A Critical Review of Shonitasthapana Varga Dravyas on Rakta Dhatu

Introduction

Dravya has been given utmost importance to achieve the objective of Ayurveda i.e, Swasthasyaswastharak shanam, aturasya vikara prashamanam and has been mentioned as one of the components of Chikitsa Chatuspada.¹ Dravyas have been classified elaborately in the Samhitas based on different factors and the classification of dravyas based on karma has been mentioned in Charakasamhita and Ashtanga Sangraha.^2,3 Charaka mentioned 500 kashayas, wherein 10 drugs were mentioned in each varga consisting of 50 kashayavargas.² Shonitasthapana Kashaya varga is one such varga enlisted by Charaka consisting of Madhu, Madhuka, Kunkuma, Mocharasa, Mritkapala, Lodhra, Gairika, Priayangu, Sharkara and Laja.⁴ This varga is unique as it includes Oudhbida dravyas like Madhuka, Kunkuma, Mocharasa, Lodhra and Priyangu; Jangama dravya like madhu; Parthiva dravyas like Gairika and Mritkapala; Ahara dravyas like Sharkara and Laja. The word ‘Shonita’ is used as a paryaya for Rakta and the vague meaning for the word ‘Sthapana’ is ‘which stops’. Generally, it is believed that shonitasthapana dravyas are the styptic drugs. However other meanings include, causing to stand, maintaining, and preserving, etc.⁵ Chakrapanidatta opined that the drugs which bring back normalcy or prakrutavasta to the dushita rakta can be termed ‘shonitasthapana’.³ Indukara while commenting on the varga, mentioned the meaning of word ‘Sthapana’ as ‘Vriddhisthairyakaram’,⁶ wherein the word ‘Vriddhi’ has the meanings like growth, increasing, prolong, elevation, development, etc.,⁷ while the word ‘sthira’ has the meanings like stability, to stop, firm, compact, steady, etc.⁸ Dalhana and Yogendranath Sen mentioned Shonitasthapana as that which stops bleeding.⁹ Based on different views and meanings, Shonitasthapana karma can be understood under main karmas or actions namely, Raktasamshodana/ Raktaprasadana, Raktavardana and Rakta Sthambana and hence a critical review of the drugs mentioned in the varga is imperative to understand their wide utility in the treatment of various diseases related to rakta.

Methodology

A comprehensive review was done on the drugs mentioned in Shonitastapana varga, for their sources, rasapanchaka, phytoconstituents, different karmas, pharmacological activities and indications. Data were collected from classic texts like Samhitas, Nighantus, texts of Rasashastra, databases and research papers related to the same. Research papers and articles were searched online using databases like Google scholar, PubMed, etc for their action on rakta and hematological parameters and their relation to Shonitasthapana karma.

Discussion

The different sources of dravyas like oushada and ahara dravyas which include parthiva, oudbida, and jangama dravyas mentioned in the Shonitasthapana varga makes it a unique varga mentioned by Charaka. In general, the dravyas mentioned in the varga have predominantly Madhura, Kashaya and Tikta rasa. Sheeta veerya, which acts on Pitta dosha has samavayi sambandha with rakta. Different opinions by the commentators of Brihatrayees give insights into the wide scope of actions that Shonitasthapana varga dravyas might possess rather limiting it to just rakta sthambana karma as generally understood.

Madhu possesses Madhura rasa and Kashaya anurasa and Sheeta veerya. Madhura rasa has karmas like preenana, sarvadhatu vardhana, jeevana which indicates its role in raktavardhana and raktaprasadana rather than raktasthambana.¹⁵ Due to its sukshma and laghu guna, madhu does srotovishodha. Iron, vitamin C, cobalt, vitamin B12 play a major role in the formation of red blood cells and haemoglobin in the bone marrow. Honey contains all the nutrients required for the same. Vitamin C helps in proper absorption of iron and vitamin B12 in the intestines, while glucose and carbohydrates provide energy, thereby acting in conditions like iron deficiency anaemia. An in vitro study on the effect of honey on human platelets and blood coagulation proteins showed inhibitory effect on platelet aggregation and blood coagulation.¹⁶ Ameliorative effect of bee honey with royal jelly was observed in animal studies by significantly improving the haematological parameters like haemoglobin, RBC, WBC, etc.¹⁷

Madhuka or liquorice has Madhura rasa, snigdha, guru guna, sheeta veerya and madhura vipaka which prominently act as vatapittashamaka and karmas as mentioned to that of madhu. Glycyrrhizin, a triterpenoid compound present in liquorice showed thrombin inhibitory activity on thrombus induced model in rats.¹⁸ In another study, administration of aqueous extract of liquorice root on rabbits showed significant increase in haematological parameters like RBC, total WBC, neutrophils and decrease in mean corpuscular haemoglobin concentration (MCHC) and eosinophils.¹⁹

Further, an in vitro study showed that liquorice infusion can stimulate the activation of lymphocytes, particularly T cells.²⁰

Kunkuma is considered as Rudhira by chakrapanidatta, whereas Indu, commentator on Ashtanga Sangraha has considered animal blood (Prani rudhira) as Rudhira. The use of Jangala prani rakta with Madhu is indicated in raktapitta and administration of rakta in raktakshaya is well documented in the classics. Kunkuma has Katu, tikta rasa and ushna veerya which help in the stimulation of ranjaka pitta bringing Ranjana to rakta dhatu. Katu rasa does raktasanga binna, thereby leading to srotoshodhana. Active ingredients of Saffron like safranal, safran and crocin are found to have protective action on somatic cells and erythrocytes in erythrocyte fragility.²¹ Saffron extract was also found to be possessing protective action against platelet aggregation and lipid peroxidation.²²

Mocharasa/ Shalmali niryasa due to predominantly Kashaya rasa - Picchila guna leads to sandhana and sthambana karma, thereby arresting the raktasrava resulting in haemostasis.²³ Lupeol present in Shalmali was found to have potent antiangiogenic activity on human umbilical venous endothelial cells (HUVEC).²⁴

Lodhra due to its Kashaya rasa - Laghu ruksha guna acts as synthesizer in pectoral lesions and helps in raktasthambana.²³ Symplocus racemosa Q was found to significantly reduce whole blood coagulation, prothrombin time and fibrinolytic activity which indicates that the drug has potential action in haemorrhagic disorders.²⁵

Priyangu has Madhura Kashaya rasa - Guru ruksha guna and sheeta veerya brings about sthirata to rakta due to jeevana karma of Madhura rasa and sandhana karma of both madhura kashaya rasa and sheeta veerya. Oleanolic acid, a major chemical present in seeds of Priyangu showed improvement in erythropoietin concentration (EPO), thereby resulting in marked increase in RBC count and other RBC indices.²⁶

Gairika is Madhura, Kashaya rasa has karmas like jeevana and sandhana - Sheeta veerya therefore used for both raktavardhana and raktasthambana. Hematite contains 70% iron which is a major precursor for haemoglobin formation in blood. Red ochre was found to be effective in controlling the bleeding in adolescent menorrhagia due its styptic and astringent activity.²⁷

Sharkara is an ikshu vikara which is sumadhura and susheeta in nature. It acts on ushna guna of pitta and does pittashamana. It also acts on sara guna of pitta and rakta by bringing sthirata to rakta. Sugar is rich in carbohydrates, iron and proteins which help in proper formation of blood components.

Laja is an edible food prepared by roasting paddy and mentioned as pathya in raktapitta. It has Madhura rasa; laghu, ruksha guna and sheeta veerya due to which it acts as pittashamaka, tarpana, balya and is easy for digestion. The ruksha guna reduces the excess dravatva in rakta and acts as raktashamaka. Parched rice is rich in nutrients like vitamin B, E and minerals like calcium, phosphorus, iron, which are essential for proper cellular functions of the body.

Mritkapala is the broken piece of earthern mud pot. Information on the properties of mritkapala is limited in the texts, though its utility is mentioned in Pittaja Trishna. As it is made out of silica (mud), it contains iron which is essential for Hb formation in blood, but scientific evidence for the same is lacking. Some references regarding the source of Mritkapala give an interesting insight. Gangadhara, commentator on Charaka samhita considered Brushtakharpara as Mritkapala.²⁸ Hemadri while commenting in Siravyadha vidhi adhyaya, in the context of raktasthambana, mentioned “Kharpara” as mritkapala.²⁹ But, while commenting on Shodanadigana adhyaya, mentioned “Karpara” as mritkapala.³⁰ Sushrutha mentioned Pralepa of Mritkapala as one of the treatments for Atidagdha Chikitsa,³¹ while Dalhana considered Mritkapala as Kharpara.³² By looking into the above references, we can mention two words for Mritkapala i.e., ‘Karpara’ and ‘Kharpara’. In Ayurvediya Shabdakosha, karpara is considered as patra or the vessel which has undergone paka, whereas Kharpara is mentioned as Khanija dravya and one among maharasas i.e., Rasaka.³³ In Rasarnava, three varieties of Kharpara are mentioned namely, Mrittikaba, Gudhabha and Pashanabha kharpara and Mrittika variety is considered as best.³⁴ Zinc oxide is considered as the source of Mrittikaba variety. However, zinc oxide in its natural form is difficult to procure, but can be easily prepared synthetically. Kharpara is sheeta, kaphapittashamaka and indicated in conditions like Prameha, Kshaya, Netraroga, Pandu, Shwayathu, Rakta pitta, Rakta gulma, Pradara, Somaroga, Rajashoola, Yoniroga, etc.³⁵ Since the karmas of rasaka are indicating towards its shonitasthapana activity, further scientific studies can be conducted on broken earthern pot and zinc oxide for eliciting the source of mritkapala mentioned in Shonitasthapana varga. Classical references of Shonitasthapana varga dravyas point towards a wider scope of pharmaceutical utility in diseases related to raktavahasrotas and raktadhatu. However, it is essential to explore the potential of the dravyas based on various scientific researches.

Majority of the drugs mentioned in the varga also were found to possess cytotoxicity activity, and can be explored for use in the treatment of cancers and also the complications caused due to chemotherapy like myelosuppression leading to various haematological aberrations.

Conclusion

A critical review of Shonitasthapana varga dravyas provides an overview on the varied pharmacological actions this group of drugs possess with relation to its utility in the treatment of different haematological disorders. More scientific implications can be explored for the diverse actions of the drugs used in the varga, wherever blood or rakta is involved in a disease pathogenesis.

Conflict of Interests

None