 0 Encouraging 20 66.66 Stable 10 33.33 Deteriorated 0 0 Chart No 24. Showing the Response to Aruchi at the end of Treatment

0 0 0 0

20

66.66

10

33.33

0 00

20

40

60

80


no

%

Table No-39 Showing the Response to Aruchi at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 13 43.33 Encouraging 17 56.66 Stable 0 0 Deteriorated 0 0 Chart No 25. Showing the Response to Aruchi at the end of Follow-Up

0 0

13

43.33

17

56.66

0 0 0 00

10

2030

40

50

60


no

%



99

Table No-40 Showing the Response to Chardi at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 4 13.33 Encouraging 15 50 Stable 11 36.66 Deteriorated 0 0 Chart No 26. Showing the Response to Chardi at the end of Treatment

0 04

13.33 15

50

11

36.66

0 00

10

20

30

40

50


no

%

Table No-41 Showing the Response to Chardi at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 8 26.66 Encouraging 15 50 Stable 7 23.33 Deteriorated 0 0 Chart No 27. Showing the Response to Chardi at the end of Follow-Up

0 08

26.66

15

50

7

23.33

0 00

10

20

30

40

50


no

%



100

Table No-42 Showing the Response to Over-All at the end of Treatment

RESPONSE No of Patients % Excellent 0 0 Good 9 30 Encouraging 21 70 Stable 0 0 Deteriorated 0 0 Chart No 28. Showing the Response to Over-All at the end of Treatment

0 09

3021

70

0 0 0 00

20

40

60

80


no

%

Table No-43 Showing the Response to Over-All at the end of Follow-Up

RESPONSE No of Patients % Excellent 0 0 Good 24 80 Encouraging 6 20 Stable 0 0 Deteriorated 0 0 Chart No 29. Showing the Response to Over-All at the end of Follow-Up

0 0

24

80

6

20

0 0 0 00

20

40

60

80


no

%



101

Table No-44 Showing Number of Patients with Degree of severity Before Treatment, After Treatment and at the End of Follow-up for individual variables and over-all severity of the disease.

Variable ▼ Severity ► Normal Mild Moderate Severe

BT 00 13 13 04 AT 06 22 02 00 Avipaka EF 22 08 00 00 BT 00 12 08 10 AT 05 25 00 00 Klama EF 08 22 00 00 BT 07 05 10 08 AT 15 15 00 00 Utklesha EF 23 07 00 00 BT 00 14 09 07 AT 07 23 00 00 Tiktodgara EF 15 15 00 00 BT 09 04 08 09 AT 19 10 01 04 Amlodgara EF 24 06 00 00 BT 09 08 13 00 AT 23 07 00 00 Gourava EF 28 02 00 00 BT 02 16 12 00 AT 11 19 00 00 Hritdaha EF 22 08 00 00 BT 01 11 18 00 AT 08 22 00 00 Kanthadaha EF 11 19 00 00 BT 00 14 16 00 AT 04 26 00 00 Aruchi EF 27 02 00 00 BT 05 14 11 00 AT 17 13 00 00 Chardi EF 25 05 00 00 BT 00 03 25 02 AT 01 28 01 00 Over-all EF 04 26 00 00



102

Table No-45 Showing Statistical analysis for individual variables and over-all severity of the disease.

Variable ▼ Mean SD ‘t’ Value ‘P’

Value significance

BT 2.70 0.70 ------ ------ AT 1.86 0.50 8.53 0.0003 HS Avipaka EF 1.26 0.44 7.88 0.0005 HS BT 2.93 0.87 ------ ------ AT 1.83 0.37 4.77 0.0049 S Klama EF 1.73 0.44 9.99 0.0001 HS BT 2.63 1.13 ------ ------ AT 1.50 0.50 8.04 0.0004 HS Utklesha EF 1.23 0.43 4.96 0.0042 S BT 2.76 0.81 ------ ------ AT 1.76 0.43 3.65 0.0147 S Tiktodgara EF 1.50 0.50 4.17 0.0087 S BT 2.56 1.22 ------ ------ AT 1.40 0.56 5.57 0.0025 S Amlodgara EF 1.20 0.40 5.57 0.0025 S BT 2.13 0.86 ------ ------ AT 1.23 0.43 5.93 0.0019 S Gourava EF 1.06 0.25 8.04 0.0004 HS BT 2.33 0.60 ------ ------ AT 1.63 0.49 5.57 0.0025 S Hritdaha EF 1.26 0.44 3.44 0.0183 NS BT 2.56 0.56 ------ ------ AT 1.73 0.44 11.14 0.0001 HS Kanthadaha EF 1.63 0.49 7.51 0.0006 HS BT 2.53 0.50 ------ ------ AT 1.86 0.34 5.57 0.0025 S Aruchi EF 1.10 0.30 7.51 0.0006 HS BT 2.20 0.71 ------ ------ AT 1.43 0.50 5.97 0.0015 S Chardi EF 1.16 0.37 5.97 0.0015 S BT 25.36 3.52 ------ ------ AT 16.26 2.82 6.47 0.0031 S Over-all EF 13.16 1.96 6.50 0.0037 S



103

Table No-46 Showing response to the individual variables and overall status of the disease after treatment and at the end of the follow up.

Variable ▼ Excellent Good Encouraging Stable Deteriorated

AT 0 4 18 8 0 Avipaka

EF 3 10 14 3 0 AT 0 11 11 8 0

Klama EF 0 12 12 6 0 AT 0 12 10 8 0

Utklesha EF 4 11 8 7 0 AT 3 6 9 12 0

Tiktodgara EF 4 8 10 8 0 AT 2 12 5 11 0

Amlodgara EF 5 10 6 9 0 AT 0 8 12 9 1

Gourava EF 0 12 8 10 0 AT 0 2 17 11 0

Hritdaha EF 0 7 18 5 0 AT 0 0 25 5 0

Kanthadaha EF 0 2 29 4 0 AT 0 0 20 10 0

Aruchi EF 0 13 17 0 0 AT 0 4 15 11 0

Chardi EF 0 8 15 7 0 AT 0 9 21 0 0

overall EF 0 24 6 0 0

Discussion


104

DISCUSSION

Since time immemorial Ayurveda has contributed a comprehensive package of

therapies and formulation for different ailments, but with the time many a things have

changed significantly, including the life style of the humans, ecological conditions,

spectra of the etiological factors and even up to the phenotype changes in many of the

herbal sources.

With present day life style, where in every individual is tested under the stress, strain

and many other viable factors to prove one self fit for survival. In the mean time one

has forgotten the basic rules and regulations of healthy living that has led him to

suffer from different ailments apart from it every one is in need of instant relief; for

which they submit themselves for different drugs and therapies, without knowing their

adverse effects.

Amlapitta, one among the disease or as a complaint is most common now a day,

which is affecting the individuals irrespective of age, sex, etc. but more of the time the

erroneous life style of the individuals fortified with the stress drags one into the

vicious cycle of the discomfort. Amlapitta which is caused mainly due to the pitta

dosha and vikriti in annavaha srotas is also associated other doshas. The treatment for

which is systemic shodhana followed by proper shamana oushadhis and pathya

palana, all of them those are not possible for every one and most of them rushes to the

instant remedies without being aware about the harmful effects.

Discussion


105

Drug being one among the chikitsa chatushpada and the armor of the physician. The

drug occupies a pre-eminent position in the requisite for achieving the success of

treatment. Appropriate reference regarding Kalamegha is not available in the samhitas

and also in most of the scripts of Nighantu kala. Only a brief reference regarding it is

available in Priya Nighantu, where in it has been mentioned under Shatapushpadi

varga, with its different synonyms and properties.

At different places and regions, drugs with different names; such as Bhunimba, Kirata

are used, those having similar properties mentioned for Kalamegha and possessing the

similar therapeutic values. This has led to a great controversy regarding the entity of

Kalamegha.

Kalamegha which has synonym as Mahatikta, Yavatikta indicates the pradhanata of

tikta rasa in it and that has been indifferently accepted by all the authors and also all

authors opine similar with guna as laghu ruksha, virya as ushna and vipaka as katu.

Based on these rasa guna virya vipaka it can be presumed to posses pittahara and

kaphahara properties.

Kalamegha with its rasa panchaka performs a multi dimensional activities on the body

starting from deepana to the extent of sroto shodhana. These karmas have established

it with a great therapeutic value.

Considering the vast gap between present and ancient time were Kalamegha was first

explained. Many of the scholars have worked to resolve the controversy and have

Discussion


106

come up with there opinion. With reference of these studies Andrographis paniculata

Nees. that resembles a lot with Kalamegha was considered for the study.

Andrographis paniculata Nees. a bitter tasting herb which can be easily identified by

its morphological features and that grows almost in all areas of tropical regions has

been subjected for many research oriented studies by different scholars in the form of

pharmacognostic, ethno botanical, chemical, pharmacological, toxicological, clinical

studies etc. that have revealed a flavonoid Andrographolide, a tri hydroxy lactone as

the bitter principle of the plant as its active principle possesses a wide variety of

pharmacological properties which seeks interest toward its detail study and the study

was framed with the objective of pharmocognostical evaluation, preliminary

phytochemical study, macroscopical evaluation, microscopical evaluation,

standardization and validation of Kalamegha with a clinical study to evaluate its

efficacy in Amlapitta.

In adhunika kala, it has been noted that is Andrographis paniculata Nees. is popularly

known as Bhunimba in M P and Nagapur area and as Chirayata in the Bihar forests.

Karmas of Kalamegha according to different Ayurvedic texts deepana, ruchikara,

swedana, jwaraghna, krimighna, pittashamaka, yakrut uttejaka etc.and also indicated

in krimiroga, kushtaroga,Amadosha, Kamala etc. The leaves and roots are also used

as febrifuge, stomachic, cholagogue, anthelmintic, stimulant, aperients and powerful

tonic.

It is a bitter shrub, used in folk medicine for the treatment of itching, skin rashes,

flatulence, malaria, worms, jaundice, intermittent fever etc, and forms the principal

ingredient of household medicine called Alvi, extensively used in Bengal.

Discussion


107

The plant is used in Unani system of medicine as blood purifier, in Homeopathy

system of medicine as febrifuge and hepato-protective.

Gastric discomfort, vomiting and loss of appetite may be caused by the large oral

doses of the drug. Injection of the crude drug extract may lead to anaphylactic shock.

Bhunimba is said to be the synonym of Kiratatikta but in recent literature viz,

Standard Nomenclature of Ayurvedic Medicinal Plants, published by CCRAS,

Bruhattrayi of vegetable drugs by Singh and Chunekar and Dravyaguna vignana part

II, by P.V.Sharma, bhunimba is described as a separate entity and identified as a

Andrographis paniculata Nees. Moreover, in Bhaishajyaratnavali both the drugs

found mention in different formulations, indicating that kiratatikta and bhunimba are

separate entities.

Chakrapanidatta in his commentator on Charaka Samhita defines amlapitta as

“Amlapittam cheti amlagounodriktam pittam”.

Means the pitta acquiring more of amla guna is known as Amlapitta.

Acharya Kashyapa explains that the Vidagdha anna rasa turns to shukta, and this

retained in amashaya and produces Amlapitta.

Srikanthadatta and Vijayarakshita, the famous commentator of Madhava Nidana said

that, “Vidahyadamlagunodriktam pittam amlapittam.”

Means the condition of pitta in which the udriktata of amla guna along with vidaha is

noticed, should be called as Amlapitta.

Discussion


108

In Madhava Nidana of Madhavakara, it is defined as

“Avipakaklamotkleshatikthamlodgaragauravaihi

Hruthkanthadaharuchibhischamlapittamvadedbhishak.

A particular disease in which there is avipaka, klama, utklesha, tiktoudgara, amlodgar,

gourava, hriddaha, kantadaha and aruchi are seen is suppose to be Amlapitta.

The general causes which are responsible for provoking pitta are also responsible for

causing the disease Amlapitta, because the vitiated dosha here is pitta. So generally

food and habits which are responsible for the vitiation of pitta are responsible for the

Amlapitta disease.

Along with these, vata and kapha are also having a role in the causation of Amlapitta,

particularly in the vataja, kaphaja, vatakaphaja types of Amlapitta, where these doshas

are in the anubandha or samsarga state.

Whatever might be the chikitsakrama either Shodhana karma or Shamankarma,

nidana parivarjana is outstanding here. In the context of amlapitta chikitsa, Acharya

Kashyapa explained about nidana varjana, texts have laid greater significance to this.

To be more prices Amla, Ushna, Vidagdha, teekshna, katu, padartha should be

avoided in Amlapitta.

It includes Langhana, Laghubhojana and usage of various dravyas, which possess the

properties of pachana, deepana have to be administered. Apart from this all the

pittashamaka dravyas specifically acting on Annavaha srotas like Amalaki, shatavari

yasthimadhu, Guduchi, Shukti, Shanka etc. have to be administered. In all Ayurvedic

texts, there is explaination to take tikta rasa pradhana ahara, aoushadha and pana in

Discussion


109

Amlapitta. Hence, for this purpose Kalamegha(Andrographis paniculata Nees.) which

is considered one of the best pittahara,tikta,deepan drug is selected for the study.

Pharmacognostic Evaluation:

Drug was selected after morphologically confirming the identity by macroscopic

study.

The macro and microscopic characteristics of the stem, leaves and floral parts of the

plant have been described. The stem is green, woody, annual and erect up to 1m high,

bearing numerous branches. The upper part is distinctly quadrangular with four bulges

arising in the four corners, while the lower part is somewhat rounded and possessing

at the nodes of the basal region adventitious roots which are green, thin, slender and

hard. The leaves are exstipulate, lanceolate having slightly undulate entire margin and

tapering base. The apex is acuminate. The leaves are opposite having reticulate

venation.

Microscopically, the epidermis of the stem possesses glandular and non glandular

hairs and stomata of caryophyllaceous type. The cortex consists of collenchymatous

strands below the epidermis and in between the bulges. This is followed by a distinct

endodermis. The phloem is characterized by acicular fibers at older stage of the plant.

The vascular bundle is represented by an ectophloic siphon stele. The leaves possess a

small winged petiole. Glandular and non glandular hairs are present on both surfaces

of the lamina while caryophyllaceous type of stomata occurs only on the lower

surface of the leaf. The midrib varies in outline at different parts of the leaves. The

cystoliths are present in the epidermal and cortical regions of the stem and epidermis

of the leaves, bracts, bracteoles and sepals of the flower. Small acicular crystals of

Discussion


110

calcium oxalate occur in the pith and cortical cells of the stem and the leaves. The

different parts of the flower possess characteristic glandular and non glandular hairs.

Preliminary phytochemical Studies:

Phytochemistry (phyton-plant) is the chemistry dealing with plants or plant products

or natural products (chemistry of natural products). Natural products comprise

different chemical constituents. These chemical constituents may be therapeutically

active or inactive.

The ones which are active are called as active constituents or active principles

(alkaloids, glycosides etc.). The inactive ones are called inert chemical constituents

(starch, cellulose etc.). Such inert constituents though they possess no

pharmacological or therapeutical activity, are essential for the normal physiological

processes.

In the recent times photochemistry has undergone significant development as a

distinct discipline.

It is concerned with the enormous variety of substances that are synthesized and

accumulated by plants and deals with the structural elucidation of these substances the

technology involving extraction, purification and characterization of pharmaceuticals

from natural-sources is the significant contribution to the advancement of natural and

physical science. The indigenous system to be internationally acceptable, it is

necessary to obtain phytochemical, biochemical in vitro clinical data.

The phytochemical screening of aminoacids, nonprotein aminoacids, pyrolizidine

alkaloids, polyacetylene, steroidal-sapogenins, glycosides, triterpenoids, bitter

compounds are undertaken.

Discussion


111

Carbohydrates:

Carbohydrates are among the first products to arise as a result of photosynthesis. They

constitute a large proportion of the plant biomass and are responsible, as cellulose for

the rigid cellular frame work and as starch for providing an important food reserve.

Carbohydrates in general and glucose in particular are an important source of energy

for cells; they are also called as “metabolic fuels”

Glycosides:

A number of medicinal plants contain complete organic molecular which are in

conjugation with sugar moieties, mostly monosaccharides. Such compounds are

called as glycosides and exert therapeutically significant effects on humans and

animals. Many glycosides are used in traditional and modern medicines because of

their cardiotonic, purgative, antirheumatics, analgesic, appetizer, liver stimulant,

antacid, vermifuge and other useful actions.

Tannins:

Tannins are one of the most widely occurring groups of natural substances in plants.

They are used in medicine for allied purposes or as mild antiseptics, in treatment of

diarrhea and to check small haemorrhages.

Proteins:

Proteins are complex nitrogenous organic substances of plant and animal origin. Apart

from the fact that they are essential foodstuffs like carbohydrates and fats, they also

provide very important group of therapeutically active compounds such as harmones,

enzymes. They are easily extractable from plant sources.

Triterpenoids:

Triterpenoids are compounds with a carbon skeleton based on six isoprene units, these

are colourless, crystalline with often high melting point. These compounds are

Discussion


112

divided into four compounds they are true triterpenoids, steroids, saponins and cardiac

glycosides. Triterpenoids are notable for their taste properties particularly their

bitterness.

Steroidal sapogenins:

Steroidal sapogenins are more important as they are used as raw-material for the

synthesis of the various medicinally useful steroids like Cardiac glycosides and

corticosteroids. Due to their pharmaceutical importance many plants have been

screened for steroidal sapogenins.

Standardization and Validation:

Ash values:

Used to determine quality and purity of a crude drug.

Ash contains inorganic radicals like phosphates, carbonates, calcium, magnesium etc.

Some times, inorganic variables like calcium oxalate, silica, carbonate of the drug

affects total ash value. Such variables are then removed by treating with acid and

insoluble ash.

Extractive valves:

Useful for evaluation of crude drug. Give idea about the nature of the chemical

constituents, soluble in that particular solvent used for extraction.

Evaluation powder drug by microscopy:

The microscopic examination of crude drug aims at determination of the chemical

nature of the cell wall along with the determination of the form and chemical nature

of the cell contents. Thus it determines the size, shape and relative structure of the

different cells and tissues in a plant drug. A dried material often requires softening

before preparation for microscopic studies. It may be done by exposing the sample in

moist condition (for leaves & flowers) or boiling in water (for roots & barks).

Discussion


113

Clinical study:

30 patients of Amlapitta, diagnosed according to classical signs and symptoms and

those willing to participate in the clinical study were selected incidentally, irrespective

of age, caste, religion based on inclusion and exclusion criteria.

Patients were subjected for preliminary examination and are graded for the severity

for individual subjective parameter and over all severity of the disease; based on four

point scale i.e. (1 Normal, 2 Mild, 3 Moderate and 4 Severe) and patients were

subjected for lab investigations for RBC count, stool test and bile test, before

treatment, after treatment and at the end of the follow-up. The chart of grading of

subjective parameters is provided along with individual proforma foe precise grading

of the parameters.

After preliminary examinations and with a written consent, the patients were

administered with Kalamegha panchanga churna 2gm twice daily after meals with

sukhoshna jala and the patients were advised to follow the diet and also to discontinue

the medicine if feels any discomfort and to report immediately.

The patients were again subjected for the examination for reassessing the response of

the treatment, i.e. after 30 days of satisfactory medication and were advised for 15

days follow up without any medication. The data was collected at the end of the

follow up.

The data thus collected BT, AT and EF were subjected for statistical analysis by

calculating mean, standard deviation, t value and P value and thus the efficacy of

Kalamegha in the management of Amlapitta was evaluated.

In the present clinical study the observation done reveals that, most of the patients

falls under the age 20-50 years, which strongly suggests the influence of stress as a

causative factor of Amlapitta. No significance difference between male and female

Discussion


114

proportion suggest that Amlapitta has almost equal incidence in both sex and is not

sex oriented.

In the present study all the patients belonged to either Hindu or Muslim religion,

which cannot be claimed as the size of the sample and the area of population covered

are too small to conclude on it, hence it may require a large sample size collected

from different regions of the population.

More number of patients in the active working group and students group, may

indicate that as they need to be more competitive to be ahead than others, that yields

them to stress factor leading to Amlapitta.

With socio-economical status the study with its sample size may not be sufficient to

claim zero percentage sufferers from the upper class, or it may be the cause that

people of that status may not feel themselves interested to involve in such clinical

study, the incidence may be confirmed with a large sample study.

There is no significant difference observed in the diet pattern with respect to

vegetarian or a mixed one.

In the present clinical study all the patients received the prescribed dosage of

Kalamegha panchanga churna for all 30 days without the discontinuity, but almost all

complained about the palatability in the form of churna due to its extreme bitterness.

But no one complained about any form of adverse effect, hence the drug can be given

in same dosage with more compliant form to the patients for better acceptance.

Patients had shown highly significance in the reduction of avipaka after the treatment,

and even at the end of follow up.

Patients had shown significance in the reduction of klama after the treatment, and

highly significance at the end of follow up.

Discussion


115

Patients had shown highly significance in the reduction of utklesha after the

treatment, and significance at the end of follow up.

Patients had shown significance in the reduction of tiktodgara after the treatment, and

even at the end of follow up.

Patients had shown significance in the reduction of amlodgara after the treatment, and


Patients had shown significance in the reduction of gourava after the treatment, and


Patients had shown significance in the reduction of hritdaha after the treatment, and

non significant change at the end of follow up.

Patients had shown highly significance in the reduction of kanthadaha after the

treatment, and even at the end of follow up.

Patients had shown significance in the reduction of aruchi after the treatment, and


Patients had shown significance in the reduction of chardi after the treatment, and


Patients had shown significance in the reduction of over all severity of the disease

after the treatment, and even at the end of follow up.

Kalamegha, which possess tikta rasa, laghu, ruksha guna, ushna veerya and katu

vipaka with deepaka, pachaka, pitta shamaka, rechaka, ruchikara, srotoshodhani and

yakruttejaka properties has established a significant effect on reducing the severity of

Amlapitta. The tikta rasa of Kalamegha is the most potent factor in relieving the

complaints of Amlapitta, which can be supported by the presence of the flavonoid

Andrographolide, a tri hydroxy lactone a bitter principle which has Antiulcer, Anti-

inflammatory, Analgesic properties that proves to be most beneficial in Amlapitta.

Conclusion


116

CONCLUSION Through the above studies we have come to the following conclusions,

1. No descriptions are available in samhitas and sangraha granthas, Priya nighatukara is

pioneer who has mentioned Kalamegha.

2. The active principal of Kalamegha is Andrographolide, but kiratatikta is devoid of

Andrographolide.

3. Andrographis paniculata Nees. can be considered as the authentic botanical source

for Kalamegha.

4. Kalamegha panchanga churna helps in decreasing the Amlapitta by its properties and

actions like tiktarasa, deepana, ruchikara, pittahara and rechana.

5. Kalamegha panchanga churna is effective in reducing the symptoms which are

statistically significant in Amlapitta.

6. From the findings of the clinical study and with the help of references available in the

texts, it can be concluded that Kalamegha (Andrographis paniculata. Nees.) is

effective in Amlapitta.

Future Prospects


117

FUTURE PROSPECTS

Though these work maximum efforts put to fulfill the subject and achieve the aims

and objective of the present project work, there is still a wide scope to a greater

distance of studies as follows.

1. The study should be conducted on the large scale to obtain more promising and

long lasting results.

2. The study with the reduced dose or in other form of formulation / dosage can also

be tried.

3. The efficacy of the drug can also be evaluated in the chronic Amlapitta patients.

Summary


118

SUMMARY

This dissertation entitled “Evaluvation of efficacy of Kalamegha (Andrographis

peniculata Nees.) in the management of Amlapitta- a clinical study.” Comprises of

literary review, pharmacognostic study, preliminary phytochemical studies,

standardization and validation,clinical study,discussion, summary and conclusion.

LITERARY REVIEW:

Deals with the literary review of the drug and the disease.

DRUG REVIEW:

Drug review deals with brief historical aspects, Kalamegha nirukthi, synonyms,

etymological derivation of synonyms, botanical name with derivation, classification,

varieties, vernacular names, taxonomical classification, Family features, morphology,

pharmacognostic features, quantitative standards, habitat, rasapanchaka,

doshaghnata, karma vignana, rogaghnata, phytochemistry, therapeutic uses, uses in

Unani and Homeopathy, folk uses, prayojya anga, matra, vishistha yogas, collection,

cultivation, mode of propagation, pest and diseases, harvesting and storage,

production and yield, marketing and trade, economics of cultivation, adulterants,

substitutes and controversy study.

DISEASE REVIEW:

It deals with historical review of Amlapitta, nirukti and paribhasha, paryaya,

bheda,amashaya, annavaha srotas, pittadhara kala, agni, aharapachana, pachakapitta

and karya, samanavata and kledakakapha, nidan panchaka, samprapti and samprapti

ghathakas,upadrava, sadhyasadhyata, sapekshanidan, chikitsa vivechana, patyapatya,

upashayanupashaya and nidanarthakara for Amlapitta.

Summary


119

PHARMACOGNOSTIC STUDY:

Comprises two parts,

Part-A:

Pharmacognostic and Preliminary phytochemical study, under pharmacognostic

study, the drug Kalamegha was colleted from the locality of Gadag, Bagalkot,

Dharwad and their identity authenticated macroscopically by organoleptic studies.

The macroscopic and microscopic structures of stem, root and leaf are elaborated

here.

Part-B:

Comprises of determination of taste.

STANDARDIZATION AND VALIDATION:

Comprises of standardization and validation studies, such as physico-chemical

analysis, poweder microscopy and TLC study.

CLINICAL STUDY:

Comprises of clinical study which was evaluation of efficacy of Kalamegha

(Andrographis peniculata Nees.) in the management of Amlapitta- a clinical study.

DISCUSSION:

Here the discussion of the drug review, disease review, clinical study, interpretation

of results along with clinical study conducted. The observations and results related to

the study are discussed.

CONCLUSION:

Conclusions are drawn based on the study.

i

Table No I- Demographic data of “Evaluation of efficacy of KALAMEGHA in Amlapitta”

SEX RELIGION OCCUPATION ECONOMIC STATUS FOOD Sl.

No OPD No.

AGE (YRS) M F H M C O 1 2 3 4 P M H V M

1 DGPG02 20 + + + + + 2 DGPG12 22 + + + + + 3 DGPG17 25 + + + + + 4 DGPG24 28 + + + + + 5 DGPG19 22 + + + + + + 6 DGPG36 36 + + + + 7 DGPGA1 22 + + + + + 8 DGPGA6 28 + + + + + 9 DGPGA3 40 + + + + + 10 DGPGA24 55 + + + + + 11 DGPGA2 28 + + + + + 12 DGPGA29 30 + + + + + 13 DGPGA36 29 + + + + + 14 DGPGA40 25 + + + + + 15 DGPGA44 20 + + + + + 16 DGPGB3 22 + + + + + 17 DGPGB9 22 + + + + + 18 DGPGB30 49 + + + + + 19 DGPGB43 45 + + + + + 20 DGPGB56 35 + + + + + 21 DGPGB66 37 + + + + + 22 DGPGB57 49 + + + + + 23 DGPGB64 42 + + + + + 24 DGPGB68 32 + + + + + 25 DGPGB71 38 + + + + + 26 DGPGB67 45 + + + + + 27 DGPGB76 48 + + + + + 28 DGPGB78 45 + + + + + 29 DGPGB119 35 + + + + + 30 DGPGB245 38 + + + + +

M=MALE, F=FEMALE, H=HINDU, M=MUSLIM, C=CHRISTIAN, O=OTHERS, 1=SEDENTARY, 2=ACTIVE, 3=LABOR, 4=OTHER, P=POOR, M=MIDDDLE,

H=HIGHER MIDDLE & HIGHER CLASS, V=VEG, M=MIXED.

ii

Table No II–Chief complaints of “Evaluation of efficacy of KALAMEGHA in Amlapitta”

1 2 3 4 5 6 7 8 9 10 Sl.No OPD No. B A E B A E B A E B A E B A E B A E B A E B A E B A E B A E

1 DGPG02 + + - + + + - - - + + + - - - - - - + - - + - - + + - + - - 2 DGPG12 + + + + + + - - - + + + + + + + + + + + + + + + + + - + - - 3 DGPG17 + - - + - - + + - + - - + + + + - - + - - + + + + - - + - - 4 DGPG24 + + + + + + + + - + + + + - - + + - + - - + + + + + - + - - 5 DGPG19 + + + + - - + + - + + + + + + + - - + + - + + + + + - + + - 6 DGPG36 + + + + + - + - - + + + + + - - - - + + + + + + + + - + + - 7 DGPGA1 + + + + + + + + + + + - + + + + + - + - - + + - + + + + - - 8 DGPGA6 + + + + + + + + - + + + + - - - - - + + - + + + + + - + + + 9 DGPGA3 + + - + + + + - - + + - + - - + - - + + + + + + + + - + + + 10 DGPGA24 + + + + + + + + + + - - - - - - - - + + - + + + + + - + + + 11 DGPGA2 + + - + + + + - - + + + + + + + - - + + + + + + + + - + - - 12 DGPGA29 + + - + + + + + - + + + + - - + - - + + - + + + + + + + - - 13 DGPGA36 + + - + + + + + + + + - + - - + + - + + + + + - + + - + + - 14 DGPGA40 + + - + + + + + + + + + + + - - - - + + + + + + + + - - - - 15 DGPGA44 + + - + + + + - - + + - - - - + - - + + - + + + + + - + - - 16 DGPGB3 + + - + + + + + - + + + + + + - - - + + - + + + + + - - - - 17 DGPGB9 + + - + + + + + + + + - - - - - - - + + - + + + + + - - - - 18 DGPGB30 + + - + + + - - - + + - - - - + - - + - - + - - + + - + - - 19 DGPGB43 + - - + - - + - - + - - + + - + - - + - - + - - + - - + - - 20 DGPGB56 + - - + + - - - - + - - - - - + - - + - - + - - + + - + - - 21 DGPGB66 + - - + - - + + - + - - - - - - - - + - - + - - + - - + - - 22 DGPGB57 + - - + - - + - - + - - - - - + - - + - - + - - + - - + - - 23 DGPGB64 + - - + + + - - - + - - + - - + - - - - - - - - + + - - - - 24 DGPGB68 + + - + + + + - - + + + + - - + - - + + - + - - + + - + + - 25 DGPGB71 + + - + + + - - - + + + + + - + - - + + - + + + + + - + + - 26 DGPGB67 + + + + + + + + + + + + + + - - + - + + + + + + + + + + + + 27 DGPGB76 + + - + + + - - - + + - + - - + - - + + - + + + + + - + + + 28 DGPGB78 + + - + + + + + - + + + - - - + + + - - - + + - + + - - - - 29 DGPGB119 + + - + + + + - - + + + + - - + + - + + + + + + + + - + + - 30 DGPGB245 + + - + + + + + + + + - + - - + - - + + - + + + + + - + + -

1=AVIPAKA, 2=KLAMA, 3=UTKLESHA, 4=TIKTODGARA, 5=AMLODGARA, 6=GOURAVA, 7=HRIDDAHA, 8=KANTHADAHA, 9=ARUCHI, 10 =CARDI.

iii

Table No III–Associated complaints of “Evaluation of efficacy of KALAMEGHA in Amlapitta”

1 2 3 4 5 6 7 8 9 10 11 12 13 Sl.No OPD No.

B A B A B A B A B A B A B A B A B A B A B A B A B A 1 DGPG02 + - + - + - + - - - + - + - - - + - - - - - + - + - 2 DGPG12 - - + - - - - - - - - - + - - - + - + - - - + - + - 3 DGPG17 - - - - + - + - - - - - + - - - + - - - - - + - - - 4 DGPG24 - - - - + - + - - - - - + - - - + - + - - - + - - - 5 DGPG19 - - + - + - + - - - - - + - - - - - - - - - + - - - 6 DGPG36 + - + - + - + - - - - - + - - - + - + - - - + - - - 7 DGPGA1 - - - - + - - - - - - - + - - - - - - - - - + - - - 8 DGPGA6 + - + - + - + - - - - - + - - - + - + - - - + - + - 9 DGPGA3 - - - - - - - - - - - - - - - - + - - - - - + - - - 10 DGPGA24 + - + - - - - - - - + - + - + - + - - - - - - - - - 11 DGPGA2 - - - - + - + - - - + - + - - - + - + - - - + - - - 12 DGPGA29 + - + - + - + - - - + - + - - - + - + - - - + - - - 13 DGPGA36 + - + - + - + - - - - - + - - - + - + - - - + - - - 14 DGPGA40 + - + - - - - - - - - - + - - - + - + - - - + - - - 15 DGPGA44 - - - - + - + - - - - - + - - - + - - - - - + - + - 16 DGPGB3 - - + - + - + - - - - - + - - - + - + - - - + - + - 17 DGPGB9 + - - - + - + - - - - - + - - - + - + - - - + - + - 18 DGPGB30 + - + - + - + - - - - - + - - - + - + - - - + - + - 19 DGPGB43 - - + - + - + - - - - - + - - - - - - - - - + - - - 20 DGPGB56 - - - - + - - - - - - - + - - - + - + - + - + - + - 21 DGPGB66 - - + - + - - - - - - - + - - - - - - - + - + - + - 22 DGPGB57 - - - - + - - - - - - - + - - - - - - - + - + - + - 23 DGPGB64 - - - - - - - - - - - - + - - - - - + - + - + - - - 24 DGPGB68 + - + - + - + - - - + - + - - - + - + - - - + - - - 25 DGPGB71 - - + - + - - - - - - - + - - - - - - - + - + - - - 26 DGPGB67 - - - - + - + - - - - - - - + - + - - - + - + - + - 27 DGPGB76 - - - - - - - - - - - - + - - - + - - - + - + - - - 28 DGPGB78 - - - - + - - - - - - - + - - - - - - - + - + - - - 29 DGPGB119 - - - - - - - - - - - - + - - - + - + - + - + - - - 30 DGPGB245 + - + - + - + - - - - - + - - - + - - - + - + - + -

1=KUKSIDAHA, 2=SIRASHULA, 3=HASTADAHA, 4=PADADAHA, 5=JWARA, 6=KANDU, 7=HRILLASA, 8=KOTHA, 9=AGNIMANDHYA,

10=ROMAHARSHA, 11=PIDAKA 12=MUKHALEPA, 13=NIDRADHIKYA

iv

Table No IV–Nidana (Etiology) of “Evaluation of efficacy of KALAMEGHA in Amlapitta”

Aahara Vihara OthersA5Sl.No OPD No

A1 A2 A3 A4 a b

V1 V2 V3 V4 V5 V6 V7 V8 V9 O1 O2 O3 O4 O5 O6

1 DGPG02 + + + + + + - + + - + + - + + + + + + - +2 DGPG12 + + + + + + + + + - + + - + + + + + + + +3 DGPG17 + + + + + + - + + - + + - + + + + + + + +4 DGPG24 + + + + + + + + + - + + - - - + + + + + +5 DGPG19 + + + + + + - + + + + + - - + + + + + + +6 DGPG36 + + + + + + - + + + + + - - + + + + + - +7 DGPGA1 + + + + + + - + + - + + - - + + + + + - +8 DGPGA6 + + + + + + - + + - + + - - + + + + + - -9 DGPGA3 + - + + + + - - + - + - - - + + + + + - -10 DGPGA24 + - - + + - + - + + - + - - - + + - + - -11 DGPGA2 + + + + + + - + + - + + - - + + + + + + +12 DGPGA29 + - + + + + + + + + + + - - + + + + + - -13 DGPGA36 + - + + + + + + - + + + - - + + + + + - -14 DGPGA40 + - + + + + + + + - + + - - + - + + + - -15 DGPGA44 + - + - + - - + + - + + - - + - + + + - -16 DGPGB3 + - + + + + - + + - + + - - + + + + + - -17 DGPGB9 + - + + + + - - + - + - - - + - - + + - -18 DGPGB30 - - + + + + - - + - + + - - + + + + + - -19 DGPGB43 + - + + + + - - - - - - - - + + + + + - -20 DGPGB56 + - + + + + - - + + + - - - + - + + - - -21 DGPGB66 - - - + + + - - - + + + - - + - + + + - -22 DGPGB57 + - + + + + - - + + + - - - + + + - + - -23 DGPGB64 - - + + + + - - + + + - - - + + + + + - -24 DGPGB68 + + + + + + + + + + + - + - + + + + + + +25 DGPGB71 + - + + + + - + + + + - + - + + + + + + +26 DGPGB67 + - + + + + + - + + + - + - + + + + + - -27 DGPGB76 + - + + + + + - - + + - - - + + + + + - -28 DGPGB78 - - + + + + + + + + + - - - + + + + + + +29 DGPGB119 + - + + + + + + + + + - - - + + + + + - -30 DGPGB245 + + + + + + + + + + + + - - + + + + + + +

A1=VIRUDDA AHARA, A2=DUSTA AHARA, A3=AMLA, A4 =VIDAHI, A5=PITTAVRUDDIKARA (a=Masha, b=Kulattha), V1=DOOMRAPANA,

V2= ATAPASEVANA, V3=JAGARANA, V4=ATIMAITHUNA, V5=PARISHRAMA, V6=VEGADHARANA, V7=MADYAPANA, V8=ATISNANA AVAGAHA, V9=RUTU (VARSHA, SHARAT), O1=KRODHA, O2=CHINTA, O3=BHAYA, O4=SHOKHA, O5=CORTICO STEROIDS, O6=NSAID’S

v

Table No V–Chief complaints (grading) of “Evaluation of efficacy of KALAMEGHA in Amlapitta”

1 2 3 4 5 6 7 8 9 10 Sl.No OPD No. B A E B A E B A E B A E B A E B A E B A E B A E B A E B A E

1 DGPG02 2 2 1 4 2 2 1 1 1 2 2 2 1 1 1 1 1 1 2 1 1 2 1 1 2 2 1 2 1 1 2 DGPG12 3 3 2 3 2 2 1 1 1 2 2 2 4 3 2 2 2 2 3 2 2 3 2 2 3 2 1 3 2 1 3 DGPG17 2 1 1 2 1 1 3 2 1 2 1 1 4 2 2 2 1 1 2 1 1 2 2 2 2 1 1 2 1 1 4 DGPG24 2 2 2 4 2 2 4 2 1 3 2 2 4 1 1 3 2 1 3 1 1 3 2 2 3 2 1 3 1 1 5 DGPG19 2 2 2 2 1 1 3 2 1 3 2 2 3 2 2 3 1 1 3 2 1 3 2 2 2 2 1 2 2 1 6 DGPG36 4 2 2 2 2 1 2 1 1 2 2 2 2 2 1 1 1 1 3 2 2 3 2 2 3 2 1 3 2 1 7 DGPGA1 3 2 2 3 2 2 3 2 2 4 2 1 3 2 2 3 2 1 3 1 1 3 2 1 3 2 2 3 1 1 8 DGPGA6 2 2 2 2 2 2 4 2 1 4 2 2 3 1 1 1 1 1 2 2 1 3 2 2 2 2 1 2 2 2 9 DGPGA3 2 2 1 4 2 2 3 1 1 3 2 1 3 1 1 3 1 1 3 2 2 3 2 2 3 2 1 3 2 2 10 DGPGA24 3 2 2 2 2 1 4 2 2 3 1 1 1 1 1 1 1 1 3 2 1 3 2 2 3 2 1 3 2 2 11 DGPGA2 3 2 1 4 2 2 2 1 1 4 2 2 4 2 2 2 1 1 3 2 2 3 2 2 3 2 1 2 1 1 12 DGPGA29 3 2 1 2 2 2 4 2 1 2 2 2 3 1 1 2 1 1 2 2 1 3 2 2 3 2 2 2 1 1 13 DGPGA36 3 2 1 2 2 2 4 2 2 3 2 1 3 1 1 3 2 1 2 2 2 3 2 1 2 2 1 3 2 1 14 DGPGA40 4 3 1 4 2 2 4 2 2 2 2 2 4 2 1 1 1 1 3 2 2 3 2 2 3 2 1 1 1 1 15 DGPGA44 3 2 1 3 2 2 3 1 1 3 2 1 1 1 1 3 1 1 2 2 1 3 2 2 3 2 1 3 1 1 16 DGPGB3 2 2 1 2 2 2 3 2 1 2 2 2 4 2 2 1 1 1 2 2 1 2 2 2 2 2 1 1 1 1 17 DGPGB9 4 2 1 4 2 2 3 2 2 2 2 1 1 1 1 1 1 1 3 2 1 3 2 2 3 2 1 1 1 1 18 DGPGB30 3 2 1 2 2 2 1 1 1 2 2 1 1 1 1 2 1 1 2 1 1 2 1 1 2 2 1 2 1 1 19 DGPGB43 2 1 1 2 1 1 2 1 1 3 1 1 4 2 1 3 1 1 2 1 1 2 1 1 2 1 1 3 1 1 20 DGPGB56 2 1 1 3 2 1 1 1 1 4 1 1 1 1 1 2 1 1 2 1 1 2 1 1 2 2 1 2 1 1 21 DGPGB66 3 1 1 3 1 1 4 2 1 4 1 1 1 1 1 1 1 1 2 1 1 2 1 1 2 1 1 2 1 1 22 DGPGB57 2 1 1 2 1 1 3 1 1 2 1 1 1 1 1 3 1 1 2 1 1 2 1 1 2 1 1 2 1 1 23 DGPGB64 2 1 1 4 2 2 1 1 1 4 1 1 4 1 1 2 1 1 1 1 1 1 1 1 2 2 1 1 1 1 24 DGPGB68 2 2 1 3 2 2 3 1 1 2 2 2 3 1 1 2 1 1 2 2 1 2 1 1 3 2 1 2 2 1 25 DGPGB71 3 2 1 4 2 2 1 1 1 3 2 2 4 2 1 3 1 1 2 2 1 3 2 2 3 2 1 2 2 1 26 DGPGB67 3 2 2 3 2 2 4 2 2 2 2 2 2 2 1 1 2 1 2 2 2 3 2 2 3 2 2 2 2 2 27 DGPGB76 4 2 1 4 2 2 1 1 1 2 2 1 2 1 1 3 1 1 3 2 1 3 2 2 3 2 1 3 2 2 28 DGPGB78 2 2 1 3 2 2 2 2 1 3 2 2 1 1 1 3 2 2 1 1 1 2 2 1 2 2 1 1 1 1 29 DGPGB119 3 2 1 2 2 2 2 1 1 4 2 2 2 1 1 3 2 1 2 2 2 3 2 2 2 2 1 2 2 1 30 DGPGB245 3 2 1 4 2 2 3 2 2 2 2 1 3 1 1 3 1 1 3 2 1 2 2 2 3 2 1 3 2 1

1=AVIPAKA, 2=KLAMA, 3=UTKLESHA, 4=TIKTODGARA, 5=AMLODGARA, 6=GOURAVA, 7=HRIDDAHA, 8=KANTHADAHA, 9=ARUCHI, 10 =CARDI.

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1

RESEARCH PROFORMA DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA

D.G.M. AYURVEDIC MEDICAL COLLEGE GADAG CLINICAL EVALUATION OF EFFECT OF KALAMEGHA CHURNA

(ANDROGRAPHIS PANICULATA) IN CASES OF AMLAPITTA.

Guide Dr. G.V. Mulagund M.D (Ayu), Scholar: Dr. Jaya. H. Malagoudar Prof. & H.O.D. Co- Guide Dr. Shashikant. B. Nidagundi M.D (Ayu), Lecturer 1) Name of the Patient

2)Father’s / husband’s name

Sl.No

3) Sex Male Female OPD No

4) Age Years IPD No

5) Religion Hindu Muslim Christian Other

6) Occupation Sedentary Active Labour

7) Marital status Married Unmarried Widow

8) Economical status Poor Middle Higher middle Higher class

9) Address

Contact No: Pin

10) Selection Included Excluded

11) Schedule Initiation

Date

Completion

Date

Well responded Moderately responded 12) Result

Responded Not responded Discontinued

13) INFORMED CONSENT I Daughter/Wife of am

exercising my free will, to participate in above study as a subject. I have been informed to my satisfaction,

by the attending physician the purpose of the clinical evaluation and nature of the drug treatment. I am also

aware of my right to about of the treatment schedule, at any time during the course of the treatment.

EzÀÄ £Á£ÀÄ ²æÃ/²æÃªÀÄw _______________________ £À£Àß ¸ÀéEZÉÒ¬ÄAzÀ PÉÆqÀÄªÀ aQvÁì ¸ÀªÀÄäw. ¥Àæ¸ÀÄÛvÀ

£ÀqÉ¢gÀÄªÀ aQvÁì ¥ÀzÀÞw0iÀÄ §UÉÎ £À£ÀUÉ aQvÀìPÀjAzÀ ¸ÀA¥ÀÇtð ªÀiÁ»w zÉÆgÉwzÀÄÝ ªÀÄvÀÄÛ 0iÀiÁªÁUÁzÀÄgÀÄ aQvÀì¬ÄAzÀ

»AwgÀÄUÀ®Ä ¸ÁévÀAvÀæ÷å«zÉ JAzÀÄ w½¢gÀÄvÀÛ£É.

gÉÆÃV0iÀÄ gÀÄdÄ / Patient's Signature

2

14. CHIEF COMPLAINTS WITH DURATION:

S.No Complaints Duration Remarks 1. Avipaka 2. Klama 3. Utklesa 4. Tiktodgara 5. Amlodgara 6. Gourava 7. Hritdaha 8. Kanthadaha 9. Aruci 10. Cardi

Colour: Consistency: Contents: Taste:

15. ASSOCIATED COMPLAINTS:

S.No Associated complaints Duration Remarks 1. Kuksidaha 2. Sirasula 3. Hastadaha 4. Padadaha 5. Jwara 6. Kandu 7. Hrillasa 8. Kotha 9. Agnimandhya 10. Romaharsa 11. Pidaka 12. Mukhalepa 13 Nidradhikya

16. HISTORY OF PRESENT ILLNESS:

17. HISTORY OF PAST ILLNESS:

18. DRUG HISTORY: Other system of medications.

Since how long

3

19. FAMILY HISTORY:

20. PERSONAL HISTORY:

Diet:

o Nature: Veg/Mix.

o Food Habits: Samasana/Visamasana/Adhyasana/Pramitasana.

o Aggravating diet:

o Rasa Pradhana: M / A / L / K / T / Ks / Sarva Rasa.

o Addictions:

Beedi/Cigarette……no.s/day; since……years.

Tobacco chewing/Snuff: since…….years.

Coffee/ Tea: ………no. of cups/day. Since ……years.

Alcohol: ……..ml./day. Since ………years.

Others:

No habits:

o Exercise: Regular/Irregular/Occasional/Only routine work.

Sleep: Sound/Irregular/Disturbed/Delayed.

Night……….Hrs. Day…………Hrs.

Bowel: Regular/Irregular/Constipation/Loose/Soft/Constipated.

No. of frequency…………..times/day.

Micturation: Regular/Irregular………….times/day.

Occupational history:

Sedentary/Moderate/Heavy

Nature of work: Physical/Mental

Time of work: Day/Night/Day Night…Hrs.

21. SOCIAL HISTORY:

Hygienic condition of residency: Poor / Moderate / Good

22. GYNECOLOGICAL HISTORY:

Menarche: Years Regular / Irregular Menopause: Yes/ No

Issues: Miscarriage / Abortions

History of gynecological medication / surgery.

4

23. GENERAL EXAMINATION:

01 Pulse 02 B.P. 03 Temp. 04 R.R. 05 weight 06 Height

a. Dashavidha pareeksha

Prakruti V P K VP VK PK VPK

Sara Pravar Avara Madhyama

Samhana Susamhita Asamhita Mudhyana samhita

Praman Height in cm Weight in kg

Satmya Ekarasa Sarvarasa Ruksha Sneha

Satwa Pravar Avara Madhyam

Aharshakti Abhyavabharan Jarana

Vyayam shakti

Pravar Avara Madhyam

Vaya Bala Yauvan Vardhakya

b. Asthasthana

Nadi Dosha Mutra Pravritti Gati Varna Purnata Gandha Spandana Katinya Jihwa Adra Shushka Mala Sama Nirama Lepa Nirlepa Shabdha Sparsha Sheeta Ushna Drik Akriti

5

24. SYSTEMIC EXAMINATION:

a. Respiratory system:

b. Cardio vascular system:

c. Central nervous system:

d. Gastro intestinal system:

i. Inspection:

Mouth: Stomatitis/Other/Normal. Shape: Distended/Scaphoid/Bulging Of Flanks/Normal. Umbilicus: Inverted/Averted/Normal. Surface: Smooth/Glossy/Scar/Wrinkles/Pigmentation/Striae. Asymmetrical bulging: Epigastric/ Hypogastric/ Umbilical/ Lumbar/ Hypochondrial/ Iliac/None. Movement: Symmetrical/ Paradoxical. Pulsation: Visible/Invisible.

ii. Palpation: Superficial-region of tenderness……… Hyperasthesia: Present/ Absent/Site… Muscle guard: Rigid/Normal

Liver: Palpable/Tender/Normal. Spleen: Palpable/Tender/Normal. Kidney: Palpable/Tender/Normal. Colon: Palpable/Tender/Normal. Any other mass: Present/Absent.

iii. Percussion:

Srotas examination:

Annavaha Srotas: Aruci/ Avipaka/ Cardi/ Anannabhilasha/ Prakritha

Rasavaha Srotas: Angasada/ Praseka/ Alasya/ Gaurava/ Bhrama/ Sosa/ Glani/

Pandu/ Asraddha/ Asyavairasya/ Arasagnata/ Prakritha.

Purisavaha Srotas: Atidrava/ Atigratitha/ Bahula/ Alpalpa/ Sasabda/ Sasula

Malapravritti /Prakritha.

Other Srotas: Prakrita/ Vaikrita.

6

25. EXAMINATION OF VYADHI: a. Nidana

AHARA VIHARA OTHERS Viruddha Dhumrapana Krodha

Dusta Atapasevana Chinta Amla Jagarana Bhaya Vidahi Atimaithuna Shoka

PittaVriddhi kara Parishrama Cortico steroids (a) Masha Vegadharana NSAID's (b) Kulatta Madyapana

Atisnana/Avagaha Ritu (varsha/sharad)

b. Samprapti

Dosha Dushya Adhistana Srotas Srotodusti Rogamarga

c. Samanya Roopam

B A B A Avipaka Klama Utklesha Tiktodgara Amlodgara Gowrava Hritdaha Kanthadaha Aruchi Vidbheda Shirashoola Hrutshoola Adhmana Angasada Antrakoojana Urodaha Romaharsha

d.Gatianusara Roopam

Adhoga Amlapitta B A Urdhwaga Amlapitta

Trishna B A B A Daha Harita Peeta Moorcha Neela Krishna Bhrama Rakta Raktabha Moha Amla Mamsodaka

Gudasrava

Van

ta

Pichchila Swascha sleshma vamana

Hrillasa Amlodgara Tiktodgara Kotha Aruchi Jwara Mandagni Kanthadaha Kushidaha Romanchana Karadaha Charanadaha Sweda Shiroruja Kandu Peetavarna Mandala Pidika Gatra Roga

7

e.Doshanusara Roopam

VATAJA B A KAPHAJA B A VATAKAPHAJA B A Shoola Gurukosta Tikta amoldgara Angasada Vamana Katukodgara Jhrumba Kapha nistivana Hrutdaha Kampa Aruchi Kushidaha Pralapa Mukha lepa Kanthadaha Murcha Kandu

Chimchimayamana Gowrava KAPHAPITTAJA Krushata Jadata Bhrama

Gat

ra

Harshata Gat

ra

Sheetata Moorcha Avasada Balanasha Aruchi Chitta vibhrama Kayagninasha Vamana Pramoha Nidradhikyata Alasya Tamah pravesha PITTA Shiro vedana Darshana vibhrama Bhrama Praseka Daha Mukhamadhurya f. Upashaya and Anupashaya

Upashaya B A Anupashaya B A Samashana Viruddhashana Madhura rasa, sheeta virya and avidahiahara

Amla, vidahi, pitta vriddhikara ahara and kulatta sevana

Vishranti Parishrama Manoharsha Chinta, krodha,bhaya g. Upadrava B A B A Jwara Atisara Pandu Shoola Shotha Bhrama Dhatukshaya Aruchi h.Sadhyasadhyata

Sadhya Asadhya Navam Chirakari

26. INVESTIGATION:

Red blood cell count Stool test Bile test

8

27. TREATMENT:

Kalamegha churna

1) Matra – churna 4 gms in divided doses

2) Anupana – Sukoshna jala

3) Duration of treatment – 30 days

4) Follow up – 6thday, 12thday, 18thday, 24thday, 30th day

28. CLINICAL EVALUATION OF THE SYMPTOMS OF AMLAPITTA

For subjective parameters each symptom has been graded or scored with

following rating method.

Sl.No Symptoms / Complaints (Severity) Severity scores 1 No Symptoms / Complaints 1 2 Mild Symptoms / Complaints 2 3 Moderate Symptoms / Complaints 3 4 Severe Symptoms / Complaints 4

Subjective parameters

Symptoms Severity Before Treatment After Treatment End of the Follow-

Up Avipaka Klama Utklesa Tiktodgara Amlodgara Gourava Hritdaha Kanthadaha Aruci Cardi Colour: Consistency: Contents: Taste:

Over all Over all severity of the disease. Normal : 10

Mild : 11-20

Moderate : 21-30

Severe : 31-40

9

29. ASSESSMENT CRITERIA:

All patients to be assessed once a week during the 30-day medication period.

There after, follow-up consisted of fortnightly assessments. All the

observations will be recorded in the proforma.

GRADING OF THE SUBJECTIVE PARAMETERS

Symptom Normal

(1) Mild (2)

Moderate (3)

Severe (4)

Avipaka Absent Irregular digestion Indigestion associated with Nausea

Indigestion associated with Chardi and Bhakta Dwesha

Klama Absent Fatigued due to excretion and relieved by rest

Fatigued without excretion, more in the morning

Fatigue associated with heaviness

Utklesa Absent In relation with specific food

In relation with normal food

Associated with chardi

Tiktodgara Absent Associated with Avipaka

Associated with Hrillasa

Associated with Kanthadaha

Amlodgara Absent Associated with Avipaka

Associated with Hrillasa

Associated with Kanthadaha

Gourava Absent Feel of heaviness in the early morning

Feel of heaviness associated with Avipaka

Feel of heaviness associated with Klama

Hritdaha Absent Retrosternal discomfort

Associated with pain

Associated with Gastric regurgitation

Kanthadaha Absent Associated with Avipaka

Associated with Utklesha

Associated with Gastric regurgitation

Aruci Absent Loss of interest in intake of food

Aversion to the food

Nausea and sometimes vomiting after intake of food

Cardi Absent Vomiting of Bilious contents

Excess mucous secretion along with undigested food

Vomiting of indigested food taken before 24 hours

Signature of Guide Signature of Co -Guide Signature of Scholar

1

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