The pharmacological action that is considered to be the cause for the control of vomiting said as छर्दि (CHARDI) in sanskrit is known as छर्दिनिग्रहण (CHARDINIGRAHANA). The action of the substance may be resulting in suppression of neural centres or neutralising the cause of vomiting, but the effect is what is be taken into consideration. For proper analysis and understanding, the details are explained on the basis of various references obtained from classical and recent texts of modern authors pertaining to the science of Ayurveda and also modern science.
DETAILS OF THE ACTION
POSSIBLE MODERN EQUIVALENTS
The reference for this definition is from Gangadhara's commentary for Chardinigrahana action mentioned for the group or Gana that performs this action by Charaka.
MODE OF ACTION / PHARMACODYNAMICS
The definition the action छर्दिनिग्रहण (CHARDI-NIGRAHANA) refers to the ability of the substance to control or stop the condition of ‘छर्दि (Chardi)’. In sanskrit language the word छर्दि ‘Chardi’ refers to ‘vomiting’, ‘expulsion’ or even ‘sickness’. But as per the general acceptance the word is meant for the condition of vomiting. The condition छर्दि (Chardi) may be due to a pathological condition or. an induced condition as incase of वमन (VAMANA) which is one among the पञ्चकर्म (Panchakarma) treatment. The action is said to have the ability to control all theses conditions. It is also useful in the control of दौहृद छर्दि (Dauhrida Chardi) or Pregnancy induced vomiting (Hyperemesis gravidorum) too.
As per Ayurveda the condition छर्दि (Chardi) or vomiting is caused by the vitiated Doshas namely वात (Vata), पित्त (Pitta) and कफ (Kapha) either individually or by the involvement of all the three (सन्निपातज – Sannipataja). Other than these 4 the fifth type is the द्विष्टार्थजन्य (Dwishtarthajanya) or Caused by uncomfortable substance, sight, thought or situation. In either of the case the pathogenesis caused by the involvement of उदानवायु (Udanavayu) gets triggered and along with the व्यानवायु (Vyanavayu) will pull out the causative factor like substance or the vitiated Dosha along with the contents of the stomach towards mouth and expel it out. Thus the process of छर्दिनिग्रहण (Chardinigrahana) can be categorised into two types namely स्थानिक (Sthanika- that deals with local or main cause) while the other सर्वदेहिक (Sarvadehika – That deals with the general cause) with main emphasis on the control of उदानवायु (Udanavayu) and Vyana vayu. Usually the properties of these subsances is either Kashaya or Amla Rasa which have their own effect on the condition. The substances will have the Sheeta and ushna veerya respectively. Other than these, there are instances where the Hrillasa (Nausea) and Chardi (Vomiting) due to vitiated Kapha Dosha. Here it is a symptom of another disease where the substance which may be used to treat will predominantly have Katu Rasa and ushna veerya. Thus depending on the condition, the medicament and its relative action will result.
The substance with Kashaya rasa nad Sheeta veerya like Kutaja will be more useful the treatment of Pittaja Chardi (Vomiting caused by vitiated Pitta Dosha), it acts more on the local parts like throat and stomach. the substance with Amla rasa and ushna veerya are purely acting against Vata dosha and to some extent against the Kapha Dosha. Here the action is general in nature so as to control the Vata Dosha especially Vyana Vata while the local action is on Kapha Dosha as the properties triggers digestion and removal of Kapha. But if the Kapha is the cause then it further aggravates the condition too. Lastly the katu rasa and Ushna veerya substance is used exclusively for Kaphaja vitiated condition as these properties help in enhancing the metabolism and thus remove the vitiated Kapha Dosha. here the action is more localised (Amashaya or Stomach) than the general effect.
The action that is equivalent to the action Chardinigrahana in Modern Pharmacology is Anti-emetics. Anti-emetics is defined as the drugs that help to relieve vomiting or nausea. Depending on their mode of action they are of different types namely Seratonin antagonists or 5-HT3 receptor antagonists, Dopamine antagonists, Neurokinin antagonists, antihistamines, Anticholinergics, Corticosteroids, Benzodiazepines and Cannabinoids. Like Ayurvedic medicine, these are also administered depending on the requirement and condition. Among these, The Seratonin antagonists, Dopamine antagonists and Anti-histamines act on the receptors of Gastrointestinal Tract. While the Nuerokinin antagonists, Anticholinergics and Cannabinoids act on the Central and Peripheral Nervous system. The Benzodiazepines act on the GABA antagonist and suppress the Dopamine indirectly. Lastly the Corticosteroids inhibit the prostaglandins and enhance the action of the Dopamine and Seratonin antagonists.
Nausea and vomiting involves many neurohumoral pathway that involves chemoreceptor trigger zone, vomiting center and Vagus nerve. The whole process is mediated by several neurotransmitters like histamine, dopamine, serotonin, acetylcholine and neurokinin. Thus the influence of these neurotransmitters are suppressed with the medications acting against their trigger. Some of them have centers in the gastrointestinal tract which are also suppressed by some medications like Dopamine antagonists, Seratonins antagonists, etc. But some medications like Anticholinergics, Cannabinoids, etc act directly and only on the neurotransmitters present in the Central and Peripheral Nervous system. Thus like Ayurvedic system, even these can be grouped into local and general.
Here those actions that act on the Gastrointestinal tract receptors can be taken as the local group while those which act on the Peripheral and Central Nervous System as general type of action. Here the selection of medication is dependent on the cause of vomiting and the relative effects on the body.
A condition of Nausea or vomiting is caused by some systemic diseases like Gastroentritis, medications like NSAIDs, Increase in biochemical components like hypercalcaemia, Radiation depending on the part of body exposed and Post operative conditions as an after affect of anaesthesia. Depending on the condition some class of medications should be avoided as they may lead to adverse effects due to the antagonising effects.
INVESTIGATIVE PARAMETERS TO ASSESS
CATEGORY OF PARAMETER
TYPE OF INVESTIGATION
NOT YET COMPILED
NOT YET COMPILED
NOT YET COMPILED
LIST OF SUBSTANCES THAT EXHIBIT THE ACTION
छर्दिनिग्रहण गण/CHARDINIGRAHANA GROUP OF CHARAKA
जम्ब्वाम्रपल्लवमातुलुङ्गाम्लबदरदाडिमयवषष्टिकोशीरमृल्लाजा इति दशेमानि छर्दिनिग्रहणानि भवन्ति। (च.सू. 4th Chapter)
Syzygium cumini (L.) Skeels
Mangifera indica L
Citrus medica L.
Zizyphus sativus Gaertn
Punica granatum Linn.
Hordeum vulgare L.
Glycyrrhiza glabra L
Vetiveria zizanioides (L.) Nash
Purified Mud or Red clay
Oryza sativa L
RESEARCH PAPERS ON THE PHARMACOLOGICAL ACTION
TITLE OF THE PAPER
Literary Review on Dashemani Kashayavarga
Antiemetic drugs: what to prescribe and when.
Darshan Babu N et al: Literary Review on Dashemani Kashayavarga. PunarnaV. July-August, 2016.Vol3.Issue 2. pg 2-10.