To study the efficacy of Twagadi Panak in madatyaya with special reference to alcohol withdrawal symptoms.

Title:-To study the efficacy of Twagadi Panak in madatyaya with special reference to alcohol withdrawal symptoms.

Dr. Mahadeo Mali had submitted his dissertation to Pune University for the P. G. degree M.D. (Kaya Chikitsa) in the year 2001. His guide was Dr. S. V. Deshpande & Research center was Tilak Ayurved Mahavidyalaya, Pune, (M.S.) India.

          Dr. Mahadeo Mali in his research work tried to study efficacy of Twagadi Panak in madatyaya with special reference to alcohol withdrawal symptoms. Twagadi Panak was prepared by hot process method . Pulp of well ripened kapithalphala (Feronia elephantum) was taken and processed in boiling water pulp was mashed and fibers were removed from the pulp. In one part of pulp, four parts of water was added, one part of crystal sugar and 250 mg of each prakshepa dravyas were added, except phalasa and karpoor.  Karpoor was added only 50 mg in each dose and phalasa was not added in the preparation because of its non availability.

          Ingredients of Twagadi panak were as follows-

1)      Twak- (Cinnamonum zeylancia) 250 mg, Nag pushpa (Mesua ferrea) 250 mg, pippali (Piper longum) 250 mg, Marich (Piper nigrum) 250 mg, Jirakam (Cuminum cyminum) 250 mg, Dhanyakam (Coriandum sativum) 250 mg, Parushak (Grewia asiatica) 250 mg Madhook (Bassia latifolia) 250 mg, Ela (Elatlaria cardamum) 250 mg, suravha (Cedres deodar) 250 mg, seeta (Cuccharum officinarum) 20 mg, Karpoora (Cinnamomum camphora)  50 mg, & Kapittha (Feronia elephantum) 20 gm.

Twagadi panak in the dose of 80 ml 4 times a day was given for 15 days.

Clinical study was carried out on 30 patients.

Some of the criteria’s for assessment were as follows-

I)                  Hridvyatha (cardiac pain) – i) Grade 0 = absence of symptom,

ii) Grade 1 = present after accustomed heavy work, iii) Grade 2 =    present after routine work & iv) Grade 3 = present at rest.

II)               Shir parshwa asthi sandhi vidyut tulya vedana ( Pain like electric shock in head, sides, bone & joints) i) Grade 0 = No pain or absent  ii) Grade 1 = mild severity but no disturbance in normal life,

iii) Grade 2 = medium severity, disturbances in daily routine life / work & iv) Grade 3 = can’t sleep or do his daily work.

III)            Sphurana (twitching throbbing/ trembling in general), vepanam (tremor/trembling) i) Grade 0 = Absence of sphuranum, ii) Grade 1 = 1to 5 times/day iii) Grade 2 = 6 to 10 times/day iv) Grade 3 = more than 10 times/day.

IV)           Urovibandha (obstruction in chest) i) Grade 0 = Absence of symptom, ii) Grade 1 = 1 to 3 times/day, iii) Grade 2 = more than 3 times & iv) Grade 3 = frequently with chest pain.

V)              Hikka ( Hiccough)  – i) Grade 0 = absence of hikka, ii) Grade 1 = Present sometimes & subside without treatment, iii) Grade 2 = present after exertion & iv) Grade 3 = present through out day.

VI)           Trik Graha – i) Grade 0 = Absence of symptoms, ii) Grade 1 = can perform routine work, iii) Grade 2 = can not perform routine work & iv) Grade 3 = continuous & unbearable.

VII)        Atisar ( Diarrhoea)– i) Grade 0 = Absence of symptom, ii) Grade 1 = 1or 2 times, iii) Grade 2 = frequently more than 3-5 times & iv) Grade 3 Frequently with general debility.

VIII)     Bhrama( Giddiness)  – i) Grade 0 = Absence of symptoms, ii) Grade 1 = occasional or after exertion, iii) Grade 2 = present at sudden walking from bed & iv) Grade 3 = continuous & present on the bed also.

IX)           Asat darshan- i) Grade 0 = Absence of symptom, ii) Grade 1 = occasional episode 1 to 2 times, iii) Grade 2 = frequently more than 3 times & iv) Grade 3 = frequently along with delirium.

X)              Jihva Samata ( Tongue coating) - i) Grade 0 = absence of samata, ii) Grade 1 – centrally coated, iii) Grade 2 = peripherally coated, iv) Grade 3 = totally coated.

In the clinical study it was found that Deshi alcohol i.e. prepared from molasis which is cheap for the economically poor people, Hatbhatti alcohol is also cheap & it gives more concentration of alcohol and other mixed agent give kick to drunker.

Ingredients in Twagadi panak are sadyatarpan & it is Jalamahabhoot pradhan so tarpan & preenan of udakadhatu was observed reliving the most common symptom in madatyaya i.e. Trushna.

The study was concluded as follows-

Twagadi panak in the dose of 80 ml 4 times a day when  given for 15 days showed very good results to control Alcohol withdrawal symptoms

Satat trushna, kshudha mandya, anidra, aruchi, sharirkampa, hridvyatha, hrullas, shrama, shwasa, malavibandha & shirogaurav were the predominant symptoms observed in patients.

1)    Not a single patient had shown delirium tremors.

2)    Symptoms were relived within 10 days.

3)    Sadhishoola, kasa, shwasa, sharirkampa, netra gaurav & udarshoola relived within 15 days.

4)    Anidra was not relived in 4% patient even upto 15 days of treatment.