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THE CONCEPT OF INDUCED-EXCRETION IN AYURVEDA
Guest Editorial
Hygeia: journal for drugs and medicines
February 2022
OPEN ACCESS
A half yearly scientific, international, open access journal for drugs and medicines
Research article section: Guest Editorial
DOI: 10.15254/H.J.D.Med.13.2022.23
THE CONCEPT OF INDUCED-EXCRETION IN AYURVEDA
Dr. D. Suresh Kumar Ph.D.
Former Head (Product Development), Cymbio Pharma Pvt Ltd, Yeswantapuram, Bangalore 560 022 India.
According to Ayurveda, diseases are caused by the destabilization of three factors v?ta, pitta and kapha, collectively called trid??a. Treatment of diseases is of two types: elimination therapy (??dhana) and curative therapy (?amana). Elimination therapy is the adoption and enlargement of the principle of excretion that is given great importance in pharmacokinetics, the branch of clinical pharmacology which comprehensively describes the changes in the quantity of drug or drug metabolite in various body compartments over time. The other three processes considered in pharmacokinetics are absorption, distribution and metabolism.
Measures such as emesis (vamana), purgation (vir?cana), medicinal enema (vasti), nasal instillation (nasya) and bloodletting (raktam?k?a) are the elimination measures for v?ta, pitta and kapha. Sesame oil, clarified butter and honey are the cures for v?ta, pitta and kapha respectively. However, the term pa cakarma (the five actions) is also used in lieu of ??dhana. Elimination therapy is more effective than curative therapy. Nevertheless, it is to be carried out with great care and under direct supervision of the physician. To prevent mishaps, the body of the patient needs to be conditioned first before the main elimination therapy. Internal and topical administration of oleaginous substances (oleation) and sudation (sv?dana) are the preparatory measures (p?rvakarma).
Vamana cures diseases such as food poisoning, internal abscess, cervical glandular swelling, epilepsy, tumor, deafness and nearly 60 other diseases. An equal number of diseases such as hemorrhoids, wounds, cataract, insanity and so on are mitigated by vir?cana. Vasti is the cure for about 100 diseases including andrological and gynecological ailments, cataract, varicose vein and the like.
Clarified butter from milk (gh?ta), bone marrow, visceral fat and oil from sesame seeds (taila) are the excellent oleaginous substances. Oleation is recommended for persons habituated to drinking alcoholic beverages, fornication and exercise; those continuously exposed to mental stress; aged persons; individuals with weak, dry and lean bodies; persons suffering from v?ta diseases, conjunctivitis and cataract and persons with lowered sexual vigor. However, internal consumption of oleaginous substances is contra-indicated in stiffness of thigh muscles, dysentery, indigestion, diseases of throat, poisoning, enlargement of abdomen, vomiting, anorexia, kapha diseases, polydipsia, alcoholism, depressed or exaggerated appetite, obesity and debility. Appropriate oleaginous substance is administered internally to the patient in graded doses so that optimum unctuousness of body is achieved in seven days.
After oleation, the patient is to be subjected to sudation (sv?dana), before undergoing elimination therapy. Suitable mode of sudation using warm medicinal liquids, steam, fire, heated stone slabs and so on is applied. On performance of oleation and sudation, the patient is served food prepared with fish, black gram and sesame seeds. These foods loosen, liquefy the disease-causing agents (d??as) in body and bring them to the alimentary canal. The next day morning, the patient consumes in overabundance gruel mixed with emetic medicine, so as to induce unctuousness. Patient vomits kapha first, followed by bile (pitta) and air (v?ta). On completion of the vomiting reflex, light food is served.
Patient subjected to vamana is made unctuous again by internal and topical administration of taila and or gh?ta. Thereafter purgation is induced by administering appropriate purgative. Medicinal enema (vasti) is suitable in the treatment of v?ta-dominant diseases. It is also the best among all treatment modes. Vasti is performed with decoctions of herbs or oleaginous substances. It is used in the treatment of abdominal tumors, distension of abdomen, v?ta-induced blood disorders, enlargement of spleen, dysentery, pricking pain in stomach, chronic fever, urinary stone and many v?ta diseases.
Nasal instillation of medicines (nasya) is desirable in diseases of throat and head. Medicines administered through nostrils spread to all parts of throat and head, promoting the elimination of d??as lodged therein. One who performs nasya regularly is endowed with well-built and raised neck, shoulders, chest, pleasant countenance and bright skin.
His sense organs will be very well organized and he will never suffer from graying of hair. Leeching and and bloodletting (raktam?k?a) cure around 80 diseases such as black pigmentation on face, hemorrhoids, irregular fever, migraine, vitiligo and so on.
Abdominal (digestive) fire becomes dull after the performance of vamana or vir?cana measures and appetite will be increased. However, heavy food cannot be digested, as the abdominal fire is weak. Therefore, two modes of diets are recommended to improve digestive efficiency. They are p?y?dikrama and tarpa??dikrama. P?y?dikrama starts with fluid decanted from rice gruel. This is followed by gruel with more fluid of and less of grains. After two days the patient is served gruel with more of grains and less of fluid. In this way digestive fire is improved by p?y?dikrama. Sequential consumption of powder of parched rice suspended in water, cooked rice mixed with lentil soup and finally rice with meat soup is known as tarpa??dikrama. This dietary schedule improves digestive efficiency after performance of elimination measures.
Elimination of disease-causing agents (d??as) after applying oleation and sudation measures, cleanses the body excellently. Carrying out elimination measures without oleation and sudation damages health. Properly performed elimination therapy improves intelligence, memory and comprehension. Ayurveda states that diseases are caused by destabilization of d??as. D??as are most probably biochemical substances that accumulate in body as a result of the appearance of the disease. The very fact that pa cakarma cures various diseases implies that the ayurvedic concept is sound. Therefore, exponents of modern medicine, pharmacology and pharmacy should investigate the rationale behind this concept. Unravelling of the roles of consumption of large volumes of oleaginous substances in a short span of time, therapeutic warming of the body followed by emesis, purgation and nasal instillation will help us understand how pa cakarma cures diseases.
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Authorship statement
I / We, the undersigned author(s) of the manuscript entitled…………………………………….hereby declare that the above manuscript which is submitted for publication in HYGEIA.J.D.Med. is not under consideration elsewhere. The manuscript is not published already in part or whole (except in the form of abstract) in any journal or magazine for private or public circulation. No part of this manuscript (referenced or otherwise) has been copied verbatim from any source. Permission to reproduce table no. ( ) and figure no. ( ) has been obtained and submitted. Reproduced text, if any has been given in italics and within quotes. I/we give consent for publication in HYGEIA.J.D.Med. in any media (print, electronic or any other). I /we do not have any conflict of interest (financial or other) other than those declared. I/we have read the final version of the manuscript and am/are responsible for what is said in it. The work described in the manuscript is my/our own and my/our individual contribution to this work is significant enough to qualify for authorship. No one who has contributed significantly to the work has been denied authorship and those who helped have been duly acknowledged. I/we also agree to the authorship of the article in the following sequence.
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BOOK REVIEW
Plant Drug Evaluation ( a laboratory guide )
ISBN:978-93-5235-376-7
doi:10.15254/PDE.2015
Author: Dr.Madhu.C.Divakar
Published by CD remedies , Ganapathy, Coimbatore,
Tamil nadu, India 641006
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Herbal Medicines: Keeping abreast with changing technology
The use of herbal medicine has increased worldwide in recent years as they are believed to be safer with fewer adverse effects while really ignoring the underlying processes,in contrariety to natural products which demonstrate better clinical results as they address effects as compared to conventional medicines. Growing evidence points out that many current conventional drug therapies suppress the symptoms of disease the root cause more effectively. The full therapeutic potential of the herb is often, however, not realized because of unsuitable molecular size and/or poor lipid solubility,which in turn results in low absorption with reduced bio-availability. The poor progress in herbal medicine development has prompted the need for a multidisciplinary approach to drug delivery....
Dr. Annie Shirwaikar M.Pharm, PhD
Professor, Department of Medicinal chemistry and Phytochemistry
College of Pharmacy,
Gulf Medical University, Ajman, UAE
annieshirwaikar@yahoo.com
read more:..
pdf
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Informed consent :: statement about the protection of human participants in research
Hygeia:journal for drugs and medicines
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EDITORIAL WORK FLOW
Hygeia::journal for drugs and medicines
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Pharmacovigilance
Editorial Hygeia.J.D.Med. 6(2) October 2014
Pharmacovigilance(PV) is the science and activities relating to the detection, assessment,understanding and prevention of adverse effects or any other drug-related problem. WHO established its Programme for International Drug Monitoring in response to the thalidomide disaster detected in 1961 The aims of PV are to enhance patient care and patient safety in relation to the use of medicines;and to support public health programs by providing reliable, balanced information for the effective assessment of the risk-benefit profile of medicines. Though it was set in motion several decades ago, some countries still look upon PV as a ritual or a copycat strategy to comply with the International bodies. PV is not yet felt as an intrinsic need.....
Dr.Shirley Samson Varghese,
Ministry of Health, P.O.Box 393, PC 113,
Muscat,Oman
read more ...
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Indian Journals and the Tyranny of Impact Factor
Editorial: Hygeia.J.D.Med.Vol.6(1) April 2014
There was a time when fairly descriptive accounts wereconsidered good enough to evaluate people, situations and outcomes. Butnot anymore! The clamour for transparency, accountability and equal opportunityhave increased the democratic burden in the dispensation of justice. In India,for instance, it has become essential to rank a candidate’s entranceexamination scores down to the second or third decimal for allotting a medicalseat. .....
Such absurd demandsfor accuracy in day to day transactions brings to my mind a good friend ofmine, back home in my village, who depended on agriculture for his livelihood.He used to sport a curious vintage HMT watch, (analog of course) with only thehour hand. For some reason, he had not bothered to replace the broken minutehand. When I asked him why, he said that minutes do not matter to a farmer. “Wethink in seasons... I do not even need a watch. A calendar is more than enoughto work in the farm.
Dr.MK Unnikrishnan, M. Pharm, PhD.
Professor, Manipal College of Pharmaceutical Sciences,
Manipal University, Manipal, Madhava Nagar
Karnataka, India- 576 104
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Conflicts of Interest statement, Statement about protection of human and animals in research
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Efficient Method of Storage of Dry Herbs
Editorial: Hygeia.J.D.Med.Vol.5 (2) October 2013 - March 2014
Herbs form the raw material for Ayurvedic medicinal products.Around 56,500 metric tons of medicinal herbs were exported from Indiaduring 2009-2010. The domestic traditional medicine industry consumesannually 177,000 metric tons of herbs. Additionally, 86,000 metric tons areused within Indian households. Therefore, the storage of herbs is an importantsubject.
Freshly dried herbs are very storage-sensitive products.Several factors are important in deciding the quality of dried andstored herbs. Because the dried herbs contain a large quantityof hydrophilic constituents like sugars, flavonoids, mucilage, choline andsalts they are very hygroscopic products. Their moisture content cantherefore, adopt the surrounding microclimatic conditions very quickly, absorbing moisturefrom the air in the stack or room very fast. .....
Dr. D. Suresh Kumar PhD.
Head (R&D), CARe KERALAM Ltd, KINFRA Small Industries Park,
Nalukettu Road, KINFRA Park Post,
Koratty-680 309, Thrissur, Kerala, India.
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Clinical effectiveness of Traditional Medicines
Editorial: Hygeia.J.D.Med.Vol.5 (1) March 2013 -September2013
There is a general conception that, herbs arenatural therefore, they are completely safe. In fact, herbs or herbalpreparations also can cause toxic adverse effects,serious allergic reactionsand adverse drug /diet interactions.
The efficacy of a drug substance is its capacityto produce a desired therapeutic effect, or the relative ability ofa drug receptor complex to produce maximum functional response. Nowadays, inhealth care systems the term 'clinical effectiveness' or 'clinical governance'is preferred instead of efficacy, though both are having similar meanings. Theterm clinical effectiveness includes the sum total of the pharmacological andthe non-medical effects of bioactive compounds that may act synergistically,otherwise termed as placebo effect, or sometimes antagonistically or the noceboeffect.
Dr.Madhu.C.Divakar M.Pharm,PhD,PGDHRM
Editor-in-chief
Hygeia.J.D.Med.
madhu.divakar@gmail.com
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Promoting the Safe use of Herbal Medicines
Editorial: Hygeia.J.D.Med.Vol.4(2), October.2012 -March 2013
The Global use of herbal medicines has been steadily increasingand today a large number of the world's population use herbalmedicines as their primary form of health care. ThisPopularity, mainly influenced by patient’sdissatisfaction with conventionalallopathic medicines may also be attributed to several otherreasons. Often associated with traditional and personal beliefs, herbal medicines because of its natural origin are perceived to be highly effectivetherapeutically, safe and free of side-effects, and insome cases complementary to western or orthodox medicine. They are freely available from health stores & pharmaciesand they actually allow the user the means to self-treat a range of conditionsfor which orthodox and even over-the-counter (OTC) medicines are limited orunavailable. This has led to extensive herbal self-medication, as users areoften unaware of the adverse drug reactions (ADRs) that thesemedicines may pose.....
Dr.Annie Shirwaikar M.Pharm, PhD
Professor,College of Pharmacy,
GulfMedical University, Ajman, UAE
annieshirwaikar@yahoo.com
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Phytotherapy of Chronic Venous Insufficiency
Editorial:: Hygeia.J.D.Med.vol.4(1), April 2012 – Sept.2012
Chronic venousinsufficiency (CVI) is primarily a vascular disease characterized byinsufficient blood flow, edema and heavy legs. It is a result of age, lifestyleand obesity. As functional valves are required to provide for efficient bloodreturn from the lower extremities, CVI often occurs in veins of the legs.Itching is a common symptom, along with hyper pigmentation of legs.Symptomsalso include phlebetic lymph edema and chronic swelling of legs.There is also increased risk of ulcers and cellulites.The description of varicose veins as a clinical entity can be traced backas early as the fifth century B.C .......
Dr.D.Sureshkumar MSc, PhD
Head, R&D, CARE Keralam Ltd,KINFRA
Small Industries Park, Nalukettu Road,
Kerala, India.680309.
0091-94-493-48897,
dvenu21@yahoo.com
Readmore........
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Citation Guide
Writers plagiarize when they present other’s ideas as a product of their own intellect. To avoid plagiarism, cite the sources from which you found ideas and make your own text. By citing references, you allow readers to locate and evaluate the quality of each reference. Citing sources also credits others for their work. To make writing credibly simpler,writing style organizations provide writers with standard formats in which to write and cite sources. Works Cited, References, Cited References or Bibliography pages provide readers with information about the sources which contributed to the content of a text or project.Sources may also be cited as footnotes, end notes, and in-text citations.
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The Harvard system of referencing
This is a guide to the Harvard system of referencing .A reference is a detailed bibliographic description of the item from which you gained your information.
read more... (Ref.Department of Library Services http://www.library.dmu.ac.uk/ )
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The Oxford Referencing Style
This resource explains some of the more common applications of the documentary-note (Oxford)system of referencing. It is based on the Style manual for authors, editors and printers, 6th edn,2002, pp. 208-15 and pp. 229-32. At Deakin the documentary-note (Oxford) system is used in some history and philosophy units offered by the Faculty of Arts and Education, and in some units offered by the School of Architecture and Building.
read more.... ( Ref. VU.EDU.AU / LIBRARY )
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Vancouver Citation Style
The Vancouver Style is the citation style used by most biomedical journals and many scientific journals. It came out of a meeting of medical journal editors in 1978, held in Vancouver, BC, and is maintained by the International Committee of Medical Journal. Editors (ICMJE). It is also known as the Uniform Requirements for Manuscripts Submitted to Bio medical Journals. Proper Citations are a reflection of your professionalism and respect for other scholars and practitioners. Failure to do so is plagiarism and is a serious academic offense.
Read more..... (Ref.Vancouver Community College Library)
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Pharmaceutical Horrors of the Environment: An emerging concern
EditorialHygeia .J.D.Med.3 (2) Oct.2011
There was a time wecould enjoy a train ride in rural India, with its pristine countryside, mostlyverdant and fresh with unpolluted air ….
But not any more...!!
Dr.MKUnnikrishnan, M. Pharm, PhD.
Professor,Manipal College of Pharmaceutical Sciences,
ManipalUniversity, Manipal, Madhava Nagar
Karnataka,India- 576 104
Fax:00918202571998
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Food is Thy Medicine
Editorial , Hygeia.J.D.Med.Vol.3(1), April.2011-Sept.2011
Almost all of us yearn for long life. But living longer is not much fun if we are not healthy enough to enjoy it.Hippocrates of Kos(460-370 B.C.) remarked centuries ago that ”Food is thy medicine and medicine thy food”. Ayurveda also holds the same view. After paying heavily for the side-effects of potent synthetic medicines, the West has lately started heeding to Hippocrates’ advice.
Dr.D.Suresh Kumar . PhD.
Sami Labs Ltd., Bangalore-560 058
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Process Analytical Technique & Quality by Design for Pharmaceutical operations
The Process Analytical Technique (PAT) has become a cornerstone of the USFood and Drug Administration’s (US FDA) Quality by Design (QbD) initiative for both the design and control of quality processes.
How PAT enabled process can work well in tandem with manufacturing execution systems?
A desired goal of the PAT frame work is to design and develop processes that can consistently ensure a pre-defined quality till the end of the manufacturing process. PATis a concept and not a specific technology, includes several technologies that enable PAT with in a manufacturing process like intelligent process analysis, Decision support systems etc.
The Optimization process not only ensures quality of the final product as per FDA guidelines but also gives the manufacturer, the required control over the process toachieve operational efficiency.
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