E-ISSN:2456-3110

Review Article

Rasa Ratna Samuchchaya

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 4 April
Publisherwww.maharshicharaka.in

Critical review of Rasa Ratna Samuchchaya w.s.r. to its Rasaprabha Teeka

Kumar Chandolia H.1*, Verma N.2, Dhakad D.3, Sahay Shukla G.4, Agrawal R.5, Goyal M.6
DOI: http://dx.doi.org/10.21760/jaims.8.4.14

1* Hemant Kumar Chandolia, Post Graduate Scholar, PG Department of Rasa Shashtra and Bhaishajya Kalpana, PGIA, Jodhpur, Rajasthan, India.

2 Neha Verma, 2Post Graduate Scholar, PG Department of Swasthavritta, PGIA, Jodhpur, Rajasthan, India.

3 Deepa Dhakad, Post Graduate Scholar, PG Department of Rasa Shashtra and Bhaishajya Kalpana, PGIA, Jodhpur, Rajasthan, India.

4 Govind Sahay Shukla, Professor & HOD, PG Department of Rasa Shashtra and Bhaishajya Kalpana, PGIA, Jodhpur, Rajasthan, India.

5 Rajaram Agrawal, Associate Professor, PG Department of Rasa Shashtra and Bhaishajya Kalpana, PGIA, Jodhpur, Rajasthan, India.

6 Manisha Goyal, Associate Professor, PG Department of Rasa Shashtra and Bhaishajya Kalpana, PGIA, Jodhpur, Rajasthan, India.

Rasa Ratna Samuchchaya (RRS) was written by Rasa Vagbhatta. This text sheds light on the extraction, purification, and transformation of metals and minerals into therapeutically useful forms, as well as the various instruments created for alchemical uses and the use of herbo-mineral preparations to treat a wide range of illnesses. Rasaprabha Teeka of RRS written by Dr. Indradev Tripathi. This Teeka is Hindi commentary of RRS. This Teeka consists total 30 chapters, 3871 verses and detailed description of 960 formulations. The main components of RRS are classification of metals and minerals, descriptions of instruments and formulations and avoiding the use of metals and minerals during pregnancy. RRS covers all eight branches of Ayurveda, although it mainly deals with therapeutic aspects of Rasashastra. Thus, the Rasaprabha Teeka of RRS is a necessary and required book for individuals who wish to learn the fundamentals and in-depth details of Rasashastra and is regarded as one of the most important reference books.

Keywords: Rasa Ratna Samuchchaya, Rasa Vagbhatta, Rasaprabha Teeka, Dr.Indradev Tripathi

Corresponding Author How to Cite this Article To Browse
Hemant Kumar Chandolia, Post Graduate Scholar, PG Department of Rasa Shashtra and Bhaishajya Kalpana, PGIA, Jodhpur, Rajasthan, India.
Email: 		Hemant Kumar Chandolia, Neha Verma, Deepa Dhakad, Govind Sahay Shukla, Rajaram Agrawal, Manisha Goyal, Critical review of Rasa Ratna Samuchchaya w.s.r. to its Rasaprabha Teeka. J Ayu Int Med Sci. 2023;8(4):86-91.
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https://jaims.in/jaims/article/view/2404

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-02-20 2023-02-22 2023-03-01 2023-03-08 2023-03-15
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2023by Hemant Kumar Chandolia, Neha Verma, Deepa Dhakad, Govind Sahay Shukla, Rajaram Agrawal, Manisha Goyaland 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

In Rasashastra we study about Mercury along with number of metals, minerals, gems and animal product and many plants. The primary goal behind the development of Rasashatra is Dehavada (living a long and healthy life through the use of formulations created from mercury and other metals and minerals). Later this knowledge was applied for Lohavada (the transformation of lower metals into valuable metals like gold and silver). It is clear from the history that 8th Century was the golden era of Rasashastra due to contribution of Nagarjuna. Rasa Ratna Samucchaya was written by Rasavagbhatta in 13th century. He was son of Singhgupt. The period of Rasavaghbhata is exactly not clear. However, given that it includes quotations from the Kings of Karwal, Nityanath Siddha, and Singhan as well as accepts the ideas presented in Rasendra Chudamani and Rasaprakash Sudhakar, one might assume that Rasavagbhatta complete this work in the 13th century. The book RRS denotes a compilation (Samucchaya) of Ratna (gems) i.e., priceless wisdom of Rasashastra. It is commonly used by scholars as the primary textbook of Rasashastra classics. The themes of Rasa Ratna Samucchaya were mostly inspired by Rasendra Chudamani. Rasaprabha teeka written by Dr.Indradev Tripathi. It is Hindi commentary of RRS. This Teeka consists total 30 chapters. In this manuscript author has focused on the compile to all 30 chapters. The 30 chapters can be divided into 2 parts. The first 11 chapters give information about Rasashastra and the pharmaceutical processes of metals and minerals. Remaining chapters provide information about formulations for treatment of various diseases. These 19 chapters briefly discuss about histology, symptoms, and various disease categories while providing detailed descriptions of many herbal, metallic, and mineral formulations. The beauty of this Teeka, there are many herbo mineral formulations for disease. The content of each chapter summarized in Tables 1 respectively.

Materials and Methods

The book has been reviewed chapter wise. Summary of each chapter is mentioned as below.

Chapter 1: Acharya Rasavagbhata starts the first chapter with Mangalacharana where worshipped Lord Shiva. This chapter give a description of

the 27 Rasa Siddhas, information about the Himalaya,[1] five different types of Rasapooja (worship). The speciality of parad described as siddherasekarishyami Nirdaridyagadamjagat.[2] The superiority of Rasayana made from Rasa, and the origins of the five different Parada varieties from the five Kupa (wells) are all provided. Loha is not described in the order of merging in "Kashthosdhayonagenagevangam".[3] Due to effectiveness of parad a common man become Devtulyabalayushh (powerful and long life like as Lord),[4] and origin of Hingula is detailed.[5]

Chapter 2: Abhraka (Mica), Vaikranta (Turmuly), Makshika (Copper pyrite), Vimala (Iron pyrite), Shilajatu (Compound of mineral oil), Sasyaka, Chapala (Bismuth), Kharpara (Smithsonite and calamite) eight Maharasa[6] (eight metals that are thought to be superior in processing mercury) are covered in this chapter, along with information on their types, acceptable variety, therapeutic properties, and procedure of purification and calcination processes. Abhraka described as Gauriteja (semen of parvati).[7] Worship of God Vinayaka and Bhairava at the collection site of Vaikranta.[8]

Chapter 3: This chapter deals with the description of Gandhashma (Sulphar), Gairika, Kasisa, Kankshi (Sphatika), Tala (Haratala), Shila (Manahshila), Anjana, Kankushtha 8 Uparasas.[9] Their origin, types, Grahyalakshana, Guna, Karma, Shodhana, Marana, Satvapatana, dose, Anupana, Rogaghnata and Doshaghnata has been explained in this chapter. Three types of Gandhak are mentioned Shukchanchunibha, Peetvarn and Shuklavarn.[10] In Kasisa Shodhan Pitta and Striraja are mentioned for Bhavana.[11] Shyamangi, Kanveerka and Khandakhya these 3 types of Manahshila are described.[12] Kankushtha origin described as Sadyojata Dantinh Varch.[13] The description of 8 Sadharana rasa are Kampillaka, Gauripashana, Navasadara, Kaparda, Vahnijara, Girisindoora, Hingula and Mriddarashringa.[14] Patana Yantra described for Hingula Satvapatan.[15] Common Satvashodhana method mentioned with Suddhivarg Darvya.[16]

Chapter 4: Eight different Ratna (gems) and five best Ratnas, their relation to specific planets described and their types, Guna, Shodhana, Marana, Satva also described. Five types of Ratnadosha are mentioned.[17] Specific Dravya mentioned for specific Ratna Shodhan.[18]


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Chapter 5: In RRS first time detailed and systematic classification of Lauhas (metals) found. The methods of conversion of lower metals into precious metals are not given but their types, attributes, purification, calcination and indications of each Lauha are mentioned. Five types of Swarna are mentioned with their origin description.[19] Marakdrvyas are described for Lauhas.[20] Garbha Yantra mentioned for the preparation of Somnathitamrabhasma.[21] Detail description of Maritani Lohani Rasibhavanti.[22] Detail description of Bhunagsatvapatna method mentioned and 1/12th part Shuddha Tamra Bhasma used in it.[23]

Chapter 6: This chapter details about quality of Guru, Shishya, Anuchara, Ayogya Shishya Lakshana and duties of Shishya has been mentioned. Name of Uparasa and Maharasa, location and establishment of Rasashala, preparation of Rasalinga, method of worship of Rasalinga are mentioned in detail.

Chapter 7: In this chapter detail description about site for Rasashala Nirmana, Chalanibheda (type of sieve), synonyms of Upala, materials required for preparation of Kupi, Chashaka, Pricharaka Lakshana, Amrita Hasta and Dagda Hasta Vaidyalakshana. Persons suitable for Dhatuvada are mentioned.[24]

Chapter 8: Kajjali means a black coloured powder, but when this word is used in Rasashastra, it means black sulphide of mercury prepared from definite proportions of Mercury and Sulphur. So terminology is an essential part of Rasashastra because meaning of a word or collection of words may be quite simple in day to day affairs but could be totally different technically. This chapter contains 78 terms which were originally defined by Somadeva in his famous treatise Rasendrachudamani.

Chapter 9: This chapter provides information on 33 different Yantra (instruments) required in Rasashala.

Chapter 10: This chapter gives information about 17 types of Musha (crucibles), 4 types of Koshthi (furnace), 10 types of Puta (various sized pits) for calcination of metals and minerals and their manufacturing. 24 frequently used terminology are mentioned in this chapter and six types of Lauhs are described.

Chapter 11: This chapter explains various units of measurements and 8 Parada Saṃskara

(eight basic processing steps of mercury), 25 Parada Bandhas (stable mercury). 8 type methods of Paradamarana (incineration of mercury) detailed in this chapter. Intake process of Paradabhasma mentioned and Pathya and Apathya during the consumption of Parada has been detailed. In the end of this chapter Devishastrokta and Shrikrishnadevokta Kakaradigana explained.[25]

Table 1: Brief description of main subjective matter in chapters no. 1-30 of RRS

Chapter number Key points mentioned Total number of formulations Total number of Shloka
1. Detailed description of Parada - 88
2. List of Maharasa and various process of their Sodhana and Marana - 162
3. List of Uparasa and Sadharanarasa along with various process of their Sodhana and Marana 4 158
4. Detailed description of Ratna - 84
5. Detailed description of Ashta‑Lauha 5 243
6. Qualities of good student and method of worshiping in pharmacy - 64
7. Blue print of pharmacy and qualities required in staff - 37
8. Definitions of terms frequently used in Rasashastra - 101
9. Introduction of instruments - 87
10. Description, method of preparation and uses of Musha, koshti and puta used in Rasashastra - 97
11. Measurements and Parada‑ashta Samskara - 135
12. Jvarachikitsa 38 150
13. Raktapittachikitsa 38 96
14. Rajayakshmachikitsa 26 100
15. Arshachikitsa 21 88
16. Udavarta, Atisara, Sangrahani, Ajirnachikitsa 44 158
17. Mutrakrichhra and Prameha chikitsa 47 142
18. Vidradhi, Vrddhiroga, Gulma, Sula, Karṣhya, Sthaulya, Amlapitta and Pittaroga chikitsa 59 221
19. Udara, Paṇḍu and Kamala chikitsa 31 109
20. Visarpa and Kustha Chikitsa 89 227
21. Aṣṭamahagada Chikitsa 63 193
22. Bandhyatva, Garbhiniroga, Sutikaroga and Balaroga chikitsa 84 167
23. Unmada and Apasmara Chikitsa 52 89
24. Karna, Nasa, Mukha, Shiroroga and Bhagna Chikitsa 104 144
25. Kshudraroga, Lingaroga and Visha Chikitsa 102 125
26. Jarachikitsa 29 59
27. Vajikarana 34 144
28. Lauha Kalpa vivechana 30 104
29. Vishakalpa vivechana 76 161
30. Rasakalpa, Achara Rasayana, Characteristics, need and importance of Vaidya 60 138

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Chapter 12 to 25: Total 64 diseases (Jwara, Kasa, Shwasa, Kshaya, Hikka, Visha Chikitsa etc.) explained in these chapters with their pathology, types and symptoms and description of many useful formulations. All formulations present the therapeutic aspects of Rasashastra.

Chapter 26 & 27: Chapter 26th related to Jara Roga (geriatric diseases), Rasayana (rejuvenation) and chapter 27th are devoted to Vajikarana (aphrodisiac therapy). 63 herbal and herbo‑mineral formulations are described in these chapters.

Chapter 28: In this chapter total 30 Lauha (Swarn, Rajata, Tamra etc.) Kalpa (formulations) are described with devoted to many diseases.

Chapter 29: This chapter detailed about many Visha Kalpa (formulations prepared from poisonous drugs) w.s.r. to many diseases and many types of Visha are mentioned.

Chapter 30: Many Parada Bhasma Kalpa (formulations of calcinated mercury) and Parada Jarana also mentioned in this chapter. Apthaya (incompatible food) during Rasa Sevan (intake of mercurial formulations) and Achararasayana are detailed.[26]

Discussion

All the eight branches of Ayurveda described by very few texts (Aṣṭanga Sangraha etc.). In Rasashastra RRS is only text which covers all eight branches of Ayurveda, although it mainly deals with therapeutic aspects of Rasashastra. In this Theeka the author has done hindi translation of 30 chapters of Rasaratna Samuchchaya. The systematic arrangement the subject of RRS is briefly summarized in Table 1. First 11 chapters deals with basic principle of Rasashastra and remaining 19 chapters briefly discuss about histology, symptoms, and various disease with detailed descriptions of many herbal, metallic, and herbo-mineral formulations. Parada is considered superior among Rasa Dravyas in Rasashastra. So, 1st chapter details about origin, types and worship of Parada. On the basis of utility of drugs in processing of Parada, they are classified in to Maharasa, Uparasa and Sadharana Rasa. Thus chapter no. 2nd and 3rd detailed as Maharasa, Uparasa and Sadharana Rasa with their origin, types, Shodhana, Marana etc. In these chapters colour of many Bhasma and Satva mentioned.


Chapter no. 4th and 5th deals with Ratnas and Lohas. Ratnas are prior mentioning because of they require more processing and are more precious than Lohas. 6th chapter deals with detail description Shishya, Guru and Anucharapareeksha (qualities of attender to be appointed in Rasashala). Qualities of student and attendant mentioned in RRS are very closely to the description available Ashtanga Sangraha. Chapter 7th details about blueprint for present era Good Manufacturing Practice (G.M.P) guidelines. Location of Rasashala, required equipment’s, raw materials used for the manufacturing of Rasaushadhi are mentioned in this chapter. For the better understanding of Paradakarma and Samskara there many technical terms described in the 8th chapter. Term Dhauta explained as Bhubhujangashakrita[27]. Chapter 9th compiled and elaborated as Yantranirupanam with detail description of 33 types of different Yantra (instruments). Marana process done before using all Rasadravyas as therapeutically. For completion of this purpose description of different type of Musha, Koshti and Puta has been given in 10th chapter. In the 11th chapter, the commentator has added Manaparkarana (Measurements), various pharmaceutical details regarding Parada Saṃskara and Parada Bandha. By the end of this chapter, Pathya-Apathya during Parada Sevana has also been mentioned to get the desired benefit of Parada. Chapter 12 to 25 explained much disease with their pathology, types and symptoms and description of many formulations. Many classical texts like Sushruta, Ashtanga Sangraha, Ashtanga Hridaya and Chakradatta mentioned Kshudrarogas (minor skin diseases). It’s very difficult to say that these Kshudrarogas directly taken from which text. The last three chapters are the most beautiful in this book since they contain sufficient information to a doctor as an expert in the field of disease treatment using only Lauha Kalpa, Visha Kalpa, or Parada Bhasma respectively.

Conclusion

In this Theeka, Theekakara done hindi translation of RRS. This work contains a comprehensive summary of all relevant material concerning RRS, hence it is anticipated that it will prove to be an important contribution to the field of Rasashastra. Thus, the Rasaprabha Teeka of RRS is a necessary and required book for individuals who wish to learn the fundamentals and in-depth details of


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Rasashastra and is regarded as one of the most important reference books.

Reference

1. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 1/10-15, page no. 2

2. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 1/30, page no. 3

3. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 1/40, page no. 4

4. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 1/49, page no. 4

5. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 1/88, page no. 10

6. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 2/1, page no. 10

7. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 2/2, page no. 10

8. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 2/61, page no. 15

9. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/1, page no. 26

10. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/3, page no. 27

11. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/57, page no. 31

12. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/61, page no. 31

13. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/115, page no. 37

14. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/126-127, page no. 37

15. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/154, page no. 41

16. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 3/157, page no. 42

17. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 4/34, page no. 46

18. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 4/60-61, page no. 49

19. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 5/2, page no. 52

20. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 5/135, page no. 53


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21. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 5/63-65, page no. 59

22. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 5/140, page no. 66

23. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 5/220-224, page no. 74

24. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 7/33, page no. 86

25. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 11/128-130, page no. 132

26. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 30/128-130, page no. 414 & 415

27. Vagbhatacharya, Rasa Ratna Samuchaya, Rasaprabha Hindi teeka, Dr.Indradev Tripathi, Printed by Varanasi: Chaukhamba Sanskrit Sansthan, Edition : Reprint 2012, 8/49, page no. 92


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