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[[Madanakalpa Adhyaya]] (pharmaceutical preparations)is the very first chapter of [[Kalpa Sthana]] of [[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, it is known as [[Madanakalpa Adhyaya#Vamana (therapeutic emesis) and Virechana (therapeutic purgation)|''Virechana sanjna''  (evacuative) [Cha. Sa. [[Kalpa Sthana]] 1/4]
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[[Madanakalpa Adhyaya]] (pharmaceutical preparations)is the very first chapter of [[Kalpa Sthana]] of [[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 [[dosha]](impurities) from gastro-oral route whereas  from lower tract- through anus it is known as purgative. Since impurities are eliminated in both the cases, it is known as [[Madanakalpa Adhyaya#Vamana(therapeutic emesis) and Virechana(therapeutic purgation)|''Virechana sanjna''  (evacuative) [Cha. Sa. [[Kalpa Sthana]] 1/4] ]]
    
=== Salient features of [[Kalpa Sthana]] ===
 
=== Salient features of [[Kalpa Sthana]] ===
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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.  
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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 ====
 
==== Factors responsible for therapeutic efficacy ====
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==== Pharmacokinetics of Drugs ====
 
==== Pharmacokinetics of Drugs ====
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Drugs (used for emesis and purgation) which are ''ushna'' (hot), ''tikshna'' (sharp), ''sukshma'' (subtle), ''vyavayi'' (those pervading the entire body before getting digested) and ''vikasi'' (those causing looseness of joints), by virtue of their own potency, reach the heart and circulate through the vessels. Because of their ''agneya'' nature (predominance of [[agni mahabhuta]], or fire element), they liquefy the compact form of (adhered) [[dosha]] (morbid material), and because of their sharpness (''tikshna'' attribute) they separate the adhered [[dosha]] located in the gross and subtle channels of the entire body.  Like honey kept in the pot smeared with fat, the morbid material, after separation, moves floating without adhesion in the body which has been oleated (by the administration of oleation therapy). Because of its nature to move through subtle channels and to flow (towards the gastrointestinal tract), this morbid material reaches the stomach, and gets propelled by ''udana vayu''. Because of the predominance of [[agni mahabhuta]] and [[vayu mahabhuta]] in these (emetic) drugs, and because of their specific action to move upwards, the morbid material gets expelled through the upward tract (mouth). On the other hand, purgative drugs, because of the predominance of ''prithvi'' and ''jala mahabhutas'', and because of their specific action, (''prabhavajanya'') move downwards to expel the morbid material through the downward tract (anus). Combination of both these attributes result in the expulsion of the morbid material through both the upward and downward tracts.
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Drugs (used for emesis and purgation) which are ''ushna'' (hot), ''tikshna'' (sharp), ''sukshma'' (subtle), ''vyavayi'' (those pervading the entire body before getting digested) and ''vikasi'' (those causing looseness of joints), by virtue of their own potency, reach the heart and circulate through the vessels. Because of their ''agneya'' nature (predominance of [[agni mahabhuta]], or fire element), they liquefy the compact form of (adhered) [[dosha]] (morbid material), and because of their sharpness (''tikshna'' attribute) they separate the adhered [[dosha]] located in the gross and subtle channels of the entire body.  Like honey kept in the pot smeared with fat, the morbid material, after separation, moves floating without adhesion in the body which has been oleated (by the administration of oleation therapy). Because of its nature to move through subtle channels and to flow (towards the gastrointestinal tract), this morbid material reaches the stomach, and gets propelled by ''udana vayu''. Because of the predominance of [[agni mahabhuta]] and [[vayu mahabhuta]] in these (emetic) drugs, and because of their specific action to move upwards, the morbid material gets expelled through the upward tract (mouth). On the other hand, purgative drugs, because of the predominance of [[prithvi]] and [[jala mahabhuta]], and because of their specific action, (''prabhavajanya'') move downwards to expel the morbid material through the downward tract (anus). Combination of both these attributes result in the expulsion of the morbid material through both the upward and downward tracts.
    
==== Similarities/ Dissimilarities of ''virya'' ====
 
==== Similarities/ Dissimilarities of ''virya'' ====
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==== ''Snehapaka'' (preparation of medicated oil or ghee) ====
 
==== ''Snehapaka'' (preparation of medicated oil or ghee) ====
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[[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''.
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[[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 ====
 
==== Purification of drugs ====
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==== Sushruta's perspective of Kalpa sthana ====
 
==== Sushruta's perspective of Kalpa sthana ====
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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 Charak and Sushruta, but Sushruta included triphala, erandataila under virechana drugs.
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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 Charak and Sushruta, but Sushruta included triphala, erandataila under virechana drugs.
    
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. Sutra Sthana, Cha.44 Virechanadravyavikalpaneeya Adhyaya verse 72-77. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>
 
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. Sutra Sthana, Cha.44 Virechanadravyavikalpaneeya Adhyaya verse 72-77. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>
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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.
 
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). 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.  
 
Ayurvedic classical texts atributed anti-diarrhoel activity to kutaja (Stem bark & seeds). 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.
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''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 [[jala mahabhuta]] dominant drugs, which can support the main ''virechaka'' drugs for inducing purgative action.
    
To summarize the content of ''Kalpa sthana'' of 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 through evidence based clinical trials which were in vogue during those times.
 
To summarize the content of ''Kalpa sthana'' of 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 through evidence based clinical trials which were in vogue during those times.
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