Case Report International Ayurvedic Medical Journal ISSN:2320 5091
CHAKSHUSHYA EFFECT OF RASAYANA CHURNA ON REFRACTIVE ERRORS- A CASE STUDY DUNGHAV MANISHA G. Associate Professor, Department of Sanskrit Samhita & Siddhanta, Dr.D.Y.Patil college of Ayurved & Hospital and Research Institute, Navi Mumbai, Maharashtra, India
ABSTRACT Nowadays whole world is under the influence of the cell phones and computer. Because of this the rate of refractive errors has been increased ultimately compelling people to use spec- tacles since childhood. WHO estimates that 153 million people worldwide live with visual im- pairment due to uncorrected refractive errors, in this Present study after taking Rasayana Churna for two years regularly, symptoms of the subject related to myopia like Double vision, Haziness, Glare or Haloes around bright lights without using spectacles has been remained same (i. e. se- vere) after one year and after another one year, subject has got relief from severe to moderate. And in symptoms like headache, eye strain without using spectacles, subject has got relief after six months which remained same at the end of two years. Refractive test also showed changes in the SPH distance correction of Rt Eye as well as Lt eye which has been reduced from -1.50 to -1.25 of Rt eye, and from -1.25 to -1.0 in Lt. eye respec- tively. It has been observed that before treatment near correction of Rt eye was+0.75which changed to +1.0 after the treatment. And also it has been observed that before treatment near cor- rection of Lt eye was+1.0 which was changed to +1.25 after the treatment. Present study shows the positive result of Rasayana Churna on myopia .Through this study people will benefitted in getting rid of using spectacles which will enhance their look. Keywords: Myopia, Rasayana Churna, Refractive errors
INTRODUCTION Eyes are the most precious gift of Hyperopia, Astigmatism and Presbyopia. God to the living beings. It holds a special Among these Presbyopia is the age related status among all the sense organs. Our new condition of eye but another 3 are the condi- generation is the pray of different problems tions which can affect both children and related to the visual, ocular and systemic adults. symptoms which are arising due to the pro- Combination of Rasayan Churna is longed use of the modern gadgets. described in Ashtanga Hridaya as rasayana The causative factors behind all which is used for strength of hair and gives problems are mainly improper use of sense long healthy life.2 According to Charaka organs, improper diet, violating the moral Samhita ,a person undergoing rejuvenation code of conduct and the effect of the time. therapy attains longevity ,memory, intellect, Among these, improper use of sense organs freedom from diseases, youth, excellence of like eye can lead to refractive errors. Re- luster, complexion and voice, excellent po- fractive errors are of 4 types i.e. Myopia, tentiality of the body and the sense organs, Dunghav Manisha G.; Chakshushya Effect Of Rasayana Churna On Refractive Errors- A Case Study
vak-siddhi (i. e. what he says comes true), vedic Formulary of India. All the ingre- respect and brilliance.3The means by which dients are shade dried and powdered one gets the excellence of rasa(the nourish- separately, passed through 80 # sieve, ing fluid which is produced immediately af- and then mixed together in equal pro- ter digestion etc.) is known as rasayana or a portions to get uniformly blended rejuvenation therapy. Combination of Gudu- churna and made into coarse powder chi (Tinospora cordifolia), Amalaki ((Em- with the help of a grinder. They are fi- blica officinalis) and Gokshura (Tribulus nally powdered and sieved (80#) sepa- terrestris) is well known as Rasayana rately. Churna. 4 The Rasayan Churna was prepared in So the present study is proposed to reputed Pharmacy from Mumbai. assess the chakshushya effect of Rasayana The Rasayana churna was given with churna in the treatment of refractive errors. Anupana Madhu (Honey) at the dosage This study is proposed to explain that Ra- 10gms at night. sayana Churna can be considered as cura- The Rasayana churna was given to sub- tive and preventive measure in refractive ject continuously for two years with errors like myopia. follow up of every six months. AIMS & OBJECTIVES: Written consent was obtained from A) To validate the concept of Rasayana in subject before giving medication. refractive errors. DURATION OF STUDY: 2 years B) To assess the Chakshushya effect of Ra- CRITERIA OF ASSESEMENT: sayana Churna in relation to refractive Criteria for refractive errors: errors. CRF (Case Record Form) was prepared. C) To spread awareness among physicians Symptoms like Double vision, Haziness, that Rasayana Churna can be used as Glare or haloes around bright lights, preventive measure in refractive errors. Headache, Eyestrain were monitored PLAN OF STUDY: after every 6 months in severe, mod- The Rasayana churna is prepared as per erate and mild format for which grada- the general method described in Ayur- tion were +++,++ and + respectively. TABLE NO.1 SHOWING CRITERIA FOR SYMPTOMS SYMPTOMS(WITHOUT USING SPECTACLES) Mild Moderate Severe Double vision + ++ +++ Haziness- + ++ +++ Glare or haloes around bright lights + ++ +++ Headache + ++ +++ Eyestrain + ++ +++ A specialized rating scale for refractive two intervals i.e. before treatment and errors examination was prepared. This after two years of the treatment. examination was done to the subject in
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Diagnostic criteria: Haziness- on and off Increased since last To evaluate the Chakshushya effect of 1month the drug, whole importance was given Glare or haloes around bright lights- on and to the findings of refractory errors given off Increased since last 1month by Private Eye Centre running by Headache- Increased since last 1month Ophthalmologist. This test was done to Eyestrain- Increased since last 1month the subject in two intervals i.e. before History of Previous illness: treatment and after two years of the No h/o any major illness/Diabetes Mellitus/ treatment. Ischaemic Heart Disease/Renal Disorder This study was done in private clinic. Patient was using bifocal spectacles since 10 OBSERVATIONS: yrs Name of the patient-: XYZ Family History: Father and Mother Sex: Male expired due to M.I before 4 yrs & 2 yrs Age: 53 yrs respectively. Profession: Teacher Special Complaint: Patient was curious Religion: Hindu about his fitness of the body . Diet: Vegetarian On Examination: Present complaints & Duration: Pulse rate-72/min Without spectacles following complaints R.R.-20/min occurs B.P.-120/70 Double vision- Increased since last one month TABLE NO.2-SHOWING REFRACTIVE TEST BEFORE TREATMENT ON DATE 12/07/2005 RT EYE LT EYE SPH CYL AXIS Vn SPH CYL AXIS Vn DISTANCE -1.50 - 0.5 700 6/9 -1.25 - 0.25 900 6/9 NEAR 0.75 0.50 700 N6 1.0 0.25 900 N6 REMARK: BIFOCALS Medicine Given: Rasayana churna 10 gms at night with Madhu(honey). FOLLOW UP STUDY: TABLE NO.3 –SHOWING FOLLOW UP STUDY SYMPTOMS(WITH- 1stFollow 2ndFollow 3rdFollow 4thFollow Remark OUT USING SPEC- Up After Up after Up after Up after TACLES) 6 months 1 year 1 year and 2 years 6 months Double vision +++ +++ ++ ++ Relieved Haziness +++ +++ ++ ++ Relieved Glare or haloes around +++ +++ ++ ++ Relieved bright lights Headache +++ ++ ++ ++ Relieved 420 www.iamj.in IAMJ: Volume 2; Issue 4; July- August- 2014 Dunghav Manisha G.; Chakshushya Effect Of Rasayana Churna On Refractive Errors- A Case Study
Eyestrain +++ ++ ++ ++ Relieved TABLE NO 4-SHOWING REFRACTIVE TEST AFTER TREATMENT ON DATE 11/08/2007 RT EYE LT EYE SPH CYL AXIS Vn SPH CYL AXIS Vn DISTANCE -1.25 - 0.50 700 6/9 -1.0 - 0.25 900 6/9 NEAR +1.0 -0.50 700 N6 +1.25 - 0.25 900 N6 It is well known that the retina and RESULT lens are enriched in these carotenoids, rela- Refractive test also shows changes in tively little is known about carotenoid levels in the uveal tract and in other ocular tissues. the SPH distance correction of Rt. Eye as In addition, human ciliary body revealed the well as Lt eye which has been reduced. It presence of monohydroxy carotenoids and has been observed that near correction of Rt. hydrocarbon carotenoids, while only the eye and Lt.eye which was shown before latter group was detected in human treatment has been changed after treatment. RPE/choroid. Uveal structures (iris, ciliary In the present study symptoms of the subject related to myopia like Double body, and RPE/choroid) account for 50% vision, Haziness, Glare or Haloes around of the eye’s total carotenoids and 30% of the lutein and zeaxanthin. In the iris,∼ these bright lights without using spectacles , has ∼ been remained same ( i. e severe) after one pigments are likely to play a role in filtering year and the after another one year it has out phototoxic short-wavelength visible been decreased from severe to moderate. light, while they are more likely to act as And symptoms like headache, eye strain antioxidants in the ciliary body. Both me- without using spectacles ,it has been de- chanisms, light screening and antioxidant, creased after six months and remained same may be operative in the RPE/choroid in ad- at the end of two years. dition to a possible function of this tissue in the transport of dihydroxy carotenoids from DISCUSSION: the circulating blood to the retina. This re- As per Modern science ,in humans, port lends further support for the critical role three carotenoids (beta-carotene, alpha-caro- of lutein, zeaxanthin, and other ocular caro- tene, and beta-cryptoxanthin) have vitamin tenoids in protecting the eye from light-in- A activity (meaning they can be converted duced oxidative damage and aging. 6 to retinal), and these and other carotenoids The beneficial effects of carotenoids can also act as antioxidants. In the eye, cer- are thought to be due to their role as antioxi- tain other carotenoids (lutein, astaxanthin[2] dants. Beta-Carotene may have added bene- and zeaxanthin) apparently act directly to fits due its ability to be converted to vitamin absorb damaging blue and near-ultraviolet A. Furthermore, lutein and zeaxanthin may light, in order to protect the macula of the be protective in eye diseases because they retina, the part of the eye with the sharpest absorb damaging blue light that enters the vision. 5 eye. 7
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Rasyana churna is said to be good result on myopia in present study may be for hairs.8 But according to the definition of due to Amalaki. rasayana ,it was decided to see the effect of Modern science also supports textual state- it on refractive errors as it is described in ment as Amalaki (Emblica officinalis) is rasayana adhyaya. Rasayana therapy (Re- richest natural source of carotenoids, vita- juvenation Therapy) attains dehaindriya min C, bioflavonoids, flavones polyphenols. bala (excellent potentiality of the body and Carotenoids including lutein (49+/- the sense organs) 9 and Tarpaka kapha nou- 27mg/100g) and β-carotene (32+/- rishes sense organs.10 It means the word Ra- 19mg/100g). 14 sayana (Rasa + Ayana) refers to nutrition It supports the health of the eye by enhanc- and its transportation in body. Such a state ing both Ranjaka Pitta (the subdosha of of improved nutrition is claimed to lead to a Pitta that governs liver function and the series of secondary attributes like prevention blood plasma)15 and Alochaka Pitta (the of ageing, provide immunity against dis- subdosha of Pitta that governs the eyes and eases, mental competence, increased vitality vision)16. The tridoshahar nature of Amalaki and luster of the body. ((Emblica officinalis) also makes it a good There are pancha indriyas (five sense or- tonic for the eyes.17Thus carotenoids present gans) in the body.11 Sense organ of vision is in the Amalaki ((Emblica officinalis) nou- Chakshu rindriya (Chakshu) is a sense organ rishes eye and all uveal structures which can consisting of teja mahabhuta.Its location is help to reduce the refractive error. eye , object (artha) is vision and perception As per Ayurveda Guduchi (Tinospora cor- of it is chakshusha buddhi Perception de- difolia) is having Katu rasa (Pungent taste), pends on contact of sense organ with its Tikta Rasa(Bitter taste), Sweet in Vipaka subject .12 (taste of end product of digestion)Rasayani According to this concept good vi- (Rejuvenative), hot in potency, Balyakara ( sion depends on site, its panchbhoutik con- gives strength) ,Agnideepaka (increases stitution and proper perception with the help digestive fire).18 Guduchi (Tinospora of proper conjugation of soul, mind, sense cordifolia) nourishes the eye and adjacent organ and its respective object.13 muscles and joints. Eye related muscle If there is misconjugation in these weakness shows the cause of the refractive things there would be defect in perception errors. Guduchi (Tinospora cordifolia) en- which causes refractive errors. hances the power of vision as it act as a re- Chakshushya, means "strengthening juvenation of eye and vision . Modern the eyes"-(Chakshu means "eye" and ayu- science also supports this statement by ela- shya means "rasayana" so it is literally a borating the composition of Guduchi "rasayana for the eyes"). Rasayana Churna (Tinospora cordifolia).A variety of con- is good to empower the strength of sense stituents have been isolated from different organs. As eye is one of the important sense parts of Guduchi (Tinospora cordifolia). The organ of the body and refractive errors are active component of the Guduchi(Tinospora indication of less strength of eye. Positive cordifolia) is Alkaloids,octacosonal and ste-
422 www.iamj.in IAMJ: Volume 2; Issue 4; July- August- 2014 Dunghav Manisha G.; Chakshushya Effect Of Rasayana Churna On Refractive Errors- A Case Study roids.19Animal study shows that Octaco- Gokshura ( Tribulus terrestris )gives sonal isolated from Tinospora Cordifolia In- strength to the dhatus and sense organ like hibits proliferation of endothelial cells and eye. Fruit of it has been found useful in all enrich ascites tumour cells , inhibits neovas- vata aggravations of the nervous system. It cularization induced by angiogenic factors draws all three doshas downward and can in chick chorioallantoic membrane and rat treat headaches, hives, itchy skin, eye cornea in vivo angiogenesis assays.20 Thus inflammation.26 Guduchi (Tinospora cordifolia) gives As eye is one of the important sense strength to the uveal structures of eye as it is organ of the body and cause of refractive explained as rasyana & balyakara. errors is indicating the less strength of eye. Modern science elaborates constituents of As per Ayurveda, Atma and mind conjugates Gokshura (Tribulus terrestris ) as fol- with chakshurendriya and eyes can establish lows:A number of steroids 21, flavonoids 22, contact with its object. Prana vayu facili- lignanamides 23and alkaloids 24have been tates this process of conjugation and impulse identified. As per Ayurveda, Gokshura of vision is transferred to mind by dhama- (Tribulus terrestris) is a plant whose root nis.27 Drushti (Vision) is formed by the es- and fruits are used for male virility and sence of panchmahbhutas with agnibhuta general vitality, respectively. Gokshura predominance. 28 Eye ball is formed by the (Tribulus terrestris) is of cold in essence of panchamahbhutas, the following potency,sweet in taste, gives strength and parts are formed by the corresponding bhuta Bastishodhaka (cleanses the basti).25 Thus predominance. TABLE.NO.5 SHOWING PREDOMINANCE OF PANCHAMAHABHUTA IN PARTS OF EYE 29 Part of the eye Bhuta Predominence Mamsa Prithvi Rakta Agni Krishna mandalam Vayu Shweta mandalam Jala Ashrumarga Aakasha In this study Rasayana Churna was From this study we can understand that to given with Honey as Anupana which is also get proper vision structures like lens, retina, Chakshushya.30And for better result for ciliary body, iris should function in proper Chakshushya it was given at night as it is manner. Weakness in muscles or decreased very well explained in text.31 carotenoids in the eye may lead to refractive In modern science correction of refractive error. Rasayana Churna plays significant errors is done by using spactacles or surgery role in correcting the refractive errors. is the only treatment. But through Ayur- CONCLUSION veda, refractive errors can be prevented and Among the contents of Rasayana churna treated by taking Rasayana Churna as per , Amalaki (Emblica officinalis) shows chak- the severity. So this study would be helpful shushya effect to the eyes, Gudu- in getting rid of using spectacles regularly. 423 www.iamj.in IAMJ: Volume 2; Issue 4; July- August- 2014 Dunghav Manisha G.; Chakshushya Effect Of Rasayana Churna On Refractive Errors- A Case Study
chi(Tinospora cordifolia) shows the effect 6. Identification and Quantitation of of rasayana on eyes as a sense organ and Carotenoids and their Metabolites in the Gokshura (Tribulus terrestris)gives strength Tissues of the Human Eye by Paul S. to the sense organ like eye. Bernsteina, f1, Frederick Khachikb, Lorena S. This study shows positive effect of Ra- Carvalhob, Garth J. Muira, Da-You sayana churna on myopia. Zhaoa, Nikita B. Katza Rasayana Churna can be used from www.sciencedirect.com Experimental eye childhood to prevent refractive errors in research children of modern era . Vol.72,issue3,March2001,pages215-223 Anupana honey plays an important role to 7. The role of carotenoids in human health get a chakshushya effect of Rasayana by Johnson EJ.Nutr Clin Care. 2002 Mar- Churna on refractive errors. Apr;5(2):56-65. Cited on 31/05/2014 from SCOPE OF FURTHER STUDY: http://www.ncbi.nlm.nih.gov/pubmed/12134 Controlled study to assess the single drug 711 study of the chakshushya effect of Ama- 8. A.H.U.39/159 Ashtang Hridaya English laki(Emblica officinalis),Guduchi(Tinospora translation by Prof.K.R.Srikantha Mur- cordifolia) ,Gokshura( Tribulus terrestris ) thy,Vol.III(Uttara sthana),Edition on refractive errors in different age groups. 2006,published by Choukhmbha Sanskrit Series Office,Varanasi-221001, page no.408 REFERENCES: 9.CH.CHI.1/7-8 Charaka Samhita English 1. Wikipedia on refractive errors cited on translation by Dr.Ramkaran Sharma and 31/05/2014 from www.who.int Vaidya Bhagwan Dash VOL.III,Edition 2. A.H.U.39/159 Ashtang Hridaya English 2005, published by Choukhamba Sanskrit translation by Prof.K.R.Srikantha Mur- Series office,Varanasi-1, page no. 8 thy,Vol.III(Uttara sthana),Edition 10. A.H.Su.12/17 English Translation of 2006,published by Choukhambha Sanskrit Ashtang Hriday ,Vagbhat Sutrasthana - I, Series Office,Varanasi-221001, page no.408 comment written by Dr.T.Shreekumar, , 3.CH.CHI.1/7-8 Charaka Samhita English III/2011,January, published by Publication translation by Dr.Ramkaran Sharma and Department Harisree hospital,Kerala State, Vaidya Bhagwan Dash VOL.III, ,Edition page no.291 2005, published by Choukhamba Sanskrit 11. CH.Su.8/8 Charaka Samhita English Series office,Varanasi-1, page no. 8 translation by Dr.Ramkaran Sharma and 4. The Ayurvedic Formulary of India; part 3, Vaidya Bhagwan Dash VOL.I,Edition 1stedition. Govt. of India, Ministry of Health 2007, published by Choukhamba Sanskrit and Family Welfare, New Delhi, 2011. Series office,Varanasi-1, page no.166. 5.Carotenoid from wikipedia en 12. CH.Su.8/10-12 English translation .wikipedia.org assesed on 25/02/2014 from A Text book of Sharir Kriya Vidnyan by Prof. Dr.Subhash Ranade, Prof. Dr.R.R.Deshpande, First edition2007, pub-
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Dingari Lakshmana Chary published by Dr.Brahmananda Tripathi ,published by Chaukhamba Sanskrit Pratishthan, Delhi, Choukhamba Surbharati Praka- page no. 17 shana,Varanasi, page no.25 30. A.H. Su.5/56 English Translation of CORRESPONDING AUTHOR Ashtang Hriday ,Vagbhat Sutrasthana- I DR.MANISHA G.DUNGHAV ,comment written by Dr.T.Shreekumar, , ASSOCIATE PROFESSOR III/2011,January published by Publication Department of Sanskrit Samhita & Siddhanta Department Harisree hospital, Kerala State, Dr.D.Y.Patil college of Ayurved & Hospital page no.128. and Research Institute, Nerul, Navi Mumbai, Maharashtra, India 31.Sharangdhara Samhita Purva khanda 2/11, Hini vyakhya , Edition 2006, by Email: [email protected]
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