Aushadh Sevan Kaala / Chronotherapy Ayurveda

Aushadh Sevan Kaala/ bhashyajya kaal/ Chronotherapy refers to the syncing of medication regimen with circadian clock. It is time of drugs administration in ayurveda.

Overview

The Ayurveda states that before starting the treatment of a patient one should be aware of the bal-abal (strength and weakness) of the disease (Rog) , the diseased (Rogi) and the medicine (Ausadh). The patient when given proper medicine on proper time is only beneficial.

Modern science view

In modern Science, Aushadha Sevan kaala can be compared with Chronotherapy, which means giving/administration of the drug or treatment according to the circadian rhythm of the body, to maximize the effectiveness and minimize the side effects of that treatment. Circadian (circa-about; dies-day or about 24 hours) rhythm – oscillations. Thus, Circadian rhythm means the biological, physiological and behavioural functions of an organism with a periodicity of about 24 hours.

The time of administration of drug is very important as it deals with the proper interaction of drug and the body. It helps the processes of pharmacodynamics and pharmacokinetics work at its fullest without any interruption. The drug taken without any proper timing may interact with the food taken and cause harm to the body. It prevents any adverse drug reactions.

Synonyms:

Bhaishajya Kaala, Ausadha sewan Kaala, Aushadha Kala, Bhaishajya grahana Kaala, Aushadha Avacharana Kaala, Agada Kaala, and Aushadhavekshana Kaala, time of drug administration, Chronotherapy, chronomedicine.

Kaal

The wise always focuses first on the kaala, Bala, aayu, Prakriti, desha and doshas to decide the time of administration of drug.

Time of drug administration doesn’t only mean medicine time in context of clock. But it also means in context of age of patients; duration of illness i.e chronic or acute; seasonal time; digestion state(jeerna kaala) and medicine time. All are important for successful management of disease.

The time should be known in relation to drug, day, patient, disease, symptoms of digestedness and season.

For the treatment of any disease the patient need to opt a healthy lifestyle, avoiding the etiological factors of the disease, proper food, proper medication and some sort of exercise whether it be yoga or any alternative.

According to Charaka: the medicine-opposite of Dosha, Dushya, and Nidan (etiological factor) or to all of the three will undoubtedly cure the disease. He also adds that – “when treating a disease we can get success only when there is proper combination of Kaala (time), Pramana (dosage), Bala (strength), Satmya (wholesomeness), Asatmya (unwholesomeness),Desha (region), Pathya (useful), Apathya (harmful) and aayu(age).

Kaala plays a very important role in chikitsa. Kaala vitiate dosha and also kaala heals it with due course. Kaala here can be related to :

1. Shadvidha kaala (Six observatory aspects of time)
2. Dasa Bheshajya Kaala (Ten durations for the administration of medicine)

Shad Kalaveksha

It is of six types :

• Dina
• Rogi
• Aushadha
• Vyadhi
• Jeerna Laxana
• Ritu

Aushadh kaala according different Aacharyas :

Aacharya	Number of Bhaishajya kaala
Charaka	10
Sushruta	10
Ashtang Hridya	10
Ashtang Sangraha	11
Sharangdhara	5

Bhaishajya kaala according to Maharishi Charaka :

भैषज्य कालो भुक्तादौ मध्ये पश्चान् मुहुर्मुहुः। सामुद्गं भक्तसंयुक्तं ग्रासे ग्रासान्तरे दश।। (च०चि०अ० 30)

• Bhuktaado : (bhukht=food;aado=before) Before having food. In the morning and evening taking the drug before having food. Chakrapaani divides this into two types
  1. ➡️Just after waking up without eating anything.
  2. In the morning before breakfast.
• Bhuktmadhye : Drug administration in the mid of having food.
• Bhuktpaschata : After having food. In the morning and evening after food.
• Muhurmuh : Administration of drug many times a day without taking care of meal.
• Samudaga : Administration of drug before and after the drug.
• Bhuktasanyukta : Administration of drug by mixing it with food.
• Sagraase : Administration of drug with every bite of food.
• Graasantare : Administration of drug in between two bites of food.

Bhaishajya kaala according to Maharishi Sushruta :

तत्राभक्तं प्राग्भक्तं अधोभक्तं मध्येभक्तं अन्तराभक्तं सभक्तं सामुद्गं मुहुर्मुहुर्ग्रासं ग्रासान्तरञ्चेति दशौषधकालाः। (सु० उत्तरतन्त्र-64/67)

Aacharya Sushruta has also told 10 types of Bhaishajya kaala but he instead of Bhuktsanyukta described Antarbhakta :

• Abhakta : Administration of drug in the morning before taking any food ,i.e., empty stomach.
• Pragbhakta : Administration of drug just before having meal in the morning.
• Antarbhakta : Administration of drug between two meals ,i.e., between breakfast and dinner.

All other kaalas by Aacharya Sushruta similar to Aacharya Charak.

Bhaishajya Sewan kaala according to Ashtang Samgraha :

न ह्यप्राप्तातीतकालमौषधं यौगिकं भवति, तस्य त्वेकादशधा ऽवचारणम्। तद्यथा:-अभक्तं प्राग्भक्तं मध्यभक्तं अधोभक्तं सभक्तमन्तरभक्तं सामुद्गं मुहुर्मुहुः सग्रासं ग्रासान्तरं निशि च ।। (अ. सं. सू. 23/12)

Aacharya Vaagbhat explains 11 Aushadh kaalas , 10 similar to Aacharya Sushruta and one Nishikaala is Extra.

• Nishikaala : The drug is to be administered at night before sleep.

Bhaishajya kaala in Sharangdhar Samhita :

ज्ञेयः पञ्चविधः कालो भैषज्यग्रहणे नृणाम्। किश्चित् सूर्योदये जाते तथा दिवसभोजने ।। सायन्तने भोजने च मुहुश्चापि तथा निशि।(शा. सं. पू. ख. 2/2-2½)

• Suryaudaya : Before sunrise.
• Diwasbhojane : At the time of afternoon meal.
• Sayantane bhojane : At the time of dinner.
• Muhur-muh : Drug administration again and again.
• Nishi : At night before sleep.

Tablet of Aushadh sevan kaala :

Charaka	Sushruta	Vagbhata	Sharangdhara
Abhakta	Abhakta	Abhakta	Suryaudaya
Pragbhakta Before lunch Before dinner	Pragbhakta	Pragbhakta	Pragbhakta (Before lunch)
Madhya bhakta	Madhya bhakta	Madhya bhakta	–
Adhobhakta (Pashchatbhakta) After lunch After dinner	Adhobhakta	Adhobhakta	Adhobhakta (After dinner)
Sabhakta (Bhaktasanyukta)	–	–	–
Samudga	Samudga	Samudga	–
Muhur-muhuh	Muhur-muhuh	Muhur-muhuh	Muhur-muhu
Sagrasa	Sagrasa	Sagrasa	–
Grasantara	Grasantara	Grasantara	–
–	Antarbhakta	Antarbhakta	–
–	–	Nishakaala	Nishakaala

Also read : Prameha rog – ayurvedic concept of urinary disorders

Purpose of Aushadh sevan in different kaala :

1. Abhakta :

In the morning just after waking up after sunrise, the administration of drug empty stomach is called Abhakta Aushadh Sewan kaala. According to Aacharya Vagbhatt due to absence of any interaction of food in the stomach , the drug shows high potency and is more effective. The drug as taken empty stomach directly comes in contact with the digestive fire and it gets completely digested and thus, maximum benefits are obtained. In this kaala the administration of drug leads to opening of all strotas of aamashya.

Synonyms : Abhakta , Ananna , Suryaudaya jaate, Nirbhukta.

Aushadh sevan kaala	Administration of drug	Indications	Contraindications
Abhakta	Before taking any food or empty stomach in the morning	•Rog and Rogi with high Bala(strength). •Mainly indicated for Kaphaj rog. •Panchvidh Kashaya Kalpana (these formulations being strong need very high digestive fire for digestion. •In vitiated pitta and kapha for vamana, veerechana, langhana, lekhana etc. the drug is administered in this time.	•Children •Aged •Women •Person with soft body

2. Pragbhakta :

Administration of drug just before meals in the morning is termed pragbhakta. After administration of drug the meal should be taken. The drug taken just before meals is digested quickly and don’t harm the strength of body in anyway. It even does not come out on emesis with the food eaten. It is helpful in the treatment of diseases of stomach.

Synonyms : prag-bhakta , prag-bhojana , bhojanagre , annadu , bhaktaadu , purvabhaktasya , bhojana purva.

Aushadh sevan kaala	Administration of drug	Indications
Pragbhakta	Before the meals (10-20 mins before the meal is taken)	Apaana vayu vikriti Aged Children Women Emaciated (krisha) or Weak Diseases of lower parts of body Strengthening lower parts of body Weight loss

3. Madhyabhakta :

Administration of drug in between the meal. Half of the food is consumed first and then the drug is administered and the later half of the food is consumed. In this Chronotherapy the digestion process begins before the drug is administered and thus, the activated Saman vayu and pachak pitta acts over the medicine. The food consumed after medicine prevents the outflow of medicine through emesis. The drug firstly acts on Saman vayu and thus, once it is corrected , the digestive fire and pachak pitta also starts working properly. As pachak pita is corrected and it nourishes all other pittas, hence, all the pittas are corrected. The function of koshtha ,i.e, metabolism and digestion , are hence done normally. It is helpful in diseases of Madhya sharir, koshtha gat Rog and pittaj vyadhis.

Synonyms : Bhaktmadhye, Madhya bhojana, Madhye bhaktam.

Aushadh sevan kaala	Administration of drug	Indications
Madhyabhakte	Between the meal	Vikriti of Samaan vayu Diseases of middle body parts Koshthagat Roga Pittaj vikara Mandagni

4. Adhobhakta :

Administration of drug just after taking meal. It is further divided into two:.

• Pratah kaala adhobhakta : Drug administration after breakfast / meal taken in the morning. It is advised in case of Vyaana vayu vikriti.
• Saayakaala adhobhakta : Drug administration after dinner/ meal taken in evening (as according Ayurveda the dinner must be taken before sunset). It is advised in case of udaana vayu vikriti.

Synonyms : Pashchatbhakta , adho bhojana , ante , adhaha , pratah ashya.

Medicines consumed after meal helps cure diseases of upper body parts (head & neck ) and provides strength. It is beneficial in kaphaj vikara & Rog of purva kaaya. Helps gain weight.

5. Antarbhakta :

Drug administration after complete digestion of food. It is taken between two meals. The drug is administered in the afternoon after digestion of breakfast. And after the digestion of food taken in evening, the medicine is administered at night.

Synonyms : Bhaktayomadhye, antarbhaktam,

Bhaishajya Sewan kaala	Administration of drug	Indications
Antarbhakta	Between two meals	– Hridya – Agni deepaka -Deeptagni purush – Vyaana vayu vikara – Strength to Manas(mind)

6. Sabhakta :

The drug administered by mixing it with prepared food or while preparing food is called sabhakta aushadha Sewan kaala. In this kaala, the medicine is given along with food, so when the food is digested and converted into aahara Rasa, the medicine is also converted and it circulates into the body and hence, cures the diseases of complete body.

Synonyms : saanna, sambhaktam, bhaktasamyuktum.

Bhaishajya Sewan kaala	Administration of drug	Indications
Bhakta-samyuktam	Mixed with food	– Weak women – Children – Sukumara vyakti – Aged – Manobala vardhaka – Aruchi – Sarvanga sharir vyadhi – Ones who dislike medicine intake

7. Samudga :

The administration of drug in both the starting and end of the food, is called samudga aushadh Sewan kaala. In this the drug must be taken before and after having light and easily digestible food. Samudga means covering or box like structure, here it is formed around the food by the drug taken both before and after the food.

Synonyms : Samputa, Samudga.

Aushadh sewan kaala	Administration of drug	Indications
Samudga	Both just before and just after the intake of food.	– Paachana – Nasya – Avleha – Churna – Hikka – Kampa – Aakshepa – Doshas vitiated in both upper and lower part of body.

8. Muhur- muh :

The drug administrated again and again whether taken after food or empty stomach. In this the drug is taken again and again after short period of time. The drug may be given empty stomach, before food, with food, after food or any time irrespective of meals.

Aushadha Sewan kaala	Administration of drug	Indications
Muhur-muh	Again and again irrespective of meals	– Shwasa roga – Hikka – Kasa – Vamana – Trishna – Swarabheda -Vishjanaya vikara -Urdhvajatrugata roga

9. Sagrasa :

The administration of drug by mixing with every or some bites of food. It is taken with the bolus/morsels of food.

Aushadh sewan kaala	Administration of drug	Indications
Sagrase	Mixed with each bolus/ morsel of food.	– Praana vayu vikara – Vajikaranarth – Agnideepana – Churna, Avleha, Vatakadi

10. Grasantare :

It is administration of drug between two bolus of food. The powdered medicine is given in this form so as it make its deglutition easier and the process of deglutition is accompanied by Praana vayu , hence the medicine works on diseases related to Praana vayu.

Aushadha Sewan	Administration of drug	Indications
Grasantare	Between two morels of food	– Praana vayu vikaras – Hridyaroga – Vamaniya dhum – Avleha given in Shwasa, kasa – Mandagni

11. Nishi :

The drug administered at night at the time of sleeping is called Nishi Aushadha Sewan kaala. According Ayurveda, ones goes to sleep after digestion of evening food or after approx. 3 hrs. of having evening meal.

Synonyms : Nishakaala, Ratre, swapnakaale, Naish.

Aushadh sewan kaala	Administration of drug	Indications
Nishi	At night or just before sleeping	– Urdhavjatrugata roga – Mridu veerechana – Lekhana – Brinhan – Paachana – Shamana – Veerechak