Vidarigandhadi Gana of Sushruta Samhita: A Review of its Clinical Indications

Abbreviations

Su: Sushrut samhita; T: Tika (Commentary); u: uttar tan- tra; chi: chikitsa sthana; sh: sharira sthana; su: sutra sthana; Ch.chi: Charak samhita chikitsa sthana.

Introduction

Dravya is the most important tool in therapeutics. It is also one of the four foundational factors of therapeutics; physician, patient and attendant being the other three [1]. Here Charaka explains that success of therapeutics is not ensured only by mere presence of these four but by their qualitative excellence. Ayurveda states that any substance of this world can be used as medicine when applied with proper rationale and in correct indication [2]. Charaka states that a single medicinal substance can be used in various clinical conditions depending upon dose, dosage, condition of the patient, etc [3]. Therefore there are practically countless medicinal substances which are used in therapeutics.

Conceptual Paper

As there are countless medicinal substances, though not impossible but it is very difficult to learn, understand and apply each medicinal substance individually. Therefore medicinal substances are classified on basis of certain common parameters like morphology, pharmacological action, therapeutic uses, etc [4]. Charaka has classified the medicinal substances into groups such as mahakashaya, moolini, phalini, etc. Sushruta has classified medicinal substances into different Gana. Gana means group of drugs having similar and special characteristics either in swaroop (morphology), rasa (taste), guna ( properties), karma (pharmacological actions). Vagbhatta has used both mahakashaya and gana at separate places for classifying medicinal substances.

Acharya Sushruta has explained 37 gana and each gana has multiple indications. The components in these gana are included in such a way that they have similar action and properties. The nomenclature of Gana is given by the first drug in that particular Gana e.g. in Vidarigandhadi Gana-

Vidarigandha is the first drug mentioned in this gana. Each gana is followed by its potential action on dosha, dhatu, mala and clinical indication.

The Ayurvedi samhita texts follow a method wherein sutra (principles) are described in the beginning of samhitas in the sutrasthana with a tenet of using them in subsequent chapters like nidan (diagnosis) and chikitsa (therapeautics) [5]. Gana is one such sutra (principle), which logically would be used in the later part of samhita. Also Sushrut has opined that these groups of drugs (gana) are mentioned in brief in sutrasthana, their detail uses would be described in section of treatment [6]. Against this background, present study was taken to review the clinical implication of Vidarigandhadi gana in other sthana of sushrut samhita.

Materials and Methods

All references regarding Vidarigandhadi gana

Sno Sanskrit name Botanical name Family Rasa Guna Virya Vipaka doshashaman

1 Vidaarigandha Desmodium gangeticum DC. Fabaceae Madhur, tikta Guru, snigdha Ushna, Madhur Tridoshhar

2 Vidaari

3 Vishwadeva Grewia populifolia Vahl. [= Grewia tenex (Forssk.) Fiori] Tiliaceae Madhur laghu, snigdha ,picchilla Sheeta Madhur Vatapittahar

4 Sahadeva/ balabheda (PV sharma)

5 Swadamshtra Tribulus terrestris Linn. Zygophyllaceae Madhur Guru, snigdha Sheeta Madhur Vatapittahar

6 Prithakparni Uraria Picta Desv. Fabaceae Madhur, tikta laghu, snigdha Ushna Madhur Tridoshhar

7 Shatavari Asparagus racemosus Willd. Liliaceae (asparagaceae) Madhur, tikta Guru, snigdha Sheeta Madhur Vatapittahar

8 Saariva Hemidesmus indicus R.Br. Periplocaceae Madhur, tikta Guru, snigdha Sheeta Madhur Tridoshhar

9 Krushnasaariva (API Vol-4) Cryptolepis buchanani Roem and Schult. Periplocaceae Madhur, tikta Guru, snigdha Sheeta Madhur Tridoshhar

10 Jivaka (API volume 5) Microstylis wallichii Lindll. Orchidaceae Madhur Snigdha, picchila Sheeta Madhur Vatapittahara

11 Rishbhaka Microstylis mucifera Ridley. Orchidaceae Madhur, kashaya Laghu, snigdha Sheeta Madhura Vatapittahara was collected from Sushrut Samhita and its available commentaries. These refecrences were thoroughly analysed to establish linkages between the indications and uses mentioned in Sutra Sthana and actual uses in other sthana of sushrut samhita (Chikitsa Sthana, uttar tantra etc). The indications and uses of Vidarigandhadi gana was then categorized on basis of its use in diseases mentioned in Sutra Sthana, as per Dosha prabhava of the Gana and also in conditions where in linkages could be logically established based on the doshic involvement of the disease.

Observation & Results

Vidarigandhadi gana comprises of 20 dravyas all of plant origin. This gana is said to be useful in Shosha, Gulma, Angamarda, Kasa, Shwasa and having Vata-Pittanashak property (Tables 1 & 2).

Vidarikanda(alpakshira)- Pueraria tuberosa DC. Fabaceae Madhur Guru, snigdha Sheeta Madhur Vatapittahar Kshirvidari(bahu kshira)- Ipomeadigitata Linn. Passifloraceae Madhur Laghu, snigdha, picchila Sheeta Madhur Vatapittahar

Discussion

Vidarigandhadi gana from sushruta samhita is reviewed and analysed from the text and commentaries as per their given indication and to find out possibility of any new indication. It is indicated in Shosha, Gulma, Angamarda, Kasa, Shwasa and having Vata-Pittanashak property [11]. On preliminary review, it has been found that its indication in other section of text is given in various clinical conditions like Vatavyadhi, Udararoga, Atisaar, Raktapitta, Mutrakricha etc (Table 3). For instance, Milk processed with vidarigandhadi gana is given as food in pittaj udara roga (Table 3) in uttartantra which could be the implication of principle of sutrasthana as per their indication given. On analysing, it has been found that vidarigandhadi gana has 8 direct indication related to vata dosha and 2 indication related to pitta dosha in different clinical conditions like udaroga, apasmara, vidradhi, abhishyanda, atisara, pratishyaya, etc. (Table 3) and one for each shosha, gulma and shwasa. It is given 3 times for kasa while no reference is found for angamarda (Table 2).

Gana give direct indication for shosha, gulma, shwas, and kasa but their dosage form, adjuvant etc. are being explained by sushruta in its descriptive chapter. For instance, ghee processed with Vidarigandhadi gana is directly indicated for Vatika kasa [12]. Vidarigandhadi gana processed with milk and ghrit are commonly used dosage forms used in various clinical conditions by acharya sushruta. Vidarigandhadi gana processed formulations are advised in new indications like sutika paricharya, makkala shula, hanuasthi bhagna, garbha appyan, aptanak, ardita, shankhaka, pratishaya, pravahika, trishna and mutraghata (Table 4). It seems that this gana has been used in situations where vata dosha is aggravated along with loss of bala. In sutika paricharya, after shodhan (3 days after delivery), acharya has advised vidarigandhadi gana processed milk gruel. It would have been given to alleviate vata dosha and enhance the body strength. Makkal shula is the pain found at nabhi, basti and udar, in sutika (female for 45 days after delivery) along with bloated stomach due to aggravated vata, here Sushrut indicated decoction of vidarigandhadi gana sprinkled with devdaru and maricha powder. If there is pain without bleeding during pregnancy, Sushrut indicated vidarigandhadi gana processed milk to alleviate vata which is the obvious cause of pain. In aptanak which comes under vata vyadhis, sushrut indicated the use of Ghee cooked with decoction of vidarigandhadi drugs, meat juice, milk and curd is given after shira shudhi to control the spreadability of vata. In karnashula, shushrut mentioned that the ear should be filled with four types of sneha cooked with urine, sour and decoction of vidarigandhadi gana. In raktapitta, rakta and pitta both are in its aggravated form therefore sushrut give vidarigandhadi processed milk basti in such situation (Su.u. 45/4-5). In shankhaka, irrigation and paste of sheeta virya drugs i.e. vidarigandhadi gana etc. is used to reduce the intensity of aggravated vata, pitta, kapha, rakta to get the relief from pain. In trishna main aggravated doshas are vata and pitta, sushrut have mentioned Warm water processed with with vidarigandhadi gana in vataj trishna and decoction prepared with sarivadi, trinapanchamula, utpaladi and vidarigandhadhi gana in kshataj trishna to maintain the mentioned doshas. In Vata-Pittaj Mutraghata, sushruta has given that the roots of vidarigandhadi gana and gokshura should be cooked in water and milk and taken with sugar and honey to compensate the intensity of doshas and get the homeostasis. In pravahika frequent watery bowel movements leads to loss of water and electrolyte along with alleviation of vata and agninasha (Ch.chi.19/30). For the management of such situation Sushrut indicated food processed with trikatu and vidarigandhadhi gana, trikatu is to maintain the agni and vidarigandhadhi gana drugs with milk to compensate the loss of fluid and to hold the vata dosha to maintain the haemostasis. After analysing the clinical condition, dose, dosage forms mentioned by acharya, it is found that the vidargandhadhi gana is not only having vata pitta vitiating property but also balya by its nature. It also follows the principle of sutra being used in later part of text.

Conclusion

Acharya sushrut have aggregated some ingredients into one gana based upon their commonality in morphology, properties, actions, etc. The first gana, Vidarigandhadi gana is analysed and it showed that it follows the principle in which sutra is described briefly in sutra sthana which is to be used in later part of samhita i.e. the indication of this gana vis-a- vis shosha, gulma, shwasa, kasa have clinical applicability in other Sthana of Sushrut samhita. Study showed that it can be given in various other clinical conditions like udaroga, apasmara, vidradhi, abhishyanda, Atisaar, raktapitta, pratishyaya, trishna, mutrakriccha etc. after analysing the separate dosha or mixed dosha.