Glimpse of Pharmacovigilance in Sutrasthana of Caraka Samhita
Dr. Samata Tomar1, Rabinarayan Acharya2
1. Ph.D. Scholar, Dept. of Dravyaguna, I.P.G.T. & R.A., Gujarat Ayurved
University, Jamnagar, Gujarat, India.
2. Professor, Dept. of Dravyaguna, I.P.G.T. & R.A. Gujarat Ayurved University,
Jamnagar, Gujarat, India. PhD Scholar DG
AbstractIntroduction-Caraka Saṃhita, one of the celebrated lexicon of Āyurvedic literature
consists of eight sections(Sthāna) and contains total 120 chapters(Adhyāya), 9035
Sutras(formula). It covers the preventive and curative data of various disease
conditions.
Aims and objectives- In this article, an attempt has been made to collect the information on
Pharmacovigilance concerns of drug and regimens noted.
Materials and method- Sutrasthana of Caraka Samhita consisting of thirty chapters has been
reviewed thoroughly and the relevant data.
Results – In Caraka Samhita a single hand information about safety issues is still lacking and
need to be explored from the related data. Nine Sutras depicts the contraindications
regarding the drugs use in different conditions, ineligibility for treatment is portrayed in six
sutras, complications caused by different drugs are shown in nine sutras and Basic principles
governing the vigilant aspect of any drug, food, and regimen are described in thirty two sutras.
Sixtyfour Ślokas explained the possible adverse effects of drugs. Thus total 120 Ślokas from
Sutrasthana of Carakasamhita are related to pharmacovigilant concept. Most unwholesome
foods are twenty, Most unwholesome drugs are fifteen, Vāta, Pitta, Kapha and
Raktaprakopaka drugs are twenty two, four, six and ten consecutively, Tridoṣaprakopaka
drugs are five, Vātapittakara are two, Kaphapittakara are four, Pittakaphakara are six,
Kaphavātakara are two drugs. All Madakāraka, Unmādakaraa, Keśaghna, Atisārkaraka,
Malavṛddhikara, Kṛmikara, Recaka, Lekhana, Acakshuśya, Amlapittakara drugs are one in
number each. Viṣṭaṃbhi drugs are twelve, Durjara drugs are three, Rukshatakaraka drugs are
two, forty two examples of fatal food and drugs combinations are described. Ajirṇakara are
four, Emaciating drugs are four(three drugs and one is regimen), Śukranuta, Kanṭhaghna,
Avruṣya and Dāhakara drugs are two each. Five drugs are causing death.
Conclusion- Compiled data regarding safety issues and Pharmacovigilance can open new
window for further researches in future for Āyurveda scholars.
Key words- Pharmacovigilance, safety issues, basic principles
Introduction
Āyurveda has been one of the ancient sciences of life of the world going back to over 4,000 years BC,
which is a branch of Atharva Veda. It is an eternal science of healthy living treasures deals with
physical, psychological and spiritual well being of the human being and covers all the aspect of human
life. Caraka Samhita is a collection of various basic principles, healthy advises and directions,
, pharmacological actions of various drugs, description of preventive, promotive and curative
aspects of various diseases along with Pancakarma Cikitsa etc.
The Sutrasthāna is that section where a collection of various important Sutras or Ślokas related to
various context are described, for which it is, also known as Ślokasthāna. This sthāna contains 1952
Sutras and 30 chapters which are divided into seven Catuṣka & two Sangrahadhyaya. Catuṣka means
a division comprising of 4 chapters relating to same topic. The first Catuska is Ausadha Catuska
comprising chapter no.1 to 4, where description about various drugs & basic principles of Ayurveda is
available. Likewise the 2nd Catuska is Swasthavritta Catuṣka comprising chapter no.5 to 8, where many
health advises are mentioned which are required for maintaining the good health of healthy
individuals. Similarly the 3rd Catuska is Nirdeśa Catuṣka comprising chapter no.9 to 12, where many
important information & directions related to Ayurveda is described. The 4th Catuṣka is Kalpana
Catuṣka comprising chapter no.13 to 16, where preparations or ways of preparations related to
Āyurvediya drugs or various treatments are advised. The 5th Catuṣka is Roga Catuska comprising of
chapter no.17 to 20, where various types & no. of diseases are mentioned. Likewise the 6th Catuṣka is
Yojana Catuṣka comprising chapter no.21 to 24, where the various types of ways of treatment
procedures of various ailments are described. Similarly the 7th Catuṣka is Annapana Catuṣka comprising
chapter no.25 to 28, where the various types of foods, food materials & various ways of preparing
food are told by Acarya Caraka. The Sangrahadhyaya comprising of the last two chapter no.29 & 30,
where the collection of different characteristics of life, body & physician (Vaidya) are elaborately
describedi. Generally the physicians follow the indications perfectly but at the same time forget to
practice the contraindications, which are rather more important part. Nighaṅtus consists of a vivid
description of pharmacotherapeutic properties of individual drugs which is lacking in Samhitas. But
Saṃhitās are the foundation of basic concepts of Āyurveda. All principles of treatment, Do’s and
Dont’s, eligibility for the procedures and treatments, number of precautions while using drugs.
Orientation of Caraka Saṃhita is basic principles and treatment protocol.
Vigilance in Āyurveda
According to WHO, Pharmacovigilance is defined as the detection, assessment and prevention of
adverse reactions to medicinal products in humansii.
Ācāryas have emphasized many a time on rational use of medicine and patient care like own
childiii. In Caraka saṃhita it is mentioned that there is nothing which cannot be therapeutically
usefuliv. Each and every substance can be used in the management of disease or to maintain
the health of an individual. But certain parameters have to be examined prior to the
application of a therapyv,vi. Quality of Bhesajam (medicine), Parikṣā (complete examination of
disease and diseased) and application of Yukti (Logical thinking of Vaidya) has been
mentioned as the key to the success of treatmentvii, viii. Ācarya Vāgbhata divided treatment
into two types, pure and impureix. Improper or impure line of treatment gives birth to new
symptoms or disease which complexes the previous one and can put a patient at riskx. It is
mentioned that a good medicine is not an isolated entity. It is expected to have multiple
actions and dosage formsxi. While mentioning the therapeutic classification of Dravya;
Śamana, Kopana and Swasthvṛttakara; Ācaryas were very meticulous to account the effects
of drugsxii,xiii. So, Vaidya has the responsibility to consider assessment and categorization of
potency to reduce the chances of intoxication and related complicationsxiv. The data is grossly
classified under five headings like Basic principles, contraindications, Unwholesome food,
Unwholesome drugs, and possible ADRs.
A] Basic principles containing Pharmacovigilant aspect1. Drugs are categorised in three groups as some alleviating Doṣās, some vitiates Dhātus, and some
are good for the maintainance of the health. So Dhātupraduṣaṇam drugs are hazardous to life and
should be avoided.(ref. C.Su. 1/67)
2.Complications of Dhumapanam(smoking)- the untimely done or overdone, smoking causes such
troubles as deafness, blindness, dumbness, bleeding from different parts of the body and
giddiness.(5/38)
3. Features of insufficient smoking Impairment of voice, presence of Kapha(phlegm) in the throat and
heaviness of the head are the features of insufficient smoking.( 5/53)
4. Features of excessive Dhumapanam – Palate, head, throat get dried up and become hot. One feels
thirsty and he becomes unconscious; there is excessive bleeding . he gets excessive giddiness in his
head. There is fainting and his sense organs become hot. (5/54-55 )
5. Even an acute poison can become an excellent drug if it properly admininstered . (on the other
hand) even a drug, if not properly administered, become an acute poison. (1/126-27)
6. Five Pharmaceutical processes are described for preparation of medicine like Svarasa(juice),
Kalka(Paste), ṣṛta(decoction), Śita(cold infusion), and Phaṅṭa(infusion). The potentiality of the
medicines of the precedings category is greater than the succeeding ones, so these preparations
should be prescribed with due regard to the strength of the patient and seriousness of the disease. All
these preparations are not equally useful in all cases. (4/7 )
7. By slow and gradual giving up the unwholesome practices and by increasing the wholesome
practices correspondingly the unwholesome practices are eradicated for ever and the wholesome
practices are fully adopted. Schedule for giving up unwholesome practices is an primary indication
how to be attentive in getting rid of bad drug and diet practices causing harm to the body, mind and
soul of a person. (7/38 )
8. Factors determining the incurability of disease are as follows-1. Diseases caused by vitiation of all
three Doṣās. 2. Diseases that transcends all therapeutic devices. 3. Diseases which involve all the three
systems. 4. Diseases that causes excitement, restlessness, and unconsciousness. 5. Diseases which
affect the senses organs. 6. The affected patient is usually weak but the Disease is sufficiently
advanced. 7. The Disease having bad prognostic signs(Ariśṭa Lakṣaṇa)
Thus the Ariṣṭa Lakṣaṇa described in Caraka Kalpasthānam should be considered seriously as bad
prognostic signs. (10/19-20)
9. Ahitakara Ahara-Unwholesome foodThe drugs and regimen which adversely affect the body and mind are regarded as Unwholesome; But
this can’t be accepted as a general rule in absolute terms. The drugs and regimen in fact change their
qualities , depending on the dosage, season, method of preparation, habitat and combination with
other useful and harmful drugs. So the natural qualities of drugs and regimen as well as the conditions
like dosages etc. are both required to be well ascertained before the administration of the requisite
therapy in order to achieve the desired effect. (25/45-47)
10. Dehadhatupratyanika bhutani The drugs and diets which are unwholesome for the normal
Dhatus, and Doṣās of the body, are in fact opposed to the proper growth of such tissue elements and
Doṣās. 1. Some act due to their mutually contradictory activities. 2. Some by combinations. 3. Some
by the method of preparation. 4. Some by virtue of the place, time and dose. 5. Some others by their
inherent nature. (26/81)
11. Fish should not be taken together with milk. Both of them have sweet taste, but due to the
contraindication in their potency, fish is hot and milk is cold). They vitiate the blood and obstructs the
channels of circulation. (26/82)
12. Cause of indisposition- All drugs and diets which vitiate the various Doṣās but do not expel them
out of the body are to be regards as unwholesome. (26/85)
13. Drugs and diets which are at variance with place, time, power of digestion, dosage, habits, Doṣās,
mode of preparation, potency, bowel, state of health , order, proscriptions and prescriptions , cooking,
combination, palatability, richness of quality and rules of eating are all unwholesome. (26/86)
14. Universal therapeutic utility of matter- Everything In the world can be used as a medicine. (26/ 12)
15. Rivers originating from Pāriyatra(western Vindhya Range), Vindhya and Sahya ranges are
responsible for diseases of head, heart, obstinate skin diseases including leprosy and filaria. (27/212 )
16. Precautions for honey consumption – Nothing is so troublesome as Āma caused by the improper
intake of honey. (27/247-48)
17. Unwholesome vegetable preparation is dried and old. Vegetables infested with insects, exposed
to wind, the sun for long time, dried, up, old, unseasonal are unwholesome. When they are cooked
without adding fat and residual water after boiling is not filtered out, vegetables become
unwholesome for use. Fruits which are old, unripe, afflicted by insects and serpents, exposed to snow
or sun for long, growing in the land and season other than the normal habitat and time and putrified
are unwholesome. ( 27/316-318)
18. Dietic consideration - Compulsory Heaviness and lightness of food articles is to be considered
mostly for the individuals who are weak, indolent, unhealthy, of tender health and who are given to
luxury. Even immature curd supresses the power of digestion of weak individuals. (27/343)
19. Factors determining the qualities of dietetics articles- Animal’s habitat and food, organs(parts) of
the body, nature, activity, sex, size as well as mode of preparation and quantity are also to be
examined to determine the properties of drugs that are not described in this text. (27/331)
20. Observation of Eight factors(Aṣṭavidhaāhār Viṣeśāyatana) described in [Caraka Vimānasthāna
1/21] is must as they are responsible for causing happiness or misery. These factors are to be examined
before taking any food. The eight factors which determine the utility or otherwise of various types of
food are 1. Prakṛti(nature of the food articles), 2.Karaṇa-method of their processing, 3.Saṃyogacombination, 4. Rāśi- quantity, 5 Deśa- habitat, 6. Kāla-time i.e. stage of the disease or the state of
the individual), 7. Upayogasaṃsthā- rules governing the intake of food), 8. Upayoktā(wholesomeness to the individual who takes it.) (28/42 )
21. Trihetu threefold causes of diseases – the unwholesome conjuction of the sense organ with their
objects, intellectual blasphemy(Pradnyaparadha), and transformation(Parinamana). These are the
three fold causes of diseases. Proper utilization of the object, action and time is beneficial to the
maintainance of normal health. (11/43)
22. Therefore always take cooked vegetables. (27/104)
23. Abnormal function of Vāta – Causes misery, all actions and thoughts, subtle(12/8)
24. Abnormal function of Pitta- Indigestion, loss of vision, abnormal body heat, abnormal complexion,
Valour, fear, anger, joy, abnormal bewilderment and happiness, (12/11)
25. Abnormal function of Kapha- Sturdiness or looseness, plumpness, emaciation, laziness, impotency,
ignorance. (12/12)
26. Complications of untimely administration of fats(Sneha dravya)- Oleation therapy done during day
time, summer or patients suffering from Vāta and Pitta causes thirst, Fainting, insanity, jaundice.
Oleation therapy given in Kaphaja Vyādhi in winter during evening causes Anāha, Anorexia, colic pain,
Anaemia. (13/20-21)
27. Anupāna for unctuous substances – Adjuvants for Unctous substances are, hot water for Ghee,
Yuṣa for oil and Manda for Muscle fat and bone marrow. For all Sneha, hot water is best. (13/22)
28. Dose schedule for fat administration – The maximum and minimum periods for the administration
of oleation therapy are seven and three nights respectively. (13/29-40)
29. Signs and symptoms of incomplete oleation causes hard and dry stool, derangement of Vayu,
weak digestive power, roughness and dryness of skin. ( 13/ 57)
30. Over oleation causes paleness, drowsiness, heaviness, anorexia, stiffness, nausea, stool indicative
of indigestion. (13/59)
31. Side reactions of oleation and its management - if unctuous substance is taken by person having
strong digestive power , gets digested quickly by virtue of the power of the digestive fire. It displaces
the Ojas and aggravates thirst with complication. In the circumstances, unless he takes recourse to
cold water, the patient may die. As a serpent lying in the midst of a heap of wood dies with the fire of
its own poisonous breath. (13/70-78 )
32. Signs of over fomentation- causes Fainting, Pittavardhaka, Prostration, thirst, burning sensation,
weakness of the voice and limbs. (14/14)
33. Signs and symptoms of adequate , inadequate and over purgation( 16/5-10 )
34. Preservation of Health - One desirous of ensured longevity for himself, should always make an
attempt for his well being as if surrounded by opponents(for his health). (17/119 )
35. Prognosis of disease in general- There are diseases of serious type which even though curable with
difficulties can cause death if not properly treated or treated wrongly. There are other diseases of mild
nature which are definitely cured by proper treatment. There are another category of palliable
diseases which are not curable but even the most effective treatment will only enable the patient to
stand the disease. There are other diseases where no treatment can succeed. Only ignorant physicians
will not. Diseases are of two types – curable and incurable. Each of them is again of two types, viz;
mild or serious. Thus, taken together, there are four types of diseases.(18/ 37-41).
Even the incurable diseases may be mild or serious according as they are palliable or fatal or they are
capable of causing death after some time.
36. Functions of abnormal Doṣas- The diminution of Vāta, Pitta, and Kapha is indicated by the
decrease in their respective normal actions or increases in their respective opposite actions. (18/52)
37. Importance of Diagnosis of in Treatment. A physician should first of all diagnose the disease and
then he should select proper medicine. (20/20)
38.The physician who is well versed in diagnosing diseases, who is proficient in the administration of
medicines and who knows about the dosage of the therapy that varies from place to place and season
to season, is sure to accomplish the desired object(20/22)
39. Complications of Over emesis-Causes diseases of head and neck due to vitiation of Vāta and
impediment of speech. (16/11-12)
41. Seven Complications of Śotha(swelling)- Vomiting, dyspnoea, anorexia, thirst, fever, diorrhoea
and general weakness.(18/18)
42. Viruddhahara-food incompatibility- All drugs and diet which dislodge the various Doṣās but do not
expel them out of the body are to be regarded as unwholesome(26/85).
43. Intake of unwholesome diet or drugs are responsible for the causation of sterility, blindness,
Visarpa(an obstinate skin diseases characterised by an acute spread), ascites, eruptions, insanity, in
throat, anaemia, poisoning due to Āma, Kilāsa type of skin diseases including leprosy, sprue, oedema,
acid dyspepsia, fever,rhinitis, foetal diseases, and even death.(26/102-103)
B] Most unwholesome food articles- (C.Su. 25/39 )
1. Paddy having bristles- Yavaka( a variety of Hordeum vulgare Linn.)
2. Pulses -Maṣa(Phaseolus radiatus Linn.)
3. Various types of Drinking water – Varṣājala (River water in rainy season)
4. Salts - Uṣara(Salt collected or prepared from saline soil)
5. Pot herbs- Mustards
6. Meat of animals- beef
7. Meat of birds- Young dove
8. Meat of animals living in holes- frog
9. Meat of fish- Cilcima
10. Ghee- of sheep milk
11. Milk- sheep milk
12.Vegetable fats- oil from Kusumbha(Canthamus tinctorius Linn.)
13. Fats of Marshy animals- Fat of buffalo
14. Fats of Aquatic animals- Fats of Kumbhira(Crocodile)
15. Fats of Aquatic animals- fats of Kākamudga(water foul)
16. Fats of gallinaceous types of birds- fat of Cataka(sparrow)
17. Fats of limbs of eating animals- Fats of elephant
18. fruits- Nikuca(artocarpus nikucha Roxb.) is unwholesome
19. Rhizomes and roots – Āluka(potato)
20. Preparation of Sugarcane- Phāṇita(treacle)
C] Most unwholesome Drugs list(C.Su. 25/40 )
1. Alkalies causing impotence
2. Unripe Kapittha ( Feronia linonia swingle)- producing harmful effect on throat
3. Food preparation from Gavedhuka(Triticum aestivum Linn.)- Emaciating
4. Food prepared of Uddālaka- drying
5. Jambu(Syzyzium cumini skeels)- Vātakopaka
6. Śaṣkuli- PittaKapha Vardhaka
7. Kulattha(Dolichos biflorus Linn.) Causing Amlapitta
8. Māsa- KaphaPittakara
9. Intake of food in excess quantity- causing serious type of indigestion
10. Wine- exhilarating
11. Heavy food- indigestion
12. Fasting - reducing longevity
13. Intake of food in reducing quantity- causing emaciation
14. Intake of irregular meals- causing irregularity in digestive power
15. water collected from untimely rains is undoubtedly unwholesome.( 27/207)
16. Types of incompatibility(26/86- 101)
1. Desha (place)viruddha: To have dry and sharp substances in dry region, unctuous substances in
marshy land.
2. Kala(time)viruddha: Intake of cold and dry substances in winter, pungent and hot substances in
summer.
3. Agni(gastric fire)viruddha: Intake of heavy food when the power of digestion is low, intake of light
food when the power of digestion is sharp and intake of food at variance with irregular and normal
power of digestion.
4. Matra(quantity)viruddha: Intake of honey and ghee in equal quantity.
5. Satmya Viruddha(habit): Intake of sweet and cold substance by person accustomed to pungent and
hot substance.
6. Doṣā(body humors)viruddha: Utilization of drugs, diets and regimen having similar qualities with
dosha, but at variance with the habit of the individual.
7. Sanskara(mode of preparation) viruddha: drugs and diets which, when prepared in particular way
produced poisonous effects. Eg. Meat of peacock roasted on a castor spit.
8. Veerya(potency) viruddha: Substance having cold potency in combination with those of hot
potency.
9. Koshtha (bowel tendency) viruddha: Less stool forming food to a person of constipative bowel.
Administration of more quantity heavy and more stool forming food to a person having laxed bowel.
(26/97)
10.Avastha (state of health) viruddha: Intake of vata aggravating food by a person after exertion
physical exertion or after sleep or drowsiness.
11.Krama (sequence) viruddha: If a person takes food before his bowel and urination or when he
doesn’t have appetite or after his hunger have been aggravating.
12.Parihara(contraindication) viruddha: Intake of hot things after taking pork.
13.Upachara(treatment) viruddha: cold things after taking ghee.
14.Paaka (cooking) viruddha: Preparation of food with bad or rotten fuel and under cooking, over
cooking or burning.
15.Samyoga (combination) viruddha: Intake of sour substance with milk.
16.Hridaya(interest) viruddha: Intake of unpleasant food.
17.Sampad (richness of quality) viruddha: Intake of substance that are not mature, over matured or
purified.
18.Vidhi (rules of eating) viruddha: Taking meals in public place. From the above it can be considered
that today’s mostly loved junk food is one of the type of Viruddha āhar.
D] Contarindications 09
Contarindications of Dhumapanam (Medicated Smoking) – A person after taking emesis or purgative
or enema, or a person having bleeding through different orifices of the body, or one afflicted with
toxins or a grief stricken person should not smoke; a pregnant woman should also refrain from
smoking; similarly one should also refrain from smoking; similarly one should not smoke when he is
fatigued or intoxicated. Smoking is also prohibited in the event of the vitiation of digestion including
metabolism vitiation of Pitta, vigil, fainting, giddiness, morbid thirst, consumption and phthisis. One
should not smoke after having liquor or milk or fatty substances or honey or curd; nor one should
smoke when there is roughness in his body or he is enraged. Smoking is also prohibited in the event
of the dryness of palate, fainting, injury to the head, Śaṅkhaka(A type of headache in the temporal
region marked by excessive pain and swelling- usually killing a patient in three days), Rohiṇī(a
condition characterised by extensive and painful swelling at the base of the tongue), diabetes and
narcosis. One who , out of ignorance, smokes in contraveneases. These disease become severe due to
the adverse effect of improper smoking.( 5/41-45)
Curd should not be used at night, alone without ghee, sugar, green gram soup, honey or
Āmalaka(Emblica officinalis Gaertn.), hot also. Otherwise it causes diseases like fever,
Rakttapitta(bleeding from different parts of the part), Visarpa(erysipelas), Kuṣṭha(Skin diseases),
Paṅdu(Anaemia), Bhrama(giddiness), Kamala(Jaundice). (5/61-62).
Curd is harmful during autumn, summer, and spring seasons. It is harmful in diseases caused by the
vitiation of blood, pitta and Kapha. (27/227 )
Machine pressed juice(Procedural) causes burning sensation. (27/237)
Treacle(Guda) is Kṛmikruta(causes increased parasitic infection. (27/238 )
Warm honey or honey taken by an individual suffering from heat is fatal. (27/246)
Contarindications of Day sleeping- Sleeping during the day time in the season other than summer is
not advisable as it causes vitiation of Kapha and Pitta. (21/44)
Contarindications for fat administration(oleation therapy) . It should not be administered to such
patients as are eligible for Rūkṣaṇa(drying) therapy except for the purpose of admininstering
elimination therapy; also to those whom Kapha and Medas are aggravated , those in whose cases the
aggravated conditions of Kapha are reflects itself in the form of mucus secretions from the mouth and
anus, those whose power of digestion is continuously weak, those suffering from thirst and fainting ,
the pregnant women, those whose palate gets dried up, those having aversion to food, those suffering
from vomiting, abdominal diseases, diseases due to improper digestion as well as metabolism, those
afflicted with Gara type of Viṣās, The weak, emaciated, those having aversion to the intake of unctuous
substances , those intoxicated and those being administered , inhalation and enema therapy is
administered to such persons, they are likely to fall victims of disastrous complications. (13/53-56)
Contraindications of substances used in oleation therapy – In skin diseases, obstinate urinary
disorders, one should not use meat juice of domesticated, marshy, aquatic animals, sugarcandy, curd,
milk and sesamum seeds. (13/91-94)
Parts Contraindicated for fomentation Swedana- Testicles, heart and eyes. Over groin region, it should
be moderate. (14/10)
Contraindications of fomentation for the persons who have taken too much astringent (Kashaya rasa)
and alcohols, the pregnant lady, suffering from Rakttapitta, Diarrhoea, Paittika type of obstinate
urinary disorders. Vidagdha Bhrushta Bradhna(inflammation and prolapse of rectum), toxic
conditions, alcoholism, dry skin, having Paittika constitution, fatigued, unconscious, fatty, thirsty,
hungary, in a fit of anger , jaundice, abdominal disease, consumption, Vatarakta gout, Timira fainting,
weak, and whose Ojas has been reduced. (14/16-19)
Fish should not be taken together with milk. Both of them have sweet taste, but due to the
contraindication in their potency, fish is hot and milk is cold. They vitiate the blood and obstructs the
channels of circulation.(26/82 )
E] Possible ADRs (27 chapter Annapānavidhi adhyaya)
Dhānyavarga
Yava Bahuvātakara (27/19)
Rāja māṣa śukrāmlaPittanuta, Vātala ( 27/25)
Kulattha ṣukrapahā(27/26)
Masura Grāhi(27/27)
Kalāya Vātala(27/29)
Til Kapha Pittakara(27/30)
Śiṃbidhānya Vātaprakopa(27/32)
Ādhaki(tur) Vātala(27/33)
Niṣpāva Vātapittala(27/33)
Śiṃbi(Dolichos lablab Linn.) Vātavardhaka, Avṛṣya, Acakśuṣya, increases flatulence(27/34)
Maṃsavarga
Matsya Bahudoṣakara(27/82)
Śākavarga
Kālāya Vata(27/92)
Cāṅgeri Kaphakara(927/93)
Śākavarga Guru, Rukṣa, Viṣṭaṃbhi, Ajirñakara. (27/103)
Tilvetasa śāka Vātala(27/109)
Kausuṃbha Pittavardhaka(27/110 )
Trapus, Ervaruka produces wind in the intestine(27/110)
Ervāruka extremely diuretic (27/111)
Water plants like Śṛuṅgāṭaka, Tāruṭa, Bisa, śāluka, Kaśeruka, Aṅkalodya are Viṣṭaṃbhi(produces wind
in the intestine) (27/116)
Vegetables alleviating Kapha and Pitta are, Manukparṇi(Centella asiatica), Vetra(Salix caprea Linn.),
Kucela(Cissampelus pariera), Vana tiktaka(Cyclea peltate), Karkoṭaka(Momordica dioica Roxb.),
Avalguja(Psoralea corylifolia Linn.), Patela(Trichosanthus cucumerina Linn.), Śakulādani(Picrorrhiza
kurroa Royle ex. Benth), Flowers of Bṛṣa(Adhatoda vasica Nees), Śārṅgeṣṭhā, Keṃbuka,
Katthillaka(Boerheavia diffusa Linn.), Nādi, round variety of Kalāya(Lathyrus opthhaceae Linn.),
Gojihvā(Onosma bractiatum wall), Vārtāka(Solanum melongena Linn.), Tilaparṇi(Gynandropis
gynandra Bripuet), Kāravellaka(Momordica chaontia Linn.), Karkaṣa, Nimba(Azadirecta indica A juss.),
Parpataka(Fumaria parviflora Linn.) (27/95-97)
Supyaśāka(Vegetables from which soups can be prepared) All Śāka are Kaphamarutakruta(produces
winds during the process of digestion). Māṣaparṅi(Teramnus labialis Spreng.), Phañji(River ornata
chois), cilli(Chenopodium album Linn.), Kutuṃbaka(Leucas linifolica Spreng.), All types of Āluka along
with their leaves, Kuṭiñjara, Śāṇa(Crotalaria juncia Linn.), Flowers of Śālmali(Salmalia malaberica
Schotts and End), Karbudāra(Bauhinia variegate Linn. White variety), Suvarcala(Helianthus annuus
Linn.), Niṣpāva(a variety of śiṃbi), Kovidāra(Bauhinnia variegate Linn. Red variety), Pattura(celosia
orgentea Linn.), Cuccuparṇi(Corcorvus oblitorius Linn.), Kumārajivā(Putraṅjiva roxburghii wall),
Loṭṭaka(Eriobotya japonica Lindl.)Pālāṅkya(Spinacia aleracia Linn.), Māriṣa(Amaranthus tricolor Linn.),
Kalamba(Ipomoea reptanse Poir), Nālika(Onosma echoides Linn.), Āsūri(Brassica juncea Czern and
coss.), Kusuṃbha(Carthamus tinctorius Linn.), Vṛkadhumaka, Lakṣmaṇa, Prapunnada(Cassia tora
Linn.), Nalini(stalk of Nelumbo nuceiferaGaertn.)Kuṭheraka(Ocimum bacillium Linn.), Loṇikā(Protulaka
oleraceae Linn.), Yavaśāka(Alhagi pseudolhagi Devs.), Kuṣmāṅda(Benincasa hispida cogn.),
Avalguja(Psoralea corylifolia Linn.), Yātuka, śālakalyaṇi, Triparṇi(Adiantum lulatum Burm.), Piluparṇi.
(27/98-103)
Kusuṃbha(Carthamus tinctorius Linn.) is Pittavardhaka. (27/109)
Rhizome , flower, fruit, of Kumuda(a variety of Utpala(Nymphaea alba Roxb.) are cold in potency,
aggravates Kapha and Pitta. (27/ 118)
Phalavarga(Fruits)
Phalgu is Viṣṭaṃbhi(produces wind in abdomen) (27/ 128)
Madhur Āmrātaka is Viṣṭaṃbhi(produces wind in abdomen) (27/129 )
Bhavya( Dillenia indica Linn.)Kapha Pittakara(27/131)
Pitta kaphakara – Paruṣaka(Grewia asiatica Linn.), Drākṣā(Vitis veniefera Linn.), Badara(Zizyphus
jujube Linn.), Āruka( Prunus persica Linn.), Karkandhu(Zizyphus nummularia W & A.),
Nikuca(Artocarpus Lakooch Roxb.) (27/132)
Unripe Kapittha(Feronia limonia swingle) is harmful for life, Vātala and bowelbinding. (27/136 )
Bilwa(Aegle marmelas corr.) is Durjaram(Hard to digest), difficult to digest, aggravates Doṣās,
producer of foul smelling flatus. (27/138 )
Jāmbavam(Syzygium cumini skeels) is Grāhi (bowel binding) (27/140)
Young fruits of Āmra(Mangifera indica Linn.) causes Rakttapitta(bleeding from different parts of
body), Matured but unripe fruits of Āmra is Pittavardhaka. (27/139)
Fruits of Lavali(Cicca acida Merill.) aggravates Vāta. (27/145)
Rukṣāmla Dādima (Punica granatum Linn.) Pittavāta prakopanam . (27/150 )
Nāgraṅga(Citrus reticulata Blanco) Diffficult to digest and heavy. ( 27/156 )
Vātāma(Prunus amygdala Batsch), Abhiśuka akṣoṭa(Juglanse regia Linn.), Mukula(Pistacia Vera Linn.),
Urumāṇa(Prunus armeniaca Linn.), Aṅkoṭa(Alangium salvifolium wang) Kaphavardhaka.( 27/157 )
Śami(Prosopis spicigera Linn.)is Keśagḥna(Depilatory) ( 27/160 )
Sour variety of Āmrātaka Spondias pinnata kurz, Dantśaṭha-Citrus medica Linn., Karamarda- Cariss
carendus, Airāvataka. These all causes Rakttapitta diseases. (27/161)
Akshikiphalam and Parpataka are Bahuvātalam(Highly aggravating Vāta). (27/162 )
Fruits of Parpataka, Aśwattha(Ficus religiosa Linn), Udumbara(Ficus racemose), Plakṣa(Ficus lacor
Back.Ham.), Nyagrodha(Ficus bengalensis Linn.) are Bahuvātalam(Highly aggravating Vāta). ( 27/164)
Nut of Bhallataka(Semicarpus anacardium) is highly caustic just like fire. (27/165 )
Haritavarga( green vegetables used in salad forms)
Overgrown Radish provokes Doṣās(27/168 )
Surasa(Ocimum sanctum) aggravates Pitta. (27/169)
Palāṅdu(Allium cepa) Kaphaprakopaka(27/175)
Madyavarga(alcoholic preparations)
Gauda wine- produces more faeces and flatus and causes Diorrheoea. (27/186)
Wine prepared with barley VātaPittakara( 27/190a)
Wine prepared with Madhulika is Kaphakara. (27/190b)
Fresh wine is Tridoṣakara. (27/193a)
Jalavarga
Sea water is responsible for the aggravation of three Doṣās. (27/126 )
Gorasvarga(Milk products)
Milk curd Mandaka( immature curd) aggravates all the three Doṣās. ( 27/228 )
Takrapinda(cheese) is Rukṣa( non slime) , heavy Ununctous and bowel binding. ( 27/236)
Ikṣuvarga(Sugarcane)
Machine pressed juice causes burning sensation. (27/237)
Guda(Treacle) causes Prabhutakrimikara(increased parasitic infection). (27/238)
Madhuvarga( Honey)
Madhu Aggravates Vāta. (27/245)
Kṛtānnavarga(cooked food preparations)
Kulmāṣa(preparation of Yava and others) is heavy Vātavardhaka, Laxative ( 27/260 )
The roasted cornflour aggravates Vāta. (27/263)
Fried barley is generally depletive of fats (Lekhana) and Durjara. (27/266 )
Viruhha Dhānya(germinated barley) is difficult to digest. (27/267 )
Supya(Pulses ) like Mudga and Māṣa are Vātavardhaka. (27/274)
Śukta( Fermented preparation of rice and other vegetables) aggrevates Haemorrhage and Kapha.
( 27/284)
Āharyonivarga
Sesamum oil aggravates Pitta. ( 27/286)
Castor oil aggravates Kapha. ( 27/289)
Mustard oil aggravates Rakta, Pitta and reduces semen. ( 27/290)
Priyal(Bauchanania lanzan spring.) oil aggravates Kapha. ( 27/291)
Kṣara oil is corrosive and work like fire. ( 27/293)
Atasi(Linum usitalissium Linn.) oil aggravates RaktaPitta. (27/292)
Discussion- From above explanation of principles, drug and foods Possible ADRs, 120 Ślokas of
Sutrasthana of Carakasamhita Contains pharmacovigilant concept vibrantly. Most
unwholesome foods are thirty eight, Most unwholesome drugs are fifteen, Vāta, Pitta, Kapha
and Raktaprakopaka drugs are twenty two, four, six and ten consecutively, Tridoṣaprakopaka
drugs are five, Vātapittakara are two, Kaphapittakara are four, Pittakaphakara are six,
Kaphavātakara are two drugs. All Madakaraka, Unmādakaraa, Keśaghna, Atisārkaraka,
Malavṛddhikara, Kṛmikara, Recaka, Lekhana, Acakshuśya, Amlapittakara drugs are one in
number each. Viṣṭaṃbhi drugs are twelve, Durjara drugs are three, Rukshatakaraka drugs are
two, forty two examples of fatal food and drugs combinations are described. Ajirṇakara are
four, Emaciating drugs are four(three drugs and one is regimen), Śukranuta, Kanṭhaghna,
Avruṣya and Dāhakara drugs are two each. Five drugs are causing death.
The term Pharmacovigilance does not feature directly in Āyurveda texts. Rational drug use are
recurrent themes of Āyurvedic pharmacology and therapeutics. Along with descriptions related to
actions and benefits of medicines Āyurvedic Pharmacology detailed adverse reactions and also how
to deal with ways ti minimize adverse reactions such as precautions in manufacturing techniques,
Time of drug administration, complimentary diet and lifestyle and so on. There is a very thin
demarcation line between food and drugs in Āyurveda. So the examples are mostly overlapping each
other but can be understandable distinctly. Dhānyavarga 10, Maṃsavarga 1, Śākavarga 87
,Haritavarga(green vegetables used in salad forms) 3, Madyavarga(alcoholic preparations) 4, Jalavarga
1,Gorasvarga(Milk products) 2,Ikṣuvarga(Sugarcane) 2, Madhuvarga(Honey) 1, Āharyonivarga 6,
Kṛtānnavarga(cooked food preparations) 7, Total 127 foods and drugs are mentioned for there
expected ADR if not use properly. High alerts are indicated about use of drugs and food. Keeping drugs
as main line of treatment Aahara Kalpana (dietary regimen), Pathya Kalpana (beneficial dietary or
behavioural regimen) are also elaborated in detailed in Ayurveda in Bruhattrayi, Laghuttraies and
Nighantus. Ayurveda considers treatment as partial if Pathya āhara-Vihara Kalpana has not been
followed, which has been thoroughly explained in above textsxv.
Conclusion- Caraka Saṃhita is one of the most referred Classical text by the Āyurveda experts.
Comprehensive review of its thirty chapters dealing with herbal drugs reports possible
pharmacovigilance aspect of 205 drugs. The present review reports contraindications, possible
adverse effects on Doṣa, Dhatu, Mala, on organ due to due to improper administration effect of
certain drugs. These aspects do not limit to medicines but also food stuffs including cereals, pulses,
fruits and vegetables that are consumed daily. These mentioned possible risk of adverse effect can be
minimize by following various guidelines and instructions mentioned in classical text of Āyurveda
related to administration of drugs and dietetics. To ensure the safety of drugs it is very important to
understand and study the principles of drug safety mentioned in Āyurveda and to follow the do’s and
don’t during prescription and consultation. This review article will be beneficial for consideration of
Pathyāpathya (dietary and behavioral regimen) that must be adopted in daily routine. The spirit of
Pharmacovigilance is vibrant throughout the texts in Caraka Saṃhita Sutrastāna so in the rest of
classics of Āyurveda. Such studies empowers the stakeholders about the queries raised against the
authenticity of the science of Āyurveda.
Conflict of interest – nil
i
Source of support- Nil
Dass Ranjip Kumar. Charaka Samhita : A critical review. Journal of Ayurveda and Holistic Medicine 2013;1(5):
20-22.
ii
Guidelines for the regulation of herbal medicines in South-East Asia, WHO Regional office for South East Asia,
New Delhi.
iii
Kaviraj Shastri Ambikadatta (2005), Susruta Samhita of Maharsi Susruta, Edited with Ayurveda-TatvaSandipika Teeka, Chaukhambha Sanskrit Sansthan, Varanasi, Part-I, Sutra Sthāna
25/43 – 44; 106.
iv
Sastri Kashinath and Chaturvedi Gorakhnath (2001), Agniveśa ’Caraka Samhita’, revised by Caraka and
Drudhabala with ‘Ayurveda Dīpikā’ commentary, by Cakrapānīdatta, Chaukhamba Vishvabharti, Varanasi
(India),Sutra Sthāna 26/12.
v
Caraka Samhita, Vimāna Sthāna 8/94 – 130, Ibidem
vi
Caraka Samhita, Vimāna Sthāna 8/68 – 78, Ibidem
vii
Caraka Samhita, SutraSthāna 2/16, Ibidem.
viii
Caraka Samhita, Vimāna Sthāna 8/68, Ibidem.
Astanga Samgraha of Vagabhatta, translated by Murthy Srikantha K.R.(2005), Chaukhamba Orientalia,
Varanasi, Vol. I, Sutra Sthana 21/29; 390.
x
Astanga Samgraha of Vagabhatta, translated by Murthy Srikantha K.R. (2005), Chaukhamba Orientalia,
Varanasi, Vol. I, Sutra Sthana 21/29; 390.
xi
Astanga Samgraha of Vagabhatta, Sutra Sthana 2/22; 27 Ibidem.
xii
Caraka Samhita, SutraSthāna 1/67, Ibidem.
xiii
Vagabhatta’s Astanga Hrudayam, translated by Murthy Srikantha K. R. (2007), Chauhamba Orientalia,
Varanasi, Sutra Sthana 1/16; 10. 14. Caraka Samhita, SutraSthāna 1/1
xiv
Caraka Samhita, SutraSthāna 1/123 – 126; 48, Ibidem.
xv
Indradev Tripathi editor. Vaidyajivana. 1st ed.Varanasi: Chaukhambha Orientalia; 2007. Pratahamvilas/10.p.
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