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Triphala in Eye Diseases: A Critical Review | OMICS International
ISSN: 2573-4555
Journal of Traditional Medicine & Clinical Naturopathy
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Triphala in Eye Diseases: A Critical Review

Gopinathan G1* and Dhiman KS2
1Ph.D scholar, Department of ShalakyaTantra, I.P.G.T and R.A, Jamnagar, Gujarat, India
2Professor and Head, Department of ShalakyaTantra, I.P.G.T and R.A, Jamnagar, Gujarat, India
Corresponding Author : Gopinathan G, Ph.D
scholar, Department of Shalakya Tantra
I.P.G.T and R.A, Jamnagar, Gujarat, India
E-mail: [email protected]
Received June 04, 2013; Accepted June 24, 2013; Published July 01, 2013
Citation: Gopinathan G, Dhiman KS (2013) Triphala in Eye Diseases: A Critical Review. J Homeop Ayurv Med 2:123. doi: 10.4172/2167-1206.1000123
Copyright: © 2013 Gopinathan G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Preventive and curative principles of ayurvedic system of medicine stands on the maintenance of Jatharagni (Internal digestive fire) and Kostha (excretory system). Jatharagni, which helps in the proper digestion and assimilation of ingested food as well as it helps in proper functioning of other types of Pitta-metabolic factors specially Alochaka pitta (rods and cones functional entity) in eyes, whereas kostha helps in the proper excretion of waste products. Proper functioning of these two systems help in maintaining the health, longevity and disease free life. Ancient Ayurvedic scholars explained lot many combination of drugs which act on both the above said system. Among them one of the most popular formulation is Triphala which contain powder of three fruits in equal proportion viz. Haritaki (Terminalia chebula Retz.), Vibhitaki (Terminalia balerica Roxb.) and Amalaki (Emblica officinalis Gaertn.) a very powerful Chakshushya rasayana (visual function enhancer/rejuvenator) [1]. A popular folk saying is “No mother? do not worry so long as one have Triphala” the reason is that Triphala is one such formula which care the body as a mother cares for her children. Upon analyzing this formula, it has control over all three body humours i.e. Haritaki- on Vata, Amalaki- on Pitta and Vibhitaki- on Kapha.

No doubt various studies show Triphala is a wonderful clinically proven drug in maintaining the health as well as treating many ailments. As need of the hour, the increased prevalence of ocular disorders posing challenges to the medical science motivated the author to highlight and critically discuss the role of Triphala in ocular health as well as treating ocular disorders.

Keywords
Jathara agn; Kostha; Triphala; Chakshushy; Rasayana; Ocular health
Introduction
Homeostasis as per ayurvedic fundamentals is harmony and balance between tridoshas (three body humours i.e. vata, pitta and kapha), dhatus (Rasa etc. seven body building blocks) and mala (excrements), Agni (digestive and metabolic process) along with the pleasant state of soul/mind and senses [2]. Among the sense organs, eye is consider to be the most important [3] as well as delicate organ which gets easily afflicted by the imbalance of basic body humours (doshas) and results in its decreased/disturbed function ie; drishti kriya (vision). All the materia medica and treatment procedures which create doshic balance (somatic and psychological) are equally implies to the treatment of eye along with a group of materia medica coined as ‘Chakshushya rasayana’ had been highlighted by our ancient scholars. Chakshushya class of medicines has a targeted action on the eye and visual apparatus. Although we have very little research data in this support but the practical experience and very long traditional usage of these medicines in the eye ailments is more than laboratory evidence.
Triphala is one such combination which can correct the imbalance of doshas as well as bring them to normalacy along with specific vision promoting effect. The ingredients that make up triphala are very potent individually; when combined correctly; synergy enhances the efficacy and healing quotient exponentially. So in this article an attempt has been made to critically study the role of triphala in ocular health as well as treating ocular disorders in the light of literature available in the ancient classics including nighantus and recent researches over it from internet
Triphala: Haritaki, Vibhitaki, Amalaki
Haritaki- It’s botanical source is Terminalia chebula and called as Chebulic Myrobalans in Latin. Charaka goes so far as to say that Haritaki is as nourishing and useful for everyone as mother’s milk. He mentions that it’s a rasayana for the eyes, hence it can be used to prevent the eye diseases. It helps in improvising the agni, and thus enhances the absorption of nutrients from the digestive system which is supported by various studies [4-6]. Another excellent quality of this fruit is that it cleanses the macro and micro circulatory channels, known as “shrotovishodhini,” which means that it can clear the channels, both big and small [7]. In addition it is called as sarvah dosha prasamani (pacifies all-doshas), very few fruits and herbs have this designation. It also supports the body’s immune system [8]. On top of everything, Haritaki has an anti-aging value “vayasthapani” (anti-aging) [9,10]. Thus advised in the prevention of age related eye disorders like Age related macular degeneration (ARMD), Senile Cataract, Open angle glaucoma and Retinal degeneration.
Vibhitaki - The botanical source is Terminalia bellerica. It is said to be best homeostatic, meaning that it helps to regulate the internal environment specially the circulation of pure blood in the body. It is an ideal herb for pacifying both Pitta and Kapha. Acharaya charaka quotes vibhitaki as netre hitam, meaning it is beneficial for the eyes and it cleanses the Rasa (plasma), Rakta (blood), Mamsa (muscular tissue) and Medo dhatus (adipose tissue) when they act as dushyas (vitiated tissues) [11] in the pathophysiology of a disease formation.
Amalaki - The botanical source is Emblica officinalies. It helps in purifying toxins from the body, by enhancing food absorption. When our digestion becomes stronger, the food we eat is converted to nutrition rather than staying undigested and producing impurities (Aama). Thus flushes out the toxins out of the body. The eyes are another organ that specially benefit from Amalaki. In fact, Amalaki is called chakshusya, which means “a rasayana for strengthening the eyes [12]. This is because Amalaki enhances both Ranjaka Pitta (one type of Pitta that governs liver function and the blood formation) and Alochaka Pitta (another type of pitta that governs the eyes/ vision phenomenon). Because of its high content of Vitamin C, Amalaki is a powerful antioxidant. Scientific research shows that Amalaki is an extremely potent antioxidant, excellent in removing excess free radicals, which are at the basis of much degenerative disease and aging. All these qualities make Amalaki a powerful immunity-enhancer [13].
Triphala: Cakshushya Rasayana
Cakshu tejomayam tasya visheshat sleshmato bhayam
By nature Kapha dosha has a tendency to create Abhishyandhi samprapti (i.e microchannel obstruction) leading to morbid physiology of the eye [14]. If this condition prevails for long time or no remedial measure is taken, it will manifest as a form of Abhishyanda one of the major pathological condition affecting all parts of the eye and becomes a cause of almost all eye diseases [15]. Abhishyanda also signifies the unstable phase of ocular physiology which not only gives raise to discharge per ocular surface but also deranges the internal ocular metabolism (including metabolism of avascular structure).
Triphala along with metabolic stimulant activity break the Abhisyandatva of the srotas by virtue of its ushna and ruksha properties. Not only this; the tridoshara combination (triphala) will maintain the homeostasis in the body and eye as a whole by further preventing the pathogenesis.
Chakshusya activity of Triphala seems to be a overall impact of this compound on the body as a whole, but the clinical and time tested experience of our ancient scholars may be the logic behind this specific/empirical effect (Prabhava) i.e. chakshusya property, which is highlighted in all classical literatures.
On the basis of the fundamental grounds this effect can be devoted to Deepana (property which increases the digestive power), Pachana (property which help in the digestion of undigested product) and Anulomaka (carminative) properties of Triphala; improvising and stimulating the Pachaka agni i.e Deepana and Pachana qualities produce a quality base essence of Ahara (ingested food) i.e Rasa (plasma nutrients), make it bioavailable after assimilation , easily transformable (by enhancing dhatuagni- tissue metabolism) thereby nourishes all types of Pitta including Alochaka pitta i.e. Photosensory layer of retina. The mrudu virechaka/Anulomaka (mild laxative/ intestinal motility enhancer) property of Triphala helps in the elimination of Biowastage/ Excrements as and when they are produced in the body which is always a risk factor to the avascular structure of the eye. In other words enhanced digestive and metabolic process of the body will produce the best anabolic strata for body structure and functions. There by improving the visual functions along with general body function (Cakshusya and Rasayana).
Triphala is usually a combination of equal parts of all the three fruits. But in classics depending upon the doshic combination and disease condition proportion of these three drugs various. While treating eye diseases the proportion of Amalaki is increased whereas while treating vata related diseases the proportion of Haritaki is increased.
Triphala: Rasapanchaka (Classical Pharmacodynamics)
When we look into the Rasa panchaka of Triphala formulation as a whole;
Rasa: Kashaya rasa pradhana pancha rasa.
Guna: Ruksa and Guru (slight)
Virya: Ushna
Vipaka: Madhura
Doshagnata [16]: Mainly used specifically in predominance of Kapha dosha, moderate vitiation of Vata and mildly derranged Pitta.
Rogagnata: Kusta, Prameha, Medhoroga and Vishama jwara.
Because of these properties it is used as Dipaniya, Pachaniya, Vatanulomana, Hridya, Chakshusya and Rasayana.
Form of Administration: Kwatha (decoction), Churna (pulvalise), Ghrita (medicated animal fat),Varti (collyrium) and Guggulu dosage forms.
Triphala in Netra roga
External/Topical use of Triphala: Netra prakshalana, Netraseka, Vidalaka, Pindi, Aschyotana ,Anjana, Tarpana and Putapaka comes under Bahirparimarjana of Netra roga.
a) Netra prakshalana - Ocular wash/Splashing with Triphala aqueous solution.
Triphala possess mainly ruksha and ushna properties, hence it can be mainly used in Kaphaja abhishyanda and Kaphaja vartmagataroga (Eye lid disorders).
b) Netra seka - Therapeutic Ocular irrigation in closed eyes from a height of 7-8 cm [9]. Though netra seka with Triphala kwatha can act as Tridosha shamaka, But it comes under lekhana Netra seka which can be used mainly in Kaphaja netra roga [17].
c) Aschyotana - Instilling medication in drop form a height of 3-4 cm [18].
Aschyotana with triphala kwatha can be used in Amavastha of Netra roga also. According to Acharya sharanagdhara triphala kwatha aschyotana is said to be best in all types of abhishyanda [19].
d) Vidalaka and Pindi - Medicated application over closed eyes in paste as well as poultice form [20,21].
Triphala churna vidalaka and pindi is used in shleshma pitta netraroga [22].
e) Anjana - Application of medicine in conjunctival sac [23].
Triphala is one of the main ingredients in various formulations of lekhana anjanas.
f) Tarpana - Satiating eye with ghee by retaining it on eye ball and blinking continuously for a stipulated period [24].
Triphala ghrita tarpana is mainly indicated in Kaphaja Timira [25].
g) Putapaka - Pouring and withholding various form of medicated extracts prepared by specific pharmaceutical process called putpaka in open eyes followed by blinking continuously for a stipulated period [26].
Triphala is used as one of the ingredient in lekhana putapaka in kaphaja netra rogas.
The above said therapeutic measure’s mode of action in different clinical conditions is supported by various Pharmacological studies which reveals, Triphala has radioprotective effect, anti-inflammatory, antimutagenic, antioxidant, cytoprotective activity and it is a potential and inhibits local anaphylaxis [27].
Internal Use of Triphala
Triphala possess tridoshasamaka property, Cakshushya as well as good kostha shodhaka hence it can be jolly well used in all Netra vikaras for the purpose of shodhana (procedure by which excess accumulation of vitiated doshas from the body is removed). Hence Triphala is used as both shaman (procedure by which accumulation of vitiated doshas from the body is pacified) and shodana in day today clinical practice to prevent and manage ocular disorders. Acharayas highlighted the role of triphala prayoga as shamana mainly in Drishtigata vikaras (group of eye disease in which vision is mainly affected). Triphala is used as rasayana dravya in all drishtigata rogas only by changing the anupana (adjuvants) depending upon the doshic predominance. For eg: Triphala with madhu, taila and ghrita in Kaphaja, Vataja and Pittaja Netra roga respectively [28]. Use of Triphala is also quoted in drugs which prevent one from eye ailments [29]. Triphala churna along with madhu (honey) and ghrita (ghee) is considered to be the best rejuvenation therapy for eye disorders [30].
Various studies has also been reported regarding the efficacy of triphala in eye disorders like Cataract Gupta SK [31] Diabetic retinopathy Lu et al. [32] and Age related macular degeneration Ponnushanker et al. [33]
Triphala: Yogas (Formulations)
Famous yogas containing Triphala as main ingredient, which are utilized in day today ophthalmic practice are Triphala Churna, Sadanga kwatha guggulu, Triphaladi kwatha ,Triphaladi anjana,Tripahala varti, Triphaladi rasakriya, Nagarjuna varti, Kokilavarti, Drustiprada varti, Candhanadi varti, Lohadi guggulu, Timirahara lauha, Saptamruta loha, Triphaladi ghrita, Mahatriphaladi ghrita and Triphala Guggulu [31].
Thus Triphala can act as a wonderful drug in maintaining the ocular health and mange the ocular disease. By adopting Triphala as a part of dietic regimen, one can be free from ocular disorders and live a disease free life.
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