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Kalpa Sthana

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{{Infobox
|title = [[Charaka Charak Samhita]] Kalpa Sthana
|header1 = Sections
 
|label2 = Preceding
|data2 = [[Chikitsa Sthana]]
 
|label3 = Succeeding
|data7 = [[Madanakalpa Adhyaya]], [[Jimutaka Kalpa Adhyaya]], [[Ikshvaku Kalpa Adhyaya]], [[Dhamargava Kalpa Adhyaya]], [[Vatsaka Kalpa Adhyaya]], [[Kritavedhana Kalpa Adhyaya]], [[Shyamatrivrita Kalpa Adhyaya]], [[Chaturangula Kalpa Adhyaya]], [[Tilvaka Kalpa Adhyaya]], [[Sudha Kalpa Adhyaya]], [[Saptalashankhini Kalpa Adhyaya]], [[Dantidravanti Kalpa Adhyaya]] }}
==Preamble of [[Kalpa Sthana ]] of the [[Charaka Charak Samhita]] ==
|}
[[Madanakalpa Adhyaya]] (pharmaceutical preparations)is the very first chapter of [[Kalpa Sthana]] of [[Charaka Charak Samhita]]. In all, there are twelve chapters in this section, of which the first six including ''Madanakalpa'' describe the various pharmaceutical formulations for emesis while the remaining six describe various purgative pharmaceutical preparations. Each chapter is named after a plant drug and in every chapter many compound formulations with suitable plant drugs are also given. Grossly, all twelve chapters can be divided into ''Vamana'' and ''Virechana'' ''Kalpa''. The literal meaning of ''Vamana'' is to eliminate the ''doshas''(impurities) from gastro-oral route whereas from lower tract- through anus it is known as purgative. Since impurities are eliminated in both the cases, hence, it is known as [[Madanakalpa Adhyaya#Vamana (therapeutic emesis) and Virechana (therapeutic purgation)|''Virechana sanjna'' (evacuative)(Cha.Ka.1/4)]]
=== Salient features of [[Kalpa Sthana]] ===
Charaka Charak detailed the Pharmacokinetics of drugs, dosage forms and weights and measures in this section. Drugs useful for ''vamana'' and ''virechana'' are discussed with their synonyms, varieties, pharmacological actions, and various modes of application in different dosage forms.
==== Factors responsible for therapeutic efficacy ====
==== Weight and measures ====
Two traditions for ''mana'' (weight and measures) are mentioned in [[Kalpa Sthana]], namely, ''Kalinga'' (part of present Orissa) and ''Magadha'' (part of present Bihar). Charaka Charak opines that Magadha is better than former. Chakrapani considers this statement as unauthentic. It is also suggested that when weight of ingredients in a recipe is not specified, then all the ingredients are to be taken in equal quantity.
==== ''Snehapaka'' (Dosage form) ====
[[Charaka Charak Samhita]] does not specify the liquid medium to be used in formulation of the medications. However, the use of certain liquids has been known through practice and other sources. In the process of ''snehakalpana'', for example, water has to be used invariably. ''Snehapaka'' (preparation of medicated oil or ghee) is categorized into three types i.e. ''mridupaka'' (mild boiling), ''madhayamapaka'' (moderate boiling) and ''kharapaka'' (full boiling). ''Sneha'' processed by ''kharapaka'' is indicated for massage purpose, ''mridupaka sneha'' is recommended to be used for ''nasya'' (inhalation) and moderately processed oil or ghee for internal use including for ''basti karma''.
==== Purification of drugs ====
To reduce the toxicity (''vikasi guna'') of ''Danti'' and ''Dravanti'', Charaka Charak evolved a process using ''Pippali'' and honey paste which is to be besmeared over the roots and once again to be smeared with mud and fomented with steam after drying up in sun. Chakrapani observes that heat of fire and sunrays makes the root free from adverse effects. This could be quoted as a best example of purification process employed for the removal of toxicity - a novel concept mentioned by CharakaCharak. In the medieval ages, ''Rasashastra'' texts adopted several purificatory procedures for various herbal and metallic drugs.
==== Sushruta's perspective of Kalpa sthana ====
The subject matter of Kalpasthana in Sushruta samhita is entirely different and deals with one of the Ashtangas of Ayurveda known as Damshtrachikitsa (Toxicology). Sushruta furnished the details of ''vamana'' and virechana drugs in Sutra sthana (43 and 44th chapter). Among vamana dravyas madanaphala, jimutaka pushpa, kutaja phala, ikshvaku pushpa, kritavedhana beeja and dhamargava phala are enumerated. Sushruta identified best virechaneeya drugs based on part used like, trivrit among root purgatives and amongst bark, fruits, oil, juice and latex, the drugs namely tilvaka, haritaki, erandataila (Castor oil), karavellaka and snuhi are considered as best respectively. Trivrit, danti, dravanti, tilvaka, haritaki, chaturangula, erandataila, snuhiksheera, saptala, and shankhini are enumerated under virechaneeya drugs. There is not much difference among the drugs enumerated in Charaka Charak and Sushruta, but Sushruta included triphala, erandataila under virechana drugs.Charaka Charak suggested root bark of tilvaka while Sushruta instructed to use bark of tilvaka. A purgative recipe is suggested for children, old people, delicate and patients suffering from dhatukshaya (weight loss/wasting condition) by Sushruta which includes erandataila (Castor oil) mixed with triphala kwatha and milk or meat soup. He also suggested chaturangula for children up to age 12. It appears that Sushruta suggested easily available purgatives.<ref>Sushruta samhita, Ed. By G. D. Shingal et al., Sutra Sthana 44/72-77.</ref>
=== Relevance of the concepts of [[Kalpa Sthana]] in the current clinical practices ===
''Vamana karma'' (emesis) and ''virechana karma'' (purgation) are mandatory before performing ''basti karma'' (enema), in order to promote health (i.e., for the patient to gain mass). Keeping this in view, the details about drugs employed in ''vamana'' and ''virechana karma'' are described in this section and the details about ''basti karma'' in the subsequent section, [[Siddhi Sthana]].
For ''vamana karma'', ''Madanaphala'' is the main drug employed in the current clinical practice. But the rest of five drugs (i.e., ''Jimutaka'', ''Ikshvaku'', ''Dhamargava'', ''Vatsaka'', and ''Kritavedhana'') are not being prescribed. Charaka Charak suggested the period of collection and procedure for extracting seed from the ''Madanaphala''. These procedures are not being followed currently. In the purgative therapy the drug ''Trivrita'' is prescribed currently in the various dosage forms and ''Aragwadha'' and ''Danti'' are infrequently prescribed. Charaka Charak suggested a procedure for extracting the pulp from the fruit of ''Aragwada''. He also described a process to reduce ''vikasi guna'' (causes looseness of tissues) of ''Danti'' root. Both these procedures are not in vogue. Sushruta suggested ''Triphala'' (three fruits, namely ''Haritaki'', ''Vibitaka'', and ''Amalaki'') and ''Eranda Taila'' (Castor oil) as purgatives and are prescribed in the current clinical practice.
''Tilvaka'', ''Saptala'', ''Sankhini'', and ''Dravanti'' are the purgative drugs suggested by Charaka Charak which are controversial and not being preferred in current practice.
The procedures described by Charaka Charak with regard to ''vamana'' and ''virechana karma'' are being followed religiously by Ayurvedic physicians of current times.
Ayurvedic classics have advocated to collect the medicinal plants according to part used and seasons in order to get desired pharmacological action and therapeutic benefits. Sushruta, Charaka Charak and other acharyas advocate the collection of various parts of medicinal plants in different seasons. The logic behind such recommendations has been validated by recent modern scientific research.
In a study the variations in the phytoconstituents of ''Ashwagandha'' root was evaluated according to lunar cycles with regard to ''grishma'' and ''shishira ritu'' (summer and late winter season). In this study, total phenolic, flavonide and carbohydrate content of ''Ashwagandha'' root were found more in ''poornima'' (full moon day) samples. GAP (''Grishma Ashadha Poornima'', or the full moon night occurring in the ''Grishma-Ashadha'' season) samples showed maximum differentiation from rest of the samples with regards to TCA, TCW, TFW, MEx, WEX, pH etc. parameters. The ''Grishma-Jyeshtha Poornima'' (GJP) and GAP samples were found to be superior than ''Amavasya'' (new moon day) samples with regard to functional groups and with anoloid content respectively. <ref>Tavhare SD, Nishteswar K, Shukla VJ. Effect of seasonal variations on the phytoconstituents of Aśvagandhā w.r. to lunar cycles. Ancient Sci Life. 2016;35((3)):150–8 available online https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850775/</ref> <ref>Tavhare SD, Nishteswar K, Shukla VJ. Influence of lunar cycles on growth of Ashwagandha(Withania somnifera [L.] Dunal). AYU [serial online] 2015 [cited 2019 Jan 22];36:258-64. Available from: http://www.ayujournal.org/text.asp?2015/36/3/258/182763 </ref> Such type of studies validate the concept of seasonal collection of drug delineated in Ayurveda classics like [[Charaka Charak Samhita]] and ''Sushruta Samhita''.
=== Contemporary perspective ===
Modern phytochemistry suggests that Saponin containing drugs act like irritants due to their foam producing action. Through this mechanism, drugs like madana, ikshvaku, jimutaka, kritvedhana may produce emesis. Till date there is no research work carried out on biological activity of kurchine regarding emesis. Drugs containing anthroquinone derivatives tend to be good laxatives. Therefore anthraqinone containing drugs like argvadha act as good virechaka drugs.
Ayurvedic classical texts atributed anti-diarrhoel activity to kutaja (Stem bark & seeds). Charaka Charak included kutaja under emetics. It may be interpreted that kutaja in emetic doses induces vomiting, while in sub-emetic or therapeutic doses controls diarrhea. According to modern pharmacology “the emetic drugs in sub-emetic doses acts as bronchodilators” indicates that alteration of the dose of the drug can produce different pharmacological actions.<ref>Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmaco- therapeutics. Revised 16th edn. Popular Prakashan Private Limited. Mumbai; 1999.</ref> It can be presumed that kutaja in emetic doses produces vomiting at the level of upper gastrointestinal tract, while the therapeutic dose of the drug controls diarrhea at the level of lower gastrointestinal tract.
''Vamanopaga'' drugs (synergistic drugs to ''vamana karma'') like kovidara, karbudara, shanapushpi, pratyakpushpi possess ''agni'' and ''vayu mahabhuta'' dominance can support main ''vamana dravya'' for emetic action, while drugs like draksha, kashmariphala, parushaka, badara, kuvala, peelu, karkandhu are ''prithvi'' and ''ap mahabhuta'' dominant drugs, which can support the main ''virechaka'' drugs for inducing purgative action.
To summarize the content of ''Kalpa sthana'' of Charaka Charak samhita it appears that the information about most popular emetic and purgative drugs with various dosage forms is furnished. And more research is required to explain modus operandii of emetic and purgative drugs and their therapeutic applicability can be documented by evidence based clinical trials.
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