|Section/Chapter||Chikitsa / Vajikarana|
|Authors||Aneesh E.G., Deole Y.S.|
|Reviewed by||Basisht G.|
|Affiliations||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar|
|Publisher||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India|
|Date of publication||May 20, 2021|
In the preservation of health and prevention
Vajikarana therapy is an important measure to preserve and promote health in healthy individuals. [Cha.Sa.Chikitsa Sthana 1/1/13] This therapy is advised to restore tissue equilibrium and prevent recurrence after the treatment of diseases. [Cha.Sa.Sutra Sthana 7/48-49]
In the management of disease
Vajikarana therapy is usually applied in the treatment of diseases due to the vitiation of the reproductive system (shukra dhatu). Diseases of male reproductive system like impotency [Cha.Sa.Chikitsa Sthana 30/193], premature ejaculation, erectile dysfunction are treated with this therapy.[Cha.Sa.Chikitsa Sthana 30/146] Vajikarana leads to the nourishment of the body. [A.S.Sutra Sthana 24/19] Therefore, this therapy is used in the management of degenerative diseases and rehabilitation therapies in disorders caused by depletion of body tissues. The therapy is also used to improve mood and mental strength in psychiatric diseases.
Vajikarana therapy leads to quick sexual stimulation and increases sexual vigor for a longer duration. In long-term therapy, it improves the quality and quantity of reproductive elements. It is effective in improving overall sexual health, fertility, and healthy progeny. Sexual vigor can be maintained even at old age. [Cha.Sa.Chikitsa Sthana 1/1/9-12]
This article deals with the concept and practices of vajikarana therapy in Ayurveda and contemporary views.
Principles of vajikarana therapy
The vajikarana therapy is based on the following principles:
- Nourishment (apyayana): Vajikarana therapy nourishes the shukra dhatu to improve its quality and quantity.
- Clearing and soothing effect (prasadana): Vajikarana pacifies dosha affecting shukra dhatu and improves its quality.
- Increasing (upachaya): It increases the production of shukra dhatu in a middle-aged person.
- Genesis (shukrajanana): It promotes genesis of shukra dhatu even if the quantity is deficient, as seen in old age.[Dalhana on Su.Sa.Sutra Sthana 1/8]
In healthy, Vajikarana is indicated in person desiring for healthy progeny and to promote sexual health.
In disease, Vajikarana is indicated in emaciation due to excess sexual intercourse, impotency, infertility and sexual disorders. [Su.Sa.Chikitsa Sthana 26/3]
Prerequisite for vajikarana therapy
Purification therapies must be done before vajikarana therapy. It is essential to remove toxins and clear body channels to achieve the optimum benefit of vajikarana therapy. [Cha.Sa.Chikitsa Sthana 2/1/50-51] The purification can be done by administration of decoction and unctuous enema (basti). [Cha.Sa.Chikitsa Sthana 2/4/9]
The substance used for vajikarana therapy should possess the following properties:
- Sweet (madhura)
- Unctuous (snigdha)
- Life promoting (jivanam)
- Nourishing (brimhana)
- Heavy to digest (guru)
- Elevating mood and happiness (mano harshana) [Cha.Sa.Chikitsa Sthana 2/4/36]
- Increases strength [A.S. Uttara Sthana 50/64]
Methods of vajikarana therapy
Vajikarana is administered through the following means:
- Daily habits
- Psychological factors
- Therapeutic measures
Following food items are helpful to improve the quality and quantity of shukra dhatu.
- Daily consumption of ghee and milk. [Cha.Sa.Chikitsa Sthana 2/3/20]
- Habitual use of diet consisting of equal parts of ghee and roasted corn flour [Cha.Sa.Sutra Sthana 25/40]
- Milk [Cha.Sa.Sutra Sthana 1/107]
- Honey [Su.Sa.Sutra Sthana 45/132]
- Coconut water [A.S.Sutra Sthana 6/23]
- Sugarcane juice[A.S.Sutra Sthana 6/49]
- Crude sugar, sugar candy and white fine sugar[A.S.Sutra Sthana 6/55]
- Barley (yava) [A.S.Sutra Sthana 7/10]
- Wheat [A.S.Sutra Sthana 7/11]
- Shashtika rice (a rice variety) along with milk, ghee, sugar and honey [Cha.Sa.Chikitsa Sthana 2/2/27]
- Powder of Glycyrrhiza glabra (yashtimadhu) with ghee and honey followed by milk [Cha.Sa.Chikitsa Sthana 2/3/18-19]
- Meat soup[A.S.Sutra Sthana 7/33], meat of rooster [A.S.Sutra Sthana 7/77], kulira (a fish variety) - [A.S.Sutra Sthana 7/91]
- Bone marrow and animal fat [Cha.Sa.Sutra Sthana 27/295]
Regimens with aphrodisiac (vajikarana) effect
- Bath [Cha.Sa.Sutra Sthana 5/94],
- Comfortable sitting and proper sleep [Su.Sa.Chikitsa Sthana 24/81]
- Affectionate and loving conversation, touch, and pleasant music [Su.Sa.Chikitsa Sthana 26/6]
- A loving and pleasant companion is the best to increase virility.[Cha.Sa.Chikitsa Sthana 2/1/4]
Decoction enema [A.S. Sutra Sthana 28/5], unctuous enema processed with vajikarana medicines (vrishyabasti) [A.S.Kalpa Sthana 5/11] and gentle massage (samvahana) [Su.Sa.Chikitsa Sthana 24/83] increases virility.
Herbs and medicines:
The herbs that increase the amount of semen are Withania somnifera (ashwagandha), Asparagus adscendens (musali), sugar (sharkara) and Asparagus racemosus (shatavari). [Sha.Purvakhanda.4/15]
The drugs which initiate proper functioning of semen are milk, black gram (masha), fruit pulp of Semicarpus anacardium (bhallataka phalamajja), and Phyllanthus embilica (amalaki). [Sha.Purvakhanda.4/16]
Solanum americanum (kakamachi) [A.S.Sutra Sthana 7/103], Pueraria tuberose (vidari) [A.S.Sutra Sthana 7/120], Benincasa hispida (kushmanda) [A.S.Sutra Sthana 7/124], grape [A.S.Sutra Sthana 7/154], dry ginger[A.S.Sutra Sthana 12/30], ginger [Cha.Sa.Sutra Sthana 27/296], Sida cordifolia (bala), Abutilon indicum (atibala), Sida cordata (nagabala) [A.S.Sutra Sthana 12/43], black gram [Cha.Sa.Sutra Sthana 27/24], Phoenix sylvestris Roxb.(dates) [Cha.Sa.Sutra Sthana 27/127], Mucuna pruriens (kapikacchu) [Sha.Purvakhanda.4/14] etc. are some of the drugs which promotes virility.
Diets contraindicated in vajikarana therapy
Following food items negatively affect virility and contraindicated during vajikarana therapy:
- All types of salts except rock salt [A.S. Sutra Sthana 18/17] [A.S. Sutra Sthana 12/17]
- Buttermilk [Su.Sa.Sutra Sthana 45/84]
- Bitter and spicy food items [Cha.Sa.Sutra Sthana 27/4] [Cha.Sa.Sutra Sthana 26/51]
- If food is taken in less quantity than required [Cha.Sa.Vimana Sthana 2/7]
Time of administration
Vajikarana medicines should be used along with morsel of food (sagrasa). [A.S. Sutra Sthana 23/22]
In modern medical systems, drugs to increase sex hormones are used. Commonly phenethylamines, synthetic testosterone are used to increase libido and treat sexual dysfunctions.
The diet, regimen, medicine, and therapies that stimulate spermatogenesis, improve sperm count, decrease spermatic defects, improve sexual desire, vigor, duration of intercourse can be considered as forms of vajikarana therapy.
Research studies are carried out on role of herbs on increasing sexual desire and aphrodisiac effect. This is elaborately discussed in the chapter of Vajikarana of Charak Samhita. Some notes are provided additionally in this article.
Reactive oxygen species (ROS) cause oxidative stress leading to idiopathic male infertility and sexual dysfunction. The oxidative stress may also lead to sperm DNA damage which has negative impact over reproductive outcome. By reducing oxidative stress, the natural antioxidants significantly increase sperm motility and sperm counts in infertile men. Mucuna pruriens (kapikacchu), Tribulus terrestris (gokshura) and Withania somnifera (ashwagandha) enhance the sexual function by increasing testosterone levels and regulating nuclear factor-kB (NF-kB) and nuclear factor erythroid 2 related factor (Nrf2) signaling pathways. It also decreases the ROS levels.
In an experimental study, Mucuna pruriens (kapikacchu), Tribulus terrestris (gokshura) and Withania somnifera (ashwagandha) combination showed increase in weight of seminal vesicles and ventral prostate of rats. The sperm motility and sperm counts were also increased by 30 -40% than the control group. FSH, LH, and testosterone levels were also improved. Lowest levels of serum and testicular tissue malondialdehyde (MDA) were found in trial group. MDA is an end product of ROS mediated lipid peroxidation. NF-kB levels were also found to be lowest in the group treated with the above medicines.
Withania somnifera (ashwagandha) is found effective in stress-induced sexual disorders in rat models. It produces a gamma aminobutyric acid (GABA) like effect and prevents the overstimulation of nerve cells. It reduces the cortisol levels to bring calming effect.
Effect of therapeutic purgation (virechana) in infertility due to oligozoospermia
In a study, cow’s ghee was administered after therapeutic purgation (virechana) in 32 infertile patients with oligozoospermia. It showed 80% increase in total sperm count, 41% increase in sperm motility, 12.58% increase in the normal form of sperm, and 45.22% increase in semen volume. It also showed 41.69% decrease in abnormal forms of sperms. An increase in FSH, LH and testosterone levels is reported after the treatment. Improvement in generalized debility, sexual weakness, sexual desire, erectile dysfunction, frequency, and duration of coitus was observed. Ghee possesses anti-oxidant properties as it contains abundant amounts of Vit A and E.
Effect of asafoetida
Asafoetida in low dose improves the viability, motility, count and morphology of sperms. In higher doses it may have adverse action. In a study, rats treated with asafoetida showed significant increase in epididymal sperm count. Improvement in sperm morphology and viability was reported. Mobility of sperms was found to decrease after treating with asafoetida. Histological study shows an increase in germ cells and signs of spermatogenesis. It may have a stimulant action on spermatogenesis.
Lower doses of Syzygium aromaticum have a stimulant effect on spermatogenesis. Its higher dose has an adverse action on male reproductive parameters like count, motility, and morphology of sperms.
Puga Khanda, an Ayurvedic formulation, improves the seminal volume, total sperm count, and motility. It also showed improvement in sexual desire, penile erection and penile rigidity. The ingredients like Areca catechu, Asparagus racemosus, Pueraria tuberosa, Tribulus terrestris, cow’s milk, ghee have aphrodisiac and antioxidant properties.
In a study on 20 patients with oligozoospermia, sperm count and semen volume are significantly increased by administering Ficus religiosa (ashwatha) fruit powder after therapeutic purgation (virechana).
List of theses done
- Rajareddy G (1999): A comparative pharmacotherapeutic study of erandamula and kapikacchu bija with special reference to vrsya karma. Department of Dravyaguna Vigyan. IPGT&RA Jamnagar
- Santosh Bhatted (2002): A comparative study of role of vajeekarana drugs administered orally and by basti in the management of klaibhya with reference to erectile dysfunction. Department of Kayachikitsa. IPGT&RA Jamnagar
- Prakash Mangalasseri (2002): A clinical study of shukragatavata w.s.r to premature ejaculation & its management with Akarakarbhati yoga yapanabasti. Department of Kayachikitsa, IPGT&RA Jamnagar
- Sanjay Gupta (2006): A clinical effect of Baladiyapanabasti and vajikarana yoga in the management of sukradushti w.s.r to oligoasthenozoospermia. Department of Kayachikitsa, IPGT&RA Jamnagar
- Basil Cardozo (2006): A clinical study on physo-somatic management of sukraavritavata (premature ejaculation) with rasayana yoga and shirodhara. Department of Kayachikitsa, IPGT&RA Jamnagar
- Jithesh C Padariya (2010): Effect of pushpadhanva rasa and swayamguptaikshurakbheejachoorna on kshinashukra (oligozoospermia). Department of Kayachikitsa, IPGT&RA Jamnagar
- Nakul A Jethva (2011): A Clinical Study on the Effect of Virechana Karma and Amalaki Rasayana in the Management of Kshinashukra w.s.r. to Oligozoospermia. Department of Panchakarma, IPGT&RA Jamnagar
- BGSM Sumanasinghe (2016): Experimental evaluation of vrishyakarma (Aphrodisiac activity) of leaf of Clitoria Ternatea Linn. (Aparajita). Department of Dravyaguna Vigyan. IPGT&RA Jamnagar
- Jitendra Varsakiya (2015): A comparative study of Ashwatthaphalachurna and shvetapalanduswarasabhavitayavani in the management of ksheenashukra W.S.R to oligozoospermia. Department of Kayachikitsa, IPGT&RA Jamnagar
- Vasava Ankitkumar Amarsinh (2017): A comparative clinical study of churnaratnam and svaguptadichurna in the management of ksheenashukra W.S.R to oligozoospermia. Department of Kayachikitsa, IPGT&RA Jamnagar
- Nikunj M (2012): A comparative study of vrishyabasti and kulinga (Blepharis edulis) after virechana karma in the management of kshinashukra w.s.r to oligozoospermia. Department of Panchakarma, IPGT&RA Jamnagar
- Jadav Hasmukh Bhavanbhai (2014): Management of premature ejaculation (shukragatavata) with erandamoolbasti and vanarikalpa- A clinical study. Department of Panchakarma, IPGT&RA Jamnagar
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Sha. = Shargadara, Sa. = Samhita.
List of References
The list of references for Vajikarana in Charak Samhita can be seen here
- Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, vaji, Page 254.
- Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, vajikara, Page 938.
- Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.
- Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
- Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.
- Sahin K, Tuzcu M, Orhan C, Gencoglu H, Sahin N, Akdemir F, Turk G, Yilmaz I, Juturu V. MAT, a Novel Polyherbal Aphrodisiac Formulation, Enhances Sexual Function and Nrf2/HO-1 Pathway While Reducing Oxidative Damage in Male Rats. Evid Based Complement Alternat Med. 2018 Apr 29;2018:8521782. doi: 10.1155/2018/8521782. PMID: 29853975; PMCID: PMC5949178.
- Mamidi P, Thakar AB. Efficacy of Ashwagandha (Withania somnifera Dunal. Linn.) in the management of psychogenic erectile dysfunction. Ayu. 2011 Jul;32(3):322-8. doi: 10.4103/0974-8520.93907. PMID: 22529644; PMCID: PMC3326875.
- Varsakiya JN, Goyal M, Thakar A, Donga S, Kathad D. Efficacy of Virechana (therapeutic purgation) followed by Go-Ghrita (cow ghee) in the management of Ksheena Shukra (oligozoospermia): A clinical study. AYU 2019;40:27-33.
- Bagheri SM, Yadegari M, Porentezari M, Mirjalili A, Hasanpor A, Dashti RM, et al. Effect of Ferula assa-foetidaoleo gum resin on spermatic parameters and testicular histopathology in male wistar rats. J Ayurveda Integr Med 2015;6:175-80.
- Mishra RK, Singh SK. Reproductive effects of lipid soluble components of Syzygium aromaticum flower bud in male mice. J Ayurveda Integr Med 2013;4:94-8.
- Baragi PC, Bhat S, Prajapati PK, Baragi UC. Clinical evaluation of V.r.sya effect of Pūga Kha.n.da on sexual health and seminal parameters. Ancient Sci Life 2013;32:134-8.
- Varsakiya JN, Goyal M, Thakar A, Patel B. Role of Virechana and Ashwatha Phala Churna in the management of Ksheena Shukra (oligozoospermia): A pilot study. Ayu. 2016 Apr-Jun;37(2):113-119. doi: 10.4103/ayu.AYU_71_15. PMID: 29200749; PMCID: PMC5688833.