Bheshaja Sevana Kala

The specific time that patients take their medication is very important as it has significant impact on treatment success. The pharmacokinetics and pharmacodynamics of an Ayurvedic medication is directly affected by biological activities of the body. The effectiveness of many drugs depends on the dosage administration time. In Ayurveda it has been told that rhythmic changes in the predominance of bodily Doshas occur. (Ashtang Hridaya Sutrasthana 1/7-8). Bheshaja Sevana Kala based on this concept of Doshas. Aacharyas have mentioned Bheshaja Sevana Kala in varying numbers. An attempt to correlate these Kala has been made. In the modern science this concept of timed dosage is known as chronotherapeutics. It was seen that all the Kalas can be incorporated in only five Kalas told by Sharangdhara. *Corresponding author: Omkar Devi Prasad Nimkar, MD Scholar, Rasashastra and Bhaishajya Kalpana, Loknete Rajarambapu Patil Ayurvedic Medical College, Hospital, Post Graduate Training and Research Centre, Urun Islampur, Tal. Walwa, Dist. Sangali-415409. Maharashtra, India, Tel: 02342661212; E-mail: onimkar@yahoo.com Received October 09, 2014; Accepted November 18, 2014; Published December 01, 2014 Citation: Nimkar ODP, Patil AA (2014) Bheshaja Sevana Kala. J Homeop Ayurv Med 3: 169. doi:10.4172/2167-1206.1000169 Copyright: © 2014 Nimkar ODP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Introduction
Chronotherapeutics refers to a treatment method in which in vivo drug availability is timed to match rhythms of disease, in order to optimize therapeutic outcomes and minimize side effects. It is based on the observation that there is an interdependent relationship between peak-to-trough rhythmic activity in disease symptoms and risk factors, pharmacologic sensitivity, and pharmacokinetics of many drugs.
The pharmacokinetics and pharmacodynamics of an Ayurvedic medication is directly affected by biological activities of the body. The effectiveness of many drugs depends on the dosage administration time. In Ayurveda it has been mentioned that, the predictable variations in bodily functions during day, season and age alters the severity of disease symptoms, results of diagnostic tests and effects of drugs and other therapies [1].
Bheshaja Sevena Kala is meant for proper time of drug administration. Ancient texts of Ayurveda have described different types of Bheshaja Sevana Kala. We get references regarding Bheshaja Sevana Kala in classical texts like Ashtanga Sangraha and Hridaya, Charaka, Sushruta and Sharangdhara Samhitas. Classification from Ashtanga Sangraha Sutrasthana 23/12-21 is considered in this study, as maximum number of Kalas is explained by Acharya Vagbhata [2].
Here an attempt is made to draw a parallel between the opinions of different Acharyas (Table 1) The Bheshaja Sevena Kala is as follows-

Niranna kala
Bheshaja is administered on empty stomach. Hemadri quotes that once the consumed food is digested, Bheshaja is given and after its digestion, food is given. According to Indu [3], it is mentioned Bheshaja is to be given on empty stomach, but two hours after sunrise. In this kala, Amashaya and Strotasas are devoid of Kapha.

Action of Bheshaja
• Highly potent as there is no contact of Bheshaja with food.
• Interaction between Agni and Bheshaja is unhindered due to absence of food.

• In Durbala Rugna, Bheshaja is to be administered [4] after
Laghu and Pathyahara, whereas in balawan Rugna it can be administered on empty stomach.

Pragbhakta kala
Bheshaja is administered before meals. According to Hemadri, Bheshaja intake is immediately followed by food.

Action of Bheshaja
• No Balakshaya as the Bheshaja is followed by food; hence it becomes the first target of Agni and not the food.
• No regurgitation of Bheshaja occurs as it is followed by food.
• The Bheshaja directly acts on the Amashaya and the vitiated Doshas [5].

• Apanavayu Vikruti
• Diseases like debility, weakness of lower parts of body,

Madhyabhakta kala
Bheshaja is administered in between the meal. According to Chakrapani and Indu, half portion of the food is taken initially, followed by Bheshaja administration, and again followed by remaining food.

Action of Bheshaja
• The Urdhwagati and Adhahgati of Bheshaja is restricted by food hence is forced to act locally and therefore helps to cure Sthanik Doshas.

Adhobhakta kala
In this kala, Bheshaja is administered after meals. According to Hemadri and Indu, Bheshaja is to be administered immediately after meals. In Vyanavikruti, Bheshaja is administered after lunch while in Udanavikruti, it is administered after dinner.

Antarabhakta kala
As previously consumed food gets digested, Bheshaja is administered; after metabolism of Bheshaja, again food is taken in the evening.
• Due to Madhyanha i.e. Pittakala, Agni is in a stimulated condition. So Bheshaja is properly metabolized in this kala.

Sabhakta kala
Bheshaja is mixed with food. Indu also opines the same.
• The drug mixes with Rasadhatu along with food and spreads all over the body through Urdhva, Adhah and Tiryak Gati and helps in Sarvanga samshrita vyadhis.
• In weaker sections like women, old age, children, debilitated patients and those who reluctant to take medicines.

Samudga kala
Bheshaja is administered just before and immediately after food. Indu and Hemadri also opine the same.

Action of bheshaja
• It helps in correcting the Gati (activity) Vikruti of Vata Dosha by promoting Anulomana of Vata Dosha. E.g.

1)
Hikka-Kapha and Vata Doshas are involved. Kapha is situated in the Urdhvasharira while Vata in the Adhahsharira. Bheshaja administered in the Samudga Kala pacifies Doshas from upper and lower parts of body.

2)
Akshepaka-Doshas are localized in Pani and Pada. Samudga Bheshaja acts on both the extremities of the body.

Muhurmuhu kala
Bheshaja is frequently administered irrespective of Bhukta or Abhuktavastha. It can be given for licking.

Action of Bheshaja
• Sublingual absorption provides faster relief. Therefore can be used in life threatening diseases.
• Treats the vitiated doshas in their Sanchaya and Vegavastha.

Grasa kala
Bheshaja is administered with each and every bolus of food. According to Arunadatta and Hemadri, Bheshaja is to be mixed with each bolus of food. This is somewhat similar to Samudga kala.

Grasantara kala
Bheshaja is administered between two bolus of food. One bolus is taken followed by Bheshaja followed by bolus again. Generally the Bheshaja dravya is for Lehana.

Action of Bheshaja
• It helps in correcting the Gati (activity) Vikruti of Vata Dosha by promoting Anulomana of Vata Dosha.

Nisha Kala
Nisha Kala is the time after the evening meal is digested. Indu opines the same. While Sharangadhara has mentioned it is an Anannavastha. The purpose of this kala is for Anulomana and Brimhana.

Action of Bheshaja
• Selective action of the Bheshaja towards the Urdhvajatrugata parts.
• Chiraparinamana (long lasting action) of the Shamana Aushadhi is achieved as no food intake occurs until the next morning [6,7].

Discussion
The specific time that patients take their medication is very important as it has significant impact on treatment success. If symptoms of a disease display circadian variation, drug release should also vary over time. Since it is seems that timing of drug administration in disease therapy has significant impact upon treatment success, chronotherapeutics remains an important area for continuing research. In Ayurveda Bhaishajya Kalas are described in relation to food, they are meant for Shaman Chikitsa only and the root of administration to all Kala is oral. Although the number of Bheshaja Sevana Kala told by