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Ayurvedic Medicines

» Analgesics

» Antacids in Ayurveda

» Anti hypertensive drugs in Ayurveda

» Antipyretic drugs in Ayurveda

» Anti anxiety drugs in Ayurveda

» Anti-arrhythmic drugs in Ayurveda

» Antibacterial drugs in Ayurveda

» Drugs that act as Antibiotic

» Anti-inflammatory drugs in Ayurveda

» Bronchodilators in Ayurveda

» Choornas

» List of Avaleha

» Expectorant in Ayurveda

» "Ghrita (Ghee based medicines) preparation in Ayurveda"

» Various Medicated Oils in Ayurveda

» Muscle relaxants in Ayurveda

» Bhaishajiya Kalpana & Virechan Medicine / Drugs

AYURVEDIC MEDICINES

Analgesics

One of the most widely used categories of medicines is analgesic or pain killers. This type of medicine are used at every instance, either it is traumatic conditions or other complications. In ayurveda the term analgesic is coined as vedanahasthapak (means that which relieves pain). The author of chukradutta text, Chakrapani in his text describes that drugs that relieves the pain and bring back the body at rest are called vedanasthapak. Generally they can be said as painkillers. Ayurveda states that the pain is due to vata and it needs to be decreased either by Sanshodhanam (elimination) or shanshamana (suppressing the cause). As per modern classification these are two categories of analgesics

(a) Non-narcotics

(b) Narcotics.

 The basic principle of painkiller is that they break the message transmitted from the affected part to the brain through the neurons. This means that the analgesics either break the pain signals arriving from the body part to the brain orinterrupt the brain to receive the message by neurons transmitting the pain signal. This is like just Again there are local and central analgesics as per their use. The analgesic category of medicineaccording to Ayurveda is not much describedbecause there are no fast acting painkillers. The clear distinction between the narcotic and non-narcotic analgesic is not seen in the ayurveda related text. The drugs are classified as per their action.

The Susruta Samhita describes about the teekshnaMadhya (liquors) bhanga (cannabis sativa). The analgesics all defines in ayurveda are scattered and fall under different categories like anagamarda prasahamana (body ache reliever), Madak (hypnotic) and Nidrakar (sedatives). The major analgesics in ayurveda are-

Local Analgesics: - These are used locally. Normally they are made paste and applied to the affected part. Several medicaments, which are used locally, are prepared for analgesic purpose like the pradeha (embrocating body paint), pralepa (same as pradeha). Belladonna, Dhustur, Vatsnabha, Kalihari.

Central Analgesics: - These drugs are used forparental use. Generally the diet preparations as described in the Charka Samhita are used tomedicate with these herbs. These drugs are acting on the central nervous system. They have pharmacological properties to serve as analgesic.

1.      Agru,

2.      Kapitha,

3.      Ahiphena,

4.      Daruharidra,

5.      Shatpushpa,

6.      Ashoka,

7.      Shalmali,

8.      Yashti madhu,

9.      Bhallatak,

10.  Punnankeshar,

11.  Parseek yavani,

12.  Sushitha,

13.  Dendaru,

14.  Katphala,

15.  Shal,

16.  Haridra,

17.  Kadamb,

18.  Dhatura,

19.  Gandhaprasarni,

20.  Priyangu,

21.  Latakasturi.

Angmarda prashaman (Body ache): - These medicines are used to relieve body pain. Generally they are used as pradeha, pralepa and other process. They are used to relieve body pain. They normally relieve body fatigue and stress. Shalparni, Prishtaparni, Brihati (both), Arand, Chandan, Usheer, Ela, Madhuyashti. Susruta described a class by name of vatashanashan (that which destroys vata). The vata entity is responsible for the pain and its sensation according to ayurveda. Susruta Samhita describes the vatanashan category, which includes following drugs.

·         Meshshringi,

·         Balam,

·         Atibala,

·         Aartgal,

·         Kapikachhu,

·         Patala,

·         Agnimantha,

·         Gaduchi,

·         Shatavari,

·         Punarnava,

·         Vasuk,

·         Bharangi,

In ayurveda there are different drugs that have analgesic properties. Apart from these the

Vidaradigandhi Gana (drugs of vidaradi group) drug, Dashumula (the ten drugs), Shula Prashaman (the medicine that are used as analgesic), Samgrahi (astringents), Shramahara (stress reliever), Kriyahara (the medicines that reduces the action of pain), Madak gana (hypnotic group of medicines) are also analgesic in properties. The major drugs of these classes are as under: -

Shula prashaman: -

• Pippali,

• Pipplimula,

• Chavya,

• Chitrak,

• Nagkesar,

• Mirch,

• Ajmoda,

• Yavani,

• Jeerak and

• Gardir.

Shramahar: -

• Draksha,

• Kharjur,

• Priyal,

• Badar,

• Dadim,

• Parushak,

Dutika / Kshuyava and Vidaradi Gana: -

• Shaliparni,

• Prishtaparni,

• Vidari,

• Nagbala,

• Sahadevi,

• Gokshur,

• Shatavari,

• Knatika,

• Krishnasariva,

• Jeebhak

• Rishabak,

• Mashparvi,

• Mugdaparni,

• Brihatidya,

• Punurnava,

• Arand,

• Hansapadi,

• Kapikachhu.

Madak and Nidrakar: -

• Ahiphena,

• Bhang,

• Ganja,

• Akararabha,

• Khurasani ajuwayan,

• Pipplamula,

• Sarpagandha,

• Upodika,

• Kasturi,

• Dhustur.

Apart from these drugs the process used as vednasthapak are: -

• Ushnaseveda,

• Sheetasweda,

• Raktamokshan,

• Jalauka,

• Pralepa,

• Pradeha

• Taila

• Malhar

• Dhum prayoga.

The following mercuric preparations are taken as analgesic medicines. Chaturmukha RasaKrishna Chaturnukla Rasa Vata Chintamani Brihta Vata Chintamani Makardhawaja Rasa Sindoor Swarna Sindoor Yogendra Rasa Balarishta, Dashnulasishta, and drakshasava are fermented preparation used for analgesic purpose. These are certain analgesic category drugs that are used in ayurveda by practitioners as per need and conditions of the patients.

Antacids in Ayurveda

The antacids are drugs that have pharmacological property to relieve hyperacidity caused due toindigestion and heartburn by neutralizing stomach acid. The complication of hyperacidity occurs due to the reflux of hydrochloric acid occurs instomach during the process of digestion. This hydro-choric acid with other enzymes is necessaryfor the digestion process. This process ofdigestion is controlled by the hormonal function of gastrin and somatostatin that induces the secretion and suppression of hydro choleric acid

respectively. This is normal physiological process of digestion but when it gets interrupted either by hormonal imbalance or mechanical disorder, it develops the complication of hyperacidity. This is characterized by following symptoms. The very primary symptom of hyperacidity is feeling of bitter taste in mouth and increased saliva. After wards it is developed to heartburn, nausea, belching, and often stomach cramps are occurs. There is pain in the upper abdominal region (epigastric). Headache and giddiness is also present in some patients. The heartburn increases while the patient lies in bed. This is one of the most uncomfortable symptoms of hyperacidity. Pregnant women also suffer from this complication.

In advance stages, the complications can be caused in the form of ulcers. Some times several mouth ulcers that can range from oral cavity to the esophagus characterize it. This is generally due to the increased secretion of hydrochloric acid. Ayurveda describes this condition as amlapitta. Itis considered to be a disease caused due toaggravation pitta. The sign and symptoms described in ayurvedic texts are very similar to that ofmodern sciences. This root cause of this disease is as follows. The main cause is irregular dietary habits, indigestion, the excessive intake of spicy, heavy and fried food, disturbed sleep and stress, hormonal imbalance of gastrin and somatostatin andloss of appetite. There are certain other causes like alcohol, smoking there could be a mechanical disorder responsible for this disease. The esophageal sphincter helps to separate wind pipe from food pipe. Some times it may be loose and thus the acid produced is refluxed with the food or alone. This is also a reason behind hyperacidity. Generally we can classify the root causes for hyperacidity as improper life style and dietary habits like fried spicy food alcohol. The physiological conditions like pregnancy, mechanical disorder like the malfunctioning of esophageal sphincter, Hormonal imbalance. Ayurveda states that the elevated pitta is responsible for this disease. When the pitta get with the rasa dhatu and enters the annavaha strota (digestive tract) then this disease happens. Basic line of treatment in ayurveda and modern science is quit different in other words opposite to each other. The antacid category drugs from the allopathic side are said to be contain acid neutralization agents as well as Central nervous system depressant. The antacids are generally containing the aluminum and magnesium salts. Alginic acid is also used for this purpose. Alginic acid is responsible to make a foamy forth into the stomach by reacting with the saliva to control the acid reflux. These antacids are having side effects of constipation and abdominal pain, nausea and giddiness sometimes.

However the antacids are among the one of the most widely used medicine all over the world and about 1/3 rd of Americans and other world population. In India about 35% of the population is suffering with this disease. This is a life style problem and those who are addicted with tobacco, alcohol as well as excess of packaged food with rich salt content can easily caught by this disease. The ayurvedic line of treatment is just opposite to that of the modern sciences. The basic principleof treating this disease is virechan karma (the removal of undigested food as well as bile by purgative drugs). The basic line of treatment is the same in allopathic and ayurveda. That is life style modification to avoid the food stuff that causes the hyperacidity. According to Ayurveda, over exposure to heat should be avoidable in this disease. But the second stage of treatment that is drug based is quite different as the drugs in ayurveda are purgatives that have got the tendencyto remove out the pitta. But the allopathic drugs are acting upon the acids to neutralize it as well as they stop the secretion of the gastric juices. Again the allopathic side has got the surgical intervention in the chronic stages of hyperacidity that is either endoscopic anti reflux measure or the gastro esophageal surgery to prevent the reflux of acid.

The side effects of allopathic drugs used in hyperacidity are headache, abdominal pain, and indigestion. As far as the ayurvedic drugs are concerned the single drugs used as antacid are Amaltas, Amalaki (ambilica offecinalis), Haritaki (Chebulic myrobalan), Turmeric, aloe vera, pippali, shatavari, madhuyashti and in general all drugs that have property of tikta and madhur rasa and snigdha guru are suppose to be antacidic in nature. They have vata pitta shamak property. The patoladi gana herbs patol, chandana, murva,gaduchi, patha, are also used as pittashamak. The herb shatavari has got good result in the treatment of this disease. It is also used in ayurveda for treating amlapitta. The diet preparations used for treating this disease are generally containing the above category drugs. The yavagu (liquid diet preparation) used for treatment are prepared by using the above drugs as well as the 4 purgative category drugs (see virechan drugs in ayurveda) to control hyperacidity by performing virechan. In early stages the use of deepan (appetizers), pachan (digestives) are useful.

In ayurveda the mineral preparations are also used for the treatment of this disease. Pravaal pishti like drugs that are rich in calcium salts are very much effective in treating the hyper-acidic conditions. Apart from that several medicines from ayurveda to treat this disease are multi drug combinations. Like avapittikar choorna, Madhuyastyadi Choorna and mineral based like abhraka bhasma, shankha bhasma, confectionary preparation like dhatri rasayana and the mercuric preparations like Kamdudha Rasa, Sutsakher rasa and more are used in the treatment of hyperacidity. The recent studies show that the Shatavari herb has effects like metaclopramide (ant emetic drug).this has been stated by ayurveda thousands of years ago.

Anti hypertensive drugs in ayurveda

The drugs that are used to control the hypertensive conditions are called antihypertensive drugs. The term hypertension is commonly taken as prolonged and excess of tension and stress caused by bloodon the arteries. According to the medical sciences this is stage of

high blood pressure. The most devastating aspect of this disease is that it doesn’t characterize by any of the symptoms and causes damage to the vital organs in long run of time. This is reason that is termed as silent killer. The raised blood pressure increases risk of certain complications like Stroke, Aneurysm, Herat failure, Heart attack and Renal disorders. Nowadays, the most of the people around the world are suffering from hypertension in later ages. This is due to the improper life style and dietary habits that are spreading all over the world. The chances of Hypertension are two times in people who are obese as compared to the other people. The blood pressure is measured on the systolic and diastolic pressure. The systolic pressure is the highest pressure of the arterial blood flow during the constricting of the heart, while as the diastolic pressure is measured as the lowest blood pressure during the diastole. The blood pressure is mentioned as per/mm of Hg pressure. For example it is written as 120 over 80 mmHg. A patient is said to be hypertensive when the value of systolic pressure is more than 140 at resting condition and the diastolic pressure is more then 90 at resting conditions. The limits of the systolic and diastolic pressures are relative to the patient specific details. However the disorder of the older people is called isolated systolic hypertension. This condition is due to the physiological changes of the body in older ages. The deadly conditions of hypertension are malignant hypertension that is due to the several reasons and the pressure is more then 210 to 120 mm/hg. However it is rarely seen into the patients but can cause death if remain untreated for a long time.The blood pressure is physiological phenomenon that turns malignant when it is disturbed. The physiology of blood pressure has got complicated mechanism that involves many factors. It depends upon the amount of the blood pumped to the heart as well as the arterial conditions and renal system. The liquid content of the blood can be changed as well as the blood flow can be increased or decreased as per the action of the heart and the dwelling conditions.

The sympathetic division of the autonomic nervous system and adrenal cortex of the kidneys govern all these mechanism. The sympathetic division uses several means to temporarily increase blood pressure during the reflex action of the body to prevent it from the coming danger. The hormones epinephrine that is released by the adrenal glands is due to the stimulation that is provided by the sympathetic division. The hormonal control of the blood pressure is due to the hormones secreted by the adrenal cortex. The renal system also affects the blood pressure as if the blood pressure is increased then the kidneys excrete the salt and water in increased quantity to maintain the blood pressure and vise versa.

The kidneys also control the blood pressure by hormonal function of rennin that tends to increase the blood pressure by causing the arterial constriction. This rennin also plays role in the release of aldestorene causing the retention of the salt and water content. The ayurvedic text does not describe the blood pressure as a disease but the symptoms are described in various segments. The relevant symptoms are found in the Vata vyadhi and rakta dushti. There are various drugs and measures to treat the symptoms arising from the hypertensive conditions. There are various medicines in ayurveda that are used to treat hypertension. These are sedative, tranquilizers as well as those acting on the renal system. There are several preparations that are commonly used in place of the barbiturates the yogendra rasa and sarpagandha mishran are used as antihypertensive medicines. There are several single drugs that are used as antihypertensive medicines. Commonly these are

taken into the intellect increasing and sedative category of medicines. The symptoms of the hypertensive conditions resemble to the vata Vriddhi symptoms. Thus the treatment used to reduce the aggravated vata is also useful in the treatment. Brahmi Vati, Brahmi Rasayana, Saraswatarishta are some of the medicines that are used as antihypertensive. These are supposed to have sedative effects. The madhur rasa (sweet) and kashaya rasa (astringent) are used in the treatment of the symptoms of hypertensive stages. These are supposed to be containing the antioxidant effect as per the modern sciences. The herbs that are used as hypertensive medicines are Brahmi, Shankhanpushpi, Jatamansi, Sarpagandha, Vacha, Gokshur, Amalaki and Punarnava. There are different combinations as well as the diet preparations based upon the above drugs and medicines, which are used as antihypertensive medicines. The mineral preparations that are used as antihypertensive are praval, mauktik, and some calcinated preparations like the abhraka bhasma. The most common vehicle for these medicines are honey and milk that is also useful for antihypertensive. There are various medicines that are used as antihypertensive by the ayurveda practitioners that are supposed to be vatanashaka (those destroying vata) like the use of drakshasava, kharjuur, priyal, milk and haridra are also having some antihypertensive properties. The yoga and pranayam are proved to be beneficial to the hypertensive people. The mudra (postures) described in the yoga section is very useful in treatment of hypertension. The saw asana is the posture that helps in lowering down the blood pressure easily. (See yoga and pranayama).

Antipyretic drugs in ayurveda

The antipyretic drugs are used for the purpose of reducing the body temperature and then maintain it to normal. It is the category of medicine that prevents feverish conditions as well as lower downs the body temperature from raised stage to normal condition. The antipyretics commonly don’t effect in the healthy state means don’t disturb the temperature regulation in healthy state. According to modern sciences antipyretic medicines are non-steroidal anti-inflammatory drugs (NSAIDs) that generally act by inhibiting prostaglandin synthesize within the hypothalamus region that acts a temperature regulator in our body. The fever is the state of the body where the body temperature reaches higher then the normal body temperature. This normal body temperature in an individual is taken on as 98.4-degree feranhite or 37 degree Celsius. The thermometer is used to measures this temperature orally, in arm pit or in rectum. Fever is caused by many factors. It can occur independently or as symptom of any disease. Fever is generally due to the pathological impact of the microbes as well as the traumatic and several other reasons. The complex biochemical syntheses of the interleukin as well as the other substances like prostaglandins are the responsible factors for the hyperpyrexia.

These biochemical are released due to the pathological invasion and complex reaction of the pathogens that affects the central nervous system resulting in fever. This temperature regulation process is governed by various systems. That involves the central nervous system and the circulatory system. In the state of fever the bodily symptoms are commonly the same as the rise in temperature, some times shivering, in acute stages the delirium as well as the unconsciousness is also there. The fever is the also described as symptom another disease. In various diseases fever is present as symptom. Like typhoid, rheumatic disease and more. In ayurveda related old classics the fever is described in details and is termed as “Jwara”. It is divided into several types and subdivisions according to the dosha theory and other pathological principles of ayurveda. The basic principle of treating the pyrexia is to reduce the body temperature by certain procedure and drugs. The antipyretics described in ayurveda can be broadly classified into following types-Antipyretics and,Analgesic and diaphoretics.

According to ayurveda the basic line of treatment for fever involves the elimination of the root cause that is aggravates the body temperature. The swedavrodha (stopped sweating) is the main cause that increases the body temperature. The process of langhanam (fasting) and paachan (using appetizers and digestive stimulants) are also described as basic line of treatment of the patient suffering from fever. There are different medicines and drugs that are used as antipyretic. Apart from that there are several therapeutic measures that are used to lower down the body temperature of the body. The action of antipyretic drugs occurs in following ways.They act by reducing the activity of the hypothalamus. They act by increasing the heat radiating speedof body.

They increase the sweating activity. The procedures that are used to lower down the temperature.The antipyretics describes in the ayurveda classics are- Jwaraghana gana (antipyretic category) Following are some of the main drugs from the ayurveda references that are used as jwaraghana. They are –Sariva, Sharkarapataha, Manjishta, Draksha, Peelu, Parushaka, Abhya, Amla, Bhibhitaki, Patola, Shewats chandan, Rakta chandan, Moorva, Gaduchi, Patha, Katuki, Nimba, Dhaniya, Padmakha, Amaltas, Madan phala, Karanj, Kalmegha, Saptaparna, Kaarvellak, Vatsanabh, Dhatura, Atis, Droon pushpi, Sahdevi, Arka and Karvir, The mineral based drugs that are used as antipyretic are- Pkitkari, Narsaar, Godanti, Neelanjana, Sankhiya, Hartaal, Manashila, Praval, Kaparda, Shankha, Qunine, The all drugs mentioned above are used according to the patient’s specific need and the dosha involved or the kind of fever. Besides these there

are several combination medicines that are used as antipyretic in ayurveda. The following medicines are used as antipyretic. Commonly following medicines are used in the different types of fever.

In navajwara (acute fever)- Tribhuvan Kiriti Rasa, Sanjivani Vati and Godanti Mishrana are given. In Visamajwara (Malarial fever) - Saptaparna ghana Vati and Sudarshana Choorna are given. In Vat shlaishmika jwara (Viral fever) - Laksmi Vilas Rasa and Samsamani Vati are given. In Jirna jwara (Chronic fever) - Pratap Lankeshvar Ras, Mahasudarsana Choorna and Amritarishta are given. In Sannipatika jwara (Typhoid fever) - Nardiya luxmi Vilas Rasa and Bhunimbadi Kwath are given. Apart from these the medicines used as antipyretic as per the dosha classification are - Mrituyanjaya rasa, trailokyasundar rasa, hinguleshvarrasa, panchavaktra rasa, amritashtaka kashaya rasa and Panchatikta kashaya The medicinal decoctions of Shaobhanjan, Aranda, Shewata Punarnava, Yava, and Kulatha are used as antipyretic. There are mineral combinations that are used as antipyretic medicines. They are-Kasturi Bhairava Rasa, Naracha-Rasa, Tarun-Jwarari Rasa, Prataap-Martanda Rasa, Chintamani Rasa, and Mritansanjavinai Rasa.

Ayurveda describes the various diet preparations of antipyretic medicines. The procedures involve the dripping and embrocating the cold temperament drugs as well as the fumigation. Ayurveda also describes fever that is caused due to mental conditions like fear and shock. It is also seen that the religious rituals are also described into the classical texts of ayurveda. However the tikta rasa pradhan (bitter taste medicines) are very much useful in the feverish conditions. The Anupaan concept of ayurveda (vehicle concept for medicine) is very useful in treatment of fever. The Shadangpaaniya combination (see different forms of medicines) is found to be very useful in reducing the aftereffects of the quinine based antipyretics. The have the tendency to treat side effects of the antipyretic.

The following five medicines are having antipyretic effect. They are used in various forms like decoctions, powder, pills, diet preparations, and more. These are Guduchi (tinaspora cardifolia), Sunthi (zingiber officinalis), Vacha (Aarus calamus), Yashti-madhu (Glycyrrhiza glabra), Musta (Cyprus rotundus).

The medicinal procedures that are used for the antipyretic purpose are also used by the modern medicine system like the cold process. The basti preparations are found to be useful in the chronic fever condition.

Anti anxiety drugs in Ayurveda

This category of medicine contains drugs that have tendency to calm down a person suffering from anxiety or stress due to any internal or external cause. This is particularly used to control the psychosomatic disorders and phobias. The general use of ant-anxiety drugs is meant to control the tension up to severe phobias. The stage of anxiety or tension can be characterized as the reaction to the stress, danger that can be real or imaginary.

The patient is having fast pulse, excess sweating, trembling, fatigue, and weakness. There may be thirst also. Certain cases that are advance stages of anxiety are Epilepsy, Pregnancy cases, Panic disorders, and Phobias. The early stages of anxiety disorders are treated easily by using the ant anxiety drugs and counseling but for complicated cases the prolonged treatment under the observation is required. For this purpose of treatment the anti-anxiety category drugs are used.

The anxiety disorders may be classified as, Panic conditions, the social phobia, the obsessive-compulsive disorders and general anxiety conditions. The symptoms of the disorders are not seen in an isolated manner. In common the patient is having the syndrome of symptoms and they are complicated. The rare cases are seen with patient having symptoms of single disorder. Normally the patient is having depression and other complications. It is seen that the anxiety disorders cannot be cured fully, the patient is relieved from the acuteness of the symptoms and the consistency of normal conditions is maintained by the use of drugs and behavior therapy. In ayurvedic classical texts the description of the anxiety disorders is seen in the bhootvidya (psychiatric) segment. The basic definition of health in ayurveda is a state of physical and mental well-being. Ayurveda states that the emotional disorders as well as mental state of a patient must be balanced and should be in equilibrium. The reason behind the anxiety disorders in ayurveda is pragya apradh (the unhealthy adaptation of physical and mental type leading into the mental imbalance). The improper diet and life style that leads the disturbed state of mind causes the negative feelings that overwhelm the mind. This is termed as manovaha strota vyadhi (the disease of mental condition. The unmaad (hysteria) and apasmaar (epilepsy) are the diseases described in ayurveda.

The root cause for these disorders are purva janmakrtia (sins of the previous birth), viruddha ahaar vihaar (improper diet, overindulgence in sex, over stress), and the graha avesha (astrological and occult reasons). The pathology of the anxiety disorders in ayurveda is due to the vikriti of manovaha strota due to vata. The basic line of treatment in ayurveda for this disease is to eliminate the vata dushti (reason). For this the nasya therapy (inhalation therapy) is used as the ayurveda suppose the nasal cavity as entrance of the brain. The anxiety disorders and the symptoms described in the classical ayurvedic

text are nearly the same with those of modern sciences. The symptoms in anxiety disorders can be divided into physical symptoms and mental symptoms. The physical symptoms are the consistent condition of the reflex action that body shows in cases of danger like increased pulse, heartbeat, hot or cold flashes, stiffed muscles, stomach pain, nausea, dizziness, headache, insomnia. The mental symptoms seen in the patient are restlessness, behavior problems, nervousness, imaginary fear, hyperactivity, and confusions. The common symptoms seen in the anxiety disorders are insomnia, some times loss of memory, nervine weakness, unrest, and more specific symptoms like convulsions and phobias are there in advance stages. The causes behind anxiety disorders are either physiological like hormonal imbalance adrenal, thyroid, hypoglycemia, insomniac conditions as well as chronic disease. There are certain other reasons like drug dependency upon certain category drugs amphetamines, respiratory medications, Hormones, Withdrawal from benzodiazepines. The modern sciences treat the anxiety disorders by drug therapy and behavior therapy.

The behavior therapy is the first stage to control the anxiety disorders. In this therapy, the

patient is exposed to the causes in a controlled environment so that they may get adapted and gain self-control to fight such conditions. The basic ideology of this is to change the basic thinking pattern by regular consoling and observations. This counseling therapy is normally taking 14 to 20 weeks. This is the best way to control the anxiety disorders. The anti-anxiety drugs from allopathic aspect are of two types. They are sedatives like Benzodiazepines, Azapirones and antidepressants. Selective serotonin reuptake inhibitors commonly abbreviated as SSRI and others like tricyclic antidepressants beta-blockers. The most of these drugs when taken for a continuous therapy creates dependency and produces side effects as well as withdrawal symptoms.

The ayurvedic line of treatment for the anxiety disorders is the use of herbs and medicines, nasya (inhalation therapy), mantra (occult rituals), and achaar vichaar (life style modification). The herbs used as anti-anxiety drugs are sarpagandha, khus, jatamansi, bramhi, kevada, vacha, tagar, amla, and rose. The medhya (brain tonics /intellect improvisers) category drugs are used to balance the loss of concentration, memory, and insomniac disturbances. The nervine tonics like ashvagandha and bala are used to strengthen the nervous system. The choorna of single and multiple combinations are used. Like saraswat choorna, tagaradi choorna and ashvagandhadi choorna, and single drug choorna like Vacha choorna, Jatamansi choorna are used. Along with these medicines the rasayana preparation Brahmi rasayana, ghrita (ghee based medicines) like Maha paishachik ghrita, panchagavya ghrita, puran ghrita, and Brahmi ghrita are given to the patient.

The fermentation preparations like Saraswatarishta, Balarishta are used. The rasa (mercuric) preparations like Krishna Chaturmukh Ras, Unmad gajkesari Ras and Smriti Sagar Ras are frequently used in anxiety disorders. The anti convulsant used for Aptantrakari Vati, and Svarna bhasma (calcinated ash of gold). The oil-based medicines used are Dhanvantaram oil; Mahanarayana oil. The confectionary based preparation is Errand paka. For controlling the insomniac conditions the Jatamansi kwath (decoction) and Madananand Modak (big shaped sugar mixed pill) are described as anti-anxiety drugs. The herb Brahmi (bacopa monari) is a good anti anxiety medicine and have good antis tress property (see- bacopa monari).

The jatamansi herb is also a good sedative and is safe, as it doesn’t perform the dependency. On the other hand the sedative from the modern sciences are very much likely to produce dependency and withdrawal symptoms. The regular use of Brahmi medicated oil on scalp at bedtime and inhalation is a better preventive measure to avoid the anxiety disorders.Anti anxiety drugs in Ayurveda This category of medicine contains drugs that have tendency to calm down a person suffering from anxiety or stress due to any internal or external cause. This is particularly used to control the psychosomatic disorders and phobias. The general use of ant-anxiety drugs is meant to control the tension up to severe phobias. The stage of anxiety or tension can be characterized as the reaction to the stress, danger that can be real or imaginary. The patient is having fast pulse, excess sweating, trembling, fatigue, and weakness. There may be thirst also. Certain cases that are advance stages of anxiety are Epilepsy, Pregnancy cases, Panic disorders, and Phobias. The early stages of anxiety disorders are treated easily by using the ant anxiety drugs and counseling but for complicated cases the prolonged treatment under the observation is required. For this purpose of treatment the anti-anxiety category drugs are used. The anxiety disorders may be classified as, Panic conditions, the social phobia, the obsessive-compulsive disorders and general anxiety conditions. The symptoms of the disorders are not seen in an isolated manner. In common the patient is having the syndrome of symptoms and they are complicated. The rare cases are seen with patient having symptoms of single disorder. Normally the patient is having depression and other complications. It is seen that the anxiety disorders cannot be cured fully, the patient is relieved from the acuteness of the symptoms and the consistency of normal conditions is maintained by the use of drugs and behavior therapy. In ayurvedic classical texts the description of the anxiety disorders is seen in the bhootvidya (psychiatric) segment. The basic definition of health in ayurveda is a state of physical and

mental well-being. Ayurveda states that the emotional disorders as well as mental state of a patient must be balanced and should be in equilibrium. The reason behind the anxiety disorders in ayurveda is pragya apradh (the unhealthy adaptation of physical and mental type leading into the mental imbalance). The improper diet and life style that leads the disturbed state of mind causes the negative feelings that overwhelm the mind. This is termed as manovaha strota vyadhi (the disease of mental condition. The unmaad (hysteria) and apasmaar (epilepsy) are the diseases described in ayurveda.

The root cause for these disorders are purva janmakrtia (sins of the previous birth), viruddha ahaar vihaar (improper diet, overindulgence in sex, over stress), and the graha avesha (astrological and occult reasons). The pathology of the anxiety disorders in ayurveda is due to the vikriti of manovaha strota due to vata. The basic line of treatment in ayurveda for this disease is to eliminate the vata dushti (reason). For this the nasya therapy (inhalation therapy) is used as the ayurveda suppose the nasal cavity as entrance of the brain. The anxiety disorders and the symptoms described in the classical ayurvedic

text are nearly the same with those of modern sciences. The symptoms in anxiety disorders can be divided into physical symptoms and mental symptoms. The physical symptoms are the consistent condition of the reflex action that body shows in cases of danger like increased pulse, heartbeat, hot or cold flashes, stiffed muscles, stomach pain, nausea, dizziness, headache, insomnia. The mental symptoms seen in the patient are restlessness, behavior problems, nervousness, imaginary fear, hyperactivity, and confusions. The common symptoms seen in the anxiety disorders are insomnia, some times loss of memory, nervine weakness, unrest, and more specific symptoms like convulsions and phobias are there in advance stages. The causes behind anxiety disorders are either physiological like hormonal imbalance adrenal, thyroid, hypoglycemia, insomniac conditions as well as chronic disease. There are certain other reasons like drug dependency upon certain category drugs amphetamines, respiratory medications, Hormones, Withdrawal from benzodiazepines. The modern sciences treat the anxiety disorders by drug therapy and behavior therapy.

The behavior therapy is the first stage to control the anxiety disorders. In this therapy, the

patient is exposed to the causes in a controlled environment so that they may get adapted and gain self-control to fight such conditions. The basic ideology of this is to change the basic thinking pattern by regular consoling and observations. This counseling therapy is normally taking 14 to 20 weeks. This is the best way to control the anxiety disorders. The anti-anxiety drugs from allopathic aspect are of two types. They are sedatives like Benzodiazepines, Azapirones and antidepressants. Selective serotonin reuptake inhibitors commonly abbreviated as SSRI and others like tricyclic antidepressants beta-blockers. The most of these drugs when taken for a continuous therapy creates dependency and produces side effects as well as withdrawal symptoms. The ayurvedic line of treatment for the anxiety disorders is the use of herbs and medicines, nasya (inhalation therapy), mantra (occult rituals), and achaar vichaar (life style modification). The herbs used as anti-anxiety drugs are sarpagandha, khus, jatamansi, bramhi, kevada, vacha, tagar, amla, and rose. The medhya (brain tonics /intellect improvisers) category drugs are used to balance the loss of concentration, memory, and insomniac disturbances. The nervine tonics like ashvagandha and bala are used to strengthen the nervous system. The choorna of single and multiple combinations are used. Like saraswat choorna, tagaradi choorna and ashvagandhadi choorna, and single drug choorna like Vacha choorna, Jatamansi choorna are used. Along with these medicines the rasayana preparation Brahmi rasayana, ghrita (ghee based medicines) like Maha paishachik ghrita, panchagavya ghrita, puran

ghrita, and Brahmi ghrita are given to the patient.

The fermentation preparations like Saraswatarishta, Balarishta are used. The rasa (mercuric) preparations like Krishna Chaturmukh Ras, Unmad gajkesari Ras and Smriti Sagar Ras are frequently used in anxiety disorders. The anti convulsant used for Aptantrakari Vati, and Svarna bhasma (calcinated ash of gold). The oil-based medicines used are Dhanvantaram oil; Mahanarayana oil. The confectionary based preparation is Errand paka. For controlling the insomniac conditions the Jatamansi kwath (decoction) and Madananand Modak (big shaped sugar mixed pill) are described as anti-anxiety drugs. The herb Brahmi (bacopa monari) is a good anti anxiety medicine and have good antis tress property (see- bacopa monari). The jatamansi herb is also a good sedative and is safe, as it doesn’t perform the dependency. On the other hand the sedative from the modern sciences are very much likely to produce dependency and withdrawal symptoms. The regular use of Brahmi medicated oil on scalp at bedtime and inhalation is a better preventive measure to avoid the anxiety disorders.

Anti-arrhythmic drugs in Ayurveda

This category of drugs has the tendency to regulate the abnormalities in the heart rate. It is known fact that the heart pumps blood through out our body. Involuntary muscles of heart keeps on working even we are working, sleeping or sitting. Heart beats are produced due to the expansion and contractions of the heart muscles. in normal condition heart beats are 60 to 80 times in a minute. Pace maker is the powerhouse of the heart that is responsible for controlling the heart beat. The pace maker sends electric vibrations to different parts of heart for proper working.

These electric signals are developed in the Sino Articular node located at the upper part of right atrium. The controlled mechanism of these electric signals and other involuntary muscles leads in a rhythmic expansion and contraction in the heart that is known to be the heart beat (characterized by lub and dub sign). Any type of irregularity in heart's natural rhythm due to any reason is called an arrhythmia. This unhealthy condition of irregular heart beat or Arrhythmias is divided into two partsVentricular Supra-ventricular. When the ventricles are supposed to flicker the Ventricular arrhythmias occurs. On the other hand when the atria or the upper chambers are flickering irregularly Supra-ventricular arrhythmias occur. Further, the Arrhythmias are subdivided by the speed of the heartbeats. Following are the three conditions for Arrhythmias The very slow heart rate is called bradycardia. In bradycardia the heart rate is less than 60 beats per minute. Second condition is tachycardia, which means increased heart rate. In this condition the heartbeats are more than 100 beats per minute. The most difficult of the arrhythmia is fibrillation. In this condition the heartbeats are uncoordinated, that means the expansion and contractions of individual heart-muscle fibers are independent from each other. There are various causes for arrhythmia. It can be congenital, due to pathological conditions, different cardiac diseases, hypertension, stress, smoking and alcohol. Some medicines also affect the heart beat pattern. Following are the symptoms of the arrhythmic conditions.

In bradycardia the patient feel tired, short of breath, dizziness, or some times he faints. The patient with tachycardia has a feeling of strong pulse in his neck, and fluttering, racing beat in his chest. He feels discomfort, weak, short of breath, sweaty, or dizzy. In ayurveda the arrhythmic conditions are mot much described, they are covered in the topic "Hridya gata roga" means a topic related to cardiac disease. In modern sciences the anti-arrhythmic medicines are belonging to digitalis, beta-blockers, potassium and calcium channel blocker. In complicated cases the surgical intervention is required. The surgery and implantation are required as last stage of treatment. Those drugs, which work by blocking the impulses, that may cause an irregular heart rhythm and by interfering with hormonal influences (such as adrenaline) on the heart's cells are called beta-blockers. They also maintains blood pressure and heart rate. Propranolol, metoprolol, and atenolol are examples of beta-blocker drugs. The sodium-channel blockers are also helpful. Theyhave a tendency to slow down the electrical conduction in the heart. Quinidine, procainamide, disopyramide, flecainide, propafenone, tocainide, and mexiletine are some of the examples. The medicines that slow down the electric impulses in the heart by blocking the its potassium channels are called potassium channel blockers. Amiodarone, sotalol, and dofetilide are some of the examples of potassium blockers. Those categories of medicine that are blocking the calcium channels in the heart are called the calcium channel blockers. Diltiazem and verapamil are few of its example.The digitalis category drugs are rarely used now.The anti-arrhythmic drugs must be used very carefully and should be taken under strict medical observation as some times the conditions of a patient may get worsen due to these medicine. This condition is known as pro-arrhythmia. Ayurveda describes the cardiac drugs as "Hridya". This category of drugs contains many medicines and herbs. Following are the main drugs and medicines used as anti-arrhythymic drugs. Hritapatri, ajamoda, lata kasturi, parushaka, draksha, katphala, dadim, rajadan, triphala, shakaphala, Amra, lakucha, amlavetas, badar, matulung and karmarda these are the cardiac tonics. Apart from these herbs, there are certain drugs that increase the contraction and expansion without increasing the heartbeat. In ayurveda a class of drug is having the effect to strengthen the cardiac muscles they are jaharmohara and kaharva. Those medicines that have madhur (sweet) and amla (acidic) taste. There are a number of preparations that can be used as cardiac tonics. These mineral preparations are lauha bhasma, abhraka bhasma, swarna bhasma, vacha, arjun, lajawarta, and praval. The combination choorna that are used in this disease are – Pippalyadi choorna, hingavadi choorna, mrigashringa choorna, nagabala choorna, kakubhadi choorna, pushkaramuladi choorna The ghee based preparations like Arjuna ghrita, baladhya ghrita, madhuka, mahameda, shalparni. Medicated milk arjun ksheer paak. The decoction of devadaru, vacha, yavani palash, shunthi, abhya, udambur are also very helpful. Arjunarishta, balarishta and ikshurasa are used. All these medicines have direct and parental effect on the arrhythmic conditions. These medicines have tendencies to effect the heart rate as well as soothes the effect on the muscles of heart. Recent studies about garlic as anti arrhythmic drug shows that it has higher dehress of sulphur compounds. Garlic has anti-arrhythymic properties to reduce both types of arrhythmias. Though the mode of action is not defined the effects are observed. The ayurvedic medicines can be divided into-

In condition of Hridya daurabalya (Cardiac weakness) Nagarjunabhra Rasa, Muktapisti, Jwahar Mohra and Arjunarishta are very effective. In Rakta Chap (Hypertension), Yogendra Rasa is considered the best.In Raktabhar Alpta (Hypo tension), Makaradhvaja gutika, Kasturi bhairav Rasa are quite beneficial.In Hritshoola (Angina), Sringa Bhasma, Mahavat Raj Rasa. There are rasa-based medicines like kalyan sundaer rasa, chintamani rasa, haridyarnava rasa, panchanana rasa, and prabhakar vati are commonly used. Modern sciences the following medicines to be cardiac tonic- Arjuna (Terminalia arjuna) Kushtha

(Saussurea lappa) Bala (Sida cordifolia) Hatapatri (Digitalis purpurea Foxglove) Rasona, (Garlic Allium sativum), Ashwagandha (Withania somnifera) The very basic preventive method against this disease is to use a garlic, pomegranate, Arjuna powder, and avoid smoking alcohol.

Antibacterial drugs in Ayurveda

The anti bacterial agents and drugs are of the most important inventions in medical field. As we know that the antibiotics are used to fight any type of infections that are due to bacteria. The antibiotics are the base for the improvement and development of the surgery part of allopathic medicines. There are various medicated liquids and powders derived form minerals as well as the herbs for this purpose in ayurveda. In the surgical text Susruta there are various medicines and processes that are used for postoperative treatment. Thought, ayurveda don't describe any thing about the antibiotic drugs but they were quite aware of the after effects that may occur due to the microbes. Thus various processes and drugs were used for the antibiotic purpose. Without this the surgical part of Ayurveda wouldn’t have flourished. Thus we can imagine that that unknowingly the ayurveda people were using the precautions against the microbial growth. The medicated decoctions that were used in the postoperative treatment by Maharishi Susruta was of antibacterial nature. In the same way the treatment for leprosy is also indicative of the

antibacterial properties of the herbs and ayurvedic medicines used. Nowadays the antibiotics are classified into various categories. The major success of the modern medicines is dependent upon the antibiotics invention. Each antibiotic is used to treat specific bacteria. In simple words that acts as antidote for the specific bacteria. The treatment is based upon the diagnosis of the microorganism causing infection.

The penicillin was the first antibiotic that was discovered in 1928 by Sir Alexander Fleming for treating the infectious caused in wounds. Further, antibiotics were refined from the penicillin and by the 1950’s a large number of antibiotics were discovered. There are a large number of antibacterial combinations that are used now days. The antibiotics can be classified upon the basis of their chemical composition as well as their mechanism of pharmacological action. Following are the some antibiotics commonly used by the practitioners. The antibiotic medicines used commonly are B-lactam antibiotics– this group contains, Penicillins (Penicillin G, Amoxicillin, Flucloxacillin) Cephalosporins (Cefoxitin, Cefotaxime) and Carbapenem (Imipenem) and their combinations. The other group is Macrolides that contains Erythromycin, Azithromycin and Clarithromycin. There is another group of tetracyclins, Fluoroquinolones, Sulphonomides, Aminoglycosides, Imidazoles, Peptides, and Lincosamides. The above mentioned antibiotics are used generally in all systemic aliments caused due to the bacterial activities. The ayurvedic medicines that are used in treating the infectious conditions are generally containing antibacterial activities. For example the Cindamycin antibiotic is used for the treatment of the serious respiratory tract infections, serious skin infections and soft tissue infections. For the serious respiratory tract infection there are ayurvedic medicines that are containing the herbs and mineral combinations as well. The rason (garlic) is found to have effects as that of Cindamycin). In the same way the combination medicine Sitopaladi Choorna is having anti tubercular action due the presence of certain drugs. Cinnamon, In the same the various combination and single drugs from the ayurveda texts are containing various antibiotic properties and are in use in spite of being the known how they work. The most famous of all as antibacterial drug from ayurveda is Neem. The herbs, which were used by Susruta for the antibiotic activity, are classified into different categories of drugs. Saalsaradi gana Lakshadi gana, and more…….

The following medicines are described into above categories. Extract of Saal, Ajakarna, Khadir, Odumbar, Supari, Bhurjapatra, Meshshringi, Tinish, Shewata Chandan, Shisham, Asan, Dhava, Arjun, Laksha, Aragvadha, Kutza, Ashvamaartawak, katphala, haridra, Nimba, Malti, Trayamana, Chukramarda, Vasa, Gaduchi, Madanphal, Vidanga, Lashun, Shrish, Jatamansi, Guggul Harenu, Vacha, Trivrita, Danti, Gairik, Anjan, Bhallatak, Lodhra, Devdaru, Sarshap, Kampillak, Arka-ksheer, Rasanjana, Kaptiharasa, Indravajava, Palshrasa, Rasana. Apart from these, there are various mineral preparations that are used for the antibacterial purpose. Some of these are Makshiaka, Gandhakayoga, Parad, Shilajit, Tutthak, Kashish, Manashila, Gairik, Anjanam, Gorochan, Suhaga, and Nilgiri tel. The madhavasava, khadirarishta, mahatikta ghrita, pancha nimbadi ghrita are some other medicines that are used as antibiotic medicines in case of infections according to ayurveda. The neem is most commonly termed as ayurvedic antibiotic. The neem tree is used in a number of ways as per the disease conditions. It has got multipurpose use from skin rashes to malaria. In the Harotkayadi varga section of drug book of ayurveda priyanighantu neem is described a great medicine for the pitta aggravations and blood purification. Neem is supposed to be a antibacterial, anti-fungal, antiviral and antiseptic drug. It used in treating anything from dandruff to acne, eczema to malaria and cold sores. All ayurvedic medicines are used in many systemic aliments and they need to be developed and tested as per the antibiotics are tested. The use of herbs and different medical decoctions can be added with the antibiotics as complementary to the medicines. Now days various single herbs are being researched in the light of modern testing parameters to establish their respective antibiotic action on different category of microbes. The haridra is used as antibiotic for skin disease for local and parental uses. In the same way there are various uses of herbs in ayurveda related text.

Drugs that act as Antibiotic

There are some herbal combinations that are found to act as antibiotic. Here we will discusstype of medicines and herbsthat act in the same way as antibiotic works. At the time of Susruta surgical aspect of Ayurveda was at its peak. Susruta applied many techniques and combinations to make surgery a success. He used decoctions of herbs, dhoom (fumigation), honey, ghee and different type of embrocating powders for healing the surgical wounds and prevents them from infections. Before Susruta; Charka also described about agantuka roga (acquired diseases) as well as different types of intestinal parasites. The use of different combinations of drugs and medicines to remove these parasites as well as for preventive treatment is supposed to be the same as antibiotics are used now days. As we study Vedas, various disease are described that are caused by microorganisms. Some of these organisms are Arti, Alinsh, Arjuna and more. From Ayurvedic text, it becomes very clear that the immunity of human body must be maintained. The use of Rasayana and the life style adaptation are the basic to maintain immunity. There are various types of drugs that are used to kill the pathogens causing these agantuka roga. Of all Ayurveda related text the surgery part that needed an extra attention towards the infection is described in Susruta Samhita. All the surgical procedures are based upon the theory of destroying the pathogens by use of various embrocating medicines as well as parental drugs that were suppose to disinfect the wounds caused by surgery. In short the postoperative treatment is very much useful for the antibiotic type of medication. For this there are a number of drugs that are used like as vacha, Kushtha, Neem, Palash as well as honey, ghee, and oil based paste.

There are various category of drugs that act as antibiotic on various systemic aliments. They can be categorized as follows - The Kotha prashamana category of drugs acts as anti putrefying agents. There pharmacological action is preventing the putrification. The mercuric preparations, clove oil, peppermint are a few example of this. In Ayurveda there is a term called agad it’s English equivalent means poison. Though the poison category is not very much clarified in Ayurveda but it is divided into animal and vegetable poisons. There are several antidotes for poisons. It is very interesting fact that for animal category poison the vegetable antidote are used. These are termed as agad. As we know that the microorganisms cause various toxins as well as disease in body. That is the basic principle behind the vegetable antidotes to be used as complementary to the basic line of treatment for agantuka roga. There are following agadkar drugs used in Ayurveda.

Nakuli,

Prishnaparni,

Shrish,

Priyangu,

Hreeber,

Kustha and more.

In the same way there are certain category of drugs that are used as systemic aliment based antibiotic like a term Ekshanapaak ghatai (anti septic for eyes) is used in Ayurveda. It means that which act as antiseptic for eyes. For this purpose a confectionary based medicine- palash Raskriya is used. Further adding to it there are drugs that are used to destroy worms they are called Krimighna. In Ayurveda there are descriptions related with the worms and medicines to remove them. For the purpose following drugs are used as per the requirement and conditions of the patient.

Apamarga,

Gandir,

Gokshur,

Maricha,

Mushaparni,

Nirgundi,

Palash,

Parseeka yavani,

Shobhanjana,

Vidanga,

Vrishparni.

As we have discussed above there are certain drugs that act as antitoxic they are termed as vishaghana. These medicines are having antibiotic properties. They are

Chandan,

Haridra,

Katak,

Manjishta,

Palindi,

Shleshmatka.

Sindhuvaar

Sukshmala,

Suvaha,

Ayurveda also describes antidotes for toxins that are produced by nails and teeth. So it is very clear that they knew some ways to tackle infection is generated and spread. Lack of knowledge of the microorganisms in their actual form was there but they were aware about the conditions of infections that develop because of these microorganisms. As those people knew about the various routes bywhich infection may be caused. Below are some of the herbs that has anti-microbial activities

Ashvakarna,

Garika lepa.

Gijhiva,

Haridra,

Sampadika,

Sombalka,

Like wise there are Naari vrinahara drugs (drugs that act as antiseptic to chronic wounds) Devdaru, Maricha, Haridra, are naari vrinhara drugs. As post-operative measure; medicated decoctions are used to wash the wounds to prevent them from infections. This process is called as Prakshaalanama as per Ayurveda. For this purpose the wounds are washed with decoctions of nimbadi, triphala and odumbar Swarasa. A term roga jantughana is used in Ayurveda that means destroyers of pathogens. Gugglu is described as roga jantughana. In common the various multiple combination medicines that are having antibiotic /antiseptic properties are herbal and mineral combinations sulphur is also used for this purpose. Some medicines are-

Gandhak Rasayana.

Haridra,

Jatyadi Tail,

Jaya Vati

Nimbadi Tel

Nimbadi Vati

Rasanjana Vati,

Shigru Guggal,

Shudh Gandhak

Swarnvang,

Apart form these, the Rasayana procedures and medicines used as Rasayanaare also helpfu in building up the immunity of body so as to prevent it from various infections.

Anti-inflammatory drugs in Ayurveda

 The anti-inflammatory drugs are used to reduceinflammation. The process of inflammation is anatural phenomenon of combating the exertion dueto mechanical and traumatic impact. There arecertain conditions that are responsible forinflammatory conditions. In the process ofinflammation the white blood cells of body combatthe foreign particles so as to protect the body.This aggregation of chemicals and increased bloodsupply make that particular area swollen andtemperature rise is noticed. This process resultsin inflammation and also causes pain..Generally inflammation is taken as the symptom ofany oth