E-ISSN:2456-3110

Review Article

Netra Anjana

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 11 December
Publisherwww.maharshicharaka.in

Evaluation of action of Netra Anjana in maintaining Netra Swasthya

N. Bagade J.1*
DOI:

1* Jayashree N. Bagade, Professor & HOD, Department of Shalakya Tantra, Shri C. B. Guttal Ayurvedic Medical College & Hospital, Dharwad, Karnataka, India.

Eyes hold special status among all the sense organs because vision is crucial for social and intellectual development of the human beings. Hence Acharyas have mentioned several preventive and curative measures for the management of ophthalmic disorders. Kriyakalpa is the basis of the treatment of ophthalmic disorders, as Panchakarma is the basis of Kayachikitsa. When we refer our classics for the therapeutic measures adopted in the management of eye diseases, we find that the management includes many of the topical treatments along with systemic ones. Netra Kriyakalpas have very fast action on the target tissues of the eye. Kriyakalpa includes various procedures like Tarpana, Putapaka, Seka, Ashchyotana, Anjana etc. for the treatment of eye diseases, as local measures. The process in which herbomineral preparation (Gutika, Rasakriya & Churna) mixed with water and applied on the lower eyelid margin with the help of Shalaka is called Anjana Karma. Its active principles may be transferred to the interior of the eye depending on their hydrophilic and lipophylic nature through the conjunctiva and cornea by paracellular and transcellular pathways respectively. Anjana therapy is highly beneficial in the anterior segment and also in the posterior segment disorders of the eye. An Ayurvedic review & probable mode of action of Anjana Karma discussed in present article.

Keywords: Ayurveda, Kriyakalpa, Panchakarma, Anjana Karma, Hydrophilic, Lipophylic

Corresponding Author How to Cite this Article To Browse
Jayashree N. Bagade, Professor & HOD, Department of Shalakya Tantra, Shri C. B. Guttal Ayurvedic Medical College & Hospital, Dharwad, Karnataka, India.
Email: 		Jayashree N. Bagade, Evaluation of action of Netra Anjana in maintaining Netra Swasthya. J Ayu Int Med Sci. 2022;7(11):111-117.
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https://www.jaims.in/jaims/article/view/2062

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-10-26 2022-10-28 2022-11-04 2022-11-11 2022-11-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 19%

© 2022by Jayashree N. Bagadeand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Shalakya Tantra is one of the eight specialities of Ayurveda which deals with the diseases which occur above the Jatru Pradesha i.e., Eye, Ear, Nose, Mouth, Throat etc. Eyes hold special status among all the sense organs because vision is crucial for social and intellectual development of the human beings and the knowledge from direct observation can be achieved from eyes only. Hence “Everyone should be dedicated enough to protect their vision, throughout the period of life because for an individual who is blind, day and night are the same and the beautiful world is useless to him even if he possesses lot of wealth.[1]

Hence for the maintenance of positive health, our Acharyas have prescribed various preventive and curative measures like application of collyrium to protect the eyes.[2]

Almost all the Acharyas prescribed several treatment procedures for the management of ophthalmic disorders such as systemic, surgical, para-surgical and local or topical treatments. Among these several types of treatment modalities local treatments are very specific, effective and unique to the eye diseases and called as “Netra Kriyakalpa”. It is similar as Panchakarma in Kayachikithsa. Netra Kriyakalpa has very fast action to the target tissues including posterior segment of the eye.

In all Kriyakalpas, Anjana has unique therapeutic efficacy for various types of ophthalmic diseases and highly recommended as preventive measure of various eye disorders. Anjana is a procedure of applying medicine in the form of Gutika, Raskriya or Churna (powder) to the inner side of lower lid margin either by fingertip or by Anjana Shalaka. Various ancient Acharyas described Anjana therapy as daily regimen especially Sauvira Anjana (Antimony sulphide) and Rasanjana (decoction of Berberista aristata – Daruharidra) mixed with bee honey as it eliminates excessive Kapha Dosha from the eye because eyes have predominance of Pitta Dosha or Teja Mahabhuta for its proper functioning or clarity of vision.[3,4,5]

Anjana is very useful in healthy eyes, as well as in ocular diseases. “Anakthi Thi Anjanam” is the definition of Anjana and word root is Anji because it gives moving, cleaning and clarity to eyes.[6]


Table 1: Karmanusara classification of Anjana

Sushruta[7] Vagbhat [8,9] Sharangadhar[10] Yogaratnakara[11] Bhavaprakasha[12]
Lekhana Lekhana Lekhana Lekhana Lekhana
Ropana Ropana Ropana Ropana Ropana
Prasadana Snehana Snehana Snehana Snehana
- Prasadana - - -

As per the Karma it is of 3 types. Lekhana means scraping action useful in Kaphaja Vikara, Ropana means healing, useful in Pittaja Vikara, Prasadana means purifying helpful in Vataja Vikaras.

Table 2: Akruti Anusara classification of Anjana with Matra[13,21]

Type of Anjana Lekhana Prasadana Ropana
Gutika 1 Harenu 1½ Harenu 2 Harenu
Raskriya 1 Harenu 1½ Harenu 2 Harenu
Churna 2 Shalaka 3 Shalaka 4 Shalaka

According to Akruti Anjana is of 3 types. such as Gutikanjana (in the form of pills), Rasakriyanjana (semisolid form) and Churnajana (powder form). Acharya Sushruta and Acharya Vagbhata mentioned that, the strength of Anjana increases in preceeding order as Gutika, Rasakriya and Churna.

Anjana Matra: Depending on the quality of drugs the Anjanas are divided in to two.

1. Tikshna
2. Mridu

So, the above mentioned Anjanas can be again categorised into two groups, the dose of Anjana depends these two qualities.

The dose of Gutika Anjana of Tikshna variety is Harenu Matra and of Mridu variety is double the dose of it. The dose of Rasakriya is Harenu Matra for Tikshna variety and in Mridu variety it’s twice the dose of above and the amount of Choorna Anjana to be applied in the eye is around two Shalaka in Tikshna variety and three in the other.

Table 3: Composition of Anjana as per types[14]

Type of Anjana Composition Action
Lekhana Tikta, Kashaya, Amla, Katu, Lavana Tastes Kshara, Tikshna Guna Drain out Doshas from eye lids, vessels, sacs, Srotas & Sringataka Marma through mouth, nostrils & eyes
Ropana Kashaya, Tikta + ghee/oil Healing, improves the colour and visual acuity
Prasadana / Snehana/ Drishti Prasadana Madhura + ghee/oil Pacifying the Doshas in vision, oleation

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Table 4: Indications of Anjana

Indication Susruta Samhita[15] Ashtanga Hridaya[16] Sharangadhar Samhita[17] Bhavaprakasha Nighantu[18]
After the Dosha manifested + - - -
Dosha located only in eye + + - -
After body purification + + - -
Dosha become Pakva - + + +
Slight oedema in eye - + - -
Severe itching in eye - + - -
Sliminess of eye - + - -
In thick eye secretions - + - -
Vata, Pitta, Kapha & Raktaja disorders   +    

Table 5: Time of application as per season[19]

Season Timing
Shisira, Hemanta Madyana
Grishma Purvanha
Sharat Aparanh
Vasant Any Time
Varsha Sudina

Table 6: Time of application within day[20]

Timing for Anjana Indications
Purvahna (morning) Sleshma Rogi
Sayaanha (evening) Vataja Rogi
Raatri (night) Pittaja, Raktaja Rogi

Table 8: Anjana Patra as per type of Anjana

SN Anjana Patra
1 Madhuranjana Swarna
2 Amlanjana Meshashrunga
3 Lavanajana Rajata
4 Katukanjana Vaidurya
5 Tiktanjana Kamsya
6 Kashayanjana Tamra,Loha

Anjana Shalaka[22] or collyrium probe is a cylindrical rod with 8 Angulas in length which is made of metals, stones or horns of animals and ends should be bluntly pointed like a flower bud.

Anjana Patra[23] The container used for the storage of Anjana is known as Anjana Patra. The material should be taken according to the medicinal property of the drug. It is further advised the Anjana Shalaka also can be made according

Contra-Indications[24],[25],[ 26]

  • Srama - tiredness
  • Udavarta - upward movement of vata
  • Ajirna - indigestion
  • Rudita - crying
  • Madya - addicted to alcohol
  • Krodha - anger
  • Jwara - fever
  • Vegaghata - suppression of natural urges
  • Shoka - depression
  • Dhuma - smoking
  • Arka - exposure to light
  • Agni - exposure to heat
  • Divaswapna - day sleep
  • Jagara - awakening in night
  • Bita - afraid

When to Advise Anjana: The appropriate time for application of Anjana is after the administration of Shodhana therapy and when the Doshas localise only in the eye and in Niramavastha of the eye and when eye starts to exhibit Pakwa Lakshana like reduced oedema, severe itching, lack of discharge etc. Implementing these methods of treatments without losing their priority in different Doshik status deserve great attention, because the patient is benefited only if we indicate the particular method in correct time of application otherwise instead of pacifying the Doshas in the eye, it may deteriorate the condition and results in complications.

When to apply Anjana: Acharya Sushruta advises to do Anjana in morning for Kapha predominant eye diseases, during evening for Vata related eye diseases and in Rakta Pitta diseases it is advised to do in night. Anjana While applying in the morning time it should be Kapha Shamaka in nature as there is chance of vitiation of the same in the morning while in the night it is better if it is Pitta Shamaka as it may make the eye fresh and cool which has became weak due to the exposure to hot sun. In this way the application of Anjana in morning and evening surely correct the daily vitiation of Doshas in a healthy eye. It is not applicable in pathological eye.

The other opinion is regarding the application of Tikshna Anjana, as it contains Katu, Lavana, Amla Dravyas which of boutique combination of Agni and Vayu, applying it in day time will again


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harm the eye as there is hot outside, but during night the coolness of the moon helps the eye to recover easily from the ill effects of Tikshna Anjana.

Method of application of Anjana

Poorva Karma[27]

After deciding the type and dose of Anjana, the desired amount of it can be applied to the eyelid using the different applicator mentioned for particular purpose. To avoid the anxiety of the patient the procedure should be explained to them.

Position - Anjana can be applied in supine or sitting position.

Pradhana Karma: Eyelids are retracted with left hand, while with the help of right hand Anjana is applied with Shalaka from inner canthus to outer canthus and vice-versa. After applying the Anjana, the patient is asked to close the eyelids gently and to rotate the eyeball, which helps in spreading of medicine in the eye. Blinking, rubbing of lids, washing the eye is contraindicated during the procedure. The dissolved Doshas come out through lacrimation.

Paschat Karma: After Anjana Karma when lacrimation stops then Netra Prakshalana (Eye wash) is performed with suitable decoction as per Dosha, Roga, and Rutu. After Prakshalana, eye is wiped with clean cloth and Pratyanjana of opposite quality of Anjana is applied.

Prakshalana Vyapad: If Prakshalana is done prior to elimination of Doshas, there is a fear of recurrence of disease.

In case of improper Prakshalana symptoms like itching, inertness occurs. In that condition Tikshnaanjana or Tikshna Dhuma is indicated.

Samyak, Atiyoga, Hinayoga of Anjana[28]

Lekhananjana Samyak Yoga: Eye becomes clean, no discharge with symptom of lightness, clarity in vision and proper activity of eyelids and free from complications.

Atiyoga Lakshana, Chikitsa: Causes squint, hardness, discoloration dryness and excessive discharge. These conditions should be treated with nourishing therapies that alleviate Vata.

Hinayoga Lakshana, Chikitsa: Aggravation of Doshas occurs. Measures such as Dhuma, Nasya, Anjana are advocated to eliminate the Doshas.

Prasadana Anjana and Ropana Anjana: Samyak Yoga, Atiyoga and Ayoga of Ropananjana is described same as that of Prasadananjana.

Samyag Yoga: Eye become pleasant with devoid of Doshas, attains unctuous, normal colour, strength and able to perform proper eye movements.

Atiyoga: Symptoms such as heaviness of eye, eye filled with tears, excessive unctuousness, lacrimation, itching, sticking of eyelashes with less severity than that of Atiyoga of Tarpana.

Ayoga: Doesn’t serve the purpose of application.

Mode of Action: According to Acharyas the Lekhan Anjana because of its Tikshna property, eliminate the Doshas from the Siras pertained to Vartma & eye and from the tissue, from related Srotas and also from the Sringataka Marma through mouth, nose and eye.[29] A medicine applied to eye spreads to Netra Sandhi, enters the nose through nasolacrimal duct and reaches the Nasa Siras, and also to Shrungataka Marma and takes away the Doshas and expels them.[30] Gutika and Churna Anjana have micro particles which may be deposited in the cul-de-sac and thereby increase the bioavailability to enhance ocular absorption. The ocular absorption of Anjana may initiate though the conjunctiva and cornea. Mainly lipophilic active ingredients may get absorbed through the cornea by transcellular pathway and hydrophilic ingredients from the conjunctiva by paracellular pathway. Most importantly molecular size and molecular weight of the active ingredients play a major role in the absorption process. Once it crosses the conjunctiva (mainly hydrophilic); the sclera is more permeable and it allows drugs to penetrate the other interior structures of the eye i.e., ciliary body, iris, aqueous humour, lens, vitreous etc. The drugs pass though the corneal epithelium (mainly lipophilic) directly goes to the aqueous humour and then get distributed to the other ocular tissues. However, some of the drugs coming to the aqueous humour either via cornea or conjunctiva are undergo to metabolization by the enzymes present in the aqueous. Considering all these factors it can be said that Anjana therapy is very beneficial in ocular diseases.[31]

Anjana Vyapad [32]: Anjana applied in case of

  • Improper sleep - causes lethargy to blink.
  • In presence of wind - causes dimness of vision

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  • In presence of dust and smoke causes redness, secretion and glaucoma
  • After Nasya causes sneezing
  • In headache - aggravates the headache
  • After head bath, before sunrise - stagnation of Dosas which doesn’t serve the purpose.
  • In indigestion causes redness, swelling

 So, Anjana should be planned as per Desha (location), Kala (time), Roga Avasta (stage of the disease)

Discussion

Anjana (collyrium) is procedure of applying medicinal pastes/ powders to the inner part of lower lid either from Kaneenika Sandhi (inner canthus) to Apanga Sandi (outer canthus) or vice versa with Anjana Shalaka (applicator). Anjana is performed after Dosha attaining Pakwavasta i.e., having symptoms like Alpashopha (reduced orbital swelling), Na Atikandu (slight itching), Na Ati Paichilya (slight slimy discharge) and signs of slight watering, redness, foreign body sensation, Vyaktarupa, Netrashraya Mala, after Samshodana, Manda Raga, Ashru (lacrimation), Garsha (foreign body sensation). Performing Anjana in Amavastha increases the severity of disease which may lead to Netra Vikara.

Conclusion

Kriyakalpas are well designed procedures to treat ocular disorders but among them Anjana is used for both ocular as well systemic diseases which was outlined by our ancient medical scholars as they were aware of the mechanism of Blood aqueous barriers, and Blood Brain Barriers thus Anjana is mentioned in Netra Vikaras as well as in some of the Systemic disorders. Anjana is the simple therapeutic procedure among the Kriyakalpas for the daily usage which will acts as Chakshushya i.e., helps in maintaining good visual acquity. It has protective and curative effect on the eyes. After application of Anjana, person is asked to rotate the eyeball by closing the lids allowing spread of medicine over the eye by limiting nasolacrimal drainage there by increasing the bioavailability of medicine. Anjana is a good, simple, easy and effective treatment modality for treating both the anterior and posterior segment disorders of the

eye which is being practiced more than 5000 years. Finally, it can be concluded that Anjana is an ideal remedy for various types of ophthalmic disorders; which can be used as preventive as well as curative measure.

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