Considering Vyadhi Bala, Agni Bala and Purusha Bala in Determining the Dose of Shamana Aushadha

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Acharya Sushruta, after explaining different groups of herbs which can be used as palliative medicines, explains about the ideal dose of taking the medicines and what factors should be taken into consideration before administration of medicines. These rules are applicable for ‘shamana aushadhas’ i.e. palliative medicines but can be generally understood as being ideal in administering various medicine forms also, including shodhana – purificatory medicines.

Ref – Sushruta Sutra Sthana, Chapter 39, verse 10 (Su.Su.39/10)

Ideal dose of Shamana Aushadhas: Palliative Medicines and the factors to consider

तत्र सर्वाण्येवौषधानि व्याध्यग्रिपुरुषबलान्यभिसमिक्ष्य विदध्यात्। तत्र, व्याघिबलादधिकमौषधमुपयुक्तं तमुपशम्य व्याधिं व्याधिमन्यमावहति; अग्रिबलादधिकमजीर्णं विष्टभ्य वा वच्यते; पुरुषबलादधिकं ग्लानिमूर्च्छामदानावहति  संशमनम् ; एवं संशोधनमतिपातयति। हीनमेभ्यो दन्तमकिंचित्करं  भवति। तस्मात् सममेव विदध्यात् ॥१०॥

All medicines and herbs should be administered after considering the below mentioned three factors in each and every patient. Considering these factors is very essential and plays a major part in the success of the treatment.

The factors to be considered are –

1.    Vyadhi bala – strength of the disease,
2.    Agni bala – strength of the digestive fire and
3.    Purusha / Atura bala – strength of the body of the patient

Dose of medicine vs strength of disease

The dose of the medicine should not be in excess of the strength of the disease. If the strength of the disease is less i.e. weak disease or moderate, if excessive dosage of palliative medicine is administered than what is required, the medicine would relieve the disease but on the other hand would also give rise to yet another disease or complication. This is not desired in the treatment plan for any disease. We expect the medicine to relieve the symptoms, mitigate the doshas and cure the disease and not to worsen a disease or cause a new one.

Dose of medicine vs strength of digestive fire

The dose of the medicine should be ideally in sync with the strength of agni i.e. digestive capacity of the individual. If the digestion power of the agni is low to moderate i.e. weak digestive fire, and if the palliative medicine is used in excessive dosage, it will result in manifestation of painful conditions in the abdomen. Also, the medicine would get digested after a long time since the agni is weak and hence the medicine will not have the desired effect.

Dose of medicine vs strength of the body of the patient

Before administering the medicine, the physician should also analyse the physical strength of the patient. The dose of the palliative medicine should be ideal to the strength of the patient. The medicines should not be used in excess of the strength of the patient. If the physical strength of the patient is low or moderate, and if the medicine is given in large dose, it would give rise to the below mentioned symptoms / complications –

–   Glani – exhaustion,
–   Murcha – fainting and
–   Mada – intoxication / toxicity

Should the same principles be followed in case of Shodhana Aushadha also?

Yes, even in case of shodhana aushadha i.e. purificatory medicines also the strength of vyadhi, agni and bala should be considered. If shodhana medicines are administered in excess of strength of the disease, digestive fire and body of the patient, they would cleanse the body (evacuate) excessively and in turn trouble the patient immensely.

Should the same factors be considered in administering low dose medicines?

Yes, if the medicines (palliative) are administered in insufficient quantities of the strength of vyadhi, agni and atura will not produce any effect i.e. the medicines would become futile.

Therefore, these medicines should be used only in suitable quantities as appropriate to the strength of vyadhi – disease, agni – digestive fire and atura – patient.

Aushada matra: Dose of medicine

व्याध्यादिषु तु  मध्येषु क्वाथस्याञ्जलिरिष्यते ॥
बिडालपदकं चुर्णं देयः कल्कोऽक्षसंमितः ॥१४॥

Below mentioned are the doses of various drug forms when the strength of the disease, digestive fire and patient are moderate –