Review on uttāmaṇi karukku a pediatric traditional medicine

Dr. D. EASWARI¹, Dr. M. SOCIYA PARVIN ² and Dr. D. K. S. SOUNDARARAJAN³

^{1- 2 PG} Scholar, Department of kuḻantai maruttuvam

³ Head, Department of kuḻantai maruttuvam

Government cittā Medical College and Hospital

Pāḷaiyaṅkōṭṭai, Tirunelveli (Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chennai)

Abstract:

According to World Health Organization (WHO) more than 80% of the world’s population relies on traditional practitioners and their armamentarium of medicinal plants in order to meet health care needs in spite of modern medicine which is well established worldwide. In cittā traditional system foremost awareness has been given to Pediatric population which is considered as the backbone of the developing nation. There are various medicinal formulation and lifestyle practices which are till date in practice. One among the pediatric diseasekaṇa māntam is treated with a sastric formulation uttāmaṇi karukku. In spite of various medicines used in other system of medicine, till date in Tamil Nadu the practice of Vacampu (piḷḷai maruntu) has its own role, the raw drug has its own positive and negative effects it is overcome with its purification method.

Keywords: cittā, kaṇa māntam, uttāmaṇi karukku, Pediatric.

Introduction:

The ancient cittā system, a tradition presumed to be lost is now finding its way back into the hearts and lives of people worldwide. Ancient wisdom in its nativity remains conserved by the teaching imparted by sages in primordial times, even in our postmodern world. ² Cittā, as a common noun known as “realized, perfect one”, a term generally applied to a practitioner who has through his practice realized his dual goal of superhuman powers and bodily immortality.

According to cittā, 96 tattuvam influence the activities of the individual from birth to death. This system also believes body- mind- spirit is inseparable is always taken into consideration as a whole as their interconnectedness is a pre-established cosmic design of existence.

As the population increasing day by day there is an exponential increase and emergence of new diseases. The environment is getting more and more polluted, the humanity has almost come to a stage where the various available preventive measures are to be valued much well than the existing curative measures. Apart from Prevention and cure which exist in all systems, cittā system in addition also believes strongly in the transcendental (immortality).

Cittā medicine deals formally and systematically with each medical subject and is usually describes in a poetic verse format so that the knowledge could be passed down orally over generations from cittā physicians to their disciples³. Similar to other Indian system of medicine cittā also follows mukkuṟṟam theory and states that psycho-biological aspect is governs by 3 mukkuṟṟam vaḷi, āḻal and aiyam any change in body is due to the imbalance of these mukkuṟṟam⁴.

Aṉupava vaittiya kaḷañciyam a classical cittā text classifies the diseases of childhood into 108 diseases which further classified into various sub-types based on the change in nature of disease presentation. One among the disease ismāntam which is a very common entity in the pediatric population;kaṇa māntam is a classification of the diseasemāntam for which the sastric formulation uttāmaṇi karukku has been given.

⁵ Symptoms of kaṇa māntam are:

“Aruntu meyyiḷait tirumalu maṭikkaṭic curamun

Tiruntu mūkkilnīr vaṭitalum vayiṟuppum ciranōy

Purinti raiccalum palavitam vayiṟupōk kuṭaṉē

Varuntu kaṇṇiṉil mayakkamu māṅkaṇa māntam”

- Kuḻantai maruttuvam (verse 91)

• Weight loss
• Cough
• Fever
• Watery Nasal discharge
• Headache
• Diarrhea
• Bloating abdomen
• Drowsiness

Cittā literature describe a group of herbals suitable for pediatric population based on the pediatric organ developments, keeping pharmacokinetic and pharmacodynamics in mind, which indicates the in depth knowledge ofcittā medicinal system in pediatric diseases. Drugs used in uttāmaṇi karukku are briefly described.

The taxonomical classification, chemical constituents, Cuvai parameters, method of preparation of the drug, their activities has been described briefly in the upcoming topics.

Uttāmaṇi karukku : ( Internal medicine)

Karukku - to grind, to burn, scorch, tan, darkens by heat ⁷

Ingredients:

1. Vacampu Acorus calamus L . 10 gram

2. Uttāmaṇi Pergularia daemia (Forssk.)Chiov. 100 ml

3. uppu Sodium chloride 1 gram

Purification of vacampu:

The most important part of the drug preparation which makes the toxic drug into non toxic, it is one of the real identity of cittā system.

Vacampu cāmpal kuṇam:

“tēṟumē vacampāṉatil cāmpaltāṉ

Nīṟumēcalamtāṉ atiliṭa uṇṇil

Vīṟukoṇṭu veḷivarum pētiyum

māṟumeṉṟu vakuttaṉar nantiyē ”

- Citamparatāṇu piḷḷai poruṭpaṇpu nūl part -1

Method of preparation:

⁶ Vacampu has been calcinated by traditional cow dung method, Uttāmaṇi leaves are collected and juice is extracted, which is mixed with salt(Sodium chloride) and calcinated vacampu and the mixture is heated until the juice is fully absorbed and made powdery, at last again it is triturated and given for administration.

Dose: 13 to 200 mg

Adjuvant: Hot water

Figure 1- Uttāmaṇi karukku preparation.

Figure 2- Uttāmaṇi karukku

PROPERTIES OF THE DRUG Uttāmaṇi karukku:

Uttāmaṇi :

A slender, hispid, fetid- smelling perennial climber. Leaves opposite, membranous, 3-9 cm long and wide, broadly ovate, orbicular or deeply cordate.

Figure 3- Pergularia daemia

Taxonomy

Kingdom : Plantae

Subkingdom : Tracheobionta

Super division : Spermatophyta

Division : Magnoliophyta

Class : Magnoliopsida

Subclass : Asteridae

Order : Gentianales

Family : Asclepiadaceae

Genus : Pergularia

Species : P. daemia (Forsk) Chiv

Other names : vēliparutti, uttamamākāṇi, uttamakaṉṉikai

Parts used : Leaves, roots and root bark

Parts used in the Trial drug : Leaves

Cuvai : kaippu

Taṉmai : veppam

Pirivu : kārppu

Action :

• Anti pyretic
• Antispasmodic
• Nervine tonic
• Sedative
• Stomachic
• Anthelmintic
• Laxative
• Expectorant (N. Balakrishnan et al 2009)
• Emetic
• Anti inflammatory

Active constituents :

• Lupeol
• Beta sitosterol
• Quercetin
• Kaemferol
• Alpha -Amyrin
• Beta- Amyrin
• Betaine
• Isohamnetin

Uttāmaṇi potukuṇam :

“Icikkum valiyiraippum ettaṭippum ēkum⁶

Pacikkumati māntamum pōm pār”

- Akattiyar kuṇavākaṭam.

The verse denotes uttāmaṇi helps to relieve from icivu (vali), iraippu and ati māntam. Appetite will be increased.

Medicinal properties:

Gastro Intestinal system:

• Digestive disturbance
• Flatulence
• Loss of appetite
• Gastric ulcer
• Choleric diarrhea in children
• Treat infantile diarrhea and
• Malarial intermittent fevers.

Respiratory system:

• Cough
• Fever
• Cold
• Asthma
• Whooping cough and
• Capillary bronchitis.

- Nadkarni’s Indian material medica vol-I

Table 1. Acute toxicity of P. daemia

A g/kg body weight/os. (S. C. Jain et al, 1998)

From Table 1, it is evident that the plant extract was well tolerated orally in mice up to a dose of 2.0 g/kg BW with no mortality or serious side effects⁹.

¹⁰ Among the aqueous and ethanolic extracts tested, the ethanolic extract of the aerial parts of Pergularia daemia possess Hepatoprotective activity against CCl4 intoxication in rats.

Table 02. Antibacterial activity of methanol, chloroform and aqueous extract of Pergularia daemia (Forsk.) Chiov.

( Ramanathan R et al, 2013)

¹¹ The methanolic extract produced zone of inhibition against S. aureus only which showed 19 mm in 75µL, 20 mm in 100µL and 21 mm in 125µL concentration. In chloroform extract active against K. pneumoniae and S. aureus which produced 17 and 12 mm in 75µL, 18 and 13 mm in 100µL and 19 and 15 mm in 125µL concentrations. In aqueous extract was the most effective against all three test pathogens, but the maximum zone of inhibition was shown at 125µL concentration which produced 15mm against E. coli and K. pneumoniae, 22 mm zone of inhibition against S. aureus.

Table 03. Antifungal activity of methanol, chloroform and aqueous extract of Pergularia daemia (Forsk.) Chiov.

( Ramanathan R et al, 2013)

¹¹ A. niger and Penicillium sp. were highly susceptible to chloroform extract (22 and 19 mm) followed by aqueous extract (17 and 20 mm) and methanolic extract (16 and 16mm) at 125µL concentration respectively.

Acute toxicity study:

¹⁰ The ethanolic and aqueous extracts did not cause any mortality up to 2000 mg/kg and were considered as safe as per OECD guidelines^15.

Vacampu :

Figure 4- Acorus calamus

A. calamus is a perennial plant with creeping and extensively branched, aromatic rhizome, cylindrical, up to2.5 cm thick, purplish-brown to light brown externally and white internally. At the rhizome forming, perennial that can grow to 2 meters resembling an iris¹²

TAXONOMY

Kingdom : Plantae

Division : Magnoliophyta

Class : Liliopsida

Order : Acorales

Family : Acoraceae

Genus : Acorus

Species : calamus/ A. aromatics / A. calamus var. americanus

Other species : Acorus gramineus

Other Tamil names : ukkiram, vacam, vacai, vēṇi, cuṭuvāṉ, uraippāṉ, pēr collā maruntu, piḷḷai maruntu⁶, koṭi kevuri, vaṅkirācam, kimaṇattippi, viṣaram, ōmacam, tiripaṅkucāti, ācuvētayam, vacuntakirumiyari.

Parts used : Dried Rhizome

Parts used in the trial drug : Ash of the Rhizome.

Cuvai : kārppu, kaippu

taṉmai : Veppam

Pirivu : kārppu

Action :

• Stomachic
• Anti periodic
• Stimulant
• Disinfectant
• Germicide
• Carminative
• Expectorant and
• Antispasmodic.

Constituents :

• Alpha – asarone- 1.17%
• Beta- Asarone- 92.68%
• Delta- Asarone- 2.27%
• 1-8 cineole, Terpionolene, sugar 8.342%
• Nitrogen 2.029%, Protein 10.318%

· A volatile essential oil- acronic.

· A bitter principle- acoretin( choline calamine)

· The essential oil of Acorus calamus is yellowish brown and is found to be composed of as aryl aldehyde, esters of palmitic acids and a small quantity of phenol, eugenol, methyl eugenol, calameneol and calameone.

-Indian Materia Medica (P. No: 35)

Active constituents:

The rhizomes of A. calamus Linn. has mixed fatty acids, as indicated by gas chromatography of the corresponding methyl esters were myristic (1.3%), palmitic (18.2%), palmitoleic (16.4%), stearic (7.3%), oleic (29.1%), linoleic (24.5%) and arachidic (3.2%). The nature of the sugars was defined by paper chromatography and confirmed by direct comparison with authentic samples. Composition of the sugars, as indicated by densitometer, was maltose (0.2%), glucose (20.7%) and fructose (79.1%). The content of the oil in dried sweet flag rhizomes was 1.20+/-0.12%. Acorenone was dominant in the rhizomes (20.86%) followed by isocalamendiol (12.75%). Besides Monoterpene hydrocarbons, sequestrine ketones, (Trans- or Alpha) Asarone (2, 4, 5-trimethoxy-1- propenylbenzene), and Beta-asarone (cis- isomer) and eugenol were also identified. Some other compound identified in A. calamus are (-)-4-Terpineol, 2-Allyl-5-ethoxy-4-methoxyphenol, Epieudesmin, Lysidine, (-)-Spathulenol, Borneol, Furyl ethyl ketone, Nonanoic Acid, 2,2,5,5-Tetramethyl-3- hexanol,Bornyl acetate, Galgravin, Retusin, (9E,12E,15E)-9,12,15- Octadecatrien-1-ol, Butyl Butanoate, Geranylacetate, Sakuranin, Acetic Acid, Camphor, Isoelemicin, á-Ursolic acid, Acetophenone, Dehydroabietic acid, Isoeugenol Methylether, Apigenin 4',7-dimethyl ether, Dehydrodiisoeugenol, Linalool, Elemicin, Linoleic acid¹³.

The biochemical constituent in Vacampu is asarone. This compound has analgesic, sedative and neuro depressive activity which can produce sedation and hence reduce the irritable cry among neonates. In neonates with diarrhea, the spasmolytic and antisecretory effect of the extract can reduce the frequency of loose stools¹⁴.

¹² Heavy Metals Analysis The content of heavy metals such as lead was present within the permissible limit, cadmium; mercury and arsenic were not found in the drug Acorus calamus (table.4).

Table. 4. Heavy Metals Analysis

(Ushakanthan et al., 2017)

The ethanolic extract of Acorus calamus significantly protects against liver injuries resulting in improved serum biochemical parameters such as SGOT, SGPT and SALP¹⁶.

Fatty acids in Acorus calamus have palmitic acid and its ester which possess significant antifungal and antibacterial activity ¹⁷.

Various essential oil components present in essential oils like linalool, 1,8-cineol, caryophyllene, α humulene, and asarone have been reported to possess antioxidant activity.

Uppu:

Sodium chloride

Other names: kaṟiyuppu, cōṟṟuppu, kaṭaluppu, vīṭṭuppu, ilavaṇam, camuttira lavaṇam¹⁸.

Kaṟiyuppiṉ potukuṇam:

“Māntam porumalaṟum vāyuvumpōmtīpaṉamām

tontitta aiyan toṭarumō- cantatamum

akkiṉiyiṉ puṣṭi aṭaruṅ kaṟiyuppāl

cikkukiṉṟa nīriṟaṅkuñ ceppu”

Kaṟiyuppāl māntam, vayiṟṟup porumal, vāyu, kapam nīṅkum. Nīraṭaippu tīrum. Paciyum camākkiṉiyum atikappaṭum.

Conclusion:

Cittā medicine has its own unique identity in its formulation of drugs. Despite of, various climatic change and geographical nature changes, the composition of drug most of its activities are similar mainly uttāmaṇi karukku, the herbo mineral combination has its own composition which has Hepatoprotective and Anti oxidant activity. Uttāmaṇi karukku will be more prioritized by further scientific validation.

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