In Ayurveda, the five elements (pañcamahābhūtās)- Earth (pṛthivī), Water (ap), Fire (tejaḥ), Air (vāyu) and Ether (ākāśa) are considered as the building components of everything. The whole universe is made of these pañcamahābhūtās and so is the human body. Any imbalance in the natural proportion of the pañcamahābhūtās in our body causes a disease and this imbalance can be rectified by introducing various substances such as plants, animal products or minerals since they too are made of the same pañcamahābhūtās.
Ayurveda does not rule out any substance from being used as a potential source of medicine. Based on the material of origin, Ayurvedic medicines are divided into three classes:
Among this, herbal formulation has gained great importance and rising global attention recently.
Drug formulations in Ayurveda are broadly of two types: single drug remedies and compound formulations with multiple components.
Use of more than one drug is known as Poly Herbal Formulations (PHF). Historically, the Ayurvedic textbook, Śārṅgadhara Saṃhitā which is dated centuries ago-in 1300 C.E., has elaborately defined the concept of poly-herbalism in Ayurveda.
How are Ayurveda Medicines Made?
The following factors are taken into consideration in Ayurvedic medicine manufacturing:
- Nature of the raw material: fresh or dry
- Required concentration of the dosage form
- Solubility of therapeutically useful component of the plant
- Heat stability of therapeutically useful component of the plant
- Route of administration
- Shelf life of prepared dosage form
Depending on the above factors, there are several categories of pharmaceutical forms. But as the names are in Sanskrit and most often pretty long, they are often confusing and sometimes even misleading to the common man. Let us explore some of the most commonly used formulations.
Common forms of Ayurveda Medicine
1. Svarasaṃ (juice extracts)
The useful plant parts (leaf, stem, fruit or whole plant etc). are cut to pieces and ground to prepare a bolus. The finely ground bolus is then collected and is mechanically squeezed to extract as much juice as possible. The juice so obtained termed as ‘svarasa’-is collected and used immediately.
Juice of Basil [Tulasi (San)- Ocimum tenuiflorum L.] and ginger [Zingiber officinale Roscoe] along with honey to relieve cold cough etc. is an example of svarasa preparation.
In some cases, the plant material requires steaming to facilitate extraction of juice. This is achieved through a procedure called ‘puṭapāka’ wherein the plant material is ground to prepare a fine paste. The paste is then rolled into a bolus which is wrapped in the coverings of leaves. Two finger thick layers of mud is then applied on the covering of leaves. The bolus is then kept in an open hearth where it is subjected to intensive heat till it becomes red hot. It is then removed from the hearth and allowed to cool. The coverings of mud and leaves are then removed and the bolus is taken out. It is then mechanically squeezed to produce the expressed juice.
Puṭapāka svarasa from Adhatoda leaves [vāśā- Justicia adhatoda L.] for curing bleeding disorders, cough and fever.
2. Kaṣāyaṃ or kvāthaṃ (decoctions)
This is arguably the most widely used category of Ayurveda medicines. They are mostly used for internal administration in clinical practice. There are many different methods for the preparation of Ayurveda decoctions. The most accepted one is made from 1 part of herbs in 16 parts of water, which is reduced to 1/8th part of liquid after simmering or cooking on a low flame. Kaṣāyaṃ contains water soluble active principles of herbs. Most of the active principles of any herbs are water soluble in nature. Hence Kaṣāyaṃ is one of the best methods to absorb the maximum benefits of medicinal plants.
For example: Daśamūlaṃ (root of ten herbs) kaṣāyaṃ can be prepared and administered to regain strength, relieving pain, etc.
3. Ariṣṭaṃ and āsavaṃ (fermented liquids)
This is another popular pharmaceutical form in use. They contain naturally generated alcohol. This acts as the medium for alcohol soluble components in herbs to get extracted into a formulation. Most fermented liquids in Ayurveda contain around 5-10% alcohol.
Typically, an ariṣṭaṃ or āsavaṃ is made by adding powder or decoction of herbs in sugar, jaggery or sometimes honey, followed by a natural fermenting agent like flowers of Fire Flame Bush [dhātakī (San)- Woodfordia fruticosa (L.) Kurz], and sealing air-tight in earthen or wooden casks for a specific period of time for maturing. During this time, the mixture undergoes a process of fermentation and an ariṣṭaṃ or āsavaṃ is ready.
Example: Amṛtāriṣṭaṃ for curing fevers and its associated symptoms.
4. Cūrṇaṃ (powders)
Cūrṇaṃs are fine powder form of drugs. The ingredients are cleaned, dried and mechanically powdered to the fineness of at least 80 mesh. The finer the powder, the better is its therapeutic value.
Examples: Aṣṭa cūrṇaṃ described in context of Mal-absorption syndrome (grahaṇī). It is also commonly administered to increase appetite and improve digestion.
5.Guṭikā or Vaṭī (tablets)
Medicines prepared in the form of tablets or pills are known as vaṭī or guṭikā. Most often a powder formulation is added with a natural binding agent like Guggul [Commiphora mukul (Hook. ex Stocks) Engl.] exudate.
Example: Vilvādi guṭikā is a popular tablet preparation in Ayurveda used in the management of poisons, venom or toxins.
6. Avalehaṃ (electuaries or jams)
Avalehaṃ or lehyaṃ is a semi-solid preparation of drugs. These are prepared by the addition of jaggery, sugar or sugar candy and boiled with prescribed drug juices or decoction till it becomes thick like a confectionery. The remaining ingredients are usually powdered and added to this sugar base and mixed well. Honey, if required, is added when the preparation is cold and mixed well. Avalehaṃs are often nourishing and comparatively more palatable.
Example: Kūśmāṇḍa rasāyanaṃ, which aids in curing burning sensation, acid reflux, and hyperacidity.
7. Ghṛtaṃ (clarified butter- ghee)
This is a unique Ayurvedic preparation method in which the ingredients are incorporated into a fat base, usually cow's ghee. From a manufacturing point of view, there is a stipulated methodology for preparing ghee or oil formulations. It includes 3 components - a paste (kalka), a fat base (sneha) and liquid (drava) which can be water, decoction, expressed juice, milk etc).
Ghee formulations plays an important role in treatment both internally and externally. Internally when consumed it enters into systemic circulation and has the potential to cross the blood brain barrier and thereby stimulating the Central Nervous System. Externally when applied it diffuses locally into the soft tissues and produces the desired therapeutic action.
Example: Indukāntaṃ Ghṛtam is useful in the management of abdominal diseases including gaseous distension, loss of appetite, bloating, flatulence, intestinal gas, abdominal spasm or colic etc.
8. Tailaṃ (medicated oils)
Medicated oils are prepared by boiling prescribed decoctions and pastes of drugs in oils like sesame oil, castor oil, coconut oil etc, according to the formulation till the whole moisture content evaporates or till the appearance of bubbles in the preparation. Oil prepared with water content is not completely evaporated (mridupākaṃ) is used for nasal instillation (nasya): when water content is slightly remaining (madhyamapākaṃ) oil is used for enema and oral administration; oil completely completely devoid of any water content (kharapākaṃ) is used for external application.
Example: Piṇḍatailaṃ is used in numbness and burning sensation of feet
9. Arka (distilled liquids)
It is a liquid preparation obtained by distillation of certain liquids or drugs soaked in water using a type of steam distillation apparatus called arka yantra. It is a suspension of the distillate in water having slight turbidity and color according to the nature of the drugs used and smell of the predominant drug.
Example: Triphalā arka is given in diabetes, constipation etc.
Why so many formulations?
Choice of the dosage form depends on several factors. Here are some:
- Based on ease of administration
Some patients may dislike svarasa due to its sharp nature (taikṣṇya). The likes and dislikes should be considered by a vaidya before prescribing a medicine since psychological factors play an important role on the efficacy of the drug.
- Based on disease
In a diabetic patient some pharmaceutical forms like Avalehaṃ may not be ideal even if effective, owing to its sugar content. There we can incorporate decoctions or tablets.
- Based on digestive strength
When a patient has good digestive strength unnecessary adoption of fermented liquids (ariṣṭaṃ and āsavaṃ) may be harmful. Since it may damage the tissues.
- Based on chronicity of the disease
Ayurveda focuses on digestive strength as the primary point in early stages of a disease we have weak digestive strength wherein the patient may not be able to digest the heavier dosages like Avalehaṃ or Ghṛtaṃ. So they can be administered in a chronic stage. While in acute phases we usually prefer Kaṣāyaṃ, Cūrṇaṃ, Guṭikā etc.
- Based on doṣa dominance
Whenever Kapha is dominant, powders are the most preferred pharmaceutical form. Medicated oils, especially made with sesame oil is ideal for Vāta and Pitta dominance is best managed with Ghṛtaṃ.
Ultimately, the most suitable pharmaceutical form is determined as per the logic (yukti) of the prudent physician. Depending on the above factors these formulations bring about excellent results when used and given wisely.