Monographs on the Use of Traditional Medicine in Primary Health CareMonographs on the Use of Traditional Medicine in Primary Health Care National Institute of Traditional Medicine Royal University of Bhutan ThimphuMonographs on the Use of Traditional Medicine in PHC Copyright © 2012 National institute of Traditional Medicine All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording or otherwise, without permission from the publisher. NITM acknowledges the support from the WHO, SEARO, New Delhi for the development and printing of this book National Institute of Traditional Medicine Royal University of Bhutan Post Box 297, Thimphu Bhutan Tel. +975 2 321473 Fax +975 2 331712 www.nitm.edu.bt Printed in Bhutan ISBN No.: 978-99936-762-0BHUTAN Monographs on the Use of fouiitional Medicine in PHC Contents Page Acknowledgement. v Glossary. vi Bhutanese Terms vii Preface...... Foreword ... eX xi Abbreviations .. 1. Acidity and gastritis Ruerta6 pa... 2. Common cold Bras-bu-3thang.ee soso 3. Conjunctivitis rdo-rje-rab- jom.. 4. Constipation Zhi byed 6 pa... wll 5. Cough Rgun-brum 7 pa 6. Diarrhoea Da-trig 9 pa. 7. Dysentry Man-ngag-gam-phye-d.mar-po. 4 8. Earache Rucrta 2 thang. 28 9. Eye discharge Spang-rtsi 12 10. Fever Norbu 7 thang... 11. Fungal dermatosis Zab-la- 8 pa... 12. Headache Tigeta 8 pasesesvee 13. Indigestion Sebru 4 pa. 14. Jaundice Gyaeki Tp. coc eee 15. Joint Pain Sen-Mdeng 23.00.10. 16. Leucorthoea Skyer-shun 8 pa... 17. Malaise A-gar 35... 18. Painful menstruation Zhi-byed-I1.. 19. Parasitic Infestation Chimed-srin-se 83 20. Piles Byi-tang-7 pa 87 21. Scabies Klu-b.dud 18. 90 NITM, Thimphued 22. Sexual dysfuntion 23, Sprain 24. Toothache 25. Urinary disorder 26. Vomiting 27. Wound 28. References 29, Annexure Sa-rai-khyung-Inga... Shing-mgar 6 pa... oo 118 2d Roma-sman-reg-pa-dhey-ter..... NIT, ThimpheAcknowledgements The National Institute of Traditional Medicine (NITM) would like to thank all the contributors who have offered their valuable time and expertise in the preparation and development of these Monographs. We are very grateful for the financial assistance provided by the WHO, SEARO, New Delhi that has made it possible for us to take on this task and to complete it successfully. Our special thanks are due to Dr Kin Shein, TIP, TRM/EDM, WHO Regional Office for South-East Asia, New Delhi who has encouraged and supported us to come up with these Monographs. Editors: Mr. Dorji Wangchuk, Director, and Ms. Dechen Choden, Assistant Lecturer, NITM, Royal University of Bhutan (RUB), Thimphu Project Operational Officers: Drungtsho Jurmie Choden, Lecturer and Mr. Dorji Wangchuk, Director, NITM, RUB, Thimphu. Experts for Technical Review and Finalization of Monographs: Mr. Sherab Tenzin, Senior Pharmacist, Menjong Sorig Pharmaceutical (MSP), Ministry of Health (MOH); Mr. Ugyen Dendup, Pharmacologist, MSP, MOH; Drungtsho Karma Gaylek, Medical Superintendent, National Traditional Medicine Hospital (NTMH), MOH; Drungtsho Dophu, Dean, Student Affairs, NITM, RUB, Thimphu and Mr. Dorji Wangchuk. Contributors for Monographs Development: Drungtsho Sangay Wangdi, Senior Lecturer, NITM, RUB; Mr, Samten, Ethno botanist, MSP, MOH; Drungtsho Tempa Gyeltshen, Senior Lecturer, NITM, RUB; Mr Tashi, In charge, Quality Control, MSP, MOH; Drungtsho Sherub Dorji, Lecturer, NITM, RUB, Thimphu and Drungtsho Jurmie Choden. For Photographs: Menjong Sorig Pharmaceutical, Ministry of Health, Thimphu, Bhutan Facilitation and Guidance: Dr Kin Shein TRM/EDM, WHO Regional Office for South- East Asia, New Delhi. ITM, Thimphu ¥ | |BHUTAN Monographs on the Use of Traditional Mle tieane an PIC Glossary bae-kan: ‘bae’ means water and ‘kan’ means carth, It refers to the combined elemental energies of earth and water, and one of the three principle energies present in the body. This energy is responsible for the firmness of the body, stability of the mind, flexibility of the joints, and providing fluidity in the body. There are five specific types of bae.kan, each with specific locations and functions. rlung: One of the three principle energies of the body and the mind, which is associated with the nature of the air element. Although, it is dominantly present in each and every component of the body, but it resides primarily in the heart, brain, nerves and blood vessels. This energy governs the functioning of the central nervous system, which involves subtle perception of various objects of consciousness. It is also responsible for all the functions of the mind and body that involves movements. There are five specific types of riumg, each with specific locations and functions. mkhris-pa:_ mKhrispa means ‘burning’. It refers to the entire heat energy and is one of the three principle energies present in the body. It is associated with the fire element and carries functions such as generation of heat energy and proper digestion of food and beverages. There are five specific types of mkhrispa, each with specific locations and functions. vi NITM, ThimphuBHUTAN I Medicine in PHC pis on the Use of Tradition Bhutanese Terms A-gar 35 Bras-bu-3-thang Byi-tang 7 pa Chi-med-srin-sel Da-trig 9 pa Gam-phye-d.mar-po glo-nad sky-bab glo-nad thang-po Gso-byed 6 pa gSo-ba-Rig-pa- Gya-ki 7-pa Khrag Kyhung-Inga-ril bu English Explanations Medicine consisting of 35 ingredients with Agar (Aquillaria malaccensis Lamarck) as the main ingredient and pronounced as Agar Songnga ‘A powder of three ingredients for decoction known as Drebu Sumthang Medicine consisting of seven medicinal herbs with Jitanga (Myrsine semiserrata Wall) as the main ingredient and called as Jitang Dheunpa Medicine which removes parasites from human body and pronounced as Chimey Sinsel Medicine comprising of 9 ingredients with Datrig (Rhus chinensis Miller) as the main ingredient and is pronounced as Datrig Gupa It is a powder which is pronounced as Gamche Marpo Chronic lung disorder with edema called as Lo Ned Cha Bab Chronic lung disorder called as Lo Ned Thangpo Medicine consisting of 6 ingredients and known as Sojed Drugpa Bhutanese term for Traditional Medicine. Medicine consisting of 7 medicinal ingredients with Yakima (Chrysosplenium forrestii Diels) as the main ingredient and is pronounced as Yaki Dheunpa Blood Medicine consisting of 5 medicinal ingredients signifying five body parts of Garuda and pronounced as Chungnga Rilbw NITM, Thimphu viiKlu-b.dud 18 Mikser Mo-m.tsan-nad Norbu 7 thang Rdo-rje-rab-joms Reun-brum 7 pa Rma-sman Ru-ria 2 thang Rnyel-nye Ru-ria 6 pa Rtsa-byug Sa-rai-khyung-Inga Se-bru 4 pa Sen-ldeng 23 Shing-mngar 6 pa Medicine consisting of 18 ingredients with Ludud (Codonopsis bhutanica Ludlow) as the main ingredient and is pronounced as Ludud Chobgay Condition where eyes get yellow due to mkhris-pa disorder Traditional Medical term for female gynecological disorder. Norbu Duenthang is a decoction made up of 7 medicinal herbs Medicine known as Doje Rabjom Medicine prepared with 7 medicinal ingredients with guendroom (Diospyros lotus L) as the main ingredient and pronounced as Guendroom Dheunpa Ointment for immediate relief of wounds pronounced as Mamen Ear drop prepared with two herbs in sesame oil and is commonly called as Ruta Nyithang Conditions of Gum receding Medicine comprising six herbs with Ruta (Saussaurea lappa) as the main ingredient and called as Ruta Drugpa A massage oil called Tsajug Medicine known as Sarai Chung Nga Medicine consisting of 4 ingredients with Ruta (Saussaurea lappa) and called as Sedru Shipa Medicine consisting of 23 ingredients with Sengdeng (Morus macroura Miqual) as the main ingredient and is called as Sengdeng Nyersum Preparation consists of six herbs and is called Shing Ngar Drugpa viii NIM. Thiisye:Spang-rtsi 12 Skyer-shun 8 pa Srin Thursel rlung Tig-ta 8 pa Tsa-wa Zab-la 8 pa Zhi-byed 6 pa Medicine consisting of 12 medicinat ingredients with Pangrsi (Pterocephalus hookeri Diels)) as the main ingredient and pronounced as Pangisi Chunyi Medicine consisting of 8 ingredients with Kershin (Berberis aristata DC) as the main ingredient and pronounced as Kershin Gaypa An inborn tiny organism that exists in the body to help digest food and to generate physical strength Downward voiding riumg (wind). Medicine comprising of 8 herbs with Tigta (Halenia elliptica D.Dons) as the main ingredient and pronounced as Tigta Gaypa Heat Ointment made out of 8 ingredients with Churtsa (Rheum australe D.Don) as the main ingredient and called as Zabla Gaypa Pacifying medicine which consisting of 6 ingredients with Chongshi (Calcium carbonate) as the main ingredient and known as Shijed Drugpa 31M, ThimphuBHUTAN Monographs ou the Use of Traditional Medicme in PHC Preface The Bhutanese health care system is based on Primary Health Care (PHC) approach and the traditional medicine functions as an integral part of the national health care delivery system. It is available in alt 20 districts and is housed under the same roof of district hospitals and the Basic Health Units (BHUs) for mutual consultation, treatment and cross referrals of patients. The use of traditional medicine in primary health care has been promoted by the World Health Organization and a series of Regional Meetings were organized by WHO, SEARO, New Delhi. The need for developing monographs on the use of traditional medicine in PHC was highlighted in such meetings and the guidelines were provided by WHO, SEARO. to member countries. Bhutan has developed this monographs based on the guidelines provided and this publication contains 27 monographs on common ailments. The traditional medicine system in Bhutan is quite popular especially amongst the older population and treats about 10-30% of the daily OPD patients in the district hospitals and BHUs. Traditional medicine and modern medicine compliments each other and it is not competitive. Sometimes one gives better results than the other; sometimes the results are the same. People feel satisfied using both modern and traditional health care system for better health results. These monographs will not only be useful to the traditional medicine practitioners, but also their modern counterpart as it is written in simple English language. As a member country of WHO, Bhutan is committed in revitalizing PHC. It is also a member of the South East Asia Primary Health Care Innovations Network (SEAPIN). In terms of PHC innovation, integration between traditional medicine and modern medicine is used as an example for Bhutan. This publication is an effort towards further strengthening the integration between the two systems of medicine and to eventually promote health for all in the context of primary health care. Dorji Wangchuk National Institute of Traditional Medicine x NITM, ThimphuBHUTAN Manographs on the Use of Traditional Medicine in PIC Foreword The World Health Organization (WHO) has been promoting the concept of “Health for All” based on primary health care (PHC) since the International Conference on Primary Health Care held at Alma-Ata in 1978. Thereafter, the Member States of WHO that have a rich heritage of traditional medicine have been relying also on their own traditional system(s) of medicine in addition to the conventional modern medicine to realize universal health-care coverage. It is becoming more and more evident that al! systems of medicine — modern and traditional — need to contribute to the attainment of “Health for All” in so far as their contributions are beneficial to the fiealth and wellbeing of the people and not adversely affecting their health. In this context, traditional systems of medicine have a role to play due to their availability, accessibility and affordability. There is also the element of social acceptability in countries where traditional medicine has become ingrained in their cultural milieu since time immemorial. The traditional system of medicine in Bhutan, gso-ba-rig-pa, became a part of the health service in 1967. This traditional medical system is an integration of science, philosophy and religion giving rise to a holistic healthcare approach that contributes to the development of “Gross National Happiness“. This book contains 27 monographs on the use of traditional medicine of Bhutan in treating common ailments seen at the primary health care level. Since this system of medicine has been in use for more than 2,500 years, there is a wealth of knowledge in treating common maladies by using medicinal plants that are native to Bhutan. It is interesting that high altitude plants have medicinal properties that are similar to their counterparts in other countries of the South-East Asia Region with different climatic conditions. Fach monograph gives information on the quality, safety and efficacy of the traditional remedies. Such sharing of information opens the door for inter-country cooperation that could lead to better development of traditional medicine in the Region and in promoting “Health for All” through a multidisciplinary approach to health development and healthcare. Dr Kin Shein Traditional Medicine Programme WHO Regional Office for South-East Asia NITM, Thimphu xiAbbreviations: BHU LOD MOH, MSP NA NITM - NTMH - OPD PET PHC PVC SEAPIN - STD TLC wiv Basic Health Unit Loss on Drying Ministry of Health Menjong Sorig Pharmaceutical Not Available National Institute of Traditional Medicine National Traditional Medicine Hospital Out Patient Department Polyethylene Terephthalate Primary Health Care Polyvinyl Chloride South East Asia PHC Innovation Network Standard Thin Layer Chromatography weight by weight xii NIT, ThiryptctBHUTAN Monographs on the Use of Traditional Medicine in PRC ee Ru-rta 6 pa for acidity/gastritis Acidity and gastritis is an unhealthy condition in the stomach due to excessive intake of salty, sour, stale, light and rough foods. It occurs when the fire-like-wind in the stomach is disturbed or unbalanced, Fasting and either eating hot or cold food will worsen the condition. Symptoms include stomach ache, lethargy, frequent diarrhoea or vomiting, difficulty in digestion, feeling of discomfort after taking meals, poor appetite and throat pain. Composition Ru-rta 6 pa is made from the following ingredients with standard ratio: SLNo. ae » Latin name pamey ste 1 | nerta Saussurea lappa (Decn.e) She. | Compositae —_| 0.1000 2 | skyueru Phyllanthus emblica L. Euphorbiaceae | 9.0500 3 | se-'bru Punica granatum L. Punicaceae 0.0500 4 | ba-sha-ka Corydalis crispa Prain Fumariaceae | 0.0500 5 | sug-smel Elettaria cardamomum Malton. | Zingiberaceae | 9.0500 6 | pi-pi-ling Piper pedicellatum C. DC. Piperaceae 0.0500 7 | ka-ra Saccharum offeinarum Poaceae 0.0500 Ru-rta plant & dried root Skyu-ru fruit & crude drug NITM, Thimphu 1BHUTAN Monographs on the Use of Traditional Medicine in PHC Sug-mel plant & dried fruit Pi-pi-ling plant & dried fruit Ka-ra plant & crude drug NITM, Thimphu nv]BHUTAN the Use of Traditional M ein PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: scree era Kientification ROD mere el It’s off white-ash color | Thin Layer [Not more | Not more and tastes bitter and {Chromatogra | than 13.0 than 2% acrid. wiw% wv hy (TLC) Ticomprises of light | TLC Not more | Not more brown-white spots fruit than 9.0% | than 2% with sweet, sour and whv why astringent taste. Seed is sour and ~[Notmore | Not more has characteristic than 11.0% | than 2% fermented odour. wiv ‘Aerial | Its yellowish green- Not more | Not more white with bitter taste. than 9.0% | than2% wi, wiv Crude drug comprises Notmore | Not more of yellowish-orange than 15.0% | than2% white fruit, wiv, wiw Tt comprises of black ‘Not more | Not more fruit with strong aroma. than 13 % than 2% wiv wiw Tt comprises of crystal Not ‘Not more white sugar of irregular applicable | than 2% shape and sweet taste. wiv Methods of Preparation 1. Dispense ingredients as prescribed in the formula N . Grind them together into a fine powder Mix powder to obtain a uniform content Prepare seed nucleus and do sizing for uniform nucleus Add bulk powder to nucleus to produce 500 mg pills aa ee Dry the pills in the room temperature and shuffle it from time to time for uni- NITM, Thimphu 3form drying and to prevent it from fungal growth 7. Pack the pills in 500g pack size in PET container with airtight screw caps 8. The pills should be stored in a cool and dry place and avoid exposure to direct sunlight Dosage form Pill Dose and mode of administration Three pills at a time Chew /crush slightly before swallowing with hot water either in the morning or evening Indications and uses Gast , vomiting, pain in abdomen, belching/flatulence, stomach ache, and colic pain Precautions and safety aspects None 4 WHE, ThorBHUTAN Monographs on the Use of Traditional Medicine in PHC 2, Bras-bu-3-thang for cold Cold is characterized by runny nose, sneezing, cough, throat pain, headache and rise in body temperature and it is also contagious in nature. The sweat carried through the three humors reaches the eyes, nose, ears, and mouth and this reduces the body temparture resulting in common cold. It is also caused by unhygienic food, poor habits and environ- ments, The symptoms of common cold are pain and irritation in the throat and palate, cough, watery nose, headache, bodyache, joint pain, frequent sneezing, loss of appetite and pus like sputum. Composition Bras-bu-3-thang is made from the following ingredients with standard ratio : SLNo | Name of the drug Latin name amily STD ratio 1 far Terminalia chebula Retzius | Combtetaceae | 0.1000 2 [baru Terminalia bellerica Roxb. | Combretaceae | 0.1000 3 | shyuerw Phyllanthus emblica L. | Buphorbiaceae | 0.1000 Skyu-ru fruit & crude drug NITM, Thimphu 5BHUTAN edicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient. ec aes peer Identification — LOD used Aeon It comprises of light yellow | TLC Not more | Not more fruit and tastes bitter‘and than 10.0 % | than 2 % astringent. viw wiw Fruit | Tt comprises of yellowish TLC Not more brown fruit and tastes sweet than 10.0% and astringent. It comprises of light brown- white spots fruit with sweet, sour and astringent taste, Not more than 10.0% than 2% wiw Methods of Preparation 1. Dispense ingredients as prescribed in the formula 2. Grind them together into a fine powder 3. Mix powder to obtain a uniform content 4. Pack the powder in 500g pack size in a PET Container with airtight screw cap 5. The powder should be stored in a cool dry ptace and avoid exposure to direct sunlight Dosage form Coarse powder Dose and mode of administration Twice a day Boil 1500 mg (table spoon) of powder in 300 ml water Concentrate the filtrate to 100 ml for medication in decoction form ‘Take orally in the morning and evening with lukewarm water Indications and uses Besides common cold, itis also directed for purifying blood, to reduce fever, for proper digestion and immune boosting Precautions and safety aspects None 6 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 3. rdo-rje-rab-‘joms for Conjunctivitis Conjunctivitis is an inflammation of conjunctiva leading to redness of eye due to al- lergic reactions. It can also be caused either through imbalance of heat or cold energies. The main causes of red eye are malnutrition, weak immune system, and living in grimly places, and from infected individuals. The symptoms are red and swollen eyes, irritation, pain and watery discharge, inability to see the sun light directly and it may even get worse in windy places. There will be irrita- tion with burning sensation and heavy discharge in the morning around the eyes. Composition for rdo-khrag Ya-sman-rdo-rje-rab-‘joms is made from the following ingredients with standard ratio. SLNo. pres che Latin name Family | sTp ratio 1 lore Terminalia chebula Retzius Combretaceae | 0.1000 4a oe lappa (Decne.) Sch. | Compositae 0.0500 3 | bya-rgod-spos | Delphinium once Royle | Ranunculaceae | 9.9500 4 | gu-gul Commiphora mukul Linn. Burseraceae | 9.9500 5 | ba-sha-ka Corydalis crispa Prin | Fumariaceae | 0.0500 6 | gur-gum anal tinctorius Linn. Compositae 0.0500 A-ru fruit & crude drug Ru-ta plant & dried root NITM, Thimphu 1BHUTAN Monographs on the Use of Traditional Medicine in PHC Bya-rgod-spos flower & crude drug Ba-sha-ka flower & crude drug Ls Gur-gum flower & crude drug Gu-gul crude drug 8 NITM, ThimphuQuality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: It comprises of light yellow fruit and tastes bitter and astringent. Not more than 10.0 % viw Not more: than 2% wiw flower and has a strong aroma, It is off white-ash color Not more | Not more and tastes bitter and than 13.0 than 2% acrid wiw% wiv It consists of green TLC Not more Not more leaves and hollow stem than 11.0% } than 2% twigs with purplish blue wiw wiv Itis translucent with TLC bitter taste and gives out sweet aroma when burnt. It is yellowish green- Not more than 11.0% wiv Not more Not more than 2% wiv ‘Not more white with bitter taste. than 9.0% | than 2% viw wav ‘gur-gum | Flower | It consists of orange to Not more | Not more reddish-yellow flower than 9.0% | than 2% with characteristic wiw odour. Methods of Preparation 1. Dispense ingredients as prescribed in the formula. 2. Grind them together into a fine powder. 3. Mix powder to obtain a uniform content. Add binder and blend them again and add water while mixing. 4. Dry the wet mass evenly in an oven and shuffle it from time to time to expedite drying process and to prevent it from dryness. 5. Granulate the dried mass to obtain uniform granules for compression. NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in P 6. Granules should be stored in an airtight PVC bags to prevent moisture ingression before the next process. 7. Compress the granules into 500 mg tablets. 8. Pack the tablets in 500g pack size in PET container with airtight screw caps. 9. The tablet should be stored in a cool dry place and avoid exposure to direct sunlight, Dosage form Tablet Dose and mode of administration Three tablets at a time Take orally in the morning or evening with hot water Indications and uses Besides conjunctivitis, it is indicated for sinusitis, headache, and throat pain and blood disorder Precautions and safety aspects None 10 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 4. Zhi-byed 6 pa for constipation Constipation is a health problem with difficulty in defecation. It is caused by the imbal- ance of three “humors* due to irregular dietary habits and lesser intake of fluids leading to dry intestinal tract. The symptoms of constipation are difficulty in defecation, dryness of stool, stomach ache, and flatulence, There will be pain in the lower part of the abdomen with itchiness around the anal region. Composition Zhi-byed 6 pa is made from the following ingredients with standard ratio: SiNo! | namenn the Latin name eoay STD ratio drug 1 | ma-nu Inula racemosa Hook.f | Compositae 0.2000 2 | sga-skya Cautleya sp. Zingiberaceae 0.4000 ary ites Terminal ela Combretaceae a 4 | churtsa Rheum austral Polygonaceae 0.8000 5 | cong-zhi Calcium carbonate 1.0000 6 | bul-tog Sodium bicarbonate |__ 1.2000 Ma-nu plant & dried root ‘Sga-skya plant & dried rhizome NITM, Thimphu llBHUTAN Monographs on the Use of Traditional Medicine in PHC A-ru fuit & crude drug Chu-rtsa plant & dried root Congzhi crude drug Bul-tog powder 12 NITM, ThimphuQuality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: Paes Not more: Root Itis yellowish- Not more white and aromatic than 11.0 [than 2% %viw wiw sga-skya [Rhizome [Itcomprises of | TLC Not more [Not more sliced off white than 12.0 | than 2% thizome with % wi [strong aroma. aru Fruit Itcomprises of — [TLC Not more [Not more light yellow fruit than 10.0 | than 2% and tastes bitter %viw wiw L and astringent, chu-risa Root It consists of TLC Should not | Not more yellowish brown be more | than 2% root sliced into than 12.0 | wiw small pieces and % wiw has characteristic odour. cong-zhi |Notap- [Itcomprisesof | On chew- Notap- | Not more plicable | white to brownish | ing, produces | plicable | than 2% white, brittle; frothy efferves- wiw odourless; hot & | cence astringen tast bul-tog Not ap- | A white crystalline | Should comply [Assay not Not more’ plicable | powder; odourless, | to sodium salt | less than | than 2 % changes into and bicarbon- | 99.0 % and | wav sodium carbonate | ate tests not more when heated in dry than 101.1 state or in solution. |% NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine i Methods of Preparation 1. Dispense ingredients as prescribed in the formula. 2. Grind them together into a fine powder. 3. Mix powder to obtain a uniform content. Add binder and blend them again and add water while mixing. 4. Dry the wet mass in an oven and make granules. 5. Granules should be stored in an airtight PVC bags to prevent moisture ingression before the next process. 6. Encapsulate 500 mg grabules into pre-gelatinised capsule shells. 7. Pack the capsules in 500g pack size in a PET container with airtight screw caps. 8. The capsules should be stored in a cool and dry place and avoid exposure to direct sunlight. Dosage form Capsule Dose and mode of administration Three capsules at a time Take orally in the morning or evening with lukewarm water Indications and uses It is directed for indigestion, constipation, colic pain and abdominal distension. It also helps in the removal of placenta and dead fetus. Precautions and safety aspects None 14 NITM, ThimphuBHUTAN Monographs on the Use of Traditionat Medicine in PHC 5. Rgun-brum 7 pa for cough Cough is a condition which is related to lungs and respiratory system and consists of wind, bile, phlegm, blood and body fluids. Imbalance of these elements results in cough. The balance of these elements is disrupted by taking stale and sour foods, and intake of salty foods for a long period. Living in a smoky room, smoking, chronic cold, delayed recovery from cold or incomplete cure of cold, chest, back and ribs injuries. The cough is severe especially in the mornings and evenings when caused by ‘glo-nad thang-po' with difficulty in breathing. Severe coughing is also caused by ‘g/a-nad sky- “bab” accompanied by swelling of eye lids and ankles. These coughs if not treated on time will lead to chronic cough, while common cold does not last for more than 1-2 weeks, The cough manifest with irritation and pain in the throat at an initial stage, followed by frequent cough, headache, chestpain and backpain in the middle stage. In the later stage, there will be pus like sputum and if the treatment is not done on time, it may lead to chronic lung disease. Composition Rgun-brum 7 pa is made from the following ingredients with standard ratio: SLNo. | Name of the drug Latin name Family STD ratio 1 | rgun-’brum-nag-po _ | Diospyros lotus L. Ebenaceae 0.0300 2 | ewgang Bambusa textilis Poaceae 0.0250 3. | kha-che-gur-gum Crocus sativus Linn. Iridaceae 0.0150 4 | shing-m.nar Glycyrrhiza glabra (L.) | Fabaceae 0.0180 5 | gla-sgang en “a refractum | Geraniacene 0.0230 6 |se-’bru Punica granatum VL, Punicaceae 0.0220 1 | shing-tsha Ginnamonum zeylani- | Lauraceae orto 8 kara Saccharum officinarum | Poaceae 0.0050 NITM, Thimphu 15Dre-zang flower & dried stigma Shing-mngar flower & dried root Se-bru flower & dried seed NITM, ThimphuBHUTAN Shing-tsha plant & dried bark Quality Standards Monographs on the Use of Traditional Medicine in PHC For quality control purpose, the following are the standards to evaluate the quality of each ingredient: eect ene tn man It comprises of oval ‘Not more | Not more ‘brum-nag- shaped black fruit with than 19.0 | than 2% po sweet odour and has sweet % wiw and astringent taste. cu-gang | Exudate | Irregular pieces or TLC Not Not more granules, variable in sizes. applicable | than 2% Externally greyish-blue, why greenish-yellow or grey- white, some pure white, translucent, somewhat shiny. Light, hard and brittle, breakable and strongly hygroscopic. Odourless and has sweet taste. fe Kha-che- | Stig-ma | Ts red to orange in colour | TLC Not more [Not more gur-gum with fragrant aroma and than 10.0 | than 2% sweet taste. The good % win wiw quality stigma gives intense red solution with water. NITM, Thimphu 17BHUTAN Monographs on the Use of Traditional Medicine in PHC eee Tee iy On INS erro ro rar) Root {Comprises of yellowish root pieces with sweetish bitter taste. Crude drug comprises of brownish colored shizomes with stringent taste. Test sample should be identical to that of reference sample. Seed is sour and has characteristic fermented odour. Should not ‘be more than 11.0 % Tt comprises of reddish brown bark with strong aroma. Should not be more than 10.0 % Not applicable it comprises of crystal white sugar of irregular shape and has sweet taste. Methods of Preparation Please see Annexture 3 Dosage form Capsule Dose and mode of administration Three capsules at a time and should be taken orally at midday with lukewarm water Indications and uses Besides cough, it is also directed for asthma and other lung diseases Precautions and safety aspects None 18 NITM, ThimphuBHUTAN Monographs on the Use af Traditional Medicine in PHC 6. Da-trig 9 pa for diarrhoea Diarrhoea is a general condition of defecating watery feaces with more frequently than the normal bowel movements, Diarrhoea can be of many types depending on its causes. It has yellowish, red, brown and dark feaces. The main cause of the diarrhoea is indigestion problem caused by distruption in the three digestive systems. Diarrhoea can affect small and large intestines showing the symptoms such as movement of bowel when the body becomes cold. If the indigestion is the cause of the diarrhoea, there will be sudden bowel movement without showing any other symp- toms. If the diarrhoea is caused due to an inflammation of liver, the stool will be dark red in colour. Diarrheoa is also caused by unhygenic foods and indigestion. The symptom of diarthoea duc to bile disorder are yellowish red feaces with foul smell, while diarthoea due to phlegm disorder will produce mucous type of feaces mostly white in colour and there will also be gas accumulation in the stomach. In case of diartheoa from wind disorder, there will be stomach swelling and flatulance. Composition Da-tri g 9 pa is made from the following ingredients with standard ratio: SuNo. | Name of the Latin name Family STD ratio rug 1 | da-trig Rhus chinensis Miller Anacardiaceae | 9.1000 2 | se-’bru Punica granatum L. Punicaceae 0.0500 3 | sga-skya Zingiber officinale Roscoe. | Zingiberaceae | 9.9590 4 | pi-pi-ling Piper pedicellatum C.DC. _ | Piperacaea 0.0500 3 |ka-bea Luffa aegyptiaca Miller | Cureubitaceae | 9.9599 6 | shing-tsha Cinnamomum zeylanicum — | Lauracaea 0.0500 ees, 7 | tha-ram Plantago depressa Willde- | Plamaginaceae |) <1 now 8 | mon-cha.ra | Quercus griffithii Miquel _| Fagaceae 0.0500 9 | na-ram Plantago sp. Plantaginaceae | 9.9500 10 | bur-d.kar Saccharum officinarum Poaceae 0.0050 NITM, Thimphu 1920 Ka-bed flower & dried seed Shing-tsha plant & dried bark NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Tha-ram leaves & crude drug Mon-cha-ra leaves & fruit Bul-kar plant & crude drug NITM, Thimphu 21BHUTAN Monographs on the Use of Traditional Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient. peer Frere Fruit It comprises of reddish Not more | Not more brown fruits of roundish than 6.0 % { than 2% shape; sour taste; has wiw wiw characteristic odour. se- ‘bru Seed Seed is sour and has TLC Should not | Not more characteristic fermented be more | than 2% odour. than 11.0 | wiw 4 % 4. sga-skya | Rhizome | It comprises of sliced TLC Not more | Not more off white rhizome with than 12.0 | than 2% strong aroma. % wiw 4_ Fruit Tt comprises of black TLC Not more | Not more fruit with strong aroma, than 13% | than 2% win wiw ka-bed Seed It comprises of whitish | TLC Not Not more brown seeds with available | than 2% characteristic odour. _4 wiw ‘shing-tsha | Root It comprises of reddish [TLC Not more | Not more bark brown bark with strong than 10.0 | than 2% aroma % wiw tha-ram | Whole Drug comprises of whole | TLC Not more | Not more plant plant with fruits and than 11.0} than 2% leaves. It is greenish in % wiw colour, mon-cha. |Fruit|NA NA | ra [ na-ram Whole | NA NA plant (oul | Crystal | It comprises of crystal | TLC ‘Not ‘Not more kar) sugar | white sugar of irregular applicable | than 2% shape and has sweet win taste. 22 NITM, ThimphuBHUTAN Monographs an the Use al iLional Medicine in PU Methods of Preparation Please see Annexure 3 Dosage form Capsule Dose and mode of administration Three capsules at a time Take orally in the morning and evening with hot water Indications and uses Diarrhoea, flatulence, bloating and belching Precautions and safety aspects None NITM, Thimphu 23UHUIAN reatage sph cer thse 7. Man-ngag-gam-phye-d.mar-po for dysentry Dysentry is a disease which is caused by inflammation of liver and bile and bacterial infection in the small intestine which leads to discharge of red mucous faeces accompanied by pain. Dysentry is usually caused by intake of uncooked food, rotten meat, sour alcohol, fruits which are not ripened and from other communicable carrier like flies. The symptom includes headache, joint pain, fever and severe abdominal pain with fre- quent urge for defecation, Composition «of Faditional Medicine in PHC Man-ngag-gan-phye-d.mar-po is made from the following ingredients with standard ratio : ‘Name of the Fa STD SLNo. arug Latin name ratio 1 | brisod-tshigs | Rubia cordifolia auct. Non.L. _ | Valerianaceae | 9.3999 2 | zhum.khan Symplocos sumuntia D.Don. Symplocaceae | 9.2000 -nga- ‘bre R r 3 | bangenga-bre- | a conitum laciniatum (Brucht) | "°° | 9 1 g99 tsel-ma 4 | bya-rgod-spas | Delphinium brunonianum Royie | Ranunculaceae | 9,0500 3 | guegul Commiphora mukul Linn, Burseraceae 19.9500 6 | shu-dag-nag-po | Acorus calamus L. Acoraceae 0.0500 7 ‘| shug-tsher Juniperus squamata D.Don. — | Cupressaceae / 9.9500 8 | Bhos Laccifer lacca 0.0500 9 brag zhu Khan Mineral Pith 0.0500 tra 24 NITM, Thimphubrisod-tshigs flower & dried stem Bong-nga-'bre-isel-ma flower & root Bya-rgod-spos flower & crude drug Shu-dag-nag-po leaves & dried rhizome Shug-tsher leaves & crude drug Le sg Tshos crude drug rag-zhun crude drug NITM, Thimph yBHUTAN Monographs on the Use of Traditional Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: [perecren meats It comprises of brownish red stem with characteristic odour. It comprises of brownish yellow leaves with smooth surface. It has darkish brown tuber with strong odour zhu-m.khan | leaves basan-dug | Tuber spos Plant ‘Not more than 11.0 } than 2% wiv Not more than 2% wiw Not more than 12.0} than 2% % wiw wiw girgul [Resin ‘shurdag- | Rhizome nag-po Not more: TLC Not more 0. wiw TLC Not more wiw LC ‘Not more wiw It consists of green leaves and hollow stem twigs and has a strong aroma. translucent c jitter taste and has sweet Cc St consists of brown LC thizome with a strong bitter taste Aerial It consists of brownish TLC green and spiny leaves than 2% with a strong aroma wiv more than | than 2% than 2% T than 2% with purplish blue flower Th Is reddish dark and has | TL characteristic odour Tl aroma and bas sweet and Tt comprises of dark solid | TLC Not more. | Not more irregular shapes and has than 12.0% | than 2 % bitter and stringent taste. 26 NITM, Thimphu.BHUTAN Monographs on the Use of fraditional Medicme in tiie eee Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration, One tablet at a time ‘Take orally in the evening with lukewarm water Indications and uses Besides dysentry, it is also directed for epidemic fever, infective fever, gout, arthritis, jumbago, kidney diseases, and for pain in the pelvic region Precautions and safety aspects Not recommended for patients suffering from heart diseases, jaundice, high and low blood pressure, weak patients, children below 10 years and elderly patients. This medi- cine contains aconitine and therefore, should be kept out of reach from children and one should strictly follow the recommended dose. You should also refrain from eating meat products and drinking alcohol and do not take this medicine concurrently with allopathic medicines. Do not drive or handle any heavy equipment. NITM, Thimphu 7 —BHUTAN Monographs on the Use of Traditional Medicine in PHC 8. Ru-rta 2 thang for earache The earache is caused due to imbalance of wind, bile, phlegm and blood. It is also casued by improper diet. The symptom of wind humor disorder includes feeling of emptiness in the ear canal, headache and partial bodyache that becomes worse in cold weather condi- tions. Disorder of bile humor causes ear inflammation, headache and yellowish discharge oozing out from ears that leads to tiny pimples. Phlegm humor disorder causes headache, pain in the lower jaw, gives rise to itchy swollen ears with saturated discharge and gradual pain. If it is a blood related problem, it will be painful and there will be heaviness in the head with impaired hearing, and the discharge color will not be distinguishable Composition Ru-rta 2 thang is made from the following ingredients with standard ratio: SI.No ae the Latin name ai STD ratio 1 | nerta Saussurea lappa (Decne) Sch. | Compositae | 0.1000 2 |aru Terminalia chebula Retzius [Combretaceae | 9.1900 3. | til-snum (oil) Sesamum indicum L. Pedaliaceae 0.2000 Ru-rta plant & dried root A-ru fruit & crude drug NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Til snum plant & dried seed Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: tif rw-rta Root Itis of white-ash_ [TLC Not more — | Not more color and has than 13.0% |than2% bitter and acrid wiw taste aru Fruit Itcomprises of | TLC Not more | Not more light yellow fruit than 10.0% | than 2% and has bitter and viw wiw astringent taste til-snum | Oil TLC Not Not more applicable | than 2% wiw Methods of Preparations 1. Dispense ingredients as prescribed in the formula Extract Ikg of crude materials with 10 litres of water under steam and filter Add sesame oil to the filtrate and concentrate until it is free from water awn Filter the medicated oil and pack it immediately in 30 ml of amber bottle with airtight aluminium screw caps 5. The drop should be stored in a cool dry place and avoid exposure to direct sun- light NITM, Thimphu 29BHUTAN Monographs on the Use of Traditional Medicine in PHC — Orroroo Dosage form Liquid drop Dose and mode of administration Daily apply two to three drops of oil into the ear cana! once Indications and uses Diseases of car especially abscess and pain Precautions and safety aspects For external use only 30 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 9. Spang-rtsi 12 for eye discharge The eye discharge is a condition caused by imbalance of wind, bile, phlegm and blood which happens due to improper diet. It is usually caused by excess of bile and blood due to intake of foods like rotten meat, garlic, onion, mutton, alcohol, sour and other spicy food. It can also spread from one person to another. The general symptoms of eye discharge are red and inflamed eyes, rashes on eyes lids, uncomfortable feeling and vague visual in bright light. If it is blood related disorder, a red rash will develop and in case of infection by germs, there will be itching sensation. If it is related to wind, there will be teary eyes accompanied by uncomfortable feeling as if there is some dust particle in it. If it is from bile, there will be some fluid discharge and if it is due to phlegm, there will be poor vision and will experience mild pain and will develop white pigmentation, Composition Spang-rtsi 12 is made from the following ingredients with standard ratio : SLNo, | Name of the Latin name Family | sp ratio drug 1 | spanerisidonbo | Perocephalus hookeri | Dipsasaesre |g 15, Diels ‘Aconitum orochnseum | Ranunculaceae 2 . 9 2 | Pomgdiar | Set 0.0130 3__[risastag-sha | Oxytropis sulphurea Leguminosae | 0.0130 Hypecoum leptocarpum | Furwariaceae 4 [parpacta Hook.f& Thomson 9.0140 ; Aconitum laciniarum Ranunculaceae 5 hadubrisitooma | oom 0.0400 6 _lewgang Bambusa textilis Poaceae 0.0100 7 [gur-gum Carthamus tinctorius Linn. | Compositae | 0.0200 8 anand ar Samuatum album Linn, | Samtalanaceae | 4.919 9_| brag-zhun Mineral Pith 0.0120 10 | Byanrgod-spos Delphinium brunonianum | Ranunculaceae 0.0120 Royle Ul gugul Commiphora mukul Linn, | Burseraceae 0.8120 NITM, Thimphu 31BHUTAN Monographs on the Use of Traditional Medicine in PHC Spang-risi-do-bo plant & crude drug Bong-kar flower & crude drug Gur-gum flower & crude drug Bisan-dan-kar-po leaf & dried wood 32 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Bya-rgod-spos flower & crude drug Cu-gang plant & crude drug stag-sha crude drug Gu-gul crude drug drag-shun crude drug ig 8 ig Ig Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: re ntg spang-risi- | Whole Crude drug leaves are | TLC Not more | Not more do-bo plant fragile and greenish than 10.0 | than 2% in color with white % wiw hairy flower. Stem is lindrical with hollow pith hong-d.kar | Aerial part | It is light green to TLC Not more | Not more whitish stalks, with than 9.0% | than 2% whitish flowers and wiw has bitter taste. NITM, Thimphu 33BHUTAN Monographs on the Use of Traditional Medicine in P| Oo Pesan Une eee) ATIC risa-stag- Its irregular in shape Not more sha with lots of root than 2% branches and has white wiw and brown color parpa-ta | Aerial part | [tis greenish-light Not more | Not more green and has bitter than 11.0 | than 2% {se _{% wiv b.dud-risi- [Tender — | tis whitish green and [TLC Not more | Not more lo-ma leaves almost odour less than 12.0 | than 2% _|% wi Exudates Irregular pieces or | Chemical test | Not Not more granules, variable applicable | than 2% in sizes. Externally wiv grayish-blue, gteenish- yellow or grey-white, Some pure white, translucent, somewhat shiny. Light, hard and brittle, breakable and strongly hygroscopic. Odourless and has sweet taste, gur-gum — [Flower | It consists of orange to | TLC Not more | Not more reddish-yellow flower than 9.0 % | than 2% with characteristic ww odour. wsan-dan-d, [Stem Itcomprises of light [TLC Not more’ | Not more kar-po without —_| brown -off white stem than 10.0 | than 2% bark and tastes acrid and % astringent with strong, pleasant aroma. ml brag-zhin [Mineral | St comprises of dark — | TLC. Not more [Not more pith solid in irregular than 12.0% | than 2% shapes and has bitter wiw and stringent taste -— —| bya-rgod- | Whole It consists of green TLC Not more | Not more spos Plant leaves and hollow stem than 11.0 | than 2% ‘twigs with purplish Ywiw | wiw blue flower and has a strong aroma, ‘gu-gul Resin Ttis translucent with [TLC Not more | Not more bitter taste and has than 11.0} than 2% a sweet aroma when Yowiw | whw burnt. i____] 34 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration One tablet at a time taken orally in the evening with lukewarm water Indications and uses Besides eye discharge, it is also directed for fever, inflammation and epidemic fever Precautions and safety aspects Not recommended for patients suffering from heart diseases, jaundice, high and low blood pressure, weak patients, children below 10 years and elderly patients. This medicine con- tains aconitine and therefore, should be kept out of reach from children and should strictly follow the recommended dose. You should also refrain from eating meat products and drinking alcohol and do not take this medicine concurrently with allopathic medicines. Do not drive or handle any heavy equipment. NITM, Thimphu 35BHUTAN Monographs on the Use of Traditional Medicine in PHC 10. Norbu 7 thang (decoction) for fever Fever is a disease where heat is combined with phlegm and wind humors. This is a condition when phlegm dominates over heat suppressing the heat and causing the wind to spread heat throughout the body which leads to a rise in body temperature. To expediate the treatment of fever, cold nature medication is provided at the initial stage of heat. erratic dream at pulse rate, urine Signs and symptoms includes headache, high fever, is sensitive to pai night, drop in body temperature, tongue appears whitish, taut and rapi appears yellow-reddish color with high concentration. Composition Norbu 7 thang is made from the following ingredients with standard ratio: Name of the ideas Family sTD drug ratio 1 jarw Terminalia chebula Retzius. | Combretaceae 0.3000 2 | baru Terminalia bellerica Roxb. | Combretaceae 0.3000 3 | skyu-ru Phyllanthus emblica Linn, _ | Euphorbiacaea 0.3000 4 | ma-nu Inula racemosa Hook.f Compositae 0.3000 5 |sle-tres Tinospora cordifolia Hook _| Menispermaceae 0.3000 6 | kan-drarka-ri_ | Rubus biflorus Smith Rosaceae 0.6000 7 | sga-skya Cautleya sp. Zingiberaceae 0.1000 A-ru fruit & crude drug Ba-ru fruit & crude drug 36 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Skyu-ru fruit & crude drug Ma-nu plant and dried root Sga-skya plant & dried rhizome NITM, Thimphu 37BHUTAN Monographs on the Use of Traditional Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: SeOrarly AVA CCMA te Meee Cm Cn Utes CU an RD It comprises of fight yellow fruit and has bitter and astringent taste Tt comprises of yellowish brown fruit and has sweet and astringent taste. It comprises of light brown-white spots fruit with sweet, sour and astringent taste. Thin Layer [Not more Chromatogra | than 10.0% | than 2% viw whw phy _| Ferric chloride [Not more | Not more test-positive | than 10.0% J than 2% ba-ru ‘Fruit Not more than 10.0% ma-nu Root It is yellowish- TLC Not more ‘Not more white and is than 11.0% |than2% aromatic. AW why sle-tres | Stem Tecomprises of | TLC Notmore | Not more ashy stem and than 10.0% | than 2% has sweet, bitter, wiw astringent taste and is acrid in nature. TLC Not more ‘Not more than 12.0% | than 2% wiv wiw kari greenish brown stem, It comprises of Not more | Not more sliced off white than 12.0% | than 2% rhizome with strong aroma. wie 38 NITM, ThimphuBHUTAN oF Psaditional Medicine in PHC Methods of Preparation 1. Dispense ingredients as prescribed in the formula Grind them together into a coarse powder Mix powder to obtain a uniform content Pack the powder in 500g pack size in a PET Container with airtight screw cap yYrPen The powder should be stored in a cool and dry place and avoid exposure to direct sunlight Dosage form Coarse powder Dose and mode of administration Boil 1500 mg (table spoon) of powder in 300 ml water Concentrate the filtrate to 100 ml for medication in decoction form Take orally in the morning and evening with lukewarm water Indications and uses Besides fever, it is also used for all diseases of “khrag” and “riung”. Precautions and safety aspects None NITM, Thimphu 39BHUTAN Monographs on the Use of Traditional Medicine in PHC 11. Zab-la 8 pa for dermatosis (fungal) This disease is caused by imbalance of non pathogenic bacteria and body fluid resulting in itchy patches in the skin, The white pigmentation which is developed gets shaded and fi- nally releases the body fluid thereby causing sever pain in that particular part of the body. The disease is usually caused by improper diet and more consumption of sweets and diary products which leads to imbalance of wind, bile and phlegm. The symptoms are formation of white pigmentation, itching sensation, rough greenish skin, falling of skin hair, and swelling surrounded by reddish-brown inflammation. Composition Zab-la 8 pa is made from the following ingredients with standard ratio: SI.No.| Name of the drug Latin name Family STD ratio 1 |churtsa Rhuem australe Polygonaceae | 0.2000 2 mi Ser-po Sulphur trioxide Z 0.1000 3. | sngo-stag-sha Oxytropis sulphurea | Leguminosae —_} 0,1000 feronica cephaloides __ | Scrophulariaceae Bie ican ge dorenreeari | Cen milo e 0.1000 Pennell = ; Daphne Ranunculaceae © up teeerennane brunonianum Royle weal 6 | stod-ja Acacia catechu Leguminosae | 0.1000 7 | big-pan Copper sulphate 0.1000 8 | brag-zhun Mineral Pith 0.1000 Chu-risa plant & dried root Dum-nag-dom-khris plant & crude drug 40 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Bya-rgod-spos flower & crude drug Tod-ja tree & wood extract Sngo-stag-sha root drug Big-pan crude drug —_—_-Brag-zhun crude drug ser-po crude drug NITM, Thimphu 41BHUTAN Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: rset Pree) It consists of TLC Not more | Not more yellowish brown than 12.0% } than 2% Toot sliced into wiw small pieces and has characteristic odour. Tt comprises of Melts easily Not more | po greenish yellow | on burning than 2% irregular masses, _| and produces a whw the texture is light J blue flame and and fragile, easily {irritant odor of broken and fractured | sulphur dioxide. often showing needle crystals, Foul odour. sngo-stag- | Whole plant | It is irregular in TLC ‘Not more | sha shape with lots of than 2% root branches and is, wiw white and brown in colour. Ttisa blue flower Should not | Not more with bitter taste. be more | than 2% wiw Whole Plant | It consists of green Not more | Not more leaves and hollow than 11.0 than 2% stem twigs with ‘win | wiw purplish blue flower and has a strong aroma. L Dark red extract of =| TLC Not more | Not more Extract irregular shapes. than 10.0. | than 2% | % wiw Not Crude drug has Chemical test [NA Not more applicable _| irregular crystal than 2% masses wit wi characteristic odour. It comprises of dark ‘Not more solid irregular shapes than 12.0% | than 2 % and tastes bitter and wiw stringent, brag-zhun | Mineral pith 2 NITM, ThimphuBHUTAN Methods of Preparation 1. . Grind them together into a fine powder a v7rnawn Dispense ingredients as prescribed in the formula . Mix powder to obtain a uniform content . Melt 2 kg Vaseline and add I kg of powder and stir to obtain homogeneity . Pack immediately into a 20 gram container before solidification airtight aluminum screw cap to direct sunlight Dosage form Ointment Dose and mode of administration Apply to the affected areas three times a day depending on the severity of the wound Indications and uses Besides dermatosis it is also directed for other skin diseases, scabies Precautions and safety aspects For external use only Monographs on the ise ol Traditional Medicine in PAs . Filter the medicated oil and pack immediately into a 30 ml amber bottle with a . The ointment should be stored in a cool and dry place and should avoid exposure NITM, Thimphu 43BHUTAN Monographs an the Use of traditional a wall 12. Tig-ta 8 pa for headache Headache is a condition caused by imbalance in rlung, m.khrispa, bae-kan, blood, high fever, sinusitis, consuming alcohol, continuous talking and crying, excessive intake of stale food, edible oil, meat soup, improper diet, being workaholic and staying in the sun or by the fire side for a long duration, continuous sleepless nights and windy environments. Signs and symtoms of headache are dependant on their causes. It includes the pain in the head and eyes, heaviness in head and bitter taste in the mouth, toothache and pais in the cheekbones, pain in the jaws, feeling tasteless, vomiting, swollen eyes, loss of appetite, giddiness, severe pain in the head in an empty stomach, feeling sad, sudden attack caused by a change in dietary habits which last for a while. ‘Composition Tig-ta 8 pa is made from the following ingredients with standard ratio : SLNo. neo the Latin name Family | stp ratio 1 | tigeta Halenia elliptica D.Don Gentianaceae | 9.1000 2 | bong-d.kar Aconitum orochryseum Stapf. Ranunculaceae (9.9500 3 [rtsa-mkhris | Not identified 0.0500 ‘Compositae 4 lente Sausrea lappa (Decne.) Sch. 0.0500 Neopicrorhiza scrophulariifolia _{ Scrophulariaceae 5 | hong-len (Powell Hong 0.0500 Hypecoum leptocarpum Hook.f & | Fumariaceae 6 | par-pa-ta Troon 0.0500 7 | skyer-shun Berberis aristata DC Berberidaceae 9.9509 Curcubitaceae HerPETospermum pedunculosum 8 | g.ser-me (Seringe) Baillon 0.0500 9 | ka-ra Saccharum officinarum Poaceae 0.0050 44 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Tig-ta plant & crude drug Bong-kar flower & crude drug Par-pa-ta leaves & crude drug Skyer-shun plant & dried bark NITM, Thimphu 45BHUTAN Monographs on the Use of Traditional Medicine in PHC Gser-me flower & dried seed Ka-ra plant & crude drug Rtsa-m.khris crude drug 46 NITM, ThimphuBHUTAN Monographs en the Use of Hraditional Medicine in PIC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: is Lac eran ption It has greenish POSS ictGe Rerey ‘Not more sugar crystal white sugar of irregular shapes and has sweet taste. Not applicable Part white stem and than 11.0% than 2% Jeaves with whitish wiv flower. hong-d.kar | Aerial | Ithas light green to Not more | Not more part whitish stalks, with than9.0% | than 2% whitish flowers and whw has a bitter taste. rsam Whole — {Crude drug TLC Not more — | Not more Khris Plant comprises of than 12.0 | than 2% brownish green Yowiwe wiw colour with bitter taste. nierta Root Itis off white-ash = {TLC ‘Not more Not more color and tastes than 13.0 than 2% bitter and acrid wiw% wiv, Itis of earth color Not more | Not more with bitter taste than 8.0% — | than 2% why parpa-ta |Whole [Its greenish-light [TLC Not more | Not more plant green and has bitter than 11.0% | than 2% taste why skyer-shun | Stem bark [It is yellowish and {TLC Not more — | Not more has bitter taste than 10.0% | than 2% L viw wiw gser-me | Seed It consists of light | TLC Not more Not more black colored seeds than 12.0% | than 2% with very bitter wiw tast than 2% NITM, Thimphu 47BAIUTAN cate Hse of Traditional Me eon PHL Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration Three tablets at a time Take orally at midday with lukewarm water Indications and uses Besides headache, it is directed for bilious fever, jaundice and severe inflammati Precautions and safety aspects None. 48 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 13. Se-bru 4 pa for indigestion Indigestion is an unhealthy condition due to imbalance of three digestive fires namely wind, bile, and phlegm. It is mainly caused by over eating of unfamiliar and raw foods with irregular meal timing. Lack of physical activity and hypothermia are other factors attributing to digestive problem. The sign and symptoms are stomach ache, loss of appetite, bloating chest, nausea and vomiting, diarrhoea, yellowish red urine with food odour, and flatulence Composition Se-bru 4 pa is made from the following ingredients with standard ratio. ISLNa!!| Namaot the Latin name . Family | gp ratio drug E i 1 | se-bru Punica granatum L, Punicacese 0.4000 2 | shing-tsha | Cinnamomum zeylanicum Nees, _ | Lauraceae 0.2000 3 | sug-smel Elettaria cardamomum Malton. | Zingiberaceae | 9.2000 4 | pi-pi-ling Piper pedicellatum C. DC. Piperaceae 0.2000 Se-bru flower & dried Shing-tsha plant & dried bark NITM, Thimphu 49BHUTAN Monographs on the Use of Traditional Medicine in PHC Sug-smel plant & dried fruit Quality Standards Pi-pi-ling plant & dried fruit For quality control purpose, the following are the standards to evaluate the quality of each ingredient. se-‘bru Seed is sour and has Should not — | Not more characteristic fermented be more than | than 2% odour 11.0% wiw pipeling [Fruit [It comprises of black — | TLC Not more | Not more fruit with strong aroma, than 13% | than2% wiw wiw sug-smel | Fruit. | Crude drug comprises | TLC Not more | Not more of yellowish-orange than 15.0% | than2% white fruit wiw wiw shing-tsha | Root It comprises of reddish | TLC Not more Not more bark — | brown bark with a than 10.0% | than 2% strong aroma. wiw 50 NITM, ThimphuBHUTAN Monographs on the Use of fraditional Medicine in PHC Methods of Preparation Please see Annexure } Dosage form Pill Dose and mode of administration Three pills at a time Take orally in the morning and evening with hot water Indications and uses Besides indigestion, it is directed for cardiac pain, pain in kidney and lumbar region, nausea and loss of appetite Precautions and safety aspects ‘None NITM, Thimphu 51BHUTAN Monographs on the Use of Traditional Medicine in PHC 14. Gya-ki 7-pa for jaundice There will be increase in the amount of bile secretion due to injury, disorder and contagious diseases or due to the effect of the diet and physical habits. As a result of this, the bile overflows in the vessels causing the skin and the eyes to become yellow. This condition is equivalent to jaundice in biomedical terms. The symptoms include yellow colouration of eyes and nails, sweating from the whole body, feeling weak with burning sensation in the stomach and pain in the eye socket. There will be loss of appetite, yearning for thirst and nausea feeling, and without any reason the eye lid will tum into bluish red colour, Composition Gyerki 7-pa is made from the following ingredients with standard ratio: SLNo, | Name of Latin name fate STD ratio the drug 1 | gya-ky-ma | Clnysosplenium forrestii Diels | Saxifragaceae 0.0800 2 aru Terminalia chebula Retzius Combretaceae 0.0400 3 | ba-le-ka —_| Aristolochia griffithii Duchartre | Aristolochiaceae 0.0400 4 | reya-tshva_| Sallucidum 0.0400 5 | gur-gum Carthamus tinctorius Linn. Asteraceae 0.0400 6 | pi-pi-ling | Piper pedicellatum C.DC. Piperaceae 0.0400 HarPiiawmermum pedunculo- 4 |\esctune 7 | gser-me . 0.0400 sum (Seringe) Baillon Gya-kyi-ma plant & crude drug A-ru fruit & crude drug 52 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Ba-le-ka flower & crude drug Gur-gum flower & crude drug Pi-pi-ling plant & dried fruit gSer-me flower and dried seed Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: g.yaa-k Whole plant | It is yellowish and TLC Should not | Not more ma has bitter taste be more than 2 % than 8.0% | w/w wiw aru Fruit It comprises of light. [ TLC Notmore | Not more yellow fruit and has than 10.0% | than 2% bitter and astringent viw wiv taste NITM, Thimphu 53BHUTAN Monographs on the Use of Traditional Medicine in PHC Perrin Not more { Not more than 9.0% | than2% wiv Not more than 2% wiv Not more than 2% It consists of orange Not more to reddish-yellow r than 2% flower with charac- wiv teristic odour Tt consists of light | TLC Not more | Not more black colored seeds % | than 2% ith very bitter taste Methods of Preparation Please see Annexure 3 Dosage form Capsule Dose and mode of administration Four capsules at a time Take orally at midday with lukewarm water Indications and uses Jaundice and all bilious disorders Precautions and safety aspects None 34 NITM, ThimphuBHUTAN Monographs on the Use of Tr 15. Sen-ldeng 23 for joint pain Joint pain is a condition caused by chuser shat stays particularly in between the outer skin and the flesh and between the joints. There are two types of chuser. White chuser which combines with bae-r/ung and it is cold in nature, and the black chuser combines with Khrag-m.khris which is hot in nature. These chusers causes joint pain which is equivalent to arthritis in biomedical term. If the joint pain is due to white chuser, the patients's condition gets worse when the body becomes cold. The condition improves when the body is kept warm and also by taking - light and nutritious diet. Both pulse reading and urine analysis show the sign of phlep disorder. On other hand, if it is due to black ciuser, the patients‘s condition gets worse when the body becomes too warm by staying either under the sun and near the fire or after the consumption of alchohol, particularly in the autumn season. Both the pulse reading and the urine analysis will show the sign of bile disorder. So, when this disorder gets into the ones, frequent pain in the joints wil! be experienced with difficulty in the movement of hands and legs while sitting or walking, The joints will be swollen causing itchiness and spots. Composition Sen-ldeng 23 is made from the following ingredients with standard ratio: SLNo, | Name of the Latin name Family sTD drug ratio I sena-ldeng:Khan- Morus macroura Miquel | Moraceae 0.0500 2 [aru Terminalia chebula Retzius |Combretaceae _| 0.0070 3 | gurgum Carthamus tinctorius Linn, | Composiate 0.0070 4 | cwgang Bambusa textilis Poaceae 0.0070 5 baru Terminalia bellerica Roxb. [Combretaceae | 0.0070 6 | somene Phyllanchus emblica L. _| Euphorbiaceae __| 0.0100 7__ | skver-shun Berberies aristataDC. | Berberidaceae | 0.0100 8 sanedaned mar. Pterocarpus santatinus Lf, | #accae 0.0100 9 | basharka Corydalis crispa Prain | Fumariaceae 0.0100 | Aristolochia griffithii Aristolochiaceae 10 | bale-kar Duchene 0.0100 NITM, Thimphu 35BHUTAN Monographs on the Use of Traditional Medicine in PHC SLNo. | Name of the Latin name Family STD drug ratio il -d.kar-po ‘Cuminum cyminum L. Umbelliferae 0.0050 Ee ra-nag-po Cuminum cyminum Le Umbelliferae 0.0050 13 | spos-dkar Canarium strictum Roxb. _ | Burseraceae 0.0100 14 | thal-rdor Cassia tora L Leguminosae 0.0100 15 |so-ma-ra-dza’ | Abelmochus manihot (L.) _| Malvaceae 0.0100 16 gu-gul Commiphora mukul Linn. | Burseraceae 0.0050 Giles ee brunonianum |Ranunculaceae | 9 yg5q Neopicrorhiza scrophulari- | Scrophulariaceae | 1 y7yq ee ifolia (Pennell) Hong 19 | hitlehe-dkar-po | Gentiana robusta Hook.f. [Gentianaceae | 0.0300 20 _ | tsan-dan-d.kar-po | Santalum album Linn. Santalaceae 0.0060 Lepisorus contortus Polypodaceae 2 Sig 21 |brag-spospa | (Christ Ching i 0.0200 Ba-ru fruit & crude drug 56 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medic Ba-le-ka flower & crude drug Spos-dkar tree & dried resin NITM, Thimphu 5UTAN Monographs on the Use of Traditional Medicine in PHC Thel-dor flower & dried seed So-ma-ra-za plant & dried seed Bya-rgod-spos flower & crude drug Hong-len leaves & dried root Kyi-che-kar-po flower & crude drug Bisan-dan-kar-po leaf & dried wood Gu-gul crude drug 58 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC nag-po seed Brag-sops-pa leaves & crude drug Zi-ra-kar-po seed Zi: Cu-gang plant & crude drug Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: seng-ldeng- | stem It comprises of red- anne Not more khan-dra dish dark extract with than 35% characteristic odour and wiw astringent taste aru Fruit It comprises of light TLC Not more | Not more yellow fruit and has bit- than 10.0. | than 2% ter and astringent taste % viw wiw NITM, Thimphu 59BHUTAN Monographs on the Use of Traditional Medicine in PHC een mec gur-gum -|Flower | It consists of orange to Not more | Not more reddish-yellow flower than 9.0% | than 2% with characteristic wiw odour skyer-shun [Stem | Its isyellowish and thas [TLC Not more | Not more bark bitter taste than 10.0 j than2 % vw _[whw cu-gang | Exudates | Irregular pieces or gran- [ TLC Not ap- | Not more ules, variable in sizes. plicable | than 2% Externally grayish- wiw blue, greenish-yellow or grey-white, some pure white, translu- cent, somewhat shiny. Light, hard and brittle, breakable and strongly hygroscopic. Odourless and is sweet, ba-ru Fruit | It comprises of yellow- | Ferric chloride | Not more _| Not more | ish brown fruit and has | test-Positive | than 10,0 | than 2% sweet and astringent % why taste skyw-ru [Fruit [Itcomprises of light | TLC Not more | Not more brown-white spots fruit than 10.0. | than 2% with sweet, sour and % wiv astringent taste san-dmar |Stem |Itis redin colour and | TLC Not more | Not more has astringent taste than 10.0 | than 2% witha pleasant aroma_| %viw _|wiw ba-sha-ka [Leaves [Is yellowish green- | TLC Not more | Not more white with bitter taste than 9.0% | than 2% viw wiw Stem It comprise of brown TLC stem which has been cut into small pieces. Not more | Not more than 9.0% | than 2% whw ze-rad. [Fruit | It comprises of brown- Not more kar-po ish seed with strong than 2% aroma wiv 60 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Pie i jentification ze-ra-nag- It comprises of black TLE Not more | Not more po seed with slightly than 10.0 | than 2% aromatic wiw% wiv, spos-dkar [Resin] It comprises of brown- [TLC Not more [Not more ish resin with aromatic than 4.0 | than 2% odour and astringent wi ww taste. thal-rdor [Seed | It comprises of darkish [TLC Notavail- [Not more brown oblong seeds; able than 2% tastes bitter; with char- wiw [acteristic odour ‘so-ma-ra- | Seed It comprises of blackish ) TLC Not more | Not more ka brown seed of similar than 10,0} than 2% shape to kidney % wiw gu-gul [Resin |Itistranslucent with [TLC Not more | Not more bitter taste and has a than 11.0 | than 2% sweet aroma when burt %wiw wiv hong-ten [Root | Has earth colour with a [TLC Not more | Not more bitter taste than 8.0% } than 2 % |’ wi wiv ‘bya-rgod- [Whole | It consists of green TLC Not more | Not more spos Plant —_| leaves and hollow stem than 11.0 | than 2% twigs with purplish blue %wiw | win flower and has a strong aroma Iyi-lehe-d. | Flower _ | itis yellowish white-off | TLC Not more | Not more kar-po white and tastes ex- than 10.0. | than 2% tremely bitter Yoviw | wiw tsan-dkar [Stem | It comprises of light Not more brown -off white stem than 10.0 | than 2% and tastes acrid and % win wiw astringent with strong, pleasant aroma ‘brag-spos- | Leaves | It consists of green | TLC Not more [a more pa leaves with yellow spots than 11.0 | than 2% underneath leaves %owiw | wiw NITM, Thimphu 61BHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration Three tablets at a time Take orally in the morning or evening with lukewarm water Indications and uses Gout and arthritis. It is also indicated for kidney related diseases Precautions and safety aspects None 62 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 16. Skyer-shun 8 pa for leukorrhoea Leukorthea is a disease relating to vaginal discharge caused by imbalance of three humors (wind, bile and phlegm) and bacterial infection. It is more common during pregnancy and among reproductive age group due to improper diet. The symptoms include itchiness in and around vagina with some sensational feeling of foreign body movement, occasional needle prick like pain and restlessness. Thick sticky white, yellow, or green discharge may occur. It will be accompanied by pain during urina- tion and it might produce tiny red rashes around the vaginal areas. Composition Skyer-shun 8 pa is made from the following ingredients with standard ratio: SLNo. | Name of the drug Latin name Fam bared a ratio 1 | skyer-shun Berberis aristata DC. Berberidaceae —_| 0.2000 2 | picpi-ting Piper pedicellatum C. DC. Piperaceae 0.0800 3 | skyuerw Phyllanthus emblica L Euphorbiaceae | 0.0500 4 | shing-m.ngar Glycyrrhiza glabra (L.) Leguminosae 0.0800 : . Delphinium brunonianum Ranunculaceae | 5 _ | bya-rgod-spos Royle | 0.0800 ~_6 | kha-che-gur-gum _ | Crocus sativus Linn. Tridaceae {0.0500 7 | aum-nag-dom-m. | yronica cephaloides Pennell | StoPhulariaceae | 4 1599 E Khris 8 | rgya-nag-snag-rtsi_ | Chinese ink 0.1500 Skyer-shun plant & dried bark Pi-pi-ling plant & dried fruit NITM, Thimphu 63BHUTAN no 1 it Cn Hi Bya-rgod-spos flower & crude drug Dre-zang flower & crude dried stigma Dum-nag-dom-khris plant & crude drug reya-nag-snag-risi 64 NITM, ThimphuBHUTAN Monosa ails on the tise of Tradivonal Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: Sree ead Identification Reve) ets Matters: skyer-shun | Stem bark } Is yellowish and Should not Not more thas bitter taste be more than | than 2% 10.0% vw __ | wiw pi-pi-ling | Fruit It comprises of a TLC Not more: Not more black fruit with a than 13 % than 2% strong aroma. wiw wiw skyueru | Fruit It comprises of light | TLC ‘Not more Not more brown-white spots than 10.0% | than 2% fruit with sweet, wiw sour and astringent taste shing-m. Root Comprises of TLC Not more Not more ngar yellowish root than 11.0% | than 2% pieces with wiw sweetish bitter taste bya-rgod- | Whole It consists of green | TLC Not more Not more spos Plant leaves and hollow than 11.0% | than 2% stem twigs with whw wiw purplish blue flower and has a strong aroma kha-che- Stig-ma It is red to orange | TLC ‘Not more Not more gur-gum with fragrant aroma than 10.0% | than 2% anda sweet taste. wiw wiv The good quality stigma gives intense red solution with water dom-nag- | Aerial Isa blue flower TLE Should not Not more Idum-m, with a bitter taste be more than | than 2% [Khris 10.0 % w/w | wiw rgya-nag- | Not Ashiny black soot | TLC Not Not more snag-rtsi_ | applicable | with pleasant odour applicable | than 2% wiw NITM, Thimphu 65BHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration Three tablets at a time Take orally at midday with lukewarm water Indications and uses It is also directed for dysuria and obstinate urinary diseases, renal disorders, and sper- matorrhea Precautions and safety aspects None 66 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 17, A-gar 35 tablet for malaise Malaise is a condition resulting from rlung wind disturbance and is characterized by general fatigue and weakness. The human body has three humors which can be considered both as energy and physiological process and they govern physiology, psychology and physio-pathology. When these humors are in balance, the health is assured and when they are disturbed, diseases and disorders will arise. The sysmptoms of malaise includes loss of appetitie, lethargy, giddiness, insomnia and depression. Composition A-gar 35 is made from the following ingredients with standard ratio : SINo, | Name of the Latin name Family stD drug ratio Aquillaria malaccensis Thylmelaceae 1 | arnag tamarele 0.0400 2 larsha ‘Aquillaria malaccensis Thylmelaceae [5 5499 Lamarck ih , Lauraceae 3 | a-gar-go-snod iewmemun grand 0.0250 4 | tsan-d.kar Santalum album Linn. Santalanaceae [9.0350 tsan-d.mar Pterocarpus santalinus L.f | Fabaceae 0.0500 6 | dza-ti Myristica fragrans Houtt. | Myristaceae 0.0100 Syzygium aromaticum (L.) | Myrtaceae 7 | deshi eae 0.0100 cu-gang Bambusa textilis Poeaceae 0.0700 9 | gurgum Carthamus tinctorius Linn. | Compositae 0.0300 Elettaria cardamomum Zingiberacea 10 | sug-smel Malton 0.0300 1 _[karko-la Amomum subulatum Roxb. |Zingiberacea __ | 0.0300 2 [arw Terminalia chebula Retzius |Combretaceae —_](0.0350 Terminalia bellerica (Gaert- | Combretaceae 13° | bare ne Roxb. 0.0350 14 | shyerw Phyllanchus emblica Linn. | Euphorbiaceae | 9 g4sq NITM, Thimphu 67BHUTAN Monographs on the Use of Traditional Medicine in PHC Name of the Family STD SI.No. drug Latin name ratio =. | Meni 15 |ste-tres Trospora cordifolia (Will. |Menispermaceae |, jenow) 16 |sga-skya Cautleya sp. Zingiberacea 0.0150 17_|kan-dra-ka-re | Rubus biflorus Smith Rosaceae 0.0310 18 | ma-nw Inula racemosa Hook.f __| Compositae 0.0450 19 | ba-sha-ka Corydalis crispa Prain Fumariaceae 0.0250 20 | tig-ta Halenia ellipticua D.Don _|Gentianaceae | 0.0250 ‘Neopicrorhiza scrophulari- | Scrophulariaceae 21 | hong-len ole (Pennell) 0.0300 22 | gwgul Commiphora mukul Linn, | Burseraceae 0.0350 23 | spos-d.kar Canarium sirictum Roxb. _ | Burseraceae 0.0350 ini i Ranuncul 24 | byaergod-spos | DélPhiniuo brunonianum mnunculaceae | 4 4 44 Royle 25 | ko-byi-la Strychnos nox-voica Linn. | Loganiaceae 0.0350 26 _|ped-ma-ge-ser | Bombax ceiba L Malvaceae 0.0250 a7 | meta Saussurea lappa (Decne.) Compositae 0.0280 Sch. Bip. Aster diplostephioides (DC) | Asteraceae 28 | a-byag CBCluake 0.0450 ap [Bree | ma grandifora Willd Compositae 0.0450 30 | go-snod ‘Carum carvi Linn. Umbelliferae 0.0150 “deh Aconitum laciriatum Ranunculaceae 31 in-pa Bruch 0.0500 Meconopsis horridula Papaveracea 32. | tsher-sngon (Hook Thoms) 0.0450 jas axillaris | Anacardiaceae 33 |smving-cho-sha | Choerospondias axillaris 0.0350 (Roxb.) 34 | se-’bru Punica granatum L. Punicaceae 0.0200 Crassulaceae Rhodiola crenulata 35. [srovlowdmar-po | rook Thomson 9.0300 68 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PH Li-shi flower & dried flower bulb Dzo-ti fruit & crude drug NITM, Thimphu 69BHUTAN Monographs on the Use of Traditional Medicine in PHC 4-ru fruit & crude drug Ba-ru fruit & crude drug 70 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Ma-nu plant & dried root Ba-sha-ka plant & crude drug NITM, Thimphu nBHUTAN Monographs on the Use of Traditional Medicine in PHC Ko-ji-la fruit & dried seed Pe-ma-ge-ser flower & crude drug 72 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Dzin-pa flower & crude drug Ther-gon flower & crude dried NITM, Thimphu 73Monographs on the Use of Traditional Medicine in PHC Sying-sho-sha fruit & crude drug Se-bru flower & dried seed > Sro-lo-mar-po flower & dried root Gu-gul crude drug 74 NITM, ThimphuBHUTAN Monographs on the lise of fraditromal Medicis ne Pi Quality Standards er ees ar-nag wood Crud drug comprises of =| TLC NA Not more white —off white color than 2 % with characteristic odour wiw ar-skya wood Crud arug comprises of — | TLC NA Not more white -off white color than 2% with characteristic odour wiw a-gar-go- |Wood |Itcomprisesofreddish [TLC Not more | Not more snod without [brown wood with a strong than 10.0 | than 2% bark aroma, % wiw wiw b asan-d.kar | Stem It comprises of light TLC Not more | Not more without | brown -off white stem and than 10.0 | than 2% bark has acrid and astringent % wiw wiw taste with a strong pleasant aroma wsan-dmar |Stem | Itistedincolorandhas | TLC Not more | Not more without | astringent taste with a than 7.0 | than 2% barck | pleasant aroma Yowh {wiv death Seed | It is similar to betel nutin [TLC Not more [Not more shape and has acrid taste than 7.0} than 2% with a strong aroma Yowiw | wiw Ti-shi Stalk | Itisdarkish brown, is | TLC Not more | Not more aromatic with pungent than 9,0 | than 2% taste { % wiw wiw cu-gang | Exudates | Irregular pieces or Chemical test [ Not Not more granules, variable in sizes. applicable | than 2% Externally grayish-blue, wiw greenish-yellow or grey- white, some pure white, translucent, somewhat shiny. Light, hard and brittle, breakable and strongly hygroscopic. Odourless and is sweet { ‘gurgum [Flower | is consists of orange [TLC Not more | Not more to reddish-yellow flower than 8.0} than 2% with characteristic odour % wiw wiw sug-smel [Fruit | Crude drug comprises of | TLC Not more | Not more yellowish-orange white than 15.0 | than 2% fruit % wiw why Viatora Fruit |Fruitis aromatic and has | TLC Not more | Not more characteristic odour than 9.0 | than 2% [ww __|w/ NITM, Thimphu 5BHUTAN Monographs on the Use of Traditional Me-ticmme im PHC Sree LIne Fruit It comprises of light meh) Not more Not more without — | yellow fruit and tastes than 10.0 | than 2% seed bitter and astringent \% win | wi! baru |Frut | itcomprises of yellowish | TLC Not more | Not a | without | brown fruit and tastes than 10.0 | than 2% seed sweet and astringent Ywiw [wi skyu-ru Fruit It comprises of light TLE Not more | Not more without | brown-white spots fruit than 9.0 | than 2% seed with sweet, sour and %wiw wi astringent taste sle-tres Stem s of ashy stem | TLC Not more without | and tastes sweet, bitter, than 10.0 _fastringent and acrid % wiw sga-skya [Rhizome | It comprises of sliced off || TLC Not more [Not more white rhizome with strong than 12.0 | than 2% aroma % wiw kan-dra- | Stem It consists of greenish TLC Not more [Not more ka-ri brown stem than 12.0 | than 2% f Yowiw | wiw [manu [Root | Itis yellowish-white and] TLC Not more | Not more aromatic than 11.0 | than 2% % vw wiw ba-sha-ka [Aerial — | Itis yellowish green-white | TLC Not more | Not more part with bitter taste than 9.0% | than 2% wiw tig-ta Aerial | Has greenish white stem [TLC Not more [Not more Part and leaves with whitish than 11.0 | than 2% flower % wiw Trong-len [Rhizome ls earth color with biter | TLC Not more | Not more taste than 8.0% | than 2% _ {ww leeund Resin It is translucent with bitter | TLC Not more | Not more taste and has a sweet than 11.0 | than 2% {aroma when burnt {6 wiw {wi spos-d.kar | Resin It comprises of brownish | TLC Not more | Not more resin with aromatic adour than 4.0% } than 2% and astringent taste wiw bya-rgod- | Whole — [It consists of green leaves | TLC Not more [Not more pos Plant and hollow stem twigs than 11.0 } than 2% with purplish blue flower %wiw | wiw and has a strong aroma 16 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC en Pare) acres rere peeeranin Perea ko-byi-la it comprises of ashy Not more brown seed in round shape than 2% wi pad-ma- Flower It comprises of brownish | TLC Not more | Not more ge-ser red flowers. than 12.0 } than 2 % % wiw wi neria Root It is off white-ash color = | TLC Not more | Not more and is bitter and acrid in than 13.0 | than 2% taste wiw% wiw a-byag | Aerial __| It is brownish with hairy | TLC Not more | Not more Parts stem and has bitter taste than 10.0 | than 2% {| wiw% [wi gser-po- Tt consists of light Not more | Not more gzer-joms brownish yellow flower than 10.0 | than 2% wiwY wi go-snyod | Seed Dark green oily seed with [TLC Not more | Not more acrid taste and aromatic than 14.0 | than 2% odour owlw wiw b.dud-risi- | Tender Itis whitish green andis || TLC Not more | Not more fo-ma leaves almost odour less than 12.0 | than 2% % wiw isher- ‘Acrial | It consists of spiny leaves | TLC Not more | Not more sngon Part and stem with spherical than 8.0 | than 2% fruit wi ‘saying. | Fruit Tt comprises of light dark Not more | Not more zho-sha brown fruit and is sour than 9.0 | than2 % % wi se-‘bru Seed Seed is sour and has TLC Not more | Not more characteristic fermented than 11.0 | than 2% odour % wiw sro-lo-d. Root It consists of brown root | TLC Not more | Not more mar-po without _ | sliced into small pieces than 11.0 | than 2 % bark of 2-5cm in diameter Yowlwe wi with wrinkles and the thickness is around 1 em, it might vary. NITM, Thimphu 77BHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation Please see Annexure 2 Dosage form Three tablets at a time Dose and mode of administration Take orally in the evening with luke warm water Indications and uses Besides malaise, it is directed for chronic fever, dry cough, arthritis, heart diseases, sleep- lessness, epidemic fever, and generalized body ache Precautions and safety aspects This medicine contains small amount of aconitine and therefore, should be kept out of reach from children and should strictly follow the recommended dose. You should aslo refrain from eating meat products and drinking alcohol 18 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 18. Zhi-byed 11 for Painful Menstruation Painful menstruation is a common problem for women in the reproductive age group. The pain will mostly occur during or before the period of menstruation and can be dull, continuous or infrequent with a sense of heaviness in the pelvic region, This happens to those women who have not given a child birth and is caused due to anxiety, stress, ovary cyst and unhealthy womb. The symptoms are severe pain especially at the pelvic region, fecling of swelling in the chest area and swelling in the face or body, giddiness, and loss of concentration. There will be less menstrual blood and the normal menstruation cycle will be disturbed. Composition Zhi-byed 11 is made from the following ingredients with standard ratio + SLNo. ne the Latin name Family | stp ratio 1 ma-nu Inula racemosa Hook.f Compositae 0.0500 2 | sga-skva Cautleya sp. Zingiberaceae | 9.1000 3. aru Terminalia chebula Retzius. Combretaceae | 0,1000 4 | churtsa Rheum austral Polyganaceae | 42000 3 cong-zhi Caicium carbonate 0.2500, 6 bul-tog Sodium bicarbonate 0.3000 7 | star-bu Hippophae salicifolia D.Don. Elaegnaceae | 0.0700 8 rgya-tshve Aluminium ammonium sulphate 0.0300 9 | olmo-se Podophyllum hexandrum Royle | Betberidaceae | 9.9799 NITM, Thimphu 9BHUTAN Monographs on the Use of Traditional Medicine in PHC A-ru fruit & crude drug Chu-rtsa plant & dried root Ol-mo-se fruit & dried fruit Tar-bu plant Cong-zhi crude drug Bul-tog powder 80 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: ern Matters etn Rin ee Peter) ‘Not more than 2% ‘Not more than 11.0 %viw wi Not more | Not more | than 12.0 | than2% Itis yellowish-white and is aromatic sga-skya Rhizome _ | It comprises of sliced off white rhizome with a strong aroma % wiw aru Fruit It comprises of TLC Not more | Not more light yellow fruit than 10.0 | than 2% and tastes bitter and %viw | whw astringent chu-rtisa | Root It consists of yellow- | TLC Not more | Not more ish brown root sliced than than 2% into small pieces and 12.0% — | wiw has characteristic odour cong-zhi|Notap- _ | It comprises of white | On chew- Not ap- _ | Not more plicable | to brownish white, ing, produces | plicable | than 2 % brittle; odourless; frothy efferves- wiw tastes hot & astrin- | cence gent bul-iog Not ap- | Awhite crystalline | Should comply plicable powder: odourless, | to sodium salt should change into | and bicarbon- sodium carbonate ate tests when heated in dry state or in solution Assay not | Not more less than | than 2% 99.0 % wiw and not more than 101.1% star-bu fruit ‘Orange yellow round [TLC Not more | Not more fruit and is extremely than 35 | than 2% sour ow _| wiw reya-tshva Itisafine powder [NA NA NA type salt ‘ol-sei’-'bru | Seed Tt consists ofared- | TLC Not avail- | Not more dish seed able than 2% wiw NITM, Thimphu 81BHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation Please see Annexure 3 Dosage form Capsule Dose and mode of administration ‘Three capsules at a time taken orally in the morning and evening with lukewarm Water Indications and uses Besides painful menstruration, it is directed for phantom tumour and pain during and after delivery Precautions and safety aspects None 82 NITM, ThimphuBHUTAN Monographs on the Use of Tradit nial Medicine in PHC 19. Chi-med-srin-sel for parasitic infestation As per the gSo-ba-Rig-pa, there are mainly two types of parasitic infestation namely heat and cold related. There are about 21000 different types of helpful non-pathogenic microbes in our human body and when there is imbalance of cold and heat energy in the body, these microbes become pathogenic. The imbalance is mainly caused by consuming too much milk, sweets, chilled and sour foods and infested raw meat. If the infestation is related to hot disorders, the signs and symptoms include pain in the lower abdomen, severe intestinal pain, dry throat, nausea, chest and back pain. For cold related disorder, fall in the body temperature, loss of appetite, vomiting and diarshoea. Composition Chi-med-srin-sel is made from the following ingredients with standard ratio: Family Name of the sTD SLNo. nd Latin name oni Ranunculaceae Aconitum laciniatum (Bruchl) 1 |bong.nag Stapt 0.1000 2 [arn Terminalia chebula Retzius | Combretaceae | 9.5090 Compositae a | merta Sura lappa (Decne.) Sch. 0.3000 4 | shwdag-nag-po | Acorus calamus L. Acoraceae 0.2000 ; Delphinium brunonianum Ranunculaceae 5 |byargod-spos | Rote 0.1000 6 | byi-tang-ga ‘Myrsine semiserrata Wall Myrsinaceae 9.1200 NITM, Thimphu 3BHUTAN Monographs on the Use of Traditional Medicine in PHC Bong-nag flower & dried root A-ru fruit & crude drug Bya-rgod-spos flower & crude drug Byi-tang-ga plant & dried fruit 84 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PAE Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: sea Matters TLC Not more | Not more than 12,0% | than 2% w/w Not more | Not more than 10.0% ] than 2% De Sts) Pre icay as aCe) Tuber Is a darkish brown tuber with strong odour b.tsan-dug It comprises of light yellow fruit and tastes bitter and astringent viw w/w rusrta Root {tis white-ash in colour | TLC Not more | Not more and is bitter and acrid than 13,0 | than2% in taste w/w% wiw shu-dag- Rhizome | It consists of brown TL Not more] Not more nag-po rhizome with strong than 12.0 % | than 2% aroma and has sweet w/w wiw and bitter taste It consists of green TLC Not more | Not more leaves and hallow stem than 11.0 % | than 2% twigs with purplish blue w/w w/w flower and has a strong aroma Not more | Not more than 11.0% | than 2% w/w w/w It comprises of purple pinkish brown fruit and has sweet and hot taste NITM, Thimphu 85SHITAN Monupraphy out Use of 1 ne in PHC Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration One tablet at a time taken orally in the evening with hot water Indications and uses Besides intestinal parasites, it is also indicated for infections in head, teeth, skin, stomach, anus and for verminous colic pain Precautions and safety aspects Not recommended for patients suffering from high and low blood pressure, old patients, pregnant women, heart patients, patients suffering from eye diseases, weak patients, children below 10 years. One should not take this medicine concurrently with allopathic medicines. This medicine contains aconitine and therefore, should be kept out of reach from children and should striclty follow the recommended dose. You should aslo refrain from eating meat products and drinking alcohol. Do not drive or handle any heavy equipment. 86 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC 20. Byi-tang 7 pa for piles Piles is a disease caused by improper diet, poor behaviour and due to bacterial infections. The main cause of piles is due to prolonged diarrhoea or forceful defecation, riding horse and sitting on a cold surface for a long period of time. It is also due to the imbalance of wind in our body. The symptoms of piles includes swelling of blood vessels in the anus, blockage of the anus due to the appearance of big spot which is painful, itchiness and occasional bleeding after the defecation, Composition Byi-tang 7 pa is made from the following ingredients with standard ratio: Name of th Family SLNo, | Name of the Latin name STD ratio drug 1 | byi-tang-ga Myrsine semiserrata Wall, |MY¥*Sinaccae | 1499 2 | shing-kuen Ferula asa-foctida L. Umbelliferae | 9 9500 3 | ma-re-tse Butea parviftora Roxb. Leguminosae | 9 9500 ; Zingiberaceae 4 | bea'-sga Zingiber officinale Roscoe 0.0500 Ranunculaceae Delphiniuim brunonianum 5 byurgodtspos | Rone 0.0500 Piperaceae 6 | pipiting Piper pedicellatum C, DC. 0.0500 NITM, Thimphu 87BHUTAN Monographs on the Use of Traditional Medicine in PHC Byi-tang-ga plant & dried fruit Ma-ru-ise fruit & dried seed Pi-pi-ling plant & dried fruit bea'-sgathizome Shing-kuen crude drug 88 NITM, Thimphuwary aN Monographs on the Use of Traditional Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of cach ingredient; remitting eee Perera bye-tang-ga it comprises of purple Not more meanest pinkish brown fruitand than T1-0% sweet and hot taste wi Not more than 2 % why Not available Is a resinous matter with strong obnoxious odour, Ts hot and bitter ‘in taste ‘Seed ‘Crude drug has irregu- | TLC Not available lar shapes with red- dish brown color and characteristic odour shing-kuen | Resin ma-ru-ise Crude drug consists of [ TLC brownish color sliced than thizome with aromatic 9.0%whw odour 1 TLC It consists of green spas Plant leaves and hollow stem than 11.0% twigs with purplish wav hue ower and has a strong aroma pi-piling | Fruit Ttcomprises ofa black [TLC ‘Not more fruit with a strong than 13% w aroma, Methods of Preparation Please see Annexure 3 Dosage form Capsule Dose and mode of administration Three capsules at a time Take orally in the morning or evening with lukewarm water Indications and uses Piles and gastro-intestinal parasites Precautions and safety aspects None NITM, Thimphu 89BHUTAN Monographs on tne use v1 srausiunar me 21. Klu-b.dud 18 for scabies Scabies is a disease characterized by itching in any part of the body skin with white pigmentation and falling off of skin hairs. It is also one of the communicable diseases and can spread from one person to another. This disease is usually caused by poor personal hygiene, weak immune system and malnutrition. ‘The symptoms are scaly and rough bluish skin and itchiness in the body. The body might swell and will even get worse while taking bath, Composition Klu-b.dud 18 is made from the following ingredients with standard ratio : SINo. | Name of drug Latin name Family STD ratio 1 | Rlucbdud Codonopsis bhutanica Ludlow | Campanulaceae | 0.3000 2 _[sman-chen | Aconitum laciniatum (Bruehl) [Ranunculaceae | 0.6000 3._|thal-ka-rdo-rje | Cassia tora L. Leguminosae | 0.1600 4 | stong-zil Corydalis calliantha Loug _|Fumariaceae | 0.0200 5 brageteim Mineral Pith 0.0200 6 | shuedag Acorus calamus L. ‘Acoraceae 0.0400 7 bste-tes Trospora cordifolia auct. Non | Menispermaceae | 1 yoy 8 fam Terminalia chebula Retzius. | Combretaceae _} 0.0140 9 dbang-tag | DAetrlorkiza hatagirea Orchidaceae 0.0140 D.Don. 10 | bare ferminalia bellerica (Gaert- Combretaceae 0.0160 11_|spos-d.kar | Canarium strictum Roxb. _| Burseraceae 0.1400 12 | byanrgodspos | DePhinium brunonianun [Ranunculaceae [5 419 Royle 13_|so-ma-ra-dza_| Abelmoschus manihot(L.) __ | Malvaceae 0.1400 14 [ewgul Commiphora rmukaul Linn, | Burseraceae 0.1000 ssen-ldeng- ; Moraceae 15 |Onondne Morus mucroura Miquel 0.1200 16 |ba-sha-ka | Corydalis crispa Prain Fumariaceae | 0.1200 17 | skye Phyllanthus emblica Euphorbiaceae | 0.1200 18 | rurta Saussurea lappa (Decne.) Sch. | Compositae 0.1400 a NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Klu-bdud plant & crude drug Sman-chen flower & dried root Shu-dag leaves & dried thizome Sle-tres leaf & crude drug NITM, Thimphu 91BHUTAN Monographs on the Use of Traditional Medicine in PHC Ba-ru fruit & crude drug Spos-kar tree & resin Bya-rgod spos flower & crude drug So-ma-ra-za plant & dried seed 2 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Skyu-ru fruit & crude drug Ructa plant & dried root Brag-shun crude drug Gu-gul crude drug NITM, Thimphu 93BHUTAN graphs on the Use of T Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: pene cone re eccrine Pennie rer Pert Crude drug consists of ashy brown leave and fragile stem. Has charac- teristic strong odour b.tsan-dug Isa darkish brown tuber ‘Not more with a strong odour than 12.0 % | than 2% wiw thal-ka-rdo- It comprises of dark- Not avail- rie ish brown oblong seeds; able than 2% tastes bitter; with charac- wiw teristic odour Ly stong-zil Whole — | Crude drug leaves are TLC Not more | Not more plant greenish with yellow- than 0.0% } than 2% ish flower. The fracture wiw wi is short with slight aroma and theroot tastes slightly bitter brag-zhun | Mineral | It comprises of dark solid | TLC Not more | Not more pith irregular shapes and is than 12.0% | than 2% bitter and astringent in win taste shu-dag- Rhizome | It consists of brown rhi- | TLC Not more | Not more nag-po zome with strong aroma than 12.0 % | than 2 % and tastes sweet and wiw wiw bitter Stem It comprises of ashy stem Not more without } and tastes sweet, bitter, than 10.0% astringent and acrid wiw Not more than 2% i Fruit It comprises of light yel-_ | TLC ‘Not more low fruit and tastes bitter than 10.0% and astringent. viw 94 NITM, ThimphuBHUTAN Monographs on the Use of traditional Medicine in PHC ire meee Lop eee peer ay It is whitish brown in Not more | Not more colour and is sweet. than 12.0% | than 2 % win ba-ru Fruit It comprises of yellowish | TLC Not more | Not more brown fruit and has sweet than 10.0% J than 2% and astringent test. wiw spos-d kar It comprises of brownish Not more | Not more Tesin with aromatic odour than 4.0% | than 2 % and has astringent taste. wiw bya-rgod- | Whole _| It consists of green leaves | TLC Not more | Not more spos Plant and hollow stem twigs than 11.0% } than 2 % with purplish blue flower wiv why and has a strong aroma. so-ma-ra- | Seed It comprises of blackish { TLC Not more [{ Not more dea brown seed of similar than 10.0% | than 2% shape to kidney. wiw ‘guegul Resin | Itis translucent with bit-_ [TLC Not more | Not more ter taste and produces a than 11.0 % | than 2% sweet aroma when burnt wiv wi, seng-ideng- | stem It comprises of reddish TLC Not more | N/A Khan-dra dark extract with charac- han 35% teristic odour and has an wiw astringent taste LL ba-sha-ka | Aerial It is yellowish green- TLC Not more Trex more part white with bitter taste than 9.0% | than 2% wi. ‘skyuer Fruit | It comprises of light TLE Not more | Not more brown-white spots fruit than 10.0 % | tian 2% with sweet, sour and wiw astringent taste ru-rta Root [tis of white-ash colour | TLC Not more — | Not more and has bitter and acrid than 13.0 | than 2% taste wiw% wiw NITM, Thimphu 95BHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation Please see Annexure 2 Dosage form Tablet Dose and mode of administration One tablet at a time Take orally in the evening with lukewarm water Indications and uses Other than scabies, it is also directed for obstinate skin diseases including leprosy, joint pain, chronic rhinitis, oedema, gout and abscess Precautions and safety aspects Not recommended for patients suffering from heart diseases, jaundice, high and low blood pressure, weak patients, children below 10 years and elderly patients. This medicine con- tains aconitine and therefore, should be kept out of reach from children and should strictly follow the recommended dose. You should also refrain from eating meat products and drinking alcohol and do not take this medicine concurrently with allopathic medicines. Do not drive or handle any heavy equipment. 96 NITM, ThimphuBHUTAN Monographs on the Use of T 22. Gso-byed 6 pa for sexual dysfuntion Sexual dysfunction is a condition of reproductive organ that lowers the kidney temperature and inhibits the genital function for sexual intercourse. It is caused by malnutrition and staying in a cold place for a long period. Due to exposure to cold, kidney temperature falls below the normal level. This leads to loosening of the semen tract whereby sperm discharges with urine resulting in erection problem during sexual intercourse. ‘The symptoms are white discharge in urine, pain in the pelvic region, backache, fatigue, loss of appetite, and erectile dysfunction. Composition gso-byed 6 pa is made from the following ingredients with standard ratio : Family SLNo. | Name ofthe Latin name STD ratio drug Polygonaceae 1 |ramnye Polygonatum verticillatum (L) All. 0.4000 Clavicipitae 2 |dbvar-risa- | Condyceps sinensis (Berk) Sace 0.4000 dgun-bu Orchidaceae 3 | dbang-lag Dactylorhiza hatagirea D.Don 0.2000 Solanaceae 4 |tea-ba Withania somnifera Linn 0.3000 Asparagaceae 5 | nye-shing Asparagus racemosus Willdenow 0.4000 Ericaceae 6 | dvatizme-tog | Rhododendron anthopogon D.Don 0.4000 NITM, Thimphu 97BHUTAN Monographs on the Use of Traditional Medicine in PHC Ra-mnye thizome & crude drug —_-Dbyar-rtsa-dgun-bu plant & crude drug Nye-shing fruit & crude drug Dacli-me-tog plant & dried flower 98 NITM, ThimphuBHUTAN Monographs on the lise of Traditional Medicine in PHC Quality Standards Lop Ingredient — Part used fear ta) Pen Not more than 9.0 Yowiw It consists of brownish yellow rhizome with prominent nodes and longitudinal wrinkles are present in dried rhizome. It tastes sweet and has pleasant odour It is whitish brown in color and is sweet Rhizome than 2 % wiw TLC Not more ‘than 12.0 Yowiw ‘Not more than 8.0 wh Not more ‘d.bang-lag | Root than 2% It consists of light dark fungus of aerial part while the underground part is yellowish brown caterpiller and has char- acteristic odour d.byar-risa- dgun-‘bu | plant than 2 % wiv tea-ba Root It is root is ash in colour | TLC Not more | Not more and white inside when than 8.0 than 2% sliced off. Its hot and Yowlw wiw sweet taste dva-li-me- | Flower Itis white and tastes TLC Not more | Not more tog sweet and aromatic than 12.0 | than 2% viw wiw Methods of Preparation Please see Annexure 3 Dose form Capsule Dose and mode of administration Three capsules at a time taken orally in the evening with lukewarm water Indication and uses Besides sexual dysfunction, it is also directed for immune deficiency, kidney disorder, piles, blood cleansing, neurological disorders, anti-aging, and as a general tonic Precautions and safety aspects None NITM, Thimphu 99BHUTAN 23. Monographs on the Use of Traditional Medici Rtsa-byug (massage oil) for sprain Sprain is a health condition where there is stretch or tear of soft tissue or skeletal muscle near the joints, It may be caused during lifting and carrying heavy weights, playing sports, getting injured by falling and by other physical activities. The symptoms are severe pain and dark bluish mark on the skin of the sprained part. There will be swelling of the affected area and the movement will be restricted. Composition Risa-byug is made from the following ingredients with standard ratio : SLNo, | Name of the Latin name Family | srp ratio drug 1 | yung-ba Curuma longa Linn. Zingiberaceae | 9.1999 2 | go-sayod Carum carvi Linn, Umbelliferae | 9 1090 3 | deati Myristica fragrans Hout, | Mytisticaceae | g 9599 | byacreodts Delphinium brunonianum —|Ranunculacese | | ‘YarBodSPS | Rovle . 5 | sga-skya Cautleya sp. Zingiberaceae | 9.0300 6 | titsnum Sesamum indicum L. Pedaliaceae 1 9.5800 100 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC \za-ti fruit & dried seed Bya-rgod-spos flower & crude drug Sga-skya plant & dried rhizome Til snum plant & dried seed NITM, Thimphu 101BHUTAN Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: eee etc petri eerie iReyP It comprises of yel- lowish-orange sliced thizome with strong aroma itis similar to betel nut in shape and has acrid taste with a strong aroma Ttconsists of green leaves and hollow stem twigs with purplish blue flower and has a strong aroma Pe comprises of sliced Not more | Not more pm [a white rhizome with an 12.0 | than 2% wiw ‘ICis yellowish brown with a sweet taste and i than 3% sbaracteristic aroma i wiw 102 NITM, Thimphu.BHUTAN Monogi phs on the Use af Peditional Medicine in PH: Methods of Preparation lL Dispense ingredients as prescribed in the formula 2. Extract the mixture with water and filter 3. Extract the filtrate with sesame oil until all the water is evaporated 4, Filter the oil and fill them into a 30ml amber colour bottle and screw cap it immediately 5, The ointment should be stored in a cool and dry place and avoid exposure to direct sunlight Dosage form Ointment (Medicated oil) Dose and mode of administration Massage copiously wherever there is pain after warming the gil in the sun or by heating Indications and uses Besides sprain it is used for paralysis and traumatic pain Precautions and safety aspects For external use only NITM, Thimphu 103BHUTAN Monographs on the Use of Traditional Medicine in PHC 24. Kyhung-Inga-ril bu for toothache There are five types of toothache according to the Bhutanese traditional medicine attributing to rlung, khrag, srin (germs), spirit related, and rnyel-nye (gum receding). ‘The main causes of this ailment are unhealthy diet (chewing betalnut, consumption of more sweets and junk food and smoking) depression, worries, and evil spirit affliction. Generally, the signs and symptoms may include mobility of teeth, pain and itchiness in the gum and lower jaw, characterized by pus oozing out and is highly sensitive to hot and cold food. Composition Kyhung-Inga-ril bu is made from the following ingredients with standard ratio: SLNo| Name of the vantage Family name | STD drug ratio 1 aru Terminalia chebula Retzius Combretaceae | 0.0400 2 |rerta iSeussirea lappa (Decne) Sch} s\coeo = | 0.0100 ‘Acora 3 | shu-dag-nag-po | Acorus calamus L. aa 0.0060 4 | bya-rgod-spos | Delphinium brunonianum Royle FE eee 0080 5 | btsan-dug Aconitum lacintatum (Brochl) | Pammncnlacess: | c200 A-ru fruit & crude drug Ru-rta plant & dried root 104 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Shu-dag nag-po leaves & dried rhizome Bya-rgod-spos flower & crude drug Bisan-dug flower & dried root NITM, Thimphu 105of Traditional Medicme ut PHC BHUTAN Monographs on the Us Quality Standards For quality control purpose, the following are the standards to evaluate the quality of cach ingredient: etree ne eee It comprises of light yellow fruit and is bitter and astringent in taste Itis white-ash in co- lour and is bitter and acridin taste It consists of brown thizome with strong aroma and sweet and bitter in taste It consists of green leaves and hollow stem twigs with pur- plish blue flower and has a strong aroma Has darkish brown tuber with strong odour 6.tsan-dug NITM, ThimphuHEE TAN Mia Hoon he Sse af Traditional Mediemne in PHL Methods of Preparation Please see Annexure | Dosage form Pills Dose and mode of administration Depending on the body weight, one to two pills at a time but do not exceed more than 250 mg . Take orally in the evening with lukewarm water. Indications and uses Besides toothache, it is also used for obstinate skin diseases including leprosy, stiffness and inflammation, rheumatic arthritis, abscess, carbuncles, stomach cramp and infec- tions. Precautions and safety aspects Not recommended for patients suffering from heart disease, high and low blood pressure, weak patients, children below 10 years and elderly patients. This medicine contains aconi- tine and therefore, should be kept out of reach from children and must strictly follow the recommended dose. You should also refrain from eating meat products and drinking al- cohol and do not take this medicine concurrently with allopathic medicines. Do not drive or handle any heavy equipment. NITM, Thimphu 107BHUTAN Monographs on the Use of Traditional Medicine m PUC 25. Sa-rai-khyung-inga for urinary disorder Urinary disorder is a condition where there is difficulty in urinating, blockage of urinary tract and frequent urge for urination. It is caused due to the formation of stones in between the small intestine and the urinary bladder affecting the normal excretion of the urine, The blockage is also due to disorder in three humors entering the urinary passage which is connected to the small intestine at the bottom side of the bladder. Similarly, frequent urination is due to the inability of the phlegm to convert fat into energy resulting in dripping. It is also attributed to excessive dietary habits like taking salty and savory foods, which are saturated fats and has cool potency in nature. Sitting on the damp ground for long duration leads to the failure of transforming phlegm and fats into seven bodily constituents namely chyle, blood, flesh, fats, bone, marrow and sperm. The symptoms of the blockage are inability to urinate even when the bladder is full, swollen ileum, pain in the urinary tract, constricted passage of urine and pain while urinating, The urine analysis will show bluish color if it is influenced by rlung (wind), reddish yellow if it is influenced by bile and viscous pungent urine if it is due to phlegm. The symptoms of frequent urination are feeling drowsy and sleepy, excessive sweating, smell of urine from the body, rapid growth of hair and nails, feeling sweetish taste in the mouth, dryness of throat and upper palate, craving for food which has cool potency in nature, the skin tuming pale and burning sensation in the inner side of the four limbs. The colour of urine will be smoky and highly viscous. Composition Sa-rai-khyung-inga is made from the following ingredients with standard ratio : Family STD SLNo. | Name of the drug Latin name ane _ | Combretaceae 1 aru Terminalia chebula Retzius 0.1520 2 | sman-chen Aconitum laciniatum (Bruch\) | Ranunculaceae {9,1 529 3 | shu-dag-nag-po | Acorus calamus L. Acoraceae 0.0300 Saussurea lappa (Decne,) | Compositae 4 [ere Sch. Bip. 0.0500 5 | bya-rgod.spos Debio arunonianum — [Ranunculaceae | 6 999 6 | mye-dga Malva sylvestris L. ‘Malvaceae 0.0220 108 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC SLNo. | Name of the drug Latin name remy ae 7 | gu-gul Commiphora mukul Linn. Burseraceae 0.0160 8 | zhu-m.khan Symplocos sumuntia D.Don. _ | Symplocaceae 0.0240 9 | tshos Laceifer lacca 0.0440 10 | brisod Rubia cordifolia auce Non L. | Valerianaceae 0.0150 11 | kha-che-gur-gum | Crocus sativus L. Iridaceae 0.0120 | 12 | fumnag-domm. | veronica cephatoides Pennell Seto eee Ooi | ris | 13. |rgva-nag-snag-risi | Chinese Ink 0.0150 | 14 | mashal Mercury sulphide 0.0460 | 15. |sue-smet Seid eT Ease EO 0350 | 16 ee Erythriana variegate L. Tea nee 0.0350 A-ru fruit & crude drug Sman-chen flower & dried root NITM, Thimphu 109BHUTAN Monographs on the Use of Traditional Medicine in PHC Shu-dag-nag-po leaves & dried rhizome Ru-rta plant & dried root Brtsod flower & crude drug Kha-che-gur-gum flower & dried stigma 110 NITM, ThimphuDum-nag-dom-khris plant & crude drug Nye-dga flower & crude drug Reya-nag-snag-risi__ Thos crude Gu-gul crude drug Mtshal pow: NITM, Thimphu 1BHUTAN Monographs on the Use of Fraditional Medicine in PHC Quality Standards For quality control purpose, the following are the standards to evaluate the quality of each ingredient: Re Identification em eee Description It comprises of light yel- low fruit and is bitter and astringent in taste Isa darkish brown tuber | TLC with strong odour Not more | Not more than 12.0 | than 2% % wiv ‘Not more than 2% wiw shu-dag- | Rhizome | It consists of brown thi nag-po zome with strong aroma and sweet and bitter taste It is ofwhite-ash color ands bitter and acrid in taste than 13.0 | than 2% wiv bya-rgod- It consists of green leaves ‘Not more: spos Plant —_| and hollow stem twigs than 11.0 | than 2% with purplish blue flower %wiw | wiw and has a strong aroma. It comprises of greenish | TLC Not more | Not more Part leaves and stems than 11.0 | than 2% % wiW, Resin | It is translucent with bit-_ | TLC Not more | Not more ter taste and has a sweet than 11,0 | than 2% aroma when burnt % win wiv Tt comprises of brown- Not more | Not more ish yellow leaves with a than 12.0 | than 2% smooth surface % ww —— —_| TLC Notbe | Not more Tt comprises of brownish red stem with characteris- more than | than 2% ic odour 0.0% — | ww 112 NITM, ThimphuBHUTAN Manesraphs un the tise off vutitional Medicine m Pi Recut LoD ec ie Not more | Not more than than 2% 9.0%wiw_| wiw Kha-che- | Stig-ma | Itis red to orange inco- | TLC Not more | Not more gur-gum lour with a fragrant aroma than 10.0. | than 2% and a sweet taste. The %wiw | wh good quality stigma gives intense red solution with water tut) peeenaias It consists of reddish dark lac characteristic odour ‘Not more than 2% wiw Should not be more than 10.0 % wiw Itisa blue flower with bitter taste Acrial Notap- | A shiny black soot with Notap- | Not more snag-risi_ | plicable | pleasant odour plicable | than 2% wiv ‘sug-smel | Fruit | Crude drug comprises of | TLC Notmore [Not more yellowish-orange white than 15.0. | than 2% fruit % wiwe wiw Tt comprises of light black [TLC Nat avail- | Not more to dark black seed which able than 2% is kidney shaped; is sweet; ww odourless NITM, Thimphu M3BHUTAN Monographs on the Use of Tetddtionat Medicine in PHC Methods of Preparation Please see Annexure 1 Dosage form Pill Dose and mode of administration Two pills at a time Take orally in the evening with lukewarm water Indications and uses Besides urinary disorder, it is also for kidney disease, parasitic infection, and spermator- thoea, inflammation in urinary tract, verminous colic pain and girdle pain Precautions and safety aspects ‘Not recommended for patients suffering from heart diseases, jaundice, high and low blood pressure, weak patients, children below 10 years and elderly patients. This medicine con- tains aconitine and therefore, should be kept out of reach from children and should striclty follow the recommended dose. You should aslo refrain from eating meat products and drinking alcohol and do not take this medicine concurrently with allopathic medicines. Do not drive or handle any heavy equipment 4 NITM, Thimphube VAN . » 26. Shing-mngar 6 pa for vomiting Vomiting is a condition wherein food particles, parasites and watery substances in the form of sticky yellow and reddish brown bubbles comes out of the mouth due to imbalance of three humors namely rlung, m.khris, and bae-kan. Vomiting is mainly caused by over eating, indigestion problem and infection. The signs and symtoms of vomiting due to riung inlcudes water bubble like vomitus accompanied by giddiness and pain in the chest, back and ribs. If the vomiting is caused by m.khris-pa, there will be bitter taste, yellowish bile or blood in the vomit with a high fever, dryness of mouth and headache. If the vomiting is due to bae.kan there will be sweet and astringent taste, loss of appetite, swelling of face and chest pain. If it is due to combination of three humours the urine and feaces will have strong foul odour with slow and weak pulse rate. Composition Shing-mngar 6 is made from the following six ingredients as per the ratio mentioned against each ingredient: Family SLNo, | Name of the drug Latin name STD ratio 1 | shing-mngar Glyeyrrhiza glabra L Fabaceae 0.1000 2 | bras Oryza sativa Linn. Poaceae 0.0500 les lazenar Rosaceae 3 | bseeyab Choenomeles lagenaria 0.0500 Koidzumi 4 | byitang-ga Myrsine semiserrara Wan | M*sinaceae 0.0500 5 | go-snod Carwm carvi Linn, Umbelliferae | 9.9590 6 | wesu Coriandrum sativum Linn, | Umbelliferse | 4 4599 NITM, Thimphu usBHUTAN Monographs on the Use of Traditional Medicine in PHC U-su plant & dried fruit Bras plant 116 NITM, ThimphuMoney BHUTAN Quality Standards the Use nf Poatstienat Medi mein PE For quality control purpose, the following are the standards to evaluate the quality of each ingredient. Perea pert Ronen ea AE :| sided shing-m. Comprises of yellowish ‘Not be more | Not more ngar root pieces with sweet- than 11.0% | than2% ish bitter taste wiw ‘bras Seed It is brownish with hairy | TLC Not more Not more stem and is bitter in than 10.0% | than 2% taste wiv, wiw b.se-yab Reddish yellow to TLC Not more | Not more brown color fruit and than 11.0% | than 2% is sour. Seeds are three wiv wiw characteristic aroma Methods of Preparation Please see Annexure 3 Dosage form Capsule Dose and mode of administration Three capsule at a time Sowilw Take orally in the morning and at midday with lukewarm water Indications and uses For all types of vomiting Precautions and safety aspects None byi-tang- Crude drug consists of Not more | Not more ga round shapes with pink- than 11.0 | than 2% ish brown fruits, Has hot “owiw wiw and sweet taste, ‘go-snyod Dark green oily seed [TLC Not more | Not more with acrid taste and than 14.0 than 2% aromatic odour Yowiw wiw “usu Light green-ash color | TLC Not more | Not more with spicy taste and than 9.0 than 2% wiw NITM, Thimphu M7BHUTAN Monographs on the Use of Traditional Medicine in PHC 27, Rma-sman-reg- pa dey ter for wound There are different types of wounds in Bhutar :se tradi al medicine. Wounds are generally reffered to a condition where the skin or outer flesh is torn or punctured by a foreign object and a condition where the body is infected from bruises with discharge of blood, fluid and pus thus affecting the overall health. Signs and symptoms includes wound becoming red and then blue and soft, with burning sensation accompanied by pus, pungent smell and pain. Composition. Rma-sman-reg- pa dey ter is made from the following ingredients with standard ratio: SLNo | Name of the drug Latin name Family aid 1 | ywegu-shing Aster neoelegans Hand-Mass _ | Asteraceae 0.9000 2° | bri-rta-sa-'dzin Fragaria nubicola Hook. Rosaceae 0.0100 3 | nsa-stag-sha Oxytropis sulphurea Leguminosae | 9.9109 4 | Skyer-shun Berberis aristata DC. Berberidaceae | 9.0100 5 | khur-mong Taraxacum eriopodum Hook.f |Compositae | 9.9199 6 | mase-Idum Ephedra gerardiana Stapf. Ephedraceae [9.0100 7 | rgu-drus Gentiana sp. Gentianaceae [9.9100 8 | chuerisa Rheum australe D.Don. Polygonaceae | 9.9100 9 | brag.spos.pa Lepisorus contortus Christ Polypodaceae 19.9100 10° | re-skon Corydalis dubia Prain Fumariaceae [9.0100 He | nerta Saussurea lappa (Decne.) Sch, |CO™POsitae —_| g 199 12 | byermgod-spos Debhinium brunonianum Ranunculaceae | 5 4199 13 | dung-thal 0.0100 14 | zang-thal Copper powder 9.0100 15 | ldum-nag-dom-m.khris | Veronica cephaloides Pennell Scropholaria- 0.0100 118. NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PH Bri-ta-sa-zin leaves & crude drug Khur-mong flower & crude drug Tshe-dum flower & crude drug Gu-drus plant & dried root NITM, Thimphu 119BHUTAN Chu-risa plant & dried root Brag-spos-pa leaves & dried leaves Bya-rgod-spos flower & crude drug Dum-nag dom-khris plant & crude drug 120 NITM, ThimphuBHUTAN Sa-ta-sha dried root Quality Standards Monographs on the Use of Traditional Medicine in PHC Dung-thel powder Zang-thel powder For quality control purpose, the following are the standards to evaluate the quality of each ingredient: yuegu- Aerial It comprises of greenish | TLC Not more N/A shing brown extract, bitter taste than 30% and has characteristic wiv odour — ‘bri-ta-sa- |Whole | It consists of red thread- | TLC Not more | Not more dzin plant like structures of greenish than 11.0% | than2% brown colour wi ww sisva-stag- | Whole TLC Not Not more sha plant Available | than 2% w/w skyer-shun | Stem bark | It is yellowish in colour TLC Should not Not more and has a bitter taste be more than | than 2% 10.0% viw | wiw khur-mong | Aerial It consists of brownish TLC Not Not more green leaves and yellow Available | than 2% flower with hollow tender wiw stem and has a slightly bitter taste NITM, Thimphu 121BHUTAN Monographs on the Use of Traditional Medicine in PHC m.tse-Idum with red fruit and has an astringent taste Has greenish brown stem | TLC Peter en Should not be more than. 9.0 % wiw rgudrus Not available It consists of yellowish brown root sliced into small pieces and has characteristic odour Not available | Not available Should not be more than 12.0 % wiw Not more than 2 % brag-spos- Leaves | It consists of green leaves with yellow spots underneath the leaves It is reddish blue and has plant a bitter taste It is of white-ash color and has bitter and acrid taste Tt consists of green leaves Should not be more than 11.0 % wiw win Not more than 2% than 11.0% spos Plant —_| and hollow stem twigs with purplish blue flower wiw wav and has a strong aroma dom-nag- | Aerial |Itisa blue flower witha [TLC Should not _ | Not more Idum-m. bitter taste be more than | than 2% Khris 10.0% wiw | wav dung-thal_ | Not Itcomprises ofa white | Should Not Not more applicable | fine powder conform applicable | than 2% to calcium wav compound test zang-thal_ [Not Reddish-brown powder, _| Chemical Test- Not more applicable | practically insoluble in distilled water, soluble in hydrochloric acid and in nitric acid, practically insoluble in alcohol gives intense than 2% blue color L 122 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine in PHC Methods of Preparation 1 . Grind them together into a fine powder Awpun Dispense ingredients as prescribed in the formula . Mix powder to obtain a uniform content . Extract 1kg of powder with 10 litres of water and filter . Concentrate the filtrate further until it becomes a paste . Immediately pack the paste in 500g pack size into a PET Container with airtight screw cap The paste should be stored in a cool and dry place and avoid exposure to direct suntight Dosage form Paste Dose and mode of administration Apply externally on the wounds in the morning and evening or as and when required depending on the severity of the wound Indications and uses All sorts of external wounds including obstinate skin diseases Precautions and safety aspects For external use only NITM, Thimphu 123BHUTAN Monographs on the Use of Traditional Medicine in PHC References: 1 Anonymous (1990) The Bantam Medical Dictionary, Revised edition, Bantam Books 2. Anonymous (1983) Formulary of Traditional Medicine of Bhutan, Royal Government of Bhutan, Ministry of Social Services, Department of Health Services, Institute of Indigenous Medicine, Thimphu, Bhutan 3. Anonymous (2005) An Introduction to Traditional Medicine Services in Bhutan, Institute of Traditional Medicine Services, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan 4, Anonymous (2010) ‘brug rang lugs gso ba rig pa’i nad kyi dhye rtags snang gsal sgron me, Institute of Traditional Medicine Services, Thimphu, Bhutan. 5. Anonymous (2009) Standard Treatment Guide for Traditional Medicine, Institute of Traditional Medicine Services, Thimphu, Bhutan 6. Anonymous: bod gzhung sman rtsi khang gso ri ga mtho slob sde tshan _bod kyi gso rig slob deb. bod ljongs mi dmangs dpe skrun khang. 7. Anonymous, sman sbyor ‘chi med srog ‘dein dgos ‘dod kun ‘byung, Institute of Traditional Medicine Services, Thimphu, Bhutan. 8. Anonymous (1991) krung go’ gso rig kun ‘dus, bod liongs mi dmangs dpe skrun khang. 9. Anonymous (2010) Traditional Herbal Remedies for Primary Health Care, Re- gional Office for South-East Asia, WHO, India. 10. Anonymous (2000) Sorig Gyueshi Drelchen Drangsong Shel lung, Merig Publish- ing House, Tibet 11. Argu, Y.P.; (2009): Short Introduction to Tibetan Medicine, bod \jos mi dmangs dpe skrun khang. 12. Chophel, Karma, Dud-tsi-smen-gi-thrung-pe-leg-shed-norbui-threng-zey, Bod- sjong-me- dmangs-pe-struen-khang. 13. Dash B.V (1997) Tibetan Medicine: Theory and Practice, Sri Satguru Publications, New Dethi, India 124 NITM, ThimphuBHUTAN Monographs on the Use of Traditional Medicine 1 4: 14. 15. 16. 17. 18. 19, 20. Kongtrut Yonten Jamtsho (1976) gso rig zin tig gces bsdus, Thso.ngoen Peoples Publishing House Samten (1996) gso rig snying bsdus skya rengs gsar pa, Tibetan Peoples Publish- ing House Thupa Tshering and Kencho Thinley (1994) sman sbyor legs bsgrigs yang gsal sgron me, kan su’u mi rigs dpe skrun khang, Wangchuk, P.; Samten; Ugyen (2009) Hand Book on High Altitude Medicinal Plants of Bhutan: An Illustrated Guide for Practical Use, Pharmaceutical and Research Unit, Institute of Traditional Medicine Services, Ministry of Health, Thimphu, Bhutan. Wangchuk, P.; Samten (2010) Hand Book on Low Altitude Medicinal Plants of Bhutan: An Illustrated Guide for Practical Use, Pharmaceutical and Research Unit, Institute of Traditional Medicine Services, Ministry of Health, Thimphu, Bhutan, Yuthok Yonten Gonpo, rgyud bzhi't rtsa ba, Reprinted by Tibetan Peoples Publish- ing House in 1980 Yuthok Yonten Gonpo, The Root Tantra and the Explanatory Tantra from the Four Tantras of Tibetan Medicine, Translated into English in 2008 by Translation Department, Mentseekhang, Dharamsala, India NITM, Thimphu 125SHUTAN Monographs on U PHC Annexure 1: Methods of Preparation for Pill 1. a er) ~ Dispense ingredients as prescribed in the formula. . Grind them together into a fine powder. Mix powder to obtain a uniform content. . Prepare seed nucleus and do sizing for uniform nucleus. . Add bulk powder to nucleus to produce 500 mg of pills. . Dry the pills in the room temperature and shuffie it from time to time for uni- form drying and to prevent from fungal growth. . Pack the pills in 500g pack size in a PET container with airtight screw caps. The pills should be stored in a cool and dry place and avoid exposure to direct sunlight, Annexure 2: Metthods of Preparation for Tablet 1 2. 3. Dispense ingredients as prescribed in the formula. Grind them together into a fine powder. Mix powder to obtain a uniform content. Add binder and blend them again and add water while mixing, Dry the wet mass evenly in an oven and shuffle it from time to time to expedite drying process and to prevent it from dryness. Granulate the dried mass to obtain uniform granules for compression. Granules should be stored in an aistight PVC bags to prevent moisture ingression before the next process. Compress the granules into 500 mg tablets. . Pack the tablets in 500g pack size in PET container with airtight screw caps. The tablet should be stored in a cool dry place and avoid exposure to direct sun- light. 126 NITM, ThimphuBHUTAN PHIL phs on the Use of Traditio Annexure 3: Methods of Preparation for Capsute 1. Dispense ingredients as prescribed in the formula. 2. Grind them together into a fine powder. 3. Mix powder to obtain a uniform content. Add binder and blend them again and add water while mixing. 4. Dry the wet mass in an oven and make granules. 5. Granules should be stored in an airtight PVC bags to prevent moisture ingression before the next process. 6. Encapsulate 500 mg grabutes into pre-gelatinised capsule shells. 7. Pack the capsules in 500g pack size in a PET container with airtight screw caps. 8. The capsutes should be stored in a cool and dry place and avoid exposure to direct sunlight. NITM, Thimphu 127