tonsillitis in ayurveda

IIॐ नमो वंेकटेशाय II

LORD VENKATESWARA

TIRUMALA TIRUPATI DEVASTHANAMS

TIRUPATI

वेेङ्कटाद्रि सम ंस्थानं ब्रह्माण्ड ेनास्स्ि ककञ्चन ्| वेेङ्कटेश ्समो देवेो न भूिो न भववेष्यति ||

Nammalvar in the hallow of Tamarind Tree

Sri Ganapati Sachidananda Sadhgurubhyo

Namaha

“A study on Grandhighna effect of Chincha bheeja yoga

(Tamarindus indica L.) paint w.s.r to Tundikeri (Tonsillitis).”

Dissertation submitted as partial fulfillment for the award of

AYURVEDA VACHASPATI

DOCTOR OF MEDICINE (Ayu)

DRAVYAGUNA

By

Dr. KURUVA RAGHU RAMUDU B.A.M.S

Guide

Dr. M. PARAMKUSHA RAO M.D (Ayu), Ph.D (Ayu)

DEPARTMENT OF DRAVYAGUNA

TIRUMALA TIRUPATI DEVASTHANAMS

S.V. AYURVEDIC COLLEGE, TIRUPATI

Dr. NTR UNIVERSITY OF HEALTH SCIENCES, VIJAYAWADA, A.P

JUNE, 2016 Regd. No. A131905002

Faculty of Ayurveda

Dr. N.T.R. UNIVERSITY OF HEALTH SCIENCES

VIJAYAWADA, ANDHRA PRADESH

POST GRADUATE DEPARTMENT OF DRAVYAGUNA

TTD's S.V.AYURVEDIC COLLEGE, TIRUPATI

CERTIFICATE

This is to certify that the dissertation entitled “A study on Grandhighna

effect of Chincha bheeja yoga (Tamarindus indica L.) paint w.s.r to

Tundikeri (Tonsillitis)” a bonafide research done by Dr. Kuruva Raghu

Ramudu under our guidance and supervision as partial fulfilment for the award of the

degree in AYURVEDA VACHASPATI– DOCTOR OF MEDICINE (AYURVEDA) in the

specialization of Dravyaguna.

I recommend that the thesis may be forwarded to the adjudicators for

evaluation.

Guide

Dr. M.Paramkusha Rao M.D., Ph.D(Ayu).

P.G. Professor & H.O.D.,

Department of Dravyaguna,

S.V. Ayurvedic College,Tirupati.

Faculty of Ayurveda

Dr. N.T.R. UNIVERSITY OF HEALTH SCIENCES

VIJAYAWADA, ANDHRA PRADESH

POST GRADUATE DEPARTMENT OF DRAVYAGUNA

TTD's S.V.AYURVEDIC COLLEGE, TIRUPATI

ENDORSEMENT BY THE HOD

This is to certify that the dissertation entitled “A study on Grandhighna

effect of Chincha bheeja yoga (Tamarindus indica L.) paint w.s.r to

Tundikeri (Tonsillitis)” a bonafide research done by Dr. Kuruva Raghu

Ramudu under our guidance and supervision as partial fulfilment for the award of the

degree in AYURVEDA VACHASPATI– DOCTOR OF MEDICINE (AYURVEDA) in the

specialization of Dravyaguna.

I recommend that the thesis may be forwarded to the adjudicators for

evaluation.

Dr. M.Paramkusha Rao M.D., Ph.D(Ayu).

P.G. Professor & H.O.D.,


S.V. Ayurvedic College,Tirupati.

Dr. N.T.R. UNIVERSITY OF HEALTH SCIENCES, VIJAYAWADA, A. P.

DEPARTMENT OF POST GRADUATE STUDIES IN DRAVYAGUNA

TTDS’ S.V. AYURVEDIC COLLEGE, TIRUPATI

Declaration

I hereby declare that the dissertation entitled: “A study on Grandhighna

effect of Chincha bheeja yoga (Tamarindus indica L.) paint w.s.r to Tundikeri

(Tonsillitis)”is a bonafide and genuine research work carried out by me under the

guidance and supervision of Dr. M. Paramkusha Rao, M.D. (Ayu), Ph.D. P.G. Professor &

H.O.D., Department of Dravyaguna, S.V. Ayurvedic College, Tirupati.

Date: Signature of the Candidate

Place: Kuruva Raghu Ramudu

ACKNOWLEDGEMENT

“Om Namo Venkatesaya”

First, I would like to pay my obeisance at the lotus feet of “Lord Venkateswara” for allowing

the smooth completion of this dissertation work.

I pay great amount of gratitude towards my respected guide Dr. M. Paramkusha Rao M.D

(Ayu), PhD (Ayu), Professor and Head, Post Graduate Department of Dravyaguna, S. V. Ayurvedic

College, Tirupati. His constant encouragement, critical supervision and learned suggestions were

indeed helpful in my work. A thorough perfectionist in him has taught me the imperative qualities of

honesty, hard work and dedication. I find myself highly fortunate and greatly privileged to have

worked under his guidance.

I am thankful to Dr. M. Rajaiah M.D (Ayu), Principal, S. V. Ayurvedic College, Tirupati, for his

support in every aspect.

I am grateful to Dr. Bulusu Sitaram for his kindness, functional freedom, valuable

suggestions and co-operative attitude all along my research work.

I express my deep gratitude to Dr. Renu Dixit, for her motherly guidance, encouragement at

every stage of my work throughout the study.

I am very thankful to Dr. S. Pavan Kumar, for his co-operation, timely guidance and support.

I am thankful to Dr. Ragamala.K.C, Asst.Professor Dept.of kaumarabhrutyam

,S.V.Ayurvedaic Medical college,TTD ,Tirupathi.

I am thankful to Dr Parvathi Devi, Superintendent, S.V Ayurvedic hospital initiating for

providing place for dravyaguna theatre to conduct the study along with many other dravyaguna

kriyayogas.

I am grateful to Dr.D.Rani Pramila, M.V.Sc, Ph.D, Asociated Professor, Department of

Microbiology & Head of State Level Diagnostic Laboratory, CVSc, Sri Venkateswara Veterinary

University, Tirupati, for his help and guidance in Microbiological study.

I express my sincere thanks to my beloved seniors Dr. J.Vishwanadh, Dr. Anshuman,

Dr. Rudrama Devi, Dr. Deepika, Dr.Anitha Baby, Dr.Varsha prabala for their help and support.

I express my sincere thanks to my colleagues Dr.Dhiraj, Dr. Yasmin, Dr.Sonal, Dr. Neeraja

and juniors Dr.Shankar, Dr.Seshamma, Dr.Dhana lakshmi, Dr. Kalpana, Dr.Swathi for their help and

support.

I also express my sincere thanks to my patients who are the base for the successful

completion of this research work.

It is next to express my profound love and gratitude to my affectionate parents

Sri K. Seetha Ramudu & Smt.K. Subhadramma who has always stood by me during each step of my

life.

My heartful thanks to my spouse Smt. K.Sudha Rani and my loving daughter Baby K.Sahithi

for staying with my in law parents and without complaining my prolonged absence.

Finally yet importantly, my thanks to all those persons who directly or indirectly helped me in

this work.

....Dr. Kuruva Raghu Ramudu

ABSTRACT

In Ayurveda Tundikeri is explained under diseases of oral cavity. This disease is grossly

explained in Ayurvedic literature under classifications of Kantagata and Talugata roga. In

contemporary science, it may be correlated to Tonsillitis. Tundikeri not only cripples children

from majority of their enjoyable and learning movement but also makes adults to feel uneasy,

restless and even bed ridden, if complication occurs.

Antibiotics are the main stay in treatment of tonsillitis as far as the allopathic system of

medicine is concerned. They can give temporary relief to the patient but cannot check the

recurrence of the disease. If there are indications that the patient might have to undergo

tonsillectomy also with the antecedent rise of post-operative bleeding and being first barrier to

pathogens and site of antibody production, then their removal put a straight forward attack on

our respiratory and gastrointestinal tract and further more surgical procedure has its own

complication also.

In this study 40 patients were divided in to 4 groups. Fresh paste (FP)- Seed rubbed against

rough surface and made into paste and then applied to Group-1; Paste of dried paste (PDP)-Seed

rubbed against the rough surface then made in to paste, this paste allowed to dry then made in to fine

powder. This was applied mixed with water to Group-2; Paste of powder (PP) - Seeds were

pulverized and were subjected for sieving to obtain fine powder. This was applied to group-3;

Placebo (PL) was given to Group-4.

Group-1 patients have shown better percentage of result when compared to other 3

Groups. That means Fresh Paste is more effect then other forms. The result with Group-3 that is

Paste of powder (PP) has shown next better results. Group-2 that is Paste of dried paste (PDP)

has not given satisfactory result, but better then Placebo Group-4.

Even with Antibiotic treatment Tonsillitis needs 7-8 days for complete remission. Besides

it reoccurs. Frequent use of Antibiotics reduces quality of life, disturbs immunity. If tonsils are

operated or removed then leads to total immunity problems. Tonsillitis stands as unattended

problem in this society. Chincha beeja has effectively controlled tonsillitis permanently. It is not

mentioned in any classical books. Hence it comes under extra pharmacopeial drugs. The rate of

remission of Tonsils swelling includes it in Fast Acting Drugs of Ayurveda. As the drug applied

locally with special instrument called Tonsils cops, the drug inaugurates a new clinical

extension Dravyaguna Kriyayogas in the discipline of Dravyaguna.

INDEX

CHAPTER CONTENTS PAGE No

LIST OF TABLES i-iii

LIST OF FIGURES iv-v

LIST OF GRAPHS vi-vii

ABBREVIATIONS viii

1 INTRODUCTION 1-6

2 LITERARY REVIEW

1) DRUG REVIEW 7-37

2) REVIEW OF GRANTHIGNA KARMA ON

TUNDIKERI.

38-65

3 DRUG STUDY

1) PHARMACOLOGICAL STUDY ACCORDING TO

ANCIENT METHODS (DGG)

66-72

2) PHARMACOGNOSTIC STUDY 71-74

3) PHYTOCHEMICAL STUDY 75-79

4) PHARMACEUTICAL PREPARATION 80-81

5) MICROBIOLOGICAL STUDY 82-84

4 CLINICAL STUDY

Material and Methods 85-89

Observation and Results 90-132

5 DISCUSSION 133-135

6 CONCLUSION 136-137

7 SUMMARY 138-140

8 REFERENCES 141-148

9 BIBLIOGRAPHY 149-151

10 ANNEXURES

1) CLINICAL MASTER CHARTS i-iv

2) LABORATORY REPORTS OF TEST DRUGS v

3) CLINICAL CASE SHEET vi-ix

4) ABOUT SRI BALRAJ MAHARSHI x-xi

5) ABOUT GUIDE xii-xiv

i

LIST OF TABLES

S.No. List of Tables Page no

1 Table.No.1. References of Chincha in Charaka Samhita 8

2 Table.No.2. References of Chincha in Susrutha Samhita 9

3 Table.No.3. References of Chincha in Ashtanga Hridaya 9

4 Table.No.4. References of Chincha in Sarangadhara Samhita 9

5 Table.No.5. Synonyms of Chincha in different Nighantus. 13

6 Table.No.6. Classical Classification of Chincha in Different Ayurvedic

Texts. 13

7 Table.No.7. Properties of Chincha Beeja 14

8 Table.No.8. Yogas of Chincha in different Ayurvedic Texts 16

9 Table.No.9. References of Chincha in Classical Texts 17

10 Table.No.10. Taxonomical Classification of Chincha 19

11 Table.No.11. Vernacular names of Chincha 20

12 Table.No.12. Composition of Tamarind seed, Kernel and Testa(%) 26

13 Table.No.13. Amino acid Content of Tamarind Seed 27

14 Table.No.14. Composition of Tamarind seed oil. 27

15 Table.No.15. Mineral Content of Tamarind. 28

16 Table No.16 Numerical Values of DOSHAGHNATA of SADRASA

67

17 Table no. 17 Dosha kara guna - doshaghna guna ganana sankhya 68

18 Table no: 18 Twenty gunas - guna – doshaghna guna gananasankhya 69

19 Table no: 19 Vipaka – doshaghnata 69

20 Table no: 20 Virya doshaghnata 70

21 Table no: 21 Doshaghnata of chincha bheeja 70

22 Table no.22 Showing the phytochemical analysis results 78

23 Table No. 23 showing sensitivity result 84

24 Table no. 24 Age wise distribution of patients 90

25 Table no. 25 Sex wise distribution of patients 91

26 Table no. 26 Chronicity wise distribution of patients 91

27 Table.no. 27 Gradation of dysphasia in group -1(FP) 92

28 Table No. 28 Statistics of Dysphagia in group -1(FP) 92

ii

29 Table no. 29 Gradation of redness in mucus membrane in group-1(FP) 93

30 Table No.30 Statistics of Redness in Mucus Membrane in group -1(FP) 93

31 Table no. 31 Gradation of temperature in group-1(FP) 94

32 Table No.32 Statistics of body temperature in group -1(FP) 94

33 Table no.33 Gradation of enlargement of tonsils in group-1(FP) 95

34 Table No. 34 Statistics of enlargement of tonsils in group -1(FP) 95

35 Table no.35 Gradation of halitosis (bad breath) in group-1 (FP) 96

36 Table No.36 Statistics of Halitosis in group -1(FP) 96

37 Table no.37 Gradation of pricking pain in group-1(FP) 97

38 Table No.38 Statistics of Pricking Pain in group-1(FP) 97

39 Table no.39 Dysphagia in before and after treatment of group-2 (PDP) 98

40 Table No. 40 Statistics of Dysphagia in Group-2 (PDP) 98

41 Table no.41 Gradation of redness in mucus membrane in group-2 (PDP) 99

42 Table no.42 Statistics of Redness in Mucus Membrane in Group-2 (PDP) 99

43 Table no.43 Gradation of temperature in group-2 (PDP) 100

44 Table No.44 Statistics of Body temperature in Group-2 (PDP) 100

45 Table no. 45 Gradation of enlargement of tonsils in group-2 (PDP) 101

46 Table No. 46 Statistics of Enlargement of Tonsils in Group-2 (PDP) 101

47 Table no. 47 Gradation of halitosis (bad breath) in group-2 (PDP) 102

48 Table No.48 Statistics of Halitosis in Group-2 (PDP) 102

49 Table no.49 Gradation of pricking pain in group-2 (PDP) 103

50 Table No.50 Statistics of Pricking pain in Group-2 (PDP) 103

51 Table no.51 Gradation of dysphagia in group-3 (pp) 104

52 Table No.52 Statistics of Dysphagia in Group-3 (PP) 104

53 Table no.53 Gradation of redness in mucus membrane in group-3 (pp) 105

54 Table No.54 Statistics of Redness in Mucus Membrane in Group-3 (PP) 105

55 Table no.55 Gradation of temperature in group-3 (pp) 106

56 Table No.56 Statistics of Body temperature in group-3 (PP) 106

57 Table no.57 Gradation of enlargement of tonsils in group-3 (pp) 107

58 Table No.58 Statistics of Enlargement of Tonsils in group-3 (PP) 107

59 Table no.59 Gradation of halitosis (bad breath) in group-3 (pp) 108

iii

60 Table No.60 Statistics of Halitosis in group-3 (PP) 108

61 Table no. 61 Gradation of pricking pain in group-3 (PP) 109

62 Table No. 62 Statistics of Pricking Pain in group-3 (PP) 109

63 Table no.63 Gradation of dysphasia in group-4 (PL) 110

64 Table No.64 Statistics of Dysphasia in group-4 (PL) 110

65 Table no.65 Gradation of redness in mucus membrane in group-4 (PL) 111

66 Table No.66 Statistics of Redness of Mucus Membrane in group-4 (PL) 111

67 Table no.67 Gradation of temperature in group-4 (PL) 112

68 Table No.68 Statistics of Body Temperature in group-4 (PL) 112

69 Table no.69 Gradation of enlargement of tonsils in group-4 (PL) 113

70 Table No.70 Statistics of Enlargement of Tonsils in group-4 (PL) 113

71 Table no.71 Gradation of halitosis (bad breath) in group-4 (PL) 114

72 Table No.72 Statistics of Halitosis in group-4 (PL) 114

73 Table no.73 Gradation of pricking pain in group-4 (PL) 115

74 Table No.74 Statistics of Pricking Pain in group-4 (PL) 115

75 Table No.75 Statistical comparison of Group-1(FP) 116

76 Table No.76 Statistical comparison of Group-2 (PDP) 117

77 Table No.77 Statistical comparison of Group-3 (PP) 118

78 Table No. 78 Statistical comparison of Group-4 (PL) 120

79 Table no:79 Overall result of the study according to % of relief 121

80 Table No.80 Inter Group Comparison (Anova Single Factor Result) 122

iv

LIST OF IMAGES

S.No. List of Images Page. No

1. Image No.1 Geographical Distribution of Chincha 19

2. Image No.2 Flowering of Chincha 24

3. Image No. 3 leaves of Chincha 24

4. Image No.4 Fruits of Chincha 25

5. Image No.5 Seed of Chincha 25

6. Image. No.6 Tundikeri resemble Cotton fruit 40

7. Image No.7 Position of Tonsils in Oropharynx 46

8. Image No.8 Primary and Secondary Crypts of Tonsills 46

9. Image No.9 Waldeyer’s Ring 48

10. Image No. 10 Blood Supply to Tonsil 53

11. Image No. 11 showing Tonsillitis 54

12. Image No: 12 digital microscope. 71

13. Image No: 13 20x Image of Chincha beeja 72

14. Image No: 14 20x image of chincha beeja 72

15. Image No: 15 200x image of beeja 73

16. Image No: 16 T.S of Chincha beeja 73

17. Image No: 17 T.S of Chincha Beeja at Endosperm 74

18. Image No. 18 Phytochemical study of FP 79

19. Image No. 19 Phytochemical study of PP 79

20. Image No. 20 Phytochemical study of PDP 79

21. Image No. 21 Preparation of powder (PP) 80

22. Image No. 22 Preparation of powder of dried Paste (PDP) 81

23. Image No. 23 Preparation of fresh paste (FP) 81

24. Image no. 24 Procedure of culture & sensitivity 82

v

25. Figure No: 25 Sensitivity of FP 83

26. Figure No: 26 Sensitivity of PP 83

27. Figure No: 27 Sensitivity of PDP 83

28. Image No. 28 Health checkup camp 86

29. Image No. 29 Health checkup camp 86

30. Image No. 30 Tundikeri salaka (Tonsil Cops). 87

31. Image No. 31 Photos of Before & After Treatment 123

vi

LIST OF GRAPHS

Sl. No. List of Graphs Page. No.

1 Graph No.1 Doshaghnata of chincha bheeja 70

2 Graph No. 2 Age wise distribution of patients 90

3 Graph No. 3 Sex wise distribution of patients 91

4 Graph No. 4 Chronicity wise distribution of patients 91

5 Graph No. 5 Gradation of Dysphagia in group -1(FP) 92

6 Graph No.6 Gradation of Redness in Mucus Membrane in group-

1(FP) 93

7 Graph No. 7 Gradation of Temperature in Group-1(FP) 94

8 Graph No. 8 Gradation of Enlargement of Tonsils in group-1(FP) 95

9 Graph No.9 Halitosis (Bad Breath) in tonsillitis patients 96

10 Graph No.10 Gradation of Pricking Pain in Group-1(FP) 97

11 Graph no.11 Dysphagia in before and after treatment of group-2 (PDP) 98


2 (PDP) 99

13 Graph No.13 Gradation of temperature in group-2 (PDP) 100

14 Graph No.14 Gradation of Enlargement of Tonsils in group-2

(PDP) 101

15 Graph No.15 Gradation of Halitosis (Bad Breath) in Group-2

(PDP) 102

16 Graph No.16 Gradation of Pricking Pain in group-2 (PDP) 103

17 Graph No.17 Gradation of Dysphagia in Group-3 (PP) 104

18 Graph No. 18 Gradation of Redness in Mucus Membrane in

Group-3 (PP) 105

19 Graph No. 19 Gradation of Temperature in Group-3 (PP) 106

20 Graph No.20 Gradation of Enlargement of Tonsils in group-3 (PP) 107

21 Graph No.21 Gradation of Halitosis (Bad Breath) in group-3 (PP) 108

22 Graph No.22 Gradation of Pricking Pain in Group-3 (PP) 109

23 Graph No.23 Gradation of Dysphasia in group-4 (PL) 110


4 (PL) 111

vii

25 Graph No.25 Gradation of temperature in group-4 (PL) 112

26 Graph No.26 Gradation of Enlargement of Tonsils in group-4

(PL) 113

27 Graph No.27 Gradation of Halitosis (Bad Breath) in group-4 (PL) 114

28 Graph No.28 Gradation of Pricking Pain in group-4 (PL) 115

29 Graph No.29 Statistical comparison of Group-1 117



32 Graph No 32 Statistical comparison of Group-4 120

33 Graph No: 33 overall result of the study according to % of relief 121

viii

ABBREVIATIONS

Charaka Samhita Ca.S

Charaka samhita sutram Ca.Su

Charaka samhita chikitsa C.S.Chi

Susrutha samhitha Su.S

Susrutha samhitha uttharam Su.S.U

Susrutha samhitha Nidanam Su.S.Ni

Susrutha samhitha Chikitsa Su.S.Chi

Astanga sangraham A.S

Astanga hridayam A.H

Ashtanga Hridaya chikitsa A.H.Chi

Ashtanga Hridaya uttaram A.H.U

Bhava prakasa B.P

Vrindha madhavam V.M

Bhavaprakasha Nighantu B.P.Ni

Dhanwanthari Nighantu D.N

Madanapala Nighantu M.N

Raja Nighantu R.N

Kaiyadeva Nighantu K.N

Shodala Nighantu S.N

Dravyaguna sangraham D.G.S

Raja vallabha Nighantu R.V.N

Vaidyamanorama V.M

Vrndamadhava V.D

Siddhabhesajamanimala S.B

Yogaratnakara Y.R

Gadanigrha G.N

Vasthuguna Deepika V.G.D

Gudaprayoga G.P

Introduction

A STUDY ON THE GRANTHIGNA EFFECT OF CHINCHA BHEEJA YOGA (Tamarindus indica L.) PAINT

W.S.R TO THUNDIKERI (TONSILLITIS). Page 1

INTRODUCTION

The “Mother Nature” has gifted a comprehensive health care management

through medicinal plants to mankind. Man has understood the importance of plants, as

source for his food, clothes and shelter. Apart from man, even animals are aware of

the medicinal value of the plants and make use of them in their own way. There is

growing interest in various communities and among practitioners of various systems

of medicines to explore the rich heritage of preventive, curative and rehabilitative

potential of medicinal preparation fromnatural sources especially belonging to plants

in origin.

India has a very old and rich tradition of Ayurvedic medicine. For centuries it

has provided very simple but effective remedies to various ailments, by using entire

herbs or individual parts of the plants like fruits, seeds etc, which are available in

village backyards or in nearby forests.

Tundikeri (tonsillitis) is commonly encountered now a day due to the dietary

habits of taking spicy food, cold beverage, refrigerated milk products and cold

climate. Lower socio-economic group people are particularly prone as the immunity

status is low in them. These factors coupled together results in recurrent episodes of

disease. Tundikeri not only cripples children from majority of their enjoyable and

learning movement but also makes adults to feel uneasy, restless and even bed

ridden, if complication occurs.

Tundikeri is that disease caused by the vitiation of Kapha and Rakta. There

is Sthula Shotha (oedema), Toda (pricking type of pain), Daha (burning sensation),

and Prapaki (Suppuration).

In Ayurveda, Tundikeri has been described under the Mukharoga

(orodentaldisordes). AcharyaCharaka has classified the disease of Mukha on the basis

of predominance of Doshas. Acharya Sushruta has enumerated it under Talu gata

roga (diseases of palate) and Acharya Vagbhatta has kept it under Kantha gata roga

(diseases of neck).

Introduction



Acharya Charaka has mentioned medicinal treatment of Mukharoga. Acharya

Sushruta has put forward the chikitsa (treatment) of this particular disease as per the

lines of the disease „Gala shundika‟ followed by local application of drugs having

properties of Lekhana (scraping), Shothahara (anti-inflammatory), Sandhaniya

(reconstruction), Ropana(healing), Raktastambana (blood cloting) and Vedana

Sthapana (analgesic) . He has also enumerated Tundikeri under classification of

Bhedyaroga (Puncturing) in Sutra sthana. Similarly references are available regarding

this disease in a more elaborated manner in Ashtangahridya; particularly its site of

origin and another is of the opinion that the disease Tundikeri occurs at the site of

Hanusandhiashrit KanthaPradesh.

TONSILS

Tonsils are one of the mucosa-associated lymphoid tissues (MALT), located at

the entrance of the upper respiratory and gastrointestinal tract. This significant

position implies a key role of the palatine tonsils in initiating immune responses

against various antigens that enter the body through mouth and nose1. Tonsils contain

both B and T lymphocytes but B cells predominant, implying that both cell mediated

and humoral function is performed by tonsils2. Tonsillar plasma cells produce all five

immunoglobulin classes but predominantly IgG and IgA3. Since the humoral role of

the immune function of the tonsil is its most important one.

A tonsil contains up to 109 lymphoid cells, up to 50% of which are T cells.

Many of these will be involved in the regulation of the antibody response, either

promoting it (helper T cells) or preventing it (suppressor T cells). Other T cells are

responsible for delayed type hypersensitivity reactions to large organisms, such as

fungi. Another type can kill virally infected cells. Recognition in both cases is by the

T cell antigen receptor, which is similar to the antigen combining site of antibody.

Cytokines, such as interferon gamma, are produced by Tonsillar T cells. Natural killer

cells are also present in tonsil, closely opposed to blood vessels these form part of the

innate immune system and can kill virus infected and tumour cells, but their method

of recognizing such cells is as yet unknown. Inflammation of the tonsils Antigens are

continuously present on the crypt epithelium giving rise to lymphocyte activation,

thus a certain amount of inflammation is physiological.

Introduction



Recurrent or chronic inflammation histologically, chronically inflamed tonsils

differ little from 'normal' ones, which have been relatively little studied. There is a

decrease in activated lymphoid cells and immiunoglobulin containing cells4, which

could be primary, or the result of infections. The relative increase in IgD-bearing cells

as noted earlier may be due to bacterial stimulation. Epithelial changes also occur,

with an initial increase in reticulated epithelium to cover the interfollicular areas as

well as the follicles. Later the follicles become covered in squamous epithelium,

which lacks M cells, thus antigen entry is likely to be reduced5.

Tonsillitis occurs when trapped organisms multiply within and on the tonsil.

Such infections are frequently polymicrobial. There are likely to be predisposing

factors to this, including failure of host defence and virulence of the organism itself.

Local production of B-lactamase by other bacteria within the tonsil has been shown to

occur6.

Antibiotics are the main stay in treatment of tonsillitis as far as the allopathic

system of medicine is concerned. They can give temporary relief to the patient but

cannot check the recurrence of the disease. Repeated administration of antibiotics may

lead to many side effects in the patients. If there are indications that the patient might

have to undergo tonsillectomy also with the antecedent rise of post-operative

bleeding and being first barrier to pathogens and site of antibody production, then

their removal put a straight forward attack on our respiratory and gastrointestinal tract

and further more surgical procedure has its own complication also.

Tonsillectomy

The human tonsils are most active in childhood, with some involution after

puberty. However considerable B-cell activity is seen in clinically healthy adult

tonsils, even at 80 years of age. In children, tonsillar disease is one of the common

causes of primary care visit to physicians and the choice of treatment is often

tonsillectomy.

Although tonsillectomy is a common surgical procedure, its possible

immunological sequel has not been fully investigated. The growing understanding in

recent years of the immunological functions of tonsil has led to arguments against

tonsillectomy7. Majority of the children in our country are living below the poverty

Introduction



level. It is assume that they have naturally lowered immunity both cellular and

humoral. As tonsil is an important secondary lymphoid organ, tonsillectomy may

further reduce the immune status. The human body is a holy gift which is given by the

lord. In this body every part have important role. Tonsils are a valuable part of our

defence mechanism against invading germs and viruses. In the process of fighting

towards the germs and microbes the tonsils get inflamed (called tonsillitis) which is

simply a symbol of the local defence mechanism at work. They need to be treated but

not to be unnecessarily removed.

INCIDENCE OF TONSILLECTOMY

Tonsillectomy is the second most common ambulatory surgical procedure

performed on children in the United States.8

In 2006, there were 530 000

tonsillectomies performed in children younger than 15 years, constituting 16% of all

ambulatory surgery in this age group. The only procedure with greater frequency was

myringotomy with insertion of tube, for which 667 000 procedures were reported the

same year. Between 1915 and the 1960s, tonsillectomy was the most frequently

performed surgical procedure in the United States. Data in 1993 from the National

Hospital Discharge Survey, however, noted a decrease of more than 50% in inpatient

tonsillectomy rates from 1977 to 1989.9

The indications for, and the therapeutic effects of, tonsillectomy for recurrent

infections remain the subject of debate. There is no evidence for benefit from the

operation in preventing the recurrence of streptococcal hypersensitivity disorders

HARMS AND ADVERSE EVENTS OF TONSILLECTOMY

Tonsillectomy is a surgical procedure with an associated morbidity that

includes possible hospitalization, risks of anaesthesia, prolonged throat pain, and

financial costs. A common complication of tonsillectomy is bleeding during or after

the surgery. In published reports, the rate of primary hemorrhage (within 24 hours of

surgery) has ranged from 0.2% to 2.2% and the rate of secondary hemorrhage (more

than 24 hours after surgery) from 0.1% to 3%.10

Hemorrhage after tonsillectomy may

result in readmission for observation or in further surgery to control bleeding.

Introduction



Other complications of tonsillectomy are diverse and have been well

described.11

Operative complications include trauma to the teeth, larynx, pharyngeal

wall, or soft palate; difficult intubation; laryngospasm; laryngeal edema; aspiration;

respiratory compromise; endotracheal tube ignition; and cardiac arrest. Injury to

nearby structures has been reported, including lip burn, eye injury, and fracture of the

mandibular condyle. Postoperative complications include nausea, vomiting, pain,

dehydration, referred otalgia, post obstructive pulmonaryedema, velopharyngeal

insufficiency, and nasopharyngeal stenosis. In addition to these common causes of

morbidity, many unusual and rare complications of tonsillectomy have also been

described.12

Among these are reports of vascular injury, subcutaneous emphysema,

jugular vein thrombosis, atlantoaxial subluxation (Grisel syndrome), taste disorders

(hypogeusia, ageusia, dysgeusia, and phantogeusia), and persistent neck pain (Eagle

syndrome).

Mortality rates for tonsillectomy have been estimated at between 1 in 16 000

to 1 in 35 000, based on data from the 1970s.13

There are no current estimates of

tonsillectomy mortality, but a prospective audit reported only 1 postoperative death

after 33 921 procedures in England and Northern Ireland.14

About one-third of deaths

are attributable to bleeding, while the remainder are related to aspiration,

cardiopulmonary failure, electrolyte imbalance, or anesthetic complications.10,15

Similarly, airway compromise is the major cause of death or major injury in

malpractice claims after tonsillectomy.16

Ayurveda-the science of life-though has its own principles, is incorporating

new theories and drugs in it and presenting them according to its principles. Medicinal

plants play an important role as a main source of treatment since thousands of years.

In the era of evidence based medicine and IT revolution 21st century witnessed an up

gradation of Ayurveda medicine as an ultimate solution to the numerous unanswered

puzzles in medical field.

Acharyas have mentioned number of single and compound drugs to treat

Tundikeri most of them developed by practice. Chincha beeja is one among

renowned Ayurvedic herbal drugs which is believed to be effective in tonsillitis

(Tundikeri). Late Sri Balaraj Maharshi has suggested a single herb treatment.

Introduction



AIMS & OBJECTIVES:

To study the efficacy of chincha beeja yoga lepa in Tonsillitis.

To develop a safe single drug for management of Tonsillitis.

To find out economical therapy for Tonsillitis without side effects.

To prevent complications and future surgical intervention.

PLAN OF ACTION:

Purchased good quality chincha beeja from Tirupati market.

The Pharmacognostic identification conducted in Dravyaguna lab.

For the clinical study selected at random 40 cases from OPD of P.G

department of Dravyaguna S.V Ayurvedic Hospital, Tirupati and some local

schools

For the clinical study the patients are selected at random and divided as per

groups according to the drug regime as follows.

1. made in to fine seed powder in machine .this has given to one group

2. Seed rubbed against the rough surface then made in to paste, allow to dry

made in to fine powder. This has given to one group

3. Seed rubbed against rough surface and made into paste and then applied

to One Group

Result collected, assessed and compared on the basis of parameters.

Drug Review



DRUG REVIEW

Etymological derivation of the word ―DRUG‖ is from the French word

―DROGUE‖. It may be defined as ―any substance which when taken by a living

organism may modify one or more functions‖. Acharya Charka has asserted that each

substance on this earth is useful in combating illness when applied with apt planning

and for a specific purpose.17

Ayurveda describes four basic factors, which are most essential for advocating

proper treatment. Among these, Aushadha (Bhaishaja) is graded at the second rank,

which is the main source of therapeutics.18

CLASSICAL REVIEW OF CHINCHA (Tamarindus indica, Linn.)

HISTORICAL BACKGROUND

From medical history one can know about recognition of the continuity of

medical thoughts. It tells us about the conceptions and misconceptions of the past

from which one can draw inferences for the present and future times. History of any

drug gives insight into its, morphology, properties and therapeutic or dietary utility as

conceived by various authors at different stages of the history.

The movement of tamarind to Asia must have taken place in the first millenium BC.

Cultivation of tamarind in Egypt by 400BC has been documented and it was

mentioned in the Indian Brahmasamhita Scriptures between 1200-200 BC. About

370-287 BC Theophrastus wrote on plants and two descriptions refer to tamarind,

Drug Review



even though not named as such (Hort, 1916); his sources were probably from East

Africa.

Renowned as Nammalwar (―Our Saint‖) among the Vaishnavas, and the greatest of

their saints and poets, was born in a small town called Kuruhur in the southern most

region of the Tamil country – Tiru – nel –veli (Tinnelvelly). He has sat in hallow of

tamarind tree doing tapas many years.many families of devotice the bark of the tree

take as a prasada.

Samhita period (up to 7th A.D)

Charaka Samhita:

The Charaka Samhita is the oldest of the three and was probably first

compiled around 1500 BC. It is considered the prime work on the basic concepts of

Ayurveda. Charaka represents the Atreya School of physicians. It is a systematic

work divided into eight Sthanas or sections, which are further divided into 120

chapters.

Table.No.1. References of Chincha in Charaka Samhita

Sr. No References Used as

1. Su.23.38 Mantha preparation for Madhya

vikara

2. Su.27.151 Phala varga

3. Su.27.121\122 Grahani hara yoga

4. vi.8.140 Amla rasa dravyas

5. Chi.14.123 Ahara for arshas rogi

6. Chi.14.200 Peya preparation

Susrutha samhita:

Sushruta represents the Dhanwantri School of surgeons, and is considered in

Ayurveda to be the father of surgery. Even a great American society of surgeons is

named after Sushruta. In the Sushruta Samhita there are sophisticated descriptions of

diseases and surgical instruments.

Drug Review



Table.No.2. References of Chincha in Susrutha Samhita

S.No References Used as

1. Su.46.136 Phala varga

2. Su.46.155/157 Properties of chinca

3. Chi.5.23 Karna purana in karna sula

4. Chi.5.27 Preparation of hingwastaka gutika

Astanga Hridayam:

The next important authority in Ayurveda after Charaka and Sushruta is

Vagbhatta, who flourished about the seventh century AD. His treatise called Ashtanga

Hridayam.

Table.No.3. References of Chincha in Ashtanga Hridaya

S.No References Used as

1. AH.Su.10.25/26 Amla gana

2. AH.Su.6.139 Properties of Chincha

3. AH.Chi.8.80 Ahara for Arshas rogi

Sarangadhara Samhita:

Table.No.4. References of Chincha in Sarangadhara Samhita

S.No References Used as an ingredient

1. Sa.S.7.22 Vyoshadi Gutika

2. Sa.S.6.54 Kapittastaka Churnam

3. Sa.S.6.76 Maha Kandava Churna

4. Sa.S.6.100 Lavanatrithayadhyam churnam

5. Sa.S.6.126 Yava khandava churnam

6. Sa.S.6.120 Hingwastaka churnam

7. Sa.S.11.38 Naga Bhasma (agent in processing)

8. Sa.S.11.40 Vanga Bhasma (agent in processing)

NIGHANTU KALAM (8th

– 17th

cent. A.D)

Detailed review has been taken from the Nighantus right from Dhanvantari

Nighantu up to the Priya Nighantu. Chincha has been described as follows-

Dhanvantari Nighantu: (10th – 12th Cent. A.D.)19

In the beginning of Nighantu, author pays homage to lord Dhanawantari and

again he mentions its name as Dravyavali. At the end of Dravyavali author desires to

Drug Review



describe the drugs of Dravyavali with their synonyms and after that he has described

their properties and actions along with synonyms. Here Synonyms & Gunas of

Chincha are described in Amradi varga.

Sodhala Nighantu: (12th Cent. A.D.)20

This nighantu was composed by Sodhala in two parts named as

―Namasangraha‖ dealing with synonyms and ―Gunasangraha‖, dealing with

properties and actions in Namasangraha. Sodhala has mentioned Chincha in

Amradivarga where synonyms mentioned. In Gunasangrah it is described It is

indicated in Trishna, Hikka, Klama, Chardhi and Srama.

Madanpala Nighatuu: (14th Cent. A.D.)21

Chincha has been mentioned in ―Phaladi varga‖. Madanapala has included

following synonyms of Chincha are Cukrika, Tintidi and Sukticandrika. Regarding its

properties it has been said about Ama phala, Pakva phala and Suska phala. It is

indicated in Srama, Branthi, Trishna and Klama.

Kaiyadev Nighantu: (Pathyapathya Vibodhaka) (15th Cent. A.D.)22

In this Nighantu ‗Chincha‘ is described in ―Aushadhi Varga‖ with following

synonyms i.e. Amlika, Suktha, Amla, Chukra, Chukrika, Thinthidi along with three

new synonyms ie. Chanda, Sthambanika, and Thinthini. Regarding its properties it

has been said as Amla in rasa, ushna in virya. Here ‗Chincha‘ has been mentioned for

various disorders such as Trushna, Klama, Srama, and Vata nasaka.

Bhavaprakasa Nighantu: (16th Cent. A.D.)23

This book is written by Bhavamishra who is an important landmark in the

history of Indian Medicine. He stands at the junction of the medieval and modern

periods which is the turning point for its future course and also because of the fact that

he revived the style of samhitas and contributed a good deal too various aspects of

Ayurveda by adding new ideas and drugs. Chincha has been mentioned in Amradi

phala varga and following synonyms are found in this Nighantu- Chukrika,

Amli,Chukra,Dantasata,Amla,Hinchaka,Tintidika and Tintidi. Ama phala possesses

Amla rasa, Guru Guna,Vata nasaka,Pitta Kapha Rakta vikara karaka. Pakva phala

possesses Agni Dipaka, Ruksha,Sara Gunas,Kapha Vata nasaka.

Drug Review



Raja Nighantu: (Nighantu Raja, Abhidhana Chudamani) (17th Cent. A.D.)24

This book is written by Narhari Pandit, who has given first place to

Dravyaguna in Astanga Ayurveda. This book is particularly based on the

Dhanwantari nighantu. The subject matter has been devided into 23 chapters.

Chincha is included in ―Amradi varga‖.he described Ama Phala, Pakva phala, Patra

and Kshara gunas and karmas .

Shaligrama Nighantu: (19th Cent A.D.)25

Acharya Shaligra m Vaidhya has followed the information from

Bhavprakash, Raja and Shodalanighantu and has mentioned ‗chincha‘ in ―Phala

Varga‖ with following synonyms i.e. Amlika , Chukrika, Amli, Chukra, Dantasata,

Amla, Chincka, Tintidi and Tinthidika along with guna karmas of Chincha phala,

Patra and Pushpa.

Nighantu Adarsha: (20th Cent. A.D.)26

Bapalalji has mentioned Chincha under Puthikaranjadi varga. He has

mentioned its properties as Madhura-amla Rasa, Ushna virya and Amla Vipaka with

Vatahara activity. Patra , Puspa, Bheej, Phala, Kshara of Chincha are described as

the useful parts.

Priya Nighantu: (20th Cent. A.D.)27

Acharya Priyavrat sharma has described Chincha in Haritakyadivarga of this

nighantu. With following synonyms i.e. Amlika, Chukrika, Chincka, Tintidi and

Tinthidika along with new synonym i.e Vakra phala Chincha is Amla in rasa, Ushna

in virya and Dipana , Anulomana karmas.

ADHUNIKA KALA (After 19th

A.D)

THE AYURVEDIC PHARMACOPIA OF INDIA

In this book botanical source, synonyms, macroscopic and microscopic

description, some parameters to judge the identity, purity and strength has been given.

Also its constituents, properties and action, important formulations, therapeutic uses

and dose have been mentioned.

FLORA OF BRITISH INDIA: VOL. 2 BY J. D. HOOKER

This seems to be oldest book describing the plant. A detail botanical description and

Drug Review



3 diffrinderent species of TAMARINDUS genus are mentioned.

1. 1.Tamarindus indica, Linn.

2. 2.Tamarindus occidentalis, Gaertn.

3. 3.Tamarindus officinalis, Hook.

HANDBOOK OF MEDICINAL HERBS

The therapeutic actions, indications and contra indications of Chincha have

been mentioned in this text.

INDIAN MEDICINAL PLANTS- Dr. KIRTHIKAR BASU

The text throws light upon detail morphological characters and therapeutic

actions of Chincha.

CLASSICAL USES OF MEDICINAL PLANTS (DR. P.V. SHARMA)

The therapeutic actions of Chincha according to various classical references

have been mentioned in this text.

GLOSSARY OF INDIAN MEDICINAL PLANTS (CHOPRA & VOYAR )

In this text, detail information of chemical constituents of chincha is given.

WEALTH OF INDIA

The macroscopic and importent uses of chincha as well as controversies have

been described in this.

DR.K.M NADIKARNI‘S INDIAN METERIA MEDIKA

The text describes Chincha in detail. The vernacular names, Chemical

constituents, therapeutic action etc, are mentioned.

VASTUGUNA DIPIKA

In this text, detail information of chincha bheeja also mentioned the seed is

indicated in krimi,grahani,raktatisara,sukra nasta. It is used as Gandha form or lehya

form.

Drug Review



SYNONYMS OF CHINCHA

Table.No.5. Synonyms of Chincha in different Nighantus.

Synonyms

D.N

10-

12ce

nt.A.

D

S.N

12

cent.

A.D

M.P.

N

14

cent.

A.D

K.D.N

15

cent.A.

D

B.P.N

16

cent.A

.D

R.N

17

centA.

D

S.G.N

19

cent.A

.D

A.D.N

20cent

.A.D

P.N

20cent

. A.D.

Amla + + + + +

Amla

Chukrika

+

Amli + + +

Amlika + + + + + + + +

Chukra + + + + + +

Chukrika + + + + + + +

Chincha + + + + + + + + +

Chinchi +

Chinchaka + + + +

Chanda +

Danthasata + +

Saka

Chukrika

+

Sukta + + +

Sukti

Chandrika

+

CLASSICAL CLASSIFICATION OF CHINCHA IN VARIOUS BOOKS

Table.No.6. Classical Classification of Chincha in Different Ayurvedic Texts.

S.NO REFERENCE VARGA

1 Caraka Phala varga

2 Susruta Phala varga

3 Astanga hridayam Amla gana

4 Dhanvantari nighantu Amradi varga

5 Madanapala nighantu Phaladi varga

6 Raja nighantu Amradi varga

7 Saligrama nighantu Phala varga

8 Kaiyadevara nighantu Aushadhi varga

9 Priya nighantu Harithakyadi varga

10 Sodhala nighantu Amradi varga

11 Bhavaprakash nighantu Amradi phala varga

12 Nighantu adarsha Putikaranjadi varga

Drug Review



PROPERTIES OF CHINCHA BHEEJA:

Table.No.7. Properties of Chincha Beeja

Rasa Kasaya

Reference

Vasthuguna Dipika28

Guna Not mentioned

Vipaka Not mentioned

Virya Not mentioned

Doshaghnata Kapha hara

Karma Sukra sthambaka

Rakta sthambaka

Upayukta Vyadhi Krimi roga,

Grahani,

Sukra nasta,

Raktatisara,

Rakta pradaram

PHARMACO THERAPEUTIC APPLICATIONS (Amayika Prayogas)

1.Gudha Bramsha: Fried amlika seeds are rubbed with water and pasted on anus

after setting the tract in position. By this it does not prolapse again. (S.B.4.919)

2.Somaroga: The seeds of amlika are soaked with water the previous day and then

pounded with milk. This past, if taken regularly, alleviates somaroga. (VD.2.13)

3.Rakta arshas: burn the seeds of chincha and make bhasma give in 1-2 masha with

curd. (G.P.113)

4.Amaatisara:

(a) Remove the outer covering of ripened chincha seed, white jeeraka and mishri

each 6 masha. Make a churna of all make a dose in 3 parts and give at every 3 hour

interval with honey. This will cure old disease also. G.P.109 (a))

(b)Root of chincha old tree and black pepper in equal quantity make a tab of mater

size give it with takra 1-1 tab three times a day cures new ama in 2 days and old ama

atisara in 20 days. (G.P.109 (b))

5.Sweta pradara ( in other pradara also): Dip seeds in water and next day remove

cover of seed make a paste of 4 seeds give with mishri it will cures sweeta pradara.

(G.P.110)

Drug Review



6.Jwara: if daha and palpitations is there seeds of chincha and kharjura 2-2 tola in

sera milk in low flame boil it , sieve it and give to patient but on that day don‘t give

any other thing to patient give this medicine only. (G.P.111)

7.Kanta sotha: 6 masha of chincha in 2 sera of jala boil and reduce to half then add 2

tola of rose water, sieve it and gargle with this it will cure kanta sotha. (G.P.112)

8.Athisara: Covering of Amlika seeds, Sunthi, Rock salt and Yavni are mixed

together and taken with fresh buttermilk it checks Athisara quickly (VD.6.5)

9.Masurika: Haridra and Amlika leaves taken with cold water prevents Masurika

(CD.54.9)

10.Sarpa Visha: Leaf juice of amlika 160ml mixed with salt 20gm is taken in Snake-

poison. (VD.19.32)

11.Netra roga: The juice of Amlika leaves mixed with milk is rubbed in a vessel and

then applied to the eye lids. It allays redness, secration,pain and congestion.

(VD.16.23)

12.Raktarsas: The paste of the tender leaves of amlika is mixed with water strained

and added with salt. It is useful in bleeding piles. (SB.4.226)

13.Abhighataja vrana: Swelling caused by accidental injury subsides by application

of leaf juice of Amlika. (B.P. Ci.48.19)

14.Asthi bhagna: Fruit pulp of Amlika is finely pressed and mixed with lime. This is

applied to the site of injury followed by fomentation. (SB.4.705)

15.Karnasula: Oil processed with juice of amlika fruit is efficacious. (VD.16.61)

16.Mandala kusta: Local application of the juice of amlika leaves cures ring worm.

(VD.11.62)

Drug Review



YOGAS MENTIONED IN VARIOUS BOOKS

Table.No.8. Yogas of Chincha in different Ayurvedic Texts

NAME OF YOGA PART

USED

INDICATION REFERENCE

Chinchadi tailam Patra Sarvanga vata S.Y taila prakarana 6

Chinchadi lehyam Phala Pandu

Kamala

Amlapitta

Vata rogas

S.Y lehya prakarana 9

Tintrini swarasadi

tailam

Patra Vata rogas S.Y taila prakarana 33

Chincha patradi yogam Patra Sheetala R.M.30.3

Chincha sanka vati _ Grahani

Visuchika

Gulma

Ajeerna

V.Chi.Gulmaroga

prakaranam 89-94

Hingwadi gutika Phala Vata rogas

Udara roga

Tuni

Prati tuni

S.Chi.5.27

Vyoshadi Gutika Phala Peenasa Sa.S.7.22

Kapittastaka Churnam Phala Grahi Sa.S.6.54

Maha Kandava Churna Phala Aruchi Sa.S.6.76

Lavanatrithayadhyam

churnam

Phala Yakrit , Pliha Gulma Sa.S.6.100

Yava khandava churnam Phala Arochaka Sa.S.6.126

Hingwastaka churnam Phala Sula Sa.S.6.120

Changeri Gritam Phala Raktarsas

Raktagulma

Bh.S.Chi.16.43

Satavari gritam Kasa,Jwara,Anaha,

Mala bandha,

Udarasula, Raktapitta

C.D.9.42

Shankha vati Kshara Sula

Visuchika

Ba.Ra.12

Mrita sanjeevani ras Seed Grahani

Atisara

Ba.Ra.10

Agni mukha ras Kshara Ajeerna , Sula

Gulma

Ba.Ra.12

Kshara tamra ras Kshara Sarva sula V.Chi.sulaprakaranam.7

5

Sanka vatakam Kshara Sula, Grahani

Atisara

V.Chi.Sulaprakaranam.1

19

Drug Review



S.NO

NAME

DOSAGE

/ FORM

FORMULATI

ON/VARGA /

GANA

PART

USED

DISEASES

REFERENCES

1 Amlika Mantha _ Phala Madhya vikara C.Su.23.38

2 Amlika _ _ Mula Grahani, Arshas,

Madhatyaya

C.Su.27.121/122

3 Amlika _ Phala varga Pakva

phala

_ C.Su.27.151

4 Amlika Vasthi _

Patra Vata disorders C.Vi.8.140

5 Amlika Ahara _

_ Arshas C.Chi.14.123

6 Amlika Peya _ Phala Raktatisara Sula

Pravahika Sotha

C.Chi.14.200

7 Amlika

_

Phala varga _ _ S.Su.46.136

8 Tintidika _ _ Ama

phala

_ S.Su.46.155/157

9 Tintidika Karna

purana

_ Phala Karna sula

Vatika rogas

S.Chi.5.23

10 Tintidika Gutika Hingwadi

gutika

Phala Vata rogas

Udara roga

Tuni

Prati tuni

S.Chi.5.27

11 Amlika _

Amla gana _ _ AH.Su.10.25/26

12 Amlika _ _ Phala Trishna

Srama

Klama

Chardhi

AH.Su.6.139

13 Amlika Ahara _

Phala Arsas AH.Chi.8.80

14 Tintidika Gutika Vyoshadi

Gutika

Phala Peenasa Sa.S.7.22

15 Tintidika Churnam Kapittastaka

Churnam

Phala Grahi Sa.S.6.54

16 Tintidika Churnam Maha Kandava

Churna

Phala Aruchi Sa.S.6.76

17 Tintidika Churnam Lavanatrithaya

dhyam

churnam

Phala Yakrit, Pliha Gulma Sa.S.6.100

18 Tintidika Churnam Yava khandava

churnam

Phala Arochaka Sa.S.6.126

19 Tintidika Churnam Hingwastaka

churnam

Phala Sula Sa.S.6.120

20 Chincha _ Naga Bhasma Twak

Churna

_ Sa.S.11.38

21 Cincha _ Vanga Bhasma Twak

Churna

_ Sa.S.11.40

22 Amlika Gritam Changeri

Gritam

Phala Raktarsas

Raktagulma

Bh.S.Chi.16.43

Table No:9 References of chincha in classical text

Drug Review



23 Tintidi Samsweda

nam

_ Patra Sotha H.S.Chi.16

24 Chincha _

_ Phala Nadivrana G.N.6.16

25 Tinthidi Lepam _ Seeds Gatra

dhaurghandhyam

G.N.31.37

26 Chincha _ Chincha patradi

yogam

Patra Sheetala R.M.30.3

27 Amlika Kavala

dharanam

_ _ Arochaka C.D.14.10

28 Chincha _ _ _ Masurika C.D.54.9

29 Chincha Yusha _ Patra Kaphaja pratisyaya C.D.58.20

30 Tintidika 3-4

masha,/

Gritam

Satavari gritam _ Kasa, Jwara

Anaha, Mala

bandha, Udara sula

Raktapitta

C.D.9.42

31 Amlika 2pala Kshara vasthi Phala Sula, Vibhandha

Udhavartha, Krimi

Gulma

C.D.72.30

32 Amlaki 4 Tula Vaitharana

vasthi

Phala Sula

Anaha

Amavata

C.D.72.32

33 Chincha Seed Bahumutrata Ba.Ra .9

34 Chincha Vati Shankha vati Kshara Sula, Visuchika Ba.Ra.12

35 Chincha _ Mrita

sanjeevani ras

Seed Grahani

Atisara

Ba.Ra.10

36 Chincha _ Agni mukha ras Kshara Ajeerna, Sula

Gulma

Ba.Ra.12

37 Tintrini _ Kshara tamra

ras

Kshara Sarva sula V.Chi.sulaprakaran

am.75

38 Chincha _ Sanka vatakam Kshara Sula

Grahani

Atisara

V.Chi.Sulaprakara

nam.119

39 Chincha _ Chincha sanka

vati

_ Grahani, Visuchika

Gulma, Ajeerna

V.Chi.Gulmaroga

prakaranam 89-94

40 Chincha 1/16 part Parada

niyamana

Leaf _

R.H.T. 2.10

41 Chincha _ Phala rasa Phala Ghosha

loha(Kanchu)

vikara

A.M. Upa Dhatu

vikarasanthi

prakaranam

42 Amla _ _ Phala Gunja bakshana

vikara

A.M.Sthavara

visha santhi

prakarana 15

43 Chincha Lepam _ Patram Snuhi ksheera

vishaktata Arka

ksheera vishaktata

A.M.Sthavara

visha santhi

prakarana.20

Drug Review



MODERN REVIEW OF CHINCHA

Taxonomical classification

Table.No.10. Taxonomical Classification of Chincha

Kingdom Plantae

Phylum Spermatophyte

Class Angiosperm

Sub class Dicotyledone

Family Leguminosae

Subfamily Caesalpiniaceae

Genus Tamarindus

Species Indica

Geographical Distribution29

Imege No.1 Geographical Distribution of Chincha

The geographical distribution of tamarind has been documented by Salim et al. (1998)

as follows:

Native: Burkina Faso, Cameroon, Central African Republic, Chad, Ethiopia, Gambia,

Guinea, Guinea-Bissau, Kenya, Madagascar, Mali, Niger, Nigeria, Senegal, Sudan,

Tanzania, Uganda, Cape Verde.

Exotic: Afghanistan, Australia, Bangladesh, Brazil, Brunei, Cambodia, China,

Colombia, Côte d‘ Ivoire, Cuba, Dominican Republic, Egypt, Ghana, Greater and

Lesser Antilles, Haiti, Hawaii, Honduras, India, Indonesia, Iran, Jamaica, Laos,

Drug Review



Liberia, Malaysia, Mauritania, Mexico, Myanmar, Nicaragua, Pakistan, Papua New

Guinea, Philippines, Puerto Rico, Sri Lanka, Thailand, Trinidad, Tobago, Togo,

United States of America, Vietnam, Zambia.

THE LOCAL NAMES USED IN VARIOUS REGIONS AND LANGUAGES30

.

(Vernacular names)

Table.No.11. Vernacular names of Chincha

Country Language Names

Africa

Bemba Mushishi

Fula dabe, jammeth, jammi

Jola Budahar

Mandinka

timbimb, timbingo, tombi,

tomi

Tigrina Humer

Wolof

daharg, dakah, dakhar,

nclakhar

Ethiopia

Amharic

hemor, homor, humar,

komar, tommar

Tigrina Arabeb

Gamo/Oromo b/roka, racahu, dereho,

dindie, ghroma,

gianko, omar

Kenya Swahili Mkwaju

Masai ol-masamburai

Turkana Eopduran

Borana Roka

Luo chwa. Waa

Meru Muthithi

Pökot Oran

Malawi Chewa ukwaju, bwemba

Yao Mkwesu

Nkande Nkewesu

Nigeria Tsamiya

Somalia Somali Hamar

South Africa Afrikaans Tamarinde

Sudan Arabic aradeib, tamarihindi

Nuba shekere, kuashi, danufi

Tanzania Swahili Ukwaju

Uganda Teso esukuru, esuguguru (leaves)

Teso/Karamojong e/apedura (fruit)

Bari/Ma‘di Iti

Acholi/Lango chwa/o

Kakwa/Acholi Pitei

Luganda Mukoge

Zambia Bemba Mushishi

Nyanja Mwemba

Tonga Musika

Asia

Drug Review



Cambodia Khmer ‗am‘ pul, ampil, khoua me

China Sino-Tibetan khaam, mak kham

India Hindi ambli, amli, imli

Sanskrit Amalika

Bengali tintiri, tintul, tetul

Marathi chinch, chitz, amli

Kannada hunase, unsi, hulimara

Coorg Pulinje

Uriya koya, tentuli

Gondi chita, hitta, sitta

Telegu Chinta

Tamil puli, pulian

Assamese Tetili

Gujarati amali, ambali

Indonesia

asam jawa, assam,

tambaring

Malaysia asam jawa

Myanmar

magyi, magyee majee-

pen

Nepal Nepali ttri, imli

Newari titis, paun

Philippines Tagalog Sampalok

Bisaya Kalamagi

Ilokano Salomagi

Sri Lanka Sinhala

siyambala, maha

siyambala

Tamil Puli

Thailand General Makham

Northern Bakham

Peninsular Somkham

Vietnam me, trai me

Elsewhere

Virgin Tanan

Islands

Arabic Ardeib

Creole Tamarenn

Dutch Tamarinde

English

Madeira mahogany,

tamarind, Indian Date

French

tamarin, tamarainer,

tamarindier

German Tamarinde

Italian Tamarindizio

Portuguese Tamarindo

Spanish tamarin, tamarindo

Source: Coronel (1991); Salim et al. (1998)

Drug Review



MORPHOLOGY:

Habit:

Tamarind is a long-lived, large, evergreen or semi-evergreen tree, 20-30 m tall

with a thick trunk up to 1.5-2 m across and up to 8 m in circumference. The trunk

forks at about 1 m above ground and is often multi-stemmed with branches widely

spreading, drooping at the ends and often crooked but forming a spreading, rounded

crown.

Leaves

Leaves are alternate and even pinnate, in length (5-)7-12(-15) cm, shortly

petiolated (up to 1.5 cm long) and petiole glabrous or puberulent as is the leaf rachis

(Fig. 1.1). Laminae are glabrous or puberulent, glaucous underneath and darker green

above. Venation is reticulate and the midrib of each leaflet is conspicuous above and

below. Leaflets are in (6-)10-18(-20) pairs / leaf, each narrowly oblong, rounded at

the apex and slightly notched and asymmetric with a tuft of yellow hairs; at the base

obliquely obtuse or subtruncate. At the leaf base is a pulvinus and two small stipules

0.5-1.0 cm long which are caducous early on; stipules are falcate, acuminate and

pubescent. A permanent scar is seen after leaf fall. Leaflets fold after dark due to the

presence of lupeol synthesised when light and degraded in the dark (Ali et al., 1998).

Flowers

Flowers are borne in lax racemes which are few to several flowered (up to 18),

borne at the ends of branches and are shorter than the leaves, the lateral flowers are

drooping Flowers are irregular 1.5 cm long and 2-2.5 cm in diameter each with a

pedicel about (5-)6(-10) mm long, nodose and jointed at the apex. Bracts are ovate-

oblong, and early caducous, each bract almost as long as the flower bud. There are 2

bracteoles, boat shaped, 8 mm long and reddish. The calyx is (8-)10(-15) mm long

with a narrow tube (turbinate) and 4 sepals, unequal, ovate, imbricate, membranous

and coloured cream, pale yellow or pink. Corolla of 5 petals, the 2 anterior reduced to

bristles hidden at the base of the staminal tube. The 3 upper ones are a little longer

than the sepals, 1 posterior and 2 lateral, these 3 obovate to oblong, imbricate,

coloured pale yellow, cream, pink or white, streaked with red. Flowers are bisexual. The

colour of the flowers is the same on each tree; they are not mixed. Stamens are 3(-5)

fertile and 4 minute sterile ones. Filaments of fertile stamens are connate and alternate

with 6 brittle-like staminodes. Stamens are united below into a sheath open on the upper

Drug Review



side and inserted on the anterior part of the mouth of the calyx tube. Anthers are

transverse, reddish brown and dehisce longitudinally. The ovary is superior with few to

many (up to 18) ovules. The ovary is borne on a sheath adnate to the posterior part of the

calyx tube. It is stipitate, curving upwards and is green with a long hooked style with a

terminal subcapitate stigma. Flowers are protogynousentomophilous and largely cross-

pollinated. Flowers are nectiferous, nectar being produced by hairs at the ovary base

(Thimaraju et al., 1977; Tucker; 2000). Some self-pollination also occurs (Coronel 1991).

Fruits and seeds

The fruits are pods 5-10(-16) cm long x 2 cm broad, oblong, curved or

straight, with rounded ends, somewhat compressed and indehiscent although brittle .

The pod has an outer epicarp which is light grey or brown and scaly. Within is the

firm but soft pulp which is thick and blackish brown. The pulp is traversed by formed

seed cavities, which contain the seeds. The outer surface of the pulp has three tough

branched fibres from the base to the apex . Each pod contains 1-12 seeds which are

flattened, glossy, orbicular to rhomboid, each 3-10 x 1.3 cm and the centre of each flat

side of the seed marked with a large central depression. Seeds are hard, red to purple

brown, non arillate and exalbuminous. Seed chambers are lined with a parchmentlike

membrane. Cotyledons are thick. Seed size is very variable and there are (320-)700(-

1000) per kilo (von Carlowitz, 1986; Hong et al., 1996; El-Siddig et al., 2000). Pods

ripen about 10 months after flowering and can remain on the tree until the next

flowering period, unless harvested (Rana Rao, 1975; Chaturvedi, 1985).

Stem:

The bark is brownish-grey, rough and scaly. Young twigs are slender and

puberulent. A dark red gum exudes from the trunk and branches when they are

damaged.

Root

Tamarind produces a deep tap root and an extensive lateral root system, but

the tap root may be stunted in badly drained or compacted soils. The tap root is

flexuous and lateral roots are produced from the main root at different levels.

Drug Review



Image No.2 Flowering of Chincha

Imege No. 3 leaves of Chincha

Drug Review



Image No.4 Fruits of Chincha

Imege No.5 Seed of Chincha

Drug Review



COMPOSITION OF TAMARIND SEED

The seed comprises the seed coat or testa (20-30%) and the kernel or

endosperm (70-75%) Whole tamarind seed and kernels are rich in protein (13-20%),

and the seed coat is rich in fibre (20%) and tannins (20%)

COMPOSITION OF TAMARIND SEED, KERNEL AND TESTA (%)31,32,33,34

Table.No.12. Composition of Tamarind seed, Kernel and Testa(%)

Constituent Whole seed Seed

kernel(cotyledons) Testa(seed coat)

Moisture 9.4-11.3 11.4-22.7 11.0

Protein 13.3-26.9 15.0-20.9

Fat/oil 4.5-16.2 3.9-16.2

Crude fibre 7.4-8.8 2.5-8.2 21.6

Carbohydrates 50.0-57.0 65.1-72.2

Total Ash 1.60-4.2 2.4-4.2 7.4

Nitrogen-free

extract 59.0

Yield of TKP 50.0-60.0

Calories/100g 340.3

Total sugar 11.3-25.3

Reducing sugars 7.4

Starch 33.1

Tannin 20.2

Source: Anon (1976), Morad et al. (1978); Ishola et al. (1990); Bhattacharyya

et al. (1994).

AMINO ACID CONTENT OF TAMARIND, mg/g N (TOTAL N)35,36

There are 20 amino acids present in the human body. 9 Essential Amino acids

and 11 Non-Essential Amino acids.Chincha beeja contain 8 Essential amino acids and

9 Non-Essential amino acids.

Drug Review



Table.No.13. Amino acid Content of Tamarind Seed

Amino Acid Tamarind

Isoleucine 313

Leucine 531

Lycine 475

Methionine 113

Cystine 106

Phenylalanin 318

Tyrosine 287

Threonine 200

Tryptophan 67

Valine 306

Arginine 450

Histidine 143

Alanine 312

Aspartic 768

Glutamic 1056

Glycine 331

Proline 287

Serine 350

Source: FAO (1970); de Lumen et al. (1986, 1990).

Seed Kernel Oil: The seed oil is a golden yellow, semi-drying oil, which in some

respects resembles groundnut oil. extracted the oil with hexane and a mixture of

chloroform and methanol.

FATTY ACID COMPOSITION OF TAMARIND SEED OIL37

Table.No.14. Composition of Tamarind seed oil.

Fatty acids Percentage

Palmitic 14-20

Stearic 6-7

Oleic 15-27

Linoleic 36-49

Arachidic 2-4

Behenic 3-5

Lignoceric 3-8

Sterols % of total sterols:

Beta sitosterol 66-72

Campesterol 16-19

Stigmasterol 11-14

Source: Andriamanantena et al. (1983).

Drug Review



MINERAL CONTENT OF TAMARIND PULP, SEED, KERNEL AND

TESTA38,33,39,40

Table.No.15. Mineral Content of Tamarind.

Mineral

mg/100g Pulp Seed Kernel Testa

Calcium 81.0-466.0 9.3-786.0 120.0 100.0

Phosphorus 86.0-190.0 68.4-165.0

Magnesium 25.0-72.0 17.5-118.3 180.0 120.0

Potassium 62.0-570.0 272.8-610.0 1020.0 240.0

Sodium 3.0-76.7 19.2-28.8 210.0 240.0

Copper 0.8-1.2 1.6-19.0

Iron 1.3-10.9 6.5 80.0 80.0

Zinc 0.8-1.1 2.8 100.0 120.0

Nickel 0.5

Manganese 0.9

Source: Marangoni et al. (1988); Ishola et al. (1990); Bhattacharya et al. (1994);

Parvez et al. (2003).

ECONOMIC USES OF TAMARIND SEED41

Large quantities of the seed are available in India as a by-product of the

tamarind-pulp industry. In former days, most of the seed was not utilized, except

sometimes during periods of scarcity when kernels were eaten by the poor. However,

as a result of the exigencie s of World War II, the seed was discovered to be a

valuable raw material for the preparation of sizing powder for textiles.

The chief collection centres for the seed are: Calcutta and Ghatal in West Bengal;

Cuttack, Jeypore, Parlakimidi, Berhampore and Rayagada in Orissa; Bobbili,

Warangal, Hyderabad, Secunderabad and Hindupur in Andhra Pradesh; Madurai and

Pollachi in Tamil Nadu; Thoduvatti in Kerala; and Bombay, Ahmadnagar, Satara and

Nasik in Maharashtra.

Application of tamarind seed in food:

The kernels have been used as food. Alone or mixed with cereal flours. The

nutritive value of kernel- proteins compares well with cereal proteins. Replacement of

25 per cent or less of rice by this kernel-powder produced a significant improvement

in the overall nutritive value of rice diet. In some areas, the kernels are mixed with

Drug Review



rice, fried, powdered and made into balls with sugar and ghee or oil, and eaten.

Certain hill-tribes eat the kernels mixed with the flowers of mahua (Madhuca

latifolia).

Gelling agent:

Gelling is a superior preservation technique for fruits. Tamarind seed kernels

contain 46-48% of a gelforming substance. It is named as jellose (jelly forming

polysaccharide). It has the ability to form gels in presence of sugar or alcohol over a

wide pH, temperature range, and can be used to form pectin like gels in jams, jellies

and other preserves. It can be obtained in abundance and is comparatively cheaper

than other gelling agents.

Food additive:

Tamarind xyloglucan is commonly known as ‗tamarind gum‘. It is used for

thickening, stabilizing and gelling in food. It is used as a stabilizer in ice cream,

mayonnaise and cheese. It is used as functional ingredient for rheological control of

aqueous phase. It can form gel at low water activity, i.e., at sugar concentration >60%

and very useful in making jam, jellies, marmalades. It is commercially available as a

food additive for improving the viscosity and texture of processed foods. It improves

the crispness and thickness of biscuits. Tamarind flour is added in wheat flour to

make chapattis and also added in cake. When XG is added to starch, the mixtures

yield high paste viscosity and the degree of pseudo-plasticity also increases with the

gum content. Gelatinization and retrogradation of tapioca starch (TS) pastes during

storage at 5ÚC can be improved by partial substitution of TS by XG polysaccharide.

Fermentation medium:

High protein content and carbohydrate content of TKP and its susceptibility to

microbial attack suggested the possible utilization of this material in fermentation

industries. However, penicillin and amylases production was observed to be less

effective compared to corn steep liquor. Germinated tamarind seed extract was found

to be as good as corn steep liquor. Tannase production under solid state fermentation

using Aspergillus niger species showed promising result with tamarind seed powder

as media component.

Drug Review



Useful as cattle-feed:

Ground seed is a useful cattle-feed; it can replace the concentrate mixture to

the extent of 50 per cent. The amount of total carbohydrates and minerals favourably

compare with those of oats and gram, whereas the protein content is much higher than

that of barley, oats and maize. The use of isolated proteins has been suggested in

feeds for cattle and as an adhesive. A high-grade, activated carbon with high

mechanical strength has also been prepared from the seeds

Application of tamarind seed in the textile industry:

1) The powder, commercially known as Tamarind Kernel Powder (T.K.P.), finds

extensive use as a sizing material in the textile industry. When the powder is

boiled, a gruel, is obtained, which, on drying in thin layers, produces strong,

smooth, continuous and elastic films — properties useful for sizing. According

to the available data, c. 20,000 tonnes powder is annually produced.

2) T.K.P. is much cheaper than corn starch. Compared with common starches,

smaller amounts of T.K.P. are necessary for comparable weaving performance

and very little or no softening is required in T.K.P. sizes. To compensate for

its creamy colour and also to improve penetration, the blending of T.K.P. with

a good cereal starch, up to 25 per cent, is recommended for use in the cotton-

textile industry. The performance of blended T.K.P. is said to be superior to

that of either pure T.K.P. or pure starch. As far as the jute industry is

concerned, the T.K.P. has almost ousted the cereal starches or flours from

size-mixings, since no blending is necessary. T.K.P. has also been found

useful for sizing spun viscose, as it offers a distinct advantage over the use of

starch in being more easily removable from the spun fabric.

3) T.K.P., when boiled with water containing boric acid and phenol (as

preservative), gives a very good paper adhesive. At higher concentrations of

borax, a T.K.P. solution is converted to an elastic, self-adhesive and rubber-

like mass, through the formation of cross-linkages. The dried and powdered

material of this complex behaves like gum tragacanth or locust-bean gum and

has been named Taminda. It is recommended for finishing textiles and

preparation of printing pastes for calico.

Drug Review



4) The desizing of textiles sized with T.K.P. cannot be done satisfactorily with

enzymic preparations, since the polysaccharide in T.K.P. is different in

structure from that of starches. Scouring of the sized goods with boiling water

containing small amounts of sodium carbonate is effective.

As creaming agent:

Because of its hydrophilic character and its ability to form solutions of high

viscosity even at low concentrations, T.K.P. serves as a good creaming-agent for the

concentration of rubber latex.

Useful for brick making:

It can be used as a conditioner and stabilizer of soil for brick making, and as a

binder in making sawdust briquettes. It has also been recommended as a thickener in

certain types of explosives. A chlorinated mixture of T.K.P. and magnesium oxide

yields hard, insoluble and infusible compositions.

In penicillin production:

Preparations of T.K.P. have been found suitable as substitutes for corn-steep

liquor in the production of penicillin.

As a manure:

The powder is also reported to be suitable as a manure.

The polysaccharide is be useful as thermoplastic resins:

The polysaccharide is composed of D-glucose, D- xylose, D-galactose and L-

arabinose in the molar ratio of 8:4:2: 1. It disperses easily in cold water, forming a

viscous, mucilaginous solution even in low concentrations. The viscosity increases so

rapidly with concentration that it is difficult to prepare a mobile solution of more than

two per cent. The polysaccharide yields a number of acetyl derivatives, of which

some give fairly strong, flexible, glossy and transparent films which adhere to glass,

metallic and wooden surfaces. They may be useful as thermoplastic resins because of

their wide melting.

Drug Review



Seed-testa uses:

In the production of T.K.P. or the jellose, large quantities of testa are left as a

residual by-product. The testa contains 38-40 per cent of water- solubles, of which 80

per cent is a mixture of tannins and colouring agents.

The utilization of testa as a raw material for the preparation of plywood

adhesives has also been recommended.

It is reported to be used as an adulterant in coffee powder. Detection of

adulteration of coffee with the seed, and quantitative estimation at more than 10 per

cent level is possible by alkali (NaOH) which gives a red coloured cyanidin.

Seed oil uses:

The fatty oil from the kernels resembles peanut oil and is reported to be useful

in the preparation of paints and varnishes and for burning in lamps.

REPORTED PHARMACOLOGICAL ACTIVITY OF TAMARINDUS INDICA

Antidiabetic, Hypolipidemic and antioxidant:

a) Hydroalcoholic and aqueous extract of seed of T. indica poses significant

antidiabetic activities [42,43]

.

b) The results of antioxidant activity clearly exhibit the antioxidant property of

ethanolic extract of T. indica on Streptozotocin induced diabetic rats [44]

.

c) Pulp and fruit extract of T.indica shows hypolipidemic and antioxidant

activities on rats fed with cholesterol rich diet [45]

.

d) Different extract of methanol and aqueous acetone extract aqueous acetone

extract shows highest antioxidant activity [46]

.

e) Ethanolic extract of T. indica fruit pulp shown hypolidemic and weight

reducing activity in cafeteria diet and sulpiride-induced obese rats [47]

.

f) Hydroalcoholic and aqueous extracts of T.indica leaves posses antioxidant

activity like Fe+3

reducing potential, NO·, OH· and DPPH· radical scavenging

potential [48]

.

Drug Review



g) Hydroalcoholic and aqueous extracts of T. indica seeds posses

hepatoprotective and antioxidant activities. Significantly decreased the hepatic

function test markers like SGOT, SGPT, ALP and serum bilirubin and

significantly increase the antioxidant enzyme like GSH, CAT, SOD and

significantly decreased lipid peroxidation [49]

.

Antimicrobial:

a) T.indica has broad spectrum antibacterial activity and a potential source of

new classes of antibiotics that could be useful for infectious disease

chemotherapy and control [50]

.

b) Ethanolic extract of leaf and stem T. indica extracts shows antibacterial

activity against some gram negative bacterial [51]

.

c) Hydroalcoholic and aqueous extracts of T indica leaves posses

antimicrobial activity

d) Against some gram positive and negative bacteria like: S. aureus, B. subtilis, E

coli and P. aeruginosa [52]

.

e) Hydroalcoholic and aqueous extracts of T. indica seeds posses antimicrobial

activity against some gram positive and negative bacteria like: S. aureus, B.

subtilis, E coli and P. aeruginosa [53]

.

Helminthes infections (parasitic worms):

Macerate of the T. indica seeds is used as vermifuge [54]

. An extract of the

leaves and the root is used to treat ankylostomiasis (hookworm) in some parts of

Tanzania [55]

.

Hepatoprotective:

Ethanolic extracts of T. indica flower was shown hepatoprotective effect in

Wister rats hepatotoxicity induced by Isoniazid and Rifampicin [56]

.

Analgesic activity:

Aqueous fruit extract of T. indica posses both central and peripherally acting

analgesic activity [57]

.

Drug Review



Antipyretic activity:

Polysaccharide obtained from T. indica pulp has been shown significant

antipyretic activity against bacterial pyrogen and polysaccharide induced pyrexia [58]

.

Laxative activity:

It improves movement of bowel it is a mild laxative due to the presence of

tartaric acid and malic acid in the salt form [59]

.

Anticancer activity:

T. indica shows cytotoxic activity against cancer cell line with IC50 value

<50µg/ml [60]

.

Antitumor and Immunopotentiating Activity:

Antitumor activity of polysaccharide PST001 isolated from the seed kernel of

Tamarindus indica was evaluated that PST001 has immunomodulatory and tumor

inhibitory activities and has the potential to be developed as an anticancer agent and

immunomodulator either as a sole agent or as an adjuvant to other chemotherapeutic

drugs. (61)

Antiemetic activity:

Methanolic and butanolic extract of T. indica posses significant anti emetic

activity [62]

.

Bioavailability enhancer:

It is having lack of toxicity and improves the bioavailability of drugs like

ibuprofen and aspirin [63]

.

Anti Inflammatory activity:

a) tamarind Seed (Tamarindus indica) Extract Ameliorates Adjuvant-Induced

Arthritis via Regulating the Mediators of Cartilage/Bone Degeneration,

Inflammation and Oxidative Stress Its anti-inflammatory property eases out

joint pain, consumption of ½ a teaspoon of roasted tamarind seed powder

Drug Review



twice a day with water boost joint lubrication which soothes pain64

(Hivrale

et al., 2013).

Anti venom activity:

Effects of Tamarind (Tamarindus indicus Linn) seed extract on Russell‘s viper

(Daboia russelli siamensis) venom75

.

Anti ulcer activity:

Antiulcer effect of the methanolic extract of Tamarindus indica seeds in different

experimental models76

.

Anti obesity activity:

Trypsin inhibitor from tamarindus indica L. Seeds reduces weight gain and

food consumption and increases plasmatic cholecystokinin levels77

.

Diarrhea:

The red outer cover of the tamarind seed cures diarrhea and dysentery

effectively. Xyloglucan can be used as an excellent substitute for fruit pectin and,

hence, can be used as an effective remedy against diarrhea, dysentery and colitis65

.

Cancer:

Sticky tamarind seed juice can treat and protect from colon cancer. Antitumor

activity and immune modulatory activity of tamarind seeds prevent the cancer

evocation in the body. Seed extract decreases oxidative stress makers and delays the

progress of renal cell carcinoma or decrease its incidence66

. (Chabetty et al., 2012;

Sano et al., 1996).

Heart disease and blood pressure:

Dietary fat rich in linoleic acid is, apart from preventing cardiovascular

disorders such as coronary heart diseases and atherosclerosis, is also associated with

preventing high blood pressure67

(Ajayi et al., 2006).

Drug Review



Reported toxicological studies of Tamarindus indica.

Acute Oral Toxicity:

In studies compliant with OECD guidelines for studies of acute oral toxicity,

tamarind seed polysaccharide was evaluated in both ddY mice and Sprague-Dawley

rats (Hachiya et al.1985). Male and female mice aged 5-7 weeks and male and female

rats aged 5-6 weeks were administered doses up to 5000 mg/kg bw by gavage (with 5-

10 animals/sex/species/dose) and observed for 14 days. No deaths or adverse

clinical signs were seen in either mice or rats of either sex, and the LD50 for male

and female mice and rats was >5000 mg/kg bw.

Chronic Oral Toxicity:

The authors concluded that, "The occurrence of numerous age-related lesions

usually encountered in this strain of rat, including nephropathy, myocardial injury,

periarteritis, changes in adrenal cortex, and tumors of pituitary, mammary and adrenal

glands were noted in the present study. These lesions appeared with equal frequency

in all groups, including control. In conclusion, the data from our 2-year feeding

study of GLYLOID [tamarind seed polysaccharide] in rats indicate no toxicity

signs in various parameters examined." The NOAEL was the highest dietary

concentration tested, 12%, equivalent to 8300 and 9400 mg/kg bw/day in male and

female rats, respectively.

Carcinogenicity:

There were no significant differences reported between groups in either sex in

the incidence of neoplastic and non-neoplastic lesions or in benign and malignant

tumors. All tumors seen were those types considered to be usual in aged B6C3F1

mice. The authors concluded that consumption of tamarind seed polysaccharide,

at up to 5% dietary concentration, is "not carcinogenic in either male or female

B6C3F1 mice with long-term dietary exposure." Based on the feed intake and body

weight of the mice, the 5% dietary concentration produced tamarind seed

polysaccharide doses of 6658 and 8575 mg/kg bw/day among males and females,

respectively, and the authors regarded 5% dietary concentration as the NOAEL.

Drug Review



Genotoxicity/Mutagenicity:

An Ames assay was conducted under GLP and following OECD Guideline

No. 471 (Bacterial Reverse Mutation Test) using Salmonella typhimurium strains

TA98, TA100, TA1535, and TA1537 and Escherichia coli strain WP2 uvrA

(Heimbach et al. 2013). Test item concentrations of 10.0, 31.6, 100, 316, 1000, 2500,

and 5000 pg/plate were used in both plate incorporation and pre-incubation tests with

and without metabolic activation. No biologically relevant increases in revertant

colony numbers of any of the five tester strains were observed follow treatment with

tamarind seed polysaccharide at any concentration level, either in the presence or

absence of metabolic activation in either experiment. The authors of the study

concluded that tamarind seed polysaccharide "did not cause gene mutations by base

pair changes or frameshifts in the genome of the tester strains used. Therefore, it

is considered to be nonmutagenic in this bacterial reverse mutation assay."

Reported Cosmetic studies of Tamarindus indica

Cosmetic Potential:

Seed husk extract with polyphenolic components (Polyant-T) was tested for

antioxidant efficiency and provides a potential use for color cosmetics and sunscreens.

Review of Granthighna Karma on Tundikeri



REVIEW OF GRANTHIGHNA KARMA ON TUNDIKERI

" "

Grandhi literally means gradhana or knot, the mechanism being clotting or

accumulation of Dushita dhatu or Dosha locally without any useful purpose.

- Cha. Vi. 5.24

Charaka while describing the 4 types of sroto Dushti mentions grandhi as one

of them68

.

Susruta also while describing Dushta Sukra Lakshanas states “Grandhi

Bhootam Vaata sleshma bhyaam" Sukra vitiated by vata and sleshma is passed as

clots. All the pitikas, growths and lumps of non inflammatory origin are grandhi

Bhootas and are due to vaata and sleshma Prakopa.

Definition:

Su.Ni.11\3

Any localised swelling looking like a knot caused by vitiated Tridoshas,

Rakta, Mamsa and medas with the Predominance of Kapha and Vata. Grandhi has got

a peculiar shape and consistency i.e vritta (round) unnata (elevated) and Vigradhita

(hard or compact) Vagbhata also is of the same opinion that Kapha Pradhana doshas

along with Rakta, Mamsa and Medas cause a swelling which is vritta, unnata and

gradhita(Round, elevated and compact)69

Charaka defines 'Grandhi as a pulsatile swelling which is not accepted by susruta or

vagbhata, but only siraja grandhi can be pulsatile.




The granthi may also develops due to the vitiation of sira, mamsa, and meda

dhatu, there is a painless enlarge mass of mamsa dhatu linked with meda on the

surface of the body, the granthi may be developed separately by the medovikar, it is

snigda and chanchal. The local treatment like lepana (external application) and

swedana (fomentation). After the pakva of granthi then that may treated as vrana. The

sarwadehika shodana (whole body Purification) treatment like vamana, virechana

may be conceded. The granthi and Arbuda are almost similar characteristic features70

(ch.chi.12/87).

When all such descriptions are analysed it can be presumed that

1) Grandhi is a localised compact collection or vriddha or unwanted tissue.

2) Main reason of such a localised growth is sroto dushti and sroto Avarodha

3) The doshas involved are vata and Kapha with the failure of Pitta to bring about

Dhatu Parinama or Dhatu Paka in that area.

With this, it can be generalised that all the localised new growths like Arbuda,

Vidradhi, Gulma, Pitika, Galaganda, Gandamala, Apachi, Valmika, Tundikeri,

Yuvana Pitika, Jatumani, Pothaki, Sikata Vartma, Nasarsas, Yonikanda, Andali etc

are nothing but the modifications of Grandhi only.

In Tundikeri pradhana dosha is Kapha, Rakta and Anubhandhi dosha is

Vata,Pitta. Tundikeri is easy to treat when it involves Rasa, Rakta Dhatu (acute)

But it becomes difficult when it approaches the Mamsa Dhatu and forms

Granthi (Chronic)71

. [Jindal Radha et al.Journal of Biological & scientific opinion

volume 1 (3).2013]




TUNDIKERI

Derivation:

The word Tundikeri has two words Tundi + Keri Tundi - this word is derived

from the root “Tung” which means “Beak” and then it is suffixed from “Ana” which

gives rise to the present word “Tundi”. The meaning of Tundi being Beak, Snout,

Bimbi, Cotton herb, swelling of umbilicus.

Keri - The meaning of the word Keri are as follows specific insect, small raw

fruit of Mango.

According to Vachaspatyam, Tundi means Mukha and Keri means Pradesha

that shows that which occurs in Mukha Pradesha. The word meaning of Tundikeri is

Vanakarpasika Phalam i.e. resembling cotton fruit

.

Image No.6 Tundikeri resemble Cotton fruit

Definition72

: -

(Su.Ni.16/44)

Tundikeri is that disease caused by the vitiation of Kapha and Rakta. There is

Sthula Shotha (oedema), Toda (pricking type of pain), Daha (burning sensation),

Prapaki (Suppuration)72

.




AH.Ut.21/47

According to Acharya Vagbhatta, Tundikeri is having the shape of

Karpasiphala and is Hanusandhi Asrita Kanta (root of the temperomandibular joint) It

is Picchila (Slimy), Manda Ruk (Mild pain) and a firm swelling73

.

The definition given by Acharya Sushruta resembles the acute stage of

tonsillitis where as the definition by Acharya Vagbhatta is featuring probably the

chronic stage of tonsillitis.

Samprapthi:

Involvement of Mamsa dhatu could be at the level of poshaka mamsa dhatu

level. Rakta dhatu Marghavarodha caused by the either sotha (caused by Bacteria,

virus, allergens) or Kapha dosha produced by Nidhana. They obstruct the flow of

Rasa Rakta dhatu and inhibit the further dhatu posana (metabolism). The nutrients

fraction of Mamsa dhatu retained in the blood accumulate in Tonsils. The

accumulated mamsa dhatu produces a Granthi.

Reasons for the disturbance of tonsils are mentioned in Nidana of Tundikeri.

i.e., Snigdha ahara, abhisyandhi ahara etc. Involvement of Bacteria, Virus, allergens

is also reason for Tonsils vitiation.

Tonsils are considered as gate way of intestines, so it likely causes tonsillitis,

further it becomes sensitive and repeated attacks of Vyadhi is possible.

If avarodha of rasa-rakta channels occur to generate swelling and thus become

Granthi. And further complications are seen i.e Dysphagia, Fever etc.

The line of treatment could be Lekhana and Soshana. Lekhana reduces

obstruction, Soshana cause for absorption of obstruction. Thus Tundikeri becomes

normal.

Chincha bheeja is Kashaya in rasa, Ruksha in guna promotes absorption, and

Kaphahara action removes obstruction. Krimi hara Karma of Chincha bheeja destroys

Bacteria, Virus invaded in to tonsils.




All together Tonsillitis is superficially limited disease so local application of

chincha bheeja lepa is appropriate in measure of treatment.

Therefore Chincha bheeja has been found with Granthi hara karma

particularly mitigates Tonsillitis.

Treatment of Granthi, Arbudha, are suggested similarly in classical text

(ch.chi.12/87) Chincha bheeja is drug of choice in cancer also therefore to established

the Anti tumor action of Chincha.

Samprapthi Ghatana




Samprapthi Vighatana

Purvaroopa:

As Tundikeri is a disease characterized by Shotha, premonitory symptoms of

Shotha can be considered here i.e. mild pain, mild burning sensation, Dhirghibhava of

Siras with mild swelling and increase in local temperature.




Roopa:

Shotha, Toda, Daha, Prapaka in Talu Pradesha, according to Acharya Sushruta

(Swelling, Pricking pain, burning sensation and temperature rise,, suppuration there

are likely to be present in acute infections). Karpasiphala appearance, Picchila,

Mandaruk, Sopha which is Katina according to Acharya Vaghbhata. (Mild pain and

firm swelling are symptoms likely to be present in chronic infection)

Treatment of Tundikeri:

According to Acharya Charaka - Dhumrapana, Pradhamana

Nasya, Virecana, Vamana, Lekhana are indicated.

Acharya Sushruta has nowhere mentioned the medicinal treatment for the

disease Tundikeri. The treatments advocated by him are both surgical

Bhedana (Incision), Chedana (Excision).

Acharya Vagbhatta has instructed that Tundikeri has to be treated on the line

of Shlesmaja Rohini, which is as follows:

Raktamoksana

Nasya with Tiksna Drugs

Gandusa with Tiksna Drugs

Kwatha of Bark (Twak) of Daruharidra, Nimba, Rasanjana,Indrayava.

Gargling (Kavala or Gandusa) with Triphala, Trikatu, Citraka,Patha,

Nimba Sukta and Gomutra. Sarangadhara in Uttara Khanda has

mentionedGandusa, Kavala, and Pratisarana as remedial measures for

Gala Rogas.

SADHYA ASADHYATA:

Acharya Sushruta has said among Talu Rogas, only Talu Arbuda is Asadhya,

all others are Sadhya Rogas. Acharya Vagbhatta too has counted Tundikeri to be

among the Sadhya Rogas i.e. Krichra Sadhya None of the later Acharyas have said

Tundikeri as Asadhya. Thus Tundikeri is a Sadhya Roga.




Pathya Apathya:

In none of the Brihattrayis, Pathya Apathya has been said for the Mukha

Rogas. But in later texts such as in Yogaratnakara they have been indicated as

follows:

Pathya:

Ahara : Trinadhanya, Yava, Mudga, Kulatta, Jangala Mamsa Rasa, Karvellaka,

Patola, Karpurajala, Usna Jala, Tambula, Khadira, Ghrita and Katu Tikta.

Viharas: Swedana, Virecana, Vamana, Gandusa, Pratisarana, Kavala, Raktamoksana,

Nasya, Dhumpana, Sastra and Agnikarama

Apathya:

Ahara: Amlarasa Dravyas, Abhisyandi Ahara, Matsya, Dadhi, Kshira, Guda, Mas a,

Ruksha Katinapadartha Sevana, Guru Ahara

Vihara: Diwaswapna, use of Shitala Jala, Adhomukha Sayana, and Snana.




MODERN REVIEW

ANATOMY:

Image No.7 Position of Tonsils in Oropharynx

Image No.8 Primary and Secondary Crypts of Tonsills

The oral cavity or the mouth is divided into an outer, smaller portion, the

vestibule and an inner larger part- the oral cavity proper. The oral cavity proper is

bounded anterolateral by the teeth, the gums and the alveolar arches of the jaws. The




roof is formed by the hard and soft palate. The floor is occupied by the tongue

posteriorly. Posteriorly the cavity communicates with the pharynges through the

oropharyngeal isthmus which is bounded superiorly by the soft palate, inferiorly by

the tongue and on each side by the palatoglossal arches. Between each pair of folds

there is a collection of lymphoid tissue called the “Palatine Tonsils”

PHARYNX:

The pharynx or throat, is a somewhat funnel shaped tube about 13 cm long

that starts at the internal nares. It is situated behind the nose, mouth and the larynx.

Clinically, it is a part of the upper respiratory passages where infections are common.

The upper part of pharynx transmits only air. The lower part only food, but the middle

part is a common passage for both air and food (but only one at a time)

The cavity of the pharynx is divided into for descriptive purposes

(a) The nasal part (nasopharynx)

(b) The oral part (oropharynx)

(c) The laryngeal part (laryngopharynx)

(a) Nasopharynx:

The part lies behind the nose above the soft palate. On the posterior wall there

are the pharyngeal Tonsils (adenoids), consisting of lymphoid tissue. They are most

prominent in children up to approximately 7 years for age. Thereafter they gradually

atrophy.

(b) Oropharynx:

This part lies behind the mouth, extending from below the level of the Soft

palate to the level of the upper part of the body of the 3rd cervical vertebrae. The

lateral walls of the pharynx blend with the soft palate to form two folds on each side.

It has only one opening. Oropharyngeal Isthmus (Isthmus of Fauces), the opening

from the mouth. It is lined by stratified squamous epithelium. This part of the pharynx

is both respiratory and digestive in function, since it is a common passageway for air,

food and drink




Waldeyer’s Lymphatic Ring:

Image No.9 Waldeyer’s Ring

In relation to the oropharyngeal isthmus, there are several aggregations of

lymphoid tissue that constitute the Waldeyer's lymphatic ring. The most important

aggregations are:

(1) The right and left Palatine Tonsils (referred to simply as the Tonsils)

(2) The Pharyngeal Tonsil (located Posteriorly)

(3) The Tubal Tonsils (located laterally and above)

(4) The Lingual Tonsils (located inferiorly over the posterior part of the dorsum

of the tongue)

Waldeyer's ring is involved in the development of nonthymus related or B

cells, particularly in the first few years of life. Production of all major classes of

immunoglobulins and T lymphocytes with intact effector function of cell mediated or

delayed immunity can be attributed to elements of the ring.




(c) Laryngopharynx:

Hypopharynx extends from the oropharynx above and continues as the

oesophagus below i.e. from the level of the 3rd to the 6th cervical vertebrae. Like the

oropharynx, the laryngopharynx is a comman part of the respiratory and a digestive

tract and is lined by stratified squamous epithelium.

Nomenclature:

In British Orolaryngology the word Tonsil has been understood exclusively as

the palatine (faucial) tonsil in practice.

Embryology :

The site of the tonsils appears in early fetal life itself. They are visible in the

fourth month of fetal life, at first as simple invaginations of the mucous membrane at

a point between the second and third bronchial arches. There is the condensation of

the connective tissue especially at the apex of the tonsillar crypts and there is

consequent massing of leukocytes mainly at these points. As the leukocytes are well

supplied with nutrients, they divide by mitosis in large numbers and form germ

centers where a special arrangement of connective tissue and vessels favors the

process of division. The crypts become so deep that the depression thus formed is

subdivided into several compartments which become the permanent crypts of the

tonsils. The lymphoid tissue is deposited around the crypts and thus the tonsillar mass

is built up.

PALATINE TONSIL:

Anatomy:

The Palatine Tonsils are two masses of lymphoid tissue situated in the lateral

walls of the oral part of the pharynx. Each tonsil occupies the Tonsillar fossa or

Tonsillar sinus between the palatoglossal and palatopharyngeal arches.

This tonsil can be seen through the mouth

Tonsil is almond shaped




Anatomically each tonsil has the following structures.

(1) Two surfaces - Medial and Lateral

(2) Two borders - Anterior and Posterior

(3) Two poles - Upper and Lower

Surfaces:

Medial Surface - is covered by stratified squamous epithelium continuous with that

of the mouth. This surface has 12 to 15 crypts. The epithelial lining the crypts are

very thin and offer poor protection to bacterial infection. The largest of these crypts is

called the intratonsillar deft.

Lateral Surface - is covered by a sheet of fascia which forms the capsule of the

tonsil. The capsule is an extension of the pharyngobasilar fascia. It is only loosely

attached to the muscular wall of the pharynx. Anteroinferiorly the capsule is firmly

adherent to the side of the tongue just in front of the insertion of the palatoglossus and

the palatopharyngeous muscles. This firm attachment keeps the tonsil in place during

swallowing. The palatine vein (paratonsillar vein) descends from the palate in the

loose areolar tissue on the lateral surface of the capsule, and crosses the tonsil before

piercing the wall of the pharynx. This vein may be injured during removal of the

tonsil (tonsillectomy)

The bed of the tonsil is formed by -

(1) The pharyngobasilar fascia

(2) The superior constrictor and palatopharyngeous muscles

(3) The buccopharyngeal fascia

In the lower part the styloglossus and the 9th cranial nerve.




Borders:

Anterior border - It is related to the palatoglossal arch with its palatoglossal muscle.

Posterior border - It is related to the palatopharyngeal arch with its

palatopharyngeus muscle.

Poles:

Upper Pole - It is related to the soft palate and also invades it. It contains deep intact

intra tonsillar deft which does not lie above tonsil.

Its upper wall contains a quantity of lymphoid tissue which may reach a large size and

extend into the soft palate.

Inferior Pole - It extends into the dorsum of the tongue.

DEVELOPMENTAL FOLDS:

(1) Plica triangularis - This is a triangular vestigeal fold of mucous membrane

covering the anteroinferior part of the tonsil. In the child this fold is usually

invaded by the lymphoid tissue and becomes incorporated in the tonsil. There

is no muscular tissue in this fold. When the tonsil is removed it should also be

removed otherwise a pocket or pouch may be formed where food and other

debris are collected. It is the source of considerable local irritation. The

lymphoid tissue with which it is thickly studded may be the seat of the future

hyperplasia or infection.

(2) Plica semilunaris - This is a similar semilunar fold that may cross the upper

part of the tonsillar sinus.

INTRATONSILLAR CLEFT:

This is the largest crypt of the tonsil. It is present in its upper part. It is

sometimes wrongly named the supratonsillar fossa. The mouth of the cleft is

semilunar in shape and parallel to the dorsum of the tongue. It represents the internal

opening of the second pharyngeal pouch. A peritonsillar abscess (quinsy) often begins

in this cleft.




Capsule:

The tonsil is always described as having a 'capsule'. But certain anatomists are

not of this view. For clinical purposes a white fibrous sheath called the pharyngeal

fascia that encloses 4/5th of the tonsil is said as the capsule.

Structures:

When viewed under the microscope the tonsil consists of three chief elements

The connective tissue

The germinating follicles.

The interfollicular tissue

The connective tissue - i.e. the trabecula or reticulam acts as a supporting framework

to the tonsil substance proper. The trabeculae carry blood vessels, nerves and

lymphatic.

The germinating follicles - The larger mother cells of the leukocyte group undergo

division and form young lymphoid cells. A dense plexus of vessels surrounds each

follicle.

The inter follicular tissue - This tissue is made up of lymphoid cells in various

stages of development. The cells differ in size and shape according to their location.

They are greater in number around the follicle and show greater difference in

anatomic construction in the immediate layers between which there are spaces of

varying sizes. This accounts for the ease in dissecting the upper pole of the tonsil. It

also provides the tendency of peritonsillar abscess to burrow around the upper half of

the tonsil.

Thus this and the other lymphoid masses of Waldeyer's ring belong to the

category of mucosa associated lymphoid tissue, which provides humeral and cellular

defence against infections of the oral and nasal cavities and pharynx related area of

elementary and respiratory tracts.




ARTERIAL SUPPLY OF TONSIL:

Image No. 10 Blood Supply to Tonsil

(1) Main source - Tonsillar branch of facial artery

(2) Additional sources

(a) Ascending palatine branch of facial artery

(b) Dorsal lingual branches of the lingual artery

(c) Ascending pharyngeal branch of the external carotid artery

(d) The greater palatine branch of the maxillary artery

Venous Drainage:

One or more veins leave the lower part of the deep surface of the tonsil, pierce

the superior constrictor and join the palatine, pharyngeal or facial veins.

Nerve supply:

Glossopharyngeal and lesser Palatine nerves. Lymphatic Drainage:

Lymphatics pass to the Jugulo digastric node. Physiology of Tonsil:




At birth, the tonsils are without germinal centers and usually quite small. But

with the loss of maternal source antibody there is an enlargement of tonsils and

adenoids and to a little extent the lingual tonsils.

Tonsils, like any other body organ, have a specific role to play. They check if

there are certain introduces such as bacteria, virus, allergens etc. attempting to attack

human body. Since they are lymphoid tissue they produce special cells called

lymphocytes. These lymphocytes form an immunological network of self defence.

Immunology of Tonsils :

The Inner Power:

Tonsils produce antibodies, which fight against the infection, stopping its

further spread to other parts of the body. They help by preventing the spread of

infection from the nearby parts such as from mouth, nose, sinuses and postnasal area.

The Tonsils are grouped as secondary lymphatic organs. The palatine tonsils

contain 10% lymphatic cells and constitute approximately 0.2% of all lymphocytes in

adults. In the process of fighting germs and microbes, the tonsils get inflamed which

is a symbol of local defence work. These tonsils need to be treated but not to be

removed necessarily. They can be compared with the soldiers fighting at the

battlefield, who need special care but not removed from the battlefield unless they are

seriously injured or incapable of doing their job.

TONSILLITIS:

Image No. 11 showing Tonsillitis




Definition:

Tonsillitis is inflammation of tonsils the large, fleshy, oval masses of tissue that

lie in the lateral wall of the oropharynx on either side of the throat. These clusters of

tissue contain cells that produce antibodies that are helpful in fighting infection. In

tonsillitis, the tonsils are enlarged, red and often coated (either partly or entirely) by a

substance that is yellow, grey or white.

Causes, Incidence and Risk factors:

The tonsils normally help to filter out bacteria and other microorganisms to

prevent infection in the body. They may become so over whelmed by bacterial or

viral infection that they swell and become inflamed, causing tonsillitis. The infection

may also be present in the throat and surrounding areas, causing pharyngitis.

Highly contagious bacterial and viral causes of tonsillitis are:

Streptococcus bacteria (most common cause of tonsillitis)

Adenovirus (these are common in childhood and account to 10% respiratory

disease)

Epstein Barr virus (The virus causing mononucleosis)

Herpes simplex virus (cold sore virus)

Influenza virus

Parainfluenza virus (Which causes respiratory infections such as laryngitis,

bronchitis)

Enterovirus (which affects the intestinal tract)

The most common problems affecting the tonsils and adenoids are:

Recurrent infections of throat and ear

Significant enlargement or obstruction that causes breathing and swallowing

problems.

Abscesses around tonsils

Infections of small pockets within tonsils that produce foul smelling, cheese

like formations.




When the cause is either an enterovirus or herpes simplex virus, the throat

may show tiny blistered or ulcerated areas and this sometimes helps in diagnosis.

When an enterovirus is the cause, the illness is called herpangina.

Tonsillitis may also occur as a result of certain allergy to food preservatives,

artificial colors etc. Common food articles that can trigger tonsillitis are

artificially coloured sweets, sour fruits, bananas, preservatives added to certain

drinks.

Environmental factors that may trigger an attack of tonsillitis are exposure to

excessive cold, damp climate or change of weather. Bacteria and virus tend to

flourish in crowded areas and hence patients who are prone to tonsillitis can

catch the infection at schools, parks, theatres etc. Tonsillitis is not common

before the first birthday. It tends to peak in the years surrounding kindergarten

but can occur throughout childhood and even in adult life.

Another causative factor that can be of importance is genetic tendency.

Recurrent tonsillitis is frequent in patients whose parents have also suffered

from the same condition.

All these factors contribute to lowering the immunity of the body and thus

the tonsils fall prey to infection by micro organisms

Infection Genetic tendency

Environmental Food Allergens

Lowered Immunity

Recurrent Tonsillitis




An improper diet that is high in refined carbohydrates, and low in protein and

other nutrients may also predispose one to develop tonsils. Each time the

tonsils become inflamed

difficult to cure.

Another causative factors is poor orodental hygiene

Clinically Tonsillitis is seen in two forms

(1) Acute Tonsillitis

(2) Chronic Tonsillitis

(1) ACUTE TONSILLITIS :

It is the acute inflammation of the Palatine Tonsillar tissue In acute tonsillitis,

discomfort usually subsides after 72 hrs.

Symptoms:

Sore Throat - This is a most common presentation. However, young babies

may not present with pain but with inability to eat.

Inability to swallow saliva

Difficulty swallowing (Dysphagia) or uncomfortable painful swallowing

This is due to pain or due to huge increase in size of tonsils

Malaise, fever, chills - Due to acute infection

Tenderness of jaw and throat

Voice change due to swelling

Bad Breath

Headache

Loss of appetite.

Sleep disturbances in children results in bed wetting (enuresis). Due to

obstruction to air passage.

May complain of ear pain, an urge to swallow constantly and tight

feeling towards back of throat.




Additional symptoms of tonsillitis in children include

Nausea

Vomiting

Abdominal Pain

Enlarged Adenoids and their symptoms

If the child's adenoids are swollen, it may be hard to breath through nose.

Other signs of constant enlargement are:

Breathing through the mouth instead of the nose most of the time

Nose sounds 'blocked' when he speaks

Noisy breathing during the day

Recurrent ear infections

Snoring at night

Breathing stops for a few seconds at night during snoring or loud breathing

(sleep apnea)

Signs:

Swelling of tonsils

Redness more than normal of tonsils

Partly or entirely coated tonsils by a substance that is yellow, grey or white.

Swollen lymph nodes in neck (i.e. jugulodigastric lymph nodes)

Blisters or painful ulcerated areas on the throat

Patient is febrile and has tachycardia

There may occur edema of the uvula and soft palate

Rise of temperature

Pathology:

The pathology of acute tonsillitis may be said in the following way:

(1) Catarrhal or superficial Tonsillitis - The process of inflammation originating

within the tonsil is accompanied by hyperemia and edema with conversion of

lymphoid follicles into small abscesses which discharge into crypts. When




tonsils are inflamed as a result of generalized infection of the oropharyngeal

mucosa, the condition is termed as catarrhal tonsillitis. In these cases there is

little or no swelling of the tonsil. The surface appearing inflamed is the

continuity with the rest of pharyngeal mucosa.

(2) Follicular Tonsillitis - This is also known as cryptic tonsillitis or lacular

tonsillitis. When the inflammatory exudates collects in the Tonsillar crypts,

these present as multiple white spots on an inflamed Tonsillar surface.

(3) Membranous Tonsillitis - Sometimes exudation from crypts may come

together to form a membrane over the surface of the tonsil giving a clinical

picture of membranous tonsillitis.

(4) Parenchymatous Tonsillitis - When the whole tonsil is uniformly congested

and swollen it is called acute parenchymatous tonsillitis.

Complications of acute tonsillitis:

(1) Chronic Tonsillitis - Repeated attacks of acute tonsillitis results in chronic

inflammatory changes in the tonsils.

(2) Peritonsillar Abscess or Quinsy - Spread of infection from the tonsil to the

paratonsillar tissues results in development of abscess between the tonsillar

capsule and the tonsil bed. The complication is rare before the age of 12 yrs.

(3) Parapharyngeal abscess - Infections from the tonsil or peritonsillar tissue may

involve the parapharyngeal space with abscess formation.

(4) Acute otitis media - Infection from the tonsil may extend to the Eustachian

tube and result in acute infection of the middle ear.

(5) Acute nephritis and Rheumatic fever

(6) Pharyngitis - viral or bacterial

(7) Dehydration from difficulty in swallowing fluids




Tests:

A culture of the tonsils may show bacterial infection

A culture for the streptococcus bacteria (Strep) may be taken because it is the

most common and most dangerous form of tonsillitis

Rapid strep test may be performed by taking a throat swab.

Blood tests can determine problems such as mononucleosis

Prevention:

The following may help to inhibit the spread of the contagious illness that

are generally responsible for spread of tonsillitis.

Keep away from anyone with tonsillitis or sore throat.

Do not share utensils, drinking glasses, toothbrushes etc with anyone

having tonsillitis or sore throat or wash dishes with hot soapy water.

Wash hands frequently

Cover the mouth when coughing or sneezing

Once recovered, throw out the toothbrush and buy a new one, this way one

cannot re-infect oneself.

Treatment:

In recent years, treatment for tonsillitis has changed dramatically. The main focus

is no longer on surgical removal of tonsils (tonsillectomy). Because it is now known that

tonsils serve an important immune function in the body. Furthermore, the old idea that

children who have their tonsils removed are less susceptible to colds and other respiratory

diseases is just an old idea. Still surgery may be the best option for some:

General management includes

Bed rest, sleep helps body fight infection.

A moist warm towel around your child's neck may also help soothe swollen

glands.




Giving plenty of fluids especially warm - soup, broth and tea are good

choices.

Prefer softer foods like ice cream, fruit fluids, and milk shakes

similar ingredients) several times a day

Use a cool mist vaporizer or humidifier in the room.

If the cause is strep bacteria - antibiotics are given to cure the infection. The

antibiotics may be given as a one-time infection or by a 10-day course of antibiotic

pills. Penicillin is the drug of choice; Erythromycin and Ampicillin may be needed for

resistant cases.

Analgesics are given to relieve pain and fever.

Do not give aspirin to children younger than age 12 because of the risk of

Reye's syndrome, a potentially life threatening illness.

Viral tonsillitis is not treated with antibiotics, as they are ineffective at

defeating them. They may reduce by themselves in a week or two.

In some patients, especially those with infectious mononucleosis, severe

enlargement may obstruct the airway. For those patients, treatment with steroids (e.g.

cortisone) is sometimes helpful.

Naturopaths often recommended dietary supplements of vitamin C,

bioflavonoid and beta carotenes found naturally in fruits and vegetables to ease

inflammation and fight infection.

Chronic tonsillitis

Chronic inflammatory changes in the tonsil are usually the result of recurrent

acute infections treated inadequately. Recurrent infections lead to development of

minute abscesses within the lymphoid follicles. These become walled off by fibrous

tissue and surrounded by inflammatory cells.




According to some authors, the incidence of chronic tonsillitis is 4-10%

among adult population and 12-15% among children. Chronically infected tonsils

harbor large number of organisms more than 105 gram of tissue. These are mostly non

pathogenic.

It is of two varieties

(1) Chronic parenchymatous tonsillitis

(2) Chronic fibrotic tonsillitis

The commonest and the important cause of recurrent infection of the tonsils is

persistent or recurrent infection of the nose and paranasal sinuses. This leads to

postnasal discharge, which then infects the tonsils as well.

Clinical Features:

Symptoms: Discomfort in the throat

Recurrent attacks of sore throat

Unpleasant taste (cacagus)

Bad smell in mouth (Halitosis)

Difficulty in swallowing Change in voice

Signs:

Tonsils may appear hypertrophic and protruding out of pillars.

These are diffusely congested.

Mouths of crypts appear open from which epithelial debris may be squeezed

on pressure.

The anterior pillars are hyperemic Enlargement of jugulodigastric lymph

nodes.




Treatment:

Treatment is given to control the infection of Tonsils, Nasal and Para

Nasal sinuses.

Gargles, mouthwashes and suction of septic foci or crypts are the best

palliative measures.

Broad-spectrum antibiotics

Analgesics, decongestants, mucolytes, mucokinetics

Antihistamines

Surgical management like septoplasty (for a deviated nasal septum),

Antral washouts, removal of nasal polyp if any etc might reduce or actually

prevent any further infection of the tonsillar tissue.

If the above measures fail and the patient continues to have recurrent attacks

of tonsillitis, surgical removal of the tonsils (Tonsillectomy) might be needed.

Complications:

Peritonsillar abscess

Parapharyngeal abscess

Intratonsillar abscess

Tonsillar crypts

Tonsillolith

Rheumatic fever

Acute Nephritis




Tonsillectomy:

Indications:

The American Academy of Paediatrics considers it a reasonable option if:

Seven or more episodes of tonsillitis in one year.

Five or more episodes of tonsillitis a year for a period of two years.

Three or more episodes of tonsillitis a year for a period of three years.

Airway or swallowing obstruction due to swollen tonsils.

An infection severe enough to cause an abscess (pocket of pus) in or

around the tonsils.

treatment. Previously, peritonsillar abscess (quinsy) was thought to be an

indication but now it has been observed that if the abscess is drained well and

proper antibiotic cover given for adequate time, usually there is no recurrence

of the abscess, hence tonsillectomy is not required.

Contraindications of Tonsillectomy:

Should not be done during an epidemic of poliomyelitis as there is a high risk

of contracting bulbar poliomyelitis.

Blood dyscrasias like purpura, aplastic anaemia, bleeding and coagulation

defects.

Cases of uncontrolled systemic disease like diabetes

Not to be done during or immediately after an attack of infection or when the

child has recently been exposed to infectious disease like measles.

Not done during menstruation or during pregnancy.

Surgery:

For at least two weeks before any surgery, the patient should refrain from

taking aspirin or other medications containing aspirin. Generally after midnight prior

to the operation, nothing (chewing gum, mouthwashes, throat lozenges, toothpaste,




and water) may be taken by mouth. Anything in the stomach may be vomited when

anaesthesia is induced and this is dangerous.

Postoperative Complications:

Hemorrhage:

It could be primary (during operation)

Reactionary (within the first 24 hours)

Secondary (between fifth to tenth postoperative days)

Primary - Usually arises because of trauma to an aberrant vessel or paratonsillar

vein.

Reactionary -Usually arises as a result of slipping of a ligature or because of the

postoperative rise in blood pressure. If a clot has formed in the fossa, it is removed.

This allows the muscular contraction and retraction of the blood vessel. A gauze pack

may also be held in the fossa for a few minutes to control bleeding. If bleeding does

not stop, the patient is re anaesthetized and the bleeding vessel is legated. Sometimes

the Tonsillar pillars may need to be stitched over a pack to control the bleeding.

Secondary- Usually is a result of infection. Bleeding is usually mild. Antibiotics,

antiseptic mouthwashes are given in addition to bed rest.

Surgical trauma to, pillars, soft palate, teeth or uvula.

Pulmonary complications because of inhalation of blood or tonsillar tissue

with the result, collapse, pneumonia or lung abscess.

Nasal speech for a few days following tonsillectomy may be there because of

temporary limitation of motion of the pillars and soft palate because of pain.

Rarely stenosis of nasopharynx and nasal airway due to the adherence by the

pillars and palate to the posterior pharyngeal wall. Laser Tonsillectomy and

adenoidectomy are effective and involve less postoperative pain, less blood

loss and more rapid healing. The main drawback is the greater expense.

Pharmacological Study



PHARMACOLOGICAL STUDY DOSHAGHNA GUNAGANANA (DGG)

DOSHAGHNA GUNA GANANA74

:- (DOSHAHARA EFFECT)

This is an effort to analyze the effects of drugs in a numerical way. It is for the

first time numerical analysis of drugs properties is proposed by Dr. M Paramkusha

Rao, P.G. Professor and Head, Department of Dravyaguna, S.V Ayurveda College

Tirupati, in year 2012.Anything presented numerical is easily reproduced whenever

and wherever is required. Drugs act by the virtue of their properties. It is called Guna

Prabhava. Such effect usually influences the Doshas in the body. The action of the

drug exhibited by the virtue of its nature is called Dravya Prabhava in Ayurveda. Here

an effort is made to measure the Guna prabhava of Ayurveda drugs with a new

methodcalled “DOSHAGHNA GUNA GANANA” (DGG). The method is a humble

effort to understand Ayurveda Pharmacology in a scientific manner.

KINCHID DOSHA PRASAMANAMKINCHID DHATU

PRADUSHANAMSVASTAVRITTAU MATAM KNCHITTRIVIDHAM DRAVYA

MUCHYATE

Drugs have been classified in to three groups in CHARAKA.

1) DOSA PRASAMANAM (Drugs Effective on Dosha)

2) DHATU PRADUSHANAM (Drugs Effective on tissues) and

3) SWASTVRITTE HITAM. (Drugs Maintain Health)

This is a premiere pharmacological classification of drugs. It is to be assumed

according to this classification assessment of the DOSHAGHNATA is essential to

analyze a drug. The drug's influence on DOSHA provides us an aid to select the drug.

Apatient of a given disease may possess different Doshic picture in a given

time.Hence, it is needed to diagnose the “dosha predominance” of the patient and

select an appropriate anti doshic drug in each situation.

DOSHAGHNA GUNA GANANA- A Cumulative numerical method to assess

Anti Doshic effect / Guna Prbhava of the drug:

RASA / GUNA directly influence the body through DOSHA. It is easy to

understand their impact on the body in the terms of DOSHAGHNA (Anti Dosha

effect) effect. The cumulative Anti Dosha effect gives us an instant idea about the




drug in relation to Dosha. This has been achieved by a simple numerical method

named as "DOSHAGHNA GUNA GANANA" (DGG). DGG provides a simpler way to

calculate and analyze the effect of the drug on DOSHAS caused by the virtue of

GUNAPRABHAVA. Details are given in the tables.

RASAM VIPAKASTAU VIRYAM PRABHAVASTANYAPOHATI / BALA SAMYE

RASADINAM ITI NAISARGIKA BALAM //

Among RASA and other GUNAS (GUNA, VIPAKA and VIRYA) RASA

isOutdone by VIPAKA. It means thestrength of VIPAKA would be double to RASA.

VIRYAM overtakes both RASA and VIPAKA. Hence VIRYA is Three times stronger

than RASA. GUNA is not mentioned here. Therefore we may consider both RASA and

GUNA have similar strength. Basing on this NAISARGIKA BALA, RASA and GUNA

has been accorded (GANANA) "One" Numerical value in the terms of

DOSHAGHNATA. For Example GURUGUNA being VATHA HARA (Pacifier ofVATA

Dosha) is accorded one numeric value as V1. The numeric values of SADRASA (Six

Tastes) are shown in;

Table No.16

Numerical Values of DOSHAGHNATA of SADRASA:

Rasa (Taste of drug)

Doshaghnata

(Anti Doshika

effect)

Doshaghnasankhya

(Numerical value of

Anti-Doshic

effect)

Cumulative Anti-

Doshika effect of

Shadrasa (Six

tastes)

Madhura (Sweet) Vata & Pitta V1,P1

V3,P3,K3

Amla (Sour) Vata V1

Lavana (Salt) Vata V1

Katu (Bitter) Pitta & Kapha P1, K1

Tikta (Pungent) Kapha K1

Kashaya (Astringent) Pitta & Kapha P1, K1

The table shows the total numerical value of Sadrasais V3, K3, P3.It indicates

that Sarvarasabhaysam Maintains Thridoshas Equally and Provide Health.

It shows the calculation of summing (addition) the Guna effect in analyzing

the Doshaghna effect is viable.




Table No. 17

DOSHA KARA GUNA - DOSHAGHNA GUNA GANANA SANKHYA

(Numerical Value)

Dosha

Doshakara Guna

(Guna that

Aggravates Dosha)

Visheshaguna

(Opposite guna

that Pacifies

Dosha)

DoshaghnagunagananaSankhya

(Numerical Value of

Anti Doshic Effect)

VATA Ruksha (Dry) Snigdha (Unctuous) V1

Laghu (Light) Guru (Heavy) V1

Sheeta (Cold) Ushna (Hot) V1

Khara (Rough) Slakshna (Smooth) V1

Sukshma (Subtle) Sthula (Gross) V1

Chala (Mobile) Sthira (Stable) V1

Vishada (Clearness) Picchila (Viscid) V1

Parusha (Hard) Mridu (Soft) V1

PITTA Ushna (Hot) Sheeta (Cold) P1

Ishatsneha

(Unctuous)

IshatRuksha (Dry) P1

Tikshna (Sharp) Manda (Dull)

Mridu (Soft)

P1

Drava (Liquid) Sandra (Semi solid) P1

Sara (Moving

Downwards)

Sthira (Stable) P1

KAPHA Guru (Heavy) Laghu (Light) K1

Sheeta (Cold) Ushna (Hot) K1

Snigdha (Unctuous) Ruksha (Dry) K1

Sthira (Stable) Chala(Mobile) K1

Picchila (Viscid) Vishada (Clearness) K1

Mridu (Soft) Tikshna (Sharp) K1

The DOSHGNATA of GUNA is decided on the basis of DOSHA GUNAs

said by Charaka (CharakaSutrasthana 1/59 -61). The Opposite property (VISESHA

GUNA) of each Guna that aggravates dosha is accorded with one numeric value of

DOSHAGHNATA. Each GUNA is accredited with one numeric value of

DOSHAGHNATA as shown in Tables 2a & 2b. Thus all the 20 Gunas has been

accredited with one Doshaghnata numerically.




Table No: 18

TWENTY GUNAS - GUNA – DOSHAGHNA GUNA GANANASANKHYA

GUNA DOSAGHNATA

GURU V1

LAGHU K1

SHEETA P1

USHNA V1K1

SNIGDHA V1

RUKSHA K1P1

MANDA P1

TIKSHANA K1 V1

VISHADA K1

PICCHILA V1

SLAKSHANA V1

KHARA K1*

SANDRA P1

DRAVA V1*

STHIRA V1P1

SARA / CHALA K1

SUKSHMA K1*

STHULA V1

MRIDU P1*

KATHINA K1

Note: Few GUNAS (indicatedwith*) namely KHARA, DRAVA,SUKSHMA and

STHULA

DOSHAGHNATA is decided on the basis of their KARMA said in other texts.

VIPAKA has accorded double numeric value to that of corresponding RASA. VIRYA

is denoted with Triple numerical value of corresponding GUNA. The details are

shown in tables – 3 & 4.

Table No: 19

VIPAKA – DOSHAGHNATA

VIPAKA DOSHAGHNATA(Double

to RASA)

MADHURA V2P2

AMLA V2

KATU K2




Table No: 20

VIRYA DOSHAGHNATA

VIRYA DOSHAGHNATA

(Triple to RASA)

USHNA V3 K3

SHEETA P3

ANUSHANA* V1 P1 K1

*Drugs like Saindhava are said to possess AnushnaVirya. This third variety of Virya

is seen in Nighantus.

Sum total of the numerical values of RASA, GUNA, VIPAKA and VIRYA is

considered as the Cumulative DOSHAGHNATA of the drug. This numerical effort is

providing a clearer and unique insight on the DOSHAGHNATA of each drug. It has

dispelled the vagueness in understanding the impact of RASA PANCHAKA at once.

Table No: 21

DOSHAGHNATA OF CHINCHA BHEEJA

DRAVYA RASA GUNA VIPAKA VIRYA CUMULATIVE

SANKHYA

CHINCHA

BHEEJA

Kashaya

P1K1

Picchala

Ruksha

V1

K1P1

Katu

K2

Sheeta

P3

V1P5K4

Graph No.1 DOSHAGHNATA OF CHINCHA BHEEJA

Vata, 1

Pitta, 5

Kapha, 4

DOSHAGHNATA OF CHINCHA

BHEEJA

Pharmacognostic Study



MEANOSCOPIC EVALUATION OF CHINCHA BEEJA

Image No: 12 digital microscope.

A digital microscope- an enlarging aid is a low- powered (USB) microscope ,

which connects to a computer , normally via a USB port, widely available at

low cost commercially.

In essence USB microscopes are a webcam with a high-powered macro lens

and in-built LEDs lights situated next to the lens. The light reflected from the

sample then enters the camera lens. As the camera attaches directly to the USB

port of a computer, eyepieces are not required and the images are shown

directly on the monitor.

They offer modest magnifications (up to about 200×).

“MEANOSCOPE” –(because neither it is micro nor it is macro) (by using

digital microscope) – term coined by Dr. M. Paramkusha Rao

Can be used as a rapid, inexpensive botanical identification technique & is

useful in standardisation




Image No: 13 20x Image of Chincha beeja

Image No: 14 20x image of chincha beeja




Image No: 15 200x image of beeja

MEANOSCOP IMAGES OF CHINCHA BEEJA SECTION

Image No: 16 T.S of Chincha beeja




Image No: 17 T.S of Chincha Beeja at Endosperm

Phytochemical Study



PHYTOCHEMICAL STUDY

The formulations chincha bheeja fresh paste (PF), chincha bheeja paste of

powder (PP) and chincha bheeja paste of dry paste (PDP) were subjected to

preliminary phytochemical screening for the detection of various chemical

constituents present. The term qualitative analysis refers to the establishing and

providing the identity of a substance. The pharmacological actions of crude drugs are

determined by the nature of their constituents. The phyto-constituents are responsible

for the desired therapeutic properties. To obtain these pharmacological effects, the

plant materials itself or extract in a suitable solvent or isolated active constituent may

be used.

I. Tests for Alkaloids

1. Dragendroff's Test: To 1 ml of the extract, 1 ml of Dragendroff's reagent was

added; formation of orange red precipitate indicated the presence of alkaloids.

2. Wagner's Test: To 1 ml of the extract, 2 ml of Wagner's reagent was added;

the formation of a reddish brown precipitate indicated the presence of

alkaloids.

3. Mayer's Test: To1 ml of the extract, 3 ml of Mayer's reagent was added, the

formation of full white precipitate confirmed the presence of alkaloids.

4. Hager's Test: To1 ml of the extract, 3 ml of Hager's reagent was added, the

formation of yellow precipitate confirmed the presence of alkaloids.

II. Test for Carbohydrates

1. Molisch Test: To 2 ml of the extract, 1 ml of -naphthol solution was added,

and concentrated sulphuric acid through the sides of test tube. Purple or

reddish violet colour at the junction of the two liquids revealed the presence of

carbohydrates.

2. Fehling's Test: To 1ml of the extract, equal quantities of Fehling's solution A

and B were added, upon heating formation of a brick red precipitate indicated

the presence of carbohydrates.

Phytochemical Study



3. Benedict’s test: To 5ml of Benedict’s reagent, I ml of extract solution was

added and boiled for 2 minutes and cooled. Formation of a red precipitate

showed the presence of carbohydrates.

III. Tests for Proteins and Amino Acids

1. Biuret Test: To 1 ml of the extract add 1 ml of 40% sodium hydroxide

solution was added followed by 2 drops of 1% copper sulphate solution.

Formation of a violet colour showed the presence of proteins.

2. Xanthoprotein Test: To 1 ml of the extract 1 ml of concentrated nitric acid

was added. A white precipitate is formed, it is boiled and cooled. 20% of

sodium hydroxide or ammonia is subsequently added; orange colour indicated

the presence of aromatic amino acids.

3. Lead Acetate Test: To the extract, 1 ml of lead acetate solution is added.

Formation of a white precipitate indicated the presence of proteins.

4. Ninhydrin Test: Two drops of freshly prepared 0.2% ninhydrin reagent were

added to the extract solution and it was then heated. Development of blue

colour revealed the presence of proteins, peptides or amino acids.

IV. Tests for Phytosterol

1. Libermann Burchard Test: The extract was dissolved in 2 ml of chloroform

in a dry test tube. 10 drops of acetic anhydride and 2 drops of concentrated

sulphuric acid were added. The solution became red, then blue and finally

bluish green, indicated the presence of steroids.

2. Salkowski Test: Dissolve the extract in chloroform and equal volume of

concentrate sulphuric acid was added. Formation of bluish red to cherry red

colour in chloroform layer and green fluorescence in the acid layer

represented the steroid components in the tested extract.

V. Tests of Glycosides

1. Legal Test: The extract was dissolved in pyridine and sodium nitro prusside

solution was added to make it alkaline. The formation of pink red to red

colour showed the presence of glycosides.

Phytochemical Study



2. Baljet Test: To 1 ml of the test extract 1 ml sodium picrate solution was

added and the yellow to orange colour revealed the presence of glycosides.

3. Borntrager’s Test: A few ml of dil HCl was added to 1 ml of the extract

solution. It was then boiled, filtered and the filtrate was extracted with

chloroform. The chloroform layer was then treated with 1 ml of ammonia.

The formation of red colour showed the presence of anthraquinone glycosides.

4. Keller Killiani Test: The extract was dissolved in acetic acid containing

traces of ferric chloride and it was then transferred to a test tube containing

sulphuric acid. At the junction, formation of a reddish brown colour, which

gradually became blue, confirmed the presence of glycosides.

VI. Test for Saponins

1. About 1 ml of methanol extract was diluted separately with distilled water to

20 ml, and shaken in a graduated cylinder for 15 minutes. A1% 1 cm layer of

foam indicated the presence of saponins.

VII. Test for Flavonoids

1. Shinoda Test: To 1 ml of the extract, magnesium turnings were added followed

by 1-2 drops of concentrated hydrochloric acid. Formation of red colour showed

the presence of flavanoids.

VIII. Test for Tannins and Phenolic compounds

1. To 1 ml of the extract, ferric chloride was added, formation of a dark blue or

greenish black colour product showed the presence of tannis.

2. To the extract, potassium dichromate solution was added, formation of a

precipitate showed the presence of tannins and phenolic compounds.

IX. Test for Triterpenoids

1. Two or three granules of tin metal in 2 ml thionyl chloride solution. Were

dissolved 1 ml of the extract was then added into the test tube. The formation of

a pink colour indicated the presence of triterpenoids.

Phytochemical Study



Test for Fixed Oils:

1. Spot Test: A small quantity of extract was pressed between two filter papers.

Oil stains on paper indicated the presence of fixed oils.

2. Saponification Test: To 1 ml of the extract few drops of 0.5 N alcoholic

potassium hydroxide was added along with a drop of phenolphthalein. The

mixture was heated on a water bath for 1-2 hours. The formation of soap or

partial neutralization indicated the presence of fixed oils.

Table No.22

Showing the Phytochemical analysis results

S.No. Test Type of test used FP PP PDP

I Alkaloids Mayer’s test - - -

II Carbohydrates Molisch test + + +

III Starch Iodine test + + +

IV Tannins Ferric chloride test + + +

V Protein and Amino Acid Biuret Test - - -

VI Flavonoids Led acetate - - -

VII Saponins - - -

VIII Acid test (pH) 7 7 7

+ Positive; - Negative

Results and observations:

The above table showed that carbohydrates, Starch and Tannins are present in

PF Group drug, PP group drug & PDP group drug. Ph is 7 in three groups.

Phytochemical Study



Image No. 18 Phytochemical study of FP

Image No. 19 Phytochemical study of PP

Image No. 20 Phytochemical study of PDP

Pharmaceutical Preparation

A STUDY ON THE GRANTHIGNA EFFECT OF CHINCHA BHEEJA YOGA (Tamarindus indica

L.) PAINT W.S.R TO THUNDIKERI (TONSILLITIS). Page 80

PHARMACEUTICAL PREPARATION

Collection of drug:

Purchased good quality chincha beeja from Tirupati market. It made into three

preparations.

Chincha beeja yoga

Preparation – 1 (PP)

Cleaned chincha beeja are taken made in to fine seed powder in machine this

has given to one group.

Image No. 21 Preparation of powder (PP)

Preparation -2 (PDP)

One sandalwood stone was taken and put some droplets of water and rub the

seed of chincha in circular motion on the sandal stone after some time and eventually

obtained paste. Water added time to time to it. After that water evaporate and then

pellets were obtained. These small pellets pulverized and were subjected for sieving

to Obtained fine powder.

Pharmaceutical Preparation



Image No. 22 Preparation of powder of dried paste (PDP)

Preparation -3 (FP)

One sandalwood stone was taken and put some droplets of water and rub the

seed of chincha in circular motion on the sandal stone after some time and obtained

paste.

Image No. 23 Preparation of fresh paste (FP)

Microbiological Study



MICROBIOLOGICAL STUDY

Materials:

Bacteria- Staphylococcus aureus, Escherichia coli

Agar plate

Glass test tube

Dropper

Test tube stand

Incubator

Method followed: Disc diffusion method.

PROCEDURE:-

First of all the bacteria Staphylococcus aureus and Escherichia coli Which

was present in the sputum is taken. Culture of bacterium is done in agar plate for one

day. Then the bacterium is taken from the culture to check the sensitivity of drug.

The Staphylococcus aureus bacterium is mixed with agar and inoculated in an

agar plate which is now called “bacterial lawn”.The plate contains even distribution of

bacteria. Then small cylinder like structure is cut from the centre of disk. Removal of

agar plugs left well like structure. Then drug is placed into the centre. The disc is

incubated for 24hrs at 370C temperature. The drug sample is diffused into the agar

from the central area where the drug is placed. The organism is killed or inhibited by

the concentration of the drug sample. If there is no growth in the immediate area

around the drug sample: This is called the zone of inhibition.

Image no. 24 Procedure of culture & sensitivity

http://www.rlc.dcccd.edu/mathsci/reynolds/micro/lab_manual/glossary.html




The above process is followed to check the sensitivity of Chincha beeja fresh

paste (FP), Paste of Powder (PP) and paste of Dry powder (PDP).

Figure No: 25 Sensitivity of FP

The same process is followed to check the sensitivity of Paste of Powder (PP)

of Chincha beeja yoga

Figure No: 26 Sensitivity of PP

The same process is followed to check the sensitivity of paste of Dry powder

(PDP) of Chincha beeja yoga

Figure No: 27 Sensitivity of PDP




RESULTS:-

Table No. 23 showing sensitivity result

Sample Sensitivity

FP + + +

PP + +

PDP +

The result shows that Chincha beeja fresh paste (FP) was more effective on

bacteria than the Paste of Powder (PP), paste of Dry powder (PDP).

Clinical Study



CLINICAL STUDY

A clinical study is a method of closely monitoring the benefits and potential

draw backs of new or existing treatments or tests. They are necessary to prove with

statistics that a treatment or test is really as good as we hope it might be.

Ayurveda like every science has its own philosophy and its own way of

approach. Clinical research is the most fruitful line of approach to evaluate the

methods of diagnosis, treatment and evaluation of efficacy of the drugs. The keen

observations during the clinical study are the final aspects to prove efficacy of the

drugs.

Our ancient Acharyas have laid down some strict parameters to remain

healthy, and had discovered some wonderful drugs to get rid of diseases. But in the

present time due to over exploitation of herbal resources many precious drugs have

become extinct and many are at the verge of extinction. In this scenario there is strong

need to improve our materia- medica by new drugs which are abundantly found in the

nature and be effective on existing ailment.

Also Acharya Charaka has mentioned that the knowledge about new drugs can

be obtained through the shepherds, cowherds or local residents, Practionars, Rushis of

that particular area. Keeping this concept in mind, the present drug Chincha beeja

(Tamarindus indica Linn) . Late Sri Balaraj Maharshi the Former advisor on

Ayurveda to the government of Andhra Pradesh, India & Brazil founder of S.V

Ayurvedic College has suggested Chincha beeja Lepa in Tonsillitis.

The guide Dr M. Paramkusha Rao close associate of Balaraj maharshi has

observed its promising effect. Therefore Chincha beeja is taken to study its

Grandhighna effect in Tundikeri to

PLAN OF ACTION:

1. Patients suffering from Tundikeri were selected on the basis of classical signs

and symptoms described in classical texts by giving special importance to

Cardinal Symptoms like Shotha, Toda, Daha, Paka etc.

2. Patient attending O.P.D. of Dravyaguna, S.V Ayurvedic hospital,

Tirupati.were selected randomly irrespective of their age, sex and religion etc.

Clinical Study



3. We have done a Health checkup camp for the students of Nehru municipal

school, Tirupati, examined 300 students and picked up few patients and gave

treatment to them.

Image No. 28, 29 Health checkup camp

GROUPING OF PATIENTS:

1. Fine seed powder made in machine, this has given to one group. PASTE OF

POWDER (PP).

2. Seed rubbed against the rough surface then made in to paste, allow drying then

made in to fine powder. This has given to one group. PASTE OF DRIED

PASTE (PDP).

3. Seed rubbed against rough surface and made into paste and then applied to one

group. FRESH PASTE (FP).

4. Placebo. (PL)

MATERIAL & METHODS:

Chincha beeja

Distilled water

Haridra churna

Flat rough stone (which is used for Sandal paste preparation)

Sterile cotton

Clinical Study



Tundikeri salaka (Tonsil cops)

Spirit lamp

Water heater

Glass bowel

Glass tumbler

Tundikeri salaka (Tonsil cops) is an arrow shaped 12c.m length instrument

which is made up of silver.

Head of this instrument have rough surfaced edges this type of edges useful

for holding Cotton without escaping.

This instrument is very comfortable for applying the medicine on surface of

tonsils

Image No. 30 Tundikeri salaka (Tonsil Cops).

Clinical Study



Drug Administration:

Patient made to gargle with lukewarm haridra kwatha.

Applied the chincha beeja lepa on affected tonsils with the help of tonsil cops

which made up of silver.

Same procedure continued for 3 days.

Form : The drug was given in the form of Lepa

Route : External application

Duration : 3 days

This procedure conducted in Dravyaguna Kriyayoga Theatre; S.V. Ayurvedic

Hospital, Tirupati.

Kriyayoga: Application of drug at the site of disease is named as Kriyayoga.

Kriya + Yoga Kriyayoga.

Kriya- Dravya Chikitsa

Yoga- Samyoga (conjoining) of drug with site of disease. They provide faster results

Such applications are told in Nighantus & other Chikitsa Grandhas. The drugs are

applied locally at the site of disease. These special treatments conducted in

Dravyaguna Kriyayoga theatre established by Dr M. Paramkusha Rao. Treatments

conducted regularly for vata kantaka, pada dhaha, kati vedana, janu vedana, apasmara.

Application of Chincha beeja yoga also a Kriyayoga.

INCLUSION CRITERIA:

1. Age group of 2years to 60years

2. Patient having symptoms of tonsillitis viz. throat pain, dysphagia ,fever etc

3. Patient willing for treatment

4. Patients of either sex will be included

EXCLUSION CRITERIA:

1. Tonsillitis with complications e.g. Quincy, laryngeal edema, abscess

2. Age group below 2 years and above 60 years

3. Other conditions which mimic tonsillitis e.g. diphtheria, herpes etc

Clinical Study



PARAMETERS:

Criteria to assess the effect of the trial drug

All the selected patients are advised to come for treatment of three days.

Subjective assessment

The symptoms that are assessed in patients are:

1. Dysphagia

2. Redness in mucus membrane

3. Temperature

4. Enlargement of tonsils

5. Halitosis(Bad Breath)

6. Pricking pain

ROUTINE LABORATORY INVESTIGATION:

1. TLC,

2. DLC,

3. ESR,

4. Hb%

Clinical Study



OBSERVATION AND RESULTS

GENERAL OBSERVATIONS:

Various demographic parameters viz., Age, Sex, Chronicity etc are analyzed in the

present clinical trial.

Table No. 24

Age wise distribution of patients

Age (in

Years)

No of

Patients in

study

2 to 10 15

10 to 20 17

20 to 30 1

30 to 40 4

40 to 50 0

50 to 60 3

Total 40

In the present study the criteria of age taken is between 2-60 years

Graph No. 2 Age wise distribution of patients

In the present study 10-20 year patients are more in number.

0

2

4

6

8

10

12

14

16

18

2 to 10 10 to 20 20 to 30 30 to 40 40 to 50 50 to 60

No

of

pat

ien

ts

Age in years

Age wise distribution of Tonsillitis patients

Clinical Study



Table No. 25

Sex wise distribution of patients

Sex

No of

Patients in

study

Male 29

Female 11

Total 40

Graph No. 3 Sex wise distribution of patients

In the present study male patients are more than female patients.

Table No. 26

Chronicity wise distribution of patients

Chronicity

No of

Patients in

study Up to 1 month 7

1 to 6 months 23

More than 6

months

10

Total 40

Graph No. 4 Chronicity wise distribution of patients

0

20

40

Male Female

No

of

pat

ien

ts

SEX WISE DISTRIBUTION OF TONSILLITIS PATIENTS

0

50

Up to 1month

1 to 6months

More than6 months

No

of

pat

ien

ts

Chronicity

Chronicity wise disribution of total Patients

Clinical Study



In the present study 1-6 months Chronicity patients are more in number.

Gradiation of symptoms before and after treatment

Table.No. 27 Gradation of Dysphagia in group -1(FP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)

Before treatment 0 8 2 0

After treatment 9 1 0 0

Grading of Dysphagia

Grade 0 - No difficulty in swallowing

Grade 1 - Patient feels difficulty in Swallowing of solid matters

Grade 2 - Patient unable to swallow even Saliva

Grade 3 - Patient unable to open his mouth completely due to severe pain

Graph No. 5 Gradation of Dysphagia in group -1(FP)

Observations:

No patients were found with grade 3 i.e., patients unable to open mouth completely

were none before treatment, and also after treatment;

With grade 2 i.e., patients unable to swallow even Saliva were 2 before treatment,

after treatment they are zero;

With grade 1 i.e., difficulty in Swallowing of solid matters were found in 8 patients

before treatment, after treatment they became one in number;

No patients were available with grade 0 before treatment, after treatment they became

nine in number.

Overall effect on swallowing: Out of 10 patients 9 are totally relieved from difficulty

in swallowing

Table No. 28 Statistics of Dysphagia in group -1(FP)

As per the statistics in group-1 reduction in Dysphagia is extremely significant.

0

5

10

Grade-0 Grade-1 Grade-2 Grade-3

No

of

Pat

ien

ts

Dysphagia in tonsillitis patients

Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-value P value Significance

B.T A.T B.T A.T B.T A.T

Dysphagia 1.20 0.10 1.10 0.42 0.32 0.13 0.10 11.0000 <0.0001 Extremely

significant


Grade 1 - Patient feels difficulty in Swallowing of

solid matters


Grade 3 - Patient unable to open his mouth completely

due to severe pain

Clinical Study



Table No. 29 Gradation of Redness in Mucus Membrane in group-1(FP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

Before treatment 0 6 4

After treatment 9 1 0

Grading of Redness in Mucus Membrane

Grade 0 -No change in colour of mucus membrane.

Grade 1-Redness present only over peritonsillar surface.

Grade 2 -Redness present completely over oropharynx including tonsils.

Graph No.6 Gradation of Redness in Mucus Membrane in group-1(FP)

Observations:

With grade 2 i.e., Redness present completely over oropharynx including tonsils were

4 before treatment, after treatment they are zero;

With grade 1 i.e., Redness present only over peritonsillar surface were found in 6

patients before treatment, after treatment they became one in number;


9 in number.

Overall effect on Redness in Mucus Membrane: Out of 10 patients 9 are totally

relieved from Redness in Mucus Membrane. One patient is held at Grade 1i.e.,

Redness present only over peritonsillar surface.

Table No.30 Statistics of Redness in Mucus Membrane in group -1(FP)

As per the statistics in group-1 reduction in Redness in Mucus Membrane is

extremely significant.

0

2

4

6

8

10

Grade-0 Grade-1 Grade-2

No

of

Pat

ien

ts

Redness in Mucus Membrane in tonsillitis patients

Before treatment

After treatment

Parameter Mean Mean

Diff



Redness in

Mucus

Membrane

1.40 0.10 1.30 0.52 0.32 0.16 0.10 8.5105 <0.0001 Extremely

significant

Grade 0 -No change in colour of mucus membrane

Grade 1-Redness present only over peritonsillar surface

Grade 2 -Redness present completely over oropharynx

including tonsils.

Clinical Study



Table No. 31 Gradation of Temperature in Group-1(FP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)


After treatment 10 0 0 0 Grading of Temperature:-

Grade 0 - Normal temperature i.e., 98.6°F

Grade 1 -Temperature rises from 98. 6°F - 100°F

Grade 2 -Temperature rises from 100°F - 102°F

Grade 3 -Temperature more than 102°F.

Graph No. 7 Gradation of Temperature in Group-1(FP)

Observations:

No patients were found with grade 3 i.e., Temperature more than 102°F were none

before treatment;

With grade 2 i.e., Temperature rises from 100°F - 102°F was 1 before treatment, after

treatment they are zero;

With grade 1 i.e., Temperature rises from 98. 6°F - 100°F were found in 5 patients

before treatment, after treatment they became zero in number;

4 patients were available with grade 0 before treatment, after treatment they became

ten in number.

Overall effect on body temperature: Out of 10 patients 4 are not having temperature

6 patients who have temperature are totally relieved from raised temperature.

Table No.32 Statistics of body temperature in group -1(FP)

As per the statistics in group-1 reduction in Body Temperature is Very significant.

0

2

4

6

8

10


No

. of

pat

ien

ts

Temperature in tonsillitis patients

Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


body

temperature

0.70 0.00 0.70 0.67 0.00 0.21 0.00 3.2796 0.0095 Very

significant





Clinical Study



Table No.33 Gradation of Enlargement of Tonsils in group-1(FP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)

Before

treatment

0 3 7 0

After treatment 7 3 0 0 Grading of Enlargement of tonsils

Grade 0- No enlargement.

Grade 1 - Mild enlargement of tonsils.

Grade 2 - Moderate enlargement of tonsils.

Grade 3 - Severe enlargement of tonsils (Kissing Tonsils).

Graph No. 8 Gradation of Enlargement of Tonsils in group-1(FP)

Observations:-

No patients were found with grade 3 i.e., Severe enlargement of tonsils (Kissing

Tonsils) were none before treatment;

With grade 2 i.e., Moderate enlargement of tonsils were 7 before treatment, after


With grade 1 i.e., Mild enlargement of tonsils were found in 3 patients before

treatment, after treatment also they are 3 in number;


7 in number.

Overall effect on enlargement of tonsils: Out of 10 patients 7 are totally relieved

from enlargement of tonsils. 3 patients are held at grade 2 i.e., moderate enlargement

of tonsils.

Table No. 34 Statistics of enlargement of tonsils in group -1(FP)

As per the statistics in group-1 reduction in Enlargement of Tonsils is extremely

significant.

0

2

4

6

8


No

. of

Pat

ien

ts

Enlargement of Tonsils

Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P value Significance


Enlargement

of tonsils

1.70 0.30 1.40 0.48 0.48 0.15 0.15 8.5732 <0.0001 Extremely

significant

Grade 0- No enlargement

Grade 1 - Mild enlargement of tonsils

Grade 2 - Moderate enlargement of tonsils

Grade 3 - Severe enlargement of tonsils (Kissing Tonsils)

Clinical Study



Table No.35 Gradation of Halitosis (Bad Breath) in group-1 (FP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)


After treatment 9 1 0 Grading of Halitosis (Bad Breath)

Grade 0-Halitosis absent

Grade 1-Halitosis present only when opening of mouth Angle

Grade 2-completely Halitosis present even during talking

Graph No.9 Halitosis (Bad Breath) in tonsillitis patients

Observations:-

With grade 2 i.e., completely Halitosis present even during talking were 5 before

treatment, after treatment they are zero;

With grade 1 i.e., Halitosis present only when opening of mouth Angle were found

in 2 patients before treatment, after treatment they became one in number;

3 patients were available with grade 0 before treatment, after treatment they became 9

Overall effect on Halitosis: Out of 10 patients 3 are not having halitosis 6 are totally

relieved from Halitosis. One patient held at grade-1i.e., Halitosis present only when

opening of mouth Angle.

Table No.36 Statistics of Halitosis in group -1(FP)

As per the statistics in group-1 reduction in Halitosis is Very significant.

0

2

4

6

8

10


No

of

pat

ien

ts

Halitosis (Bad Breath) in tonsillitis patients

Before treatment

After treatment

Parameter Mean Mea

n

Diff

S.D S.E t-

value P value Significance B.T A.T B.T A.T B.T A.T

Halitosis 1.20 0.10 1.10 0.92 0.32 0.29 0.10 3.9727 0.0032 Very

significant


Grade 1-Halitosis present only when opening of

mouth Angle

Grade 2-completely Halitosis present even during

talking

Clinical Study



Table No.37 Gradation of Pricking Pain in Group-1(FP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)



Grading of pricking pain

Grade 0-No pricking pain

Grade 1-Pain during talk

Grade 2 - Continuous pain

Graph No.10 Gradation of Pricking Pain in Group-1(FP)

Observations:-

With grade 2 i.e., Continuous pain were 3 before treatment, after treatment they are

zero;

With grade 1 i.e., Pain during talk were found in 5 patients before treatment, after

treatment they became one in number;


nine in number.

Overall effect on pricking pain: Out of 10 patients 2are not having pricking pain. 7

are totally relieved from pricking pain. One patient is held at grade-1 i.e., Pain during

talk.

Table No.38 Statistics of Pricking Pain in group-1(FP)

As per the statistics in group-1 reduction in Pricking Pain is Very significant.

0

2

4

6

8

10


No

of

pat

ien

ts

Pricking Pain in Tonsillitis patients

Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Pricking pain 1.10 0.10 1.00 0.74 0.32 0.23 0.10 4.7434 0.0011 Very

significant




Clinical Study



Table No.39 Dysphagia in before and after treatment of group-2 (PDP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)


After treatment 7 3 0 0

Grading of Dysphagia





Graph no.11 Dysphagia in before and after treatment of group-2 (PDP)

Observations:


were none before treatment;


after treatment they are zero;


before treatment, after treatment they became three in number;

1 patient was available with grade 0 before treatment, after treatment seven in

number.

Overall effect on swallowing: Out of 10 patients one patient is not having

Dysphagia. 6 patients who have Dysphagia are totally relieved from difficulty in

swallowing. 3patients are held at grade-1 i.e., difficulty in Swallowing of solid

matters.

Table No. 40 Statistics of Dysphagia in Group-2 (PDP)


0

2

4

6

8


No

. of

Pat

ien

t

Dygphagia in tonsillitis patients

Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Dysphagia 1.10 0.30 0.80 0.57 0.48 0.18 0.15 6.0000 0.0002 Extremely

significant


Grade 1 - Patient feels difficulty in Swallowing of

solid matters


Grade 3 - Patient unable to open his mouth completely

due to severe pain

Clinical Study



Table No.41 Gradation of Redness in Mucus Membrane in group-2 (PDP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)


After treatment 9 1 0 Grading of Redness in Mucus Membrane




Graph No.12 Gradation of Redness in Mucus Membrane in group-2 (PDP)

Observations:

With grade 2 i.e., Redness present completely over oropharynx including tonsils was

1 before treatment, after treatment they are zero;


patients before treatment, after treatment they became one in number;


nine in number.


relieved from Redness in Mucus Membrane. One patient is held at grade-1 i.e.,


Table No.42 Statistics of Redness in Mucus Membrane in Group-2 (PDP)



0

2

4

6

8

10


No

of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value P value Significance


Redness in

Mucus

Membrane

1.10 0.10 1.00 0.32 0.32 0.10 0.10 6.7082 <0.0001 extremely

significant

Grade 0 -No change in color of mucus membrane

Grade 1-Redness present only over peritonsillar

surface

Grade 2 -Redness present completely over

oropharynx including tonsils.

Clinical Study



Table No.43 Gradation of temperature in group-2 (PDP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)







Graph No.13 Gradation of temperature in group-2 (PDP)

Observations:

No patients were found with grade 3 i.e., Temperature more than 102°F were none before

treatment;

With grade 2 i.e., Temperature rises from 100°F - 102°F were 2 before treatment, after


With grade 1 i.e., Temperature rises from 98. 6°F - 100°F were found in 2 patients before

treatment, after treatment they became two;

6 patients were available with grade 0 before treatment, after treatment they became 8.

Overall effect on body temperature: Out of 10 patients 6 patients are not having

temperature 2 patients who have temperature are totally relieved from raised temperature.

2 patients are held at grade-1 i.e., Temperature rises from 98. 6°F - 100°F.

Table No.44 Statistics of Body temperature in Group-2 (PDP)

As per the statistics in group-2 reduction in Body Temperature is significant.

0

2

4

6

8


No

. of

Pat

ien

ts

Body Temperature in tonsillitis patients

Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


body

temperature

0.60 0.20 0.40 0.84 0.42 0.27 0.13 2.4495 0.0368 Significant





Clinical Study



Table No. 45 Gradation of Enlargement of Tonsils in group-2 (PDP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)







Graph No.14 Gradation of Enlargement of Tonsils in group-2 (PDP)

Observations:-




treatment they are zero in number;


treatment, after treatment also they 6 in number;


4 in number.


from enlargement of tonsils. 6 patients are held at grade-1 i.e., Mild enlargement of

tonsils.

Table No. 46 Statistics of Enlargement of Tonsils in Group-2 (PDP)

As per the statistics in group-2 reduction in Enlargement of Tonsils is Very

significant.

0

2

4

6

8


No

. of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Enlargement

of tonsils

1.30 0.60 0.70 0.48 0.52 0.15 0.16 4.5826 0.0013 Very

significant





Clinical Study



Table No. 47 Gradation of Halitosis (Bad Breath) in Group-2 (PDP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)



Grading of Halitosis (Bad Breath)




Graph No.15 Gradation of Halitosis (Bad Breath) in Group-2 (PDP)

Observations:-

No patients With grade 2 i.e., completely Halitosis present even during talking before

treatment, after treatment also they are zero;

with grade 1 i.e., Halitosis present only when opening of mouth Angle were found in 5

patients before treatment, after treatment they became two in number;

5 patients were available with grade 0 before treatment, after treatment they became 8.

Overall effect on Halitosis: Out of 10 patients 5patients are not having Halitosis. 3

patients who have Halitosis are totally relieved from Halitosis. 2 patients are held at

grade-1 i.e., Halitosis present only when opening of mouth Angle.

Table No.48 Statistics of Halitosis in Group-2 (PDP)

As per the statistics in group-2 reduction in Halitosis is Not significant.

0

2

4

6

8


No

of

pat

ien

ts

Halitosis (Bad Breath) in Tonsillitis patients

Before treatment

After treatment

Parameter Mean Mea

n

Diff

S.D S.E t-

value P value Significance B.

T

A.

T

B.

T

A.

T

B.

T

A.

T

Halitosis 0.5

0

0.2

0

0.30 0.5

3

0.4

2

0.1

7

0.1

3

1.9640 0.0811 Not significant



mouth Angle

Grade 2-completely Halitosis present even

during talking

Clinical Study



Table No.49 Gradation of Pricking Pain in group-2 (PDP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)







Graph No.16 Gradation of Pricking Pain in group-2 (PDP)

Observations:-

No patients with grade 2 i.e., Continuous pain before treatment, after treatment also

they are zero;


treatment they became one in number;


9 in number.

Overall effect on pricking pain: Out of 10 patients 5 patients are not having pricking

pain 4 patients who having pricking pain are totally relieved from pricking pain. One

patient is held at grade-1 i.e., Pain during talk.

Table No.50 Statistics of Pricking pain in Group-2 (PDP)

As per the statistics in group-2 reduction in Pricking Pain is significant.

0

2

4

6

8

10


No

of

pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P -

value

Significance


Pricking

pain

0.50 0.10 0.40 0.53 0.32 0.17 0.10 2.4495 0.0368 Significant




Clinical Study



Table No.51 Gradation of Dysphagia in Group-3 (PP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)


After treatment 8 2 0 0 Grading of Dysphagia





Graph No.17 Gradation of Dysphagia in Group-3 (PP)

Observations:

No patients were found with grade 3 i.e., patients unable to open mouth completely were

none before treatment;

With grade 2 i.e., patients unable to swallow even Saliva were 2 before treatment, after



before treatment, after treatment they became two in number;

One patient was available with grade 0 before treatment, after treatment they became 8.

Overall effect on swallowing: Out of 10 patients one patient not having Dysphagia. 7

patients who have Dysphagia are totally relieved from difficulty in swallowing. 2 patients

are held at grade-1 i.e., difficulty in Swallowing of solid matters.

Table No.52 Statistics of Dysphagia in Group-3 (PP)


0

2

4

6

8


No

. of

Pat

ien

ts


Before treatmentAfter treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Dysphagia 1.10 0.20 0.90 0.57 0.42 0.18 0.13 5.0138 0.0007 Extremely

significant




Grade 3 - Patient unable to open his mouth completely due to

severe pain

Clinical Study



Table No.53 Gradation of Redness in Mucus Membrane in Group-3 (PP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)


8 2 0





Graph No. 18 Gradation of Redness in Mucus Membrane in Group-3 (PP)

Observations:

With grade 2 i.e., Redness present completely over oropharynx including tonsils were 4

before treatment, after treatment they are zero;

With grade 1 i.e., Redness present only over peritonsillar surface were found in 6 patients

before treatment, after treatment they became two in number;

No patients were available with grade 0 before treatment, after treatment they became 8.


relieved from Redness in Mucus Membrane. 2 patients are held at grade 1 i.e., Redness

present only over peritonsillar surface.

Table No.54 Statistics of Redness in Mucus Membrane in Group-3 (PP)



0

2

4

6

8


No

of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value P value Significance


Redness in

Mucus

Membrane

1.40 0.20 1.20 0.52 0.42 0.16 0.13 9.0000 <0.0001 Extremely

significant

Grade 0 -No change in color of mucus membrane

Grade 1-Redness present only over peritonsillar surface

Grade 2 -Redness present completely over oropharynx

Including tonsils.

Clinical Study



Table No.55 Gradation of Temperature in Group-3 (PP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)







Graph No. 19 Gradation of Temperature in Group-3 (PP)

Observations:

No patients were found with grade 3 i.e., Temperature more than 102°F were none before

treatment;

With grade 2 i.e., Temperature rises from 100°F - 102°F was 1 before treatment, after


With grade 1 i.e., Temperature rises from 98. 6°F - 100°F were found in 3 patients before

treatment, after treatment they became zero in number;

6 patients were available with grade 0 before treatment, after treatment they are ten in

number.

Overall effect on body Temperature: Out of 10 patients 6 patients are not having

temperature 4 patients who have temperature are totally relieved from raised

temperature.

Table No.56 Statistics of Body temperature in group-3 (PP)

As per the statistics in group-3 reduction in Body Temperature is significant

0

2

4

6

8

10


No

. of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Body

Temperature

0.50 0.10 0.40 0.71 0.32 0.22 0.10 2.4495 0.0368 Significant





Clinical Study



Table No.57 Gradation of Enlargement of Tonsils in group-3 (PP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)







Graph No.20 Gradation of Enlargement of Tonsils in group-3 (PP)

Observations:-






treatment, after treatment also they 4 in number;


6 in number.


from enlargement of tonsils. 4 patients are held at grade 1i.e, Mild enlargement of

tonsils.

Table No.58 Statistics of Enlargement of Tonsils in group-3 (PP)

As per the statistics in group-3 reduction in Enlargement of Tonsils is extremely

significant.

0

2

4

6

8


No

. of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Enlargement

of tonsils

1.20 0.40 0.80 0.42 0.52 0.13 0.16 6.0000 0.0002 Extremely

significant





Clinical Study



Table No.59 Gradation of Halitosis (Bad Breath) in group-3 (PP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)



Grading of Halitosis (Bad Breath)




Graph No.21 Gradation of Halitosis (Bad Breath) in group-3 (PP)

Observations:-

With grade 2 i.e., completely Halitosis present even during talking were 1 before

treatment, after treatment they are zero;


patients before treatment, after treatment they became two in number;


Overall effect on Halitosis: Out of 10 patients 4 are not having Halitosis 4 patients who

have Halitosis are totally relieved. 2 patients are held at grade 1 i.e., Halitosis present only

when opening of mouth Angle.

Table No.60 Statistics of Halitosis in group-3 (PP)

As per the statistics in group-3 reduction in Halitosis is significant.

0

2

4

6

8


No

of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Halitosis 0.70 0.20 0.50 0.67 0.42 0.21 0.13 3.0000 0.0150 Significant



mouth Angle


talking

Clinical Study



Table No. 61 Gradation of Pricking Pain in Group-3 (PP)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)







Graph No.22 Gradation of Pricking Pain in Group-3 (PP)

Observations:-


they are zero;


treatment they became zero in number;


10 in number.

Overall effect on Pricking Pain: Out of 10 patients 6 are not having prickling pain. 4

patients who have prickling pain are totally relieved.

Table No. 62 Statistics of Pricking Pain in group-3 (PP)

As per the statistics in group-3 reduction in Pricking Pain is significant.

0

2

4

6

8

10


No

of

pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Pricking

Pain

0.40 0.00 0.40 0.52 0.00 0.16 0.00 2.4495 0.0368 Significant




Clinical Study



Table No.63 Gradation of Dysphagia in group-4 (PL)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)


After treatment 2 6 2 0 Grading of Dysphagia





Graph No.23 Gradation of Dysphagia in group-4 (PL)

Observations:


were none before treatment;


after treatment they are two in number;


before treatment, after treatment they became six in number;


2 in number.

Overall effect on swallowing: Out of 10 patients 2 are totally relieved from difficulty

in swallowing. 6 patients are held at grade 1 i.e., difficulty in Swallowing of solid

matters. 2 patients are held at grade 2 i.e., patients unable to swallow even Saliva.

Table No.64 Statistics of Dysphagia in group-4 (PL)

As per the statistics in group-4 reduction in Dysphagia is not significant.

0

2

4

6

8


No

. of

Pat

ien

t


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value

Significance


Dysphagia 1.20 1.00 0.20 0.42 0.67 0.13 0.21 1.0000 0.3434 Not significant

Grade 0 - No difficulty in swallowing Grade 1 - Patient feels difficulty in Swallowing of solid matters


Grade 3 - Patient unable to open his mouth completely due to

severe pain

Clinical Study



Table No.65 Gradation of Redness in Mucus Membrane in group-4 (PL)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)






Grade 2 -Redness present completely over oropharynx Including tonsils.

Graph No.24 Gradation of Redness in Mucus Membrane in group-4 (PL)

Observations:

With grade 2 i.e., Redness present completely over oropharynx including tonsils was

1 before treatment, after treatment they became zero;


patients before treatment, after treatment they became seven in number;


3 in number.


relieved from Redness in Mucus Membrane. 7 patients are held at grade 1 i.e.,


Table No.66 Statistics of Redness of Mucus Membrane in group-4 (PL)


significant.

0

2

4

6

8

10


No

of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Redness in

Mucus

Membrane

1.10 0.70 0.40 0.32 0.48 0.10 0.15 2.4495 0.0368 Significant

Grade 0 -No change in color of mucus

membrane

Grade 1-Redness present only over

peritonsillar surface

Grade 2 -Redness present completely over

oropharynx Including tonsils.

Clinical Study



Table No.67 Gradation of temperature in group-4 (PL)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)







Graph No.25 Gradation of temperature in group-4 (PL)

Observations:

No patients were found with grade 3 i.e., Temperature more than 102°F were none

before treatment;

No patients With grade 2 i.e., Temperature rises from 100°F - 102°F before treatment,

after treatment also they are zero;

No patients with grade 1 i.e., Temperature rises from 98. 6°F - 100°F before

treatment, after treatment they became one in number;


nine in number.

Overall effect on Temperature: Out of 10 patients all are having normal

temperature. But after treatment one patient is held at grade 1 i.e., Temperature rises

from 98. 6°F - 100°F.

Table No.68 Statistics of Body Temperature in group-4 (PL)

As per the statistics in group-4 reduction in Body Temperature is not significant.

0

2

4

6

8

10


No

. of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


Temperature 0.00 0.10 0.10 0.00 0.32 0.00 0.10 1.0000 0.3434 Not

significant





Clinical Study



Table No.69 Gradation of Enlargement of Tonsils in group-4 (PL)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)

No of patients

with grade-3

(severe)







Graph No.26 Gradation of Enlargement of Tonsils in group-4 (PL)

Observations:-



No patients with grade 2 i.e., moderate enlargement of tonsils before treatment, after

treatment they are two in number;


treatment, after treatment they became 8 in number;

No patients were available with grade 0 before treatment & after treatment.

Overall effect on enlargement of tonsils: Out of 10 patients no one relieved from

enlarged tonsils. 8 patients are held at grade 1 i.e., Mild enlargement of tonsils. 2

patients are held at grade 2 i.e., moderate enlargement of tonsils.

Table No.70 Statistics of Enlargement of Tonsils in group-4 (PL)

As per the statistics in group-4 reduction in Enlargement of Tonsils is not significant.

0

2

4

6

8

10


No

. of

Pat

ien

ts


Before treatment

After treatment

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


enlargement

of tonsils

1.00 1.20 0.20 0.00 0.42 0.00 0.13 1.5000 0.1679 Not

significant




Grade 3 - Severe enlargement of tonsils

(Kissing Tonsils)

Clinical Study



Table No.71 Gradation of Halitosis (Bad Breath) in group-4 (PL)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)


After treatment 7 3 0 Grading of Halitosis (Bad Breath)




Graph No.27 Gradation of Halitosis (Bad Breath) in group-4 (PL)

Observations:-

No patients With grade 2 i.e., completely Halitosis present even during talking before treatment, after

treatment also they are zero;


patients before treatment, after treatment they became three in number;


Overall effect on Halitosis: Out of 10 patients 6are not having halitosis one patient who has

Halitosis is totally relieved. 3patients are held at grade 1 i.e., Halitosis present only when

opening of mouth Angle.

Table No.72 Statistics of Halitosis in group-4 (PL)

Parameter Mean Mea

n

Diff

S.D S.E t-

value P value Significance B.T A.T B.T A.T B.T A.T

Halitosis 0.40 0.30 0.10 0.52 0.48 0.16 0.15 1.0000 0.3434 Not

significant

As per the statistics in group-4 reduction in Halitosis is not significant.

0

2

4

6

8


No

of

pat

ien

ts


Before treatment

After treatment



mouth Angle


talking

Clinical Study



Table No.73 Gradation of Pricking Pain in group-4 (PL)

No of patients

with grade-0

(Nil)

No of patients

with grade-1

(Mild)

No of patients

with grade-2

(Moderate)







Graph No.28 Gradation of Pricking Pain in group-4 (PL)

Observations:-


they are zero;


treatment also they five in number;

5 patients were available with grade 0 before treatment, after treatment also they are

5 in number.

Overall effect on pricking pain: Out of 10 patients no one relieved from pricking

pain. No change at all

Table No.74 Statistics of Pricking Pain in group-4 (PL)

As per the statistics in group-4 reduction in Pricking Pain is not significant.

Parameter Mean Mean

Diff

S.D S.E t-

value

P

value Significance


pricking

pain

0.40 0.50 0.10 0.52 0.53 0.16 0.17 1.0000 0.3434 Not significant

0

1

2

3

4

5


No

of

pat

ien

ts

Pricking Pain in tonsillitis patients

Before treatment

After treatment




Clinical Study



STATISTICAL ANALYSIS OF DATA

Table No.75 Statistical comparison of Group-1

Above table shows reduction of Tonsillitis symptoms statistically in Group-1

Effect of Chincha bheeja fresh paste (F.P) on dysphagia of tonsillitis: Chincha

bheeja Fresh Paste reduced Dysphagia of tonsillitis by 91.67% which was statistically

extremely significant (p<0.0001).

Effect of Chincha bheeja fresh paste (F.P) on Redness in Mucus Membrane of

tonsillitis: Chincha bheeja Fresh Paste reduced Redness in Mucus Membrane of

tonsillitis by 92.85% which was statistically extremely significant (p<0.0001).

Effect of Chincha bheeja fresh paste (F.P) on Body temperature of tonsillitis:

Chincha bheeja Fresh Paste reduced Body temperature of tonsillitis by 100% which

was statistically very significant (p=0.0095).

Effect of Chincha bheeja fresh paste (F.P) on Enlargement of Tonsils of

tonsillitis: Chincha bheeja Fresh Paste reduced Enlarged Tonsils by 82.35% which

was statistically extremely significant (p<0.0001).

Effect of Chincha bheeja fresh paste (F.P) on Halitosis of tonsillitis: Chincha

bheeja Fresh Paste reduced Halitosis of tonsillitis by 91.67% which was statistically

very significant (p=0.0032).

Effect of Chincha bheeja fresh paste (F.P) on Pricking pain of tonsillitis:

Chincha bheeja Fresh Paste reduced Pricking pain of tonsillitis by 90.90% which was

statistically very significant (p=0.0011).

Parameter Mean Mean

Diff

% of

relief



Dysphagia 1.20 0.10 1.10 91.67 0.42 0.32 0.13 0.10 11.0000 <0.0001 Extremely

significant

Redness in

Mucus

Membrane

1.40 0.10 1.30 92.85 0.52 0.32 0.16 0.10 8.5105 <0.0001 Extremely

significant

body

temperature

0.70 0.00 0.70 100 0.67 0.00 0.21 0.00 3.2796 0.0095 Very

significant

Enlargement

of tonsils

1.70 0.30 1.40 82.35 0.48 0.48 0.15 0.15 8.5732 <0.0001 Extremely

significant

Halitosis 1.20 0.10 1.10 91.67 0.92 0.32 0.29 0.10 3.9727 0.0032 Very

significant

Pricking

pain

1.10 0.10 1.00 90.90 0.74 0.32 0.23 0.10 4.7434 0.0011 Very

significant

Clinical Study



Graph No.29 Statistical comparison of Group-1

Table No.76 Statistical comparison of Group-2 (PDP)


Effect of Chincha bheeja Paste of Dried Paste (P.D.P) on dysphagia of tonsillitis:

Chincha bheeja Paste of Dry Powder (P.D.P) reduced Dysphagia of tonsillitis by

72.72% which was statistically extremely significant (p=0.0002).

Effect of Chincha bheeja Paste of Dried Paste (P.D.P on Redness in Mucus

Membrane of tonsillitis: Chincha bheeja Paste of Dry Powder (P.D.P) reduced

Redness in Mucus Membrane of tonsillitis by 90.90% which was statistically

extremely significant (p<0.0001).

Effect of Chincha bheeja Paste of Dried Paste (P.D.P) on Body temperature of

tonsillitis: Chincha bheeja Paste of Dry Powder (P.D.P) reduced Body temperature

of tonsillitis by 66.67% which was statistically significant (p=0.0368).

Parameter Mean Mean

Diff

% of

relief

S.D S.E t-

value



Dysphagia 1.10 0.30 0.80 72.72 0.57 0.48 0.18 0.15 6.0000 0.0002 Extremely

significant

Redness in

Mucus

Membrane

1.10 0.10 1.00 90.90 0.32 0.32 0.10 0.10 6.7082 <0.0001 extremely

significant

body

temperature

0.60 0.20 0.40 66.67 0.84 0.42 0.27 0.13 2.4495 0.0368 Significant

enlargement

of tonsils

1.30 0.60 0.70 53.84 0.48 0.52 0.15 0.16 4.5826 0.0013 Very

significant

Halitosis 0.50 0.20 0.30 60 0.53 0.42 0.17 0.13 1.9640 0.0811 Not

significant

pricking

pain

0.50 0.10 0.40 80 0.53 0.32 0.17 0.10 2.4495 0.0368 Significant

020406080

100

% o

f re

lief

Statistical comparison of Group-1

Clinical Study



Effect of Chincha bheeja Paste of Dried Paste (P.D.P)) on Enlargement of Tonsils

of tonsillitis: Chincha bheeja Paste of Dry Powder (P.D.P) reduced Enlarged Tonsils

by 53.84% which was statistically very significant (p<0.0013).

Effect of Chincha bheeja Paste of Dried Paste (P.D.P) on Halitosis of tonsillitis:

Chincha bheeja Paste of Dry Powder (P.D.P) reduced Halitosis of tonsillitis by 60%

which was statistically not significant (p=0.0811).

Effect of Chincha bheeja Paste of Dried Paste (P.D.P) on Pricking pain of

tonsillitis: Chincha bheeja Paste of Dry Powder (P.D.P) reduced Pricking pain of

tonsillitis by 80% which was statistically significant (p=0.0368).


Table No.77 Statistical comparison of Group-3 (PP)


0

100

% o

f re

lief

symptoms


Parameter Mean Mean

Diff

% of

relief

S.D S.E t-

value



Dysphagia 1.10 0.20 0.90 81.81 0.57 0.42 0.18 0.13 5.0138 0.0007 Extremely

significant

Redness in

Mucus

Membrane

1.40 0.20 1.20 85.71 0.52 0.42 0.16 0.13 9.0000 <0.0001 Extremely

significant

body

Temperature

0.50 0.10 0.40 80 0.71 0.32 0.22 0.10 2.4495 0.0368 Significant

enlargement

of tonsils

1.20 0.40 0.80 66.67 0.42 0.52 0.13 0.16 6.0000 0.0002 Extremely

significant

Halitosis 0.70 0.20 0.50 71.42 0.67 0.42 0.21 0.13 3.0000 0.0150 Significant

Pricking

Pain

0.40 0.00 0.40 100 0.52 0.00 0.16 0.00 2.4495 0.0368 Significant

Clinical Study



Effect of Chincha bheeja paste of Powder (P.P) on dysphagia of tonsillitis:

Chincha bheeja Paste of Powder (P.P) reduced Dysphagia of tonsillitis by 81.81%

which was statistically extremely significant (p=0.0007).

Effect of Chincha bheeja paste of Powder (P.P) on Redness in Mucus Membrane

of tonsillitis: Chincha bheeja Paste of Powder (P.P) reduced Redness in Mucus

Membrane of tonsillitis by 85.71% which was statistically significant (p<0.0001).

Effect of Chincha bheeja Paste of Powder (P.P) on Body temperature of

tonsillitis: Chincha bheeja Paste of Powder (P.P) reduced Body temperature of

tonsillitis by 80% which was statistically significant (p=0.0368).

Effect of Chincha bheeja Paste of Powder (P.P)) on Enlargement of Tonsils of

tonsillitis: Chincha bheeja Paste of Powder (P.P) reduced Enlarged Tonsils by

66.67% which was statistically extremely significant (p=0.0002).

Effect of Chincha bheeja Paste of Powder (P.P) on Halitosis of tonsillitis:

Chincha bheeja Paste of Powder (P.P) reduced Halitosis of tonsillitis by 71.42%

which was statistically significant (p=0.0150).

Effect of Chincha bheeja Paste of Powder (P.P) on Pricking pain of tonsillitis:

Chincha bheeja Paste of Powder (P.P) reduced Pricking pain of tonsillitis by 100%

which was statistically significant (p=0.0368).


020406080

100

% o

f re

lief

Symptoms


Clinical Study



Table No. 78 Statistical comparison of Group-4 (PL)


Effect of Placebo (P.L) on dysphagia of tonsillitis: Placebo (P.L) effect on Dysphagia of

tonsillitis by16.67% which was statistically not significant (p=0.3434).

Effect of Placebo (P.L) on Redness in Mucus Membrane of tonsillitis: Placebo (P.L)

effect on Redness in Mucus Membrane of tonsillitis by 36.37% which was statistically

significant (p=0.0368).

Effect of Placebo (P.L) on Body temperature of tonsillitis: Placebo (P.L) effect on Body

temperature of tonsillitis by 0% which was statistically not significant (p=0.3434).

Effect of Placebo (P.L) on Enlargement of Tonsils of tonsillitis: Placebo (P.L) effect on

Enlarged Tonsils by 20% which was statistically not significant (p=0.1679).

Effect of Placebo (P.L) on Halitosis of tonsillitis: Placebo (P.L) effect on Halitosis of

tonsillitis by 25% which was not significant (p=0.3434).

Effect of Placebo (P.L) on Pricking pain of tonsillitis: Placebo (P.L) effect on Pricking

pain of tonsillitis by 25% which was statistically not significant (p=0.3434).

Graph No 32 Statistical comparison of Group-4

010203040

% o

f re

lif

Symptoms


Parameter Mean Mean

Diff

% of

relief

S.D S.E t-

value

P

value Significance


Dysphagia 1.20 1.00 0.20 16.67 0.42 0.67 0.13 0.21 1.0000 0.3434 Not

significant

Redness in

Mucus

Membrane

1.10 0.70 0.40 36.37 0.32 0.48 0.10 0.15 2.4495 0.0368 Significant

Temperature 0.00 0.10 0.10 0 0.00 0.32 0.00 0.10 1.0000 0.3434 Not

significant

enlargement

of tonsils 1.00 1.20 0.20 20 0.00 0.42 0.00 0.13 1.5000 0.1679

Not

significant

Halitosis 0.40 0.30 0.10 25 0.52 0.48 0.16 0.15 1.0000 0.3434 Not

significant

pricking

pain 0.40 0.50 0.10 25 0.52 0.53 0.16 0.17 1.0000 0.3434

Not

significant

Clinical Study



Table No: 79

OVER ALL RESULT OF THE STUDY

Parameter % of Relief

Grup-1 Grup-2 Grup-3 Grup-4

Dysphagia 91.67 72.72 81.81 16.67

Redness in Mucus

Membrane 92.85 90.9 85.71 36.37

body temperature 100 66.67 80 0

Enlargement of

tonsils 82.35 53.84 66.67 20

Halitosis 91.67 60 71.42 25

Pricking pain 90.9 80 100 25

Above table shows reduction of Tonsillitis symptoms statistically in 4 groups.

Graph no: 33 overall result of the study according to % of relief

Above Graph shows statistically Group-1 patients have shown better

percentage of result when compared with other 3 Groups, because Fresh Paste

is more effective than other forms. The result with 3rd

group Chincha beeja

powder mixed with water has shown next better results. 2nd

group chincha

beeja dry powder has not given satisfactory result. But better than Placebo

Group.

0102030405060708090

100

% o

f R

elie

f

Symptoms

OVER ALL RESULT OF THE STUDY ACCORDING TO % OF RELIEF

Grup-1

Group-2

Group-3

Group-4

Clinical Study



Table No: 80 Inter Group Comparison (Anova Single Factor Result)

S.No Symptom

F-Value P-Value Significance

1 Dysphagia 6.000 0.0020

Very

significant

2 Redness in Mucus

Membrane 7.222 0.0006

Extremely

significant

3 Temperature

4.041 0.014 Significant

4 Enlargement of

Tonsils 22.46 <0.0001

Extremely

significant

5 Halitosis (Bad Breath) 5.419 0.0035

Very

significant

6. Pricking Pain 7.515 0.0005

Extremely

significant

The results of a ANOVA statistical test for all symptoms of Tundikeri is significant

Overall effect of Chincha bheeja on dysphagia of tonsillitis: Chincha bheeja

effect on Dysphagia of tonsillitis was statistically very significant (p=0.0020).

Overall effect of Chincha bheeja on Redness in Mucus Membrane of tonsillitis:

Chincha bheeja effect on Redness in Mucus Membrane of tonsillitis was statistically

extremely significant (p=0.0006).

Overall effect of Chincha bheeja on Body temperature of tonsillitis: Chincha

bheeja effect on Body temperature of tonsillitis was statistically significant (p=0.014).

Overall effect of Chincha bheeja on Enlargement of Tonsils of tonsillitis:

Chincha bheeja effect on Enlarged Tonsils of tonsillitis was statistically extremely

significant (p<0.0001).

Overall effect of Chincha bheeja on Halitosis of tonsillitis: Chincha bheeja effect

on Halitosis of tonsillitis was statistically very significant (p=0.0035).

Overall effect of Chincha bheeja on Pricking pain of tonsillitis: Chincha bheeja

effect on Pricking pain of tonsillitis was statistically extremely significant (p=0.0005).

Clinical Study



Image No: 31

Photos of Before & After Treatment

CASE NO:1 ( GROUP-3)

CASE NO: 4 (GROUP-3)

Clinical Study



CASE NO:5(GROUP-1)

CASE NO: 6 (GROUP-1)

Clinical Study



CASE NO:7 (GROUP-1)

CASE NO:8 (GROUP-2)

Clinical Study



CASE NO:10 (GROUP-2)


Clinical Study





Discussion



DISCUSSION

Chincha is found in all Nighantus. Cincha Bija is found only in Vastuguna

deepika the description is found.

Renowned as Nammalwar (“Our Saint”) among the Vaishnavas, and the

greatest of their saints and poets, was born in a small town called Kuruhur in the

southern most region of the Tamil country – Tiru – nel –veli (Tinnelvelly). He has sat

in hallow of tamarind tree doing tapas for many years, many families of devotees

consume the bark of the tree as a prasada.

Sri Balraj maharshi (20th

December 1917- 28th

August 1998) had

demonstrated several single drug applications in various clinical conditions.

Chincha beeja also a clinical application suggested by him to my guide Dr M.

Paramkusha Rao he has treated several tonsillitis patients with this medicine. It has

been tried in this study to establish a scientific evidence for a successful practice.

The chemical composition of Chincha beeja is found with peculiar chemical

named as Xyloglucan (XG) 65

. It is very hydroscopic in nature and found to may be

effectiveness. to prove it another study is required.

The result of Phytochemical study carbohydrates, Starch and Tannins are

present in PF Group drug, PP group drug & PDP group drug. Ph is 7 in three groups.

The study on 40 patients with 4 different groups has shown that Chincha beeja

lepa fresh paste application is more effective. Application of drug at the site of disease

is named as Kriyayoga. Such applications are told in Nighantus & other Chikitsa

Grandhas. The drugs are applied locally at the site of disease. These special

treatments conducted in Dravyaguna Kriyayoga theatre established by Dr M.

Paramkusha Rao.

Chincha beeja can be considered as an effective medicine by action & also

cost effective in Tonsillitis.

A proper care during application of medicine with desegngated instrument

(Tonsils Cops) is necessary to replicate the result.

Discussion



Group-1 patients had shown better percentage of result when compared with other 3

Groups. That means Fresh Paste is more effective than other forms.

Chincha bheeja Fresh Paste reduced Dysphagia of tonsillitis by 91.67% (P<0.0001)

Fresh Paste reduced Redness in Mucus Membrane of tonsillitis by 92.85%

(P<0.0001)

Fresh Paste reduced Body temperature of tonsillitis by 100% (P=0.0095)

Fresh Paste reduced Enlarged Tonsils by 82.35% (P<0.0001)

Fresh Paste reduced Halitosis of tonsillitis by 91.67% (P=0.0032)

Fresh Paste reduced Pricking pain of tonsillitis by 90.90% (P=0.0011)

Group-3 patients had shown better percentage of result when compared with

Group 2&4. That means Paste of powder (Power mixed with water) has shown next

better result than the Group 2 & 4.

Chincha bheeja Paste of Powder (P.P) reduced Dysphagia of tonsillitis by 81.81%

(P=0.0007)

Paste of Powder (P.P) reduced Redness in Mucus Membrane of tonsillitis by 85.71%

(P<0.0001)

Paste of Powder (P.P) reduced Body temperature of tonsillitis by 80% (P=0.0368)

Paste of Powder (P.P) reduced Enlarged Tonsils by 66.67% (P=0.0002)

Paste of Powder (P.P) reduced Halitosis of tonsillitis by 71.42 % (P=0.0150)

Paste of Powder (P.P) reduced Pricking pain of tonsillitis by 100 % (P=0.0368)

Group-2 patients have shown better percentage of result when compared with

Placebo (Group-4) That means Paste of Dried Paste (Seed rubbed against the rough

surface then made in to paste, allow to dry then made in to fine powder.) has shown

next better result than the placebo group.

Chincha bheeja Paste of Dried Paste (P.D.P) reduced Dysphagia of tonsillitis by

72.72% (P=0.0002)

Discussion



Paste of Dried Paste (P.D.P) reduced Redness in Mucus Membrane of tonsillitis by

90.90% (P<0.0001)

Paste of Dried Paste (P.D.P) reduced Body temperature of tonsillitis by 66.67%

(P=0.0368)

Paste of Dried Paste (P.D.P) reduced Enlarged Tonsils by 53.84% (P=0.0013)

Paste of Dried Paste (P.D.P) reduced Halitosis of tonsillitis by 60% (P=0.0811)

Paste of Dried Paste (P.D.P) reduced Pricking pain of tonsillitis by 80% (P=0.0368)

Group-4 (Placebo) patients have shown very low percentage of result when compared

with other groups (1, 2&3)

Placebo (P.L) effect on Dysphagia of tonsillitis by16.67%

Placebo (P.L) effect on Redness in Mucus Membrane of tonsillitis by 36.37%

Placebo (P.L) effect on Body temperature of tonsillitis by 0%

Placebo (P.L) effect on Enlarged Tonsils by 20%

Placebo (P.L) effect on Halitosis of tonsillitis by 25%

Placebo (P.L) effect on pricking pain of tonsillitis by 25%

Chincha Bheeja lepa has shown very effective result on the base of above

discussions.

Among three groups Group-1 i.e., Chincha beeja fresh paste has been found

very effective in all the symptoms of tonsillitis the probability P<0.0001

At certain cases body temperature also reduced effectively that means Chincha

beeja lepa is useful at acute condition by the application temperature is reduced within

one day. In this way the result with 3rd

group Chincha beeja powder mixed with water

has shown next better results. 3rd

group chincha beeja dry powder has not given

satisfactory result. But better than Placebo Group.

Conclusion



CONCLUSION

1. No earlier research work is found on the drug Chincha beeja in Tundikeri.

2. The Drug is not found referred in the earlier Ayurvedic treatises and appears

in the Vasthuguna Dipika (the first power printed Telugu book in ayurveda).

3. Involvement of Mamsa dhatu could be at the level of poshaka mamsa dhatu

level. Rakta dhatu Marghavarodha caused by the either sotha (caused by

Bacteria, virus, allergens) or Kapha dosha produced by Nidhana. They

obstruct the flow of Rasa Rakta dhatu and inhibit the further dhatu posana

(metabolism). The nutrients fraction of Mamsa dhatu retained in the blood

accumulate in Tonsils. The accumulated mamsa dhatu produces a Granthi.

4. Reasons for the disturbance of tonsils are mentioned in Nidana of Tundikeri.

i.e., Snigdha ahara, abhisyandhi ahara etc. Involvement of Bacteria, Virus,

allergens is also reason for Tonsils vitiation.

5. Tonsils are considered as gate way of intestines, so it likely causes tonsillitis,

further it becomes sensitive and repeated attacks of Vyadhi is possible.

6. If avarodha of rasa-rakta channels occur to generate swelling and thus

become Granthi. And further complications are seen i.e Dysphagia, Fever etc.

7. The line of treatment could be Lekhana and Soshana. Lekhana reduces

obstruction, Soshana cause for absorption of obstruction. Thus Tundikeri

becomes normal.

8. Chincha bheeja is Kashaya in rasa, Ruksha in guna promotes absorption, and

Kaphahara action removes obstruction. Krimi hara Karma of Chincha bheeja

destroys Bacteria, Virus invaded in to tonsils.

9. The chemical composition of Chincha beeja is found peculiar with chemical

named as Xyloglucan (XG) 65

. It is very hydroscopic in nature and found to be

effective. To prove it another study is required.

10. Group-1 patients have shown better percentage when compared with other 3

Groups. That means Fresh Paste is more effect then other forms.

Conclusion



11. The result with 3rd

group Chincha beeja powder mixed with water has shown

next better results. 2nd

group chincha beeja dry powder has not given

satisfactory result. But better than Placebo Group.

12. Microbiological study also shows same result. Group-1 has shown better

result. 3rd

group Chincha beeja powder mixed with water has shown next

better results. 2nd

group chincha beeja dry powder has given less result.

13. All together Tonsillitis is superficially limited disease so local application of

chincha bheeja lepa is appropriate in measure of treatment.

14. Therefore it is concluded that Chincha bheeja has been found with Granthi

hara karma particularly mitigates Tonsillitis.

15. Application of drug at the site of disease is named as Kriyayoga. Such

applications are told in Nighantus & other Chikitsa Grandhas. The drugs are

applied locally at the site of disease. These special treatments conducted in

Dravyaguna Kriyayoga theatre established by Dr M. Paramkusha Rao.

Summary



SUMMARY

The dissertation entitled “A STUDY ON THE GRANTHIGNA EFFECT OF

CHINCHA BHEEJA YOGA (Tamarindus indica L.) PAINT W.S.R TO

THUNDIKERI (TONSILLITIS)” has been distributed into six main headings viz.

Drug Review, Review of Grandhighna karma on Tundikeri, Experimental Study,

Clinical Study, Discussion and Summary & Conclusion.

A brief introduction deals with the importance of traditional system of

medicine, folklore uses of the drug and sentences quoted by various Acharya

regarding the introduction, collection and properties of standard drug. The aims and

objectives, materials and methods and plan of study are given.

The review of literature is done into two sections viz. Drug review and Drug

action review. In drug review section Definition of drug, Historical background of

Chincha from the ayurvedic and modern point of view are mentioned. In ayurvedic

review references of drug Chincha in various ayurvedic text, vernacular names of

Chincha, Nirukti synonyms, interpretations of synonyms, Panchabhautik constitution

of drug and their properties are given in detail. In the same section some common

therapeutic uses of Chincha beeja are mentioned.

In the section of Modern review the various Flora viz., Indian Medicinal plant,

Wealth of India, Dictionary of Economic product of India and many other floras have

been referred for the identification, geographical resources, traditional and folklore

uses of the drug Chincha. Review of previous research work in various institutions

has been quoted here.

In Review of Drug action Grandhighna karma on Tundikeri section, under

ayurvedic point of view description of Tundikeri its Nidana (aetiology), Samprapti

Ghatana (Pathogenesis), Purvarupa (Prodromal symptoms), Rupa (Signs &

Symptoms), prognosis and therapeutic aspects are given in detail. Under modern

review details information regarding Tundikeri i.e., Tonsillitis is given. In this section

information are given about types of tonsillitis, their signs & symptoms, pathology,

complications, treatments are discussed in detail.

Summary



The pharmacognostical study of the drug, it includes study of Meanoscopic

images of Chincha beeja with a digital microscope.

The pharmaceutical Preparation of Chincha beeja Lepa, in three forms i.e, FP

(Fresh paste), PP (Paste of Powder) and PDP (Paste of Dried Paste)

In the Microbiological study, the test drugs FP (Fresh paste), PP (Paste of

Powder) and PDP (Paste of Dried Paste) were evaluated for anti-Bacterial effect in

vitro study.

The clinical evaluation of the test drugs was divided into four groups viz. FP,

PP, PDP and PL.

The results reveals that group-1(FP) provided statistically highly significant

(P<0.001) relief in Dysphagia by 91.67%, Redness in Mucus Membrane by 92.85%,

Fever by 100 %, Enlargement of Tonsils by 82.35%, Halitosis by 91.67% and in

Pricking Pain by 90.90%.

The results reveals that group-2 (PDP) provided also statistically highly

significant (P<0.001). But the relief in % is lesser to group 1in comparison Dysphagia

by 72.72%, Redness in Mucus Membrane by 90.90%, Fever by 66.67 %, Enlargement

of Tonsils by 53.84%, Halitosis by 60% and in Pricking Pain by 80%.

The results reveals that group-3(PP) provided statistically highly significant

(P<0.001). But patients in this group have shown marginal relief over group-1. The

relief in Dysphagia by 81.81%, Redness in Mucus Membrane by 85.71%, Fever by 80

%, Enlargement of Tonsils by 66.67%, Halitosis by 71.42% and in Pricking Pain by

100%.

The result reveals that group-4(PL) provided statistically not significant.

Relief in Dysphagia by 16.67%, Redness in Mucus Membrane by 36.37%, Fever by

0%, Enlargement of Tonsils by 20%, Halitosis by 25% and Pricking Pain by 25% .

These negative results indicate that test drugs have marked influence in treating

Tonsillitis.

Summary



Discussion:

The Discussion contains where in findings observed in conceptual,

phytochemical, microbiological and clinical study is analyzed and documented.

Conclusion:

The Conclusion comprises of the final results of the study. Group-1

patients have shown better percentage of result when compared with other 3 Groups.

That means Fresh Paste is more effect then other forms. The result with Group-3 that

is Paste of powder (PP) has shown next better results. Group-2 that is Paste of dried

paste (PDP) has not given satisfactory result, but better then Placebo Group-4.

References



REFERENCES

1. Bernstein JM, Gorfien J and Brandtzaeg P. The immunobiology of the tonsils

and adenoids. Ogra Mucosal immunology. Academic Press, San Diego.

1999:1339-1362.

2. Mckerrow WS. Disease of tonsil. In: Gleeson M, Browning GG, Burton MJ,

Clarke R (eds): Scott Brown’ Otolaryngology, Head and Neck Surgery1 (B):

Seventh edition. London: Hodder Education; 2008:1219-1220.

3. Sebastia LIA, Ramirez MJF, Molla CL, Llatas C,Mocholi P, Ruiz MD, Ferriol

JE and Martinez RL.Changes in immunoglobulin levels following

adenoidectomy and tonsillectomy. Acta Otolaryngol 2004 ;55: 404-408.

4. Surjan L Jr, Brandtzaeg P, Berdal P. Tmmunoglobulin systems of human

tonsils. 11. Patients with chronic tonsillitis or tonsillar hyperplasia:

quantification of Ig-producing cells, tonsillar morphometry and serum Ig

concentrations. Clin Exp Immunol 1978;31:382-90

5. Surgan L Jr. Tonsils and lymphoepithelial structures in the pharynx as

immunobarriers. Acta Otoaryngol (Stockh) 1987;103:369-72

6. Brook I, Youson P. Quantitative measurement of B-lactamase in tonsils of

children with recurrent tonsillitis. Acta Otolaryngol (Stockh) 1984:536-59

7. Ikinciogullari A, Dogu F, Ikinciogullari A, Egin Y and Babacan E. Is immune

system influenced by adenotonsillectomy in children? Int J Pediatr

Otorhinolaryngol 2002 ; 66: 251-257

8. Cullen KA, Hall MJ, Golosinskiy A. Ambulatory Surgery in the United States,

2006. National Health Statistics reports no. 11, revised. Hyattsville, MD:

National Center for Health Statistics; 2009.

9. Derkay CS. Pediatric otolaryngology procedures in the United States: 1977-

1987. Int J Pediatr Otorhinolaryngol. 1993;25:1-12.

10. Windfuhr JP, Chen YS, Remmert S. Hemorrhage following tonsillectomy and

adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg.

2006;132:281-286.

References



11. Johnson LB, Elluru RG, Myer CM. Complications of adenotonsillectomy.

Laryngoscope. 2002;112:35-36.

12. Leong SC, Karkos PD, Papouliakos SM, et al. Unusual complications of

tonsillectomy: a systematic review. Am J Otolaryngol. 2007;28:419-422.

13. Pratt LW, Gallagher RA. Tonsillectomy and adenoidectomy: incidence and

mortality,1968–1972. Otolaryngol Head Neck Surg. 1979;87:159-166.

14. Royal College of Surgeons of England. National prospective tonsillectomy

audit: final report of an audit carried out in England and Northern Ireland

between July 2003 and September 2004. May 2005. http://www.entuk.org

/members/audits/tonsil/ Tonsillectomyauditreport_pdf. Accessed February 3,

2010.

15. Randall DA, Hoffer ME. Complications of tonsillectomy and adenoidectomy.

Otolaryngol Head Neck Surg. 1998;118:61-68.

16. Morris LG, Lieberman SM, Reitzen SD, et al. Characteristicsand outcomes of

malpractice claims after tonsillectomy. Otolaryngol Head Neck Surg.

2008;138:315-320.

17. Kashinath Shastri, Dr. Gorakhnath chaturvedi, Charaka samhita of

Agnnivesa,revised by Charaka and Drdhabala , Chowkhamba Bharti Academy,

Varanasi 2001. Sutrasthana 26/12, Page No: 335.



Varanasi 2001. Sutrasthana 9/3, Page No:132.

19. Dr.S.Kamat, Dhanvanthari Nighantu, Chaukambha Sanskrit Pratishthan,

Delhi,First published-2002, Amradi varga, Page No:398

20. Prof. P.V Sharma, Sodhala Nighantu of Vaidyacharya Sodhala Edition -1,Oriental

Institute, Baroda,1978.

21. Dr.J.L.N.Sastry Madanpal Madanpal Nighantu, (2010), Ist Ed. Chaukhambha

Orientalia, Varanasi,Phaladi Varga,Page No: 617

References



22. Kaiydeva, Kaiyadeva Nighantu, Edited by Translated by Prof. P. V. Sharma and

Dr. Guhy Prasad Sharma (1979) Ist ed., Chaukhambha Orientalia, Varanasi. Sloka

No: 363-367,Page No: 67-68.

23. Bhavmishra, Bhavprakash Nighantu, Commentary by K. C. Chunekar, edited by

Dr. G. S. Pandey (1993) 10th Ed., Chaukhambha Bharti Academy, Varanasi. Sloka

No.142-143, Page.586-588

24. Narshari, RajNighantu, Commentary by Tripathi. Inderdeva (1998) Krishra Das

Academy, Bombay. Sloka No. 162-168 Page. 373

25. Saligrama Vaidya, Saligrama Nighantu, Published by Khemraj Shrikrishnadass,

reprint.1067. Page.441-443

26. Vaidya Bapalal: Nighantu Adarsha, Chaukhamba Bharti Academy, Varanasi, vol I,

Reprint. 1998.

27. Priya nighantu, P.V.Sharma, Chaukumbha ayurvijnan Book stall, published by

chaukumbha surabharati.page.52.

28. Sri Yarra Subbarayudu, Vasthuguna Deepika, published by A.B.S publishers,

Rajamandry, 1984, Page No.266.

29. Salim, A., Simons, A., Waruhin, A. and Orwa, C. (1998) Agroforestry Tree

Database: A tree species reference and selection guide and tree seed suppliers

directory. International Council for Research in Agroforestry, PO Box 30677,

Nairobi, Kenya. http://www.worldagroforestry.org /Sites/TreeDBS/ aft/

species PrinterFriendly. asp?Id=1589

30. Anon (1976) Tamarindus indica L. In The Wealth of India (Raw Materials

Series) Vol.X: 144-122. Council of Scientific and Industrial Research, New

Delhi.

31. Morad, M.M., El Magoli, S.B. and Sedky, K.A. (1978) Physico-chemical

properties of Egyptian tamarind seed oil. Fette Seifen Anstrichmittel, 80:357-

359.

http://www.worldagroforestry.org/

References



32. Ishola, M.M., Agbaji, E.B. and Agbaji, A.S. (1990) A chemical study of

Tamarindus indica (Tsamiya) fruits grown in Nigeria. Journal of Science,

Food and Agriculture, 51: 141-143.

33. Bhattacharya, P.K., Bal, S. and Mukherji, R.K. (1994) Studies on the

characteristics of some products from tamarind (Tamarindus indica L.)

kernels. Journal of Food Science and Technology (India), 31(5): 372-376.

34. FAO (1970) National Studies, FAO/UN, Rome No. 24: 50-52.

35. de Lumen, B.O., Becker, R. and Reyes, P.S. (1986) The nutritive value of

tamarind seed for broiler chicks. Animal Feed Science and Technology, 22(4):

285-293.

36. Andriamanantena, R.W., Artuad, J., Gaydofn, E.M., Iatrides, M.C. and

Chavalier, J. L. (1983) Fatty acid and sterol composition of malagasy

tamarind kernels. Journal of the American Oil Chemist’s Society, 60(7): 1318-

1321.

37. Marangoni, A., Alli, I. and Kermasha, S. (1988) Composition and properties

of seeds of the true legume Tamarindus indica. Journal of Food Science, 53:

1452-1455.

38. Bhattacharya, P.K., Bal, S. and Mukherji, R.K. (1994) Studies on the

characteristics of some products from tamarind (Tamarindus indica L.)

kernels. Journal of Food Science and Technology (India), 31(5): 372-376.

39. Parvez, S.S., Parvez, M.M., Nishihara, E., Gemma, H. and Fujii, Y. (2003)

Tamarindus indica L. leaf is a source of allelopathic substance. Plant Growth

Regulation, 40(2)107-115.

40. Mukherjee (1940), Wealth of India - vol. - VII, D.E.P.V. 443, F 1 Br. Ind. IV 609;

Bof. Surv. India 14 (1).

41. Ramchander T, Rajkumar D, Sravanprasad M, Goli V, Dhanalakshmi CH.

Antidiabetic activity of aqueous methanolic extracts of leaf of Tamarindus

indica. IJP and PR, 2012; 4(1): 5-7.

References



42. Maiti R, Jana D, Das UK, Ghosh D. Antidiabetic effect of aqueous extract of

seed of Tamarindus indica in streptozotocin-induced diabetic rats. Journal of

Ethnopharmacol. 2004; 92: 85–91.

43. Bhutkar MA, Bhise SB. Anti-oxidative effect of Tamarindus indica in

Alloxan induced diabetic rats. Int. J of Res. in Pharmaceutical and Biomed.

Sci, 2011; 2 (3):1006-1009.

44. Martinello F, Soares S M, Franco JJ, Santos AC, Sugohara A, Garcia SB,

Curti C, Uyemura SA. Hypolipemic and antioxidant activities from

Tamarindus indica L. pulp fruit extract in hypercholesterolemic hamsters,

Food and chem. Toxico, 2006; 44: 810– 818.

45. Siddhuraju P. Antioxidant activity of polyphenolic compounds extracted from

defatted raw and dry heated Tamarindus indica seed coat, 2007; 40:982–990.

46. Jindal V, Dingra D, Sharma S, Parel M, Harna RK .Hypolipidemic and weight

reducing activity of the ethanolic extract of Tamarindus indica fruit pulp

extract in cafeteria diet and sulpiride-induced obese rats. Journal of

Pharmacology and Pharmacother, 2011; 2: 2.

47. Meher B, Das DK. Antioxidant and antimicrobial properties of T. indica

International Journal of Phytomedicine, 2013; (5): 322-329.

48. Meher B, Das DK. Evaluation of hepatoprotective and antioxidant activity of

Tamarindus indica seeds extracts in Streptozotocin induced diabetic rats, Int.

Journal of Phytomed., 2013 ;( 5):228-297.

49. Doughari JH. Antimicrobial activity of Tamarindus indica Linn. Tropical

Journal of Pharmaceutical Res, 2006; 5 (2): 597-603.

50. Uchechukwu U. Nwodo, Grace E. Obiiyeke, Vincent N. Chigor, Anthony

Okoh. Assessment of Tamarindus indica extracts for antibacterial activity,

Int. J. Mol. Sci. 2011; 12: 6385-6396.

51. Meher B, Dash DK, Bhoi BB. Evaluation of in vitro antioxidant and

antimicrobial properties of hydroalcoholic and aqueous seeds extracts of

Tamarindus indica. World Journal of Pharmacy and Pharmaceutical sciences,

2013; 3(1): 436-452.

References



52. Le FE, Lemordant D, Lignon A, Rezkallah N. Pratiques ethnobotaniques des

populations afars de la moyenne vallee de lawash , (Ethiopie), J

Ethnopharmacol. 1985; 14:283–314.

53. Haerdi F. Basel: Universität Basel. Die Eingeborenen-Heilpflanzen des

Ulanga-Distriktes Tanganjikas (Ostafrika). Philosophisch-naturwissens

chaftliche Fakultät, 1964.

54. El Siddig K, Ebert G, Ludders P. Tammarind (Tamarindus indica L.): A

review on multipurpose tree with promising future in Sudan. Journal of

applied Botany– Angewandte Botanik 1999; 73:202-205.

55. Mahesh KM , Rao KM, Rajeswari G, Ravindra Reddy KR , Jyothi B.

Hepatoprotective activity of ethanolic flower extract of Tamarindus indica in

Wistar rats hepatotoxicity induced by isoniazide and rifampicin IJAPR, 2010;

1( 1): 17 -20.

56. Khalid S, Shaik Mossadeq WM, Isaraf DA, Hashim P, Rajeb S, Shaberi AM,

Mohamada AS, Zakaria ZA, Sulaiman MR. In Vivo Analgesic effect of

aqueous extract of Tamarindus indica Linn. fruits, Int J of Kuwait University

Heath Sc. Cent, 2010; 19(4):255-259.

57. Izquierdo T, Gracia –Tamayo F, Soto C, Castrillon LE. A Tamarindus indica

Linn pulp polysaccharide inhibits fever in-vivo and IL-1β release by murine

peritoneal exudates cell. Pharmaceutical biology 2007; 45:22-30.

58. Havinga RM, Hart A, Pustcher J. Tamarindus indica L. (Fabaceae): Pattern of

use in traditional African medicine. Journal of Ethnopharmacol., 2010;

127:573-588.

59. AL-fatimi M, Wurster M, Schroder G, Lindeiquist U, antioxidant

antimicrobial and cytotoxic activities of selected medicinal plant from

Yemen. Journal of Ethnopharmacol., 2007; 111: 657-666.

60. Antitumor and Immunopotentiating Activity of Polysaccharide PST001

Isolated from the Seed Kernel of Tamarindus indica: An In Vivo Study in

Mice / The Scientific World JournalVolume 2012 (2012), Article ID 361382,

14 pages / http://dx.doi.org/10.1100/2012/361382

http://dx.doi.org/10.1100/2012/361382

References



61. Uchechukwu U. Nwodo, Grace E. Obiiyeke, Vincent N. Chigor, Anthony

Okoh. Assessment of Tamarindus indica extracts for antibacterial activity, Int.

J. Mol. Sci. 2011;

62. Isha D, Milind P. Imli: A craze Lovely. International research Journal of

pharmacy, 2012; 3 (18): 110-115.

63. Hivrale, M. G., Bandawane, D. D., Mali, A. A.(2013) Anti-inflamatory and

analgesic activities of petroleum ether and ethyl acetate fractions of

Tamarindus indica seeds. Oriantal Pharmacy and Experimental Medicine13

(4):319-326.

64. Arkadiusz Kozioł1, Evaluation of Structure and Assembly of Xyloglucan

from Tamarind Seed (Tamarindus indica L.) with AtomicForce Microscopy.

65. Food Biophysics (2015) 10:396–402

66. Chabetty Y. Vargas-Olvera, Dolores Javier Sánchez- González, José D.

Solano, Francisco A. Aguilar- Alonso, Fernando Montalvo-Muñoz, Claudia

María Martínez-Martínez, Omar N. Medina- Campos and María Elena Ibarra-

Rubio (2012). Characterization of N-diethylnitrosamine-initiated and ferric

nitrilotriacetate-promoted renal cell carcinoma experimental model and effect

of a tamarind seed extract against acute nephrotoxicity and carcinogenesis,

Molecular and Cellular Biochemistry, 369(1-2) : 105- 117.

67. Ajayi, I.A., Oderinde, R.A., Kajogbola, D.O., Uponi, J.I. (2006). Oil content

and fatty acid composition of some underutilized legumes from Nigeria. Food

Chemistry, 99: 115-120.



Varanasi 2001. Vimana sthana, 5/24.Page No: 596.

69. Kaviraj Ambikadutta Shastri, Vaidya yadhavji Trikamji Acharya, Sushruta

Samhitha, Chowkhamba Krishnadas academy, Varanasi 2008. Nidana sthana 11/3.

Page No: 350.

References





Varanasi 2001. Chikitsa sthana, 12/87.Page No: 311.

71. Jindal Radha et al. Journal of Biological & Scientific opinion Volume 1 (3).

2013.

72. Kaviraj Ambikadutta Shastri, Vaidya yadhavji Trikamji Acharya, Sushruta

Samhitha, Chowkhamba Krishnadas academy,Varanasi 2008. Nidana sthana

16/44.

73. Sarvanga sundar Tika, Ashtanga hridayam by Arundata ,Chaukhambha Sanskrut

sansthan,Varanasi,2008 Utaratantra 21/47

74. Doshagna Guna Ganana (DGG) – A new arithmetic assessment of drugs

effect on dosha based on Guna prabhava, International Journal of Ayurvedic

Medicine, 2012,3 (3), 130-139, published online in http://ijam.co.in.

75. Maung KM, Lynn Z. Effects of Tamarind (Tamarindus indicus Linn) seed

extract on Russell's viper (Daboia russelli siamensis) venom. Trop Biomed.

2012 Dec;29(4):580-7.

76. Kalra P1, Sharma S, Suman, Kumar S. Antiulcer effect of the methanolic

extract of Tamarindus indica seeds in different experimental models. J Pharm

Bioallied Sci. 2011 Apr; 3(2):236-41. Doi: 10.4103/0975-7406.80778.

77. Ribeiro JA1, Serquiz AC

1, Silva PF

2, Barbosa PB

1, Sampaio TB

3, Araújo

Junior RF4, Oliveira AS

1, Machado RJ

1, Maciel BL

2, Uchôa AF

5, Santos EA

1,

Morais AH2. Trypsin inhibitor from tamarindus indica L. seeds reduces

weight gain and food consumption and increases plasmatic cholecystokinin

levels.

78. Donn Brennan, Balaraj Maharishi and the first clinical trial of Ayurvedic

medicines in the West J Ayurveda Integr Med. 2010 Jul-Sep; 1(3): 222–224.

http://ijam.co.in/

http://www.ncbi.nlm.nih.gov/pubmed/23202603


http://www.ncbi.nlm.nih.gov/pubmed/?term=Kalra%20P%5BAuthor%5D&cauthor=true&cauthor_uid=21687352

http://www.ncbi.nlm.nih.gov/pubmed/?term=Sharma%20S%5BAuthor%5D&cauthor=true&cauthor_uid=21687352

http://www.ncbi.nlm.nih.gov/pubmed/?term=Suman%5BAuthor%5D&cauthor=true&cauthor_uid=21687352

http://www.ncbi.nlm.nih.gov/pubmed/?term=Kumar%20S%5BAuthor%5D&cauthor=true&cauthor_uid=21687352



http://www.ncbi.nlm.nih.gov/pubmed/?term=Ribeiro%20JA%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Serquiz%20AC%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Silva%20PF%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Barbosa%20PB%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Sampaio%20TB%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Ara%C3%BAjo%20Junior%20RF%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Ara%C3%BAjo%20Junior%20RF%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Oliveira%20AS%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Machado%20RJ%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Maciel%20BL%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Uch%C3%B4a%20AF%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Santos%20EA%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Morais%20AH%5BAuthor%5D&cauthor=true&cauthor_uid=25789523

http://www.ncbi.nlm.nih.gov/pubmed/?term=Brennan%20D%5Bauth%5D

Bibliography



BIBLIOGRAPHY

Ashtanga Hridaya – Sarvanga sundari vyakhya by Arunadatta and Ayurveda Rasayana

by Indu- Chaukhamba Orientalis.

Kashinath Shastri, Dr. Gorakhnath chaturvedi, Charaka samhita of


Varanasi 2001.

Kaviraj Ambikadutta Shastri, Vaidya yadhavji Trikamji Acharya, Sushruta Samhitha,

Chowkhamba Krishnadas academy,Varanasi 2008.

Bulusu sitaram, Ashtanga hridayam by Vagbhata,Chaukhambha

Orientalia,Varanasi,2008

Bulusu sitaram, Bhavaprakasha of Bhavamisra, Chaukhambha, Orientalia, Varanasi,

2006.

Chunekar K.C, Commentary on Bhava Prakash Nighantu, Choukhmaba Bharathi

Academy, Varanasi, 2004 (Hindi).

Dhyani, Dr. S.C.: Rasa Panchak, Krishna Das Academy, Varanasi, 1st

Ed. 1994.

E-Nighantu – collection of ayurvedic lexicons,by Central council for research in

ayurvedic sciences( CCRAS) under AYUSH, New Delhi.

Gadanigraha of Srivaidya Sodhala, Part-III Kaya Chikista Khanda,The

Chowkhamba Sanskrit series office, Varanasi-1 1969.

Indradeva Tripathi ,Gadanigraha of Sri Vaidya Sodhala Part-3.

Harrison’s principles of internal medicine 16 th edition.

Indradeva Tripathi, Rajanighantu of pandit Narahari, Chowkhamba Krishnadas

Academy, Varanasi.

Kaideva nighantu (Pathyapathya vibodhak), chaukhamba orientalia, 1st

edition,vidyavilas press,Varanasi.

Bibliography



Indradeva Tripathi and Daya Sankar Tripathi ,Yogaratnakara,Vaidyaprabha hindi

Commentary

Sharma, P.V.: Introduction to Dravyaguna (Indian pharmacology), Chaukhamba

Orientalia, Varanasi, 2nd

Edi. 1995.

Sharma P.V. illustrated Dravyguna vijnana vol-1- 5, Chaukhamba Bharathi academy,

Varanasi, 2006.(Hindi).

Sharma P.V, Shodala Nighantu of vaidyacharya Shodala, Oriental institute, Baroda,

1978.

Shailaja Srivastava, Sarangadhara Samhitha of Sharangadharacharya Chaukhamba

Orientalia, Varanasi 2013.

Priya nighantu, P.V.Sharma, Chaukumbha ayurvijnan Book stall, published by

chaukumbha surabharati.

Sharma,P.V.(1996),Classical uses of medicinal plants ,Chaukhabha Viswabharathi,

Varanasi,India,

Shastry J.L.N, Illustrated Madanapala nighantu, chaukumba, orientalia, Varanasi.

The Ayurvedic Pharmocopoea of India part – 1, vol-II, Govt of Ayurveda, Yoga and

Naturopathy, Unani, Sidda and Homeopathy(Ayush), New Delhi .

Vaidya Bapalal: Nighantu Adarsha, Chaukhamba Bharti Academy, Varanasi, vol I,

Reprint. 1998.

Dictionary of Sir Monier Williams Sanskrit to English dictionary,addition 1992.

Chopra R.N.; Nayan S.L. & Chopra 1. C (1992), Glossary of Indian Medicinal plants.

Gokhale S.B. : Kokata C.K.; Purohi A.P. (1999); Textbook of pharmacology 12 ed.

IJAPBC – Vol. 1(3), Jul- Sep, 2012 Pharmacological Actions of Ocimum sacntum–

Review Article , P. Kalyan kumar *, M. Rupesh Kumar, K. Kavitha, Jagadeesh singh

and Rawoof Khan.

Bibliography



Mukherjee (1940), Wealth of India - vol. - VII, D.E.P.V. 443, F 1 Br. Ind. IV 609;

Bof. Surv. India 14 (1).

Nadkrani K.M.: Indian Materia Medica with Ayurvedic, Unani - Tibbi, Siddha,

Allopathic, Homeopathic, Naturo pathic & Home remedies, vol. 1, 865.

International Journal of Environmental Science and Development, Vol. 5, No. 5,

October 2014, Margaret E. Collins* and John E.K. Foreman. The University of

Western Ontario, London, Canada.

Annexures

A STUDY ON THE GRANTHIGNA EFFECT OF CHINCHA BHEEJA YOGA (Tamarindus indica L.) PAINT W.S.R TO

THUNDIKERI (TONSILLITIS). Page i

ANNEXURE-1

CLINICAL MASTER CHARTS

Master Chart of Group-1(FP)

N

o

Name

Se

x

A

ge

Relig

ion

Occupa

tion

Durat

ion

(in

mont

hs)

Dyspha

gia

Redness

in

Mucus

Membr

ane

Improve

ment in

temperat

ure (as

observed

by its fall)

Enlarge

ment of

Tonsils

Halito

sis

(Bad

Breat

h)

Pricki

ng

Pain

B T

A T

B T

A T

B T

A T

B T

A T

B

T

A T

B T

A T

1

B.Kal

yan

kumar

naik

M 13 Hind

u Student 2 2 1 1 0 1 0 2 0 1 0 1 0

2

N.Tiru

pal

Naidu

M 14 Hind

u Student 12 1 0 1 0 0 0 2 1 2 0 1 0

3

Dr

Siva

prasad

M 31 Hind

u

P.G

Scholar 6 1 0 1 0 0 0 1 0 0

0

1 0

4

Dr

V.Gay

atri

F 35 Hind

u Doctor 4 1 0 1 0 0 0 1 0 0

0

0 0

5.

Chara

n

M 7 Hind

u Student 12 1 0 2 1 1 0 2 0 2

0

2 0

6. Jeevan

M 9

Hind

u Student 12 2 0 2 0 1 0 2 0 2

0

2 0

7

S.Farh

an

M 5 Musli

m Student 1 1 0 1 0 2 0 1 0 2

1

1 0

8

E.Sub

ba

Reddy

M 54 Hind

u Farmer 24 1 0 2 0 1 0 2 1 1

0

0 0

9

M.

Bhava

ni

F 12 Hind

u Student 8 1 0 2 0 1 0 2 0 0 0 1 0

1

0

G.

Bhasy

a

F 9 Hind

u Student 6 1 0 1 0 0 0 2 1 2 0 2 1

Annexures


THUNDIKERI (TONSILLITIS). Page ii

Master Chart of Group-2(PDP)

N

o

Name

Se

x

A

ge

Relig

ion

Occupa

tion

Durat

ion

(in

mont

hs)

Dyspha

gia

Redness

in

Mucus

Membr

ane

Improve

ment in

temperat

ure (as

observed

by its fall)

Enlarge

ment of

Tonsils

Halito

sis

(Bad

Breat

h)

Pricki

ng

Pain

B T

A T

B T

A T

B T

A T

B T

A T

B T

A T

B T

A T

1.

D.

Subbir

ami

reddy

M 55 Hind

u

Busines

s 12 2 1 1 0 0 0 1 0 0 0 1 0

2.

V.M.

Vijaya

F 51 Hind

u

House

wife 24 1 0 1 0 0 0 2 1 1 0 1 0

3.

K.Snik

ita

F 8 Hind

u Student 2 0 0 1 0 0 0 1 1 0 0 0 0

4.

V.Ram

esh

M 34 Hind

u

Busines

s 6 1 0 1 0 1 0 1 0 1 0 0 0

5

Leena

Rukmi

ni

F 5 Hind

u Student 6 2 1 1 0 2 1 2 1 1 1 0 0

6

Sakrut

h

chowd

ary

M 7 Hind

u Student 12 1 1 2 0 1 0 1 1 1 1 0 0

7.

Dushv

anth

M 9 Hind

u Student 3 1 0 1 0 0 0 1 0 0 0 1 1

8.

Jashmi

tha

F 8 Hind

u Student 6 1 0 1 0 0 0 1 0 1 0 1 0

9.

C.Kris

hna

reddy

M 12 Hind

u Student 1 1 0 1 1 2 1 1 1 0 0 1 0

1

0.

N.Dha

rma

Naidu

M 13 Hind

u Student 5 1 0 1 0 0 0 2 1 0 0 0 0

Annexures


THUNDIKERI (TONSILLITIS). Page iii

Master Chart of Group-3(PP)

N

o

Name

S

e

x

A

g

e

Reli

gio

n

Occu

patio

n

Dur

atio

n

(in

mo

nths

)

Dysp

hagia

Redn

ess in

Mucu

s

Mem

brane

Improv

ement

in

temper

ature

(as

observ

ed by

its fall)

Enlarg

ement

of

Tonsils

Halit

osis

(Bad

Brea

th)

Pric

king

Pain

B T

A T

B T

A T

B T

A T

B T

A T

B T

A T

B T

A T

1

.

A.Jyo

thswe

r

M 1

1

Hin

du

Stude

nt 1 2 0 2 0 2 1 1 0 0 0 1 0

2

.

G.

Prabh

u

M 1

2

Chr

istia

n

Stude

nt 2 1 0 1 0 1 0 1 0 1 0 1 0

3

.

C.Nav

een M

1

2

Hin

du

Stude

nt 3 1 0 1 0 0 0 2 1 1 1 0 0

4

.

A.Ra

mu M

1

2

Hin

du

Stude

nt 2 1 0 2 0 1 0 1 1 1 0 1 0

5

.

Halee

ma

sadiya

F 9 Mu

slim

Stude

nt 6 1 0 1 0 0 0 1 0 1 0 0 0

6

.

S.Hari

ka F

1

2

Chr

istia

n

Stude

nt 24 2 1 2 1 0 0 2 1 2 1 0 0

7

.

N.A.P

riyank

a

F 1

0

Hin

du

Stude

nt 1 1 0 1 0 0 0 1 0 0 0 0 0

8

.

M.Ma

raiah M

1

2

Hin

du

Stude

nt 8 1 1 2 1 0 0 1 1 0 0 0 0

9

.

P.Lok

esh M

1

3

Hin

du

Stude

nt 2 0 0 1 0 0 0 1 0 0 0 1 0

1

0

.

V.Ro

hit

yadav

M 1

2

Hin

du

Stude

nt 5 1 0 1 0 1 0 1 0 1 0 0 0

Annexures


THUNDIKERI (TONSILLITIS). Page iv

Master Chart of Group-4(PL)

N

o

Name

S

ex

A

ge

Relig

ion

Occup

ation

Dura

tion

(in

mont

hs)

Dyspha

gia

Rednes

s in

Mucus

Membr

ane

Improve

ment in

temperat

ure (as

observed

by its

fall)

Enlarge

ment of

Tonsils

Halito

sis

(Bad

Breat

h)

Prickin

g Pain

B T

A T

B T

A T

B T

A T

B T

A T

B T

A T

B T

A T

1

M .

Nagesh M

12

y

Hind

hu Student 3 1 1 1 1 0 0 1 1 0 0 1 1

2

V.Dhan

ya F 6y

Hind

hu Student 2 1 0 1 1 0 0 1 1 1 0 1 1

3

B.

Manoj

kumar

M 8y Hind

hu Student 1 2 1 1 1 0 0 1 1 0 0 0 0

4 G.Sarik

a F 8y

Chris

tian Student 2 2 2 1 1 0 1 1 2 0 0 0 0

5. S.Sana F 12

y

Musli

m Student 6 1 1 1 0 0 0 1 1 0 0 1 1

6.

C.

Kedhrn

ath

M 23

y

Hind

hu

Busines

s 12 1 2 1 1 0 0 1 2 0 0 0 0

7

V.Jithen

dra

reddy

M 5y Hind

hu Student 3 1 1 2 1 0 0 1 1 1 1 0 0

8

S.Soma

seker

naidu

M 35 Hind

hu

Busines

s 1 1 1 1 0 0 0 1 1 1 1 0 0

9

T.Yuge

ndher M 6

Hind

hu Student 3 1 0 1 0 0 0 1 1 0 0 0 1

1

0

P.jagade

sh M 5

Hind

hu Student 1 1 1 1 1 0 0 1 1 1 1 1 1

Annexures


THUNDIKERI (TONSILLITIS). Page v

ANNEXURE-2

LABORATORY REPORTS OF TEST DRUGS

Annexures


THUNDIKERI (TONSILLITIS). Page vi

ANNEXURE-3

CLINICAL CASE SHEET

1. S. no. of the patient : O.P.no of the patient:

2. Name of the patient :

3.Group Code (Of clinical trial) :

4. Age :

5. Gender : Male Female

6. Address :----------------------------------------------------------------------------

----------------------------------------------------------------------------------------------------------------

------------------------------------------------------------------------------------

7. Educational status :

Illiterate Read &write Primary

Middle school High school College

Others (specify) INA

Annexures


THUNDIKERI (TONSILLITIS). Page vii

8. Occupation : Desk work Field work

Field work with physical labour

Field work with intellectual

Indicate nature of work……………………………………..

9.Religion: Hindu Muslim Sikh

Christian other

12. Marital status: married unmarried

Chief complaint with duration (if any) in days

Absent Present Duration

1. Dysphagia

2.Redness in mucous memberane

3.Fever

4.Enlarged tonsil

5.Sore throat

6.Halitosis

7.Pricking pain

8.Cough

9.Headache

10.Loss of appetite

11.Change in voice

12.Enlarged lymph nodes(submandibular)

History of Present Illness

1. Onset of disease Acute Chronic

2. Duration of Disease in months

3. Factors aggravating the disease/Chief complaints –cold climate/ occupational/

damp climate

4. Factors relieving main complaints - hot water gargling/other

5. History of past illness, having relation with present illness: Yes No

History of Past Illness

1. Undergone Treatment before Yes No

PERSONAL HISTORY

1. Place : Anupa a jangala Sadharana

2. Diet : Vegetarian Mixed

3. Appetite : Good Normal Poor

Annexures


THUNDIKERI (TONSILLITIS). Page viii

4.Digestion : Good Normal Poor

5.Micturition : Frequency : Day………/Night…………

6.Bowel : Regular Constipated any associated problem

7.Sleep : Normal Disturbed Excess Insomnia

8. Addictions : Smoking Tobacco Alcohol Nil

9.Emotional stress : Yes No

Family History Mother Father Husband/ Wife Others

History of tonsillitis

LOCAL EXAMINATION :

TONSILS :

Size : hypertrophied / atrophied / inflammed

Symmetry : unilateral / bilateral enlargement

Crypts: white / yellow spots (follicles)

Membrane: present / absent

Ulcers: present / absent

PILLARS :

Uniform congestion of anterior & posterior pillars / tonsils /

Pharyngeal mucosa

ASTAVIDHA PARIKSHA :

1. Nadi :

2. Mutra :

3. Mala :

4. Jihvava :

5. Sabda

6. Sparsha

8. Akriti :

DASA VIDHA PARIKSHA:

1. Prakriti : vataja / pittaja / kaphaja / vata-pittaja /

vata-kaphaja / pitta-kaphaja / tridosaja/sama

Annexures


THUNDIKERI (TONSILLITIS). Page ix

2. Vikriti

pradhana : vata / pitta / kapha

anubandha : vata / pitta / kapha

3. Sara : rasa / rakta / mamsa / meda /

asthi / majja / sukra / satva

4. Samhanana : pravara / madhyama / avara

5. Pramana : samyak / hina /adhika

6. Satmya : ekarasa / vyamisra /sarvarasa

7. Satva : pravara / madhyama //avara

8. Ahara sakti : jatara sakti : pravara / madhyama / avara

9. Vyayama sakti : pravara / madhyama / avara .

10. Vayah : bala /madhyama / vriddha

SAMPRAPTI GHATAKA: (Srotas Pariksha evam Dushti Prakara)

1. Dosha 2. Dushya

3. Srotas 4. Adhishtana

5. Srotodushti Prakara

a. Atipravritti b. Sanga c. Vimargagamana d. Siragranthi

INVESTIGATIONS

1.Hb%

2.TC

3.DC

4.ESR

Treatment

Medication: CHINCHA BHEEJA LEPAM

OBSERVATION AND FOLLOW UP CHART:

S.NO SYMPTOMS BEFORE TREATMENT

AFTER TREATMENT

0 1 2 3 0 1 2 3

1. Dysphagia

2. Redness in mucous memberane

Annexures


THUNDIKERI (TONSILLITIS). Page x

3. Temperature

4. Enlargement of Tonsils

5. Halitosis

6. Pricking pain

Scholar: Guide:

Annexures


THUNDIKERI (TONSILLITIS). Page xi

ANNEXURE-4

ABOUT BALARAJ MAHARSHI

Dr. Balraj Maharishi (1917-1998)

Leading expert in Ayurveda and Dravyaguna‚ the identification and utilization of

medicinal plants. Former advisor on Ayurveda to the Tirumala Tirupati Devasthanams,

Government of Andhra Pradesh,India and Government of Brazil.

Vanaushadhi samrat Sri Balraj Maharshi is born in Akividu village, West godhavari

district of Andhrapradesh on 20th

December 1917. He lived up to 28th

august 1998. Parents

named him as Rudraraju NarasimhaRaju. In childhood, he is found of learning “Harikatha

Vidhana “ and left the home in search of a guru at the age of fourteen years. Fate/God made

him to meet with Rajanada Maharshi and followed him in to the deep forests of Assam. He

learned ayurveda treatment and secrets of medicinal plants from his Guru Sri Rajanada

Maharshi during his association of 14-15 years.

To follow his Guru Sri Rajanada Maharshi‟s directions he conducted hundreds of free

ayurvedic camps and saved millions of patients with free medicines. He travelled all over

India attained familiarity as an expert Ayurvedician and eminent herbalist. He is named and

became popular as Balaraj Maharshi.

He has travelled several countries like America, Africa, Brazil, Holland, Canada and

Portugal. He has served as the Chief expert of Ayurveda in Maharshi Ayurveda Prathistan,

New Delhi along with stalwarts like Sri Vaidya Vasudevbhai Mulasankar Dvivedhi and Sri

Brihaspathi Dev Thriguna. Balaraj Maharshi formulated popular medicine like „Amritha

Kalas‟ produced by Maharshi Ayurveda Prathistan, New Delhi. In 1988, Governament of

Brazil has honoured him as the Advisor for Ayurveda.

One day in Brasilia, it was decided that the visiting Vaidyas would join a group of

traditional practitioners from South America on a field trip into the jungle to study local

Annexures


THUNDIKERI (TONSILLITIS). Page xii

plants. By the end of the day, Balaraj Maharishi had earned the respect of all. Whenever they

had come to a plant whose identity or health benefits were unknown to all others, Balaraj

would explain everything about it, Sanskrit name, Latin name, common name, and uses of its

different parts. His knowledge seemed encyclopedic. He was subsequently described as

“sarvagyan oushadhi” – having universal knowledge of plants78

.

He has continued his services at Tirumala Tirupati Devasthanams of Tirupati as the

Advisor for Ayurveda. He has established one college, hospital and pharmacy under the

auspices of TTD. he has authored only one book, i.e., “Griha Vaidhyam”. It has undergone

several reprints and about 1, 50,000 copies are sold. Dr M. Paramkusha Rao edited and

translated it.

Griha Vaidyam

Annexures


THUNDIKERI (TONSILLITIS). Page xiii

ANNEXURE-5

ABOUT GUIDE

Dr. M.Paramkusha Rao

P.G Professor and Head,


S.V. Ayurvedic College,

Tirupati.

“SRI RAMARAMAM”

G-01; Sripada Residency,

18-3-61/10, Shanti Nagar, Khadi Colony,

Tirupati – 517 507, A.P, INDIA.

Phone: 91-877-2230339

Cell: 9393608779

E-mail – [email protected]

www.paramkusha.com

Education:

B.A.M.S – 1976-1981, Osmania, Hyderabad

M.D (Ayu) Dravyaguna – 1981-1984, G.A.U, Jamnagar

Ph.D (Dravyaguna – Ayurveda) 2004 – Registered with National Institute of Ayurveda,

Jaipur, Rajasthan Ayurveda University, Rajasthan.

Teaching Experience:

2010 – Till Date – P.G Professor and Head, Post Graduate Department of

Dravyaguna, TTD’s S.V. Ayurvedic Medical College, Tirupati, India.

1991 – 2010 – Professor/Head of the Department of Dravyaguna, TTD‟s S.V.

Ayurvedic Medical College, Tirupati, India.

1987 – 1991 – Lecturer, Department of Dravyaguna, TTD‟s S.V. Ayurvedic Medical

College, Tirupati, India.

mailto:[email protected]

http://www.paramkusha.com/

Annexures


THUNDIKERI (TONSILLITIS). Page xiv

1987 – MAHARSHI AYURVEDA PRATISTHAN INTERNATIONAL LTD,

Santiago, Chile.

1986 – 1987 – Ministry of Social Welfare and Health, Government of Goias. Goiania,

Brazil.

Research Experience:

Honorary Research Co-ordinator – I-SERVE, Hyderabad since 2005

Board of Studies Member, Rajiv Gandhi University, Bangalore

Member for Ethical Committee, Chadalawada Pharmacy College, Tirupati

Awards:

Talented Scientist Award – 35th

World Congress on Natural Medicines, 1997,

Tirupati.

A.P State‟s B.N.Sastry Foundation Award as the Distinguished Ayurveda Physician

for the year 2004.

Ayurveda Pracharagraganya – Title given by Brahmana Samajam, Tirupati in 2013.

Clinical Expertise:

Special Treatments for Urinary Calculi, Uterine Fibroids and Tonsillitis.

New Ayurveda Formulas with instant action for Chikun Gunya and Dengue.

Books and Works:

Editor - “GRIHA VAIDYAM” Ayurvedic Home Remedies in Telugu – Published by

T.T.Devasthanams, Tirupati – 1992, 1993, 1994, 1995, 1996. (Sold about 10 million

copies till date)

Editor and Translator Balaraj Maharshi’s GRIHA VAIDYAM (English) –

Ayurvedic Home Remedies, Published by T.T. Devasthanams, Tirupati – 1994.

Editor – International journal of Pharmacy, Bombay.

Authored “MEE AROGYANIKI YEE AAHARAM” (Ayurvedic Clinical

Nutrition) (Telugu), Live-Long Publications, Tirupati – 1994.

Contributory author to “Principles of Ayurvedic Therapeutics”, Indian Book

Centre, Delhi, India – 1995.

Annexures


THUNDIKERI (TONSILLITIS). Page xv

Founder and Chief Editor for “Allied Ayurvedic Medical Research Abstracts

(AAMRA)” - The sole abstract journal of Ayurveda since 1997.

Editor for “SANCAYA” a monograph on Ayurveda, 1997.

Authored “Chituku Chikitsalu” (Simple Ayurveda Treatments and Limitations)

(Telugu), I-SERVE Publications, Hyderabad, 2007.

Authored “Chituku Chikitsalu” (Simple Ayurveda Treatments and Limitations)

(Telugu), Second enlarged edition – 2010, EMESCO, Hyderabad.

Datta Ayurvedam – Telugu, Avadhootha Datta Peetham, Mysore (Under Process)

Rasa Chintana – English, Chowkambha Krishna Das Academy, Varanasi. (Under

Process)

Papers published and presented:

57 in different journals and conferences

Dravyaguna Kriya yogalu – Telugu – SFPAA, Ayurvedic Magazine, Nellore

Digital Works:

“Charaka Samhitha Word Search Engine” (Computerized Data Bank) – I-SERVE,

Hyderabad, 2007-2008.

“Susrutha Samhitha Word Search Engine” (Computerized Data Bank) – (Relesed

by Sri Sri Sri Ganapati Sachchidanandha Swamiji, Datta peetham, Mysore, 2016 ).

Electronic Media and Media:

“Sanjivani” popular programme on SVBC Channel – since 2008 – 40 programmes

Authored popular and scientific columns on Ayurveda herbs (Weeds and Foods) in

local news papers (Eenadu, Andhra jyothi and Vartha) and Periodicals like Annadata,

Kaliyuga Narada and Saptagiri, Manphar Vaidya Pathrika and SFPAA Diary.

tonsillitis in ayurveda

Healthcare