A study on the Granthigna effect of Chincha Beeja Yoga (Tamarindus indica l.) Paint W.S.R to...

A study on the Granthigna effect of Chincha Beeja Yoga (Tamarindus indica l.) Paint W.S.R to Tundikeri (Tonsillitis).

Dr M. PARAMKUSHA RAOM.D.(Ayu),Ph.D.

P.G.Professor& H.O.D.Department of Dravyaguna

S.V.Ayurvedic college, Tirupati,

Andhrapradesh

By-Dr K.RAGHU RAMUDU,

Final year P.G ScholarDepartment of Dravyaguna

S.V.Ayurvedic college,Tirupati,Andhrapradesh

Tundikeri is commonly encountered now a days due to the dietary habits of taking spicy food, cold beverages, refrigerated milk products and cold climate. Lower socio-economic group people are particularly prone as the immunity status is low in them. These factors coupled together results in recurrent episodes of disease. Tundikeri not only cripples children from majority of their enjoyable and learning movement but also makes adults to feel uneasy, restless.

INTRODUCTION

Antibiotics are the main stay in treatment of tonsillitis as far as the conventional medicine is concerned. They can give temporary relief to the patient but cannot check the frequent reoccurrence of the disease. Their surgical removal put a straight forward attack on respiratory, gastrointestinal tract and immunity. Further surgical procedure has its own complications also.

INTRODUCTION

Late Sri Balaraj Maharshi the Former advisor on Ayurveda to the government of Andhra Pradesh, India & Brazil founder of this college has suggested Chincha beeja Lepa in Tonsillitis.My guide Dr M. Param kusha Rao close associated of Balaraj maharshi was observing its promising effect.Therefore Chincha beeja is taken to study its Grandhighna effect in Tundikeri.

Why CHINCHA BEEJA is taken?

Dr. Balraj Maharishi (1917-1998)

AIMS & OBJECTIVES

•To study the efficacy of chincha beeja lepa in tonsillitis•To develop a safe single drug for management of tonsillitis•To find out economical therapy for tonsillitis with minimum or with out side effects

Kingdom PlantaePhylum Spermatophyte

Class AngiospermSub class DicotyledoneFamily LeguminosaeSubfamily Caesalpiniaceae

Genus TamarindusSpecies Indica

Taxonomical classification of chincha

DRUG REVIEW

Rasa Kasaya ReferenceVasthuguna

Dipika

Guna Not mentionedVipaka Not mentionedVirya Not mentioned

Doshaghnata Kapha haraKarma Sukra sthambaka

Rakta sthambaka Upayukta Vyadhi Krimi roga,

Grahani, Sukra nasta,Raktatisara,

Rakta pradaram

Properties of chincha bheeja

PHARMACO THERAPEUTIC APPLICATIONS

(DRAVYAGUNA KRIYAYOGA) 1.Gudha Bramsha: Fried amlika seeds are rubbed with water and pasted on anus after setting the tract in position. By this it dose not prolapse again. (S.B.4.919)2.Somaroga: The seeds of amlika are soaked with water the previous day and then pounded with milk. This past, if taken regularly, alleviates somaroga. (VD.2.13 )3.Rakta arshas: burn the seeds of chincha and make bhasma give in 1-2 masha curd. (G.P.113)4.Amaatisara: Remove the outer covering of ripened chincha seed, white jeeraka and mishri each 6 masha. Make a churna of all make a dose in 3 parts and give at every 3 hour interval with honey. This will cure old disease also. G.P.109 (a)

5.Sweta pradara ( in other pradara also): Soak seeds in water and next day remove seed coat and make a paste of 4 seeds administered with mishri will cure sweeta pradara. (G.P.110)6.Jwara: If daha and palpitations is there seeds of chincha and kharjura 2-2 tola are boiled in sera milk on low flame, sieve it and given to patient. No other food or medication should be given on that day. (G.P.111 ) 7.Kanta sotha: 6 masha of chincha in 2 sera of jala is boiled till the jala remains half then 2 tola of rose water is added and sieved. Gargling with this will cure kanta sotha. (G.P.112 )8.Athisara: Seed coat of Amlika seeds, Sunthi, Rock salt and Yavani are mixed together and taken with fresh buttermilk it checks Athisara quickly. (VD.6.5)

PHARMACO THERAPEUTIC APPLICATIONS

(DRAVYAGUNA KRIYAYOGA)

Mineral mg/100g

Tamarind Seed

Calcium 9.3-786.0Phosphorus 68.4-165.0Magnesium 17.5-118.3Potassium 272.8-610.0Sodium 19.2-28.8Copper 1.6-19.0Iron 6.5Zinc 2.8Manganese 0.9

Mineral content of tamarind seed

Source: Marangoni et al. (1988); Ishola et al. (1990); Bhattacharya et al. (1994); Parvez et al. (2003).

Amino acid content of tamarind seed There are 20 amino acids present in the human body. 9 Essential Amino acids and 11 Non-Essential Amino acidsChincha bheeja contain 8 Essential amino acids and 9 Non-Essential amino acids.

Amino Acid

Tamarind mg/g N (Total

N)

Isoleucine 313Leucine 531Lycine 475

Methionine 113Cystine 106

Phenylalanin 318

Tyrosine 287Threonine 200

Valine 306

Arginine 450

Histidine 143

Alanine 312

Aspartic 768

Glutamic 1056

Glycine 331

Proline 287

Serine 350Source: FAO (1970); de Lumen et al. (1986, 1990).

Reported Pharmacological Activity of Tamarindus indica seed

Antidiabetic activityAntioxidant activity Anti Inflammatory activity Antimicrobial activityAntipyretic activityAnticancer activityAntitumor and Immunopotentiating ActivityAntiemetic activityHepato protective activityAnalgesic activityAnti Diarrheal activityLaxative activity Anti venom activityAnti ulcer activityAnti obesity activity Hypolipidemic activity

Granthi

Any localised swelling looking like a knot caused by vitiated Tridoshas, Rakta, Mamsa and medas with the Predominance of Kapha and Vata.

Vagbhata also opinion that Kapha Pradhana doshas along with Rakta, Mamsa and Medas cause a swelling which is vritta, unnata and gradhita(Round, elevated and compact).

REVIEW OF GRANTHIGHNA KARMA ON TUNDIKERI

Tundikeri

शॊफः सु्थलस्तोददाह प्रपाकि� । प्रागु�ताभ्यां तुण्डि��ेरि� मता तु ॥ (Su.Ni.16/44) Tundikeri is that disease caused by the vitiation of Kapha and

Rakta. There is Sthula Shotha (oedema), Toda (pricking type of pain), Daha (burning sensation), Prapaki (Suppuration).

According to Acharya Vagbhatta, Tundikeri is having the shape of Karpasiphala and is Hanusandhi Asrita Kanta (root of the temperomandibular joint) It is Picchila (Slimy), Manda Ruk (Mild pain) and a firm swelling.

The definition given by Acharya Sushruta resembles the acute stage of tonsillitis.

where as the definition by Acharya Vagbhatta is featuring probably the chronic stage of tonsillitis.

Involvement of Mamsa dhatu could be at the level of poshaka mamsa dhatu level. Rakta dhatu Marghavarodha caused by the either sotha (caused by Bacteria, virus, allergens) or Kapha dosha produced by Nidhana. They obstruct the flow of Rasa Rakta dhatu and inhibit the further dhatu posana (metabolism). The nutrients fraction of Mamsa dhatu retained in the blood accumulate in Tonsils. The accumulated mamsa dhatu produces a Granthi.

Tundikeri is modified Granthi*Samprapthi

*Dr. M. Rama Sunder rao, text book of Shalya Tantra Vignamam,2002,page No.397

Samprapthi vighatana ( Dravya Karma)

20x Image of Chincha beeja 200x image of chincha beeja

MEANOSCOPIC EVALUATION OF CHINCHA BEEJA

Pharmacognostic study

T.S of Chincha beeja

DRAVYA RASA GUNA VIPAKA VIRYACUMULATIVE

SANKHYA

CHINCHA

BHEEJA

Kashaya

P1K1

Picchala

Ruksha

V1

K1P1

Katu

K2

Sheeta

P3

V1P5K4

Vata; 1

Pitta; 5

Kapha; 4

Doshaghna Gunaganana of chincha bheeja

Reference : Doshagna Guna Ganana (DGG) By Dr M.Paramkusha Rao A new arithmetic assessment of drugs effect on dosha based on Guna prabhava, International Journal of Ayurvedic Medicine, 2012,3 (3), 130-139, published online in http://ijam.co.in.

http://ijam.co.in/

S.No. Test Type of test

usedFP PP PDP

I Alkaloids Mayer’s test - - -II Carbohydrates Molisch test + + +III Starch Iodine test + + +

IV Tannins Ferric chloride test

+ + +

V Protein and Amino Acid Biuret Test - - -VI Flavonoids Led acetate - - -VII Saponins Foam test - - -VIII Acid test (pH) 7 7 7

Results and observations: Carbohydrates, Starch and Tannins are present in PF Group

drug, PP group drug & PDP group drug. Ph is 7 in three groups.

Phytochemical analysis results

Pharmaceutical preparationChincha beeja yoga

Preparation – 1 Paste of powder (PP)

Preparation -2 Paste of dried paste (PDP)

Preparation -3 Fresh paste (FP)

Microbiological study

Materials:•Bacteria- Staphylococcus aureus• Agar plate•Test tube•Dropper •Test tube stand •Incubator Method followed: Disc diffusion method.

Procedure of culture & sensitivity

Sensitivity Streptococcus aureus to Chincha beeja fresh paste (FP), Paste of Powder (PP) and paste of Dry powder (PDP).

Sensitivity of FP Sensitivity of PP

Sensitivity of PDP

Sample Sensitivity

FP + + +

PP + +

PDP +

The result shows that Chincha beeja fresh paste (FP) was more effective on Streptococcus aureus than the Paste of Powder (PP), paste of Dry powder (PDP).

REPORT

Chincha bheejaDistilled waterHot WaterSandalwood stone(which is used for chandan paste preparation) Sterilized cottonThundikeri salaka(Tonsil cops)Spirit lampWater heater Glass bowlGlass tumbler

MATERIAL AND METHODS

CLINICAL STUDY

Distilled waterSandalwood stone

Sterilized cotton Thundikeri salaka(Tonsil cops)Spirit lamp

Water heater Chincha bheeja churna

Glass bowl

Glass tumbler

Patients selected from P.G department of Dravyaguna and Kaumarabhritya OPD.

A Health checkup camp conducted for the students of Nehru municipal school, Thirupati And examined 300 students and picked up few patients and gave treatment to them.

MATERIAL AND METHODS

HEALTH CHECKUP CAMP

In this study 40 patients were divided in to 4 groups. Groups Treated With

Group-1 Fresh paste (FP)

Group-2 Paste of dried paste (PDP)

Group-3 Paste of powder (PP)

Group-4 Placebo (PL) Wheat Powder with water

Patient allowed to gargle with lukewarm

water

Applied the chincha bheeja lepa on affected

tonsils with the help of tonsil cops.

Same procedure continued for 3 days

DRUG ADMINISTRATION

12 c.m

THUNDIKERI SALAKA (TONSIL COPS)

THUNDIKERI SALAKA (TONSIL COPS)

Thundikeri salaka(Tonsil cops) is a arrow shaped instrument which is made up of silverHead of this instrument have rough surfaced edges this type of edges useful for holding Cotton with out escaping.This instrument is very comfortable for applying the medicine on surface of tonsils

Inclusion criteriaAge group of 2years to 60yearsPatient having symptoms of tonsillitis viz. throat pain, dysphagia ,fever etcPatient willing for treatmentPatients of either sex will be included

Exclusion criteria Tonsillitis with complications e.g. Quincy, laryngeal edema, abscessAge group below 2 years and above 60 yearsOther conditions which mimic tonsillitis e.g. diphtheria, herpes etc

Dysphagia Score

No difficulty in swallowing 0

Patient feels difficulty in Swallowing of solid matters

1

Patient unable to swallow even Saliva 2

Patient unable to open his mouth completely due to severe pain

3

ASSESSMENT CRITERIA

Improvement in temperature (as observed by its fall):

Score

Normal temperature i.e., 98.6°F 0

Temperature rises from 98. 6°F - 100°F 1

Temperature rises from 100°F - 102°F 2

Temperature more than 102°F 3

Enlargement of tonsils Score

No enlargement 0

Enlarged within anterior pillars 1

Enlarged within posterior pillars 2

Kissing tonsils 3

Halitosis (Bad Breath) Score

Halitosis absent 0

Halitosis present only when opening of mouth angle completely

1

Halitosis present even during talking

2

Pricking Pain Score

No pain 0

Pain during food intake 1

Continuous pain 2

Symptoms No of patients with grade-0

(Nil)

No of patients with grade-1

(Mild)

No of patients with grade-2(Moderate)

No of patients with grade-3

(severe)

Dysphagia B.T 0 8 2 0

A.T 9 1 0 0

Redness in Mucus Membrane

B.T 0 6 4 0

A.T 9 1 0 0

Temperature B.T 4 5 1 0

A.T 10 0 0 0

Enlargement of Tonsils

B.T 0 3 7 0

A.T 7 3 0 0

Halitosis (Bad Breath)

B.T 3 2 5 0

A.T 9 1 0 0

Pricking Pain B.T 2 5 3 0

A.T 9 1 0 0

OBSERVATION & RESULTSGRADIATION OF SYMPTOMS BEFORE AND AFTER TREATMENT

GRADATION OF SYMPTOMS BEFORE AND AFTER TREATMENT IN GROUP -1(FP)

SYMPTOMS BEFORE AND AFTER TREATMENT OF GROUP-1 (FP)

B.T A.T B.T A.T B.T A.T B.T A.T B.T A.T B.T A.T 1 2 3 4 5 6

0

1

2

3

4

5

6

7

8

9

10

0

9

0

9

4

10

0

7

3

9

2

9

8

1

6

1

5

0

3 3

2

1

5

1

2

0

4

0

1

0

7

0

5

0

3

00 0 0 0 0 0 0 0 0 0 0 0

No of patients with grade-0 (Nil) No of patients with grade-1 (Mild) No of patients with grade-2 (Moderate) No of patients with grade-3 (severe)

Dysphagia 1


2

Temperature 3Enlargement of Tonsils 4Halitosis (Bad Breath) 5Pricking Pain 6

GRADATION OF SYMPTOMS BEFORE AND AFTER TREATMENT IN GROUP -2 (PDP)

Symptoms No of patients with

grade-0(Nil)

No of patients with

grade-1(Mild)

No of patients with

grade-2(Moderate)

No of patients with

grade-3(severe)

Dysphagia B.T 1 7 2 0A.T 7 3 0 0


B.T 0 9 1 0A.T 9 1 0 0

Temperature B.T 6 2 2 0A.T 8 2 0 0


B.T 0 7 3 0A.T 4 6 0 0


B.T 5 5 0 0A.T 8 2 0 0

Pricking Pain

B.T 5 5 0 0A.T 9 1 0 0

SYMPTOMS BEFORE AND AFTER TREATMENT OF GROUP-2 (PDP)


0

1

2

3

4

5

6

7

8

9

1

7

0

9

6

8

0

4

5

8

5

9

7

3

9

1

2 2

7

6

5

2

5

1

2

0

1

0

2

0

3

0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0


Dysphagia 1


2


GRADATION OF SYMPTOMS BEFORE AND AFTER TREATMENT IN GROUP -3 (PP)


grade-0(Nil)

No of patients with

grade-1(Mild)

No of patients with

grade-2(Moderate)

No of patients with

grade-3(severe)



B.T 0 6 4 0A.T 8 2 0 0



B.T 0 8 2 0A.T 6 4 0 0


B.T 4 5 1 0A.T 8 2 0 0

Pricking Pain

B.T 6 4 0 0A.T 10 0 0 0

SYMPTOMS BEFORE AND AFTER TREATMENT OF GROUP-3 (PP)


0

1

2

3

4

5

6

7

8

9

10

1

8

0

8

6

10

0

6

4

8

6

10

7

2

6

2

3

0

8

4

5

2

4

0

2

0

4

0

1

0

2

0

1

0 0 00 0 0 0 0 0 0 0 0 0 0 0


Dysphagia 1


2


GRADATION OF SYMPTOMS BEFORE AND AFTER TREATMENT IN GROUP -4 (PL)


grade-0(Nil)

No of patients with

grade-1(Mild)

No of patients with

grade-2(Moderate)

No of patients with

grade-3(severe)



B.T 0 9 1 0A.T 3 7 0 0



B.T 0 10 0 0A.T 0 8 2 0


B.T 6 4 0 0A.T 7 3 0 0

Pricking Pain

B.T 5 5 0 0A.T 5 5 0 0

SYMPTOMS BEFORE AND AFTER TREATMENT OF GROUP-4 (PL)


0

1

2

3

4

5

6

7

8

9

10

0

2

0

3

10

9

0 0

6

7

5 5

8

6

9

7

0

1

10

8

4

3

5 5

2 2

1

0 0 0 0

2

0 0 0 00 0 0 0 0 0 0 0 0 0 0 0


Dysphagia 1


2


ParameterMean

Mean Diff

% of relief

S.D S.Et-value P value SignificanceB.T A.T B.T A.T B.T A.T

Dysphagia 1.20 0.10 1.10 91.67 0.42 0.32 0.13 0.10 11.0000

<0.0001

Extremely significant


1.40 0.10 1.30 92.85 0.52 0.32 0.16 0.10 8.5105 <0.0001

Extremely significant

body temperature 0.70 0.00 0.70 100 0.67 0.00 0.21 0.00 3.2796 0.0095 Very

significant

Enlargement of tonsils 1.70 0.30 1.40 82.35 0.48 0.48 0.15 0.15 8.5732 <0.000

1Extremely significant

Halitosis 1.20 0.10 1.10 91.67 0.92 0.32 0.29 0.10 3.9727 0.0032 Very significant

Pricking pain 1.10 0.10 1.00 90.90 0.74 0.32 0.23 0.10 4.7434 0.0011 Very

significant

STATISTICAL ANALYSIS OF DATA STATISTICAL COMPARISON OF GROUP-1

STATISTICAL COMPARISON OF GROUP-2 (PDP)

ParameterMean

Mean Diff

% of relief

S.D S.Et-value P value Significance

B.T A.T B.T A.T B.T A.T

Dysphagia 1.10 0.30 0.80 72.72 0.57 0.48 0.18 0.15 6.0000 0.0002 Extremely significant

Redness in Mucus

Membrane1.10 0.10 1.00 90.90 0.32 0.32 0.10 0.10 6.7082 <0.0001 extremely

significant

body temperature 0.60 0.20 0.40 66.67 0.84 0.42 0.27 0.13 2.4495 0.0368 Significant

enlargement of tonsils 1.30 0.60 0.70 53.84 0.48 0.52 0.15 0.16 4.5826 0.0013 Very

significant

Halitosis 0.50 0.20 0.30 60 0.53 0.42 0.17 0.13 1.9640 0.0811 Not significant

pricking pain 0.50 0.10 0.40 80 0.53 0.32 0.17 0.10 2.4495 0.0368 Significant

STATISTICAL COMPARISON OF GROUP-3 (PP)Parameter Mean Mean

Diff% of relief

S.D S.E t-value

P value Significance

B.T A.T B.T A.T B.T A.T

Dysphagia 1.10 0.20 0.90 81.81 0.57 0.42 0.18 0.13 5.0138 0.0007 Extremely significant


1.40 0.20 1.20 85.71 0.52 0.42 0.16 0.13 9.0000 <0.0001 Extremely significant

body Temperature

0.50 0.10 0.40 80 0.71 0.32 0.22 0.10 2.4495 0.0368 Significant

enlargement of tonsils

1.20 0.40 0.80 66.67 0.42 0.52 0.13 0.16 6.0000 0.0002 Extremely significant

Halitosis 0.70 0.20 0.50 71.42 0.67 0.42 0.21 0.13 3.0000 0.0150 Significant

Pricking Pain

0.40 0.00 0.40 100 0.52 0.00 0.16 0.00 2.4495 0.0368 Significant

STATISTICAL COMPARISON OF GROUP-4 (PL)

Parameter Mean Mean Diff

% of relief

S.D S.E t-value P value SignificanceB.T A.T B.T A.T B.T A.T

Dysphagia 1.20 1.00 0.20 16.67 0.42 0.67 0.13 0.21 1.0000 0.3434 Not signific

antRedness in

Mucus Membrane

1.10 0.70 0.40 36.37 0.32 0.48 0.10 0.15 2.4495 0.0368 Significant

Temperature 0.00 0.10 0.10 0 0.00 0.32 0.00 0.10 1.0000 0.3434 Not signific

antenlargement

of tonsils1.00 1.20 0.20 20 0.00 0.42 0.00 0.13 1.5000 0.1679 Not

significant

Halitosis 0.40 0.30 0.10 25 0.52 0.48 0.16 0.15 1.0000 0.3434 Not signific

antpricking pain 0.40 0.50 0.10 25 0.52 0.53 0.16 0.17 1.0000 0.3434 Not

significant

OVER ALL RESULT OF THE STUDY ACCORDING TO % OF RELIEF

Parameter % of Relief (B.T-A.T/B.T 100)

Group-1Fresh paste

(FP)

Group-2Paste of dried paste (PDP)

Group-3Paste of

powder (PP)

Group-4Placebo (PL) Wheat Powder

with water

Dysphagia 91.67 72.72 81.81 16.67Redness in Mucus Membrane 92.85 90.9 85.71 36.37

body temperature100 66.67 80 0

Enlargement of tonsils 82.35 53.84 66.67 20

Halitosis 91.67 60 71.42 25Pricking pain 90.9 80 100 25

OVERALL RESULT OF THE STUDY ACCORDING TO % OF RELIEF

Dysphag

ia

Redn

ess in

Mucus M

embra

ne

body t

empe

rature

Enlarg

ement

of to

nsils

Halitos

is

Pricki

ng pa

in0

10

20

30

40

50

60

70

80

90

100

OVER ALL RESULT OF THE STUDY ACCORDING TO % OF RELIEF

Grup-1Group-2Group-3Group-4

Symptoms

% o

f Re

lief

INTER GROUP COMPARISON (ANOVA SINGLE FACTOR RESULT)

S.No Symptom F-Value P-Value Significance

1Dysphagia 6.000 0.0020 Very

significant

2 Redness in Mucus Membrane 7.222 0.0006 Extremely

significant

3 Temperature 4.041 0.014 Significant4 Enlargement of

Tonsils 22.46 <0.0001 Extremely significant

5 Halitosis (Bad Breath) 5.419 0.0035 Very

significant

6.Pricking Pain 7.515 0.0005 Extremely

significant

BEFORE TREATMENT AFTER TREATMENT

Group:3 Pt No: 5


Group:1 Pt No: 2


Group:1 Pt No: 8


Group:3 Pt No: 7


Group:2 Pt No: 5

DISCUSSION

•Chincha is found in all Nighantus. Cincha Bija description is found only in Vastuguna deepika.

•Sri Balraj maharshi (20th December 1917- 28th August 1998) had demonstrated several single drug applications in various clinical conditions.

•Chincha beeja also a clinical application suggested by him to Dr M. Paramkusha Rao he has treated several tonsillitis patients with this medicine. It has been tried in this study to establish a scientific evidence for a successful practice. Chincha bheeja is Kashaya in rasa, Ruksha in guna promotes absorption, and Kaphahara action removes obstruction. Krimi hara Karma of Chincha bheeja destroys Bacteria, Virus invaded in to tonsils.

•The chemical composition of Chincha beeja is found peculiar with chemical named as Xyloglucan (XG) . It is very hydroscopic in nature and found to be effective. To prove it another study is required.

CONCLUSION

•Group-1 patients have shown better results when compared with other 3 Groups. That means Fresh Paste is more effective than other forms. •The result with 3rd group Chincha beeja powder mixed with water has shown next better results. 2nd group chincha beeja dry powder has not given satisfactory result. But better than Placebo Group.

ACKNOWLEDGEMENT

I am thankful to TTD, Late Sri Balaraj Maharshi, Principal S.V Ayurvedic college Tirupathi, and my guide & Professor Dr M. Paramkusha Rao garu and my teachers for kind support.

Dr Parvathi Devi garu S.V Ayurvedic hospital for providing Dravyaguna theater to conduct the study along with many other dravyaguna kriyayogas.

A study on the Granthigna effect of Chincha Beeja Yoga (Tamarindus indica l.) Paint W.S.R to...

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