Why So Many Dosage Forms In Ayurveda? Six Scientific Criteria

Ayurveda pharmaceutics explains a variety of dosage forms. Dosage form means, forms of medicine. Example – Kashayam, Asava, Arishta, Vati (tablets), Avaleha (herbal jams) etc. This discussion helps to know why so many dosage forms are explained in Ayurveda, whether all of these are necessary in today’s world etc.

Dosage forms video

Dosage form is termed as Kalpana in Ayurvedic pharmaceutics. Kalpana refers to various kinds of preparations, prepared based on necessity of the chemical constituents, required for the particular purpose. In Sanskrit, it is told,

kalpa: vidhi: vidhane samskare  |

Types of dosage forms

Depending upon the sequence or depending upon the step or depending upon the special pharmaceutical process, i.e. Samskara, what kind of chemical constituents are required in a particular medium, accordingly we are preparing specific pharmaceutical preparations, like
Swarasa – fresh juice extract
Kalka – medicated paste,
Kwatha – decoctions,
Hima – cold infusions, (Example: Coriander infusion)
Phanta – hot infusions,
and their derived dosage forms like Taila (herbal oil), Ghrita (medicated ghee), Asava and Arishta (naturally fermented alcoholic preparations like Dasamolarishtam), Avaleha (herbal jams),  Churna (powders), Kshara, Lavana, etc so many preparations are there.

Based on chemical constituents

Based on requirement of particular chemical constituents:
If water extracts are needed in a disease, then usually, Kashaya is preferred. Example: Triphala Kashayam
If fat soluble principles of herbs are needed, then Taila / Ghrita dosage form is preferred.
If volatile oils are to be used, then Churna / Hima (cold infusions) dosage forms are preferred.

In primordial text like Charaka Samhita, more than 160 such dosage forms are mentioned. While explaining the utility of each and every formulation,

Based on patient’s comfort

Choice of dosage form based on patient’s comfort –
Acharya Charaka correctly refers,

Means, every individual has particular likes and particular dislikes, Depending upon the particular likes and dislikes of the patient, we should choose appropriate dosage forms. If a person who does not like Swarasa (fresh juice), we should not compel him to take Swarasa, because psychological factors do have impact on the efficacy of the medicine. Because, swarasa will be usually bitter and pungent in taste and patient may not like it to have.

Based on disease

Choice based on patient’s disease – Another difficulty is, for a patient of diabetes, we cannot administer Asava and Arishta in large doses, or for long period of time, because these dosage forms have sugar content. In such a condition, Kashaya  or tablet etc can be chosen.

Based on stage of disease

Choice based on stage of disease –
In a patient, the choice of dosage form can be made by looking whether the disease is new or old.
In acute conditions, it is not suitable to administer any kind of oleaginous dosage forms like Ghrita, Taila or Avaleha. Whereas in chronic conditions, administration of basic dosage forms like Swarasa or Kalka might not be very helpful.
In chronic conditions, we should chose Asava, Arishta dosage forms / Lehya preparations (like Ajamamsa Rasayanam) or ghrita, taila (for oral administration), etc.

The reason for this is, digestion strength.
Ayurveda focuses on digestive strength as a primary consideration point. When the digestive strength is low in early stages of disease, patient might not be able to digest heavier dosage forms like Avaleha or ghrita. If these dosage forms are administered in a newer disease, a condition called as Aushadha Ajirna may occur. Here, medicine itself causes indigestion. This may lead to further increase in morbidity (Dosha worsening) and disease may become more difficult to cure.

In initial stages of disease, usually Kashayam (herbal decoction) is preferred. Because, Kashaya, by nature itself, has capacity to digest. They innately have digestive and carminative quality. (Deepana and Pachana quality).
But natural Deepana and Pachana effect will not be there in Taila, Ghrita etc.

Based on digestion strength

When the patient already has good digestive capacity, unnecessary adoption of Asava and Arishta dosage forms may be harmful. Because, it may damage the tissues.
This is why, even in Panchakarma procedure, before administering Snehakarma (high amounts of ghee), first, Deepana and Pachana treatment is done to improve Agni (Digestion power) in the patient. Hence it is told,

deepanai: paacanai: snehaistan svedaishcha parishrutaan | |
Shodhayet shodhanai: kaale yathaasannam yathaamalam ||

Before the administration of Panchakarma purification procedures like Vamana (emesis), Virechana (purgation treatment), Nasya (nasal drop treatment), etc, First of all, Deepana (improving digestion strength) and Pachana (digesting the remnant Ama in the stomach) treatment is administered. Then the Dosha is brought to Koshta (GI tract) by Snehana (oleation) and Swedana (sweating treatment) and is eliminated out either through oral route for Kapha (because stomach is the site of Kapha) or through anal route (because of intestines is site for Pitta and Vata Doshas). Read more – site of Kapha Dosha

Based on Dosha dominance

Whenever Kapha is dominant, we should prefer Churna Yogas.
Whenever Vata Dosha is dominant, we should prefer Taila or Ghrita yogas.
Whenever Pitta is dominant, we can opt for Hima Kalpana (cold infusion) or Phanta Kalpana (hot infusion).

Raw herb Vs medicine forms

Is it not best if we take the medicine directly from the root, i.e. the plant/seed etc.? Because by the time it is placed in a capsule, it loses its effectiveness. If this is true, should we not use plants or medicine that is nearer to their origin?Dr JV Hebbar: 
If this question is further extrapolated, we may ask, why even take the kadha? We can just take the raw herb directly. After all, the nutrients are fresh in the raw herbs. 
The primary purpose why we manipulate herbs into the form of kadha or powder or capsule, is to present the required medicinal chemicals from the herbs to the body in an easy-to-absorb way. 
This is why we do not eat the paddy or the rice as it is. We remove the husk, cook it and then only consume it with yummy sambar, gravy, chutney, rasam etc.
– A south Indian bias on meals 😉 Bear with it. haha 🙂 

Similarly, the phytonutrients in most of the herbs are hidden deep in the herbs or they are present in a complex form.
Turning them into
kashaya by boiling it in water,
churna by drying and pounding herbs into powders 
Vati by binding the powder into tablet 
Asava or arishta by fermenting the decoction or infusion 
Arka by the process of distillation etc.

Giloy Kadha (Kashaya) vs Giloy GhanvatiWe cannot argue that kadha is better than a tablet or vice versa. 
In a Kadha (Kashaya), the giloy is boiled with water and then filtered. The water soluble medicinal chemicals of giloy are found suspended or dissolved in the water medium. 
In the ghanavati form, the same boiling process is further continued till the mass turns solid, and it is rolled into pills. This is the principle behind kashayam tablet or kwatham tablets
Kashaya is good but it cannot be stored for long. If we want to store it for long time, we have to add preservatives to it. 
Ghanavati tablets / Kashayam tablets require very less amount of additives, can be stored for longer period of time, are easy to swallow by avoiding the bitterness of Kashaya, dose-fixing is also very easy. Just take a tablet and gulp it with water. 

But the phyto-chemical availability and absorption rates are higher in kashaya than in tablet forms. 
So, both these two forms of medicine have their own advantages and minor disadvantages as well.
Read related: Kashayam Tablets – innovative Speciality Products

I am not saying that all herbs should be modified before consuming.
For example, we can avoid taking these nutrients individually – Alpha-linolenic acid, Ferulic acid, Isoquercetin, Lutein, Niacin, Neoxanthin, Thiamine, Riboflavin, Pantothenic acid etc., by just eating the damn apple fruit as it is. 

Amla, mango, jamun fruits etc. are good to consume as they are. 

Sometimes, modern scientists overdo this chemical extraction process. For example, coconut oil contains lauric acid, which is very good for the brain and has potential to treat many different neurological disorders such as Parkinson’s, Alzheimer’s etc.  Likewise, coconut oil has many other alkaloids, glycosides, Terpenoids that are useful to improve our health. So why bother taking the lauric acid extract, when you can enjoy a teaspoon of coconut oil a day? 

Reasoning for different ingredient proportions

In Ayurveda, Kashaya or herbal tea is prepared by adding 8 or 16 parts of water to 1 part of coarse powder of herb and boiling it to 1/8 or ¼ parts, filtered and used.
Eg: 10 grams of triphala + 160 ml of water, boiled and reduced to 40 ml, filtered and used for washing eyes or wounds to clear off infection and irritation.
Read detailed riphala Kashaya preparation and benefits

Usually Kashaya or decoctions are very strong. They are meant to treat strong diseases. Hence, they are boiled and reduced to a quarter or 1/8^th. These decoctions are usually given once or twice a day only.
Read related: Kashayam (Kwath) – Herbal Teas Preparation [Video], Benefits, examples

There is a weaker version of decoction, called Paneeya. Here, one part of coarse powder of herb is added with 64 times water, boiled and reduced to just half, filtered and used.
It is more dilute compared to decoction. This is designed so, because the paneeya or herbal drink is meant to be given many times, throughout the day or as part of food. Here, the purpose of Paneeya is to keep the recurring symptoms such as burping, sneezing, cough, hiccups, vomiting etc. under check.
More on this, in my book Easy Ayurveda Home Remedies

Weaker than the above two are hot or cold infusions.  

Hot infusions – 1 part of herb is added with 4 parts of hot water, stirred or macerated, filtered and used.
Cold infusion – 1 part of coarse powder of herb is added with 6 parts of cold water, kept for several hours, filtered and used.
The proportion of water in hot infusion is lower because the hot water extracts the medicinal principles of herbs into water medium with some positive force.
In case of cold infusion, it is an unforced attraction. In the course of few hours of time, the transfer of medicinal principles happens without any additional force. So, the proportion of water is kept slightly higher.

In herbal ghee or herbal oil preparation, 1 part of herb added with 4 parts of ghee / oil and 16 parts of liquid / water.
Here, liquid / water proportion is four times to that of oil or ghee.
If water is not there in the mix, if just the herbs and ghee is taken together and heated, the transfer of medicinal principles will not happen in a staggered way and in a few minutes, the ghee can get charred.
Adding a liquid or water here gives plenty of time for the medicinal principles to get transferred into the medium of ghee. Even water-soluble medicinal principles get into the ghee or oil.
Read: How To Make Hair Oil At Home With Amla

Overall, suitable proportions are explained for different medicinal forms in Ayurveda.
The ancient masters might have done several trials and errors to arrive at these proportions of herbs and liquids. Even today, the same proportions are utilized in preparing these medicines and the same results are got. So, these proportions are taken as Apta vachana – directions from the learned people and followed as such.
Why change the proportions, when they are working as expected?