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Jimutaka Kalpa Adhyaya (view source)

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<big>'''Abstract'''</big>

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<div style="text-align:justify;">[[Kalpa Sthana]] of [[Charaka Samhita]] deals with different dosage forms of ''vamana'' (emetics) and ''virechana'' (purgative) drugs along with their therapeutic application in various diseases. Six emetic drugs - ''Jimutaka'', ''Ikshvaku'', ''Dhamargava'', ''Kutaja'' and ''Kritavedhana'' are described in separate chapters. Dridhabala who redacted [[Kalpa Sthana]] (section on pharmaceutics) has described individual drugs with synonyms. Chakrapani opines that ''Madanaphala'' is relatively safe in comparison to other emetic drugs and rest of the drugs produce more untoward side effects in the ascending order. Fruits and flowers of ''Jimutaka'' are used as emetics and other parts like leaves and branches of this plant are not useful in ''Vamanakarma'' (therapy of emesis).In this chapter, 39 recipes of ''Jimutaka'' processed in various media like milk, alcohol, water etc. are enumerated. In the context of ''vati'' (pill) preparation it is suggested to prepare them in the size of ''Kola'' (1/2 ''tala''-6gm)in comparison to ''Madanaphala'' (in pill form) which can be administered in the quantity of ''Haritaki'' (2 ''tola''), ''Vibhitaki'' (1 ''tola'') and Amalaki (1/2 ''tola''). It appears that ''Jimutaka'' produces emesis relatively in small doses. ''Jimutaka'' is bestowed with ''Tridoshaharakarma'' (curing vitiated conditions of ''Tridosha'') and indicated in the treatment of ''Jwara'' (fever), ''Pittashleshma jwara, Vatapitta jwara, Swasa'' (breathlessness including asthma), ''Hikka'' (Hiccough), ''Arochaka'' (Anorexia), ''Kasa'' (Cough), ''Pandu'' (Anaemia), ''Rajayakshma'' (Wasting diseases) and such other diseases. Drugs like ''Guduchi, Yashti, Kovidara, Karbudara, Nipa, Vidula, Bimbi, Shanapushpi, Sadapushpi, Pratyakpushpi, Nimba, Kutaja, Aragwadha, Swadukantaka'' (''Babbul'' or ''Gokshura''), ''Patha, Gunja, Patala, Murva, Jivaka, Rishabhaka, Ikshu, Shatavari, Madanaphala'' etc. are also incorporated along with ''Jimutaka'' in various formulations.

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<div style="text-align:justify;">[[Kalpa Sthana]] of [[Charaka Samhita]] deals with different dosage forms of [[vamana]] (emetics) and [[virechana]] (purgative) drugs along with their therapeutic application in various diseases. Six emetic drugs - ''Jimutaka'', ''Ikshvaku'', ''Dhamargava'', ''Kutaja'' and ''Kritavedhana'' are described in separate chapters. Dridhabala who redacted [[Kalpa Sthana]] (section on pharmaceutics) has described individual drugs with synonyms. Chakrapani opines that ''Madanaphala'' is relatively safe in comparison to other emetic drugs and rest of the drugs produce more untoward side effects in the ascending order. Fruits and flowers of ''Jimutaka'' are used as emetics and other parts like leaves and branches of this plant are not useful in ''Vamanakarma'' (therapy of emesis).In this chapter, 39 recipes of ''Jimutaka'' processed in various media like milk, alcohol, water etc. are enumerated. In the context of ''vati'' (pill) preparation it is suggested to prepare them in the size of ''Kola'' (1/2 ''tala''-6gm)in comparison to ''Madanaphala'' (in pill form) which can be administered in the quantity of ''Haritaki'' (2 ''tola''), ''Vibhitaki'' (1 ''tola'') and Amalaki (1/2 ''tola''). It appears that ''Jimutaka'' produces emesis relatively in small doses. ''Jimutaka'' is bestowed with ''Tridoshaharakarma'' (curing vitiated conditions of ''Tridosha'') and indicated in the treatment of ''Jwara'' (fever), ''Pittashleshma jwara, Vatapitta jwara, Swasa'' (breathlessness including asthma), ''Hikka'' (Hiccough), ''Arochaka'' (Anorexia), ''Kasa'' (Cough), ''Pandu'' (Anaemia), ''Rajayakshma'' (Wasting diseases) and such other diseases. Drugs like ''Guduchi, Yashti, Kovidara, Karbudara, Nipa, Vidula, Bimbi, Shanapushpi, Sadapushpi, Pratyakpushpi, Nimba, Kutaja, Aragwadha, Swadukantaka'' (''Babbul'' or ''Gokshura''), ''Patha, Gunja, Patala, Murva, Jivaka, Rishabhaka, Ikshu, Shatavari, Madanaphala'' etc. are also incorporated along with ''Jimutaka'' in various formulations.

'''Keywords''': ''Jimutaka, Vamanakarma,'' Luffa echinata Roxb.

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== Introduction ==

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[[Kalpa Sthana]] contains the descriptions of ''Vamaka'' and ''Rechaka'' drugs (Emetics and Purgatives). Six drugs i.e. ''Madanaphala, Jimutaka, Ikshvaku, Dhamargava, Kutaja'' and ''Kritavedhana'' are denoted for emesis while nine drugs namely ''Shyama, Trivrit, Chaturangula, Tilvaka, Mahavrikshaka, Saptala, Sankhini, Danti'' and ''Dravanti'' are described for purgation.

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[[Kalpa Sthana]] contains the descriptions of Vamaka and ''Rechaka'' drugs (Emetics and Purgatives). Six drugs i.e. ''Madanaphala, Jimutaka, Ikshvaku, Dhamargava, Kutaja'' and ''Kritavedhana'' are denoted for emesis while nine drugs namely ''Shyama, Trivrit, Chaturangula, Tilvaka, Mahavrikshaka, Saptala, Sankhini, Danti'' and ''Dravanti'' are described for purgation.

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Atreya formulated 600 emetic and purgative recipes from 15 drugs. Emetic drugs predominantly constituted by ''agni'' and ''vayu mahabhutas''. ''Rechana'' drugs constituted by ''prithvi'' and ''jala ~~mahabhutas''~~. It is also observed that drugs with these ''panchabhautika'' compositions may not exert either emetic or purgative action and the activity is attributed to general principle of drug action known as ''prabhava''. ''Virya'' (a principle responsible for each and every drug action) is augmented by ''Deshasampat'' (quality of soil in which plant grows), ''Kalasampat'' (Ideal season for collecting the plant), ''Gunasampat'' (enrichment of principles of drug action) and ''Bhajanasampat'' (suitability of storage containers) contributing to maximum therapeutic effect.[Cha. Sa. [[Kalpa Sthana]] 1/7]

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Atreya formulated 600 emetic and purgative recipes from 15 drugs. Emetic drugs predominantly constituted by [[agni]] and [[vayu]] [[mahabhutas]]. ''Rechana'' drugs constituted by [[prithvi]] and [[jala]] [[mahabhuta]]. It is also observed that drugs with these ''panchabhautika'' compositions may not exert either emetic or purgative action and the activity is attributed to general principle of drug action known as ''prabhava''. ''Virya'' (a principle responsible for each and every drug action) is augmented by ''Deshasampat'' (quality of soil in which plant grows), ''Kalasampat'' (Ideal season for collecting the plant), ''Gunasampat'' (enrichment of principles of drug action) and ''Bhajanasampat'' (suitability of storage containers) contributing to maximum therapeutic effect.[Cha. Sa. [[Kalpa Sthana]] 1/7]

Chakrapani comments that container to be used for storing drugs should have [[guna]] (attributes) similar to the stored drugs. Different adjuvants (''anupana'') are required to be used in accordance with [[dosha]] involved in the pathogenesis of disease during the administration of drugs. Recipes are prepared basing on the dravya (Nature of drug), deha (Physique), [[dosha]] (factor for causation of diseases), [[Prakriti]] (Constitution), bala(Strength), [[satmya]](Homologation), rogavastha(stage of the disease), vaya(age), [[agni]](digestive and enzymatic complexes) etc.[ Cha. Sa. [[Kalpa Sthana]]1/12].

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Before the administration of emetic therapy [[snehana]] (oral oleation therapy) and [[swedana]] (fomentation) are mandatory. Administered drug first reaches the heart and circulated all over the body through ''dhamani'' (Blood vessels) and liquefy morbid matter (''mala'') and separate it from channels and bring them to ''koshtha''. Emetic and purgative drugs facilitate the expulsion of ~~''malas''~~ brought into ''koshtha'' from rest of the body.

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Before the administration of emetic therapy [[snehana]] (oral oleation therapy) and [[swedana]] (fomentation) are mandatory. Administered drug first reaches the heart and circulated all over the body through ''dhamani'' (Blood vessels) and liquefy morbid matter ([[mala]]) and separate it from channels and bring them to ''koshtha''. Emetic and purgative drugs facilitate the expulsion of[[mala]] brought into ''koshtha'' from rest of the body.

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Drugs for emesis which are ''ushna'' (hot), ''tikshna'' (sharp/penetrating),''sukshma'' (subtle), ''vyavayi'' (pervading), and ''vikashi'' (loosening), by virtue of their own potency (''swa viryena''), reach the heart and circulate throughout the body through vessels. It liquefies the mass of impurities by its ''agneya'' nature (dominance of ''agni mahabhuta'') and due to ''tikshna guna''(penetrating property) separate the adhered ~~''doshas''~~ situated in gross and subtle channels of the entire body. Consequently the separated mass floating in the oleated body like honey kept in a fat smeared vessel reaches the stomach because of its nature to move through subtle channels (''anumarga sancharitwat'') and to flow towards gastrointestinal tract (''koshta gamanonmukhatwam''). Because of the predominance of ''agni'' and ''vayu ~~mahabhutas''~~ in these drugs, their specific action ( due to ''prabhava'') to move upwards and by action of ''udana vata'', the morbid matter gets expelled through the upward tract (mouth) [Cha. Sa. [[Kalpa Sthana]] 1/5]

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Drugs for emesis which are ''ushna'' (hot), ''tikshna'' (sharp/penetrating),''sukshma'' (subtle), ''vyavayi'' (pervading), and ''vikashi'' (loosening), by virtue of their own potency (''swa viryena''), reach the heart and circulate throughout the body through vessels. It liquefies the mass of impurities by its ''agneya'' nature (dominance of [[agni]] [[mahabhuta]]) and due to tikshna [[guna]](penetrating property) separate the adhered [[dosha]] situated in gross and subtle channels of the entire body. Consequently the separated mass floating in the oleated body like honey kept in a fat smeared vessel reaches the stomach because of its nature to move through subtle channels (''anumarga sancharitwat'') and to flow towards gastrointestinal tract (''koshta gamanonmukhatwam''). Because of the predominance of [[agni]] and [[vayu]] [[mahabhuta]] in these drugs, their specific action ( due to ''prabhava'') to move upwards and by action of udana [[vata]], the morbid matter gets expelled through the upward tract (mouth) [Cha. Sa. [[Kalpa Sthana]] 1/5]

Vomiting is a complex process that consists of a pre-ejection phase (gastric relaxation and retro peristalsis), retching (rhythmic action of respiratory muscles preceding vomiting and consisting of contraction of abdominal and intercostals muscles and diaphragm against a closed glottis), and ejection (intense contraction of abdominal muscles and relaxation of the upper oesophageal sphincter). The process appeared to be coordinated by a central emesis centre in the lateral reticular formation of the mid brain-stem adjacent to both the chemoreceptor trigger zone (CTZ) in the area postrema at the bottom of the fourth ventricle and the solitary tract nucleus (STN). The lack of blood-brain barrier allows the CTZ to monitor blood and cerebrospinal fluid constantly for toxic substances and to relay information to the emesis centre to trigger nausea and vomiting. The emesis centre also receives information from the gut, principally by the vagus nerve (via the STN) and also by splanchnic afferents via the spinal cord. The CTZ has high concentrations of receptors for serotonin (5-HT3), dopamine (D2), and opioids; the STN is rich in receptors for enkephalin, histamine, and Ach, and also contains 5-HT3 receptors.In the emetic response fundus and body of stomach, eosophageal sphincter and esophagus relax, while duodenum and pyloric stomach contract in a retrograde manner. Rhythmic contractions of diaphragm and abdominal muscles then compress the stomach and evacuate its contents via mouth<ref>K D Tripathi, Essentials of Clinical Pharmacology, 6th edition, Jaypee Brothers Medical Publishers, 639.</ref>.

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Administration of drugs in emetic or purgative therapies and rest of the [[Panchakarma]] procedures, complication arising out of their improper administration and their successful management dealt in [[Siddhi Sthana]] (section on successful administration of therapeutic measures) in detail. Indications and contraindications of emetic and purgative therapies are described by Charak in [[Siddhi Sthana]].Appearance of ''pitta'' at the end of emesis and ''kapha'' at the end of purgation though described under signs of proper elimination, Chakrapani opines that they may also occur in inappropriate purification (''asamyakshudhhi''). Therefore additionally associated signs like emaciation (''karshya''), weakness (''daurbalya'') and lightness of the body (''laghavata'') only indicate appropriate purification.

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Administration of drugs in emetic or purgative therapies and rest of the [[Panchakarma]] procedures, complication arising out of their improper administration and their successful management dealt in [[Siddhi Sthana]] (section on successful administration of therapeutic measures) in detail. Indications and contraindications of emetic and purgative therapies are described by Charak in [[Siddhi Sthana]].Appearance of [[pitta]] at the end of emesis and [[kapha]] at the end of purgation though described under signs of proper elimination, Chakrapani opines that they may also occur in inappropriate purification (''asamyakshudhhi''). Therefore additionally associated signs like emaciation (''karshya''), weakness (''daurbalya'') and lightness of the body (''laghavata'') only indicate appropriate purification.

In seminar held on the topic of “Determination of appropriateness of medicaments for enema” [ Cha. Sa. [[Siddhi Sthana]] 11]. Saunaka said “Amongst the fruits, ''Jimutaka'' is the foremost in efficacy for [[basti]] (medicated enema) because of its effect to eliminate [[kapha]] and [[pitta]]. Atreya concluded that ''Jimutaka'' is useful for the treatment of ''kushtha'' (skin diseases including leprosy), while ''Madanaphala'' is not contraindicated in any disease. He further writes that there is no drug that is absolutely free from any side effects - good or bad. One has to think of a drug which possesses more of good attributes in the treatment of a particular ailment.[Cha. Sa. [[Siddhi Sthana]] 11/ 5-14].To make it more explicit the physician has to judiciously evaluate ''rogibala'' (strength of patient) and ''rogabala'' (severity of disease) to draft suitable therapeutic regimens.

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</div></div>

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''Jimutaka'' when administered with appropriate drugs cures diseases caused by all the three ~~''doshas''~~. It is useful in fever, dyspnea, hiccup and similar other disorders. [4]

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''Jimutaka'' when administered with appropriate drugs cures diseases caused by all the three [[dosha]]. It is useful in fever, dyspnea, hiccup and similar other disorders. [4]

=== Various Preparations ===

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Jimutaka endowed with all attributes, growing in appropriate land should be collected according to the prescribed procedures as described in earlier chapter(Madanaphala kalpa 1:9,10,14).

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Milk should be prepared with its flowers, milky gruel with freshly appeared fruits, milk cream with hairy fruits, curd with non hairy one and sour curd from milk boiled with the pale green fruit. Fully matured fruit is dried, powdered well and kept in a clean container. One suffering from ailments caused by vata and pitta should take one shukti (20 gm) of this preparation.[5-7]

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Milk should be prepared with its flowers, milky gruel with freshly appeared fruits, milk cream with hairy fruits, curd with non hairy one and sour curd from milk boiled with the pale green fruit. Fully matured fruit is dried, powdered well and kept in a clean container. One suffering from ailments caused by [[vata]] and [[pitta]] should take one shukti (20 gm) of this preparation.[5-7]

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</div></div>

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The fruits of Jimutaka should be macerated in sura -manda (the supernatant part of alcohol) overnight. Thereafter it is stirred and the juice is strained. It can be taken in anorexia due to kapha, cough, anemia and wasting diseases. [8]

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The fruits of Jimutaka should be macerated in sura -manda (the supernatant part of alcohol) overnight. Thereafter it is stirred and the juice is strained. It can be taken in anorexia due to [[kapha]], cough, anemia and wasting diseases. [8]

Two or three fruits of bristly luffa should be squeezed and put into the decoction of either Guduchi, Yashti , Kovidara, Karbudara, Nipa, Vidula, Bimbi, Shanpushpi,Sadapushpi, Apamarga ,Nimba or Kutaja and should be kept overnight. It should then be strained and taken as potion in the manner already described in madanaphala kalpa.[9]

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Or the powder of Jimutaka may be taken with any one of the decoction of the Aragvadhadi seven drugs mentioned in Madanaphala kalpa i.e Aragwadha, Vrukshaka, Swadukantaka (Babbul or Gokshura), Patha, Patala, Gunja and Murva according to the procedure described in the previous chapter, by a person suffering from fever of Pitta and Kapha origin. [10]

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Or the powder of Jimutaka may be taken with any one of the decoction of the Aragvadhadi seven drugs mentioned in Madanaphala kalpa i.e Aragwadha, Vrukshaka, Swadukantaka (Babbul or Gokshura), Patha, Patala, Gunja and Murva according to the procedure described in the previous chapter, by a person suffering from fever of [[Pitta]] and [[Kapha]] origin. [10]

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</div></div>

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In fever due to Pitta –and-kapha or Vata-and-Pitta, the powder of Jimutaka should be administered with the juice of one of the four drugs viz. Jivaka, Rushabhaka, Ikshu or Shatavari. [12]

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In fever due to [[Pitta]] –and-[[kapha]] or [[Vata]]-and-[[Pitta]], the powder of Jimutaka should be administered with the juice of one of the four drugs viz. Jivaka, Rushabhaka, Ikshu or Shatavari. [12]

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== Vidhi Vimarsha (Applied Inferences)==

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Emetics should be administered with vehicles depending on ''dosha''. For example in ''pitta'' dominant conditions drugs are administered with milk, ''draksha, amalaka, parushaka'', etc., honey and ''gomutra'' are employed in ''kapha dosha'' and with ''sura'' (wine) and other fermented drinks, curd etc. in ''vata dosha''. Gangadhara described the use of ''jimutaka'' in kotha (urticaria) and he also commented that Hikkadi includes Kasa. Chakrapani specifically indicates that diseases which are due to urogatadosha should be considered under hikkadi.

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Emetics should be administered with vehicles depending on [[dosha]]. For example in [[pitta]] dominant conditions drugs are administered with milk, ''draksha, amalaka, parushaka'', etc., honey and ''gomutra'' are employed in [[kapha]] [[dosha]] and with ''sura'' (wine) and other fermented drinks, curd etc. in [[vata]] [[dosha]]. Gangadhara described the use of ''jimutaka'' in kotha (urticaria) and he also commented that Hikkadi includes Kasa. Chakrapani specifically indicates that diseases which are due to urogatadosha should be considered under hikkadi.

Chakrapani mentions the use of freshly appeared fruit in the preparation of milk gruel. Arunadatta comments there are two varieties of ''Jimutaka'' fruits viz ''Mridu'' and ''Kathina'' , based on their hairy and non hairy texture.<ref>Arunadatta, Vagbhata. Kalpa Sthana, amana Kalpa Adhyaya verse 21. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref> Fruits described as ''Haritapandu'' should be of moderate growth and of texture that lies between hairy and non hairy ones.

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Jimutaka Kalpa Adhyaya (view source)

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