E-ISSN:2456-3110

Review Article

Kamadudha Rasa

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 4 April
Publisherwww.maharshicharaka.in

Scientific explanation of mode of action of Kamadudha Rasa in Amlapitta with special reference to Acid Peptic Disorders: A Review

Singh D.1*, Mal N.2, Kumar V.3, Prasad Sharma R.4, Pareek P.5
DOI: http://dx.doi.org/10.21760/jaims.8.4.17

1* Divya Singh, Post Graduate Scholar Final Year, Department of Rasa Shastra & Bhaishajya Kalpana, National Institute of Ayurveda DE-NOVO, Jaipur, Rajasthan, India.

2 Nakhat Mal, Post Graduate Scholar Final Year, Department of Rasa Shastra & Bhaishajya Kalpana, National Institute of Ayurveda DE-NOVO, Jaipur, Rajasthan, India.

3 Vinod Kumar, Post Graduate Scholar Final Year, Department of Rasa Shastra & Bhaishajya Kalpana, National Institute of Ayurveda DE-NOVO, Jaipur, Rajasthan, India.

4 Rajendra Prasad Sharma, Professor, Department of Rasa Shastra & Bhaishajya Kalpana, National Institute of Ayurveda DE-NOVO, Jaipur, Rajasthan, India.

5 Purva Pareek, MD, Department of Rasa Shastra & Bhaishajya Kalpana, National Institute of Ayurveda DE-NOVO, Jaipur, Rajasthan, India.

Amlapitta, also known as hyperacidity, is an illness that has been around for a while and is still very prevalent today. It is a very troublesome illness that, if left untreated, can result in a number of severe issues. Amlapitta symptoms and signs closely resemble gastritis or hyperacidity. The body's Pitta Dosha becoming more active is the primary contributor to hyperacidity. The Ayurvedic humour of Pitta represents heat or flames. There are a variety of factors that can aggravate Pitta, but the major ones are eating foods that are unsuitable for the body type or foods that shouldn't be consumed together (such as milk and fish or milk and salt), as well as drinking overly sour or spicy foods and liquids. In Ayurveda, hyperacidity is referred to as Amlapitta. Thus, a situation known as hyperacidity is one in which the body becomes more hot and sour. Pitta imbalances the digestive fire, resulting in poor food digestion and the creation of Ama. An essential medication used in Amlapitta is Kamadudha Rasa. We are attempting to provide a scientifically sound explanation of the drug's mechanism of action in this review paper.

Keywords: Kamadudha Rasa, Amlapitta, Rasaushadhis, Peptic Ulcer Disease, Anti-Ulcer Activity

Corresponding Author How to Cite this Article To Browse
Divya Singh, Post Graduate Scholar Final Year, Department of Rasa Shastra & Bhaishajya Kalpana, National Institute of Ayurveda DE-NOVO, Jaipur, Rajasthan, India.
Email: 		Divya Singh, Nakhat Mal, Vinod Kumar, Rajendra Prasad Sharma, Purva Pareek, Scientific explanation of mode of action of Kamadudha Rasa in Amlapitta with special reference to Acid Peptic Disorders: A Review. J Ayu Int Med Sci. 2023;8(4):99-105.
Available From
https://jaims.in/jaims/article/view/2306

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-03-01 2023-03-03 2023-03-10 2023-03-17 2023-03-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Ni Yes 16%

© 2023by Divya Singh, Nakhat Mal, Vinod Kumar, Rajendra Prasad Sharma, Purva Pareekand 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

Health is the supreme foundation of virtue wealth enjoyment and salvation. Drugs are being used for preservation of health and elevation of disorder since centuries. All societies invariably looked upon to the natural resources for maintenance of health and for attaining freedom from illness. The utility of Ayurveda science is to maintain the health of an invisible and also to cure the disease of the patients. It deals not only with treatment but also physical mental and spiritual well-being at mankind and also showing their experience logic and power of wisdom. Rasashastra deals with knowledge of Alchemy (Lohavadha) and pharmaceutical process like Samskara of Mercury and also processing of different metals and minerals, calcium substances and poisonous herbal drugs with therapeutic parameters vice dose duration indications and contraindications were mentioned.[1] Rasashastra is not counted among the Ashtanga Ayurveda but the evolvement of as a specialised branch is traced to the greatest Nagarjuna who is considered as the father of Rasashastra, it is believed to come into proper existence with its scientific classification and documentation around 8th century. Atreya Punarvasu stresses the significance of Ahara and Vihara in the maintenance of Agni. Agni in Ayurveda is an important entity in the treatment. The impairment Agni leads to many ailments. This Agni if tried to correlate in the lines of modern medicine if directs towards different secretions from gastric and liver mostly the secretion of the gastric are taken into account when the Agni is though as a physiological and pathological entity. Owing to the lifestyle and food habits at modern day human the disease resulted due to the gastric secretion impairment are most common.[2]

Amlapitta in Ayurveda: Mandagni is the main root cause of all diseases. It leads to Ajeerna. If it neglected, it gives rise to a vicious cycle called as Amlapitta. Amlapitta Vyadhi is a very common problem in socio-economically developed as well as developed countries. Though the intensity of this disease is not very high its volume is very large. Pitta Dosha Has Katu, Amla Rasatmak, Tikshna, Ushna, Laghu, Visra, Drava, Guna etc.[3] When the Amla and Drava Guna of the Pitta Dosha becomes exaggerated there is a sour, belching and it's condition is regretted to be pathological condition termed as Amlapitta.


Amlapitta vis- a- vis hyperacidity

It is very difficult to correlate any disease mention in allopathic system with Vyadhi mentioned in Ayurveda. But based on sign, symptoms and line of treatment mention in Ayurveda and modern medical science can be able to establish their similarity. So, in the same way, Amlapitta cannot be correlated with one acid reflux syndrome which comprises with GERD, gastritis, dyspepsia, peptic ulcer, hyperacidity.[4] The burning sensation in upper abdominal chest, acid reflux, water brash, nausea, vomiting, vertigo and flatulence characterize it.[5] The term dyspepsia and indigestion are difficult to define. Patients use these terms variously to express a feeling of epigastric fullness, discomfort or pain, heartburn or acidity, nausea, vomiting, belching or flatulence.[6] In digestion is a non specific term that encompasses a variety of upper abdominal complaints including nausea, vomiting, heartburn, regurgitation and dyspepsia. Kamadudha Rasa[7,8] is one of the ancient formulations used since centuries to treat Amlapitta (hyper acidity), Jirna Jwara (chronic fever), Unmada (insanity) etc. It contains Pravala, Mukta, Sankha, Shukti, Varatika in Pishti/Bhasma form with Guduchi Satwa.

Physiology of Acid Secretion

The stomach consists of two primary functional zones i.e., the oxyntic gland area, representing approximately 80% of the organ, and the pyloric gland area representing the remaining 20%. Parietal cells secrete hydrochloric acid and intrinsic factor which are predominantly present in the oxyntic glands. Chief cells secrets the digestive enzyme precursor pepsinogen.[9] The histamine, gastrin and acetylcholine released from postganglionic enteric neurons[10] are the principal stimulants for acid secretion from gastric mucosa.

Basal acid secretion is modulated by acetylcholine from parasympathetic vagal efferent. It directly stimulates acid secretion by binding to muscarinic receptors on parietal cells. Indirectly, acetylcholine also stimulates acid secretion through activation of M2 and M4 receptors on D cells.[11]

Antacids work instantaneously and give rapid relief from hyperacidity. The primary effect of antacids is partial neutralization of gastric hydrochloric acid and inhibition of the proteolytic enzyme pepsin.[12] These all antacids are administered orally, and their potency is measured by the amount of acid neutralized by a given dose of the antacid.


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Most commonly we use sodium bicarbonate, calcium carbonate, magnesium hydroxide and aluminium hydroxide as antacids. For example, calcium carbonate is sparingly soluble and it reacts with HCl and generates soluble calcium chloride, which is converted back to calcium carbonate in the alkaline conditions of the small intestine. Other used antacids are the insoluble aluminium hydroxide and magnesium hydroxide. Aluminium and calcium containing products generally cause constipation therefore these agents are often combined with magnesium hydroxide, which can cause diarrhoea and loose stools when administered alone.

Materials and Methods

The material is gathered from Ayurvedic texts, current references of publications, and published articles to review Kamadudha Rasa.

Based on their therapeutic activities, published research papers were compiled and examined from internet resource.

Results

Showing Rasa Panchaka of Ingredients of Kamdudha Rasa[17-19]

SN Dravya Rasa Guna Virya Vipaka Dosha Karma
1. Mukta Pishti   Madhura   Laghu   Sheeta   Madhura   Tridosh Shamaka (Mainly Pitta Shamaka) Ruchikarak, Deepana, Pachana  
2. Pravala Pishti   Madhura Kinchit Amla, Kashaya Laghu   Sheeta   Madhura   Tridosh Shamaka (Mainly Pitta Shamaka) Deepana, Pachana, Vrushya, Netrya, Vishanashaka, Mutral
3. Sankha Bhasma Tikta, Katu, Kashaya Laghu, Ruksha Kshara Grahi Sheeta   Madhura   Kapha Pittaghna Grahi, Varnya, Balya, Netrya, Vrushya, Paushtika
4. Shukti Bhasma   Katu, Madhura   Snigdha Sheeta   Madhura   Vata Pitta Shamaka   Deepana, Ruchikara, Stambhaka, Dahashamaka, Shotha Nasaka
5. Varatika Bhasma Katu, Tikta Ruksha Guru Teekshn Ushna   Madhura   Vata-Kaphaghna Deepana, Pachna, Netrya
6. Swarna Gairika   Madhura & Kashaya Snigdha Sheeta   Katu   Pittashamaka Kinchit Kapha Nashaka Netrya, Dahanashaka, Vishaghna, Vrana, Ropaka, Balya
7. Guduchi Satva   Tikta, Kashaya   Guru, Snigdha   Sheeta   Madhura   Tridosh Shamaka   Deepana, Pachana, Pittashamaka, Anuloman, Rasayana


References of Kamadudha Rasa

SN Reference Ingredients Preparation Indication Dose Anupana
1. Rasa Yoga Sagara  (Jwaradhikara)[13]  Hariprapannaji   1.Swarna Gairika, 2.Ghrita, 3.Amalaki Swarasa (juice of Emblica officinalis) Bharjana (frying) of Swarna Gairika is done with Ghrita, powdered and seven Bhavana (trituration) given with Amalaki Swarasa. Pitta Roga, Prameha (diabeties), Pradara, Pandu Roga (anemia), Kamala (jaundice), Daha, Trishna, Bhrama, Jirna jwara 2 Valla (750mg)   Sita, Ajya, Madhu  
2. Rasa Yoga Sagara (Amlapittadhikara)[14] Hariprapannaji   1. Guduchi Sattva, 2. Swarna Gairika, 3. Abhraka Bhasma All the ingredients are finely powdered and mixed well.   In Prameha with Madhu, Pippali, Tandulodaka. In Pradara with Goksheera, Matsyanda, Tandulodaka etc. 1 Valla (375mg)   Madhu, Pippali, Goksheera, Matsyanda, Tandulodaka etc.
3. Rasa Yoga Sagara (Amlapittadhikara)[15] Hariprapannaji 1.Mukta Bhasma, 2.Pravala Bhasma, 3.Shukti Bhasma, 4.Kapardika Bhasma, 5.Shankha Bhasma, 6.Shuddha Gairika, 7.Guduchi Sattva all in equal quantity All the ingredients are taken in equal quantity and triturated homogeneously Jirna Jwara, Bhrama, Unmada, Pitta Roga, Amlapitta And Somaroga. 2 Ratti (250mg)   Sita, Jiraka  
4. Rasamritam of Yadavaji Trikamji Acharya (Ratna Pradhana Yoga)[16]   1.Swarna Gairika, 2.Guduchi Sattva, 3.Sharkara, 4. Amalaki Swarasa Shodhita Swarna Gairika triturated with Amalaki Swarasa continuously for 21 days, dried and powdered. Mix Guduchi Sattva equal to it and also mix Sugar equal to both and grind well. Rakta Pitta, Trishna, Daha, Bhrama, Murcha   1 Masha (1gm) Sita, Tandulodaka  
5,6 Rasa Tantra Sara & Sidha Prayoga Sangrah / AFI- part -2)   1.Mukta Pishti, 2.Pravala Pishti, 3.Shukti Bhasma, 4.Kapardika Bhasma, 5.Shankha Bhasma, 6.Shuddha Gairika, 7.Guduchi Sattva all in equal quantity All the ingredients are taken in equal quantity and triturated homogeneously.   Jirna jwara, Bhrama, Unmada, Pitta Roga, Amlapitta and Somaroga.   1-3 Ratti (125-375mg)   Sita, Jiraka.etc In Amlapitta with Amla Churna &Ghrita  



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Composition of Kamadudha Rasa (with Mukta Pishti)

(Ref: Rasa Yoga Sagara/ Rasa Tantra Sara & Sidha Prayoga Sangrah / AFI- part -2)

SN Ingredients Latin / English name Form used Quantity
1. Mukta Pearl Pishti 1 part
2. Pravala Coral Pishti 1 part
3. Shukti Pearl oyster Bhasma 1 part
4. Sankha Conch shell Bhasma 1 part
5. Varatika Marine shell Bhasma 1 part
6. Swarna Gairika Red ochre Purified 1 part
7. Guduchi Tinospora cardifolia Thunb Miers Satva 1 part

Probable Mode of Action of The Drug

Kamadudha Rasa with Mukta

The contents of this Herbo-mineral formulation are Mukta Pishti, Muktashukti Bhama, Prawal Pishti, Shankha Bhasma, Suvarna Gairika, Kapardika Bhasma, Guduchi Satva.

  • These drugs are Madhura, Tikta, Katu, Kashaya Rasa Pradhana Dravya, Sheeta virya and kinchit Ushna in Virya, Madhura Vipaka Pradhana, Laghu, Snigdha, Ruksha, Teekshana Guna Pradhana.
  • Kamadudha Rasa having properties like Deepana, Pachana, Netrya, Balya, Rasayana, Varnya, Tridoshshamaka (mainly Pittashamaka), Anulomana, Vrushya
  • Mukta Pishti is a Madhura Rasa, Sheeta Virya and Madhura Vipaka These properties of Mukta Pishti help in the Tridoshshamana (mainly Pitta Shamana). Acharya Vagbhata has specifically mentioned Dahaghna & Agnimandyahara properties of Mukta in Rasa Ratna Samucchaya.[20] In Amlapitta, vitiated Pitta Dosha causes various symptoms like Daha, Amlodgara, Burning sensation in the epigastric region (Hrit- Kantha Daha) etc. This drug helps in neutralizing the excessive acid formation and has an anti-inflammatory action. Mukta Pishti also has other properties like Deepana, Pachana, Ruchikara which helps in digestion of ingested food and removes Ama Dosha and other toxins from the body. In Mukta Yukta Kamadugha Rasa, these properties help in enhancing the action of drug as compared to Mukta Rahita Kamadugha Rasa.
  • When Amalta (Amla Guna) of the Pitta gets increased and Pitta Dosha becomes Vidhagadha e., Amlapitta. Nidana Sevana causes Pitta Dusti and causes sign and symptoms mentioned in the disease review section. If patient continues Nidana Sevana, Pitta becomes more Vidagdha and causes irritation and inflammation of stomach lining and even form ulcers as a complication. In this case, Kamadugha Rasa which consists of Madhura and Sheeta Virya drugs reduces Pitta Dosha and reduces inflammation.
  • Kapardika Bhasma is Katu, Tikta in Rasa, Ushna Virya, Vata Kaphaghna. It is alkaline in nature, hence helps in neutralization of excessive acid formation in the stomach and reduces pain (stomach). It aids in Deepana & Pachana because of its Katu Tikta Rasa and Ushna Virya and ultimately removes the Ama Dosha from the body.
  • Swarna Gairika is Stambhaka drug which helps in reduction of Pitta Srava.
  • Rasa Panchaka of Guduchi Sattva has not mentioned separately, hence Rasa Panchaka of Guduchi is considered as Guduchi Sattva Rasa Panchaka but more potent. Pitta Dosha is the main Dosha in Amlapitta and Guduchi is having Tikta, Kashaya Rasa and Madhura Vipaka helps in balancing the Pitta Dosha. Guduchi contains other properties like Pitta Ghna, Dhatwanidipana, Raktaprasadana, Dahashamaka, Rasayana, Amapachna, Dhatuvardhaka helps in balancing Dosha (Tridoshanashaka).
  • Shankha Bhasma is Kshariya, Sheeta according to Bhavaprakasha helps in balancing the Amla Guna of the Grahi Guna of the Shankha Bhasma cures Amlapitta and Grahani.[21]
  • Kamadudha Rasa contains drugs of Sudha Vargae., calcium carbonate which reacts with hydrochloric acid (HCL) i.e., CaCo3 + HCl = H2O+Co2+CaCl2 and neutralizes the acid, hence acts as efficient antacid
  • Kamadudha Rasa contains calcium oxide, calcium carbonate and in traces calcium silicates. Calcium is the main ingredients & many enzymes and hormones that regulate digestion and metabolism are produced by it.



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Discussion

Amlapitta is caused by aggravated Pitta due to excessive intake of pungent and sour food items, alcoholic preparations, salt, hot and sharp stuff. This aggravated Pitta cause burning sensations. To pacify the Pitta, anger, fear, excessive exposure to sun and fire, intake of dry vegetables and alkalis, irregularity in taking food, and all Pitta Prakopak factors should be avoided. Various drugs are described for treatment of Amlapitta. Among these Avipattikar Churna, Leela Vilas Ras, Amla-Pittantak Lauha, Triphala Mandur, Kushmand Khand, Prawaal Panchamrit, Shankh Bhasm, Prawaal Pishti, Mukta Pishti, and Yavakshar are the main drugs. Kamadudha Rasa is used very commonly used in Amlapitta. But due to lack of scientific explanation, nobody wants to believe that it is as useful as allopathy drugs. After scientific explanation of its mechanism everyone has proud on the concepts of Ayurveda that it is also very scientific.

Conclusion

Kamadudha Rasa is a very commonly used drug in Amlapitta and it helps not only in reducing the symptoms but also maintains the health. The specially prepared lifestyle chart containing Ahara and Vihara helps in reducing the symptoms and maintaining the healthy lifestyle. This drug is very beneficial in this disease due to multiple actions such as anticholinergic and directly acting antacid.

Reference

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2. Pharmaceutico Experimental study on certain formulations with special references to gastric antisecretory and anti-ulcer activity by Dr. Jagadeesh G. Mitti, Dr. K. Shankar Rao. A dissertation submitted to the Rajasthan Ayurveda University, Jodhpur. (2010)

3. Shastri.S, Vidyotini hindi commentary on Madhav Nidan of Madhavakar, Part 1 Chaukambha Bhawan Sanskrit Bhawan, Varanasi, edition 2004,170-172

4. Kuntal G, Bhagel S.M. Review of clinical observational studies conducted on 1812 patients of Amlapitta at IPGT&RA Jamnagar. IJRAP,5,1410-141, 2011.

5. Susharshan Shastri Madhava Nidana of Madhavakar, Amlapitta Niadanam, Shloka (2-12) ,Vijaya Rakshit and Kanthgat Chaukabha Sanskrit Sansthan,Varansi edition 2004(170-172)

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8. Rasa Tantra Sara & Sidha Prayoga Sangrah/Krishna Gopal Ayurveda Bhawan (Dharmarth Trust)/21st publication/year2012 Kharaliya Kasayan 80

9. Hirschowitz BI, Keeling D, Lewin M, Okabe S, Parsons M, Sewing K, Wallmark B, Sachs G, Pharmacological aspects of acid secretion, Dig Dis Sci. 1995 Feb; 40:3S-23S

10. Schubert ML, Peura DA, Control of gastric acid secretion in health and disease. Gastroenterology. 2008 Jun; 134(7):1842- 60

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12. Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs. 1999; 57:855–870

13. Vaidya Pandit Hariprapannaji, Rasayogasagara, 7 th edition, Varanasi, Krishnadas Academy Publication, 1999, Vol-I, Shloka 702-706, page-260.

14. Vaidya Pandit Hariprapannaji, Rasayogasagara, 7 th edition, Varanasi, Krishnadas Academy Publication, 1999, Vol-I, Shloka 707-710, page-260

15. Vaidya Yadavaji Trikamji Acharya,Rasamritam, English translation by Dr.Damodar Joshi and Dr.G.Prabhakar Rao, 2nd Edition, Varanasi, Chaukhambha Sanskrit Bhawan, 2003, 5th Chapter, Shloka 22-24, page-176

16. Vaidya Pandit Hariprapannaji, Rasayogasagar, 7 th edition, Varanasi, Krishnadas Academy Publication, 1999, Vol-I, Shloka 711-713, page-260



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17. Vaidya Shamrao Dhonodopant Kulkarni, Ayurvediya Rasaaushadhi Nirman, First Edition, Ch 8 p.243-244, Continental Prakashan Vijay Nagar Colony, Pune, 1981.

18. Vaidya Shamrao Dhonodopant Kulkarni, Ayurvediya Rasaaushadhi Nirman, First Edition, Ch 3 p.71- 73, Continental Prakashan Vijay Nagar Colony, Pune, 1981.

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20. Shastri A., Rasa Ratna Samucchaya of Vagbhata, 9th edition, Chaukhamba Sanskrit publication, Varanasi,1995, ch. 4/15.

21. Ajay Kumar and Tina Singhal. Scientific explanation of mode of action of Sutshekhar Ras in Amlapitta with special reference to acid peptic disorders: A review. Int. J. Res. Ayurveda Pharm, 2018;9(5): 47-49 http://dx.doi.org/10.7897/2277- 4343.095154.


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