Sanjay Prakash, Amit Kumar A, Dwivedi K. N. Role of Pippali Kshirapaka in Prevention and Management of Chronic Fever. Biomed Pharmacol J 2012;5(1)

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Sanjay Prakash, Amit Kumar and K. N. Dwivedi

Department of Dravyaguna, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005 (India).

Abstract

Kshirapaka is one of the most useful kalpana mentioned in our Ayurveda text. By Kshirapaka kalpana we may increase efficacy and potency of drugs and minimize unwanted effects. By this kalpana we may find both water and fat soluble constituents present in drugs in the milk. In Ayurvedic texts, it has been mentioned that Pippali is Katu rasa, laghu, snigdha and tikshna guna, madhur vipak & Anushna shita Virya. By virtue of above qualities pippali is kaphavatashamak, hence it is beneficial in urdhvajatrugata rogas like kasa, asthama and Rajyakshama. Katu rasa in pippali is Agnideepak and Triptighna. Due to snigdha and Ushna Guna pippali is Vatanulomak and Shula Prashmana, due to Rasayan Property used as Vardhaman Pippali. In Charak Samhita milk is allowed in Jirnajvara because patient of jirnajvara remains weak, due to weakness of Agni, so the aim of treatment in jirnajvara is to increase both agni and bala of patient. Pippaliksirapaka kalpana may be very beneficial preparation in patient with jirnajvara as it increases both Agni bala and Aatur bala.

Keywords

Ayurveda; Kshirapaka; Kwatha; Jirnajvara

Introduction

Kshirapaka is one of the unique preparations of Ayurvedic pharmaceutics. Here milk is used as a media for the formulation. Because milk an emulsion, having capacity to dissolve mainly water soluble, protein soluble and fat soluble ingredients to some extent from the drugs used for Kshirapaka preparation. Besides to this, milk is also having antacid property due to its alkalinity. Because of more dietic value of milk it is used as a dietic regimen and as well as medicine. Because of its palatability, it can be used easily for treatment purposes. Because of alkalinity of milk and its antidote activity Kshirapaka can be used in wide range. Usually Kashaya rasa dravyas are used for the preparation of Kshirapaka. Reason is that because of the irritability of the Kashaya rasa acceptance of these drugs in direct form is comparatively less. Hence ancient Ayurvedic scholars have made a step to make the palatable form of Kashaya rasa dravya by the name of Ksirapaka. Moreover synergetic action of both milk and medical drugs also achieved by means of this formulation.

Pippali Kshirapaka

Pippali Kshirapaka is made by following Kwatha like preparation. As this   drug   is   having Katu Rasa and Ushna Virya. That will be reduced by doing Kshirapaka and by doing this active principles of the drug will get dissolved in milk. For making the milk laghupaki, Shunti Kshirapaka    are   also mentioned. Usually for making Kshirapaka, drugs which are having amla and lavana rasa not supposed to be taken, because amlarasa and lavanarasa will spoil the milk. Drug is mixed after making it into coarse powder from. Always Kshirapaka has to be prepared in mandagni so that sensitive active principles may not get spoiled with severe temperature. It can be administered by mixing appropriate of sugar. Medicated milk has been recommended in jirnajavara¹. Milk should be taken eight times of the drugs. To this, water should be added in four times the quantity of milk. After boiling only the quantity of milk should remain. This is the procedures for preparing the medicated milk. When medicinal drugs are made paka with Kshirapaka medicine may not release active principles completely in to the milk. Hence by using medicinal drug, kwatha is proposed. Equal quantity of this kwatha and Kshira are taken, then heated with mandagni till milk alone is left². Here Vagbhata’s technique regarding Kshirapaka is seems to be more reliable for separation of more active principles from the drug and introducing them in to milk. In chronic fever when kapha is attenuated, milk works like rector while the same taken in acute one kills the patient like poison.³ But milk is unwholesome like poison to human being suffering from jvara in primary stage of fever.⁴ The milk cooked by addition of drugs is alleviating to all types of chronic fever especially nirama jvara predominated by vatapitta doshas and with burning sensation and thirst. Such mediated milk may be used when cooled down or hot.⁵  One part of drug is boiled in 8 part of milk with the addition of 32 parts of water. The boiling is continued till the water is get evaporated and milk alone is left. It is used for treatment of Shula and ama.⁶ Medicinal drug one part, milk fifteen part, water fifteen part. All are mixed and made paka till total quantity is reduced upto the quantity equal to milk then filtered and collected liquid is called Kshirapaka.⁷

Pippali

Botanical Name-Piper longum Linn., Family- Piperaceae. Pippali is a powerful stimulant for both the digestives and the respiratory systems and has been shown to have a rejuvenating effect on the lungs. Pippali plays an important role in aiding the thermogenic response. This effect is the result of  thyroid hormone in the body and makes Pippali Ayurvedic complementary component whose benefit increases the bioavailability and enhance absorption other active ingredients. Slender aromatic climber with perennial woody roots, stems creeping below and climbing on supports young shoots downy. Branches prostrate or creeping with broad leaves flowering shoots erect. Spike cylindrical pedunculate male larger and slender, fruits ovoid yellowish orange sunk fleshy spike. In transaction of the fruiting spikes are seen one seeded fruitless, arranged in a circle on the main axis. Plant occurs throughout the country. The long-pipper is cultivated on large scale in limestone soil. There are four kinds of pippali – pippali, Gajapippali, saimhali and  vanapippali. Gajapippali is named as chavya (Piper chara hunter).In market there are two types chhoti papal and barhi papal. The dried ftuit yields 0.7 % of an essential oil with spicy odour resembling that of pepper and ginger oil. Fruit contains piperine 4-5% and pipalatine alkaloids.  Two new monocyclic sesquiterpenes 15.5 and 11.1% respectively. The roots contain piperine (0.15-0.18%) and pippalartine  (0.13-0.20%) piper longuminne, a steroid and glycoside. Besides the traces of a yellow crystalline pungent alkaloid, other constituents found in the drug include triacontane, dihydrostigmasterol and unidentified steroid. The new liquid alkaloids have been isolated form root, one of which is designated as alkaloids A which is closely related to pellitorine producing marked salivation, numbness of the mouth. Alkaloid A showed significant in vitro antitubercular activity against m.tuberculosis. Pippali is having Katu Rasa, Guru, snigdha, Tikshna Guna, Anusnasita Virya, Madhura Vipaka and pittasamaka Dosakarma.

Therapeutic uses

The drug pippali is altirative,digestive,stimulant and tonic. It is used in abdominal distention,ascites,colic consumption,cough and fever.Piperine isolated from the drug possess anticolic property. It is used as counter irritant and analgesic when applied locally for muscular pains and inflammations. A snuff in coma and drowsiness is used and internally as carminative, as sedative in insomnia and epilepsy. Pippali is chiefly an esteemed drug in cough pulmonary tuberculosis allied diseases of respiratory system. It is specifically useful in chronic fever. Pippali belongs to valuable Rasayana group of drugs. Pippali has diverse pharmacological activities including nerve depressant and antagonistic effect on electro shock and chemo shock seizures, as well as muscular incoordination 1% essential oil, which exhibits antibacterial activities. A common us, of fruit in the permission of recurrent effects of bronchial asthma and in malaria in children, also enhances thermogenic response or role as or metabolic heat energy.

Pathogenesis of Jeerna jawara

Figure 1   Click here to View figure

Discussion and conclusion

Concept of Ksirapaka is seen first time in Charaka samhita, Jwara chikitsa, here he described Ksirapaka of trikantaka, bala, etc. similar concept about kshirapaka has been given by other scholar after Charaka like Sushruta, Vagbhatta, Sharangdhara etc. The drugs having kashaya, tikta and kutu rasa and tiksna properties are commonly used for Kshirapaka preparation. The main aim of kshirapaka is to reduce the tikshna guna of dravyas by means it becomes more palatable. Apart from this both water soluble and fat soluble active ingredients comes in to this preparation, which makes this formulation more efficacious than other preparation like kwatha. The additional advantage of Ksirapaka is due to the property of milk itself. Property  of kshira are 10 in number similar to property of Ojas. By these  properties kshira promotes the longevity of life and maintain the dhatus.⁸ Pippali is having katu rasa, madhura, vipaka and anushna shita virya, through madhura vipaka and anushna shita virya it may pacifies pitta, Charaka placed pippali in dipaniya mahakasaya and triptighna mahakasaya. So it seems that pippali has the property of kaphahar and Amapachana, by which it performs dipan and triptighna karma. As we know the root cause of jwara is formation of ama at GIT level as well as in the systemic level so Ama pachana property of pippali will help to pacify the jvara.It also helps in fracture healing. Dose of pippali kshirapaka is 2 to 4 tola.

Refrences

1. Charaka Samhita (C.Ci.3/238)
2. Ashtanga Samgraha (A.S.Ka.8/12)
3. Chakradatta (C.1/262)
4. Bhaishajya Ratnawali(B.R.3/192)
5. Bhaishajya Ratnawali(B.R.3/193)
6. Sharangadhara Samhita (Sha.M.Kha.2/161)
7. Dravyaguna Vigyanam(D.G.Vi.7/6)
8. Charaka Samhita (C.Su.27/218)