ISSN: 2322 - 0902 (P) ISSN: 2322 - 0910 (O) International Journal of Ayurveda and Pharma Research Research Article ROLE OF KANA KAJJALI IN THE MANAGEMENT OF AJEERNA (INDIGESTION): AN OPEN CLINICAL STUDY Namrata Joshi1, Manoj Kumar Dash2*, Pradeep Kumar Panda3 1Associate Professor, Dept. of Rasashastra, Faculty of Ayurveda, IMS, BHU, Varanasi. *2Lecturer, P.G Dept. of Rasashastra & Bhaishajya Kalpana, Govt. Ayurveda College, Raipur, Chhattisgarh, India. 3Professor & Head, Dept. of Rognidana, Govt. Ayurvedic College, Balangir, Odisha. ABSTRACT Ajeerna (Indigestion) is the state of unfinished process of digestion of ingested food. Kana Kajjali is a classical formulation indicated in the treatment of Ajeerna. It is prepared by Kana (Piper longum)- a herbal drug and herbomineral preparation Kajjali (Black sulphide of mercury). In the present study, an effort has been made to assess the effect of herbomineral formulation Samaguna (Hg:S=1:1) Kana Kajjali and Shadadguna (Hg:S=1:6) Kana Kajjali (Black sulphide of Mercury with Piper longum)on indigestion. Materials and methods: The study was carried out on 83 patients of indigestion. Patients were divided into three groups with simple random sampling method: Group A was treated with Samaguna Kana Kajjali tablet at the dose of 125 mg; Group B was treated with Kana tablet 250 mg; while group C was treated Shadaguna Kana Kajjali tablet at the dose of 125 mg; twice a day after meal. Duration of the treatment was 10 days. Assessment was done on the basis grading of classical signs and symptoms of the disease with application of paired t- test. Results: Highly significant (p<0.001) effect was seen in Samaguna Kana Kajjali group on symptoms like Angamarda, Tiktoamlodgara and Shadguna Kana Kajjali on one Vataja symptom viz. Pravahanam and three Kaphaja symptom viz. Utlesha, Arochaka and Avipaka with best result with Shadguna Kana Kajjali especially on Kaphaja symptoms. Conclusion: Above study confirms that an increase in the concentration of Gandhaka in Parada enhances the therapeutic efficacy of the later drug. KEYWORDS: Kajjali, Murchhna, Samaguna Kajjali, Shadaguna Kajjali, Kana Kajjali, Ajeerna, Indigestion. INTRODUCTION Acarya Charaka says that food can nurture the diseases according to associated Doshas. Deha (Physical), Dhatus (Tissues) and Ojas (vigour) Indigestion, or dyspepsia, is a term frequently used to etc only when it has been properly processed on by describe a variety of symptoms generally appreciated Agni.[1] Digestion of food (Aahaara-pachana) is a very as distress associated with the intake, of food. To complex phenomenon that requires exact and some patients indigestion refers to actual abdominal accurate conglomeration of so many factors that in pain, pressure, or heartburn. Others may use the Ayurveda includes the quality of food, codes and term to describe a sense of abdominal fullness or a conducts of food consumption. Thus, right from the vague feeling that digestion has not proceeded type of the food to the condition of consumer, Agni is naturally. Still others may use it to describe belching, predominant for proper digestion and metabolism of a feeling of excessive gas, or flatulence. Symptoms of food. If at any stage, Agni balance is troubled it will dysphagia, anorexia, and nausea and vomiting etc are certainly lead to improper digestion and metabolism closely related to indigestion. which will ultimately result into release of biotoxins Kajjali (black sulfide of mercury) is a (Aamotpatti) and genesis of various disorders. preparation which is made either triturating Parada Ajeerna is the condition of incomplete state of (Mercury) with Gandhaka (Sulpher) alone in different digestion of ingested food due to Mandagni.[2] Ajeerna proportions or Parada (Mercury) with Gandhaka anna, partially digested, sour in taste and toxic in (Sulphur) along with other metals and minerals nature is termed as Annavisha also which produces without using any liquid and is converted into very IJAPR | May 2019 | Vol 7 | Issue 5 1 Int. J. Ayur. Pharma Research, 2019;7(5):1-9 soft powder, just like collyrium.[3] The Kajjali when Kana Kajjali ratio of mercury to sulphur is 1:1 used properly along with other metals or herbs can triturated with Adraka swaras while in Shadaguna cure all the diseases, pacify all the three humors Kana Kajjali it was 1:6. Both the formulations were (Tridoshahara), increases Shukradhatu (Vrishya), levigated with Adraka swaras in accordance to the immediately spreads in the body when consumed, reference text Siddha Bhaishya Manimala. Kana clears the obstructed channels at the diseased organ, extract tablet was prepared as per reference of API. and enhances the properties of other metallic or Research design herbal medication when taken along with proper It was an open clinical trial (study). Anupana.[4] Statistical design Hundreds of formulations are explained in Paired “t” test was used to assess the effect of classical texts with the permutation combination therapy in each group. The results were interpreted of Kajjali which is combination of Sulphur and at p< 0.05, p< 0.01 and p< 0.001 significance levels. Mercury in varying proportion along with/ without The obtained results were interpreted as: other metals/minerals or herbal ingredients.[5] Kana Insignificant if P value is not < 0.1 Significant P< 0.05, Kajjali, is a one such example of herbomineral P< 0.01 highly significant P < 0.001 formulation containing Kajjali and herbal drug Kana (Piper longum)[6] and is indicated in the treatment of Inclusion criteria Ajeerna. In the present research work Kana Kajjali Patients suffering from Ajeerna (Indigestion) – has been trialed to check its efficacy in the mentioned chronicity of maximum 2 weeks. clinical condition. Patients with decreased Agni-Bala (digestive Aims and Objectives power). To assess the effect of Samaguna Kana Kajjali Patients between 18 to 60 years of age. tablet (Black sulphide of Mercury, Hg: S=1:1), Exclusion criteria Kana tablet (Piper longum), Shadadguna Kana Sufferers from diseases other than Ajeerna Kajjali tablet (Black sulphide of Mercury, Hg: (Indigestion). S=1:6) in patients of Ajeerna (Indigestion). Patients with the symptoms >2 weeks. To assess the role of Sulphur in Kana Kajjali in Patients on drugs causing hyperacidity. the patients of Ajeerna. Grouping and posology To assess role of quantity of Sulphur in Kajjali in Patients were randomly divided into three groups: treatment of the disease. 1. Group A: Treated with Samaguna Kana Kajjali Materials and Methods tablet 125 mg; 1 tablet twice a day after meal Patients having classical signs and symptoms with Takra. of Ajeerna, attending the OPD and IPD of Rishikul 2. Group B: Kana extract tablet 125 mg; 1 tablet Govt. Ayurveda College, Haridwar and Govt. twice a day after meal with Takra. Ayurveda College, Bolangir, Odisha were selected without any bar of cast, religion, occupation, and sex. 3. Group C: Treated with Shadaguna jarita Kana Kajjali 125 mg; 1 tablet twice a day after meal Test drug: Kana Kajjali is a formulation consisting of with Takra. herb Kana (Piper longum), Kajjali triturated in Adraka (Zingiber officinalis) Swaras. All the drugs Patients of all groups were treated for duration of 15 were procured from authentic sources. In Samaguna days. Table No-1 Group Drug Form of Drug Dose Time Anupana No. of Pts A Samaguna Gandhaka Tablet 125 mg After meals- Takra 27 Jarita Kana Kajjali twice a day B Kana Extract tab. Tablet 125 mg After meals- Takra 27 twice a day C Shadaguna Gandhaka Tablet 125 mg After meals- Takra 29 Kana Kajjali twice a day Assessment criterion Assessment criteria were based on subjective parameters of Ajeerna (Indigestion). All clinical manifestation was categorized in accordance to Doshika involvement as Vataja, Pittaja, Kaphaja and gradations of each manifestation were made as under. IJAPR | May 2019 | Vol 7 | Issue 5 2 Namrata Joshi et al. Role of Kana Kajjali in the management of Ajeerna (Indigestion): An open clinical study Vataja Symptoms 1. Vishtambha (Severe Constipation) Symptom Grade Not at all : 0 Occasionally/at 1 meal time per 24 hrs without trouble : 1 For first 24 hrs with trouble : 2 For > 24 hrs with marked trouble : 3 2. Sadanam (Loss of Physical activities) Symptom Grade Not at all : 0 Able to carry out all types of activities but feeling of “well- : 1 being” is lost Able to carry out only routine activities : 2 Not able to carry out even routine activities : 3 3. Angamarda (Bodyache) Symptom Grade Not at all : 0 Mild bodyache, not alarming : 1 Mild to moderate body ache, alarming : 2 Severe body ache : 3 4. Prushthagraha (Stiffness in Lumber area) Symptom Grade Not at all : 0 Occasional and bearable : 1 Often and unbearable : 2 Daily and unbearable : 3 5. Katigraha (Stiffness in Low back area) Symptom Grade Not at all : 0 Occasional and bearable : 1 Often and unbearable : 2 Daily and unbearable : 3 6. Shiraso ruk (Headache) Symptom Grade Not at all : 0 Occasional but not troubling : 1 Occasional, troubling to some extent, no need of medication : 2 Often/daily, medication needed : 3 7. Pravahanam (Straining at the time of defecation) Symptom Grade Easy defecation : 0 Needs to make some efforts for defecation : 1 Needs to make great efforts for defecation, Purgatives : 2 needed occasionally No defecation without taking purgatives : 3 Available online at: http://ijapr.in 3 Int. J. Ayur. Pharma Research, 2019;7(5):1-9 8. Vibandha (Constipation) Symptom Grade Defecation : daily, stool consistency- semisolid : 0 Defecation : daily, stool consistency- solid : 1 Defecation : 1time/2days, stool consistency- solid and hard : 2 Defecation: 1time/>2days, stool consistency- solid and very : 3 hard Pittaja Symptoms 9. Pravritti (Defecation frequency) Symptom Grade Defecation frequency: Normal as per Prakriti : 0 Defecation frequency: Occasional increased with/without : 1 change in stool consistency Defecation frequency: Often increased with loose motion : 2 Defecation frequency: Daily increased with loose motion : 3 /Watery diarrhea 10.