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Kalpa Sthana deals with the study of formulations used in therapeutic purification procedures.
{{Infobox
{{Infobox
|title = [[Charaka Samhita]] Kalpa Sthana
|title = [[Charak Samhita]] Kalpa Sthana
|header1 = Sections
|header1 = Sections
|label2 = Preceding
|label2 = Preceding
|data2 = [[Chikitsa Sthana]]
|data2 = [[Chikitsa Sthana]]
|label3 = Succeeding
|label3 = Succeeding
|data3 = [[Siddhi Sthana]]
|data3 = [[Siddhi Sthana]]
|label5 = Subsequent Sections
|label4 = All Sections
|data5 = None
|data4 = [[Sutra Sthana]],[[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|header6 = Chapters
|header5 = Chapters
|label7 =
|label7 =
|data7 = [[Madanakalpa]], [[Jimutaka Kalpa]], [[Ikshavaku Kalpa]], [[Dhamargava Kalpa]], [[Vastaka Kalpa]], [[Kritavedhana Kalpa]], [[Shyamatrivrita Kalpa]], [[Chaturangula Kalpa]], [[Tilvaka Kalpa]], [[Sudha Kalpa]], [[Saptalashankhini Kalpa]], [[Dantidravanti Kalpa]] }}
|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 Samhita]] ==
==Preamble of Kalpa Sthana ==
<div style="text-align:justify;">A healthy individual is an asset to any society, while a sick individual will be a liability to his family in particular and the society at large. To keep oneself healthy, [[Ayurveda]] lays down the principles of various lifestyles in terms of daily regimen (''dinacharya''), seasonal regimen (''ritucharya'') and modified lifestyles to cure the diseases. Physical exercise for the preservation of health begins with adapting techniques for purification of the body and the mind along with an intake of ''rasayana'' drugs (rejuvenatives). Accumulated ''malas'' (metabolic waste) at the level of cell, tissue or organ should be expunged out to facilitate the restoration of normal functioning of the body by five purificatory procedures (''shodhana karma'') often referred as [[Panchakarma]], namely ''vamana'' (emesis), ''virechana'' (purgation), ''asthapana basti'' (evacuative enema), ''anuvasana basti'' (restorative enema), and ''shirovirechana'' (errhines) are indicated for healthy as well as diseased persons. If ''malas'' are not taken out of the body, they cause diseases and decay (ageing) of the body. After purification procedures, ''jatharagni'' (gastro-intestinal digestive juices) becomes weak and may not digest the food normally. For restoration of this function, the food that is easily digestible is introduced and increased gradually over a period of time and this procedure is called ''samsarjana karma''. Details of pharmaceutical process of drugs employed in ''vamana'' and ''virechana'' procedures are given in this section and detailed therapeutic implications of all the ''shodhana'' karma in [[Siddhi Sthana]].
''Vamana'' and ''virechana'' therapies should be administered before administering ''basti'' (medicated enema therapy). Therefore, ''vamana'' and ''virechana'' drugs are first described in [[Kalpa Sthana]] before the description of ''basti'' therapy, which is described in detail under [[Siddhi Sthana]]. Generally, purgation therapy is administered only after the administration of emetic therapy and keeping this view the first six chapters are allocated for description of emetic drugs.
Six drugs have been described for emesis and nine others are described for purgation. Six hundred recipes prepared from these drugs (Total 15 drugs) are for the use of physician of low caliber and intelligent physician can formulate many other recipes to suit the exact requirement of his patient. The formulations are prescribed according to disease in different dosage forms like ''kashaya'' (decoction), ''svarasa'' (juice), ''kalka'' (paste), ''churna'' (powder), ''peya'' (drinks), ''lehya'' (lickable), and ''bhojya'' (foods).
Six drugs are described for emesis and nine others are described for purgation. Six hundred recipes prepared from these drugs (Total 15 drugs) are for the use of physician of low caliber and intelligent physician can formulate many other recipes to suit the exact requirement of his patient. The formulations are prescribed according to disease in different dosage forms like ''kashaya'' (decoction), ''svarasa'' (juice), ''kalka'' (paste), ''churna'' (powder), ''peya'' (drinks), ''lehya'' (lickable), and ''bhojya'' (foods).
==== Table no 1: Kalpa Sthana Contents at a Glance====
==== [[Kalpa Sthana]] Contents at a glance====
{| class="wikitable"
{| class="wikitable"
! scope="col"| No. of Recipes
! scope="col"| No. of Recipes
! scope="col"| Part Used
! scope="col"| Part Used
! scope="col"| Botanical identification<ref>Thakur Balvant Sing and Chunekar K. C., Glossary of Vegetable Drugs in Brihattrayi, Chaukhamba Amarabharati Prakashan, Varanasi, Ed. (2015)</ref>
|-
|-
| 1
| 1
| [[Madanakalpa]]
| [[Madanakalpa Adhyaya]]
| 30
| 30
| ''Madanaphala''
| ''Madanaphala''
| 133
| 133
| Fruit and Flower
| Fruit and Flower
| ''Randia dumetorum''
|-
|-
| 2
| 2
| [[Jimutaka Kalpa]]
| [[Jimutaka Kalpa Adhyaya]]
| 15
| 15
| ''Jimutaka''
| ''Jimutaka''
| 39
| 39
| Fruit and Flower
| Fruit and Flower
| ''Luffa echinata'' Roxb.
|-
|-
| 3
| 3
| [[Ikshavaku Kalpa]]
| [[Ikshvaku Kalpa Adhyaya]]
| 23
| 23
| ''Ikshavaku''
| ''Ikshvaku''
| 45
| 45
| Leaf, Fruit, Seed
| Leaf, Fruit, Seed
| ''Lagenaria siceraria'' Standl.
|-
|-
| 4
| 4
| [[Dhamargava Kalpa]]
| [[Dhamargava Kalpa Adhyaya]]
| 20
| 20
| ''Dhamargava''
| ''Dhamargava''
| 60
| 60
| Fruit, Flower, Tender Leaves
| Fruit, Flower, Tender Leaves
| ''Luffa cylindrica'' (Linn.) M. Roem.
|-
|-
| 5
| 5
| [[Vatsaka Kalpa]]
| [[Vatsaka Kalpa Adhyaya]]
| 12
| 13
| ''Vatsaka''
| ''Vatsaka''
| 18
| 18
| Fruit
| Fruit
| ''Holarrhena antidysenterica'' Wall.(male ''Kutaja'')and ''Wrightia tinctoria'' R.Br.(or W. tomentosa Roem. & Schult.)(female ''Kutaja'')
|-
|-
| 6
| 6
| [[Kritavedhana Kalpa]]
| [[Kritavedhana Kalpa Adhyaya]]
| 14
| 14
| ''Kritavedhana''
| ''Kritavedhana''
| 60
| 60
| Flower, Fruit
| Flower, Fruit
| ''Luffa acutangula'' (Linn.)
|-
|-
| 7
| 7
| [[Shyamatrivrita Kalpa]]
| [[Shyamatrivrita Kalpa Adhyaya]]
| 80
| 80
| ''Shyama'', ''Trivrita''
| ''Shyama'', ''Trivrita''
| 110
| 110
| Root
| Root
| ''Ipomoea petaloidea'' Chois.(Shyama trivrita),Operculina turpethum (Arun trivrita)
|-
|-
| 8
| 8
| [[Chaturangula Kalpa]]
| [[Chaturangula Kalpa Adhyaya]]
| 18
| 18
| ''Araghvadha''
| ''Araghvadha''
| 12
| 12
| Fruit
| Fruit
| ''Cassia fistula'' Linn.
|-
|-
| 9
| 9
| [[Tilvaka Kalpa]]
| [[Tilvaka Kalpa Adhyaya]]
| 18
| 18
| ''Tilvaka''
| ''Tilvaka''
| 16
| 16
| Root, Bark
| Root, Bark
| ''Viburnum nervosum''(According to Thakur Balavant Singh)
|-
|-
| 10
| 10
| [[Sudha Kalpa]]
| [[Sudha Kalpa Adhyaya]]
| 22
| 22
| ''Sudha''
| ''Sudha''
| 20
| 20
| Milky Latex
| Milky Latex
| ''Euphorbia neriifolia'' Linn.
|-
|-
| 11
| 11
| [[Saptalashankhini Kalpa]]
| [[Saptalashankhini Kalpa Adhyaya]]
| 19
| 19
| ''Saptala'', ''Shankhini''
| ''Saptala'', ''Shankhini''
| 36
| 36
| Root (of ''Saptala''), Fruit (of ''Shankhini'')
| Root (of ''Saptala''), Fruit (of ''Shankhini'')
| ''Euphorbia dracunculoides'' Lam. and ''Colonyction muricatum'' G Don.
|-
|-
| 12
| 12
| [[Dantidravanti Kalpa]]
| [[Dantidravanti Kalpa Adhyaya]]
| 107
| 107
| ''Danti'', ''Dravanti''
| ''Danti'', ''Dravanti''
| 49
| 49
| Root
| Root
| ''Baliospermum montanum'' Muell.-Arg.
|-
|-
! scope="row"|Total
! scope="row"|Total
|
|
| 378
| 379
|
|
| 600
| 600
|
|
|}
|}
[[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.Ka.1/4)]]
=== Salient features of [[Kalpa Sthana]] ===
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 ====
Four important factors for producing maximum therapeutic efficacy of these drugs are identified. ''Deshasampat'' (collecting the plant from appropriate habitat), ''kalasampat'' (collecting the drugs in the appropriate season), ''gunasampat'' (collecting the plants when they are enriched with excellent attributes like ''rasa'', ''guna'', ''virya'', etc.) and ''bhajanasampat'' (storage of drugs in appropriate container).
Four important factors for producing maximum therapeutic efficacy of these drugs are identified. ''Deshasampat'' (collecting the plant from appropriate habitat), ''kalasampat'' (collecting the drugs in the appropriate season), ''gunasampat'' (collecting the plants when they are enriched with excellent attributes like ''rasa'', ''guna'', ''virya'', etc.) and ''bhajanasampat'' (storage of drugs in appropriate container).
==== Pharmacokinetic of Drug ====
==== Pharmacokinetics of Drugs ====
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) ''doshas'' (morbid material), and because of their sharpness (''tikshna'' attribute) they separate the adhered ''doshas'' 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 gastro-intestinal tract), this morbid material reaches the stomach, and gets propelled by ''udana vayu''. Because of the predominance of ''agni'' and ''vayu mahabhutas'' in these (emetic) drugs, and because of their specific action (''prabhavajanya'') 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.
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) ''doshas'' (morbid material), and because of their sharpness (''tikshna'' attribute) they separate the adhered ''doshas'' 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'' and ''vayu mahabhutas'' 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.
==== Similarities/ Dissimilarities of ''virya'' ====
==== Similarities/ Dissimilarities of ''virya'' ====
Sometimes, the drugs of secondary nature (mixed with main drug) have antagonistic property. Even then they do not contradict the effects of the principal drug. If these drugs of secondary nature are similar in potency as that of the principal drugs, then the recipe becomes all the more effective therapeutically. Trituration, boiling etc. are considered ''samskaras'' which bring in chemical changes in the chemical structure of the drug which results in potentiation or neutralization of the drug activity.
Sometimes, the drugs of secondary nature (mixed with main drug) have antagonistic property. Even then they do not contradict the effects of the principal drug. If these drugs of secondary nature are similar in potency as that of the principal drugs, then the recipe becomes all the more effective therapeutically. Trituration, boiling etc. are considered ''samskaras'' which bring in chemical changes in the chemical structure of the drug resulting in the modification of the drug activity.
==== Modification of drug activity ====
==== Modification of drug activity ====
==== Weight and measures ====
==== 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 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.
Two traditions for ''mana'' (weight and measures) are mentioned in [[Kalpa Sthana]], namely, ''Kalinga'' (part of present Orissa) and ''Magadha'' (part of present Bihar). 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) ====
==== ''Snehapaka'' (Dosage form) ====
[[Charaka 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''.
[[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 ====
To reduce the toxicity (''vikasi guna'') of ''Danti'' and ''Dravanti'', Charaka 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 Charaka. In the medieval ages, ''Rasashastra'' texts adopted several purificatory procedures for various herbal and metallic drugs.
To reduce the toxicity (''vikasi guna'') of ''Danti'' and ''Dravanti'', 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 Charak. 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 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 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 ===
=== 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]].
''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 weight). 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. 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. 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 Charak which are controversial and not being preferred in current practice.
The procedures described by 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, Charak and other acharyas advocate the collection of various parts of medicinal plants based on the 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 [[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). 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 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.
=== Important concepts in Kalpa Sthana ===
* Mode of action of [[Vamana]] and [[Virechana]] (Chapter 1 Verse 5)
* Factors responsible for potency of drug (Chapter 1 verse 7)
* Selection of soil and desha classification for collecting good quality medicinal plants (Chapter 1 verse 7-8)
* Ideal and forbidden areas for collecting medicinal plants (Chapter 1 verse 9)
* Time period of collection and harvesting herbs (Chapter 1 verse 10)
* Storage of herbs (Chapter 1 verse 11)
* Concept of [[Anupana]] (vehicle) (Chapter 1 verse 12)
* Nasal drug delivery of herbs (Chapter 1 verse 19, Chapter 3 verses 11-12, Chapter 4 verse 10, Chapter 10 verse 17)
* Concept of ascending dosage schedule (vardhamana matra) (Chapter 3 verse 13)
* Development of different dosage forms of purgatives according to constitution (Chapter 7 verse 28)
* Formulation of purgative drugs according to seasons (Chapter 7 verse 56 and 59)
* Formulation designing according to koshtha(Chapter 10 verse 17)
* Principles of indicating nomenclature of formulation (Chapter 12 verse 44)
* Concept of potentiation of drugs including the theory of antogonism and synergism (Chapter 12 verse 45-48)
* Categorization or classification of therapeutic response into mild, moderate and severe categories (Chapter 12 verse 50-56)
* Importance of assessment of roga bala and rogi bala ( severity of disease and strength of patient) for prescribing purification procedures(Chapter 12 verse 60)
* Management of residual [[dosha]] with food and medicated decoctions after purification therapies (Chapter 12 verse 66)
* Concept of examination of koshtha (status of gastrointestinal tract) while administering [[vamana]] and [[virechana]] drugs (Chapter 12 verse 67)
* Concept of sneha and ruksha [[virechana]] (Chapter 12 verse 82-83)
* Inhibiting factors fro prevention of purgative actions (Chapter 12 verse 80)
* Concept of posology based upon koshtha(status of gastro intestinal tract), vaya(age) and bala(strength) (Chapter 12 verse 86)
=== Important areas of research and its clinical applications ===
* Standardization of procedure of [[vamana]] and [[virechana]] karma
* Standardization of processes of different dosage forms
* Studies on procedures and processing of different [[anupana]] like Kwatha, Yavagu, Ksheerapaka, Swarasa, Shashkuli, Shadava, Raga, Shukta, Suramanda, Asava, Sura, Varit, Krishara, Panaka, Sauvira, Tushodaka, Avaleha, Shritapaka, Seedhu, Utkarika
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==References==