Chaturbhadra Decoction for Indigestion

          Improper digestion of food usually results from over eating, frequent eating without having the feeling to eat, untimely eating, emotional outbursts and improper sleep. Decreased secretion of digestive juices is a relatively less common cause of indigestion. Usually there is a relative deficiency of digestive enzymes, an imbalance of gastrointestinal environment and impaired movement of the intestines. In order to facilitate proper digestion, food should be taken on time, in the right amount and should be of proper contents.

          Individuals with a stressful lifestyle mostly suffer from persistent low-grade indigestion with acute attacks in between because of dietary indiscrimination. Indigestion can also result from gastrointestinal infection, consumption of contaminated food or due to certain medicines, which cause irritation in the stomach and in the upper part of the intestine.

          Indigestion becomes apparent with a feeling of fullness or heaviness in the abdomen, low appetite, nausea, abnormal taste in mouth and disturbed bowel movements in the form of constipation or loose motions. In acidic indigestion, sour eructation or belching and water brash are usually present. Indigestion is primarily a selflimiting condition manageable with avoidance of solid food for a day or two followed by intake of soft, light and easily digestible food for a couple of days.

          Severe and prolonged indigestion, however, always needs medication and can be effectively managed with simple digestive herbal formulations such as Chaturbhadra decoction.

Chaturbhadra Decoction:

          Chaturbhadra decoction is a herbal formulation listed in the Ayurvedic Formulary of India1 for management of indigestion and indigestioninduced gastro-intestinal problems. Its ingredients are individually described in the Ayurvedic pharmacopoeia and are reported to have therapeutic properties useful for management of bowel disorders including impaired digestion, diarrhoea, vomiting, loss of appetite and protozoal infection. The formulation is carminative and astringent and it improves the digestive and gastro-intestinal functions.

Composition:

          Chaturbhadra decoction is made from the following four ingredients in equal parts.

 

Sr. No.	Name of the Drug	English Name	Latin Name	Family	Part Used
1.	Ativisha	Indian Atis	Aconitum heterophyllum Wall.ex.Royle	Ranunculaceae	Root
2.	Guduchi	Tinospora	Tinospora cordifolia (Willd.) Miers. ex. Hk.f. & Th.	Menispermaceae	Stem
3	Mustaka	Nut grass	Cyperus rotundus Linn.	Cyperaceae	Rhizome
4	Shunthi	Ginger	Zingiber officinale Rosc.	Zingiberaceae	Rhizome

 

Main chemical constituents:

1. Ativisha3 : Alkaloids like atisine, dihydroatisine, hetisine, etc.
2. Guduchi2 : Terpenoids, alkaloids, etc.
3. Mustaka5 : Volatile oil.
4. Shunthi4 : Essential oil, pungent constituents: gingerols and shogaols, resinous matter and starch.

Quality standards:

         For quality assurance, physical constants of the ingredients used in the formulation should be as under.

 

Ingredient	Foreign Matter	Total Ash	Water Soluble Ash	Acid Soluble Ash	Alcohol Soluble Extractive	Water Soluble Extractive	Volatile Oil
Ativisha3	Not more than 2%	Not more than 4%	-	Not more than 1%	Not less than 6%	Not less than 24%	-
Guduchi2	Not more than 2%	Not more than 16%	-	Not more than 3%	Not less than 3%	Not less than 11%	-
Mustaka5:	Not more than 2%	Not more than 8%	-	Not more than 4%	Not less than 5%	Not less than11%	Not less than 1%
Shunthi4	Not more than 1%	Not more than 6%	Not less than 1.5%	-	Not less than 3%	Not less than 10%	-

 

Method of Preparation: The decoction is prepared as follows.

1. First dry and clean all the four ingredients.
2. Make coarse powder of each ingredient.
3. Take the coarse powder of all the four drugs in equal quantity and mix properly.
4. The mixture should be stored in an air-tight container for use within one year, after which its potency is reduced.
5. Boil 10 grams of the mixture in 160 millilitres of water till one fourth water remains.
6. Filter the liquid.
7. Add 1-2 grams of fine powder of ginger (Zingiber officinale Rosc.) and cumin seeds (Cuminum cyminum Linn.) in the decoction just before taking, to make it more effective.

Dosage Form: Warm, light-brownish decoction.

Therapeutic Properties1:

         Chaturbhadra decoction has digestive, appetizing, anti-emetic, stomachic, carminative and anti-diarrhoeal properties.

Dose and mode of Administration:

          The dose of Chaturbhadra decoction for adults is 40 millilitres of freshly prepared warm decoction and 5-10 ml for children, to be administered twice a day before meals. It is advisable to sip the decoction instead of swallowing it in one lot.

Indications and Uses:

1. The decoction is mainly used for the management of indigestion resulting from overeating, untimely meals and consumption of heavy food items and from liver dysfunction.
2. Other indications include poor appetite, vomiting, flatulence, nausea and indigestion associated with diarrhoea and dysentery.
3. Gastro-intestinal upsets due to giardia and amoebic infections can also be managed with Chaturbhadra decoction6.

Precautions and Safety Aspects:

1. Freshly prepared decoction should be used always. Stale decoction may not be useful.
2. Individuals not liking the taste of the formulation can add sugar or honey.
3. To facilitate recovery, patients should consume soft, light and semisolid or liquid diet and avoid cold and heavy foods and raw vegetables.
4. If indigestion is induced or aggravated due to stress, mental relaxation must be achieved.
5. The formulation is traditionally considered to be safe in the recommended doses and side effects are mostly unlikely. However, due to presence of Ativisha and Shunthi in the formulation, an overdose may cause symptoms like dryness of mouth, tremor, nervous depression, etc.
6. Pregnant women should use the formulation under medical supervision.
7. It is safe for the baby if the nursing mother is taking this medication.

References:

1. India, Ministry of Health and Family Welfare. The Ayurvedic formulary of India. Second revised English edition. Part I. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2003. p. 54.
2. India, Ministry of Health and Family Welfare The Ayurvedic pharmacopoeia of India. Part I. Vol. I. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2001. p. 42.
3. India, Ministry of Health and Family Welfare The Ayurvedic pharmacopoeia of India. Part I. Vol. I. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2001. p. 23.
4. India, Ministry of Health and Family Welfare The Ayurvedic pharmacopoeia of India. Part I. Vol. I. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2001. p. 104.
5. India, Ministry of Health and Family Welfare The Ayurvedic pharmacopoeia of India. Part I. Vol. III. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2001. p.130.
6. Billore KV et al. Database on Medicinal Plants Used in Ayurveda, Vol. 7. New Delhi: Central Council for Research in Ayurveda and Siddha, 2005. p. 40.

WHO