Priyanka Havalad* 1
Nataraj H. R. 2
Amr̥utottaram Kaṣhayam, also known as Nagaradi Kaṣhayam, is a well-known traditional Ayurvedic herbal decoction extensively used in clinical practice for the management of digestive disorders, febrile conditions, inflammatory states, and for enhancing immunity. Though this formulation is not described in the classical Bṛihattrayi texts, it holds a prominent place in traditional Kerala Ayurveda and is clearly documented in authoritative regional treatises such as Chikitsamanjari, Sahasrayogam, and Sarvaroga Chikitsaratnam. Amr̥tottaram Kaṣayam is a simple yet potent combination of three herbs Guduci(Amṛuta), Haritaki, and Nagara each renowned for their deepana–pacana (digestive stimulant), jwaraghna (antipyretic), Sothahara (anti-inflammatory), and rasayana (rejuvenative) properties. The synergistic action of these ingredients makes the formulation effective in correcting agnimandya, ama accumulation, and doṣha imbalance, particularly involving Pitta and Kapha.
The ingredients are easily procurable, economical, and the preparation method is straightforward, contributing to its wide acceptability and frequent prescription in day-to-day practice. Owing to its immunomodulatory and detoxifying potential, Amr̥utottaram Kaṣhayam gained renewed clinical relevance during epidemic outbreaks such as chikungunya and COVID-19. Thus, it continues to be valued as a versatile, safe, and effective formulation in both preventive and curative Ayurvedic therapeutics.
Amrithotharam Kashayam
Nagaramritha harithaki kramat
Nagahastham nayananghri bhaghasaha
Saadhusiddhamudhakam sa sarkaram
Nasayathyakhila doshajam jwaram
Sahasrayogam -Jwara chikitsa
The proportion of ingredients in this formulation is explained through an interesting symbolic method. Nagara (Suṇṭhi), Amṛta (Guḍuci), and Haritaki are prescribed in terms of anghribhaga (one-fourth part) of Naga, Nagahasta, and Naganayana, respectively. Here, Naga symbolically denotes the eight elephants representing the Aṣṭa-digpalakas (guardians of the eight directions). Accordingly, Nagara corresponds to Nagabhaga, that is, 8 parts. Amṛta is taken as Nagahastabhaga, where hasta signifies three limbs (two forelimbs and the trunk), giving 8 × 3 = 24 parts. Haritaki is represented by Naganayana, where nayana denotes two eyes, resulting in 8 × 2 = 16 parts. All three ingredients are finally reduced to their anghribhaga (one-fourth). Thus, Nagara becomes 8 × 1/4 = 2 parts, Amṛta 24 × 1/4 = 6 parts, and Haritaki 16 × 1/4 = 4 parts, Anupanam-Sarkara,
Indication: All types of Jwara(fever).[1]
Acc to (Sarvaroga chikitsaratnam)
Amritharukazhanjaakku
Naal Kazhanju Kadukkayum
Chukku Randum Kashayathaal
Virechichozhiyum jwaram
Amritu-6 Kazhanju=32.4gm, Kadukka-4, Kazhanju=21.6gm, Chukku-2 Kazhanju=10.8gm
Indication-Virechanam Jvaram[2]
Acc to (Chikitsa Manjari)
Amritumaarukazhanjay, Rechaki Naal Kazhanjay Akhilamirukazhanjaay,
Kondu Pakwam Kashayam Gulalavana Sametham Tat Pibetaasutheerum
Paniyodu Malasangham Veekkavum Kamila Cha.
In this formulation, Rechaki denotes Haritaki, highlighting its purgative action, while Akhilam refers to Nagara. Gudam (jaggery) and Lavanam (Saindhavam) are mentioned as the Anupana.
Indications: Jwaram, Malabhandham, Sopham, and Kamala. [3]
Therapeutic Actions:
Doṣhakarma includes Kaphavata-samanam, Tridoṣha-haram, and Vatanulomanam, thereby pacifying Kapha and Vata, balancing all three doṣhas, and promoting the normal downward movement of Vata. Dhatukarma involves Rakta-prasadanam, contributing to the purification and nourishment of the blood tissue. Agnikarma comprises Dipanam and Pacanam, enhancing digestive fire and facilitating proper digestion and metabolism. Malakarmam is characterized by Virechanam, producing a mild purgative effect and aiding in the elimination of waste products. Srotokarmam includes Srotovishodhanam and Lekhanam, which help in cleansing the bodily channels and reducing pathological accumulations. [4]
Rasa panchaka and Dosha karma [5]
|
Drug |
Rasa |
Guna |
Virya |
Vipaka |
Doshakarma |
|
Nagara |
Katu |
Laghu snigdha |
Ushna |
Madhura |
Vatakaphasamaka |
|
Haritaki |
Madhura Amla Katu Tikta Kashaya |
Laghu Ruksha |
Ushna |
Madhura |
Tridoshahara |
|
Amritu |
Tikta Kashaya |
Laghu snigdha |
Ushna |
Madhura |
Tridoshahara |
Integrated action
Through their combined and mutually reinforcing action, the formulation regulates bowel movement and enhances metabolic activity. Amṛuta facilitates Ama-pacana, thereby correcting impaired Agni, reducing body temperature in Jwara, and alleviating tissue swelling, edema, inflammation, and pain. Haritaki acts as Anulomana, while Nagara exhibits Grahi properties; together, they stimulate and support Jaṭharagni, promoting efficient digestion and overall gastrointestinal health. This combination effectively relieves abdominal flatulence and colic resulting from indigestion, rectifies metabolic disturbances, and improves liver function. Additionally, Haritaki, a constituent of Triphala, possesses anti-aging and rejuvenative properties and acts as a mild laxative. Since Ama, primarily caused by Jaṭharagni-mandya, is considered the root cause of several disorders such as Amavata, Grahaṇi Doṣha, and Tamaka Swasa, the formulation plays a crucial role in disease prevention and management by correcting digestive and metabolic dysfunction. [6]
Role of Anupana: [7]
Generally, Guḍa is used as the Anupana for this formulation. Guḍa facilitates the elimination of feces and urine without excessively aggravating Kapha, thereby enhancing the therapeutic efficacy of the Kaṣhaya. Thus, it is presumed to potentiate the overall action of the formulation. Lavaṇa possesses Vṛṣya and Hṛudya properties and pacifies the Tridoṣhas. It exhibits a mild Madhura rasa, acts as Dipana, does not cause Vidaha during digestion, is not excessively Uṣhṇa, and is beneficial for ocular health. Therefore, the addition of Lavaṇa further augments and complements the therapeutic effects of the Kaṣhaya.
Alternative Anupanas used in practice:
- In Jwara, the Kaṣhaya is administered along with Veṭṭumaran Guṭika or Cukkuṃ Tippalyadi Guṭika.
- In conditions such as Anaha and Gulma, it is prescribed with Hiṅguvacadi Curṇa.
- In Prameha, Nisamalaki Curṇa is used as an adjuvant, while in Yakṛit–Pliha roga, it is administered with Navayasa Guṭika.[8]
- When increased bowel movements are required in the above conditions, Eraṇḍa taila (castor oil) may be added, as it possesses natural laxative properties that help promote regular bowel evacuation and relieve constipation [9]
- As described in Kriyakoumudi, under Akhuviṣha Prakaraṇa, this Kaṣhaya is also beneficial in conditions such as Pratisyaya and Twakroga [10]. The consumption of Ghṛita is strictly contraindicated, as Amṛtottara Kaṣhaya possesses strong Ama-pacana properties.
Topial administration:
The internal administration of Amṛtottara Kaṣhaya in combination with Suryaprabha Guṭika, along with the topical application of Rasnadi Curṇa, exhibits pronounced Kapha-hara properties. This therapeutic combination offers multiple health benefits, particularly in the management and correction of Kapha doṣha imbalance. In routine Ayurvedic practice, Amṛtottara Kaṣhaya is commonly prescribed as an independent formulation for a wide range of disorders. However, the judicious addition of suitable medicines either during preparation or through the administration of appropriate Anupana enhances its therapeutic efficacy and improves patient compliance, thereby reducing the need for multiple separate medications. [11]
DISCUSSION
Amṛtottara Kaṣhaya is an internally administered formulation described under the Kaṣhaya Prayoga Prakaraṇa of Sahasrayogam. When used in combination with other medicines, it can be employed in a wide range of clinical conditions based on the Yukti (rational judgment) of the physician. According to Ayurvedic principles, the therapeutic application of any drug is determined by a comprehensive evaluation of its Rasapancaka, namely Rasa, Guṇa, Vipaka, Virya, and Prabhava. Therefore, a proper assessment of Rasapancaka is essential for a thorough understanding of individual drugs as well as their formulations.
CONCLUSION
Amṛtottara Kaṣhaya is a classical Ayurvedic formulation prepared from easily available ingredients, making it cost-effective and suitable for routine clinical practice. Its simple method of preparation enhances its applicability in both institutional and community healthcare settings. The formulation exhibits broad therapeutic utility in various types of Jwara, inflammatory conditions, rheumatoid arthritis, and certain dermatological disorders, highlighting its relevance in managing both acute and chronic diseases. The efficacy of Amṛtottara Kaṣhaya is attributed to its balanced Rasapanchaka properties and the synergistic action of its ingredients, which promote Ama-pachana, restore the normal functioning of Agni, and correct metabolic disturbances. By addressing Jatharagni-mandya, it helps interrupt the pathogenesis of several Ama-janya vyadhis, considered fundamental in many systemic disorders in Ayurveda. Moreover, the administration of Amṛtottara Kaṣhaya with appropriate Anupana, selected according to disease condition and patient constitution, enhances its therapeutic effectiveness and patient compliance. Owing to its safety, affordability, and wide spectrum of action, it remains a valuable and relevant formulation in contemporary Ayurvedic practice.
REFERENCE
- Nishteswar, K.(tran.) (2007) Sahasrayogam: Sanskritwith English Translation. Varanasi, India: Chowkhamba Sanskrit Series Office.
- Anekkaleelil S. Gopalapilla, Sarvaroga Chikitsaratnam, Devi Book stall, Sringapuram, kodunghallur
- D. Sreeman Nampoothiri, Chikitsamanjari PartIandII, Vidyarambham Publications,2019
- Upadhyay AK, Kumar K, Kumar A, Mishra HS. Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) -validation of Ayurvedic pharmacology through experimental and clinical studies. Int J Ayurveda Res. 2010 Apr;1(2):112-21. doi: 10.4103/0974-7788.64405. PMID: 20814526; PMCID: PMC2924974.
- Dr Parag Vasudev Yadav, M.D. (Rognidan Avam Vikriti vidnyan) Assistant Professor, MES Ayurved Mahavidyala, Ghanekhunt Lote, Taluka -Khed, District-Ratnagiri, Maharashtra, India
- Dr Parag Vasudev Yadav, M.D. (Rognidan Avam Vikriti vidnyan) Assistant Professor, MES Ayurved Mahavidyala, Ghanekhunt Lote, Taluka -Khed, District-Ratnagiri, Maharashtra, India
- Vagbhata, Astanga Hridaya Samhita, Sarvangasundara and Ayurveda Rasayan commentary, edited by Vaidya Jadavaji Trikamaji Acharya, Choukhambha Surbharti Prakashan, Varanasi, reprint 2017, Sutra sthana, chapter5, sutra1
- Sri Arumanur Parameshwaran, Dr.K.V Ramankutty warrier, yogamanjari (onnam Bhagham), edited by Dr.k.Murali and Ashtavaidyan P.T.N Vasudevan moos, print in April 2019
- Ramraj Singh, Rupali Kakade, Jayant Gulhane, Therapeutic aspects of Eranda Tail (Oil of Ricinus Communis) J Ayu Int Med Sci. 2023; 8(4): 158165.Available Fromhttps://jaims.in/jaims/articl e/view/2413
- Menon Kuttikrishna VM Kriyakaumudi (A Malayalam text book on Ayurvedic toxicology).1st ed. Kottayam: Sahitya pravarthaka Co-operative society Ltd; 1986.
- Aswathy.P B, A.S. Baghel, Mahesh Vyas, & Kamal Kumar. (2024). Application of Rasnadi Churnam on Shiras (Mid-Scalp) as a Daily Regimen. International Journal of Ayurveda and Pharma Research, 12(2), 162-166. https://doi.org/10.47070/ijapr.v12i2.3035.
10.5281/zenodo.19536258