INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE Bi-Monthly Peer Reviewed International Journal

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1 Vol-2 / Issue - 6 / Nov - Dec Free Full I J A A M INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE Bi-Monthly Peer Reviewed International Journal

2 RESEARCH ARTICLE Global Impact Factor (GIF) (2013) ANALYTICAL STUDY ON EFFECTS OF TRIKATUKADI DECOCTION IN THE MANAGEMENT OF PAKSHAGHATA (HEMIPLEGIA) Ranasinghe R.L.D.S 1*, Ediriweera E.R.H.S.S 2 1. Medical Officer, Post Graduate Scholar, Department of Nidana Chikitsa, Institute of Indigenous Medicine, University of Colombo, Sri Lanka, Contact No , - rlsandu@gmail.com 2. Professor, Department of Nidana Chikitsa, Institute of Indigenous Medicine, University of Colombo, Sri Lanka, Contact No E mail- ayurvedadocsujatha@yahoo.com Article Received on - 18 th Nov 2014 Article Revised on - 5 th Dec 2014 Article Accepted on - 8 th Dec 2014 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

3 RESEARCH ARTICLE ANALYTICAL STUDY ON EFFECTS OF TRIKATUKADI DECOCTION IN THE MANAGEMENT OF PAKSHAGHATA (HEMIPLEGIA) *Corresponding Author Ranasinghe R.L.D.S Medical officer, Post Graduate Scholar, Department of Nidana Chikitsa, Institute of Indigenous Medicine, University of Colombo, Rajagiriya, Sri Lanka, Contact No , - rlsandu@gmail.com QR Code IJAAM ABSTRACT: Sri Lanka has a great history of traditional medical system. Trikatukadi Decoction is an Anupana of Seetarama Vati which is mostly used by traditional medical physicians in the management of diseases like Pakshaghata, Akshepa and Apasmara. The present study aims to understand the pharmacological attributes of the ingredients of Trikatukadi Decoction and its reaction on Pakshaghata. This decoction contains rhizome of Zingiber officinale, Cyperus rotundus, Acorus calamus, Picrorhiza kurroa, seeds of Piper longum, Piper nigrum, Coriandrum sativum, pericarp of Terminalia chebula, Terminalia bellirica, Phyllanthus emblica, bark of Azadirachta indica, and stem of Tinospora cordifolia. According to Ayurvedic pharmacodynamic properties, Trikatukadi Decoction pacifies vitiated Vata Dosha due to Rasa, Snigdha Guna, Veerya and Vipaka. Having Laghu Guna, Guna and Vipaka, it also pacifies vitiated Kapha Dosha. It also has properties of Vedana sthapana, Nadi uttejaka, Nadi balyakara, Shulahara, Deepana, Jvaraghna, Mutra karaka and Sroto shodhana. Ingredients of the Trikatukadi Decoction contain alkaloids, flavanoides, glycosides, tannin and volatile oils. Further, these phytochemicals are found to possess antioxidant, anti-inflammatory, anti-cholinergic, anti-carcinomic, anti microbial, diuretic and hypoglycaemic activities. Trikatukadi Decoction can be effectively used to manage Pakshaghata due to its pharmacodynamic properties, phytochemicals and scientifically proven bioactivities. Key Words: Trikatukadi Decoction, Pakshaghata, Anupana, Paralysis, Phytochemicals. INTRODUCTION Pakshaghata is one among the Nanatmaja Vata Vyadhi. [1] Maharshi Charaka describes Pakshaghata is a disease that morbid Vata beholds either side of body, dries up Sira (Vessels) and Snayu (Nerves) of that part rendering it dead and producing Cheshta- Nivritti (Loss of functions) along with Ruja (Pain) and Vakstambha. [2]. It is considered as a disease of Madhyama Roga Marga. The diseases occurred due to the lesions of Marma, Asthi or Sandhi are categorized under Madhyama Roga Marga. [3] The clinical entity of Pakshaghata can be correlated with Hemiplegia; the disease with paralysis of one side of the body. [4] It is one of the most frequent clinical presentations of Stroke and the third leading cause for death in the world. Sri Lanka has a great history of Traditional Medical System which is dated back to the period of King Ravana. Using Anupana is quite popular among this fraternity. Anupana is a fluid vehicle for medicine. [5] It is useful while administrating drug preparations such as Kalka (Paste) and Vati (Pills). Trikatukadi Decoction, an Anupana of Seetarama Vati is successfully used by traditional physicians as well as Ayurveda physicians in the treatment of Pakshaghata. A large number of patients effectively managed with Trikatukadi Decoction in Ayurveda Teaching Hospital, Sri Lanka too. So far, no scientific study has been conducted to evaluate the efficacy of this potent drug, Trikatukadi Decoction. The present study aims to the pharmacological attributes of the ingredients of Trikatukadi Decoction. MATERIALS & METHODS Data were collected from Sri Lankan traditional and Authentic Ayurvedic texts, scientific journals & using Web sources. Interviews were conducted with Traditional physicians to gather knowledge. Then the collected data were analyzed. RESULTS Vatika Prakaranaya, written by Aylapperuma is a valuable Sri Lankan Traditional Medicine Text. It is a compilation of various Vati (Pills) and Kalka (Pastes) which are used by Sri Lankan Traditional Medical practitioners. Formula of Trikatukadi Decoction is given below according to Vatika Prakaranaya. [6] [Table No 01] Method of preparation of Trikatukadi Decoction. Kalan and Pala are the units of measuring weight which are mentioned in both Indian and Sri Page22

4 Lankan pharmacopeias. In both systems 1 Pala is equalized to 12 Kalan. In Sri Lanka 1 Pala is considered as 60 g [7] while in India as 48 g. [8] Method of the preparation of decoctions is mentioned in chapter 2, Kwatha kalpana of Sharangadhara Samhita. [9] According to that, one Pala (48 g) of coarsely powdered drug should be boiled with 16 parts (48x 16= 768 ml) of water in an earthen pot, over a mild fire till the liquid is reduced to one eighth (96 ml) of the original quantity. But traditional physicians of Sri Lanka have been followed a different method. According to that, one Pala (60 g) of coarsely powdered drug is boiled with 8 Pata (240x8= 1920 ml) of water and reduce to one eighth (240 ml). Dosage of Trikatukadi Decoction 120 ml of Trikatukadi Decoction was given two times per day before meal with 2-3 Seetarama pills. Indications of Trikatukadi Decoction [6] In Vatika Prakaranaya, it is advised to give Trikatukadi Decoction in the treatment of Jvara and Sanni. Vata vyadhis such as Akshepa, Pakshaghata and Apasmara are described under the term of Sanni. Ayurveda pharmacodynamic properties and other properties of ingredients of Trikatukadi Decoction. Ingredients of Trikatukadi Decoction have various properties which are capable of pacifying vitiated Dosha. Rasa, Guna, Veerya, Vipaka and Dosha karma of these ingredients are given in Table No 02. Botanical name Table 01: Ingredients of Trikatukadi Decoction Family Sanskrit Name Local Name Part Used Propor tion Zingiber officinale Zingiberaceae Shunti Inguru Rhizome 5g Piper nigrum Pipraceae Maricha Gammiris Fruit 5g Piper longum Pipraceae Pippali Tippili Fruit 5g Terminalia chebula Combretaceae Haritaki Aralu Pericarp 5g Terminalia bellirica Combretaceae Vibhitaka Bulu Pericarp 5g Phyllanthus emblica Euphorbiaceae Amlaki Nelli Fruit 5g Coriandrum sativum Umbelliferae Dhanyaka Kottamalli Dried 5g Fruit Acorus calamus Araceae Vacha Vadakaha Rhizome 5g Picrorhiza kurroa Scrophulariaceae ka karosana Root 5g Azadirachta indica Meliaceae Nimba Kohomba Bark 5g Tinospora cordifolia Menispermceae Guduchi Rasakinda Stem 5g Cyperus rotundus Cyperaceae Mustaka Kalanduru Rhizome 5g Table 02: Ayurveda pharmacodynamic properties and other properties of ingredients of Trikatukadi Decoction. [10]- [21] Ingredient Rasa Guna Veerya Vipaka Dosha Karma Other Properties Shunti Maricha Pippali Haritaki Vibhitaka Amlaki Dhanyaka, Tikta, Amla,,, Amla,,,, Snigdha, Teekshna Anushna Laghu Sheeta Snigdha Kapha, Vata Vata, Pitta Kapha, Vata Kapha, Vata Tridosha Tridosha Tridosha Nadi uttejaka, Deepana, Pachana, Rakta shodhana Nadi uttejaka, Balya, Vata aulomana, Deepana, Pachana Medhya, Shula prashamana, Vata anulomana Vedana sthapana, Shothahara, Nadi balakaraka, Medhya, Rasayana Vedana sthapana, Shothahara Medhya, Nadi balakaraka, Deepana, Rochana, Vata anulomana, Yakrut uttejaka Shula prashamana, Shothahara, Deepana, Pachana, Yakrut uttejaka, Mutrala Page23

5 Vacha Teekshna ka Nimba Guduchi Mustaka Tikta, Sheeta Laghu Sheeta Guru, Snigdha Sheeta Kapha, Vata Kapha, Pitta Kapha, Pitta Tridosha Kapha, Pitta Mashtishka balakaraka, Nadi balakaraka, Medhya, Rasayana Rakta shodhana, Hrudya, Yakrut uttejaka, Deepana Rochana, Rakta shodhana, Yakrut uttejaka Vedana sthapana, Deepana, Pachana, Vata anulomana, Rakta shodhana Nadi balakaraka, Medhya, Balya, Rakta prasadana Table 03: Phytochemicals of ingredients of Trikatukadi Decoction [22] - [33] Ingredient Zingiber officinale Piper nigrum Piper longum Terminalia chebula Terminalia bellirica Phyllanthus emblica Coriandrum sativum Acorus calamus Picrorhiza kurroa Azadirachta indica Tinospora cordifolia Cyperus rotundus Phytochemical Containing Zingerone, Shogaol, Camphene, Phellandrene, Zingiberene, Cineol, Borneol, Gingerol, Gingerin, Resins, Geraniol Acid resin, Oleoresin, Volatile oil, Starch, Gum, fatty oil, Akaloids, Chavicine, Piperidine, Piperovatine Piperine, Volatile oil, Resin Gallic acid, Tannic acid, Chebulinic acid, Myrobalanin Tannin, Gallic acid, Chebulegic acid, Alpha sitesterol Triterpenoides, Flavanoides- lupeol, Lupenone, Quercetin, Kaempferol, Tanninsphyllembin, gallotannin, Alkaloids, Phenolic Acid Volatile oil, Pentosan, Furfurol, Pectin, Vit C, Potassium malate Alkaloid mainly choline, Acorin a glucoside, Aromatic volatile oil, Alkaloid Choline, Acorin - a glucoside, Beta-asarone Calamine, Calamenone, Calaminol, Alcohol, Tannin Glucoside, Picrorhizin, Picrorhizitine, Kuktin, Apocynin, D-mannitol, Vanillic acid Margozine Tinosporin, Furanoid deterpine, Giloin, Giloinin, Berberin, Waxy subatance Essential oil, Alkaloid, Albuminous matter, Alpha cyperone Table 04: Bioactivities of ingredients of Trikatukadi Decoction [34] - [47] Bioactivity Antioxidant Anti-inflammatory Anti tumour Analgesic Anti bacterial Immunomodulatory Diuretic Anti biotic Hypoglycemic Antihyperlipidaemic Ingredients Picrorhiza kurroa, Cyperus rotundus, Phyllanthus emblica, Piper nigrum Cyperus rotundus, Picrorhiza kurroa, Piper longum, Zingiber officinale Acorus calamus, Picrorhiza kurroa Piper nigrum, Piper longum, Tinospora cordifolia, Phyllanthus emblica Piper nigrum, Coriandrum sativum, Cyperus rotundus Tinospora cordifolia, Piper longum Phyllanthus emblica, Coriandrum sativum Cyperus rotundus Phyllanthus emblica Picrorhiza kurroa, Acorus calamus Phytochemicals of ingredients of Trikatukadi Decoction Phytochemicals are chemical compounds that occur naturally in plants. Different phytochemicals have been isolated from the ingredients of Trikatukadi Decoction. They are tabulated below. [Table No 03] Bioactivities of ingredients of Trikatukadi Decoction Ingredients of Trikatukadi Decoction are found to possesses different bioactivities according to their phytochemical content. Some of these activities are scientifically proven by researches. Those bioactivities are given in the following table. [Table No 04] DISCUSSION Pakshaghata is a disease occurred due to vitiation of Vata and Kapha Dosha. In the treatment of Pakshaghata it is essential to pacify vitiated these Doshas. According to Ayurveda pharmacodyanamic properties, Trikatukadi Decoction has ability to pacifying vitiated Vata Dosha as it is having Rasa, Snigdha Guna, Veerya and Vipaka. It pacifies vitiated Kapha Dosha by, Rasa, Laghu Guna, Page24

6 Guna, Veerya and Vipaka. It is capable of pacifying vitiated Pitta Dosha due to its Rasa, Snigdha Guna, Sheeta Veerya and Vipaka. In the Samprapti (Pathogenesis) of Pakshaghata it is described that the Pakshaghata is a resultant of Srotorodha (obstruction of body channels), Dhatu kshaya (emaciation) or Marma abhighata (damage to the vital points). Increased Kapha Dosha and Ama lead to obstruction of the Srotas. Due to its Tikta Rasa, Laghu Guna and Veerya it performs Ama pachana effect in the body. Then it eliminates Srotorodha (obstruction of body channels), occurred due to Ama as well as Kapha. The properties of ingredients of Trikatukadi Decoction would be instrumental in restoring the Gati (motor activities) and Gandhana (Sensation). Symptoms of aggravated Vata in Vatavaha srotas and Nadi such as Cheshta nasha (Loss of activities), Sandhi shaitilya (Loosens of the joints), Vaktardra vakrata (Deviation of mouth), Gadgada (Stammering of speech), Jihva sphurana (Fasciculation of tongue) and Sajna hani (Loss of sensation) would be subsided. Phytochemicals of ingredients are also affecting the action of Trikatukadi Decoction. Alpha cyperone, a phytochemical found in Cyperus rotundus has the ability to minimize nerve damage due to its anti-inflammatory action. Kutkin and Piperine helps to improve the outcome of patients by reducing inflammatory features at the site of the brain damage. Kutkin as well as Tinosporine are anti oxidants which are capable of relieving the oxidative stress occurred due to free radicals. They reduce the risk of atherosclerosis, stroke and hypertension by neutralizing the damaging effects of free radicals. Beta-asarone and Curcubitacins are having hypolipidaemic action reduce coagulation time and acts against the formation of Atheroma. Beta-asarone further inhibits adipogenesis and help to reduces lipid accumulation in fat cells. Acorin, a neuroprotective strengthen the memory against stroke and chemically induced neuro degeneration. Rotundine A, B and C are having hypotensive action and decrease blood pressure. All these bioactivities may be beneficial in the management of Pakshaghata (Hemiplegia) where the lesion is Haemorrhagic, Thrombotic or Embolic. CONCLUSION It can be justified that due to its Ayurvedic pharmacodynamic properties and scientifically proven bioactivities of different phytochemicals of the ingredients, Trikatukadi Decoction can be used effectively in the management of Pakshaghata (Hemiplegia). REFERENCES 1. Sharma RK, Vaidya Bhagavan Dash. editors. Agnivesha, Charaka Samhita; English Translation. Sutra Sthana. 27. Vol. 1. Varanasi. Chaukhambha Prakashan p Caraka Samhita, Atreya Punarvasu, Jaikrishnadas Ayurveda Series, English Translation. Chikitsa Sthana. Vol 4. Varanasi. Chaukambha Orientalia p Sharma RK, Vaidya Bhagavan Dash. editors. Agnivesha, Charaka Samhita; English Translation. Sutra Sthana. 11. Vol. 1. Varanasi. Chaukhambha Prakashan p Kumar P, Clark M. Essentials of Clinical Medicine. 5 th Edi. China. Saunders Elsevier p Williems MM. Sanskrit English Dictionary. Corrected ed. New Delhi. Motilal Banarsidass p Aylapperuma ESDA. Vatika Prakaranaya, The text book of Treatment on Pills. 4th ed. Colombo. Granthaprakasha Press p [Anonymous].Ayurveda pharmacopeia Vol 1. Part 1, Colombo: Department of Ayurveda p Srikanta Muthy K. R. Sarangadhara Samhita. English translation. 3rd ed. Varanasi. Chaukhambha Orientalia p Srikanta Muthy K. R. Sarangadhara Samhita. English translation. 3rd ed. Chapter 2.Varanasi. Chaukhambha Orientalia p [Anonymous].Ayurveda pharmacopeia Vol 1. Part 3, Colombo. Department of Ayurveda p Ibid p Ibid p Ibid p Ibid p Ibid p Ibid p [Anonymous].Osuthuru Visithuru Vol 2. Colombo. Department of Ayurveda p [Anonymous].Ayurveda pharmacopeia Vol 1. Part 3, Colombo. Department of Ayurveda p Ibid p Ibid p Ibid p Jayaweera, DMA. Medicinal Plants (Indigenous & Exotic) used in Ceylon. Part 5. Colombo. The National Science Council p Jayaweera, DMA. Medicinal Plants (Indigenous & Exotic) used in Ceylon. Part 4. Colombo. The National Science Council p Ibid. p Jayaweera, DMA. Medicinal Plants (Indigenous & Exotic) used in Ceylon. Part 2. Colombo. The National Science Council p Ibid. p Ibid. p Jayaweera, DMA. Medicinal Plants (Indigenous & Exotic) used in Ceylon. Part 5. Colombo. The National Science Council p Jayaweera, DMA. Medicinal Plants (Indigenous & Exotic) used in Ceylon. Part 1. Colombo. The National Science Council p Page25

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