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ANTIPYRETIC-ANALGESIC AYURVEDIC DRUGS: AN APPRAISAL

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PHARMA SCIENCE MONITOR

AN INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES

ANTIPYRETIC-ANALGESIC AYURVEDIC DRUGS: AN APPRAISAL

Anilkumar D1, Hemang Joshi2*, K. Nishteswar3
1
Dr B.R.K.R., Govt. Ayurved Medical College, Hyderabad.
2
Dept. of Dravyaguna, Institute of Ayurvedic Pharmaceutical Sciences, Gujarat Ayurved University,
Jamnagar
3
Dept. of Dravyaguna, Institute for Post Graduate Teaching and Research in Ayurved, Gujarat Ayurved
University, Jamnagar

ABSTRACT
Ayurvedic material medica comprises of vegetable, animal, metals & minerals drugs. The
subject related to herbal medicine described in Ayurvedic classics is drawing the
attention of modern scientists for carrying out research studies with a proper scientific
validation. Charak samhita and Susruta samhita have referred many a drugs possessing
analgesic and antipyretic activities. An analysis was carried out to review the information
recorded in Ayurvedic classics as well as the observations reported by various research
studies.
Keywords: Antipyretic, Analgesic, Ayurvedic drugs.
INTRODUCTION
Ayurveda identified that mind and body as the sites of manifestation of diseases basing
on the etiological factors of the diseases and classified into exogenous and endogenous in
origin. External factors like fall, thunderbolt, assault, fire, weapon and demoniac seizure
(may be interpreted as bacilli, virus and other microorganisms) cause exogenous diseases
(Agantuja vyadhi). Endogenous diseases (Nijavyadhi) on the other hand are caused by the
disturbance in the equilibrium of vata, pitta, and kapha and food (Ahara) as well as
behavior (Vihara) may act as etiological factors. Nijavyadhi is further divided into
samanyaja (general) and nantmaja vyadhi(specific diseases exclusively caused by the
individual doshas i.e. vata, pitta and kapha). Charaka enumerates certain painful
conditions specially caused by vata (vatananatmaja vyadhi) viz; padashoola (pain in
foot), pindikodwestana(cramps in the calf), gridhrasi(sciatica), urusada (pain in the
thigh), gadarti (tenesmus), sronibheda (pain in pelvic girdle), vrishanakshapa (pain in
scrotum), udaravesta(griping pain in abdomen), vakshauddarsha(rubbing pain in chest),

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vakshatoda(stabbing pain in chest), dantabheda(toothache), karnasoola(earache),

akshisoola(pain in eye), lalatabheda (pain in frontal region), siroruk(headache) etc.
MATERIALS AND METHODS
A critical review of Ayurvedic literature including Charak Samhita and Susruta Samhita
for the concept of antipyretic and analgesic was done; while scientific evidences in
recorded in current researches pertaining to the same Ayurvedic drugs was carried out.
RESULTS AND DISCUSSION
Ayurvedic concept of analgesic and antipyretic activities:
The cause of any pain in the body is due to vitiation of vata. Pain was expressed with
various terms such as soola, vedana, bhedana, soola, ruja, arti etc. Drugs indicated in
such conditions act as analgesics and relieve pain.
Charak has introduced three groups of analgesics useful for management of pain of mild,
moderate and severe forms. Angamarda gana, Vedanasthapana gana, and
shoolaprashamana gana; may be prescribed in the treatment of mild, moderate and
severe forms of pain. The symptom ‘shoola’ is applied to pain due to musculoskeletal as
well as smooth muscle involvement. In view of this shoolahara drug may act either as
analgesic or antispasmodic agent. Drugs having sweet, sour and saline tastes with
unctuous (snigdha) and hot (ushna) qualities are preferred in the management of vata
vitiation. Charaka furnished the pharmacological basis for the treatment modalities
usually prescribed for vata disorders Asthapana and Anuvasana types of enema strikes at
the very root of vitiated vata and simultaneously alleviates the other systemic forms of
vata vitiation. Vedanahara drugs when orally or rectally administered pacify vata by
acting on the colon. Nasya karma (nasal drug administration) one of the panchakarmas is
mainly advocated in the treatment of headache. Drugs may irritate nasal mucous
membrane and reflexly relieve either vasoconstriction or vasodilation. Nasya karma may
be interpreted as vasomodulator.
Ergotamine which indicated in migraine on oral administration is less effective and
suppositories act more effectively. In an attempt to avoid the inconvenience of infections

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and suppositories and the relative inefficacy, due to slow absorption, and vomiting, of
oral ergotamine, a device for inhalation has been developed by modern medical scientists.
Nasya karma indicated for relief from shirhashoola (headache) may not be ridiculed as
the drug gets absorbed even from nasal mucous membrane and initiates its activity.
In general, pain arising from somatic structures (skin, muscles, bones, joints) responds to
analgesics such as aspirin and paracetamol (non-narcotic) which do not alter psychic
function and do not induce serious dependence (addiction). Pain arising from viscera is
most readily reduced by morphine and pethidine(narcotic) which alter both the pain
threshold and psychic reaction to pain and do induce serious dependence. Mild pain from
any source may respond to the non-narcotic analgesics. Drugs of opium group may also
be needed for severe pain. In Ayurvedic material medica opium is indicated in the
management of atisara, but is not employed for the treatment of pain. All the drugs
indicated in the management of pain in Ayurvedic therapeutics should be categorized as
non-narcotic analgesics only.
In Jwara, dysfunction of Agni (Mandagni) initiates the pathogenesis. According to
physiological doctrines, Agni is the component of pitta and functions in the body. Jwara
is such a paradoxical condition in which agni’s functions decreases resulting in ama
(endotoxin or pyrogen) and pitta gets aggravated. Rasa (taste) of the drugs is mainly a
projected tool for prescribing in Ayurvedic therapeutics. Among six rasa, tikta rasa
(bitter taste) is preferred to address two components involved in jwara i.e. Agni & pitta.
Charaka enlisted antipyretic (Jwarahar) group of drugs.
The antipyretic and anti-inflammatory effects of the salicylates are primarily due to the
blockage of prostaglandin synthesis (by inhibiting cyclo-oxygenase enzyme irreversibly)
at the thermo regulating centers in the hypothalamus and at peripheral target sites. They
also prevent the sensitization of pain receptors to both mechanical and chemical stimuli
[1]
.
Fever is a complex physiologic response triggered by infectious or aseptic stimuli.
Elevations in body temperature occur when concentrations of prostaglandin E (2) [PGE

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(2)] increase within certain areas of the brain. These elevations alter the firing rate of
neurons that control thermoregulation in the hypothalamus. Although fever benefits the
nonspecific immune response to invading microorganisms, it is also viewed as a source
of discomfort and is commonly suppressed with antipyretic medication. Antipyretics such
as aspirin have been widely used since the late 19th century, but the mechanisms by
which they relieve fever have only been characterized in the last few decades. It is now
clear that most antipyretics work by inhibiting the enzyme cyclooxygenase and reducing
the levels of PGE (2) within the hypothalamus. Recently, other mechanisms of action for
antipyretic drugs have been suggested, including their ability to reduce proinflammatory
mediators, enhance anti-inflammatory signals at sites of injury, or boost antipyretic
messages within the brain. Although the complex biologic actions of antipyretic agents
are better understood, the indications for their clinical use are less clear. They may not be
indicated for all febrile conditions because some paradoxically contribute to patient
discomfort, interfere with accurately assessing patients receiving antimicrobials, or
predispose patients to adverse effects from other medications. The development of more
selective fever-relieving agents and their prudent use with attention to possible untoward
consequences are important to the future quality of clinical medicine [2].
Acharya charaka [3] has given detailed account of various categories of herbs useful for
various conditions of pain and pyrexia which are tabulated as follows.
TABLE 1: GROUP OF PLANTS TO TREAT BODY ACHE
(ANGAMARDAPRASHAMAN)
No. Ayurvedic name of the plant Botanical name
01 Vidarigandha Desmodium gangeticum DC (Fabaceae)
02 Prushniparni Uraria picta Desv.(Fabaceae)
03 Bruhati Solanum indicum Linn. (Solanaceae)
04 Kantakari Solanum surattense Burm.f. (Solanaceae)
05 Eranda Ricinus communis Linn.(Euphorbiaceae)
06 Chandana Santalum album Linn.f. (Santalaceae)
07 Ushira Vetiveria ziznioides (Linn.) Nash (Poaceae)
08 Ela Elettaria cardamomum Maton. (Zingiberaceae)
09 Madhuka Madhuka indica J.F. Gmel. (Sapotaceae)
10 Kakoli Roscoea proceraWall. (Zingiberaceae)

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TABLE 2: ANALGESIC (VEDANASTHAPANA) GROUP OF PLANTS

No. Ayurvedic name of the plant Botanical name
01 Sala Shorea robusta Gaertn.(Dipterocarpaceae)
02 Katphala Myrica esculanta Buch.-Ham.(Myricaceae)
03 Kadamba Anthocephalus cadamba Miq.(Rubiaceae)
04 Padmaka Prunus cerasoides D.Don (Rosaceae)
Lagenaria siceraria (Mol.) Standl.
05 Tumba
(Cucurbitaceae)
06 Mochrasa Bombex ceiba Linn. (Bombacaceae)
07 Shirisha Albizia lebbeck(Linn.) Benth.( Mimosaceae)
08 Vanjula Salix caprea Linn.(Salicaceae)
09 Elavaluka Prunus cerasus Linn.(Rosaceae)
10 Ashoka Saraca asoca (Roxb.) De Wilde.(Caesalpincae)

TABLE 3: PLANTS FOR COLIC PAIN SHOOLPRASHAMANA

No. Ayurvedic name of the plant Botanical name
01 Pippali Piper longum Linn.(Piperaceae)
02 Pippalimoola Piper longum Linn.(Piperaceae)
03 Chavya Piper chaba Hunter(Piperaceae)
04 Chitraka Plumbago zeylanica Linn. (Plumbaginaceae)
05 Shrungvera Zingiber officinale Rosc.(Zingiberaceae)
06 Maricha Piper nigrumLinn.(Piperaceae)
07 Ajmoda Apium graveolens Linn. ( Umbelliferae)
08 Ajagandha Gynandropsis gynandra (Linn.) Briquet
09 Ajaji Nigella sativa Linn.(Ranunculaceae)
10 Gandira Achyranthus aquatica Br.(Amaranthaceae)
TABLE 4: ANTIPYRETICS (JWARHARA) GROUP OF SUBSTANCES
No. Ayurvedic name of the Botanical name
plant
01 Sariva Hemidesmus indicus R.Br. (Asclepidaceae)
02 Sarkara Cane sugar
03 Patha Cissampelos pariera Linn.(Menispermaceae)
04 Manjistha Rubia cordifolia Linn. (Rubiaceae)
05 Draksha Vitis viniferaLinn.(Vitaceae)
06 Pilu Salvadora persica Linn.(Salvadoraceae)
07 Parusaka Grewia asiatica Linn. (Tiliaceae)
08 Haritaki Terminalia chebula Retz. (Combretaceae)
09 Amalaki Emblica officinalis Gaertn. (Euphorbiaceae)
10 Bibhitaka Terminalia bellirica Roxb. (Combretaceae)

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Susruta[4] has quoted following ganas for the management of vedana(pain) and
jwara(fever).
TABLE 5: GROUPS OF HERBS GIVEN BY SUSRUTA FOR VEDANA AND
JWARA
No. Name of the group Indication
01 Vidarigandhadi Angamarda(Body ache)
02 Aragwadhadi Jwara(Fever)
03 Varunadi Shirashoola(Headache)
04 Virtarvadi Ruja(pain)
05 Brihatyadi Ruja(pain)
06 Patoladi Jwara(Fever)
07 Guduchyadi Jwara(fever)
08 Triphala Vishmajwara (Fever like Maleria)
09 Amalakyadi Jwara (Fever)
10 Dasamoola Jwara(Fever)

Scientific evidences for Antipyretic activity among Ayurvedic plants:

Azadirachta indica (Nimb): In hyperpyretic rabbits methanolic extracts (leaf, bark), as
well as certain further fractions of these, and ‘nimbidin’ have shown antipyretic
activity[5,6].
Caesalpinia bonducella (Latakaranja): Total bitter principles and especially a particular
fraction (fraction B) thereof, show antipyretic activity[7].
Emblica officinalis (Amalaki): Diethyl ether extract of E. officinalis leaves at 50 µg/ml
inhibited calcium ionophore A23187-induced leukotrienes B 4 release from human
polymorphonuclear leukocyte by 40%, thromboxane B2 production in platelets during
blood clotting by 40% and adrenalin-induced platelet aggregation by 36%. These results
have a bearing on the traditional use of the plant as an anti-inflammatory and antipyretic
agent [8].
Fumaria indiaca (Parpat): Both hexane and choloform extracts (of the 90% ethanolic
extract of the dried plant material) showed antipyretic effect in yeast-induced pyrexic
rabbits. The extracts (150 mg/kg) suspended in 0.25% agar were administered by gastric
tube. Effect was comparable to that of aspirin (150 mg/kg)[9]

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Glycerrhiza glabra (Yestimadhu): Glycyrrhetic acid showed antipyretic activity similar

to that of sodium salicylate on rectal temperature of normal and pyretic rats. In a clinical
trial for traumatic inflammation, it was noted that G.glabra possesses more potent
antipyretic effect than oxyphenylbutazone[10].
Hedychium spicatum (Gandhasati): The 50% alcoholic extract exhibited antipyretic
(hypothermia) action[11].
Nigella sativa (Upkunchika): There is a clinical record that in three mild cases of
puerperal fever, the patients were cured by intake of boiled powdered seeds (along with
jiggery)[12].
Psoralea corylifolia (Bakuchi): Bavachinin, a flavonoid constituent of P. corylifolia
seeds, exhibited a dose dependent antipyretic action in rats. Effect of 150 mg/kg dose was
comparable to that of 500 mg/kg dose of paracetamol[13]. In another investigation,
bakuchiol at an oral dose of 20 mg/kg showed significant antipyretic activity in rabbits
(pyrexia was induced by i.v. administration of Escherichia coli endotoxin)[14].
Valeriana jatamansi (Jatamansi): In a Pharmacological study, benzene extract of the
rootstock showed antipyretic effect (hypothermia in mice)[15].
Scientific evidences for Analgesic activity among Ayurvedic plants:
Boerhavia diffusa (Punarnava): juice of fresh leaves of B.diffusa exhibits significant
analgesic activity in animal(mice) model experiments[16].
Cannabis sativa (Vijaya): Cannabinoids have significant analgesic activity, especially for
chronic pain states. Both tetrahydrocannabinol (THC) and Cannabidiol(CBD) are active,
though they act through different mechanisms. Although most results have come from
animal models, several small clinical trials have shown that THC (and related analogues)
can relieve postoperative pain, cancer pain, etc. potency wise, THC proved 80 times more
potent than aspirin, and appears to be superior to codeine. There are few case studies of
migraine patients using cannabis for relief [17,18].
Cedrus deodara (Devdaru): At the dose level of 50 and 100 mg/kg body weight, the oil
displayed against hot-plate reaction and acetic acid-induced writhing in mice[19].

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Celastrus paniculatas (Jyotismati): At a dose level of 100 mg/kg (i.p.) it performed

better than hydrocortisone (10 mg/kg in the carrageenan test, and 40mg/kg in the cotton
pellet test)[20]. Both alchoholic extract[21] as well as a pure sesquiterpenoid polyol ester
(ex seed oil)[22].
Crocus sativus (Kumkum): Both aqueous and alcoholic extracts of stigma and petals of
C. sativus showed analgesic activity (i.p., mice, acetic acid- induced writhing)[23].
Curcuma zedoaria (Karchur): both curzerenone and curcumenol show moderate
analgesic action in model experiments[24].
Desmodiaum gangeticum (Shalparni): Aqueous extract of the herb showed pronounced
analgesic activity in the acetic acid induced abdominal writhing assay in the test animals.
On the other hand, it did not exhibit this action in the hot plate method [25].
Eclipta alba (Bhringraj): Hydro-alcoholic extract of E. alba, at 200 mg/kg inhibited ~ 50
% of acetic acid –induced writhing in mice, indicating a moderate analgesic action[26,27].
Embelia ribes (Vidang): Embelin exhibits useful analgesic action in animal models, but
only via i.p. route. However its potassium salt is active orally and by other routes, and the
activity was comparable to that of morphine. The mechanism of action has been
investigated and opiate receptors are considered to be involved [28].
Moringa oleifera (Shigru): Alcoholic extract of M.oleifera root bark showed analgesic
activity[29].
Nigella sativa (Upkunchika): Oral administration of N. sativa oil to mice (50-400 mg/kg)
showed dose dependent analgesic (antinociceptive) action in a battery of pharmacological
tests (hot-plate test, tail pinch test, acetic acid induced writhing test). Thymoquinone was
demonstrated to be the active compound, and it attenuated the nociceptive response at a
dose level of 2.5-10 mg/kg p.o. and 1-6 mg/kg i.p. Mechanism of action has been
investigated and it was concluded that thymoquinone produces the antinociceptive action
through indirect activation of supraspinal µ1- and κ-opioid subtypes[30].
Ocimum santum (Tulsi): Alcoholic extract of the leaves of O. santum (50,100 mg/kg,
i.p.; 50,100,200 mg/kg, p.o.) showed analgesic activity against glacial acetic acid-induced

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writhing test in mice. Mechanism of antinociceptive action was also investigated, and it
was concluded that the action is being exerted both centrally and peripherally [31].
Phyllanthus fraternus (Bhumyamalki) : hydroalcoholic extract of the P.niruri, given
intraperitonially(1-30 mg/kg) or orally (25-200 mg/kg), caused marked dose-dependent
analgesic effect on capsaicin- induced pain in mice[32].
Terminalia bellirica (Bhibhitak): In connection with other claimed therapeutic effects, it
may be noted that ellagic acid has analgesic action [33].
Tinospora cordifolia (Guduchi): Aqueous extract of plant stems has been shown to
exhibit analgesic and antipyretic action in rats. The extract at a dose of 500 mg/kg (oral)
significantly inhibited acute inflammatory response evoked by carageenan[34].
Vitex negundo (Nirgundi): Mature fresh leaves were macerated with double the quantity
of water, and then filtered to obtain an aqueous extract which was evaluated for its
analgesic activity in the tail flick test in rats[35].
Scientific evidences for Analgesic-Antipyretic activity among Ayurvedic plants:
Aegle marmelos (Bilva): The alkaloid skimmianine displayed analgesic, antipyretic,
sedative and anticonvulsant activities in various animal studies; its neuroleptic activity
was less than that of chlorpromazine[36].
Calotropis procera (Arka): Dry latex in a single oral dose produced significant dose-
dependent analgesic effect against acetic acid –induced writhing in mice[37]; the
chroloform extract of roots also showed this activity[38]. It has been recorded [39] that the
terminal leaves of the plant have been used (in a prescribed fashion) to cure (100%)
patients suffering from migraine. Different extracts of the plant [40], as well as that of the
flowers alone [41], showed meaningful antipyretic activity in rats.
Cassia fistula (Argvadha): Plant has been shown, in animal experiments to have
significant antipyretic and analgesic activity [42].
Cyperus rotundus (Musta): Triterpene cut isolated from the petroleum ether extract (vide
supra) at 5 mg/kg had an analgesic action equal to that of acetylsalicylic acid at 30 mg/kg
in in vivo experimental models (aconitine-induced writhing in albino mice)[43] Same

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fraction also exhibited antipyretic activity in rats with fever due to injection of yeast. Its
efficacy was found to be superior to that of acetylsalicylic acid [44].
Nelumbo nucifera (Padma): Ethanol extract of stalks, as well as methanol extract of
rhizomes of N.nucifera, have been shown to possess antipyretic activity in experimental
animal models (normal body temperature and yeast-induced pyrexia in rats) at doses of
200 mg/kg (p.o.). Results were comparable to those obtained with the standard drug
paracetamol[45]. Nuciferine has been shown to exhibit analgesic activity [46].
Lawsonia inermis (Madayantika): Ethanolic extract of leaves showed significant and
dose-dependent (0.25-2.0 g/kg) analgesic and antipyretic actions in rats. Active
constituent was demonstrated to be lawsone[47].
Zingiber officinale (Sunthi): [6]-gingerol and [6]-shogoal, on oral administration (70-
140 mg/kg), exhibited antipyretic and analgesic activities in experimental animals[48].
CONCLUSION
Charaka has enumerated a list of drugs indicated for Asthapana and Anuvasan basti
karma which may act as potent vatahara activity and may be helpful to design a poly-
herbal analgesic formulation. Acharya Sarandhara[49] delineated one poly herbal
formulation namely Sudarshan churna, and attributed to it with broad spectrum
antipyretic and potent analgesic activities. The herbs namely; Dasmoola, Bala,
Punarnava, Guduchi, Palasha, Badara, Kulatha, Katruna, Eranda and Rasna are
bestowed with vatahara property and are incorporated in various prescriptions for the
management of painful conditions. There are number of Ayurvedic plants found
experimental evidences in the current research reports.
A proper analysis of the evidence based activity of the herbs indicate that; Nimb,
Latakaranja, Amalaki, Parpat, Yestimadhu, Gandhasati, Upkunchika, Bakuchi,
Jatamansi have been found to possess significant antipyretic activity. While Punarnava,
Vijaya, Devdaru, Jyotismati, Kumkum, Karchur, Shalparni, Bhringraj, Vidang, Shigru,
Upkunchika, Tulsi, Bhumyamalki, Bhibhitak, Guduchi, Nirgundi were found to possess
significant experimental evidences for their analgesic activity. The herbs namely; Arka,

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Aragvadha, Bilva, Musta, Sunthi, Madayantika, Padma found to possess both analgesic
and antipyretic activity.
Ayurvedic concepts for the management of pain and pyrexia along with proven medicinal
plant based formulation may be helpful to formulate effective therapeutic regimen.
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For Correspondence:
Hemang Joshi
Email: hemang.ayu@gmail.com

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