Critical analysis of Anjana in Systemic Diseases

REVIEW ARTICLE May-June 2021 Journal of Ayurveda and Integrated Medical Sciences | May - June 2021 | Vol. 6 | Issue 3 121 Critical analysis of Anjana in Systemic Diseases Dr. Prashant G. Kalyanshetty 1 , Dr. Vinod Jadhav 2 , Dr. Venkangouda Naganur 3 *1 Post Graduate Scholar, Department of PG Studies in Shalakya Tantra, S V M Ayurvedic Medical College and Research Centre, Ilkal, Karnataka, India. 2 Professor & HOD, Department of PG Studies in Shalakya Tantra, S V M Ayurvedic Medical College and Research Centre, Ilkal, Karnataka, India. 3 Professor & PG Guide, Department of PG Studies in Shalakya Tantra, S V M Ayurvedic Medical College and Research Centre, Ilkal, Karnataka, India. I NTRODUCTION Eyes are the doorway of perception and without eyes this world seems to be useless because when our own existence ended up in darkness then how can we enjoy the nature of universal existence. So always our Ayurvedic Acharyas given prime importance to protect our eyes not only to enjoy the Nature of Address for correspondence: Dr. Prashant G. Kalyanshetty Post Graduate Scholar, Department of PG Studies in Shalakya Tantra, S V M Ayurvedic Medical College and Research Centre, Ilkal, Karnataka, India. E-mail: gangaprashant 3@gmail.com Submission Date: 16/05/2021 Accepted Date: 11/06/2021 Access this article online Quick Response Code Website: www.jaims.in Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CCby-NC-SA outside world but also to see the insight of life in totality. In Dinacharya Acharyas described about daily usage of Anjana especially like Sauvira Anjana and Rasanjana (decoction of Berberis aristate - Daruharidra ) [1] mixed with honey as it eliminates excessive Kapha Dosha from eyes because it is told eyes have predominance of Pitta Dosha ( Alochaka Pitta ) [2] or Tejamahabhuta for its proper functioning. Thus, Anjana is the unique therapeutic procedure to prevent eye disorders as well as to treat various type of advanced ophthalmic Disorders like Arma , Timira , Kacha etc. Meanwhile Anjana is the only therapeutic procedure among Netrakriyakalpa which is highly recommended to treat some of the Systemic diseases like Kaamala, Vishamajwara, Unmada Apasmara, Moorcha, etc . Meanwhile It should be understood that Anjana is not the main line of treatment for the above-mentioned diseases, but when all the other treatment aspects A B S T R A C T In the management of various ophthalmic disorders Kriyakalpa plays an important role. Netrakriyakalpa like Tarpana, Putapaka, Ashchyotana, Seka, Anjana, Pindi, Bidalaka all these procedures have very fast action on target tissues of eye. Among the Netrakriyakalpa Anjana is the one which had tremendous importance in both Healthy people (as a cosmetic preparation) as well as in ophthalmic patients. Moreover, to this, there are other few Aushadakalpanas which are even indicated in systemic diseases too i.e., Vishamajwara, Kaamala, Unmada, Apasmara. Moorcha, Grahabaada, and even Sthanika Visha Chikitsa can be done through the usage of Anjana . Anjana is the only Kriyakalpa which is mentioned to treat ocular disease as well as Systemic diseases, but due to lack of critical analysis in treating systemic diseases, it is lagging behind in the usage of clinical practises and although it is only Kriyakalpa mentioned in Dinacharya . So here all efforts has been made to explain the probable mode of action of Anjana in systemic diseases though there are barriers to it, meanwhile how barrier will become boon for systemic circulation will be overviewed. Key words: Aushadakalpana, Pharmacological action, Dinacharya, Apasmara

Dr. Prashant G. Kalyanshetty et al. Critical analysis of Anjana in Systemic Diseases ISSN: 2456-3110 REVIEW ARTICLE May-June 2021 Journal of Ayurveda and Integrated Medical Sciences | May - June 2021 | Vol. 6 | Issue 3 122 fails, now Anjana come into action where Some references with Anjana formulation has been mentioned below. O BJECTIVE OF THE S TUDY To explain the probable mode of action of Anjana in systemic diseases. M ATERIALS AND M ETHODS This is conceptual type of study. All sorts of references have been collected and compiled from various available literatures like Charak Samhita , Sushruta Samhita , Chakradatta , Bhaishyaja Ratnavalli with available commentaries and other modern resources like Pharmacology, ophthalmology texts and various research articles, journals, scientific papers etc. all these methods are used as source materials to the topic to draw the necessary conclusions. Preparation of Anjana mentioned in different Classics. 1. Acharya Charaka in Jwara Chikitsa mentioned about preparation of Anjana yoga which is Jwara Nashaka in nature [3] Saindavam Pippalinam Cha Tandula Sa Manashilaha |Netraanjanam Tailapishtamshasyate Vishama Jware|| Take Saindava + Pippali + Manashila all these 3 Ingredients is to be taken and triturated with Tilataila till it becomes very fine this Anjana is applied to lower eyelids which is Vishamajwara - nashaka . 2. Likewise, In Bhaishyaja Ratnavali a Special formulation is mentioned for Dusaadya Sannipathaja Jwara where Shithikukkuta Rasa means Black colour hen having creamy white egg inside it has a jelly colourless fluid which is used as Paanartha , Nasya , and Anjana for the Shamana of Sannipathaja Jwara [4] Presently Kadaknath chicken – completely Black but eggs are creamy white *Found in madyapradesh in jhabua and dhar district. Known for medicinal properties due to high amounts of melanin - helpful in producing several vital neurotransmitters and harmones * Speciality - rich in protein but low cholesterol . 3. Even Acharya Vagbhata in Chikitsasthana mentioned the Kamalahara Chikitsa through the special Anjana formulation where Haridra + Gairika + Amalaki are taken in equal quantity and mixed with Madhu and applied as Anjana to treat Kamala [5] 4. Acharya Chakradatta mentioned usage of Anjana in certain psychological conditions like Unmada where Varthi made up of Daruharidrachurna and Madhu is rubbed and applied on the day of Pushyanakshatra which treats Unmada for sure [6] Darvimadhubyam Pushyayamkrutam cha gudikanjaanam | netrayoranjanam Unmaadam nashayeddrutam|| 5. Even Acharya Charaka mentioned importance of Anjana in treating Psychological conditions like Unmada , Apasmara and Grahabaada Rogas where Trikatu + Haridra + Daruharidra + Manjista + Hingu + Shirisha Beeja made Powdered and triturated with goats urine used as Anjana [7] which alleviates Unmada , Graharogas and Apasmara . 6. Chakradatta ’ s another Anjana formulation: Krishna Marichadya Anjana [8] : Pippali + Maricha + S . lavana triturated with Gopitha made Varthi while applying it is rubbed with Madhu and applied as Anjana - treats all types of Unmaada and Bhuthonmada . 7. Acharya Sushruta mentioned in Madhumeha Chikitsa Adyaya about the Anjana preparation to treat NakthaAndyatha , Pilla Rogas , Kacha , Timira etc. which can be inferred that Netra Rogas is due to Madhumehaja and to treat Madhumehajanya Netr a Rogas Tuvarakaadi Anjana is preferred which is Mehahara and Kushtahara [9] The above Preparations are few examples which can be made use to treat Systemic diseases and other then these preparations there are again a lot of Anjana formulations which has been explained in Classical texts. So nowadays the usage of Anjana became more limited clinically. As a Cosmetic purpose

Dr. Prashant G. Kalyanshetty et al. Critical analysis of Anjana in Systemic Diseases ISSN: 2456-3110 REVIEW ARTICLE May-June 2021 Journal of Ayurveda and Integrated Medical Sciences | May - June 2021 | Vol. 6 | Issue 3 123 a lot of people using Kajal/Soorma to their eyes without knowing and understanding how safety it is to apply on eyes. Probable mode of Action in Systemic Diseases Anatomical barriers Cornea is lipid-water-lipid layer, lipid content of epithelium and endothelium is 100 times more than that of stroma and therefore allow more liphophilic then to hydrophilic substance because of the dual nature of corneal barriers, drug possessing both lipid and water solubility penetrates the cornea more readily. However lipid solubility is more important than water. Conjunctiva is more permeable than cornea especially for Hydrophilic molecules, and high vascularity renders this route not suitable for drug delivery as the blood vessels remove the large fraction of absorbed dose. Blood ocular barriersinclude Blood aqueous barrier and blood retinal barrier. Physiological barriers ▪ Nasolacrimal drainage of administered drug. ▪ Reflex blinking. Factors influencing local drug penetration into Ocular tissue: ▪ Drug concentration and solubility - The higher the concentration very good will be the penetration but limited by reflex tearing. ▪ Lipid solubility - Higher the lipid solubility more the penetration. ▪ Alkaloids - when an alkaloid drug is put in relatively alkaline medium, the proportion of uncharged form will increase, thus more penetration. Barriers becoming boon for Systemic Circulation ▪ Tear film - Under normal circumstances the volume of tear fluid is 5.7 microlitre with rate of secretion about 1.2 microlitre/min. ▪ Ph - The normal tear ph is 7.4 and if the drug Ph is different, it will cause reflex tearing. ▪ When any Anjana is applied over eyelids, it causes an increase in blinking and squeezing which propels towards Sac. Now drug passes into Lacrimal sac further it reaches to Nasolacrimal duct and thus reaches to Nasal cavity by then once it comes to contact with the Vascular nasal mucosa, relatively rapid absorption of drugs into blood stream where up to 80% of applied drugs may diffuse into systemic circulation will take place by reaching target tissues. An important property of absorption via this route is bypassing the liver due to this fact, First-pass metabolism is minimized compared to peroral administration [10] ▪ It’s not the only route even when Anjana is applied it will get absorbed through transcorneal absorption further moving into Aqueous humor where some amount of drug is absorbed in the intraocular tissues and rest passes into trabecular meshwork into Episcleral pathway there by distribution into Systemic circulation [11] DISCUSSION ▪ Certain Anjana formulations are mentioned for Psychological conditions like Unmada and Apasmara , this is because Anjana reaches to Nasal passage as it is important route of drug administration called as Shirsodvara i.e. Gateway to Head. The Anjana preparation having unique combination of drugs, and most of them are Katu, Thiktha, Kashaya in nature, which is highly penetrative and increases Blinking rate which will cause reflex tearing and drained into Nasolacrimal duct and thus enters into Nasal Cavity which is highly vascular in nature and thus reaches to Brain. ▪ Drug like Piperine [C 17 H 19 O 3 N] is Alkaloid and shows high lipophilicity. It is a Bio-enhancer which when mixed with drugs promotes and augments their bioavailability without showing any synergistic effect with the drug. Piperine when

Dr. Prashant G. Kalyanshetty et al. Critical analysis of Anjana in Systemic Diseases ISSN: 2456-3110 REVIEW ARTICLE May-June 2021 Journal of Ayurveda and Integrated Medical Sciences | May - June 2021 | Vol. 6 | Issue 3 124 used in combination with various drugs reducesdose, side-effects, and increases bioavailability. ▪ Formulations like Darvigutikadi Anjana in Unmada is mentioned to use particularly on Pushyanakshatra , so here importance of Pushayanakshatra and its impact on Pharmacodynamic and Pharmacokinetic action need to be studied scientifically to prove the role of medicine in association with Pushya Nakshatra in the Psychological disorders. ▪ Anjana preparations are most of lipophillic and sparingly water soluble in nature, which are meant to be absorbed through topical (Episcleral vein) as well nasal route. ▪ Drugs mentioned for Unmada , Apasmara having Chemical constituents like Flavanoids, Phenolic compounds, Alkaloids, Saponinns, are major phytoconstituents responsible for Anticonvulusant activity [13] ▪ Though there are some practical problems, but still it’s important to adopt in clinical practices by finding out the solution. CONCLUSION Kriya - kalpas are well designed procedures to treat ocular disorders but among them Anjana is used for both ocular as well systemic diseases which was outlined by our ancient medical scholars as they were aware of the mechanism of Blood aqueous barriers, and Blood Brain Barriers thus Anjana is mentioned in Netra Vikaras as well as in some of the Systemic disorders. Anjana is the simple therapeutic procedure among the Kriya - Kalpas for the daily usage which will acts as Chakshushya i.e., helps in maintaining good visual acquity. The purpose of above article is to popularize Anjana and to create awareness in the society, so that to overcome the lack of practical utility of medicated Anjana in Clinical practice and offcus still more research work is needed to be done on the applied aspects of Anjana in both Ocular as well as Systemic diseases. Table 1: Showing properties and chemical constituents of Drugs. [12] Drug name Rasa Doshagnata Guna Chemical constituent s Maricha Katu Tikta Kaphavatagna Ushnaveerya, chedaneeyagun a Piperin, Essential oil and alkaloid Pippali Katu Kaphavatagna Laghu, Snigda and teekshnaguna. Essential oils and Alkaloids Karanja Thiktha, Katu, Kashaya Kaphavatagna Laghuteekshna Karanjin, and essential oil Devadaru Thiktha Kaphavatagna Laghu ,Snigda Terpinods, flavanoids and glycosides. Vacha Katu, Thiktha Kaphavatagna Laghuteekshna Acalamone, Calamenol Amalaki Amla Pradhan a Lavana Varjitha Rasa. Tridoshagna Ruksha, Laghu Ascorbic acid and Galotannin s Goats Urine Kashaya, Madhur a Tridoshanasha k Vishagna ,Pathyam. Ushna ,Ruksha --------- Manashill a Thiktha, Katu Kaphavatagna Ushnaveerya Arsenic disulpide Rasona Katu, Thiktha, Kashaya Kaphavatagna Snigda, Teekshna Allinase, Volatile oil. Shirisha Thikta, kashaya, Tridoshagna -- Saponins and Tannins REFERENCES 1 Arunadatta, Vagbhata, In: Harisadashiv Shastri Paradkar Vaidya (ed). Ashtanga Hridaya. Varanasi: Choukumba Surbharathi Prakashan. Sutrasthana, Chapter 2, Dinacharya Adhyaya, verse 5, 2017;p 25

Dr. Prashant G. Kalyanshetty et al. Critical analysis of Anjana in Systemic Diseases ISSN: 2456-3110 REVIEW ARTICLE May-June 2021 Journal of Ayurveda and Integrated Medical Sciences | May - June 2021 | Vol. 6 | Issue 3 125 2 Arunadatta, Vagbhata, In: Harisadashiv Shastri Paradkar Vaidya (ed). Ashtanga Hridaya. Varanasi: Choukumba Surbharathi Prakashan. Sutrasthana, Chapter 2, Doshabediya Adhyaya, verse 14, 2017;p 194 3 Harishchandra Singh Kushawaha (ed). Charak Samhita with Ayurveda Dipika hindi commentary. Varanasi: Chaukumba Orientalia. Chikitsasthana, Chapter 3, Jwara Chikitsa Adhyaya, verse 306-307, Reprint ed, 2012;p 133 4 Kaviraj Govind Das Sen. Bhaisajya Ratnavalli with Siddhiprada Hindi Commentary. Varanasi: Choukumba Surbharathi Prakashan. Chapter 5, Jwara Rogadikara, verse 230, 2017;p 105 5 Arunadatta, Vagbhata, In: Harisadashiv Shastri Paradkar Vaidya (ed). Ashtanga Hridaya. Varanasi: Choukumba Surbharathi Prakashan. Sutrasthana, Chikitsa sthana, Chapter 16, Panduroga Adhyaya, verse 44, 2017;p 704 6 Chakradatta, Ramanath Dwivedy (ed). Chakradata with Vaidyaprabha hindi commentary. Varanasi: Choukumba Samskrit Sansthan. Chapter 20, Unmada chikitsa, verse 46, Third ed, 1997;p 128 7 Harishchandra Singh Kushawaha (ed). Charak Samhita with Ayurveda Dipika hindi commentary. Varanasi: Chaukumba Orientalia. Chikitsasthana, Chapter 9, Unmada Chikitsa Adhyaya, verse 65-66,2012;p 259 8 Chakradatta, Ramanath Dwivedy (ed). Chakradata with Vaidyaprabha hindi commentary. Varanasi: Choukumba Samskrit Sansthan. Chapter 20, Unmada chikitsa, verse 45, Third ed, 1997;p 128 9 Dalhana, Sushruta, In: Jadavji Trikamji Acharya (ed). Sushruta Samhita. Varanasi: Choukumba Surbharathi Prakashan. Chikitsasthana, Chapter 13, Madhumeha Chikitsa Adhyaya, Verse 35, Reprint ed, 2017;p 457 10 Andre Farouh, Peter Frigo, Martin czejka. Systemic Side effects of eye drops: a pharmacokinetic perspective. Clin Opthalmol. 2016;10:2433-2441 11 K D Tripathi. Essentials of Medical Pharmacology. Antiadrenergic drugs. Chapter 10, 7 th Ed,p 152 12 D Shanthkumar Lucas. Dravyaguna Vijnana Vol II. Choukumba Visvabharathi, Varanasi. Reprint ed,2013 13 Sucher NJ, Carles MC. A pharmacological basis of Herbal medicine for Epilepsy. Epilepsy Behav. 2015 Nov; 52(Pt B):308-18. doi:10.101-/j.yebeh.2015.05.012. Epub 2015 Jun 12.PMID:26074183 ******************************* How to cite this article: Dr. Prashant G. Kalyanshetty, Dr. Vinod Jadhav, Dr. Venkangouda Naganur. Critical analysis of Anjana in Systemic Diseases. J Ayurveda Integr Med Sci 2021;3:121-125. Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2021 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc-sa/4.0), which permits unrestricted use, distribution, and perform the work and make derivative works based on it only for non-commercial purposes, provided the original work is properly cited

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Anjana, Sushruta-samhita, Pushyanakshatra, Dinacarya, Kriyakalpa, Chakradatta, Medicinal properties, Therapeutic Procedure, Ocular disease, Mode of action, Psychological condition, Charak Samhita, Bioavailability, Acharya Charaka, Systemic disease, Nasal route, Acharya Vagbhata, Ophthalmic Disorder, Ayurvedic acharya, Pharmacological action, Systemic circulation, Clinical practise, Chemical constituent, Vishamajwara, Lipid solubility, Ocular tissue, Cosmetic preparation, Netrakriyakalpa, Visual acquity.