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CLINICAL RESEARCH
Year : 2013  |  Volume : 34  |  Issue : 3  |  Page : 259-262  

Evaluation of biophysical parameters of Amrutapatolaksheeravasti Dravya and Karma - An observational study


1 Medical Officer, Govt. of Uttarakhand, India
2 Professor and H.O.D, P.G. Department of Panchakarma, Dr. BRKR Govt. Ayurvedic College, Hyderabad, India
3 Reader, P.G. Department of Panchakarma, Dr. BRKR Govt. Ayurvedic College, Hyderabad, India

Date of Web Publication17-Dec-2013

Correspondence Address:
Sandeep Kumar Gupta
S/O Shri Hariom Gupta, 479, Jwala Nagar, Rampur, - 244 901, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8520.123112

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   Abstract 

The study aims to observe the effects of Amrutapatolaksheeravasti Dravya (medicated milk enema) in values of biophysical-chemical parameters. The classical Vasti (enema) can be analyzed with the help of biophysical parameters like pH, temperature, and specific gravity (Sp.gr.). Three hundred samples of classically prepared Amrutapatolaksheeravasti were analyzed for pH, temp., Sp.gr. with the calibrated instruments before each Vastikarma. The clinical symptoms based on proper Vastikarma and its complication were recorded and assessed. The parameters - pH, temperature, Sp.gr., and viscosity have shown a significant to highly significant value of correlation coefficient "r" and 't' in relation to successful Vastikarma and retention time of Vasti Dravya respectively. pH <5.8 and temperature >39°C led to anal irritation in Ksheera Vasti. Similarly, pH >6.1 and temperature <32°C resulted in flatulence. The effects of pH and Sp.gr. are due to temperature as both are temperature-based variables.

Keywords: Biophysical parameters, standardization, Vastikarma


How to cite this article:
Gupta SK, Srinivasulu M, Murthy V K. Evaluation of biophysical parameters of Amrutapatolaksheeravasti Dravya and Karma - An observational study. AYU 2013;34:259-62

How to cite this URL:
Gupta SK, Srinivasulu M, Murthy V K. Evaluation of biophysical parameters of Amrutapatolaksheeravasti Dravya and Karma - An observational study. AYU [serial online] 2013 [cited 2020 Oct 30];34:259-62. Available from: https://www.ayujournal.org/text.asp?2013/34/3/259/123112


   Introduction Top


Vasti is one of the five special therapeutic procedures (Panchakarma) described in Ayurveda medicine. It is similar to conventional enema due to its similarity in procedure and route of administration, but Vasti has a wider sphere of action than enema. Vasti is considered as the supreme line of treatment by Acharyas. It is said to be a preventive, promotive, and curative therapeutic intervention. In Ayurveda, Vastikarma alone is considered as "Ardhachikitsa", i.e., half of the treatment. Due to its long-lasting effects and radical relief from diseases, it is now being considered as an effective treatment globally.

The dosage schedule, procedure patterns, the prepared medicine (Aushada) which is one of the four pillars in the practice of medicine are to be standardized so that a uniform system of practice may be developed for treating patients at all centers. Standardization is an important concept for the quality assurance regarding Ayurvedic procedures. Standardization of Vasti Dravya can be done on the basis of the following parameters:

  1. Biochemical parameters
  2. Biophysical parameters.


Biochemical parameters

It is very hard to develop biochemical parameters for Ayurvedic formulations, as they contain large number of drugs with different chemical constituents in different concentrations. Moreover, when medicines are mixed to form an formulation, a number of chemical reactions takes place and lots of new chemical components are generated with different proportion every time.

Biophysical parameters

These parameters have an edge over biochemical parameters for standardizing the Ayurvedic formulation like Vasti Dravya because these parameters can be measured within specific limits with minimum variations. Hence, the biophysical parameters available in hand viz., pH temperature, and specific gravity (Sp.gr.) are taken for the analysis of Vasti Dravya, which can be applied for all sorts of Vasti Dravyas, i.e., Kashaya, Taila, and Ksheera, etc.

This pilot study was undertaken by the P.G. Department of Panchakarma, Dr. B.R.K.R Govt. Ayurvedic College, Hyderabad for the standardization of Vasti Dravya at random with the help of simple practicable parameters like pH, temperature, and Sp.gr.

pH

It is written in the classical text that when Vasti Dravya is sent into the colon, in left lateral position, it may reach the Grahani. [1] The pH of small intestine varies between 7.5 and 8. The pH in the colon varies from 5.5 to 7. It is important to measure the pH of Vasti Dravya which is sent into the colon every time because it can alter the pH of gut easily.

The mucosal lining of colon is permeable to the ionized form of a weak acid or weak base. The weakly acidic and basic drugs exist in two forms:

  • An unionized component predominantly lipid soluble which is absorbed rapidly
  • An ionized and often water-soluble component which is absorbed poorly.


Acidic drugs are rapidly absorbed from the stomach. Basic drugs are not absorbed until they reach the alkaline medium of the small intestine. The alkaline environment in which the major component of the drug exists in an unionized form, facilitates their absorption. [2]

Chemoreceptor cells in the gut are responsible for the pH regulation and substrate concentration. The pH, viscosity, and enzyme content of the chyme are all optimized for rapid enzymatic breakdown. Once the chyme leaves the initial segment of duodenum, no further adjustment can be done. But if Vasti Dravya with desirable pH is sent into the gut, it may create a favorable environment for enzymatic activity in the distal segments of intestine.

Studies in vitro and vivo have already shown that consumption of carbohydrate substrate and H 2 production by human colonic bacteria are directly related to luminal pH, [3] which can be easily altered by the pH of Vasti Dravya sent into the colon.

It has been observed that low pH of Vasti Dravya has some corrosive action on the mucosa, these symptoms are nothing but the complication of Vasti like cutting pain in anal region (Parikartika), and anal discharge due to inflammation (Parisrava) already mentioned in the Charakasamhita. [4]

Temperature

Temperature is a measure of hotness or coldness. Regarding Vasti, some people advocate that the temperature of Vasti Dravya should be same as the rectal temperature; some say that it should be 1°C less than the rectal temperature. Rectal temperature is more accurate than the oral or axillary temperature. It averages about 1°F (0.560°C) higher than the oral temperature.

Temperature also plays an important role in absorption of Vasti Dravyas. As the temperature increases, the average speed of the molecule in a liquid increases and the amount of the time they spend "in contact" with their neighbor decreases. Thus as temperature increases, the average intermolecular forces decreases, which facilitates the absorption of the concerned molecule. [5]

Dealing with temperature is like dealing with the fire, as colonic mucosa is very sensitive to the temperature gradient. In the Charakasamhita, it is clearly mentioned that Vasti Dravya should not be excessively hot or cold. Excessive hot Vasti Dravya causes: Fainting (Murcha), burning sensation in anal region (Daha), diarrhea (Atisara), and increases Pitta Dosha in the body. Excessive cold Vasti Dravya causes constipation (Vibandha) and flatulence (Adhmana) increase Vata Dosha. [6],[7]

Owing to these probable effects of Vasti Dravya, all the safety procedures and precautions were taken. To maintain the safety of the patient, all the material for combating any type of complication of Vasti were procured.

Specific gravity (Sp.gr.)

Weight of a substance compared with an equal volume of water is called its Sp.gr. It denotes how tightly particles are packed in a particular volume. The particle size of sparingly soluble drug can affect their absorption. Thus, Vasti Dravya that contains large aggregates of active compound does not disintegrate easily, even on prolonged contact with the mucosa of colon, hence it is poorly absorbed. Small size of particle is important for absorption. Thus, the dosage of the active drug can be reduced without losing efficacy, simply by reducing the particle size.


   Materials and Methods Top


Drug

Amruta (Latin name - Tinospora cordifolia, Family - Menispermaceae).

Patola (Latin name - Tricosanthem diocius, Family - Cucurbitaceae).

Milk (Standardized homogenized toned milk with 3% fat content).

Distilled water.

Materials and Methods

Procedure given in the Sharangadharasamhita (Ayurvedic text) is taken as authority for the preparation of milk enema (Ksheera Vasti). 10 g each of dry stem Kashaya powder of Amruta and Patola were taken and mixed with eight times milk, i.e. 160 ml and 32 times water, i.e. 640 ml (1:8:32). The mixture was heated and reduced to only milk, i.e., 160 ml. The mixture was then filtered using cotton cloth and used as a Vasti Dravya in Ksheera Vasti. Three hundred samples of Amrutapatolaksheeravasti were taken for the study. [Table 1]
Table 1: Preparation of Ksheera Vasti

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Patients

Ten persons of age group 30-45 years with five men and five women were selected for the study. All the selected patients were suffering from Asthidhatukshaya (Osteoporosis).

A course of 30 Vasti was given to each patient with the gap of 4 days after every 10 Vasti. In this way, 300 Vasti procedures were recorded. Informed consent was taken from all the patients. Ethical clearance was also obtained from the institutional ethics committee.

Instrument used

A calibrated pH meter (range 0-14), thermometer (0-100°C), lactometer (range 1.000-1.040) were the instruments used in the research work.

The readings were taken with the help of these instruments and their effects were assessed on the basis of criteria for the symptoms of proper Vasti Karma mentioned in the classical text.


   Results and Discussion Top


pH

The pH of Amrutapatolaksheeravasti varied between the range of 5.6 to 6.3. In 84% of the cases, the pH range was 5.8-6.1 which resulted in proper Vasti Karma, without causing any discomfort to the patients. In 7.33% of the cases, where pH was below 5.8, i.e., 5.6 or 5.7, anal irritation-like complaints were reported by the patient. This might have happened because of the corrosive action of Vasti Dravya in such conditions. In other 8.66% of the cases where the pH was above 6.1, the patients have complaint of flatulence. Although the retention time was maximum in these cases, the symptoms of proper Vasti Karma were not seen. This might have happened because of temperature dependence of pH. In all these cases, the temperature was 30°C-31°C which is much below the normal body temperature [Table 2] and [Table 3] and [Figure 1].
Figure 1: Effect of pH on Vasti retention time

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Table 2: Relation between pH and retention time

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Table 3: Statistical significance-pH versus retention time

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Temperature

Temperature range between 32°C and 37°C resulted in proper Vasti Karma with maximum retention time. Temperature above 39°C was not comfortable for the patients regarding procedure point of view as well as in getting proper result of Vasti Karma. Increase in temperature above 39°C has a sclerosing action on colonic mucosa which can be the reason of anal irritation in the patients. This also stimulates the sensory nerve endings which results in early evacuation and less retention time [Table 4] and [Table 5] and [Figure 2].
Figure 2: Effect of temperature on Vasti retention time

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Table 4: Relation between temperature and retention time

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Table 5: Statistical significance temperature versus retention time

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Specific gravity (Sp.gr.)

Sp.gr. range 1.019-1.026 was proved to be the most appropriate for proper Vasti Karma and maximum retention time. Sp.gr. decreased with the increase in temperature. Sp.gr. below 1.019 is less viscus, velocity with which it comes out is more (velocity of fluid is inversely proportional to the viscosity). Hence, the retention time was less. Similarly, Sp.gr. more than 1.026 resulted in increased retention time and flatulence [Table 6] and [Table 7] and [Figure 3].
Figure 3: Effect of specific gravity on Vasti retention time

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Table 6: Relation between specific gravity and retention time

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Table 7: Statistical significance specific gravity versus retention time

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   Conclusion Top


All the parameters - pH, temperature, S.g., and viscosity have shown the significant and highly significant value of correlation coefficient "r" and value of "t". pH <5.8 and temperature >39°C led to anal irritation in Ksheera Vasti. Similarly, pH >6.1 and temperature <32°C resulted in flatulence. The effects of pH and Sp.gr. are due to temperature as both are temperature-based variables. In the present era of evidence-based medicine, there is urgent need for standardization of the classical Panchakarma procedure and it is important to generate such data that will support decisions to use Ayurveda in the mainstream of healthcare.

 
   References Top

1.Chakrapanidatta, Commentator. Ayurveda Dipika Commentary on Charaka Samhita, Siddhisthana, Kalpana Siddhi Adhyaya. Ch. 1 24 th Shloka. Varanasi (India): Chaukhamba Bharati Academy; 2004. p. 671.  Back to cited text no. 1
    
2.Satoskar, Kale, Bhandarkar. Pharmacology and Pharmacotherapeutics. 7 th ed. Bombay: Popular Prakashan Pvt. Ltd.; 1980. p. 3-4.  Back to cited text no. 2
    
3.Perman JA, Modler S, Olson AC. Role of pH in production of hydrogen from carbohydrates by colonic bacterial flora. Studies in vivo and in vitro. J Clin Invest. 1981 Mar;67(3):643-650.  Back to cited text no. 3
    
4.Chakrapanidatta, Commentator. Ayurveda Dipika Commentary on Charaka Samhita, Siddhisthana, Vasti Vyapada Siddhi Adhyaya 7/58. p. 1041 Chaukhamba Bharati Academy; 2004. p. 671.  Back to cited text no. 4
    
5.Jennifer V, Burtwistle C, Despo NG, Dujardin JP, Gapp DA, Goodman HM, et al. Human Physiology: The Mechanism of Body Function. 8 th ed. The McGraw-Hill Companies; 2001. p. 116.  Back to cited text no. 5
    
6.Chakrapanidatta, Commentator. Ayurveda Dipika Commentary on Charaka Samhita, Siddhisthana, Vasti sutriya Siddhi Adhyaya. Ch. 3 21st Shloka. Varanasi (India): Chaukhamba Bharati Academy; 2004. p. 671.  Back to cited text no. 6
    
7.Susruta, Susruta Samhita, Chikitsasthana Netravastivyapada Chikitsa 36/19. Susruta Vimarshini Hindi Commentary by Dr. Anant Ram Sharma. Varanasi: Chaukhamba Subharati Prakashana; 2004. p. 452.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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