Whatsapp discussion series- 3 : Therapeutical use of Kupilu (Strychnous nuxvomica)

[16/03 5:00 PM] Professor Satyendra ojha sir:

 Case report 

on 14th, elder male aged 56 years came in OPD with low backache, tingling and numbness in both lower extremities, constipation (passage of hard stool in alternate days), headache. non hypertensive, non diabetic, non alcoholic, non smoker. on examination; HR -76/min, BP -190/110, JVP0, CVS - S1normal S2 loud, no added sounds, RS normal, P/A normal, SLR: + ve bilaterally, knee, ankles and plantar reflexes are diminished. ECG is done, normal findings. BSL is normal, CBC- normal, urinalys- normal. X-ray; lumbosacral AP & Lateral view, degenerative changes with osteophytes; lumbar spondylosis. Rx- sinhadad guggul 500 mg bid, lakshadi guggula 500 mg bid, Vishatinduka vati 250 mg bid, gandharva haritaki vati 4gm at night, combination of punarnava gokshuru vacha jatamansi shankhapushpi each 1gm, tds, snahana svedana and Kati basti.. Admission in morning time .. In evening BP was 180/100, so, I decided not to start modern antihypertensive drug.. On 15th in morning BP was 170 /100, in evening 160/100, today in morning 140/90 mm of Hg. Now no headache, bowel motion is normal. There is improvement in low backache and numbness & tingling, SLR is normal..

[16/03 5:07 PM] Dr. Mayur Surana:

 Ojha sir

Was this symptomatic treatment or based on any Ayu nidan ?

Any particular reason why Aushadh sevan kalas were not followed ?..Like why not Gandharva haritaki apane instead of HS

[16/03 5:30 PM] Professor Satyendra ojha sir:

Dr Mayur !  where is it mentioned that gandharva haritaki should be taken in apaana kaal ?

[16/03 5:32 PM] Prof Gujjarwar:

   Prof. Ojha ji.

[16/03 5:37 PM] Professor Satyendra ojha sir:

 Dr Mayur ! my approach to patient is as per ashthi majja gata vaata/guda gata vaata & Hypertension..

[16/03 5:40 PM] Dr. Mayur Surana: 

Sir ! neither it is mentioned to be taken HS..!!...isn't dat allopathic kala..like cremaffin HS?...So what was your thinking behind it...?...plz guide sir

[16/03 5:47 PM] Dr Ranga prasad : 

If a patient consumes supper by 8 PM and sleeps by 10:30.

And when Gandharva hareetaki is taken by 10:30 before sleeping at night..

The stomach being empty, can't that be considered as empty stomach dosage ? 

[16/03 5:49 PM] Professor Satyendra ojha sir:

 If, we consider the transit time is concerned with constipation (as in guda gata vaata and purishaavrita vaata), we have to give drugs acting as snigdha anulomaka to facilitate normal bowel motion either in morning time or at night or at both times. Different procedures are adviced and would be done in day time, so , soft bowel motion in morning is more applicable and desirable.. I find, after giving gandharva haritaki at night, there is help by lying down posture to provide better efficacy of gandharva haritaki or any anulomaka dravya..

[16/03 5:52 PM] Professor Satyendra ojha sir: 

Dr Ranga Prasad Bhatt, dinner time 9 PM and drug at night time to be given at 9.30 PM..

[16/03 5:52 PM] Dr. Mayur Surana: 

It might be true sir...but doesn't it contradict our principle...that d medicine at that time will work on urdhwajatru may be because of dravyaprabhav it will act on apaan too...but if same drug is given at apaan kala wont its dose be reduced  may work at minimum dose ?

[16/03 5:57 PM] satyendra ojha : 

I have seen, when there  is delayed gastric emptying, apaana kaal for dravya administration is best choice.  But in colo-rectal transit time, choice is HS..

[16/03 5:58 PM] satyendra ojha sir:

 If, I use avipattikara, time is apaana..

[16/03 6:02 PM] satyendra ojha sir: 

See, please, in this case no use of sarpagandha and Arjun..

[16/03 6:03 PM] satyendra ojha sir: 

No meditation,  no shorodhara , no rakta mokshana..

[16/03 6:04 PM] Dr.Mayur Surana:

 Thanks sir...

Can we equate hypomobility or decreased colonic transit time to hampered praana gati..and hence praanakali I.e. muhurmuhur + apaan Kali medicines to cover the two important vayus in this regard?

[16/03 6:04 PM] Pawan madan Dr:

 @Mayur ji...

Whts the benefit of giving such type of medicine apaan kaale in ayurvedic terms?

Whenever I used this time for anulomana or similar such action I never got the results...

[16/03 6:07 PM] satyendra ojha sir: 

Gut-brain relationship & praana- apaana sahasambandha can be considered as interchangeable words..

[16/03 6:09 PM] satyendra ojha sir: 

The use of trifala, or amritaa, or nimba, or daarvi in morning time for paandu-kaamala is best choice (ch.chi 16)

[16/03 6:10 PM] satyendra ojha sir: 

प्रातःकालिन योग..।

[16/03 6:11 PM] Mayur Surana: 

@ Pavan sir any malavrodha (barring avaranjanya) is due to अपान..अन्नादौ विगुणे अपाने and शकृतनिष्क्रमण is fn. of apaan...so if snigdha madhur amla lavan anulomak drugs with suitable anupaanas are given they definitely work...

If specifically tikta aahar history in constipation its tatpratyanik amla pradhan मूढवातानुलोमन amla drug like aamalki/dadim/aamsul at apaan kala:;if katu aahar pradhan history then madhur pradhan anulomak at apaan kala and if kashayrasapradhan diet d cause then lavan pradhan स्तंभसंघातभेद drug at similar time...

[16/03 6:13 PM] Dr Surendra A. Soni: 

Sir

My query is that kupilu preparation usually avoided in hypertension...? You used it wisely with herbs useful in hypertension...! And gradually bp also came down. Did I get your approach Sir.. correctly....?

[16/03 6:18 PM] pawan madan Dr: 

Mayur ji..

Ur observations seems to be right.

But I chose the vaat anulomak dravya acc to tye quality of the sthaan......as the koshtha is usually........so  I chose raatrikaal almost 2 hours after dinner for this purpose and it gives sufficiently good results irrespective of the pradhaana diet one is taking because practically the type of diet these days are quit variable and poeple go on changing the type and style of food usually..

[16/03 6:18 PM] pawan madan Dr: 

BP usually comes down with a good vaata anuloman if udaavarta and vibandh could have been a major contributor of the raised BP..

[16/03 6:20 PM] satyendra ojha sir: 

Dr Surendra, in this case Vishatinduka vati is given, but formulation of antihypertensive purpose works well.  the selection of specific dravya is very important for result.

[16/03 6:20 PM] Dr Surendra A. Soni:

 Agree pawan Sir

But strychnine is an established cardiac stimulant previously plenty of use were there in modern....!

[16/03 6:21 PM] Dr Surendra A. Soni: 

Thanks Sir

[16/03 6:21 PM] pawan madan Dr: 

Sir ..that is strychnine......not vishatinduka as whole...

I have used vishtinduka in a dose of five tab bd also with no raise of bp....

[16/03 6:22 PM] satyendra ojha sir:

 I posted earlier here that I am working on Hypertension and selecting few combination without sarpagandha and Arjun..

[16/03 6:23 PM] pawan madan Dr: 

Ojha sir....

Why i used singhnaad here but not tryodashaang or triphala.....?

any specific motive....

is that because of the history of vibandha or something else??

[16/03 6:23 PM] Dr Surendra A. Soni: 

It contains strychnine...

Definitely it increases bp...

It's possible that you didn't use in hypertension case....

Or Bala praman Samhanan etc also work...

[16/03 6:24 PM] Prof gujjarwar: 

Means in this case chronic  constipation is the main cause for hypertension ir increase the BP ?  and aapan Vata dusti.

After correcting apandusthi and constipation BP came down and symptoms released.

Is it correct sir ?

[16/03 6:25 PM] satyendra ojha sir:

 Dr Pawan Madan ji, yes, due to vishtabadhtaa/ guda gata vaata..

[16/03 6:27 PM] satyendra ojha sir:

 Prof. Shriniwas Gujjarwar, see, please, drugs combination, where Hypertension and gudagata vaata / ashthimajaagata are considered separately..

[16/03 6:29 PM] Prof gujjarwar ay pith:

 Ok sir

[16/03 6:44 PM] Dr Anamika: 

Sinhnaad gugglu is very good vataanuloman...and...benefits in hypertension too....

[16/03 6:46 PM] pawan madan Dr:

 Dr Anamika ji in how much dose u used singhnaad for vaata anulomana ??

[16/03 6:48 PM] Dr Anamika: 

Usually 500mg bd or Tds.....

[16/03 6:50 PM] pawan madan Dr: 

I have using this in a dose of 1 to 1.5 gm tds in various cases but didnt get result ...

[16/03 6:51 PM] pawan madan Dr: 

Sorry ...have been using....

[16/03 9:35 PM] Dinesh Katoch sir: 

Morning posts today started by Dr Ojha about Kuchla use really meant a lot to the practitioners in the group. 

My observations about Kuchla formulations for more than 25 years are- 

1.Vishmusti or Vishtinduk Vati good for somatic nerve pain

2. agnitundi vati for spasmodic autonomic nerve pain

3. navjivan ras for febrile illness induced neuralgia and

4. karskar vati for LMN implications particularly  male sexual incapability.  

During the use of these formulations care should be taken to avoid dry foods and must take milk products.

[16/03 9:38 PM] pawan madan Dr: 

Katoch sir....

That means Kupilu preparations are good in various vaata vyaadhis ?

[16/03 9:40 PM] Pawan rajyan: 

Yes obviously dr madaan ji

[16/03 9:43 PM] Pawan rajyan:

 but.. Predictions of ojha sir have worthy. Its depend on ay. physician how  compositions are made for a particular illness of a particular patient

[16/03 9:44 PM] pawan madan Dr: 

Sad......I have used vishtinduk as vaata shaamak in various doses from various companies.....but no vaata shaamak effect found..

...in last 10 yrs

Only using agnitundi.......but as agnideepaka in vaataj agnimaandya, vaataj ajeern like cases....

[16/03 9:46 PM] Pawan rajyan : 

sir

first thought of aavaran then  akshansh kalpana then decide medicines. So simple

[16/03 9:47 PM] pawan madan Dr: 

Sir...I consider everything....

[16/03 9:47 PM] Dinesh Katoch sir:

 Alas Dr Pawan, ashukari  Visha formulations of kuchla did not work in yout patients. Definitely some errors incurred in diagnosis or concomitant use of other medicines.

[16/03 9:48 PM] pawan madan Dr:

 It may be sir.....

[16/03 9:48 PM] Pawan rajyan: 

agnitundi vati should be used only in aamaj or kafhvataj ailments only

should not be as agnideepak purpose.

[16/03 9:49 PM] Pawan rajyan:

 Mostly i use visaushad and ras medicines for sure results !!!!

[16/03 9:49 PM] pawan madan Dr: 

I dont think so.....but if u are saying I will have to check..

But I am getting pretty good effects in such cases.

All is explained in Rasatantrasaar...

[16/03 9:51 PM] pawan madan Dr: 

Agnisandeepan.......for pittaja agnimaandya

Agnitundi......for vaataj agnimaandya

Agnikumar ......for kaphaja agnimaandya

[16/03 9:51 PM] Pawan rajyan AP: 

I yet never experianced any side effects even after year long treatment

[16/03 9:52 PM] pawan madan Dr:

 Yaa...thats okk

[16/03 9:55 PM] satyendra ojha sir: 

Dr Katoch sir, great observation, the same is my  findings.. Thanks for sharing your experience..!

[16/03 9:57 PM] Katoch sir:

 To nullify the bad effects of Kupilu formations it is advisable to combine them with shatavari, musli, til like snigdha dravyas.

[16/03 9:59 PM] Tapan Vaidya: 

My experence with Vishtinduk Pradhan yogas is somewhat unique.

All of them after three months of usage exibit Agnimandya in all and heavy periods in female pts.

Giving a break of 15 days resumes the routine. Do anyone hv such experence?

[16/03 10:00 PM] Pawan rajyan: 

Traditional yogs are well balanced i rarely use any patent medicines.

[16/03 10:01 PM] venugopal Dr.: 

We advice to eat 100 grm of Khowa for nullifying kupilu bad effects

[16/03 10:02 PM] Pawan rajyan AP: very true sir but we add drugs like parval chanderputi  ,such symptoms will not arise

[16/03 10:03 PM] Katoch sir: 

Great Dr Venugopal. If Khowa not available or affordable, desi ghee jalebi is wonderful with kuchla medicines.

[16/03 10:03 PM] satyendra ojha sir: At the recommended dose and for brief duration , if used , these are best combination in vaata kapha predominant conditions..

[16/03 10:03 PM] pawan madan Dr:

 I use vishtinduk for a good sexual stimulant action rather in cases of erecticle dysfunction and really it is very useful in few types of ED....

[16/03 10:04 PM] Pawan rajyan: 

i never use used vistundak for ED

[16/03 10:04 PM] Katoch sir:

 Provided the patient is not hypertensive.

[16/03 10:04 PM] Swati Patil: 

Ghrita, madhu and sharkara r used to treat vishalakshanas of vishtinduk

[16/03 10:07 PM] venugopal Dr.: 

Kuchala combined with Triphala

Loha bhasma

Or

Pravalapisti+Guduchu satwa+Swarnamakshika bh

Doesn't cause any adverse effects

Rather make the yoga potent further

[16/03 10:07 PM] pawan madan Dr: 

Pawan ji...try it...its wonderful..

[16/03 10:08 PM] Pawan rajyan: 

as per my little understanding  for results

in pure vataz vyadies  kuchla may be added to ras chikisha with gold containing drugs but kaph aur aam lakhan should not be there

[16/03 10:09 PM] Pawan rajyan: 

agreed and thanks dr. Venugopal ji

[16/03 10:17 PM] M gopikrsnan Dr.: 

Even shudha kuchala is very effective in radiating type of pain as in sciatica, cervical spondylitis.....etc

It is more effective as rasayana if kuchala shodhana done with goksheera swedana method, especially in demylination disorders.

If its (kuchala) is erandataila shodhita then its good as shoola prashamana, quick In action, does not aggravate HTN.

I USE this erandataila shodhita kuchala choorna as ekadravya prayoga in vata vitiation condition especially radiating pain.

Similarly

Shudha vatsanabha (ekadravya prayoga) in localised, musculoskeletal pains .

[16/03 10:18 PM] satyendra ojha sir: 

Due to autonomic nervous system dysfunction as in DM, when spastic colon is present, my choice is sinhadad guggul, agnitundi vati, and gandharva haritaki ..

[16/03 10:20 PM] satyendra ojha sir: 

Gopi Garu and venu Garu , great !

[16/03 10:20 PM] satyendra ojha sir:

 Dr Rajyan.. I am agreed with you..

[16/03 10:21 PM] Pawan rajyan:

 vatsnaab if given singly as said by ojha sir (but remember is bhahit by  oil of erend)

[16/03 10:22 PM] satyendra ojha sir:

 In fibromyalgia, my choice is ashwagandha bala shatavari chopachini and shunthi..

[16/03 10:23 PM] Pranav Deshmukh Dr.: 

Vishtinduk kalpas effective in

Raksanjanam param ,

Sara kitta vibhajanm,

Shyamutrta.

[16/03 10:24 PM] satyendra ojha sir:

 In all above mentioned diseases, the thinking with ayurveda perspective is done before selecting combination..

[16/03 10:27 PM] Dr Surendra A. Soni: 

Great inputs on kupilu....

[16/03 10:28 PM] ‪+91 94239 75874‬: 

Is vish and prativish be given together..???

Like.. with kuchala ghee and madhu as anupaan  should be given or not ????

[16/03 10:29 PM] pawan madan Dr: 

Vishtinduka ....in sciatica, in autonomic pain, in somatic  pains, in spastic colon...

How can we understand this in ayurvedic perspective ????

[16/03 10:29 PM] ‪+91 98228 98091‬: 

This is called healthy and fruitful discussion.....thanks all vaidyagana. ......

I remember that some vaidya in a seminar revealed the use of sheded skin of black cobra.....used for skin disorders .....I was a student that time ...... any reference

[16/03 10:30 PM] pawan madan Dr:

 I havent seen any side effect of vishtinduk in a dose of 250 mg bd for many months..

[16/03 10:38 PM] Ujjwala Dr.:

 Dr.Pawan sir, you may not have seen any side effects with that dose in the long run, but did you notice any benefits in the symptoms? If it was beneficial in any ways, was that result sustainable or depended on ongoing consumption?

[16/03 10:42 PM] Pawan rajyan: 

Ras and visausdhi starts showing results in few doses if properly given....

[16/03 10:58 PM] M gopikrsnan Dr.: 

Use of antidote or its shodhana/marana dravya or excess shodhana of the said drugs SHOULD NOT BE CARRIED OUT .

(unless untill its invitable)

As most of these visha dravyas have special adorable features like "ashukari, vyavahi, vikasi guna " by which there action is so quick in body, but by any of above said reasons like antidote/excess shodhana the specific qualities of visha is nullified/reduced and the drug action is hampered.

They are vishas, allow them to act like visha in a justified(therapeutic) way .

[16/03 11:02 PM] Prof gujjarwar:

 

TheBest discussion about Kuchala and it's preparations. 

[16/03 11:05 PM] Pawan rajyan:

 100% Agreed with dr gopalkrishan views

[16/03 11:06 PM] Mayur Surana Dr.:

 Kuchala ko aaj sabhi diggajo ne badi nazakat se kuchal diya🏻

[16/03 11:15 PM] pawan madan Dr: 

Dr Ujjawala ji..

I am.using this in ED patients and sometimes it helps in vaata shaamak with other medicines.

I haven't notice much painkiller action with kuchala..

[16/03 11:16 PM] M gopikrsnan Dr.:

 Also as specified few days back, keshavarama taila of marmachikitsa is also based on kupeelu only.

Excellent analgesic action observed in this taila also shothahara action seen, simple lymph node enlargement will vanish in 1 day, by local application of this taila.

[16/03 11:17 PM] M gopikrsnan Dr.:

 Kupeelu mahima 

[16/03 11:17 PM] Prof. Upendr dixit: 

Kupeelu performs Shoshana of Kapha Pitta and removes Margavarodha. It also increases Vata Gati. So Gati Avasaada is removed. So Kupeelu is useful in Margavarodha Janya Vata Prakopa and Avasaada of Vata. Because Vata Gati is improved, Agni and Dhatvagni Deepana takes place. So indirectly helps in improving Dhatu Nirmana.

For better understanding of the actions of Kupeelu and precise conditions in which Kupeelu should be used,  please refer Rasa Tarangini.

[16/03 11:17 PM] Dr. Jayagovinda SDM: 

Kuchla shodhana done with soaking in gomuthra (should be changed daily) for 7 days follwed by boiling in kshira for 1 hr in the dose of 20mg tid dose is excellent pain killer

[16/03 11:21 PM] pawan madan Dr:

 Dixit sir....

These are the effects I am getting. 

[17/03 8:15 AM] ‪+91 98504 59381‬: 

Does that mean kupilu should not be used in vaatavyadhi with wasting ?

[17/03 8:22 AM] upendr dixit prof: 

Yes definitely . Rasa Tarangini has described that

मांसपेशीशोषयुते नवे कठिनपेशिके ।

पक्षाघाते न युञ्जीत स्पर्शानुभववर्जिते ।।

Thats why I said that Rasa Tarangini will provide guidance in this regard.

[17/03 9:33 AM] Vinay Chodhry Dr.:

 Good discussion on kuchla is going on . Ya agreed with katoch sir and dixit sir. karaskar is ruksha in nature should b used judiciously in vat vyadhi. keeping the drug induced dhatu shoshan in mind we should use snigdha dravya with it if we r using it for a long time. Unani physicians used it a lot u will find many yogas in Ayurvedic literature which r parallel to that era, to overcome it's ruksha Guna thr is a preparation Majoon AZRAKI ( Majoon is just like lehyam n AZRAKI is kuchla ) beautiful yoga containing nariyal, gojihva, lavang with .

[17/03 9:42 AM] Dr Zankhana Buch:

 Thanks, indeed a useful discussion. Mahavishagarbha Taila has given excellent result in Diabetic Peripheral Neuropathy.

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Above discussion held on 'Ayurveda Peetha'(Initiated by Prof. S. N. Ojha Sir) a Whatsapp group of famous Vaidyas from all over the India. 

Compiled & edited by

Dr.Surendra A. Soni

M.D.,PhD (KC)

Associate Professor

Dept. of Kaya-chikitsa

Govt. Ayurveda College

Vadodara Gujarat, India.