A compendious review of Chitraka Haritaki Avaleha - A polyherbal Ayurveda formulation for bronchial asthma.

INTRODUCTION: Avaleha (confection) is an unique dosage form of Ayurvedic pharmaceutics, which is frequently prescribed in various disorders and especially in respiratory disorders. Chitraka Haritaki Avaleha (CHA) is one such formulation being used extensively by Ayurveda physicians for bronchial asthma, despite its classical use in various other disorders too. CHA was first time described by Vrindamadhava in the 9th century and had been amended for many times till today. Because of its demand, many pharmaceutical companies are also manufacturing it, and is freely available in the market. AIM: The aim is to screen and compile references pertaining to composition, method of preparation, therapeutic uses, organoleptic, and physico-chemical parameters of CHA from different classics and original research articles.
MATERIALS AND METHODS: Description of CHA was extensively reviewed from Vrindamadhava, Chakradatta, Vangasena, Gadanigraha, Yogatarangini, Bhaishjya Ratnavali and Yogaratnakara. Synonyms, Rasapanchaka (Ayurveda principles of drug action), and Dosha Karma (therapeutic attributes) of ingredients were compiled from Bhavaprakasha Nighantu. Organoleptic and physicochemical parameters were compiled from original research articles, searched from PubMed, Google Scholar, and Research Gate.
RESULTS: Variations in formulation name, ingredients, method of preparation, therapeutic indications and Anupana (adjuvant) was observed in the classical texts. Value of water-soluble extracts and pH of analytical study was found different than Ayurveda Pharmacopeia of India standards.
CONCLUSION: Screening through various texts revealed that CHA has been mentioned in seven classical treatises and two gazetted texts with amendments which indicate its high demand and clinical efficacy in bronchial asthma along with other diseases. Disparity found in analytical parameters indicates the need of standardization of pharmaceutical process. Copyright:

Introduction

In Ayurveda, Avaleha (confection) are compound formulations, used in the management of various disease conditions. Chitraka Haritaki Avaleha (CHA), Bharangyadi Avaleha, Kantakari Avaleha, Vasa Avaleha, Chyavanaprasha Avaleha, and Kansa Haritaki Avaleha are frequently prescribed Avaleha, especially for ailments of the respiratory tract.[12345] CHA is one of the important Avaleha formulation used for the management of bronchial asthma.[6] CHA consists of 23 ingredients, as per the (Ayurvedic Formulary of India [AFI]).[7] It is also known to pacify symptoms of diseases such as Agnimandya (digestive impairment), Shwasa (asthma), Kasa (cough), Kshaya (tuberculosis), Pinasa (chronic rhinitis/sinusitis), Krimi (worm infestation), Gulma (abdominal lump), Arsha (hemorrhoids), Udavarta (constipation).[8] As there is no need of food restriction during the intake of CHA,[9] it is easy to prescribe and hence widely used among physicians. However, since the 9th century till today, different classics have modified its pharmaceutical processing, ingredients and Anupana (adjuvant). As, it is important for the physician to know details of drugs being used by them, critical review of the classical references along with available original published researches on pharmaceutical parameters of CHA was done.

Aim and objective

To screen and compile references pertaining to composition, method of preparation, Anupana and therapeutic indications, along with available research data of organoleptic and physico-chemical parameters of CHA from different classics, published reports, and original research works.

Materials and methods

A review of Ayurveda formulations related to Sanskrit based classical texts available in the library of the Institute of Teaching and Research in Ayurveda, Jamnagar was carried out. The texts having formulation named CHA, or formulations with different names but having the same ingredients as mentioned in AFI, were included for the review study. Compiled text or classical texts which did not mention such formulations were excluded from the study. After screening seven classical texts (Vrindamadhava, Chakradatta, Vangasena, Gadanigraha, Sharangdhara Samhita, Bhavaprakasha, Yogaratnakara) and two gazetted books [Ayurveda Pharmacopeia of India (API) and Ayurvedic Formulary o India (AFI)] were reviewed for the study, out of which reference of Bhaishajya Ratnavali was considered as standard comparator (as it is mentioned in AFI) [Table 1].

Table 1

Description of Chitraka Haritaki Avaleha in various texts

Reviewed text (Chapter name, number/verse number)	Name of formulation	Total number of ingredients	Name of ingredients	Anupana	Therapeutic indication
Vrindamadhava (Nasarogadhikara, 60/29-31)	Chitraka Haritaki	23	Chitraka, Amalaki Swarasa (juice), Guduchi juice, Dashamulaa, Haritaki, Guda, Madhu, Trikatub, Trijatac, Yavakshara	Yathagni (As per digestive capacity)	Mandagni (subdued digestive power), Kshaya, Kasa, Pinasa, Krimi, Gulma, Udavarta, Arsha, Shwasa, Rasayana (rejuvenating drugs)
Chakradatta (Nasa Roga Chikitsa, 56/28-30)	Chitraka Haritaki	23	Chitraka, Amalaka, Guduchi, Dashamula, Haritaki Churna, Trikatu, Trijata, Yavakshara, Madhu, Guda	-	Mandagni, Kshaya, Kasa, Pinasa, Krimi, Gulma, Udavarta, Arsha, Shwasa, Rasayana
Vangasena, (Nasaroga, 70/35-39)	Nrupati Rasayana	23	Chitraka, Amalaki Swarasa, Guduchi Swarasa, Dashamula, Haritaki, Guda, Madhu, Trikatu, Trijata, Yavakshara	-	Mandagni, Pinasa
Gadanigraha, Prathama Bhaga (Lehadhikara, 5/118-113)	Chitraka Haritaki	23	Chitraka, Amalaka, Guduchi, Dashamula, Haritaki Churna, Trikatu, Trijata, Yavakshara, Madhu, Guda	As per digestive capacity	Arsha, Shwasa, Bhagandara (anal fistula), Kasa, Krimi, Shopha (swelling), Kushtha (skin disease), Gulma, Aantravriddhi, Pinasa, Rajyakshma
Gadanigraha, Prathama Bhaga (Lehadhikara, 5/112-114)	Dvitiya Chitraka Haritaki	23	Chitraka, Amalaka, Guduchi, Dashamula, Haritaki Churna, Maricha, Pippali, Nagakeshara, Trijata, Yavakshara, Madhu, Guda	As per digestive capacity	Kasa, Shwasa, Bhagandara, 18 Kushtha, 8 Udara Roga (diseases related to abdominal organs), Kshatakshaya (lung parenchymal diseases), Rajyakshma
Yoga Tarangini (Taranga 72)	Chitraka Haritaki	18	Chitraka, Laghu Panchamulad, Guduchi, Amalaki, Guda, Madhu, Trijata, Trikatu, Yavakshara	-	Shosha, Shwasa, Pralapa (insanity), Kasa, Vamathu (vomiting), Kaphaja Pratishyaya (a type of cold), Urahkshata (lung parenchymal diseases), Hikka (hiccup), Kaphaja Shiroroga (a type of headache), Mandagni
Bhaishajya Ratnavali (Nasa Roga Chikitsa, 63/25-28)	Chitraka Haritaki	23	Chitraka, Amalaka, Guduchi, Dashamula, Haritaki, Trikatu, Trijata, Yavakshara, Madhu, Guda	-	Mandagni, Kshaya, Kasa, Pinasa, Krimi, Gulma, Udavarta, Arsha, Shwasa
Yoga Ratnakara, Uttarardha (Nasa Roga Chikitsa)	Chitraka Haritaki	23	Chitraka, Amalaka, Guduchi, Dashamula, Haritaki, Trikatu, Trijata, Yavakshara, Madhu, Guda	-	Shosha, Shwasa, Malavarodha (constipation), Vamana, Kaphaja Pratishyaya, Kshina, Urahkshata, Hikka, Kapha Roga, Shiro Roga
AFI Part 1, volume 1 (Avaleha, 3/10)	Chitraka Haritaki	23	Chitraka, Amalaka, Guduchi, Dashamula, Haritaki, Trikatu, Trijata, Yavakshara, Madhu, Guda	Milk	Mandagni, Kshaya, Kasa, Pinasa, Krimi, Gulma, Udavarta, Arsha, Shwasa
API Part 2, volume 1 (Avaleha, 1/4)	Chitraka Haritaki		23-Chitraka, Amalaka, Guduchi, Dashamula, Haritaki, Trikatu, Trijata, Yavakshara, Madhu, Guda	-	Mandagni, Kshaya, Kasa, Pinasa, Krimi, Gulma, Udavarta, Arsha, Shwasa

: Equal mixture of ten drugs namely Agnimantha (Premna mucronata Roxb.), Bilva (Aegle marmelos Corr.), Brihati (Solanum indicum Linn.), Gokshura (Tribulus terrestris Linn.), Kantakari (Solanum surattense Burm.), Gambhari (Gmelina arborea Linn.), Patala (Stereospermum suaveolens DC.), Prishnaparni (Uraria picta Desv.), Shalaparni (Desmodium gangeticum DC.) and Shyonaka (Oroxylum indicum Vent.), bTrikatu: Equal mixture of three drugs namely Shunthi (Zingiber officinale Rosc.), Maricha (Piper nigrum Linn.) and Pippali (Piper longum Linn.), cTrijata: Equal mixture of three drugs namely Tvaka (Cinnamomnm zeylanicum Breyn.), Ela (Elettaria cardamomum Maton.) and Patra (Cinnamomum tamala Nees and Eberm), dLaghu Panchamula: Equal mixture of five drugs namely Brihati, Kantakari, Shalaparni, Prishnaparni and Gokshura

Along with the review of CHA, synonyms of its ingredients, Rasapanchaka (Ayurveda principles of drug action) and Dosha Karma (therapeutic attributes) were compiled from Bhavaprakash Nighantu [Tables 2 and 3].

Table 2

Synonyms of Ingredients of Chitraka Haritaki Avaleha

Ingredients	Synonyms
Chitraka	Agni, Anala, Dahana, Pathi, Vanhisam, Vyala, Ushna
Amalaki	Vayasya, Vrishya, Dhatriphala, Amalaka, Amritaphala, Tishyaphala
Guduchi	Amrita, Madhuparni, Chhinnaruha, Vatsadani
Haritaki	Abhaya, Pathya, Kayastha, Putana, Amrita, Haimavati, Avyatha, Chetaki, Shreyasi, Shiva, Vayastha, Vijaya, Jivanti, Rohini
Brihati	Simhi, Kshudrabhantaki
Kantakari	Kantakari, Duhsparsha, Vyaghri, Kshudra, Nidigdhika, Kantakarika, Dhavani, Kanthalika
Shalaparni	Vidarigandha, Anshumati
Prishnaparni	Prithaparni, Kalashi, Dhavani, Shrigalvina
Gokshura	Shwadamshtra, Trikantaka, Chanadruma, Ikshugandhika
Patala	Madhuduti, Krishnavrinta, Tamrapushpi, Kuberakshi, Amogha
Shyonaka	Tuntuka, Kutannata, Prithushimba
Agnimantha	Jaya, Shriparna, Vatgni
Bilva	Shriphala, Sadaphala, Mallora, Shailoosha, Mahakapittha, Gandhag, Granthila
Gambhari	Madhuparnika, Shriparni, Kashmiri
Shunthi	Vishva, Vishvam, Nagaram, Vishvabheshajam, Ushna, Katubhadram, Shringaveram, Mahaushadham
Maricha	Vellaja, Krishna, Ushna, Dharmapattanam
Pippali	Magadhi, Krishna, Vaidehi, Chapala, Kana, Upakulya, Ushna, Saundhi, Kola, Tikshnatandula
Tvaka	Swadutvak, Tanutvaka, Darusita
Ela	Shuksma-Ela, Upakunchika, Tuttha, Korangi, Dravidi, Truti
Patra	Tamalpatra, Patranamaka, Tejapatra
Yavakshara	-
Guda	Ikshu, Dirghachchhda, Madhutrina, Gudamoola
Madhu	Makshika

Table 3

Rasapanchaka and Dosha Karma of Ingredients of Chitraka Haritaki Avaleha as per Bhavaprakasha Nighantu

Drug	Rasa (taste)	Guna (property)	Virya (potency)	Vipaka (posthigestive effect)	Dosha Karma (type of action on specific Dosha)
Chitraka	Katu (pungent)	Laghu (light), Ruksha (dry), Tikshna (sharp)	Ushna (hot)	Katu (pungent)	Kapha Vatahara (pacifies Kapha and Vata Dosha)
Amalaki	Pancha Rasa-Alavana (all 5 tastes except salty)	Guru, Ruksha, Shita (cold)	Shita	Madhura (sweet)	Tridosha Shamaka (pacifies all three Dosha)
Guduchi	Tikta (bitter), Kashaya (astringent)	Guru (heavy), Snighdha (oily)	Ushna	Madhura	Tridosha Shamaka
Haritaki	Madhura (sweet), Amla (sour), Katu, Tikta, Kashaya	Laghu, Ruksha	Ushna	Madhura	Tridoshahara (pacifies all three Dosha)
Brihati	Katu, Tikta	Laghu, Ruksha, Tikshna	Ushna	Katu	Kapha Vata Shamaka (pacifies Kapha and Vata Dosha)
Kantakari	Katu, Tikta	Laghu, Ruksha, Tikshna	Ushna	Katu	Kapha Vatahara
Shalaparni	Madhura, Tikta	Guru, Snigdha	Ushna	Madhura	Tridoshahara
Prishnaparni	Madhura	Laghu, Snigdha	Ushna	Madhura	Tridosha Shamaka
Gokshura	Madhura	Guru, Snigdha	Shita	Madhura	Vata Pitta Shamaka (pacifies Vata and Pitta)
Patala	Tikta, Kashaya	Laghu, Ruksha	Ushna	Katu	Tridosha Shamaka
Shyonaka	Madhura, Tikta, Kashaya	Guru	Ushna	Katu	Kapha Pitta Shamaka (pacifies Kapha and Pitta)
Agnimantha	Katu, Tikta, Kashaya, Madhura	Laghu, Ruksha	Ushna	Katu	Kapha Vatahara (pacifies Kapha and Vata)
Bilwa	Kashaya, Tikta	Laghu, Ruksha	Ushna	Katu	Kapha Vata Shamaka
Gambhari	Tikta, Kashaya, Madhura	Guru	Ushna	Katu	Tridosha Shamaka
Yavakshara	Kashaya, Madhura	Guru, Ruksha, Sukshma (subtle)	Shita	Katu	Kapha Pitta Shamaka
Guda	Madhura	Laghu, Snigdha	Shita	Madhura	Vata Pitta Shamaka
Madhu	Madura, Kashaya	Guru, Ruksha, Sukshma	Shita	Katu	Kapha Vata Shamaka
Shunthi	Katu	Laghu, Snigdha	Ushna	Madhura	Vatahara (pacifies Vata)
Maricha	Katu	Laghu, Tikshna	Ushna	Katu	Kapha Vata Shamaka
Pippali	Katu	Laghu, Snigdha, Tikshna	Anushna-shita	Madhura	Kapha Vata Shamaka
Tvaka	Madhura, Katu, Tikta	Ruksha, Laghu, Tikshna	Ushna	Katu	Kapha Vatahara, Pitta Vardhaka (increases Pitta)
Ela	Madhura, Katu	Laghu, Ruksha	Shita	Shita	Tridoshahara
Patra	Madhura, Tikta, Katu	Ruksha, Laghu, Tikshna	Ushna	Katu	Kapha Vatahara

For organoleptic and physicochemical parameters of CHA, original research articles of the last 10 years were searched from PubMed, Google Scholar, and Research Gate with keywords “Chitraka Haritaki Avaleha,” “organoleptic,” pharmacognostical” and/or “physico-chemical.” Five articles were found to have these parameters [Table 4].

Table 4

Results for organoleptic and physico-chemical parameters of Chitraka Haritaki Avaleha

Author/s	Title	Journal	Volume (issue), Year
Achyuta et al.[10]	Pharmacognostical and physicochemical evaluation of Chitraka Haritaki: A compound Ayurvedic formulation	Int. J. Res. Ayurveda pharm.	5 (3), 2014
V K Singh et al.[11]	Physico-chemical and phytochemical standardization of Chitraka Haritaki Avaleha	International journal of pharmaceutical & biological archives	6 (3), 2015
VK Singh, et al.[12]	Accelerated stability study of Chitraka Haritaki Avaleha	International journal of pharmacy and pharmaceutical sciences	8 (2), 2016
Poonam et al.[13]	Pharmaceutical and pharmacognostical evaluation of Chitraka Haritaki-An Ayurvedic compound	World journal of pharmaceutical research	6 (5), 2017
Yadav and Tukaram[14]	A randomized controlled clinical study on the efficacy of Chitrakaharitaki Avaleha in Vataja Pratishyaya w.s.r. to allergic rhinitis in children	International Journal of Ayurvedic Research (PIJAR)	1 (3), 2017

Results

Out of total of 15 classical texts screened, CHA was not found in eight Ayurveda texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Ashtanga Samgraha, Kashyapa Samhita, Sharangdhara Samhita, Sahastrayoga and Rasa Ratna Sammuchaya) and hence excluded from the review. The rest of the seven texts have mentioned this formulation with the same or different names [Table 1]. Vrindamadhava (9th century) had described this formulation for the first time.[15] Later on, this formulation appears in Chakradatta (11th century), Vangasena (12th century), Gadanigraha (12th century), Yoga Tarangini (17th century), Bhaishajya Ratnavali (19th century) and in Yogaratnakara (20th century).

Details of name, ingredient, Anupana, indications in different texts are mentioned in Table 1.

The formulation composition and ratio of ingredients for the preparation of CHA are mentioned in Table 5.

Table 5

Formulation composition of Chitraka Haritaki Avaleha as per Bhaishajya Ratnavali

Name of ingredients	Scientific name/English name	Part used	Ratio
Chitraka	Plumbago zeylanica Linn.	Root	25 part
Amalaki	Emblica officinalis Gaertn.	Fruit	25 part
Guduchi	Tinospora cordifolia Mier ex Hook	Stem	25 part
Haritaki	Terminalia chebula Retz.	Fruit pericarp	32 part
Brihati	Solanum indicum Linn.	Root	2.5 part
Kantakari	Solanum surattense Burm.	Root	2.5 part
Shalaparni	Desmodium gangeticum DC.	Whole plant	2.5 part
Prishnaparni	Uraria picta Desv.	Root	2.5 part
Gokshura	Tribulus terrestris Linn.	Root	2.5 part
Gambhari	Gmelina arborea Linn.	Root	2.5 part
Patala	Stereospermum suaveolens DC.	Root	2.5 part
Shyonaka	Oroxylum indicum Vent.	Root	2.5 part
Agnimantha	Premna mucronata Roxb.	Root	2.5 part
Bilva	Aegle marmelos Corr.	Root	2.5 part
Yavakshara	Alkaline substance of Hordeum vulgare L.	Water soluble ash of plant	¼ part
Guda	Jaggery	-	50 part
Madhu	Honey	-	4 part
Shunthi	Zingiber officinale Rosc.	Rhizome	1 part
Maricha	Piper nigrum Linn.	Fruit	1 part
Pippali	Piper longum Linn	Fruit	1 part
Tvaka	Cinnamomnm zeylanicum Breyn	Bark	1 part
Ela	Elettaria cardamomum Maton.	Seeds	1 part
Patra	Cinnamomum tamala Nees and Eberm	Leaves	1 part

As mentioned in Table 1, total seven classical texts and two gazetted texts (API and AFI) were reviewed out of which Acharya Vangasena in Chikitsa Sara Samgraha has mentioned different name, for this formulation, i.e., Nrupati Rasayana. In Gadanigraha, Acharya Sodhala has mentioned two formulations with the name of Chitraka Haritaki.

Contents of CHA mentioned in Vrindamadhava, Chakradatta, Yogaratnakara, AFI and API are similar to that of Bhaishajya Ratnavali, while in Dvitiya CHA, Shunthi has been replaced with Nagakeshara (Mesua ferrea Linn.) and in Yoga Tarangini; Dashamula has been replaced with Laghu Panchamula.

Vrindamadhava and Gadanigraha, have mentioned that Anupana of CHA should be as per digestive capacity while AFI has advocated milk. The rest of the classics have not mentioned Anupana (vehicle) for this formulation.

According to Gadanigraha, CHA cures Antra Vriddhi (intestinal hernia) if taken continuously for 2 months and if taken for 3 days, it cures Pinasa along with Rajayakshma, Kushtha, Arsha, Bhagaadara and Shopha; while Dvitiya CHA if taken for 21 days, then the person can digest food efficiently in addition to above effects. The rest of all details are same as available in standard comparator, Bhaishajya Ratnavali.

Synonyms for ingredients of Chitraka Haritaki Avaleha

Ingredients with their different names are depicted in Table 2 and the source of the synonyms is Bhavaprakasha Nighantu. The synonyms are mentioned to avoid confusion between various synonymous names of the same drugs mentioned by different texts.

Rasapanchaka of ingredients of Chitraka Haritaki Avaleha

Ingredients (according to standard reference i.e., Bhaishajya Ratnavali) of CHA and their Rasapanchaka and Dosha Karma are depicted in Table 3. Maximum Dravya of this formulation possesses Ushna Virya (hot potency) and Madhura (sweet) Vipaka (post-digestive effect). The source of the Rasapanchaka and Dosha Karma is Bhavaprakasha Nighantu.

Organoleptic and physico-chemical parameters of Chitraka Haritaki Avaleha

As shown in Table 4, total of five published articles has mentioned organoleptic and/or physicochemical parameters of CHA, out of which, article serial number 3 (Accelerated stability study of CHA; V K Singh et al.) has only organoleptic parameters which are also mentioned in article serial number 2 (Physico-chemical and phytochemical standardization of CHA; V K Singh et al.) by the same author of the same sample and hence article serial number 3 was excluded from the review. Article serial number 5 (A randomized controlled clinical study on the efficacy of Chitrakaharitaki Avaleha in Vataja Pratishyaya w.s.r. to allergic rhinitis in children; T J Yadav et al.) has mention organoleptic parameters and hence was included for analytical review only. Hence, results of organoleptic characters of the remaining three original research works are mentioned in Table 6 and physicochemical parameters mentioned in four original research works are mentioned in Table 7 and compared with available standards of API.

Table 6

Organoleptic characters of Chitraka Haritaki Avaleha as per various published articles

Parameters	Achyuta Atara et al.	Poonam Gaur et al.	V.K. Singh et al.	API[16]
Color	Dark brown	Dark brown	Blackish brown	Blackish Brown
Touch	Soft	Semisolid	Soft and viscous	Semisolid paste
Odour	Pleasant	Sweetish aromatic	Spicy pleasant	Pleasant
Taste	Astringent, pungent	Sweetish sour with astringent	Bitter astringent	Bitter Astringent
Appearance	-	-	Thick semi solid mass	-

API: Ayurveda Pharmacopeia of India

Table 7

Physico-chemical parameters of Chitraka Haritaki Avaleha as per various published articles

Parameter	Achyuta Atara et al.	Poonam Gaur et al.	V. K. Singh et al.	T. J. Yadav et al	API
Loss on drying (%w/w)	23.5	14.25	23.78	15.86	Not more than 36.0
Total ash (%w/w)	2.5	0.787	4.045	10.56	Not more than 4.7
Acid insoluble ash (%)	-	-	0.306	-	Not more than 1.0
Alcholic-soluble extractive (%w/w)	69	89.2	48.64	17	Not less than 21.0
Water soluble extractive (%w/w)	61%	79.85	65.29	24	Not less than 67.0
pH (1% aqueous solution)	5.80	4.5	5.19	5.72	6.4 to 6.6

API: Ayurveda Pharmacopeia of India

As per Table 6, according to standards of API, CHA has blackish brown color, semisolid touch, pleasant odor and bitter astringent taste. Out of these, taste mentioned for CHA articles of Achyuta Atara et al. and Poonam Gaur et al. is astringent, pungent and sweetish sour with astringent respectively, which is devoid of bitterness and hence different than API standards, and the justification for this change is not found in the article.

The physico-chemical parameter of any drug provides information about its purity.[17] As mentioned in Table 7, loss on drying, total ash, acid insoluble ash and alcohol soluble extractive of three researches are fulfilling the standards of API, but values of water-soluble extractive and pH are not matching with API standards. Total ash and alcohol soluble extractive mentioned in the research work of Yadav et al. are also different than that mentioned in API.

Discussion

The basic method of the preparation of CHA includes three major components; Drava Dravya (containing decoction of Chitraka, Amalaki, Guduchi and Dashamula), Madhura Dravya (jaggery and honey) and Prakshepa Dravya (Trikatu Trijata, and Yavakshara). Drava Dravya helps in the extraction of water-soluble active principles; Madhura Dravya is responsible for palatability and also acts as preservatives; Prakshepa Dravya enhances the taste as well as increases the bioavailability of the drugs.[18]

This standard pharmaceutical procedure of CHA was amended by Chakradatta and Gadanigraha by using fresh juice of Guduchi and Amalaki in place of decoction, while Yogaratnakara, had specified the quantity of water (3 Drona = 36.6 liters) for preparation of decoction from Kwathya Dravya (400 Pala = 19.2 kg). Major variation was observed in stages of the process during which Haritaki is to be added. Chakradatta, Acharya Vangasena, Gadanigraha, Yoga Tarangini and API opined to add Haritaki at the timing of boiling of decoction during Gudapaka, while Yogaratnakara opines to add Haritaki after Gudapaka. It is important to note that, as boiling of the tea leaves leads to more yield of tannin,[19] boiling of Haritaki during Gudapaka leads to more tannin release which makes Avaleha more astringent. Hence to reduce astringent taste of CHA, Yogaratnakara might have changed the sequence of Haritaki addition. The same could be the reason of the change in taste of CHA in the research work of Poonam Gaur et al. In the same work; sour taste might be because of the proportionate increase in Amalaki content when Haritaki proportion is reduced.

Acharya Vangasena has mentioned another name “Nrupati Rasayana” of this formulation and claimed that it can digest food which is as hard as stone, cures Pinasa in three days if taken continuously and there is no need to follow food restrictions while taking this formulation. This name is given as no food restriction is needed during intake of it.

In Gadanigraha, Acharya Sodhala has done amendment in Dvitiya CHA and used Nagakeshara (Mesua ferrea Linn.) in place of Shunthi and has mentioned to use fresh (Navina) Chitraka root and doubled the quantity of honey and Yavakshara (1 Pala = 48 grams). Here, it is interesting to notice that by amending the content and procedure, Acharya has changed the indication by focusing on improvement in digestion. This might be because Shunthi, due to its pungent taste; oily property; and sweet post digestion effect, enhances its effect on the respiratory system. While Nagakeshara due to its bitter, pungent, astringent taste; light, dry property; and pungent post-digestive effect[20] and increased dose of Yavakshara enhances digestion power.

In Yoga Tarangini and Yogaratnakara, the quantity of Prakshepa Dravya (Trikatu and Trijata) is reduced to half in comparison to the standard comparator. This may be to make CHA more palatable by reducing its spicy and bitter taste. The impact of this change, on the phytochemical constitution and clinical efficacy is a matter of further study.

According to AFI, the therapeutic dose of Chitraka Hartitaki Avaleha is mentioned as 6–12 g and has been indicated for Gulma (abdominal lump), Udavarta (constipation), Pinasa (chronic rhinitis/sinusitis), Kasa (cough), Shwasa (dyspnoea/asthma), Arsha (hemorrhoids), Agnimandya (digestive impairment), Kshaya (tuberculosis) and Krimi (worm infestation). According to API, part to be used of Dashamula Dravya is stem bark; which might be to conserve the biodiversity of herbal plants.[21]

It is always important to observe organoleptic and physicochemical parameters of the finished product, especially in which stringent and multiple complex procedures are involved. All the reviewed articles had mentioned that CHA was prepared as per the reference of Bhaishajya Ratnavali, which is also mentioned in AFI and API. Despite having same method of preparation, disparity in the organoleptic and analytical parameters is apparent [Tables 6 and 7]. Water-soluble extractive and pH of all these samples are not matching with API standards. This disparity might be due to variation in the quality of raw drugs, seasonal variation, differences in pharmaceutical instruments used in CHA preparation or may be due to difference in the assessment method of organoleptic and physicochemical parameters. Hence, this may be matter for further research to find out that, how to overcome above-mentioned confounders to achieve unanimity in these parameters.

Scope and limitations of this study

Review article provides bird eye view of the subject that is an important and probably required step in the scientific validation or discovery process.[22] This review article provides the historical background of amendments along with data of organoleptic and analytical parameters of recent (last 10 years) original research works which provide platform for researchers to develop research questions for fundamental as well as applied research. Along with these outcomes, this review study also has certain limitations. In this review work, classical texts, which are not available in the Institute of Teaching & Research in Ayurveda library, were not screened. Unpublished raw data of original research carried out on organoleptic and analytical parameters of CHA was also not included in this study.

Conclusion

Chitraka Haritaki Avaleha was introduced by Vrindamadhava in Ayurveda pharmaceutics and is mentioned thereafter in various texts, which indicates its clinical acceptance and efficacy. By keeping Bhaishajya Ratnavali as standard comparator, variations in formulation name, ingredients, method of preparation, indication and Anupana is observed. Most of the ingredients in Chitraka Haritaki Avaleha have Vatakapha and Tridosha pacifying properties, which makes it effective in the treatment of bronchial asthma. Organoleptic and physicochemical parameters mentioned in the published research works when compared with available standards of API reveals that the values of water-soluble extracts and pH differs and this can be a matter for further extensive research. This review might help the clinician and researcher to get the compendious idea of Chitraka Haritaki Avaleha.

Conflicts of interest

There are no conflicts of interest.