LITERATURE REVIEW

DISEASE PROFILE
Sthoulya
Nirukti/ Paribhasha
In Sanskrit grammar each and every word is derived from a particular root word

called as Moola Dhatu. Similarly, the word Sthoulya is derived from Moola Dhatu

“Sthu” with “Ach” pratyaya(श.क.ध्र.ु ), which stands probably for bulky or big or thick.

Nirukti of Sthoulya:

Nirukti of Sthoulya according to various authors is given as follows-

1. ू स्यभवस्थौल्यं।(श.क.ध्र.ु )
स्थल
Here the word Sthoulya means heaviness of the body.

2. ू परिभ्रमणे। (अमिकोश)
स्थल
This definition emphasizes on excessive growth of the body.

Definition of Sthoulya

Definition of A person in whom excessive and abnormal increase of Medo dhatu

along with Mamsa dhatu is found, which result into pendulous appearance of

buttocks, belly and breasts is called as sthoola. The increased bulk is not matched by

corresponding increase in energy. (Agnivesha et al., 2011)

Synonyms of Sthoulya

Amarkosha has given synonyms of sthula as Vipula, Pina, Pinvi, Pivara which

indicates over nutritional condition of the person. Other synonyms mentioned by

various Ayurvedic texts have been given in tabular form.

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Table 1. – Synonyms of Sthoulya

No. Synonyms च.सं सु.सं का.सं. अ.सं . अ.हृ मा.नि. शा.सं. भा.नि यो.र.
1. Sthoulya + + + + + - - + +
2. Ati Sthoulya + + - + + - - + +
3. Sthulata - + - + + - - - -
4. Sthulatva - - - + + - - - -
5. Sthavima - - - + + - - - -
6. Medoroga - + - + + + + + +
7. Medodosha + - - - + - + + +
8. MedoVriddhi - - - - - - - + +
9. MedoVikara - - - - - - - + -
10. Medogada - - - - - - + + -
11. Medapushti - - - - - - - - +
12. Medadushti - - - - - - - - +
13. Atipushti - - - + - - - + -
14. Pushti + + + + - - + + +
15. Upachaya + + + + + - + + +
16. Jatharya - + - - - - - - -
17. Brimhatva + - + + + - - - -
18. Sthulodara - - - - - - - + -
19 Tundika - - - - - - - - +

These synonyms can be differentiated in following pattern for its better implication.

• Pinata, Pivarta, Pusti etc. for well-nourished deposition of fat with slightest degree

of overweight.

• Medasvita, Medovriddhi, Medurata, Medapusti etc for extensive growth of

Medadhatu without riskfactor.

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• Sthoulya, Sthulata, Medoroga etc for extensive growth of Medodhatu with

minimum riskfactor.

• Ati Sthoulya, Medodosha, Medodusti, Medovikar, Jatharya etc formorbid Obesity.

• Tundika, Mahodara, Sthulodara etc for androidobesity.

Nidanapanchaka

The need for proper diagnosis of a disease before planning its management needs no
special emphasis as it has been rightly described by Charaka. He says–

िोगमादौपरिक्षेतततोअनतं िमऔ
् षधम।् (च. स.ु 21/20 )
It means that the Rogapareeksha should be done properly before prescribing the
medicines.

Nidana means to arrive at the conclusive diagnosis of the disease after due

consideration of the NidanaPancaka viz., Hetu (Etiology), Purvarupa (Prodromal

symptoms), Rupa (Symptomatology), Upashaya (Relieving and Aggravating factors)

and Samprapti i.e., Pathogenesis.

Nidana

The knowledge of Nidana not only aids the physician towards therapeutics but also in

advising about Pathyaapathya.

The vitiation of Meda and Sleshma are said to be responsible for Sthoulya. Charaka

has stressed more on the exogenous causes while Sushruta and Vagbhatta mentioned

the endogenous causes of Sthoulya. Exogenous causes pertain to the diets that has the

potential of increasing the Meda or body fat where as Dosha, Dhatu, Mala, Srotas etc
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comes under endogenous causes.

In short, Nidana of Sthoulya can be categorized under four categories-

• Aharaja Nidana

• Viharaja nidana

• Manasika Nidana

• Anya Nidana

The Nidana of Sthoulya are compiled and categorized from various Samhita as
follows

Table 2. Aharaja Nidana

Sr No Aharaja Nidana च.सं सु.सं अ.सं . अ.हृ मा.नि. भा.नि यो.र.

1 Atisampurna + _ _ _ _ _ _

2 Santarpana + _ + + _ _ _

3 Adhyashana _ + _ _ _ _ _

4 Guru aharasevana + _ _ _ _ _ _

5 Madhura aharasevana + _ _ _ _ _ _

6 Sheetaaharasevana + _ _ _ _ _ _

7 Snigdhaaharasevana + _ + + + _ +

8 Sleshmalaaharasevana + + _ _ + + +

9 Navannasevana + _ _ _ _ _ _

10 Navamadyasevana + _ _ _ _ _ _

11 Gramya Rasa Sevana + _ _ _ _ _ _

12 Mamsasevana + _ _ _ _ _ _

13 Payavikarasevana + _ + + _ _ _

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14 Dadhisevana + _ _ _ _ _ _

15 Sarpisevana + _ _ + _ _ _

16 Ikshuvikarasevana + _ _ + _ _ _

17 Gudavikarasevana + _ _ _ _ _ _

18 Shalisevana + _ _ _ _ _ _

19 Godhumasevana + _ _ _ _ _ _

20 Masha sevana + _ _ _ _ _ _

21 Rasayana sevana + _ _ _ _ _ _

22 Vrishyasevana + _ _ _ _ _ _

23 BhojanottaraJalapana _ _ + _ _ + +

Table 3. Viharaja Nidana

Sr No Viharaja Nidana च.सं सु.सं अ.सं . अ.हृ मा.नि. भा.नि यो.र.

1 Avyayama + + + _ + + +
2 Avyavaya + _ + _ _ _ _
3 Diva Swapna + + + _ + + +
4 Asana Sukha + _ + + _ _ _
5 Swapnaprasangat + _ + + _ _ _
6 GandhamalyanuSevana + _ _ _ _ _ _
7 BhojanottaraSnana + _ _ _ _ _ _
8 BhojonottaraNidra _ _ _ _ _ + +
9 BhojanottaraAushadhiSevana _ _ + _ _ _ _

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Table 4. ManasikaNidana
Sr No ManasikaNidana च.सं सु.सं अ.सं . अ.हृ मा.नि. भा.नि यो.र.
1 Harshanityatvat + _ + + _ _ _
2 Achintanat + _ + + _ _ _
3 Manasonivritti + _ + + _ _ _
4 Priyadarshana + _ _ _ _ _ _
5 Saukhyena _ _ _ + _ _ _

Table 5. - Anya Nidana

Sr No Anya Nidana च.सं सु.सं अ.सं . अ.हृ मा.नि. भा.नि यो.र.
1 Ama rasa _ + _ _ _ + _

2 Snigdha Madhura Basti + _ + + _ - _

3 Tailabhyanga + _ + + _ - _

4 SnigdhaUdvartana + _ _ _ _ - _

Purvarupa

Purvarupa are the symptoms that appear prior to the complete manifestation of the

disease (च. नि. 1/8). None of the Ayurvedic texts has described the Purvarupa of

Sthoulya. Acharya Charaka, in nidanasthana, has mentioned similar pathogenesis of

Prameha, Sthoulya (च. नि. 4/8). the reason being that in both there is vitiation of

Kapha and Meda. Therefore, Purvarupa of Prameha and Medovaha Strotodushti

Lakshana can be considered as Purvarupa of Sthoulya.

These are as follows:

Atinidra, Tandra, Alasya, VisraShariraGandha, AngaGaurava, AngaShaithilyata etc

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According to Charaka, wherever Purvarupa of disease are not mentioned, the weak

manifestation of Rupa should be considered as Purvarupa of the concerned diseases

(च.नच.11/12; च.नच.28/19). Keeping the views of Acharya Charaka in mind, Lakshana

of KaphaVriddhi like Alasya, Angashaithilya, Madhurasyata, Atinidra, Atipipasa etc.

may also be considered as Purvarupa.

Roopa

Roopa or Lakshana is the most important diagnostic parameter of a disease. At this

stage, DoshaDooshyaSamurchana is completed & the onset of the diseases takes

place, which gives rise to the symptomology of the disease. These sign & symptoms

may change from time to time according to the progress of the diseases. Certain

symptoms may newly appear while some may disappear as the disease progresses.

We may not find all the symptoms in every patient at a time.

The cardinal symptoms, Ashta Dosha of Sthaulya viz. Ayusyahrasa, Javoprodha,

Krichavyavayata, Daurbalya, Daurgandhya, Svedabadha, Ksudha Atimatrata,

PipasaAtiyoga are the most prominent clinical features of Sthoulya as narrated by

Charaka (च.सू . 21/4), Susruta (सु.सू . 21/5) and Ashtanga Sangraha (अ.सं.सू . 24/23-26)

Various Lakshan of Sthoulya mentioned in different Samhita are compiled and

tabulated as follows –

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Table 6. Lakshana of Sthoulya

S. No. Roopa च.सू . सु.सू अ.सं.सू . अ.हृ.सू मा.नि भा.नि. यो.र.

1. ChalaSphika + - + + + + -

2. Chalaudara + - + + + + -

3. Chalastana + - + + + + -

4. AyathaUpachaya + - + - + + -

5. Anutsaha + - + - + + -

6. Ayushohrasa + - - - - + -

7. Javoparodha + - - - - + -

8. KricchVyavaya + - - - - - +

9. Daurbalya + - + - - - -

10. Daurgandhya + + + - + + +

11. Svedabadha + - - - - - +

12. Kshudhatimatra + + + - + + +

13. Pipasatiyoga + + + - + + +

14. Kshudrashwasa - + + - + + +

15. Nidradhikya - + + - + + +

16. Gatrasada - + - - + + +

17. Gadgadvani - + + - - - -

18. Krathana - + - - + + +

19. Alpaprana - + + - + + +

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20. Sarvakriyasu - + - - + + -
Asamarthata

21. Alpavyavaya - + - - + + -

22. Kasa - + - + - - -

23. Shwasa - + + - - - -

24. Snigdhangata - + - + - - -

25. Udaraparshva - + - + + + -
vriddhi
26. Alasya - - + - - - -

27. Ama - - - + - - -

28. Moha - - - - + + +

29. Saukumarata + + - - - - -

30. Angasaithilya + + - - + + -

31. Alpabala - - + - - - -

32. Alpavega - - + - - - -

Samprapti

Series of pathological events taking place during the journey of a healthy human body

towards any disease is known as Samprapti (अ.हृ.नि.1/8). Involvement of Dosha,

Dushya, Srotas, Agni, Ama etc. is mandatory for disease manifestation. They are

known as Samprapti Ghataka.

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Samanyasamprapti

Nidana sevan
(Kapha and medovardhaka aahara)

Vishamagni

Samannarasautpatti

Predominance of Apa and prithvi bhoota

Dhatwagnimandya

Medovaha srotodushti

Medovaha srotosanga Vataprakopa

Sanchita of apachita meda Sancharana of vata

Sphik, sthana, udara in koshta

Sthoulya Lakshana Jatharagni sandukshana

Ati aahara sevana/Adhyasana/

Akala bhojana sevana

Schematic representation of Samanya Samprapti of Sthoulya Roga

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SampraptiGhataka of SthoulyaRoga

For the manifestation of any disease, vitiation of few basic components of the body is

required. They are Dosha, Dushya, Srotas, Agni, Ama etc. These factors are termed as

SampraptiGhataka. Their vitiation with respect to Sthoulya is explained here

Sampraptighataka

• Dosha Kapha kledaka

Pitta pachaka

Vata Samana,Vyana

• Dushya Rasa, Meda (initially), later other Dhatu also

• Agni Jatharagni vruddhi,

DhatvagniMandya

• Srotas Annavaha, Rasavaha, Medovaha

• Srotodushti Sanga, Vimargagamana, Atipravrutti

• Udbhavasthana Amashaya

• VyaktaSthana Sarvanga, especiallyinsphik,udara.stana and

galapradesha

• Prasara/ sanchara By Rasayini, in whole body, predominantly

wherever the Medodharakala is present.

• Rogamarga Bahya and Abhyantara both

• Swabhava Chirakari

• Sadhysadhyata Kruchrasadhya

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Chikitsa

Chikitsa in general is defined as the actions, which bring the equilibrium of Dhatu

(च.सू .16/34). Acharya Charaka has further amplified the scope of the term Chikitsa.

According to him, “Chikitsa aims not only at the radical removal of the causative

factors of the disease, but also at the restoration of the Doshika equilibrium”

(च.सू .9/5).

While describing the Chikitsa of Sthoulya, Charaka has said that it is very difficult to

treat Atisthoola people because, if Karshana therapy is applied then it leads to further

aggravation of already aggravated Jathragni and Vayu and if Brimhana therapy is

applied it further increase the Meda. General principles of management of any

disorder is

संशोधिम् संशमिम् निदािस्य च वर्जिम्। (च.नव.9/30)

Thus, in any disorder management is divided into 3 parts.

1. Samshodhana

2. Samshamana

3. NidanaParivarjana

The management of Sthoulya is also explained in detail as follows-

Bahyachikitsa -

Ruksha Udvartana is the BahiParimarjana Chikitsa indicated for the management of

Sthoulya (अ.सं.सू .24/34). Acharya Charaka has also mentioned RookshaUdavartana

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(Cha.Su.21/21) for Sthoulya. Vagbhata has mentioned the benefits of Rooksha

Udavartana in general as Kaphahara, MedasaParivilayana, Sthirikarnam Angam etc.

(अ.हृ.सू .2/15)

Samshodhana

The therapies in which the vitiated Dosha are eliminated after mobilizing them from

their respective sites by Urdhva or Adhamarga from the body is known as Shodhana

therapy (अ.हृ.सू .14/6)

Being a syndromic entity (Bahudoshalakshana), Samshodhana therapy is highly

recommended for Sthoulya management by Charaka. According to Vagbhata,

Atisthoulya patients with AdhikaDosha and AdhikaBala should be treated by

Samshodhana therapy (अ.हृ.सू .14/12).

Description of various Poorvakarma and Pradhanakarma of Shodhana for Sthoola

given by various Acharya is as follows:

Snehana

Snehana Karma is always restricted for the patients of Sthoulya. However, Lekhaniya,

Medohara properties and Sthulatvhara Karma of Taila are described in Ayurveda (सु.

सू 45/112). So, on exigency usage of Taila is recommended (च.सू 13/46).

Swedana

Swedana for obese patient is contraindicated but if essential Mrudu Sweda is adviced.

Anagneya sweda mentioned in Sutrasthana of Charaka can also be adopted.

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Vamana-
Most of the texts have prohibited the use of Vamana Karma due to inability to bear

the potency of medicine and therapy causing Pranaparodha (life threatening

condition) (च.नस.2/8).

Virechana -
Though Virechana has not been recommended for patients of Sthoulya but Virechaka

Dravya mentioned in Ayurvedic texts like Haritaki, Katuki, Aragvadha, Trivruta,

Danti Dravanti etc., which have Medonashaka property could be applied to the

patients of Sthoulya. Practically also Virechana Karma seems to be fruitful for the

management of Sthoulya.

Basti-

Ruksha, Ushna&Tikshna Basti are suggested by Acharya Charaka for Sthoulya

chikitsa. A number of Basti kalpa are also mentioned in Ayurvedic texts but Lekhana

Basti is considered as the best therapy for Sthoulya/Medovriddhi(सु.नच.38/42).

Sharangdhara has given a clear description regarding the properties of Lekhana

Dravya and characteristics of Lekhana Basti (शा. पू.4).

Raktamokshana-
Maharshi Kashyapa and Bhavamishra have recommended Raktamokshana for the

treatment of Sthoulya in Chikitsasthana, MedasviDhatriChikitsa. Charaka has also

mentioned Raktamokshana for treatment of SantarpanaJanya Vyadhi including

Atisthoulya (च.सू . 23/6-9).

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Nasya-
Sushruta has recommended the use of Triphaladi Taila Nasya in the patients of

Medovriddhi(सु.नच.34/33-35).

Samshamana Therapy:

Shamana is defined as the therapy, which does not do Shodhana of the Dosha, not

disturb the equation of balanced Dosha and simultaneously bring equilibrium of

imbalance of Dosha (अ.सं.सू .24/8).

Langhana is advisable in Santarpana Janya Vyadhi, Amashyotha Vikara, Shleshmika

Vikara, Rasaja Vikara and it is the best remedy for the Sama condition of disease. So,

all ten types of Langhana can be applied for the patients of Sthoulya according to

Rogi-RogaBala. Charaka Samhita has given treatment of Sthoulya in following

words (च.सू.21/21-22).

गुरू चातपजणं चेष्टं स्थूलािां कशजिं प्रनत।

कृशािां बृंहणाथं च लघु सन्तपजणं च यत् ॥ (च.सु. 21/21)

i.e. Administration of Guru and Apatarpana articles which possess additional Vata,

Shleshma and Medonashaka properties are considered as ideal for Shamana therapy.

Chakrapani has explained that Guru property is required to alleviate vitiated Agni

thereby suppressing the Atikshudha. Along with Guru Dravya, Apatarpana dravya

provides non-nourishment and thus leads to depletion of Meda. For e.g. Madhu

possess Guru and Ruksha properties, hence it is ideal for management of Sthoulya.

The drugs planned for Sthoulya should have Deepana & Pachana property to enhance

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Agni. They should also be Amapachaka as obstruction of MedovahaSrotas by Ama is

main factor for Medoroga. The drugs must have Rookshna & Chedana property to

produce Srotovishodhana. Along with these Teekshna, Ushna, Rooksha, Guna dravya

are adviced as they are opposite to Manda, Snigdha &S heetaGuna of Kapha & Meda.

(च.सु . 21/10-12)

Some important references about Shamana Chikitsa of Sthoulya are mentioned

as follows-

• Some Samshamana yoga like Guduchi, Bhadramusta, Triphala, Takrarishta,

Mukshika, Vidangadi Lauha, Bilvadipanchmula and Shilajatu with

Agnimantha Svarasa are adviced for prolonged period (च.सु .21/21-24).

• In Charaka Samhita, drugs and preparations like Karshana Yavagu of

Gavedhuka, Lekhaniya Mahakashaya, Bibhitaka, Venuyava and Madhudaka

are advocated as Medonashaka and Lekhana (च.सु .2/25,4/8(3),27/148,27/323)

• In Sushruta Samhita, administration of Virukshana and Chedaniya dravya

especially Shilajatu, Guggulu, Gomutra, Triphala, Loha Raja, Rasanjana and

Madhu in proper dose and duration are advised (सु.सू .15/38). Here, Dalhana

has explained that Virukshana property helps to reduce Meda and Chedaniya

property helps to remove obstruction from body channel, particularly from

Medovaha Srotas by its Srotovishodhana property.

• In SushrutaSutrasthana 38th chapter various groups of drugs like Varunadi

gana, Salasaradi gana, Rodhradi gana, Arkadi gana, Mushkadi gana,

Trayushnadi gana etc. are mentioned as Medonasaka (सु.सू .38).

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• Haritaki is advised for the treatment of Santarpanajanya Roga and Amalaki is

mentioned as Medopaham. So, Haritaki and Amalaki can be used for

treatment of Sthoulya (सु.सू .44/69-70).

• Karpura, Kansya, Trapusisa, different Mani are described as Lekhana and

Medohara, which can be used for treatment of Sthoulya (सु.सू .44/203).

• In Ashtanga Samgraha Madanphaladi Churna, Kutajadi Churna, Hingvadi

Churna and Vidangadi Mantha are added in line of treatment. Krishna Lauha,

Shankha and Samudraphena, Tuttha, Manahsila, Anjana and Silajatu are

Dhatu described as Lekhana and Medonashaka (अ.सं.सू .24/37, 12/78).

• Rasanjana is mentioned as the best for the treatment of Sthoulya while

Guggulu is mentioned as the best for the disorders of Meda and Vata(अ.सं.सू

13/3). So Guggulu can be used for the treatment of Medavrita Vata condition.

• In Ashtanga Hridaya, GomutrapakiHaritaki, Rodhrasava, Vardhamana

Bhallataka Rasayana etc. are the various preparations added for the

management of Sthoulya. (अ.हृ.नच.8/55,12/28)

• Navaka Guggulu, Amrutadya guggulu etc are told in Bhaishajya

Ratnawali (भै.र. 39/43).

• Bhavaprakash has mentioned the remedies for Medohara purpose like

ChavyadiSaktu (39/15), Triphaladya Churna (39/16), Erandpatra Kshara

(39/23), Badaripatra Peya (39/25), Amritadi Guggulu (39/27), Dashanga

Guggulu (39/28), Trayusnadi Guggulu (39/29), Lauha Rasayana (39/30-40),

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NidanaParivarjana:

Both Charaka and Sushruta have laid great emphasis on the principle of Nidana

Parivarjana. Sushruta in particular has recommended Nidana Parivarjana as an

essential component in the management of any disorder. This can be well interpreted

by the Sankshepta Kriyayoga Nidan aParivarjanam sutra of Sushruta.

NidanaParivarjana Chikitsa means avoiding all the Aharatmaka, Viharatmaka

Manasika and Anya Nidana responsible for the manifestation of a disease. All the

Nidana mentioned earlier, such as Ati Madhura, Guru, Snigdha Ahara Sevana,

Divaswapna, Atiharsha etc. should be avoided in case of Sthoulya.

Obesity

Overweight and obesity occur when excess fat accumulation (regionally, globally, or

both) increases risk to health. It is the point at which health risk is increased that is

most important because, as covered below, body weights and fat distributions that

lead to expression of co-morbid diseases occur at different thresholds depending on

the population.

Body Mass Index

Body mass index (BMI) is calculated by dividing weight (in Kg) by height (in meters

squared) or by dividing weight (in pounds) multiplied by 704 by height (in inches

squared). There is a strong curvilinear relation between BMI relative body fat mass.

(Gallagher D. et al. 2000) However, the current practical definition of based on the

relationship between BMI and health outcome rather than BMI and body composition.

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Table 7. Weight classification by Body Mass Index

Status obesity class Body Mass Index Risk of the

[Kg/m2] diseases

Underweight <18.5 Increased

Normal 18.5-24.8 Normal

Overweight 25.0-29.9 Increased

Obese I 30.0-34.9 High

Ⅱ 35.0-39.9 Very High

Ⅲ ≥ 40.0 Extremely high

Table 7. summarizes the guidelines for classifying weight status by BMI, proposed

by the major national and international health organizations (WHO 1998; NIH, 1998).

Large epidemiological studies have established that there is a strong inverse

relationship between BMI and mortality. Men and women with BMI of 25.0 to 29.9

kg/m2are considered overweight and those with BMI 30kg/m2or greater are obese.

Obese persons have high risk for adverse health consequences than those who are

overweight. The of obesity related diseases, such as diabetes, begins to increase at

BMI values below 25 kg/m.2 (Larsen R. et al. 2003)

• Prevalence Etiological factors

1. Neuro-endocrine disorders:

a) Hypothalamic disorder: Injury to the ventromedial region of the hypothalamus

results in obesity.

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b) Hypothyroidism: Thyroid deficiency in the adult presents with clinical

features of myxoedema. With thyroxine replacement therapy, clinical

improvement is obvious with weight loss.

c) Cushing’s syndrome: The pattern of weight gain in Cushing’s syndrome is

characteristic, with accumulation of fat in the trunk, supraclavicular fossa and

dorsal cervical region.

d) Polycystic ovary syndrome (Stein-Leventhal syndrome) consists of irregular

absent menses, hirsutism, obesity and infertility.

e) Hyperinsulinism: Hypersecretion of insulin occurs in insulinoma; this can

increase body weight.

f) Genetic syndromes: These rare syndromes—Lawrence-Moon-Biedl syndrome,

Prader-Willi Syndrome, Alstom syndrome, Cohen syndrome—are associated

with dysmorphic features.

In addition to obesity, hypogonadism is common; other features are short

stature, mental retardation and polydactyly.

2. Drug-induced obesity: Drugs such as corticosteroids, tricyclic antidepressants,

cyproheptadine, phenothiazines and lithium can lead to weight gain.

3. Excess calorie intake and physical inactivity:

This is the most common cause of obesity in adulthood. Available data

suggest that childhood obesity continues into later life in the majority

Psychological factors in the development of obesity are widely recognized.

Ingestion of excess food can result from an emotional reaction to

environmental situations. Also, a feeling of deprivation that has been present

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since childhood can be reflected in the ingestion of food.

Energy metabolism

1. The components of daily total energy expenditure (TEE) are:

2. Resting energy expenditure (REE) accounting for approximately 70% of REE.

3. Energy expended in physical activity, accounting for apprx 20% of TEE

The thermic effect of food (TEF), accounting for approximately 10% of TEE.

REE represents the energy expended for normal cellular and organ function under

post-absorptive resting conditions. Energy expended in physical activity includes the

energy costs of both volitional activity such as exercise and nonvolitional activity

such as spontaneous muscle contractions, maintaining Posture and fidgeting. The

thermic effect of food represents the energy expended in digestion, absorption and

sympathetic nervous system activation after ingestion of a meal.

Cross sectional studies have investigated whether alterations in energy metabolism are

involved in obesity. Obese individuals have a greater rate of REE than lean

individuals of the same height because obese individuals have a greater amount of

adipose tissue cell mass. It is known that when energy intake exceeds weight gain

usually occurs. However genetic factors may influence the amount of weight gained

with overfeeding. (Larsen R.2003)

Adipose tissue and triglyceride metabolism

Triglyceride stored within adipose tissue constitute the body’s major energy reserve.

Triglycerides are a much compact fuel than glycogen because of their energy density

and hydrophobic nature. Triglycerides yield 9.3kcal/g upon oxidation and are

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compactly stored as oil inside the fat cell, accounting for 85% of adipocyte weight.

Glycogen in contrast, yields only 4.1 Kcal/g upon oxidation and is stored

intracellularly as a gel containing approximately 2gm of water for every gram of

glycogen.

Adipose tissue is an effective storage mechanism for transportable fuel that allows

mobility and survival when food is scarce. During starvation, the duration of survival

is determined by the size of the adipose tissue mass.

Triglyceride storage

The major function of adipocytes is the storage of triglycerides for future use as

energy substrate. Lipogenesis from glucose makes only a limited contribution to

triglyceride storage in the adipocyte. Most of the triglyceride in adipocytes is derived

from chylomicrons and very low-density lipoprotein (VLDL) triglyceride that

originate, respectively from dietary and hepatic sources. These plasma triglycerides

are hydrolyzed by lipoprotein lipase (LPL),

A key regulator of fat cell triglyceride uptake from circulating triglycerides. LPL

is synthesized by adipocytes and transported to the endoluminal surface of the

endothelial cells. The interaction of LPL with chylomicrons and VLDL release fatty

acids from plasma triglycerides, which are then taken up by local adipocytes. Plasma

free fatty acids themselves can also be taken up by a adipose tissue, independent

lipoprotein lipolysis.

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Adipose tissue as an endocrine organ

Traditionally, adipocytes have been viewed as energy depots that store triglycerides

during feeding and release fatty acids during fasting to provide fuel for other tissue

has major integrative physiologic functions and secretes numerous proteins.

Table 8. Adipocyte secreted proteins

Category Protein

Potential hormone Leptin, Resistin, angiotensinogen, adiponectin/

ACRP 30, estrogens

Cytokine Interleukin-6, tumor necrosis factor α

Extracellular matrix Type I, III, IV and VI collagens, fibrinogen,

Proteinosteonectin, laminin, enactin and

matrix metalloproteinases

complement factor Adipsin, compliment C3, factor B

Enzyme LPL, cholester ester transfer protein

Acute phase response α1 – acid glycoprotein, haptaglobin

Proeins

Other Fatty acids, plasminogen activating inhibitor-

1, Prostacyclin

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In part, these factors participate in autocrine, and paracrine regulation within adipose

tissue. In addition, these factors have profound effects on the function of distant

organs such as, muscle, liver, brain and pancreas. The realization that adipose tissue

functions as an endocrine organ has important implications for understanding the

pathophysiologic relationship between excess body fat and pathologic states such as

insulin resistance and type 2 Diabetes Mellitus.

Clinical features and complications of obesity

Accumulation of adipose tissue in different areas has distinct consequences. Many of

the important complications of obesity, including insulin resistance, diabetes mellitus,

hypertension and hyperlipidemia, are linked to the amount of intra-abdominal fat

rather than to lower body fat or subcutaneous abdominal fat.

Obesity is associated with increased levels of free fatty acids (FFA) which are due in

large measure to the presence of more lipolytically active intra-abdominal adipocytes.

Increased level of FFA is associated with inhibition of hepatic clearance of insulin

and thus with hyperinsulinism and its consequences.

Medical conditions associated with the more common obesity are hypertension,

atherosclerosis, diabetes mellitus and hypoventilation syndrome; the less common

ones include hepatic steatosis, gall bladder disease, osteoarthritis of weight-bearing

joints and gout. The mortality is 10-12-fold higher in the morbidly obese compared to

the general population.

Some common complications and associated conditions are dealt henceforth.

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Cardiovascular

Obesity contributes to an increased incidence of cardiovascular disease not only

directly but also indirectly by predisposing to hypertension, diabetes mellitus and

hyperlipidemia. Obesity results in circulatory changes such as increase in

pulmonaryandsystemicbloodvolumeandincreaseinstrokevolumeandcardiac output.

The increased workload on the heart leads to dilatation and hypertrophy which

predispose to congestive cardiac failure. There is an increase in myocardial oxygen

demand; when the supply cannot meet the demand, it results in infarction and death.

Hypertension

Obesity is associated with hypertension, which can be reduced with improvement in

weight. Increase in cardiac output and peripheral resistance is responsible for the

hypertension. There is evidence to show that both basal and stimulated levels of

norepinephrine are increased in obesity. As the body mass increases, arterial pressure

rises. Weight reduction not only improves the hypertension but also improves

carbohydrate intolerance and hyperlipidemia, thus diminishing the risk for coronary

artery disease.

Diabetic mellitus

Obesity is a common association in NIDDM; however, in most developing countries

obesity is seen in less than 50% of patients with NIDDM. Obesity predisposes to

carbohydrate intolerance by increasing insulin resistance.

Pulmonary Disorders

Significant alteration in pulmonary function occurs in the severely obese and is due to

increased oxygen consumption associated with breathing. The extreme form of

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pulmonary dysfunction is the Pickwickian syndrome or obesity-hypoventilation

syndrome which is characterized by somnolence, obesity and hypoventilation.

Hypoxemia and CO2 retention along with mechanical factors are responsible for the

hypoventilation. The sleep apnea in the obese may be central, obstructive or mixed.

Pulmonary hypertension, polycythemia result from prolonged pulmonary dysfunction.

Endocrine disorders

In men, there is a consistent reduction in the concentration of total serum testosterone.

Obesity is associated with clinical symptoms suggestive of abnormal ovarian

function, including irregular menstruation, secondary amenorrhoea, hirsutism, early

menarche and delayed menopause. Both in pre and postmenopausal women,

circulating androgens from the adrenal gland are converted to oestrogens in the

peripheral tissue. This enhanced production of oestrogen in obese postmenopausal

women may have a causative role in the high incidence of endometrial carcinomas

and low incidence of osteoporosis. The serum free testosterone level has been

reported to be elevated in obese women and this hyperandrogenaemia is said to be

responsible for the irregular menses and hirsutism.

The basal concentration of gonadotrophins as well as the gonadotrophic response to

luteinizing hormone-releasing hormone (LHRH) are normal in the obese.

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Treatment

The principles of treatment include calorie restriction with exercise, and behavioral

program to maintain the reduced weight. Mild to moderate obesity can be treated with

low-calorie diet and increase in exercises. In moderate exercises like walking, 5

Kcal/min is used up, while in a little more strenuous exercise 7-10 Kcal/min is

utilized. In general, a negative balance of around 7500 Kcal is required to lose a

kilogram of weight. Various dietary regimes are advocated for weight reduction, from

total fast to calorie-restricted diets. Very low-calorie diets provide rapid improvement

in obesity-related disease but can be associated with various complications such as

headache, gastrointestinal symptoms, fatigue, arrhythmias and

evensuddendeath.Abalanced,low-caloriedietisoftenrecommendedforgradual weight

loss. Vitamins, minerals and unsaturated fatty acids have to be added to the basic

protein-carbohydrate diet.

Both diet therapy and exercise have to be continued for long periods to maintain

reduced weight. Often the obese get back to their original eating habits after the initial

weight reduction. Obese subjects need the help of behavioral therapists to adjust to the

new lifestyle and often the family should be included in the training programme.

Behavioural programmes have been widely practiced and the focus is on eating

behaviours, attitudes, social support, exercise, nutrition and other factors related to

eating.

Appetite suppressant drugs have been used with some initial weight reduction.

Following withdrawal, weight gain recurs. Appetite suppressant drugs like

diethylpropion and phentermine are CNS stimulants, while fenfluramine has

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depressant qualities. Studies using dexfenfluramine in obese subjects have reported

beneficial effect by selective reduction in fat mass. Recently dexfenfluramine has

been withdrawn due to side-effects. Thermogenic drugs like thyroid hormone,

ephedrine and beta-adrenergic agonists have no place in the treatment of obesity.

Surgical treatment is offered to morbidly obese individuals with 100 per cent weight

above the weight-for-height standards and who are unable to maintain adequate

weight loss by other means. Mortality statistics demonstrate a substantially increased

risk of premature death at this weight level.

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Plant Profile
1. Cyperus rotundus

Musta consists of dried rhizome of Cyperus rotundus Linn. (Fam. Cyperaceae);

occurring throughout the country, common in waste grounds, gardens and

roadsides, upto an elevation of 1800 m. (Anonymous 2000)

Here are some classical references as follows:

Samhita period-

Charaksamhita–

Acharya Charak explained Musta in आरग्वधीय अध्याय, षड् नवरे चिशतनितीय अध्याय,

मात्राशीनतय अध्याय, सन्तपज णीय अध्याय, यज्जःपुरूषीयअध्याय. नवमािस्थाि- रॊगनभषग्जितीय

नवमाि अध्याय ,In नचनकत्सास्थािमुस्ताis explained in the context ofज्वरनचनकत्सा,

रक्तनपत्तनचनकत्सा, प्रमेह नचनकत्सा, कुष्टनचनकत्सा, रार्यक्ष्मनचनकत्सा, अपस्मारनचनकत्सा, श्वयथु

नचनकत्सा, उदर नचनकत्सा,अशज नचनकत्सा , ग्रहणी नचनकत्सा, पाण्डु रोगनचनकत्सा,

नहक्काश्वासनचनकत्सा,कासनचनकत्सा,अनतसार नचनकत्सा, नवसपज नचनकत्सा, नवष नचनकत्सा,

मदात्यय नचनकत्सा, निवणीयनचनकत्सा, नत्रममीयनचनकत्सा, उरुस्तम्भनचनकत्सा,

वातव्यानधनचनकत्सा, वातशॊनणतनचनकत्सा,योनिव्यापदनचनकत्सा. In कल्पस्थाि, श्यामानत्रवृत्

कल्प अध्याय Musta is explained. In नसग्जिस्थाि- बग्जस्तसूनत्रयनसग्जिरध्याय,

वमिनवरे चिव्यापत् नसग्जदद, बग्जस्तनसग्जदद, उत्तरबग्जस्तनसग्जदद explained.

In sushruta Samhita
In सू त्रस्थािरसनवशेषनवज्ञािअध्यायI, नचनकत्सास्थािमुस्ताis explained in the context of

कुष्टनचनकत्सा, महाकुष्ठनचनकत्सा, मुखरोगनचनकत्सा, निरुहक्रमनचनकत्सा अध्याय.

Kalpasthana स्थावरनवषनवज्ञािीय कल्पः, दु न्दु नभस्विीय कल्पः Musta is explained.

उत्तरतन्त्र :-श्लेष्मानभष्यन्दप्रनतषेधाध्याय,रक्तानभष्यन्दप्रनतषेधध्याय,शीतपूतिप्रनतषेधाध्याय,

ज्वराप्रनतषेधाध्याय, अनतसातप्रनतषेधाध्याय, पाण्डु रोगप्रनतषेधाध्याय,

अपस्मारप्रनतषेधाध्याय,उन्मादप्रनतषेधाध्याय.
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Table 9. Musta is mentioned in various ganas and vargas as per the list below.

सं नहता गण

चरक सं नहता लेखिीय गण, तृ ष्णानिग्रहण गण, कंडूघ्न गण, स्तन्यशोधि गण

सु स्रूतसं नहता मुस्तानद गण, वचानद गण

अष्टां गह्रुदय मुस्तानद गण, वचानद गण

निघन्टु वगज

सौिुत निघन्टु वचानद गण

धन्वं तररनिघन्टु गु डूच्यानद गण

शब्द चग्जिका वृ क्षानद वगज ,नत्रफलानद वगज

शोडल निघन्टु गु डूच्यानद वगज , सं कीणज गण

माधवद्रव्यगु ण नवनवधौषनध वगज

अनभधाि रत्नमाल कषायस्कन्ध

मदिपाल निघन्टु - अभयानद वगज

रार् निघन्टु नमिकानद वगज

कैयदे वनिघन्टु औषनध वगज

भावप्रकाशनिघन्टु कपूजरानद वगज , सं धाि वगज , अिेकाथजिाम

वगज

शनलग्रामनिघन्टु कपूजरानद वगज

निघन्टु आदशज मुस्तानद वगज

नप्रयनिघन्टु हररतक्यानद वगज

अनभधाि मंर्री वचानद वगज , हररद्रानद वगज

अमरकोश विौषनध वगज

अष्टां ग निघण्टु वचानद गण

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निरुक्ति (Sharma P.V. et al. 2011)

१. मुस्तकम्- मुस्ते संघाते र्ायते इनत, ’मुस्त सं घाते ’।

Mustaka grows gregariously in aquatic regions.

२. गां गेयी- गंगायास्तटवनतजप्रदे शेषु भवा।

Musta commonly grows near water resources, so very common on the banks of
the river Ganga.
३. कच्छोत्था- कच्छे षु र्लप्रायभुनमषु र्ायते इनत।
It grows in marshy land.

४. प्राच्यं - प्रानच भवः।

Musta is common in north eastern region of India.

५. वररदिामकम्- अम्भोदः घिः वाररद इत्यानद मेघपरकिामान्यस्य।

Musta grows near water resources hence the synonyms related to water is also
synonyms of Musta

६. ग्रंनथला- ग्रंनथरुपा।
Tubers are nodular.

७. सुगग्जन्ध- शोभिगन्धयुक्तः।
Musta has agreeable odour.

८. क्रोडे ष्टा- क्रीडािां वराहाणानमष्टा नप्रया।

Musta is liked by pigs.

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Table 10. Paryaya or synonyms of Musta

पयाा य ध.नि कै.नि भा.प्र रा.नि शा.नि. नप्र.नि

मु स्ता + + + + + +

गाङ्गेयी + + - + + -

कुरुनवन्दक + + + + + -

भद्रमु स्त + + + + - -

वराह - + - + - -

नपठर - + - - - -

नपण्डमु स्त + - - _ - -

भद्रहं स - + - _ - -

प्राच्य - + - _ - -

रार्कसेरुक + + - _ - -

क्रीडकसेरुक - - + _ - -

घि + + - + - -

भद्र - - - + - -

वाररद - + - + - +

िोरद - - - + - -

अम्भोद - - - + - -

मे घा + - - + - +

र्ीमू त + - - + - -

अब्द + - - + - -

संख्यात - - + - - -

अम्र - - - + - -

गुञ्जा - - - + - -

ग्रंनथ - - - + - -

भद्रकासी - - - + - -

कसेरु - - - + - -

क्रोडे ष्ठा - - - + - -

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सुगग्जन्ध - - - + - -

ग्रंनथला - - - + - -

नहमा - - - + - -

वन्या - - - + - -

गर्कसेरु - - - + - -

कच्छोत्था - - - + - -

कवनतजमुस्तक - - - - - -

वाले य - - - - + -

पररपले व - - - - + -

अम्बुधर - - - - - -

र्लद + - - - - -

बलाहक + - - - + -

वाररधर/ - - - - + -

वाररवाह

मे घाख्य - - - - + -

गुिा - - + - - -

Table 11. Guna-Karma of Musta as per various authors

गु ण ध.नि कै.नि भा.प्र शा.नि रा.नि नप्र.नि
कटु - + + + - +
रस नतक्त + + + - + +
कषाय + + + - + -
गु ण शीत + + + + + -
वीयज शीत + + + + + -
नवपाक कटु - + + + - -
नपत्तहर + - + + + -
दोषघ्नता
कफहर + - + + + -

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Table 12. Musta karma as per various authous

ध.नि कै.नि भा.प्र शा.नि रा.नि नप्र.नि

ग्रानह - + + - + +

दीपि - + + - - +

पाचि - + + - + +

तृ ष्णाहर + + + - - -
ज्वरहर + + + + + +

आमपाचि - - - + - -
िमहर - - - - + -
कृनमघ्न/र्न्तु घ्न + + + + - -
कण्डूघ्न - - - + - -
रक्तनर्त् + + + + - -
दाहशामक - - - + + +
शूलघ्न - - - + - -

Table 13. Indication of Musta in various disorders.

व्यानध ध.नि कै.नि भा.प्र शा.नि रा. नि नप्र.नि

ज्वर + + + + + +

ग्रहणी _ - _ _ + +

आमदोष _ - _ + - +

अरुनच _ + + _ - -

कृनम/र्न्तु + + + + - -

अनतसार + - _ + - -

तृष्णा + + + _ - -

कण्डु - _ _ + - -

रक्तनवकार + + + + - -

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Vishistha yoga
Table 14. Vishistha Yoga of Musta in which Musta as a main ingredient.

षडं ग पािीय ज्वर च. नच.

मुस्तानद चूणज कुष्ठ च. नच.

मुस्तानद वनतज अपस्मार च. नच.

मुस्तकाररष्ठ अनिमां द्य भै. र.

Table 15. Vishistha Yoga in which Musta is secondary ingredient.
च्यविप्राश रसायि च. नच.

वत्सकानद कषाय ज्वर च. नच.

मधु कानद शीत कषाय ज्वर च. नच.

बृ हत्यानद कषाय ज्वर च. नच.

नपप्पल्यानद घृत ज्वर च. नच.

वासानद घृत र्ीणज ज्वर च. नच.

बलानद घृत ज्वर च. नच.

त्रायमाणानद घृत गु ल्म च. नच.

किकनबन्िाररष्टम् कुष्ठ च. नच.

किकक्षीरर तै ल कुष्ठ च. नच.

नतक्त षट् पल घृत कुष्ठ च. नच.

महानतक्तक घृत कुष्ठ च. नच.

कृष्णानद चूणज श्वयथु च. नच.

क्षारगु नडका श्वयथु च. नच.

नपप्पल्यानद लवण उदर च. नच.

सु निषण्णकचाङ्गेरीघृत अशज च. नच.

चन्दिानद घृत ग्रहणी च. नच.

िागराद्य चूणज ग्रहणी च. नच.

भू निम्बानद चुणज ग्रहणी च. नच.

नकराताद्य चूणज ग्रहणी च. नच.

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नवशालानद फाण्ट पाण्डु च. नच.

मण्डूर वटक पाण्डु च. नच.

पुििजव मण्डूर पाण्डु च. नच.

व्योषाद्य घृत पाण्डु च. नच.

शट्यानद चूणज नहक्का-श्वास च. नच.

मिःनशलनद धू म कास च. नच.

महागन्धहग्जस्तिामक अगद नवष च. नच.

मृनिकानद चूणज नत्रमनमजय नचनकत्सा च. नच.

खनदरानद गुनटका नत्रमनमजय नचनकत्सा च. नच.

स्वणज क्षीयाज नद योग ऊरुस्तम्भ च. नच.

पुष्यािग चूणज योनिव्यापत् च. नच.

AFI REFERENCE
Table16. Vishistha Yoga mentioned in Ayurvedic Formulary of India
Name of the formulation Name of classical texts

Amrutarishta BaishajyaRatnavali, jwaradhikara

Ashokarishta BaishajyaRatnavali, streerogadhikara
Ashwagandharishta BaishajyaRatnavali, murchhadhikara
Ahiphenasava BaishajyaRatnavali, Atisaradhikara
Jirakadyarishta BaishajyaRatnavali, streerogadhikara
Mritasanjeevanisura BaishajyaRatnavali, Jwaradhikara
Lohasava Sharangadhara Samhita, madhyama khanda,
10th chapter
sarivadyasava BaishajyaRatnavali, pramehapidakadhikara
Bramha rasayana Astangahridaya, uttarasthana 39th chapter
soubhagyashunthi BaishajyaRatnavali, streerogadhikara
Chaturbhadrakwathchurna BaishajyaRatnavali,grahanirogadhikara
Brihanmanjistadikwathchurna Sharangadhara Samhita, madhyama khanda,
2nd chapter
Gokshuradiguggulu Sharangadhara Samhita, madhyama khanda,
7th chapter
Yogarajguggulu BaishajyaRatnavali, amavatadhikara
Vyoshadiguggulu Astangahridaya, chikitsasthana21st chapter
Saptavimshatikaguggulu BaishajyaRatnavali, bhagandarachikitsa
Tiktakaghrita Astangahridaya, chikitsasthana, 19th chapter
Patoladighrita Astangahridaya, uttarasthana, 13th chapter
Pippalyadighrita Astangahridaya, chikitsasthana, 1st chapter

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Avipattikarachurna BaishajyaRatnavali, amlapittadhikara

Nimbadichurna BaishajyaRatnavali, vataraktadhikara
Pramehamihirataila BaishajyaRatnavali, pramehapidakadhikara
Brihatmashataila BaishajyaRatnavali, vatavyadhidhikara
Sarvajwaraharaloha BaishajyaRatnavali, jwaraadhikara
Ardraka khanda avaleha Bharat baishashajyaratnakara, Prathama
bhaga,406
Shri bhanushalaguda BaishajyaRatnavali, arshorogadhikara
Devadarvyadikwathchurna BaishajyaRatnavali, shirorogadhikara
Dhanyapanchakakwathchurna BaishajyaRatnavali, atisararogadhikara
Brihatchhagalyadighrita BaishajyaRatnavali, vatavyadhirogadhikara
Shatavaryadighrita Sahasrayoga, ghrita prakarana:23

References
मुस्तकं ि स्त्रीयां मुस्तं नत्रषु वाररदिामकम्।
कुरुनवन्दश्च संख्यातोअपरःऽपरः नक्रडकसेरुकः।
भद्रमुस्तश्च गुिा च तथा िागरमुस्तकः। (भा.प्र. कपूजरानद वगज ९२-९३)

मुस्तं कटु नहमं ग्रानह नतक्तं नदपि पाचिम्।

कषायं कफनपत्तास्र् तॄङ्ज्ज्वरारुनच र्न्तु ह्यत् ।
अिुपदे शे यज्जातं मुस्तकं तत्प्रशस्यते।
तत्रानप मुनिनभः प्रोक्तं वरं िागरमुस्तकम्। (भा. प्र. कपूजरानद वगज ९३-९४)

मुस्ता नतक्त कषायाऽनतनशनशरा श्लेष्मरक्तनर्त्।

नपत्ताज्वरानतसारनघ्न तॄष्णाकॄनमनविानशनि॥ (ध.नि. गुडुच्यानद वगज)

मुस्ता नतक्त नहमं दीपिं पाचिं कटु ।

कषाय कफनपत्तास्र तॄङ्ज्ज्वरारुनच र्ं तुनर्त् ॥ (कै.नि. ओषनध वगज १३५८-१३५९)

भद्रमुस्ता कषाया च नतक्ता शीता च पाचनि

नपत्तज्वर कफनघ्न च ज्ञेयासङ्ज्ग्रहणी च सा॥ (रा.नि. नपप्पल्यानद वगज १४०)

िागरमुस्ता-
‘नतक्ता िगरमुस्ता कटु ः कषाया च शीतला कफिुत्।
नपत्तज्वरानतसारारुनच तॄष्णा दाहिाशनि िमह्यत् ॥ (रा.नि. नपप्पल्यानद वगज १४३)

मुस्तं नतक्तं कटु ग्रानह दीपिमामपाचिम्।

ज्वरे दाहे ऽरुचावामे ग्रहण्याञ्च प्रशस्यते॥ (नप्र. नि. शतपुष्पानद वगज ४३)

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Modern review of Musta

Scientific classification

Domain:Eukaryota

Kingdom: Plantae

Phylum: Spermatophyta

Subphylum: Angiospermae

Class: Monocotyledonae

Order: Cyperales

Family: Cyperaceae

Genus: Cyperus

Species: Cyperus rotundus

Vernacular names

The drug is known and accepted universally by its scientific name but still knowledge

of regional and local language is important to procure the drug from the regions of its

availability.

Hindi -Nagarmotha
Kannada -tungegadde, tungahulli, Badramusti
Marathi -Bimbal, motha
Arabic -Soad, Soadekufi
Bangali -Nagarmotha
Burma -Vomonniu
Gujarati -Nagaramothaya
Urdu - Saad kufi
English: Cocograss, purple nutsedge

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German: Nussgras, RundesCypergras

French: Souchetrond
Spanish: Castañuela,
Portuguese: Junça, tiririca-comum

Distribution

It is found throughout India up to an elevation of 1800 m., from Kashmir to simla,

Garhwal, and Khasia hills, throughout the plains of almost all the states and ascending

the mountains of the central table- land from Mount Abu and Pune to the Nilghiri

hills.

Habit-

Globous; stolons elongate, slender,10-20cm. long, bearing hard, ovoid tunicate black

fragrant tubers 0.8-2.5cm diameter, root fibres clothed with flexuous hairs; stems

subsolitry, 10-75cm. long, triquetrous at the top, sometimes tuberous at the base.

Leaves shorter or longerthan the stem, narrowly linear, 4-8mm. broad, finely

acuminate, flat, 1-nerved. Umbel simple or compound; rays 2-8, the longest reaching

7.5cm long bearing short spikes of 3-10 slender spreading red-brown spikelets (the

inflorescence sometimes contracted into a head, occasionally of only one spikelet);

bracts 3, variable in length, 1.6-3.8cm. by 2.5cm., linear,subacute, red brown, 10-50

flowered, compressed; rhachilla with hyaline wings. Glumes 3-4mm long, oblong,

obtuse or slightly apiculate; back reddish brown, 3-7 nerved; sides,margins, and tip
hyaline. Stamens 3; anthers 2.5mm long. Nut 1.6mm long, broadly obovoid,

trigonous, greyish black; style 1.6mm long; stigmas 3, elongate, reaching 4mm long,

much exserted.

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Genus charecters- cyperus Linn

Perennial (rarely annual) glabrous herbs; rhizome creeping, short or long. Leaves

mostly towards the base of the stem, occasionally reduced to sheaths. Spikelets in

solitary globose or umbellete heads or spikes; involucral bracts 1 or more, foliaceous;

bracteoles under the secondary divisions of the inflorescence; rhachilla usually

persistant, not or in a few species disarticulating towards the base, sometimes with

membranous wings derived from the persistent glume-bases. Glumes distichous, the 2

lowest empties, those above 2-sexual, all nearly equal, deciduous from below

upwards, the uppermost 1-3; anthers linear or oblong. Ovary compressed; style short

or long orobsolete; stigmas 2 or 3. Fruit trigonous, triquetrous, obovoid or plano-

convex. The bitter aromatic tubers are stimulant, stomachic, diuretic, emmenagogue

and anthelminthic. (Kirtikar et al. 2012)

Pharmacognosy

Stolon is slender, 10-20cm long; tubers hard, ovoid, tunicate, black from outside,

fragrant, 0.8 to 2.5cm in diameter, inner surface white, fracture mealy; root fibres

clothed with flexuous hairs. In transverse section the rhizome is characterised by a

thick-walled endodermis dividing a cortical portion and central ground tissue.

Epidermis consists of typical parenchymatous cells with brownish pigments.

Hypodermis consists of 2-3 layers of thick-walled cells. Cortex is composed of

parenchymatous cells, outer part compact, inner part arenchymatous with large

intercellular spaces. Some cells in cortex region contain brownish oleoresinous matter

and others starch grains. Vascular bundles are closely scattered in the pith. Pith is

composed of parenchymatous cells containing starch grains and a few filled with

oleoresinous contents. Each vascular bundle is enclosed by a lignified fibrous sheath

1-3 layers. Vessels have blunted or tapering ends.

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Root – Transverse section of root shows a broad zone or cortex, outer cortex two

layered, inner cortex rapidly breaking down, only 3-4 innermost layers persistent,

cells tangentially flattended, thick walled. Endodermis consists of uniformly

thickened roundish cells. Xylem consists of 12 small vesselsadjacent to pericycle and

4 large vessels of unequal size near centre.

Chemical Constituents

β-sitosterol, 4α,5α- oxidoeudesm-11-en-3α-ol from (rhizomes); pinene , cineol,

alcohol-isocyperol(essential oil from tubers); linolenic, linoleic, oleic, myristic and

stearic acids and glycerol (fatty oil); a sequeterpeneketone-Mustakone and copaene,

cyperotundone, sesquiterpenes- (+)-copadiene, (+)-epoxyguine, (-)-rotundone and

cyperlone; cypernone designated as isopatchoul-4(5)-en-3-one and aureusidin

(essential oil); two sesquiterpenicketoalcohols, α-royunol, β -royunol, kobusone and

isokobusone; oleonolic acid and its glycoside, oleonolic-acid-3-0-neohesperidone

alongwith sitosterol, sesquiterpenes-α-cypernone, β-selinine and cypernone (tubers);

luteolin and aureusidin(leaves)

Uses

1. In Yunani-

• The roots are commonly used as a diaphoretic and astringent. They are

also credited with stimulant and diuretic properties.

• They are hrld in great esteem as a cure for disorders of the stomach

and irritation of the bowels.

2. In folklore –

• Fresh tubers are applied to the breast as a galactagogue.

• Decoction of roots are used in fever, diarrhoea, dyspepsia, and

stomach complaints.

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• The root is considered as diuretic and antiperiodic in Cambodia.

3. In Chinese medicine-

According to Chinese system of medicine these small tubers act on the lungs

and liver. Their general action is tonic, stimulating and stomachic

Actions

Tranquilizing, anti-inflammatory, antipyretic, diuretic, estrogenic, anti-emetic,

anthelmintic, smooth muscle relaxant, inhibitory activity against {3H} flunitrazepam

binding to bebzodiazepine receptor, antimicrobial and juvenile hormone mimicking

activity.

Toxicology

The LD50 of petroleum ether extract of the root was 50mg/kg and ED was 1.6mg/kg

intraperitoneally.

Substitutes and Adulterants

Cyperus scariosus R.Br. and Cyperus arundinaceumn Baker are used as substitutes to

Cyperus rotundus.

Propagation and Cultivation

It is perennial weed, thrives on all kind’s soils under varying climatic conditions.

Regenerations is mainly through underground rhizomes. Green house observations

show that a new tuber is formed in about 3 weeks after an isolated tuber is planted and

146 tubers and basal bulbs are produced from a single tuber in 3 and half months.

TRADE AND COMMERCE- Retail market price- Powder- Rs. 140/-per kg

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2. Plant profile - Saraca asoka (Roxb.) dewilde

निरुक्ति (Sharma P.V. et al. 2011)

Ashoka

ि शोकोऽस्मात् , शोकिाशि इत्यथजः।

It relieves pain and patients get relief from many health problems.

१.गन्धपुष्प - सुगग्जन्धपुष्पत्वात् ।
Flowers of Ashoka are aromatic.

२.ताम्रपल्लव - ताम्रवणाज ः पल्लवा अस्य।

Tender leaves are coppery red coloured.

३.नपन्डपुष्प - नपण्डाकारः सघिाः पुष्पगुच्छा अस्य।

Inflorescence (corymb) is globose.

४.मधुपुष्प - मधौ वसंते पु ष्पवनत।

Plants flowers in vasant rutu.

५.हे मपुष्प - स्वणाज भानि पु ष्पाण्यस्य।

Flowers are golden coloured.

६.स्त्रीनप्रयः - स्त्रीणां नप्रयः, स्त्रीरोगेषु नहतत्वात्।

Women like this plant or Ashoka is useful in striroga.

७.कंकेनल - कं सुखं केलनत र्ियनत, आह्लादकरः।

It generates happiness.

Table 17. Paryaya or synonyms of Ashoka

पयााय ध.नि कै.नि भा.प्र रा.नि सो.नि. नप्र.नि

अशोक + + + + + +

शोकिाश + + - + + -

नवनचत्र + + - + + -

कणजपूरकः + + - + + -

नवशोक + + - + - -

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रागी + + - - - -

नचत्र + - - + - -

षट् पदमञ्ज + - - - - -
रर

गतशोक - + - - - -

वीतशोक - + - - - -

ताम्रपल्लव - + + - - -

नपण्डीपुष्प - + + + - -

हे मपुष्प - + + + - -

सुभग - + - + - -

रक्तक + + - - - -

रामस्तकम - + - - - -
ञ्जरी

नचत्रशोक - + - - - -

शोकिाश - + - - - -

वञ्र्ुल - - + - - -

कङ्केनल - - + + + -

नपण्डपुष्प - - + - + -

गन्धपुष्प - - + - - -

िट - - + + - -

मधुपुष्प - - - + - -

केनलक - - - + - -

रक्तपल्लव - - - + - -

स्मरानधवा - - - + - -
सा

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दोषहारी - - - + - -

रागीतरु - - - + - -

किककुसु - - - - - +
म

कल्यः - - - - - +

वञ्र्ु लद्रुम - - - + - -

प्रपल्लव - - - + - -

Table 18. Guna-Karma of Ashoka as per various authors

गुण ध.नि कै.नि भा.प्र रा.नि षो.हृ. नप्र.नि

कटु - + - - - -
नतक्त - + + - + +
रस
कषाय - + + - + +
मधुर + - - - - -
गुण शीत + + + + + +
निग्ध - + - - - -
वीयज शीत + + + + + +
नपत्तहर - - - + - -
दोषघ्नता
कफहर + - - - - -

Table 19. Ashoka Karma as per various authors

Karma ध.नि कै.नि भा.प्र रा.नि षो. हृ. नप्र.नि

हृद्य + - - + - -

सन्धािीय + - - - - -

कृनमघ्न + - - - - -

सुगग्जन्धक + - - - - -

वण्यज - + + - - +

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ग्रानह - + + - - -

तृष्णाहर - + + - - -

नवषघ्न - + + - + +

िमहर - - - + - -

Table 20. Indication of Ashoka in different disease.

ध.नि कै.नि भा.प्र रा. नि षो. हृ. नप्र.नि.

व्यानध

अशज + - - - - -

कृनम + + + + - -

अपनच + + + - - -

व्रण + - - - - -

तृष्णा - + + - - -

शोष - + + - - -

नवष - + + - + +

रक्तनवकार - + + - - -

प्रदर - - - - + +

योनिव्यापत् - - - - - +

दाह - + + + - -

गुल्म - - - + - -

उदरशू ल - - - + - -

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आध्माि - - - + - -

Table 21. Vishishta yoga of Ashoka in ayurvedic formulary of India

Sl. No. Formulation Name of classical texts

1. Ashokarishta BaishajyaRatnavali,
streerogadhikara

2. Ashoka ghrita BaishajyaRatnavali,

streerogadhikara

Referance

अशोको हे मपुष्पश्च वञ्र्ु लस्ताम्रपल्लवः ।

कङ्केनलः नपण्डपुष्पश्च गन्धपु ष्पो िटस्तथा ॥(भा.प्र. पुष्पवगज ४७)

अशोको शीतलाग्जस्तक्तो ग्रानह वण्यज कषायकः।

कङ्केनलः नपण्डपुष्पश्च गन्धपु ष्पो िटस्तथा॥ (भा.प्र. पुष्पवगज ४८)

अशोक शीतलश्चाशज ः कॄमीन्हग्जन्त प्रयोनर्तः।

अपनचं िाशयत्येव सवजव्रणनविाशिः।
अशोको मधुरो ह्रॄद्यः सन्धानियः सु गंनधकः॥(ध.नि. आम्लानद वगज १४७-१४८)

अशोको शीतलः निग्धो वण्यो ग्रानह कषायकः।

दोषापनचतॄषादाहकॄनमशोष नवषास्रनर्त् ॥ (कै.नि. ओषनधवगज १४०३)

अशोकः नशनशरो हॄद्यः नपत्तदाहिमापहः ।

गुल्मशूलोदराध्माि िाशिः नक्रनमकारकः ॥ (रा.नि. करवीरानद वगज ५७)

अशोक ग्जस्तक्तस्तु वरः शीतो वण्यो नवषापहः ।

स्त्रीणां प्रदररोगे च योनिव्यपत्सु शस्यते ॥ (नप्र.नि.हररतक्यानद वगज १७४)

Modern review on Ashoka

BOTANICAL NAME- Saraca asoka (Roxb.) dewilde

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Syn. Saraca indica auct. Non. Linn.

Domain: Eukaryota

Kingdom: Plantae

Phylum: Magnoliphyta

Subphylum: Angiospermae

Class: Magnoliopsida

Order: Fables

Family: Caesalpiniaceae

Genus: Saraca

Species: Saraca asoka

Vernacular Names

English- Ashoka

Hindi- asok, asoka, Ashoka, anganpriya

Bengali- Asok, asoka, Ashoka, anganpriya

Gujarati- Ashopalava Asipala

Kannada- Ahsunkar, asoka, Ashoka, Ashokada, Kengalimara, Aksunkar,

Ashokadamara

Malayalam- Asokam, hemapushpam, vanjulam

Marathi- Ashoka, Jasundi

Punjabi- Asok

Tamil- Asogam

Telugu- Asek, kankeli, Asokamu, Vanjulamu, Asoka

Oriya- oshoko, Asoka

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Distribution-

It occurs almost throughout India up to an altitude of 750 m in the central and in the

eastern Himalayas and Khasi, Garo and Lushai hills, wild in Chittagong, Bihar,

Orissa, Konkan, Deccan, S.M. country, N.circars, Mysore, Travancore. It has become

quite scarce in several localities and is reported to be threatened in North eastern

region of India.

Genus characters

Saraca linn.

Erect tress. Leaves abruptly pinnate; stipules large, intrapetiolar, completely united or

rarely foliaceous and partially free. Leaflets usually of few pairs, coriaceous. Flowers

in dense sessile paniculate, (rarely simple) corymbs on old nodes or rarely axillary;

bracts small, deciduous; bracteoles persistent, coloured, shorter than the tube of the

calyx. calyx petaloid; tube elongate, cylindric, crowned bt a lobed disc; segments 4,

oblong, subequal, imbricate. Petals 0. Stamens 2-9, free exserted; filaments long,

filiform; anthers oblong, versatile, dehiscing longitudinally. Ovary stalked, the stalk

attached to and produced beyond the disc; ovules many; style filiform;

stigma,minute,capitate. Pod flat, dehiscent, rigidly coriaceous. Seeds exalbuminous-

(Kirtikar K. et al.2009)

Characters of species – Saraca asoka

A tree 6-9mtr high; branches glabrous. Leaves 15-25cm long; rhachis glabrous, corky,

at the base; petioles very short; stipules intrapetiolar, completely united, 10-13 by

6mm., scarious, ovate-oblong, obtuse, parallel-nerved. Leaflets 4-6 pairs, 10-20 by 3-

5cm., oblong-lanceolate, obtuse or acute quite glabrous, base rounded or cuneate,

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slightly oblique; petiolules 4.5-6.5mm long, stout, wrinkled; stipels deciduous.

Flowers fragrant, numerous, in dense axillary corymbs 7.5-10cm. across; peduncles

stout; pedicels 8-13mm long, red, glabrous,; bracts ovate, subacute; bracteoles 2,

appearing like calyx 4mm long, spathulate-oblong subacute, ciliolate, amplexicaul,

coloured. Calyx passing from yellow to orange and finally red; tube 1.3-2cm long,

cylindric, solid at the base; segments 4, oblong or ovate oblong 1cm long. Petals 0.

Stamens 7 or 8, much exserted ; filaments filiform, thrice as long as the calyx-

segments; anthers purple. Ovary pubescent, especially on the sutures; style covered

into ring. Pods black, 10-25 by 4.5-5cm linear oblong, tapering to both ends,

compressed, glabrous, veined. Seeds 4-8, ellipsoid-oblong, 3.8cm long, slightly

compressed.

The bark is bitter and acrid; refrigerant, astringent to the bowel, alexiteric,

anthelmintic, demulcent, emollient; cures dyspepsia, thirst, burning sensation,

diseases of the blood, biliousness, effects of fatigue, tumors, enlargement of the

abdomen, colic, piles, ulcers, bloody discharges from the uterus, menorrhagia; useful

in fractures of the bones; beautifies the complexion. (Kirtikar K. et al.2009)

Pharmacognosy

Stem bark- dried bark is channelled, outer surface is rough with warty protuberances

and exfoliations and is rusty brown in colour. Lenticels are conspicuous and occur in

these protuberances, circular, to transversely elongated. There are also transverse and

longitudinal cracks. The inner surface of the bark is reddish brown in colour. The

fracture is short and fibrous; odour indistinct and taste astringent. Transverse section

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of mature bark shows cork which is composed of 4 to 10 layers of tangentially

elongated cells. In surface view the cork cells appear polygonal to isodiametric and

have suberized walls. Following the phellogen is the phelloderm of 10-20 layers of

parenchymatous cells, inter spread in which are small groups of thick-walled stone

cells, which vary in shape from cubical to linear. In some in some specimens where

the outer bark is ruptured due to the formation of rhytidome, the phelloderm is only

small and the medullary rays are long. In such cases, the secondary phloem consists of

sieve tubes, companion cells, phloem parenchyma and phloem fibres. The sieve tube

elements have transverse simple sieve plates. The phloem fibres occur in rectangular

bands,2-4-6-9 cells wide in radial direction and extending in tangential direction from

one medullary ray to another. The fibres are long with tapering ends but occasionally

have truncated ends. Crystal fibres are absent but stone cells are present. Cells of the

medullary rays in tangential section are often very irregular in shape, with occasional

large cells interspersed among the smaller cells. These cells contain rosette, prismatic

and acicular crystals of calcium oxalate. Prisms are present in stone cells of

phelloderm region. Starch grains, mostly of simple type, are found plentifully

throughout the parenchymatous tissue. Some of the phelloderm cells contain dark

granular masses which dissolve in chloralhydrate. Many cells of phelloderm and

phloem region contain resin and tannin.

Powder treated with NaOH in methanol gives violet florescence under ultraviolet

light. (SHARMA P.C.et. al. 2001)

Actions and Uses-

1. Folklore-

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• The flowers pounded and mixed with water are used in hemorrhagic

dysentery.

• The bark is much used in uterine affections and especially in menorrhagia.

Decoction of the bark in milk is generally prescribed.

• The bark, flower and fruit are all equally useless in the treatment of snake-bite

and scorpion sting.

2. The bark is bitter, astringent, sweet, refrigerant, anthelmintic, stypic,

tomachin, constipating, febrifuge, demulsant. It has stimulating effect on

endometrium and the ovarian tissue. It is useful in dyspepsia, fever,

biliousness, burning sensation, abnormal enlargement of visceral organs, colic,

dysentery, internal bleeding, haemorrhoids, ulcers, uterine affections,

menorrhagia especially due to uterine fibroids, meno-metrorrhagia,

leucorrhoea, and pimples. Leaves possess blood purifying properties and its

juice mixed with cumin seed is used to cure gastralgia. Flowers are considered

as excellent uterine tonic and used in cervical adenitis, biliousness, syphilis,

hyperdipsia, burning sensation, haemorrhagic dysentery, piles, scabies in

children and inflammation. Dried flowers are used in diabetes. Seeds are used

in treating bone fractures, steangury and vesical calculi. (kirtikar et al. 2012)

Chemical Constituents

Glycosidic principles, non-phenolic,sapogenetic glycoside, sterols and aliphatic

alcohols (plant); tannins and catechol, n-alkanes, ester, free primary alcohol and n-

octacosal (wax) (-) epicatechin, procyanidin β2, 11`-deoxyprocyanidin B, (+)

catechin, (24,ξ)-24-methyl-cholesta-5en-3β-ol(22E, 21ξ)-24-ethycholesta-5, 22dien-

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3β-ol, (24ξ)-24-ethylcholesta-5-en-3-β-ol, leucopelargonidin-3-0-β-D-glucoside,

leucopelargonidin and leucocyanidin (bark); oleic ,linoleic, palmitic, and stearic acids

(seeds); β-sitosterol, quercetin, kaempferol-3-0- β-D-glucoside, quercetin-3-0- β-D-

glucoside, apigenin-7-0- β-D-glucoside, pelargonidin-3, 5-diglucoside, cyanidin-3, 5-

diglucoside, palmitic, stearic, linolenic, β and γ sitosterols, leucocyanidin (pods) and

gallic acid (flowers); catechol, (-) epicatechol and leucocyanidin (pods); quercetin

(wood).

Pharmacological Activities

Spasmogenic, oxytocic, uterotonic, antibacterial, anti-implantation, antitumor,

antiprogestational, antioestrogenic activity against menorrhagia and anticancer.

Toxicology

Pure phenolic glycoside was nontoxic to animals up to 250mg/kg.

Substitutes and Adultrants

Polyalthia longifolia Benth. & Hook. (Family-Annonaceae) goes by the same name

“Ashoka” and is often used as an adulterant or as a substitute of genuine Ashoka bark

i.e. Saraca asoka. There are few more plants viz. Bauhinia variegata Linn., Trema

orientalis (Linn) Blume and Shorea robusta Gaertn,f., the barks of which are largely

used and sold in the drug market under the name of Ashoka.

Propagation and Cultivation

Propagation from seed provides an easy and relatively rapid means of producing this

species. The plants may be raised by direct sowing or by transplanting the seedlings

raised in nursery beds or pots. Pruning of taproot should be avoided, as it is liable to

check the plant growth considerably. Samplings have been transplanted at various

stages from one month old to 2-year-old, with success. The seeds may be sown
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directly using 2 or 3 seeds per pit. Later the more robust of the plants are retained and

the rest pulled out. Seeds should be sown shortly after gathering to prevent loss in

germination, which may be from 50-100%. Young plants grow best in porous soil and

if sheltered from direct sun in the earlier stages. Effect of weeding, hoeing, and

watering on the development of seedling is marked. Growth is rapid, a bare stem 8-

10cm long is formed with 2 or 3 scale leaf nodes before the first leaf appears. By the

end of the season, a height of 23 to 30 cm is ordinarily attained if watering and

weeding is regularly carried out. The season’s growth ceases about November and

new growth commences around March. It does best in localities with a rainfall of over

200cm. however, sites with good soil moisture are said to be suitable. (Sharma P.C. et

al.2001)

Retail market price – Bark powder- Rs-. 260/- per kg.; Ashoka Ghana vati

(solidified aqueous extract)- Rs. 700/- per kg.

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