A review article on Vedanasthapan Mahakashaya, a Potent Ayurvedic Analgesic

REVIEW ARTICLE August 2023 Journal of Ayurveda and Integrated Medical Sciences | August 2023 | Vol. 8 | Issue 8 79 A review article on Vedanasthapan Mahakashaya , a Potent Ayurvedic Analgesic Karishma Kaushik 1 , Champak Medhi 2 , Pankaj Kumar Barman 3 ¹Post Graduate Scholar, Dept. of Shalya Tantra, Govt. Ayurvedic College, Guwahati, Assam, India. ²Associate Professor, Dept. of Shalya Tantra, Govt Ayurvedic College, Guwahati, Assam, India. ³Professor and Head, Dept. of Shalya Tantra, Govt Ayurvedic College, Guwahati, Assam, India. I NTRODUCTION Pain, predominantly caused by Vata , is a pathological symptom. Therefore, while screening the drug for this problem, it should be kept in mind and outstanding drugs that may prove useful in this regard should be selected. However, there may be other drugs that might be effective due to their Prabhava , i.e., specific action that cannot be explained based on Rasa, Guna, Virya, Vipaka. The classification of drugs and the Address for correspondence: Dr. Karishma Kaushik Post Graduate Scholar, Dept. of Shalya Tantra, Govt. Ayurvedic College, Guwahati, Assam, India. E-mail: karishmakaushik 40@gmail.com Submission Date: 08/06/2023 Accepted Date: 16/07/2023 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.8.8.11 creation of the group Vedanasthapaniya were done by Acharya Charak [1] The word " Vedana " can be interpreted in two ways. It may denote pain and sensation in general, indicating that the problem of pain was equally troubling the minds of ancient sages, just as we are currently eager to discover some effective drugs. It is clearly stated by Charaka that health is happiness and disease is pain. Based on the same principle, life has also been divided into two broad categories: Sukha (happiness) and Dukha (pain). To address this issue, various remedies were discovered and attempts were made to prevent and treat painful situations when they arise. In their respective fields, all branches of Ayurveda have been involved in fulfilling these responsibilities. In Shalya Tantra, this problem has gained prominence due to the traumatic nature of ailments that inflict severe pain on the body and mind. Urgent management of these problems is required, and the surgeons apply the necessary methodology to effectively handle the situation. A B S T R A C T Pain is experienced as a subjective feeling. Several words such as Vedana, Shoola, Dukha, Ruja and Pida have been employed to describe pain. Due to its subjective nature, the intensity of pain varies from individual to individual, time to time, and site to site. Pain, predominantly caused by Vata , is a pathological symptom. Therefore, while screening the drug for this problem, it should be kept in mind and outstanding drugs that may prove useful in this regard should be selected. Within the Vedanasthapana Mahakashaya, mentioned in Charaka Samhita, certain medicinal compounds exhibit remarkable abilities to alleviate pain, regardless of its cause. A closer examination of these compounds has been studied in this paper which reveals their distinct pharmacological properties. These compounds display analgesic, anti-inflammatory, and mild sedative attributes, which collectively contribute to pain relief. This paper aims to scrutinize the pharmacological properties of compounds within the Vedana Sthapana Mahakashaya which display valuable insights into the multifaceted mechanisms through which pain can be effectively alleviated Key words: Vedana, Pain management, Ayurvedic analgesic

Karishma Kaushik et al. A review article on Vedanasthapan Mahakashaya ISSN: 2456-3110 REVIEW ARTICLE August 2023 Journal of Ayurveda and Integrated Medical Sciences | August 2023 | Vol. 8 | Issue 8 80 Concept of pain in Ayurveda Pain is experienced as a subjective feeling. Several words such as Vedana, Shoola, Dukha, Ruja and Pida have been employed to describe pain. Due to its subjective nature, the intensity of pain varies from individual to individual, time to time, and site to site. It is greatly influenced by the sensitivity of the mind. In Vataja Prakriti patients and individuals with Vata vitiation, the prominence of pain sensation is observed [10-11] Mechanism of pain in Ayurveda Vitiated Vata , among the Tridosha , stands as the primary causative factor for all pain conditions. The manifestation of pain is significantly influenced by Vata's Rooksha and Chala Guna. The nature and attributes of pain differ based on the accompanying Dosha with Vata . The manifestation of Vedana varies in the body due to the distinct expressions of Vata associated with Kapha and Pitta [10-11] Mythological description of Shoola in Ayurveda The mythological origin of Shoola is mentioned in Harita Samhita. It is mentioned that Lord Shiva, who was disturbed by Kamadeva during meditation, became angry. Kamadeva , in fear, took refuge in the body of God Vishnu. Lord Shiva, in his anger, threw his Trishula , which was diverted by God Vishnu towards Prithivi (earth). As a result, Shoola arose in human beings from the Trishula . It came to be known as Soola due to its origin from the Trishula [10-11] Sites of Vedana / Pain The manifestation of happiness and miseries primarily occurs in the sense organs, which are considered the most important sites. In Ayurvedic literature, focus has been directed towards the origin, nature, and classification of pain. The term " Shoola " is utilized to denote painful sensation. Shoola is not regarded as a symptom or an independent disease entity in Ayurveda, but a more comprehensive perspective is taken regarding the etiopathology and management of pain. Shoola is described as the outcome of Vata Vyadhi. The involvement of Vata is deemed essential for the presence of pain ( Shoola ), as stated in Sushrut Samhita [4] However, both Pitta and Kapha influence the nature and intensity of pain. Therefore, all three Doshas ( Vata , Pitta , and Kapha ) collectively bear responsibility for the origin, development, and perception of Pain [4] Shoola is described by Susruta as Shankha Sphotanavat Teevra Vedana. Focal symptoms in the body are produced by Shoola . In Stree Roga, Shoola in the Yoni (reproductive system) is considered a symptom of Vatala Yoni. Thus, it is evident that in Ayurveda, Shoola is regarded both as a symptom and a disease. Consequently, the perception of a painful stimulus, ranging from negligible to severe pain, depends on the predominance of Vayu ( Vata ) in an individual at that given time. Pain is felt throughout the body in the Manas (brain), except in hairs, small hairs, tip of nails, ingested food, excreta, and urine [3] Types of Vedana /Pain The exact nature of pain experienced by the individual is vividly described in Ayurveda, leaving little room for additional adjectives and adverbs. Detailed descriptions are provided regarding various methods, including the use of drugs, vomiting, fasting, and more, for the alleviation of all types of pain. Vedana is classified into five types based on the predominance of Dosha in relation to Vrana (wound) [5] 1 Pain of Vatik Vrana : When pin pricking, stabbing, staffing, beating, cutting, girdling, stirring, throwing, irritating, burning, bursting, tearing or dividing type of pain is experienced in a Vrana , or when there is cramp, radiating, filling type of pain, rigidity, numbness, penetrating pain, or various types of non-specific pain that occur repeatedly, it should be recognized as Vedana resulting from excessive vitiation or predominance of Vata . A similar concept is found in Sushrut Samhita [6] 2 Pain of Paittik Vrana : When the pain of Vrana cause local, regional or generalized burning sensation it appears as if smoke coming out of wound or sensation of burning charcoal covered all over the body, with rise of temperature and pain as if Kshar has been applied on the cut, wound, predominance of Pitta should be concluded. Same idea exists in Sushrut Samhita [6]

Karishma Kaushik et al. A review article on Vedanasthapan Mahakashaya ISSN: 2456-3110 REVIEW ARTICLE August 2023 Journal of Ayurveda and Integrated Medical Sciences | August 2023 | Vol. 8 | Issue 8 81 3 Pain of Raktaja Vrana : The pain caused by the predominance of vitiated blood ( Shonita Rakta ) is similar to that caused by the vitiation of Pitta . 4 Pain of Kaphaja Vrana : When a Vrana exhibits itching sensation, heaviness, numbness, a sensation of being covered with paste, mild pain, rigidity, and a feeling of coldness, it is presumed to be caused by the vitiation of Sleshma or Kapha . A similar concept is found in Sushrut Samhita [6] 5 Pain in Sannipataja Vrana : When there is a mixed sense of all the types of pain described above, it should be deemed to be due to the vitiation of all three Doshas . The same description is found in Sushrut Samhita [6] Contents of Vedanasthapan Mahakashay [1] 1 Sala ( Shorea robusta Gaertn.f) 2 Katphala ( Myrica esculenta Buch-Ham.) 3 Kadamba ( Anthocephalus indicus A. Rich) 4 Padmaka ( Prunus cerasoides D. Don) 5 Tumba ( Zanthoxylum armatum Roxb) 6 Mocarasa (Resin of Salmalia malabarica Schott and Endl) 7 Sirisa ( Albizzia lebbeck Benth) 8 Vanjula ( Salix caprea Linn) 9 Elavaluka ( Prunus cerasus Linn) 10 Asoka ( Saraca asoca ) Properties of Vedanasthapan Mahakashhay [7] Name Chemical Composition Pharmacodynamics Part used Sala Barktannin 7- 12% w Tree trunkdeo-gum resin commonly known as 'ral' (sala niryasa). Rasa - Kashaya, Madhura Guna - Ruksha Virya - Sita Vipak - Katu Prabhav - Vedanasthapana Resin, Stem Bark, leaf, heart wood, fruit, flower. Doshakarma - Pittakapha Samak Katphala Barktannin (32.1%), myricetin (hexahydroxy flavone), glycoside myricitrin, aglycone, quercetrin. Rasa - Kasaya, Tikta, Katu Guna - Laghu, Tikshna Virya - Ushna Vipaka - Katu Doshkarma - Kaphavata Samak Bark, flowers. Kadamba Cinchotannic acid, steroids and reducing sugars. Rasa - Kashaya, Madhura, Lavana. Guna - Ruksha Virya - Sita Vipak - Katu Prabhava - Vedanasthapana Doshakarma - Vatapittasamak Bank, leaf, fruits, root. Padmaka Flavonoid Sakuranetin (1%), flavone genkwanin, isoflavone prunerin, isoflavone, padmakastin, glycosides sakuranin, padmakastin, taxifolin. Rasa - Kasaya, Tikta Guna - Laghu Virya - Sita Vipaka - Katu Dosakarma - Kaphapitta Samaka Bark, seeds (kernel) Tumba Linalocol, dipentene, cinamic methyl ester, fragramie, berberine, dictamine, mangofluorine, xanthoplanine, skimmianine, volatile oil and resin. Rasa - Katu, Tikta. Guna - Laghu, Ruksha, Tikshna Virya - Ushna Vipaka - Katu Dosakarma - Kaphavatasamak, Pittavardhaka Bark, fruits Mocarasa mineral matter, tannin, tannic acid, gallic acid. Rasa - Madhura, Kasaya Exudate (gum resin)

Karishma Kaushik et al. A review article on Vedanasthapan Mahakashaya ISSN: 2456-3110 REVIEW ARTICLE August 2023 Journal of Ayurveda and Integrated Medical Sciences | August 2023 | Vol. 8 | Issue 8 82 Guna - Laghu, Snigdha, Picchila Virya - Sita Vipaka - Katu Dosakarma - Khapittasamak Sirisa Tannin 7-11% and saponin. Bark also yields gun-resin Rasa - Madhura, Tikta, Kashaya Guna - Laghu, Ruksha, Tikshna Virya - Sita Vipak - Katu Dashakarma - Tridoshasamak Bark, flower, seed, leaf Vanjula Cyanidin, pipecolic acid, phenol glycosides, fragilin, picein, salicin, salicortin, salireproside, triandrin, vimalin. Rasa - Kasay, Tikta Guna - Laghu Virya - Sita Vipaka - Katu Dosakarma - Kaphapitta Samaka Bark, flowers, roots, leaves Elavaluka Polyphenol, phenolic acids(3- caffeoylquinic, 5- caffeoylquinic and p-coumaric acids), Flavanols (catechin and epicatechin derivatives), flavonols (glycosides of quercetin and kaempferol), Phytoconstituen t (arabinose, galactose, xylose, mannose, and rhamnose) Rasa - Kashay Guna - Laghu Virya - Sita Vipaka - Katu Dosakarma - Kaphavata Samak Bark, fruit Asoka Tannins (0.57% – 7.85%), ash (2.43% – 6.69%), and other Rasa- Kashya, Tikta Guna- Laghu, Ruksha. Virya- Sita Stem bark, Flowers seeds extracts (5.74% – 14.07%) Vipak- Katu Doshakarma- Kaphapitta Samak Probable mode of action of each drug [9] Shaal - Shaal brings soothing relief to aggravated Pitta caused by its naturally Madhura Rasa and Shita Virya . Its Madhura Anurasa help in Anulomana of Vata . Moreover, its composition rich in nor-triterpenes, tannic acid, and tri-terpenic acid grants it antiinflammatory, bactericidal, and analgesic properties. Katphala - With its Tikshna, Laghu Guna and Ushna Virya, Katphala harmonizes imbalanced Kapha and other Doshas . Its Ushna Virya alleviates pain by easing Vata blockages due to Kapha or other Doshas , while its potent warmth aids in this process. Kadamba – Kadamba is Tikta and Kashaya Rasa, along with its Shita Virya, possesses potent antiinflammatory abilities. By taming aggravated Pitta , it naturally relieves discomfort. The presence of cinchotannic acid further enhances its anti-inflammatory and pain-relieving characteristics. Padmaka - Embracing a blend of Kasaya, Tikta Rasa, Shita Virya and Laghu Guna, Padmaka specifically soothes aggravated pitta. Remarkably, it balances Vata and kapha, offering comprehensive pain relief. Notably, constituents such as prunetin, padmakastein, sacchuranin, and taxifolin contribute to its CNS-acting analgesic potential. Tumba – Tumba is Katu, Tikshna , and Ushna Guna attributes dissolve Vata obstructions caused by Kapha imbalance. Mocharasa - Easing discomfort by calming elevated Pitta and Rakta through its Kashaya Rasa, Shita Virya, and Snigdha Guna. Notably, berberine, dictamine, and xanthoplanin lend antipyretic properties. Shirisha - Its combination of Kashaya, Madhura, and Tikta Rasa works to balance Pitta and Rakta . This also indirectly soothes Vata , Pitta and Rakta , ultimately providing pain relief. Vanjula - Vanjula effectively alleviates pain resulting from Pitta and Rakta issues like burning sensations and

Karishma Kaushik et al. A review article on Vedanasthapan Mahakashaya ISSN: 2456-3110 REVIEW ARTICLE August 2023 Journal of Ayurveda and Integrated Medical Sciences | August 2023 | Vol. 8 | Issue 8 83 inflammation. Its blend of Kashaya and Tikta Rasa, combined with its Shita Virya, facilitates this relief. Additionally, the presence of salicylic acid imbues it with analgesic, antipyretic, and anti-inflammatory potential. Elavaluka – Elavaluka is Kasaya Rasa and Shita Virya specifically pacify provoked Rakta Dosha, diminishing discomfort. It also exhibits antipyretic qualities. Ashoka - With its Tikta, Kashaya Rasa, coupled with a Shita Virya, Ashoka reduces Pitta -related concerns. By harmonizing Pitta , it effectively diminishes pain. Additionally, its content of tannic acid and gallic acid contribute to its analgesic and anticoagulant effects. S UMMARY AND CONCLUSION Pain, regardless of its origin, is a universal challenge that people worldwide grapple with. The sensation of pain serves as a protective mechanism, alerting individuals to potential harm or adverse conditions within their bodies. In Ayurveda , Vata Dosha emerges as the underlying source of various types of pain. The convection and the enforcement of all the sensations of the body are enforced by Vata. [2] Remarkably, within the Vedana Sthapana Mahakashaya , certain medicinal compounds exhibit remarkable abilities to alleviate pain, regardless of its cause. A closer examination of these compounds reveals their distinct pharmacological properties. Initially, specific substances within the Vedana Sthapana Mahakashaya mitigate pain by appeasing Vata Dosha through their lubricating qualities ( Snigdha Guna ) and warming potency ( Ushna Virya ). Subsequently, the same compounds, due to their lubricating properties, foster an increase in Kapha Dosha, inducing restful sleep and further reducing pain through their sedative effects [8] Among the compounds, Shaal, Mocharasa, and Jalvetas exhibit pain-alleviating properties by pacifying Vata Dosha, owing to their heavy ( Guru ) and slimy ( Pichchhila ) attributes. Additionally, Ashoka , Mocharasa, Shirisha, and Kadamba demonstrate efficacy in managing hemorrhagic pain through their capacity to constrict blood vessels ( Rakta-Stambhana ) and mitigate blood-related imbalances ( Rakta-Pitta Shamana ). From a contemporary perspective, several compounds in this context contain gallic acid, salicylic acid, hydrocyanic acid, and cinchotannic acid. These compounds display analgesic, anti-inflammatory, and mild sedative attributes, which collectively contribute to pain relief. Notably, their sedative effects extend to the nervous system, further substantiating their role in pain reduction. In summary, this discourse delves into the intricate world of pain management within Ayurvedic principles and modern pharmacology. By scrutinizing the pharmacological properties of compounds within the Vedana Sthapana Mahakashaya, we gain valuable insights into the multifaceted mechanisms through which pain can be effectively alleviated REFERENCES 1 Sastri K, Chaturvedi G, editors. Charak Samhita of Agnivesha, Vidyotini, Sutrasthan, Ch. 4, Ver. 47. Varanasi: Chowkhamba vidya bhawan. 1962.pp.96. 2 Sastri K, Chaturvedi G, editors. Charak Samhita of Agnivesha, Vidyotini, Sutrasthana, Ch. 12, Ver. 8. Varanasi: Chowkhamba vidya bhawan. 1962.pp.215 3 Sastri K, Chaturvedi G, editors. Charak Samhita of Agnivesha, Vidyotini, Sharirasthana, Ch. 1, Ver. 36. Varanasi: Chowkhamba vidya bhawan. 1962 4 Ambika Dutta Shastri, Sushruta Samhita (1962). Hindi Commentary. Sutrasthan, Chapter 17, ver 12. Chow. Curr. Res. 7:361 5 Ambika Dutta Shastri, Sushruta Samhita (1962). Hindi Commentary. Sutrasthan, Chapter 22, ver 11-12. Chow. Curr. Res. 7:361 6 Ambika Dutta Shastri, Sushruta Samhita (1962). Hindi Commentary. Uttarasthana, Chapter 42, ver 82-87. Chow. Curr. Res. 7:361 7 Sharma PV. Dravyaguna Vigyan, Vol. 2. Varanasi: Chaukhambha Bharati Academy. 2018.pp.671. 8 Kumar P, Dave OP, Paliwal B. A Randomized Controlled Double Blind clinical trial to evaluate the efficacy of Vedanasthapana Mahakashaya as an anxiolytic and analgesic polyherbal drug in perioperative anorectal cases. J Ayu Herb Med 2022;8(3):178-182. DOI: 10.31254/jahm.2022.8308 9 Prabhakar Shukla, Poonam Bijalwan, Suresh Chubey, Athul TP. A review article on role of Vednasthapan

Karishma Kaushik et al. A review article on Vedanasthapan Mahakashaya ISSN: 2456-3110 REVIEW ARTICLE August 2023 Journal of Ayurveda and Integrated Medical Sciences | August 2023 | Vol. 8 | Issue 8 84 Mahakshaya on management of pain. IRJAY, vol 2, issue 4, July-Aug:2019; 1-8. 10 Champak Medhi, Evaluation of Shigru ( Moringa oleifera Lam.) seed in Sangyaharan in post-operative pain management, Ph.D Thesis, SSUHS, Ghy-32. 11 Champak Medhi, Evaluation of Shigru ( Moringa oleifera Lam.) in Sangyaharan as pre anaesthetic agent, (2003) M.S. (Ay.) Sangyaharan Thesis, IMS, BHU, Varanasi. ******************************* How to cite this article: Karishma Kaushik, Champak Medhi, Pankaj Kumar Barman. A review article on Vedanasthapan Mahakashaya, a Potent Ayurvedic Analgesic. J Ayurveda Integr Med Sci 2023;08:79-84. http://dx.doi.org/10.21760/jaims.8.8.11 Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2023 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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