Conceptual Review on Sugandha Cikitsā in Āyurveda

Introduction

Āyurveda is a comprehensive health system that originated during the ancient Vedic times of India, primary emphasising is on Ātura Vikāra Praśamana (prevention of disease) and Svāstya Rakṣaṇa (maintenance of health). Āyurveda defines health as “The equilibrium state of Dōṣas (Vāta, Pitta & Kapha), Agni, Sapta Dhātus, Trimala and pleasure or happiness of the soul, senses and the mind”. Āyurveda offers the precious knowledge on use of various measures to preserve health and life. Therefore, individualized Dinācāryā (specific daily regimen), R̥tucaryā (seasonal regimen), Sadvr̥tta (behavioural and ethical considerations) are suggested to remain free from the presenting illness. Vikāra Praśamana is one of the aims of Āyurveda. Thus, various management protocols are recommended to treat the diseases and re-establish the disturbed state of the body elements to bestow health. Sugandha Chikitsā is one such protocol and have a wide range of application throughout the Saṁhitā. Since Gandha Guṇa is an inherent component of Sugandha, Sugandha Cikitsā can also be considered as a kind of Pāñcabhōutika Cikitsā. 

Aims and Objectives:

1. To review the concept of Sugandha Cikitsā in Br̥hatrayī

2. To understand influence of Saumansya on Sugandha Cikitsā

3. To elaborate the concept of Sugandha Cikitsā mainly based on Swastya paripālana and Āturavikāra prashamana

Review on Sugandgā:

Derivation:

The word ‘Sugandha’ is a Strīliṅga pada.

• That which is endeavoured with pleasant smell i.e., śōbhanō gaṁdhō yasyāḥ¹ -Śabdhakalpadr̥ma

Definition:

• sugandhayāḥ śōbhanagandhāḥ² -A.H.ci.6/6

The odor which is pleasant in nature is called Sugandha.

Synonyms³ :

Sagandhaḥ, Iṣṭagandhaḥ, Surabhiḥ, Ghrāṇatarpaṇaḥ. - Amarakōṣa

Sugandha as a Guṇa⁴ :

In sushrutha saṁhitā, Sugandha is considered as one among Vimashati (20) Guṇa.

Qualities:

sukhānubandhī sūkṣmaśca sugandhō rōcanō mr̥duḥ -S.S.Su.46/521

It is having qualities like Sukhānubandhi (Pleasant), Sukṣma (Subtle), Rōcana & Mr̥du (Soft).

Pārthiva Dravyā Lakṣaṇa

Gandha Guṇa is the inherent quality of Pārthiva Dravyā. i.e.,

tatra dravyāṇi gurukharakaṭhinamanda sthiraviśadasāndra sthūla gandhaguṇabahulāni pārthivāni⁵ -C.S.Su.26/11

The substances which possesses the qualities such as Guru (heavy), Khara (rough), Kaṭiṇa (hard), manda (dull), Sthira (stable), Viśada (non-slimy), Sandra (solid), Sthūla (gross) & predominant in Gandha (smell) is called Pārthiva Dravyā.

Review on Cikitsā:

Etymology

• The word ‘Cikitsā’ is derived from root word ‘Kit’ (िकत्). It is a Strīliṅga pada.

• In Sanskrit, Kit means eradication or elimination (of diseases) i.e. kit rogapanyane⁶

Thus, the word ‘Cikitsā’ means elimination or separation or destruction of diseases from the body.

As per Amarakosha,

cikitsā ruk pratikriyāḥ⁷

Hence, Cikitsā is called the action taken against a disease or eradicating pain or disease.

Definition:

yābhiḥ kriyābhirjāyantē śarīrē dhātavaḥ samāḥ| sā cikitsā vikārāṇāṁ karma tadbhiṣajāṁ smr̥tam⁸ - (C.S.Su.16/34-35)

According to Acārya Charaka, whatever activities bring the normalcy of dhātus are known as Cikitsā. This in fact is the duty of a physician.

Synonyms:

• Rōgapratīkāraḥ, Rukpratikriyā. ⁹

• Vyādhiharaṁ, Pathyaṁ, Sādhanam, Auṣadham, Kāryaphala, Prāyaścittaṁ, Praśamanaṁ, Prakr̥tisthāpanaṁ. ¹⁰

Methods

To fulfill the above aims and objectives, this review article is divided in 2 phases:

1. Systematic compilation of the references of Sugandha Cikitsā from classical Āyurvēda texts vis., Charaka saṁhitā, Suśruta saṁhitā, Aṣṭāṅga hr̥daya, Aṣṭāṅga saṅgraha, related journals and works were undertaken.

2. Basic information related with saumansya had been included for better understanding of Sugandha Cikitsa and finally application & understanding of Sugandha Cikitsa based on Swastya paripālana & Āturavikāra Praśamana was done.

Review of Sugandha Cikitsā in Br̥hatrayī for Swāstya Paripālana:

As per Charaka Saṁhitā, main aim of āyurveda is to maintain dhātusāmyata. i.e., dhātusāmyakriyaiva yasmādāyurvēda prayōjanaṁ¹¹ as dhātusāmyata is considered as ārogya i.e. dhātusāmyam ārōgyaṁ¹²; -C.S. Su.1/53.

Hence to maintain dhātusāmyata in svastha individuals, Sugandha Cikitsā is also one modality which is having references throughout br̥hatrayī (Table 1).  

Review of Sugandha Cikitsā on Br̥hatrayē oor ĀTuravikāra Praśamana.

Utility of Sugandha dravyā is mentioned not only in Svāstya Paripālana, it’s application is found even in Aātura vikāra praśamana. In Saṁhitā, vikāra is defined as dhātu vaiṣamya i.e., vikārō dhātuvaiṣamyaṁ, sāmyaṁ prakr̥tirucyatē¹² -C.S.Su.9/4. Table 2 emphasises the utility of Sugandha dravyās in both svāstya and Ātura paripālana and enlists the references of utility of Sugandha dravyās in ātura vyadhi Cikitsā. 

NOTE ON SAUMANASYA:

As the article focuses on review on Sugandha Cikitsā, it is important to brief about sumanas.

Definition:

• saumanasyaṁ sumanskata¹³-S.S.Su.46/481(Comm)

• saumanasyakr̥taṁ cittaprasādakr̥t ¹⁴-A.H.Su.3/22 (Comm)

Sumanas represents the calmness or peaceful state of mind. Here the manas will be sātvika in nature possessing proper discriminating power between the indriyārthas.

• saumanasyaṁ..... svādu sañjanayatyannam¹⁵-S.S. Su.46/481

Madhura rasa pradhāna āhāra is endowed with saumanasya guṇa. Through which its application can also be appreciated in śarīra.

• daurmanasya chittavicēsḥṭitaṁ¹⁶-S.S.Su.29/45

However, daurmana represents the disturbed or pathological state of mind where the mind is affected by rajas and tamō dōṣha.  

A person can be considered as ‘swasta’ if one has the praśāntata of manas along with other proper physical entities.

Sugandha dravyās are considered as saumanasya janaka, because of its positive effect on manas which intern is also due to its pleasant aromas. Caraka Saṁhitā has described iṣṭa gandha (pleasant odor) has good influence on manas. By the smell of Sugandha dravyās, manas moves towards the state of calmness due to the alleviating mānasika dōṣhas.

Implementation of Sugandha Cikitsā in Āyurveda:

Āyurvedic literatures mention the following extended application of Sugandha (Aroma) in health maintenance:

I. Implementation as prophylactic measures

II. Implementation in environmental and public salutariness

III. Implementation in pharmaceutics

IV. Implementation in therapeutics

I. Implementation as prophylactic measures

1. Use of Gandha mala for Dharanartha as a part of Dinācāryā. ¹⁷ i.e.,

vr̥ṣyaṁ saugandhyamāyuṣyaṁ kāmyaṁ puṣṭibalapradam|

saumanasyamalakṣmīghnaṁ gandhamālyaniṣēvaṇam||96|| – C.S.Su.5/96

Spraying perfumes & wearing garlands gives following benefits; acts as an aphrodisiac (vr̥ṣyaṁ), emits good smell (saugandhyaṁ), increases span of life (āyuṣyaṁ), appears beautiful (kāmyaṁ), nourishes body & bestows strength (puṣṭi-balapradam), pleasantness of mind (saumanasyam), puts an end to misfortune (alakṣmīghnaṁ).

2. Use of Sugandha Dravyās for Dhūmanartha as a part of Dinācāryā.¹⁸

śvētā jyōtiṣmatī caiva haritālaṁ manaḥśilā||26||

gandhāścāgurupatrādyā dhūmaṁ mūrdhavirēcanē |27| - C.S.Su.5/26-27

Śvētā (Aparājitā), Jyōtiṣmatī, Haritālaṁ, Manaḥśilā, Gandhāścāgurupatrādyā (aromatic drugs mentioned in jvara cikitsā for the preparation of agurvādi taila such as agaru, patra etc except Kuṣṭha and Tagara) are useful for conducting vairēcanika dhūmapāna.

3. Use of Sugandha dravyās as a part of Sadvr̥tta. ¹⁹

tat sadvr̥ttamakhilēnōpadēkṣyāmō'gnivēśa ! tadyathā- dēvagōbrāhmaṇaguruvr̥ddhasiddhācāryā narcayēt,......sumanāḥ sugandhiḥ syāt,–C.S.Su.8/18

4. To stay in Gardens / Forests having Sugandha dravyās as a part of r̥tucaryā especially in Vasanta and Grīṣma R̥tu. ²⁰

vicitrapuṣpavr̥kṣēṣu kānanēsḥu sugandhiṣu - A.H. Su.3/25

5. Avoidance of exposure to improper smells /flavors to prevent diseases.²¹

dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśana darśanaiśca|

yacchardayēttaptamanā manōdhnairdviṣṭārthasaṁy ōgabhavā matā sā||18|| -C.S.Chi.20/18

II. Implementation in Environmental & Public salutariness

1. Fumigating the Surrounding environment with Sugandha dravyās to prevent Janapadōddhvaṁsa. ²³

Because vikr̥ta Gandha of Vāyu, Jala, Dēśa is one of the reason for Janapadōddhvaṁsa i.e,

yathartuviṣamamatistimitamaticala………..parasparagatimatikuṇḍalinamasātmyagandhabāṣpasikatāpāṁśudhūmōpahatamiti (1);

udakaṁ tu khalvatyarthavikr̥tagandhavarṇarasasparśaṁ (2);

dēśaṁ punaḥ prakr̥tivikr̥tavarṇagandharasasparśaṁ klēdabahulamupasr̥ṣṭaṁ. -C.S.Vi.3/7

2. Purification of water with Sugandha dravyās. ²²

sauvarṇē rājatē tāmrē kāṁsyē maṇimayē'pi vā | puṣpāvataṁsaṁ bhaumē vā sugandhi salilaṁ pibēt ||13|| -S.S.Su.45/13

3. Sterilizing the Pediatric wards etc. with antimicrobial aromatic plants (Daśāṅgadhūpa).²⁴

śayanāsanāstaraṇaprāvaraṇāni kumārasya mr̥dulaghuśucisugandhīni syuḥ;... ||60|| -C.S.Sh.8/60.

III.Implementation in pharmaceutics:

1. Fumigating and sterilizing the containers or drug store houses with Sugandha dravyās to prevent contamination & infestations.

2. Development of stipulated dosage forms for Sugandha dravyās to retain their medicinal properties (Arka etc.). 

3. Determining the pharmaceutical specifications / end-points of manufacturing processes of various dosage forms (Avalēha and medicated oil/ghee etc.)

4. Use of Sugandha dravyās for patients’ compliance/ acceptability.

5. Treating the oils with Sugandha dravyās for manufacture (Taila and Ghrita mūrccana).

IV. Implementation in Therapeutics:

1. As a pittaja upakrama. ²⁵

sugandhiśītahr̥dhyānāṁ gandhānāmupasēvanam … -A.H.Su.13/5

2. Fumigation in wound: not only for healing purpose, but also to prevent unpleasant smell from wound & and to avoid insects, etc.²⁶

tatō guggulvagurusarjarasavacāgaura sarṣapacūrṇairlavaṇa nimbapatravimiśrairājyayuktairdhūpayēt -S.S.Su.5/18

na kevalam varanam dhupyet shyanadyapivarandaurgandyapagmaratham neelamkashikadiparihararatham cha [com]

3. In management of Rājayakṣma, Dviṣṭharthaja Chardi, Tr̥ṣṇa, Viṣa, etc. many contexts have utility of suganda dravyā.

4. Induction of emesis i.e. Ghrēya vamana yōga²⁷.

tumbyā phalarasaiḥ śuṣkaiḥ sapuṣpairavacūrṇitam||11||

chardayēnmālyamāghrāya gandhasampatsukhōcitaḥ||12|| -C.S. Ka.3/11-12

gandhasampatsukhōcita iti gandhasampat sugandhavattvaṁ, tayā gandhasampadā sukhamucitamabhyastaṁ yēna saḥ; (Comm)

The juice and powder of dried flowers of ikṣvāku should be sprinkled over a garland. The patients habituated to pleasant smell will vomit by the very smell of this garland of flowers.

5. As a Vr̥ṣya yoga.²⁸

mattadvirēphācaritāḥ sapadmāḥ salilāśayāḥ| jātyutpalasugandhīni śītagarbhagr̥haṇi ca|26||

Big ponds having lotus flowers, surrounded by intoxicated dvirepha, fragrance of jāji and utpala and underground which are cold acts as Vr̥ṣya in grīṣma r̥tu.

Discussion

Sugandha Cikitsā (Aroma therapy) is an aesthetic branch of Āyurveda. It aims towards comfort and satisfaction of an individual wherein these procedures acts as a part of normal healthy routine. In Saṁhitās, the aesthetic approach towards maintaining the health, preventing and treating the diseases has been highlighted. Best examples are, having food in a comfortable place with desired things or making the patient comfortable during pañcakarma therapy.

A Sugandha dravyā has pleasant smell that makes the environment peaceful. In classics much importance is given to the concept of gandha or odour. There are many technical terms related to gandha (Sugandha, durgandha, asātmyagandha, nirgandha, atigandha etc). where nāsa is having direct contact with śiras (Head) and gandha (Fragrance) directly acts on śiras (Head). Thus the effect is seen immediately. Though pleasant smell maintains the balance of mental health, unpleasant one leads to the disturbance of the mental health.

•  sumanāḥ sugandhiḥ syāt | - C.S.Su.8/18, by inhaling the pleasant or good odor, manas can do its function properly. Thus maintains mānasika swasthya.
•  sugandhiśītahr̥dhyānāṁ gandhānāmupasēvanam|| -A.H.Su.15 /5, in classics it is clearly indicated that one should inhale the pleasant odor daily and it pacifies the pitta dōṣa. This reference highlights that gandha not only acts on mānasika dōṣa but acts on śārīrika dōṣa too.

So with above references one can understand the influence of Sugandha dravyās on śārīrika and mānasika bhava both.

Probable mode of action of Sugandha dravyās (Aroma drugs):

Mainly Sugandha Cikitsā (Aroma therapy) works through the sense of olfaction because gandha Guṇa is having adhiṣṭhāna in nāsa (Nose). As nāsa is the only dvāra to śiras, drugs administered or used makes olfactory nerves active and leads to stimulatation of limbic system. Depending on the type of Sugandha dravyās used, nerve cells release different neurotransmitters (encephalin, noradrenalin and serotonin). Benzodiazepines of the essential oil can increase the effects of gabaaminobutyric acid a checal that acts as an anxiolytic. The drugs administered by nāsal route possibly act through Phaṇa Marmā (olfactory bulb and olfactory area) and Śriṅgāṭaka Marmā (cavernous sinus) owing to their rich, neural and vascular connections. However, accurate mechanism of neurologic function of Sugandha dravyās is difficult to identify.

In terms of Āyurveda it can be considered as follows:

Conclusion

From the above description, one can conclude that Sugandha Cikitsā (aroma therapy) is one of the many nātural gifts from nature for humans. As benefit of any kind of Cikitsā is mainly attaining dhātusāmyata, which can be seen through lakṣaṇas (pleasure of mind, intelligence, senses and body). [i.e., ..... tasya lakṣaṇaṁ manōbuddhīndriyaśarīratuṣṭiḥ || This criterion is achieved even by Sugandha dravyās in terms of maintaining health and curing diseases. Hence Sugandha Cikitsā is a unique and important branch of Āyurveda, which utilizes Sugandha dravyās for preventive and promotive aspects of disease.

Conflicts of interest:

None

Acknowledgement:

None