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1 ISSN International, Peer reviewed, Open access, Monthly Online Journal Review Article HEPATOPROTECTIVE PROPERTY OF VARNYA MAHAKASHAYA AN INNOVATIVE INSIGHT Sapna Narasanagi 1 *, Sujnana VS 2, Jyoti Devangamath 3, Shreevathsa 4 1, 2, 3 P.G. scholar, Department of PG studies in Ayurveda Siddhanta, Government Ayurveda Medical College, Mysuru, Karnataka, India 4 HOD and Professor (I/C) Department of PG studies in Ayurveda Siddhanta, Government Ayurveda Medical College, Mysuru, Karnataka, India *Corresponding Author: narasanagi.sapna4@gmail.com; Mob: ABSTRACT Received: 24/05/2015; Revised: 15/07/2015; Accepted: 31/07/2015 Liver is considered to be one of the vital organs which help in maintaining the health of the human body. Not many of the physicians relate the outer glow of complexion to the liver health. After critical analysis it can be understood that there is a tremendous importance of liver function to one s appearance. Modern lifestyles can overstress the liver and make it malfunctioning. No significant and safe hepato-protective drugs are available in existing contemporary therapeutics. Liver is the metabolic factory of the body producing energy to sustain the thousands of functions performed every minute by all body s cells. Skin cells require energy to eliminate toxins, repair and regenerate. Nature has bestowed some plants with the property to prevent, treat and cure hepatic disturbances. The focus of this review is to elucidate the importance of liver in maintenance of Varna and also the probable mode of action of Varnya mahakashaya gana dravyas on yakrit (liver) based upon Ayurvedic aspects. As varnya gana helps in detoxification of blood in Raktapradoshaja vikaras (disorders due to vitiated blood) and yakrit is the moola Sthana (root site) for raktavaha Srotas (channels of blood circulation). KEYWORDS: Yakrit, Varna, Varnyamahakashaya gana. Cite this article: Sapna Narasanagi, Sujnana VS, Jyoti Devangamath, Shreevathsa (2015), HEPATOPROTECTIVE PROPERTY OF VARNYA MAHAKASHAYA AN INNOVATIVE INSIGHT, Global J Res. Med. Plants & Indigen. Med., Volume 4(7):

2 INTRODUCTION Liver The liver is the largest glandular organ in the body which works all the time to keep the body healthy. The liver is important because a person s nutritional level is not only determined by what he or she eats, but by what the liver processes. Liver is considered to be one of the most vital organs that functions as a centre of metabolism of nutrients such as carbohydrates, proteins and lipids and excretion of waste metabolites. Additionally, it is also handling the metabolism and excretion of drugs and other xenobiotic from the body thereby providing protection against foreign substances by detoxifying and eliminating them (Sembulingam. K, 2006). Skin cells require energy to eliminate toxins, repair and regenerate. Nature has bestowed some plants with the property to prevent, treat and cure hepatic disturbances. The focus of this review is to elucidate the importance of liver in maintenance of Varna and also the probable mode of action of Varnya mahakashaya gana dravyas on yakrit (liver) based upon Ayurvedic aspects. Hence here an attempt is made to create a hypothesis that varnya mahakashayaa dravyas can be a drug of choice in case of skin disorders associated with liver dysfunction Role of liver in healthy skin As per Ayurveda: In Ayurvedic literature, Bhavamisra (16th Century) has described that it is situated right and below to the hridaya (heart) and is the sthana of pitta and sonitha (blood). Susrutha (500 BC) mentioned yakrit as the abode of ranjaka pitta and describes it as the sthana of rakta (blood). Charaka (1000 BC) while describing the Srotas (channels), mentioned yakrit and pleeha (spleen) as the moola of raktavaha Srotas (Giby abraham et al., 2014). Vagbhata holds the opinion that the twak (skin) is formed from the rakta. After the paka of rakta by its dhatwagni, it gets dried up to from the skin, like the deposition of cream on the surface of boiling milk (Hari Sadashiva Shastri Paradakara, 2002). Hence liver is directly related to the skin. As per Contemporary medicine: Healthy Liver Can Mean Healthy Skin said by Jody Smith Liver is the metabolic factory of the body producing energy to sustain the thousands of functions performed every minute by all body s cells. Hair follicles need energy to grow strong shiny hair and skin cells require energy to eliminate toxins and repair and regenerate them. Heart requires energy to pump blood efficiently to skin to maintain collagen production and oxygenate the cells to protect them from aging (Liver Doctor, 2015), thereby Based on the physiology of liver, there is a relation between the outer glows of complexion to liver health. Role of liver in skin diseases: As per Ayurveda: In Ayurveda it can be understood in relation with Shonita, Raktavaha Srotas, and yakrit. In shonitaja rogas (disorders due to vitiated blood), Vaivarnya (skin discoloration) is mentioned (CS, vimana stana 5/8, pp. 250) (Acharya Y.T, 2006), Prasanna varnendriyaartha (bright skin tone and texture etc) are the lakshanas of vishuddha rakta purusha (characteristics of a person having pure and detoxified blood) (CS, Sutrasthana 24/13&24, pp.124&125) (Acharya Y.T., 2006), snigdha rakta Varna in rakta sara purusha (CS, Vimanasthana 8/104, pp.278) (Acharya Y.T, 2006) and liver is said to be the moola of shonitavaha/ raktavaha srotas. This shows that liver is the karana (cause) for vaivarnya, prasanna Varna and other disorders of skin. As per Contemporary medicine: The kidney-bladder system, liver system, lung system, and heart system are the creators of the structure of human protein. It is the direct result of the cooperation of these four organic systems. So any functional disorders will bring about disorders in protein formation which can appear as various kinds of symptoms, and also

3 as skin diseases. If this indication is taken as a working hypothesis, then the connections between particular skin diseases and the four protein-forming organs mentioned could be studied (Alla Selawry, ). Hence here the focus is laid on liver system wherein if liver is not doing its function of breaking down toxins efficiently then they must be eliminated from the body by other means in many cases they come out through the skin. When excessive toxins build up in the deeper layers of the skin this causes inflammation to occur and this can manifest as: Dermatitis, Eczema, Premature aging and wrinkling of the skin etc. (Liver Doctor, 2015). Treatment of dermatological conditions where liver is involved: Ayurvedic view In dealing with problems of the liver, the primary goal is to enhance liver detoxification processes and to protect against further liver damage. Significant and safe hepato-protective agents are unavailable in contemporary therapeutics. Therefore, due importance has been given globally to develop plant-based hepato-protective drugs effective against a variety of liver disorders. So in this review the important herbs in varnya mahakashaya gana used to treat (vaivarnya) skin discolouration associated with liver disorders have been described. Varnya mahakashaya dravyas: (CS, Sutrasthana 4/10, pp.32) (Acharya Y.T., 2006) Varnya mahakashaya dravyas are the group of drugs which are used to treat and prevent the Vaivarnya (skin discoloration) related conditions, to maintain and enhance the complexion in healthy. These can be administered both internally and externally. According to Charaka Samhita Sutra Sthana 4 th chapter Varnya mahakashaya dravyas includes Acc to Charaka Samhita Sutra Sthana 4th chapter Varnya mahakashaya dravyas mainly includes - Chandana (Santalum Album), Tunga (Calophyllum inophyllum), Padmaka (Prunus cerasoides), Ushira (Vetveria zizanoides), Madhuka (Glycyrrhiza glabra), Manjishta (Rubia cordifolia), Sariva (Hemidesmus indicus), Payasya (Pureaeria tuberosa), Sita (Cynodon dactylon), Lata (Cynodon linearis). A brief drug review of Varnya Mahakashaya dravyas is show in table no.1. Table no 1: Varnya Mahakashaya dravyas (Pallavi. G et al., 2012)

4 DISCUSSION From the above review it is understood that liver is one of the important component in maintaining the Varna, and varnya mahakashya dravyas possess both hepato protective and varnya property. Thus the link is found between the liver and the skin, wherein varnya mahakashya can be used; as both these conditions are checked by it. Some of the examples of Varnya mahakashaya dravyas used in Yakrit vikaras mentioned in classics have been shown in table no.2, and References of research and review articles on hepatoprotective action of each varnya gana dravyas in Table no. 3. Table no.2 References of Varnya mahakashaya dravyas used in Yakrit vikaras mentioned in classics. 1. Chandana Ex: In kamala (jaundice) Katukaadhya ghrutam (CS, Chikitsasthana 16/47. pp.529.)(acharya Y.T, 2006), It is also mentioned in vishagna, kandughna (CS, Sutrasthana 4/11.pp.33) (Acharya Y.T, 2006) 2. Punnaga (Nagakesara) Ex: in Mrutbhakshana nivarana vidhi (CS. Chikitsasthana 16/108. pp. 531) (Acharya YT et al., 2006). 3. Ushira Ex: in kamala Bijakarishta (CS. Chikitsasthana 16/121. pp. 532.) (Acharya Y.T, 2006), Blood purifier (PV Sharma, 2006). 4. Manjishta Ex: in kamala Gaudoarishta (CS. Chikitsasthana 16/121. pp. 532.) (Acharya Y.T, 2006) (Acharya Y.T, 2006), It is also mentioned in vishagna gana 5. Madhuka Ex: in kamala Haidari ghruta, Dhatryaavalehya, Bijakarishta, Gaudoarishta (CS. Chikitsasthana 16/121. pp. 532.) (Acharya Y.T, 2006), It is also mentioned in jeevaneeya, kandugna, mutravirajaneeya, shonitasthapanaani gana (CS, Sutrasthana 4/9, 11, 15, and 18) (Acharya Y.T, 2006). 6. Payasya (Vidari) It is also mentioned in balya, (CS, Sutrasthana 4/10 pp.32) (Acharya Y.T, 2006). Purishavirajaneeya gana (CS, Sutrasthana 4/15 pp.33) (Acharya Y.T, 2006). in hepatosplenomegaly (PV Sharma, 2006) 7,8 Sita & Lata Ex: in Mrutbhakshana nivarana vidhi (CS. Chikitsasthana 16/121 chakrapani. pp. 532.) (Acharya Y.T, 2006), These varnya mahakashaya dravyas can be administered both internally and externally.

5 Table no. 3 References of research and review articles on hepatoprotective action of each varnya gana dravyas: 1. Santalum album Hepatoprotective Potential of Hydro alcoholic Extract of Santalum album Linn. Leaves. International Journal of Pharmaceutical Sciences and Drug Research 2014; 6(3):pp Vetiveria zizanioides 3. vetiveria zizanioides Hepatoprotective activity of Vetiveria zizanioides Linn.against ethanolinduced liver damage in rats. Pharmacognosy Magazine, Vol 4, Issue 16 (Suppl.), Oct-Dec, 2008, pp 216. Hepatoprotective potential of methanolic extract of vetiveria zizanioides roots against carbon tetrachloride induced acute liver damage in rats. Digest Journal of Nanomaterials and Biostructures, Vol. 8, No. 2, April - June 2013, pp Prunus puddum Ethnopharmaco-Botanical Review of Padmaka Prunus puddum Roxb. International Journal of Ayurvedic and Herbal Medicine 1:3 (2011) pp. 87: Calophyllum inophyllum. Antibacterial and Analgesic Effects of the Stem Barks of Calophyllum inophyllum International Journal of ChemTech Research, Vol.2, No.2, April-June 2010, pp Rubia cordifolia. Hepatoprotective activity of Rubia cordifolia. Pharmacologyonline (2007)3: pp Glycyrrhiza glabra Glycyrrhiza glabra (Liquorice) - a potent medicinal herb. International Journal of Herbal Medicine 2014; 2(2):pp Cynodon dactylon Pharmacological Perspectives of Cynodon dactylon. Research Journal of Pharmaceutical, Biological and Chemical Sciences, April June 2012, Volume 3 Issue 2 pp Hepatoprotective activity of Hemidesmus indicus R.Br. in rats. Indian journal of experimental biology, vol.44, May 2006, pp Hemidesmus indicus 10. Mesua ferrea Evaluation of Hepatoprotective Activity of Isolated Mesuol from Mesua Ferrea L. In Paracetamol Induced Hepatotoxicity in Rats. International journal of research article pharmaceutical innovations, sept oct 2013, volume 3, issue 5, pp Mesua ferrea Evaluation of antioxidant and hepatoprotective efficacy of methanolic extract of Mesua ferrea linn leaves in experimentally challenged mice. International Journal of PharmTech Research, Oct-Dec 2009, Vol.1, No.4, pp Mesua ferrea Hepatoprotective Effect of Stamen Extracts of Mesua ferrea L. against Oxidative Stress induced by CCl4 in Liver Slice Culture Model. Natural Product Sciences, (2012), 18(2):pp

6 Ayurvedic pharmacology of Varnyamahakashaya dravyas: Before understanding the Ayurvedic pharmacology of varnya mahakashaya understanding of factors involved in formation of varna (skin complexion) is very essential which would in turn help to analyse the effect of varnya mahakashaya dravyas on varna and the yakrit. Hence Factors involved in the process of formation of Varna are as follows: (Pallavi. G et al., 2012) 1) Dosha (functional entities of the body): a) Vata- Udana vata & vyana vata. b) Pitta- Bhrajaka pitta & Ranjaka pitta. 2) Dhatu (tissue elements): Rasa & Rakta Dhatu. 3) Agni (digestive fire/enzymes): Jatharagni, Bhutagni, & Dhatwagni. 4) Srotas (channels): Rasavaha Srotas & Raktavaha Srotas. In figure no. 1 Schematic representation of mode of action of varnya mahakashaya dravyas on Twacha (skin) internally have been shown and in table no.4 the relation between the factors for formation of Varna and the varnya kara bhavas present in the varnya mahakashayaa dravyas have been shown. Figure 1: Schematic representation on mode of action of varnya mahakashaya dravyas on Twacha (skin) Intake of Aushadha Rasa Dhatu Rakta Dhatwagni and Ranjaka Pitta Rakta Dhatu Through vyana vayu Yakrit is involved Circulates Throughout the Body Increase in Ojas Reflects in Twacha (skin)

7 1. Rasa Dhatu (lymph tissue) 2. Rakta Dhatu (blood tissue) Table.no 4: Varnya dravyas: Varnya Kara bhavas Varnya Kara Bhavas of Varnya Mahakashaya dravyas Rasa (taste) - Madhura rasa (sweet taste), Guna (quality) - guru (difficult to digest) & snigdha guna (unctuous quality) Vipaka (post metabolic effect) - Madhura (sweet) vipaka, Virya (potency) - sheeta virya (cold potency). Vipaka (post metabolic effect) - Katu (pungent) vipaka, Virya (potency) - Ushna (hot) virya, Guna (quality) - laghu (easily digestible) & snigdha guna (unctuous quality). 3. Twacha (skin) Among panchmahabhuta (5essential elements)- Vayu mahabhuta (air element) for sensitivity Prithvi (earth element) as gross form. 4. Vata (Qualities reflecting elements of space and air 5, Pitta (qualities reflecting the elements of fire and water) Rasa (taste) Kashaya (astringent) & Tikta (bitter) Guna (Quality) laghu & Ruksha (dry) guna Vipaka (Post metabolic effect) Katu (Pungent) vipaka, Virya (potency) Sheeta virya Vipaka (post metabolic effect) - Katu vipaka, Virya (potency) ushna virya 6. Agni (digestive fire) Virya (potency) ushna virya Vipaka (post metabolic effect) - Katu vipaka 7. Ojas (prime energy) Rasa (taste) Madhura rasa, Guna (quality) guru & snigdha guna, Vipaka (post metabolic effect) - madhura vipaka, Virya (potency) sheeta virya. Discussion on Probable mode of action of varnya mahakashayaa dravyas on yakrit To understand the probable mode of action, Etio-pathogenesis of yakrit roga should be understood, which is as follows- in Figure 2. The main aim of treatment is to purify the blood and to regain the normal functions of the liver for which the Cikitsa siddhanta (Line of treatment) in Ayurveda is (Hari Sadashiva Shastri Paradakara, 2002). A. Sodhana (Purificatory therapy) - virechana B. Sanshamana (Palliative therapy) - Kapha pitta hara cikitsa Shodana is done by the respective line of treatments and samshamana can be done by administrating the supportive drugs of varnya mahakashaya dravyas such as madhuka, chandana, ushira, punnaga (Nagakesara), payasya (vidari) possessing hepatoprotective property as single drugs or compounded drugs. Toxins and Yakrit: Garavisha, a type of toxin described in Ayurveda affects liver & hepatomegaly may also take place. The reason for hepatomegaly is that the blood has special affinity towards toxins. The toxins immediately get spread in the body through blood (Hari Sadashiva Shastri Paradakara, 2010) and hence treatment is given

8 to pitta dosha, thereby purification of rakta dhatu takes place. According to pharmacology, the main mechanism involved in the protection of liver could be associated with the strong capability of hepato-protective drugs to reduce the intracellular levels of reactive oxygen species by enhancing the level of both enzymatic and non-enzymatic antioxidants. These drugs protect liver tissues against oxidative damage and help in stimulating the repair mechanism of liver (Giby Abraham et al., 2014). Figure 2: Etio-pathogenesis of yakrit roga (liver disease) Vidahi annapanam (food and drinking that cause burning sensation, Madhya sevana (alcohol intake), Teekshna padartha (strong/ sharp substance) Pitta prakopa (aggrevation of pitta) Dushita rakta dhatu (Vitiated blood tissue) Rakta pradoshaja roga (disease caused by vitiated blood tissue) Yakrit rogas Analysis based on Rasapanchakas: Rasapanchakas means rasa, guna, virya, vipaka and karma (functions), which are the base for pharmacology of varnya mahakashaya dravyas. Analysis of these present in the individual drugs reveals that maximum number of drugs have Madhura, Tikta and Kashaya rasa, laghu guna, Madhura katu Vipaka and Sheeta Virya. Madura rasa: Its snigdha (unctuous) sheeta (cold in nature) and guru (heavy to digest) guna does dhatuposhana (nourishment to all essential body tissues) function thereby increasing the immunity, strength and stability in the body and protect liver tissues against oxidative damage. Due to its pittaghna (destroying the excess of qualities reflecting the elements of fire and water) and vishaghna (destroying of toxins) functions helps in removing the obstruction and toxins from the rakta vaha channels and yakrit (CS, sutrasthana 26/42-43)(Acharya Y.T, 2006). Tikta rasa: Its Laghu guna (easy to digest quality) helps in increasing jatharagni as they are easily digestible and they form less nitrogenous waste products, Arochakaghna (treat loss of appetite), Agnidipana (increases metabolism) Aharapachana (helps in digestion) (Sharma Dinesh Chandra et al., 2014) helps in proper metabolism (by enhancing the catabolism) thereby these herbs help in digestion of nitrogenous waste products collected in body, due to disturbed metabolism. kashaya rasa have Ropana property (Healing property) helps in stimulating the repair mechanism of liver. Vipaka: Madhura and Katu Vipaka that cause catabolism in our body and removes obstruction of Rakta Vaha Channels. (Sharma Dinesh Chandra et al., 2014) Virya: varnya mahakashayaa is chiefly of Sheeta Virya and by virtue of its pitta and

9 Rakta alleviating property it pacifies the pitta dosha and thereby purifies/detoxifies the rakta dhatu in twak rogas associated with yakrit vikaras. Sheetavirya also act as diuretics and antioxidant thus reduce the intracellular levels of reactive oxygen species (Giby Abraham et al., 2014). Acharya Sushruta mentioned the composition of rakta (blood) on the basis of Pancha- mahabhuta (five elements), in the same way modern physiology illustrated. (Table. 5) Tables no. 5 the composition of blood on the basis of Pancha- mahabhuta Panchamahabuta composition Rakta Visrata (Prthvi mahabhuta), Dravta (Jala mahabhuta), Raga (Agni mahabhuta), Spandana (Vayu mahabhuta) and laghuta (Akasha mahabhuta). According to contemporary science Blood serum protein, glucose etc, plasma, lipids etc, haemoglobin, potassium, magnesium, iodine, chloride, acid phosphate, lipase, insulin etc. Colloidal substances in the blood, blood pressure. Oxygen, carbon di oxide, nitrogen gases contributes to laghu guna of rakta. Thus, in Ayurveda Panchamahabhutas (five basic elements of the body) is the base for all the body components and these are the bridges which links all the body tissues. These are the base for creating such hypothesis. CONCLUSION On the basis of above study it can be concluded that in skin disorders associated with liver involvement varnya mahakashayaa can be used as a supporting tool along with the main treatment; because conventional skin creams or drugs can suppress the condition but ultimately there may be side effects because the main challenge which contemporary science facing is how to ensure effective metabolism of the drugs that have been prescribed since the liver itself is in disorder. So in a natural approach for the health of the liver, Ayurveda sages have used their intellect, to formulate such herbal formulations that can be metabolized even by a sluggish liver. The logic behind how such formulations work is that they first heal and strengthen the liver and then contribute to the restoration of its normal functions that may reduce inflammation and does detoxification of blood. Preserving health of the liver means adding more complexion to the skin. ACKNOWLEDGEMENT Author is thankful to Dr. Shreevathsa, HOD and Professor (I/C), Dr. Sujnana V.S and Dr. Jyoti Devangamath B.A.M.S., P.G. scholar, MD (Ayu), Department of PG studies in Ayurveda Siddhanta,GAMC, Mysuru for all the help and guidance in writing this article.

10 REFERENCES: Acharya YT (Ed) (2006) Charaka Samhita with Chakrapanidatta and Ayurveda Dipika, Commentary, Varanasi: Chaukhambha Surabharati Prakashana. Alla Selawry ( ) Anthroposophic Medicine 'Connections Between Skin Diseases and Organ Dysfunctions'.Retrieved on 8/11/2014, from Giby abraham (2014), A Review on Hepatoprotective Herbs used in Ayurveda, global j res. Med. Plants & indigen. Med., volume 3(7): Hari Sadashiva Shastri Paradakara (Ed) (2002) Ashtanga Hridaya, 6 th Ed, Sharirasthana 3/8, Chikitsasthana16/39, Uttarasthana 35/60Varanasi: Chaukhamba Surbharati prakashan; pp. 386, 703, 906. Liver Doctor, (2015) your skin reflects your liver, Retrieved on 8/11/2014, from Pallavi. G (2012), A Study on the concept of varnya vis-vis clinical evaluation of efficacy of varnya gana lepa in vyanga. PV Sharma (2006) Dravyaguna vijnana. Reprint ed. Varanasi: chaukhambha bharati academy; Vol-2.pp.115, pp.739. Sembulingam K, Sembulimgam Prema (2006) Essentials of Medical Physiology, 4th Ed. New Delhi: Jaypee Brother Medical Publishers, pp.222, 228 Sharma Dinesh Chandra (2014), a scientific study on rakta dhatu and its related disorder and effect of varnya mahakashaya ghanvati and Chandra prabha lepa in the management of yuvan pidika (acne vulgaris), Int. J. Ayur. Pharma Research; Volume 2(2): pp Source of Support: NIL Conflict of Interest: None Declared