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Ashwagandha (Withania Somnifera); A potential aphrodisiac drug in Ayurveda

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Abstract

Ashwagandha (Withania somnifera) a is a shrub of Solanacae family. (Solanum =comforting) commonly known as winter cherry. Balada, Gandhanta, Vajinama, Balya, Punya, Vrusha are some of its Sanskrit names. This shrub attains a height of 1-2 mtrs. Its branches distributed in all directions and rounded. Leaves are alternate, 5-10cms long rounded and hair. Flowers are inflorescence in bunch, umbrella erupting from the base of the leaves. Sessile flowers, greenish or lurid yellow cyme. Fruits are small, round, juicy, capsulated, bright red like gunja seeds. Seeds are small, slimy and flat. The pharmacological importance of this plant is anti-oxidant, anxiolytic, adaptogen, memory enhancing, anti-venom, anti-inflammatory, antitumor properties. Various other effects like hypolipidemic, anti-bacterial, immunomodulation, cardiovascular protection and sexual behaviour is also influenced by Ashwagandha. It is a potential aphrodisiac drug in Ayurveda. It is one of the best herbs for building fertility and libido for both men and women. Ashwagandha is relatively inexpensive than other medicinal plants because it is easily grown and the roots require only a year to harvest. Infertility is defined as the failure of a couple to conceive after 12 months of unprotected sexual intercourse. Infertility affects 15% of all couples with approximately 50% of these having detectable male partner abnormality, usually because of lack of sperm motility and low sperm count. In general, there is a lack of specific medically effective therapies for male infertility. However, Ayurvedic and other systems of traditional herbal medicine around the world offer many effective options. Ashwagandha herb is one such option, and that a modern scientific study has been found to be effective is of great value for its aphrodisiac nature.
International journal of basic and applied research
www.pragatipublication.com
ISSN 2249-3352 (P) 2278-0505 (E)
Cosmos Impact Factor-5.86
1034
Received: 5 July Revised: 13 July Accepted: 22 July
Index in Cosmos
August 2018 Volume 8 Number 8
UGC APPROVED JOURNAL
Ashwagandha (Withania Somnifera); A potential aphrodisiac drug in Ayurveda
Neha Rawat1, Rakesh Roushan2*
P.G Scholar, P.G Department of Kriya Sharir, CBPACS, New Delhi, India1
Assistant Professor, P.G Department of Kriya Sharir, CBPACS, New Delhi, India2
Abstract
Ashwagandha (Withania somnifera) a is a shrub of Solanacae family. (Solanum =comforting)
commonly known as winter cherry. Balada, Gandhanta, Vajinama, Balya, Punya, Vrusha are some of
its Sanskrit names. This shrub attains a height of 1-2 mtrs. Its branches distributed in all directions
and rounded. Leaves are alternate, 5-10cms long rounded and hair. Flowers are inflorescence in
bunch, umbrella erupting from the base of the leaves. Sessile flowers, greenish or lurid yellow
cyme. Fruits are small, round, juicy, capsulated, bright red like gunja seeds. Seeds are small,
slimy and flat. The pharmacological importance of this plant is anti-oxidant, anxiolytic, adaptogen,
memory enhancing, anti-venom, anti-inflammatory, antitumor properties. Various other effects
like hypolipidemic, anti-bacterial, immunomodulation, cardiovascular protection and sexual
behaviour is also influenced by Ashwagandha. It is a potential aphrodisiac drug in Ayurveda. It is
one of the best herbs for building fertility and libido for both men and women. Ashwagandha is
relatively inexpensive than other medicinal plants because it is easily grown and the roots require
only a year to harvest. Infertility is defined as the failure of a couple to conceive after 12 months of
unprotected sexual intercourse. Infertility affects 15% of all couples with approximately 50% of
these having detectable male partner abnormality, usually because of lack of sperm motility and
low sperm count. In general, there is a lack of specific medically effective therapies for male
infertility. However, Ayurvedic and other systems of traditional herbal medicine around the
world offer many effective options. Ashwagandha herb is one such option, and that a modern
scientific study has been found to be effective is of great value for its aphrodisiac nature.
Key words: Ashwagandha, Impotency, Aphrodisiac, Infertility.
Introduction
Ashwagandha (Withania somnifera) also known as Indian ginseng, poison gooseberry, or winter
cherry, is a plant in the Solanaceae or nightshade family. It is a wellknown herb of the Indian
ayurvedic system of medicine as a rasayan. It is used for various kinds of disease processes and
many studies were carried out. It is no wonder, with all the benefits this beloved whole plant has
to offer! Ashwagandha has been used in Indian system of medicine for thousands of years as a
Rasayana and it is renowned as an apoptogenic herb, which means it is used to help the body
resist psychological and physiological stress by adapting to the needs of the body accordingly.
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Ashwagandha functions as to tone, revitalize and support bodily functions. It has been valued over
time for its dual capacity to energize and calm at the same time. Stress can cause fatigue, often
manifesting as “hyper” signs like tension and difficulty napping. By providing a nourishing, yet
energizing effect, ashwagandha can support a healthy nervous system. With the use of
ashwagandha, stress doesn’t impact the nervous system with such intensity, and the “hyper” signs
of stress and agitation will naturally resolve over time1. Rasayan is described as herbal and
metallic preparations that promotes a youthful state of physical and mental health and expands
happiness. Ashwagandha holds the most prominent place and is known as “sattvic rasayan” herb
and it has anti stress effect. The root of ashwagandha is regarded as narcotic, diuretic, tonic,
aphrodisiac, astringent, stimulant and thermogenic. The root smell like horse “ashwa”, that is why
it is called ashwagandha. It is commonly used for growth and nutritive effect in children, debility
from old age, vitiated conditions of Vata, constipation etc. The paste formed when roots of
ashwagandha are crushed with water and is applied at joints to reduce the inflammation. It can be
locally applied in carbuncles and painful swellings. In snake venom the root of ashwagandha in
combination with other drugs is prescribed. The leaves are recommended in painful swellings
and fever. The flowers are aphrodisiac, astringent, depurative as well as diuretic. The seeds of
ashwagandha are antihelmentic and used for eyes diseases, it can be combined with astringent
and rock salt to remove white spots from the cornea. Ashwagandharishta is used in memory loss,
syncope, hysteria, anxiety, etc. It also acts as stimulant in males and increases the sperm count.
Flowering in ashwagandha occurs in spring and fruits in winter. In rainy season seeds of
Ashwagandha are to be implanted and in hemanta ritu harvesting of ashwagandha plant should be
done. In these specific seasons the parts of plants collected are said to be best. Male impotency
can have many causes, including physiological and psychological ones. However, many if not
most cases of functional male impotency are accompanied with low sperm count and low sperm
motility. Whereas Ashwagandha can serve as an aphrodisiac in stimulating libido in both the
genders and it builds semen potency as well and considered best as a potential aphrodisiac drug.
Ayurvedic description
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Ashwagandha (Withania somnifera)
Solanaceae Family
Medicinal Qualities:
Ras
Katu, tikta, kashaya
Guna
Snigdha, laghu
Veerya
Usna
Vipaka
Katu
Prabhava
Balances tridoshas, especially kapha and
vata
Parts used
Roots, leaves and alkali, flowers and seeds
Formulations
Ashwagandhadi lepa, Brahmi vati,
Ashwagandharishta etc.
Charak classification
Balya, Brihaneeya
According to different acharyas
Ras
Veerya
Vipaka
Prabhava
Bhav
Prakash
Tikta,
Kashaya
Ushna
Katu
Balkarak,
Shukravardhak, Rasayan,
Vatakaphashamak
Kaidev
Nighantu
Tikta,
Kashaya
Ushna
Katu
Rasayan, Pushtikarak,
Shukravardhak, Balkarak
Dhanvantari
Nighantu
Tikta,
kashaya
Ushna
Katu
Vatakaphashamak
Phytochemistry:
Ashwagandha is an important source of many medicinally and pharmacologically important
chemicals such as sitoindosides withaferins and various useful alkaloids. The withanolides are the
most searched chemical constituent. Withaferin A and 3 b hydroxy 2, dihydrowithanolide F
isolated from ashwagandha show promising antitumoral, immunomodulating as well antibacterial
and anti-inflammatory properties.
Action and Uses Of Ashwagandha:
External Uses:
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It reduces oedema and pain, that is why leaves and root paste is applied on enlarged cervical
glands or swelling of other glands. In vata diseases and weakness, oil massage is done. The juice
of ashwagandha leaves is used as eardrops in ear discharge.
Internal Uses:
Nervous system
As it is a sedative and nervine tonic, it helps in atonic nerves, fainting
giddiness and insomnia.
Digestive system
The bark powder is appetizer, carminative and antihelminthic and
hence used in abdominal pain, constipation and worms.
Circulatory system
It has an effect on the heart, purifies the blood and reduces oedema.
Respiratory system
It is an expectorant and has anti-histamic property, due to which it is
useful in cough.
Ashwagandha ash along with ghee and honey is effective in asthma.
If phlegm is thin, it is used in the form of ash or its alkaline extract is
used. In cough and asthma decoction of bark should be given in low
dose.
Reproductive system
Ashwagandha is well known for its aphrodisiac property. It is used in
semen disorders and leucorrhoea caused due to endometritis.
A mixture of 5gms of ashwagandha powder+ 10gms of ghee+ 250ml
milk+ sugar is a good tonic, nutritious and also aphrodisiac. It
completely cures puerperal backache.
Urinary system
It is a diuretic and so used in oliguria or anurea. It is used to
strengthen medo dhatu.
Skin
It is used in vitiligo and other skin diseases, blisters heal when black
ashes of the root are applied on them.
Benefits Of Ashwagandha:
Anxiolytic- antidepressant
Anti-convulsant activity
Helps in erectile dysfunction
Anti- oxidant activity
Effects on cardio-pulmonary system
Anti-inflammatory properties
Improves cardiorespiratory endurance
Anti-cancer property
Immune function
Haemopoetic effect
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Anti- arthritic effect
Pharmacological Activities:
Ashwagandha has been widely studied for their various Pharmacological activities like anti-
oxidant, anxiolytic, adaptogen, memory enhancing, anti-venom, anti-inflammatory, antitumor
properties. Various other effects like immunomodulation, hypolipidemic, anti-bacterial,
cardiovascular protection, sexual behaviour is also influenced by Ashwagandha.
Mode of Action of Ashwagandha:
Aphrodisiac: Due to the sweetness present in ashwagandha, it helps in nourishment and
enhancement of rasadi dhatus. Specifically, mansa and shukradhatu. Madhura ras and madur vipaka
helps to increase shukra and its usna virya helps in shukra pravartan. So, ashwagandha has best
aphrodisiac effect. The tikta ras present in ashwagandha helps to increase the dhatvagni and in
formation of dhatus. For instant aphrodisiac effect ashwagandha should be used with ksheer, ghee
and sharkara. Shukra kshaya leads to Rajakshama. Ashwagandha mixed ghrita gives the best effect
in rajakshama. Due to shukra janan and shukra Vardhan effect of ashwagandha it should be used in
shukra kshaya.
Rasayan: Due to the Madhur ras and snigdha guna present in ashwagandha it helps to increase
from Ras dhatu to Shukra dhatu. Tikta ras does agni deepan karma. Therefore, dhatu gets nourished
and enhanced. Ashwagandha helps to increase prithvi and jal mahabhuta Pradhan ansh present in
dhatu which results in increase of mansa dhatu. Mansa dhatu helps to provide nourishment to body
and helps in brimhan karma.
Kasa Shwas: Tikta ras and usna veerya helps in kapha viliyan and decrease kapha. When kapha
viliyan occurs prana vayu anuloman takes place which helps to clear the obstruction of srotas. In
kshayaj kasa ashwagandha kwath mixed with ksheer is indicated. In kaphaj tamak shwas
ashwagandhamashi should be liked with madhu.
Shotha: Tikta ras helps in blood purification and is anti- inflammatory. Hence in blood vitiated
disorder and vataj shota ashwagandha mixed ghrita should be used. It helps in dhatu kshayajanya
shotha.
Scientific Research Based Evidence on Ashwagandha:
Ashwagandha In Erectile Dysfunction (ED)
Erectile dysfunction is the persistent inability to attain and maintain an erection sufficient to permit
satisfactory sexual performance. ED affects physical and psychosocial health and has a significant
impact on the quality of life of sufferers and their partners and families. In the National Health and
Social Life Survey (NHSLS), the prevalence of sexual dysfunctions (not specific ED) was 31%2. In
Classical texts, sexual dysfunctions are allocated under the domain of Klaibya. Susruta first
described the condition called Manasa Klaibya, which closely resembles with Psychogenic
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Erectile Dysfunction and for treating this condition Susruta has given priority to Hetu Viparyaya
Chikitsa and various Vajeekarana Yogas3. For treating Psychogenic Erectile Dysfunction, the drug
should possess the qualities of Vajeekarana and at the same time it should be able to pacify the
vitiated Manasika Doshas. Ashwagandha is widely claimed to have potent sedative, rejuvenative,
aphrodisiac, and life-prolonging properties. It is also used as a general energy -enhancing tonic
known as Medharasayana4.
Anxiolytic Antidepressent Activity of Ashwadandha:
Many studies on ashwagandha, its anxiolytic and antidepressent actions of the bioactive
glycowithanolides are investigated found to be isolated from ashwagandha roots in rats elicited
bylorazepam and imipramine. The investigators support the use of ashwagandha as a mood
stabilizer in clinical conditions of anxiety in Ayurveda.
Ashwagandha In Improving Cardiorespiratory Endurance:
Ashwagandha has been traditionally used as vitalizer helps to promote longevity, helps in
improving immunity, improve endurance and stamina and helps in male and female fertility.
A prospective, randomized, and placebo-controlled study was done to evaluate the efficacy of
Ashwagandha roots extract in enhancing cardiorespiratory endurance and improving the quality
of life (QOL) in 50 healthy male/female athletic adults. As a result of this the QOL scores for all
subdomains significantly improved to a greater extent in the Ashwagandha group at 12 weeks
compared to placebo (P< 0.05). The findings suggest that Ashwagandha root extract enhances the
cardiorespiratory endurance and improves QOL in healthy athletic adults5.
Ashwagandha in Menopausal syndrome
Menopause is a gradual and natural transitional phase of adjustment between the active and
inactive ovarian function and occupies several years of a women’s life and involves biological and
psychological changes adjustments. Anxiety is one of the prominent features of post-menopausal
women because of sudden withdrawal of sex hormone i.e., estrogen and progesterone.
Ashwagandha is one of the Medhya rasayan but also acts as anxiolytic drug. So it helps to reduce
anxiety level in post-menopausal women and hence improve the quality of life. A randomized
open clinical trial was done under the direction of Central Council for Research in Ayurvedic
Sciences, New Delhi to evaluate the efficacy for Ashwagandha churna, Ashokarishta and Praval
pishti in the management of postmenopausal syndrome and it was concluded that combined
treatment of above drugs gives better result in both somatic as well as psychological complaints
in women with mild to moderate symptoms of menopausal syndrome6.
Discussion
Ashwagandha has a long history in traditional medicines as an aphrodisiac. Modern scientific
studies suggest that ashwagandha's amorous reputation may be warranted, and that it may be a
natural herbal alternative treatment for loss of libido and erectile dysfunction. In sexual
dysfunction Mental stress, anxiety, and depression are all significant factors as well. According to
some data, if untreated depression can reduce libido 40-74% of cases, and cause ED in up to 50%
of men suffering from depressive conditions. Anxiety disorders were associated with 33% and
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46% of reduced libido for both men and women, respectively 10% of men suffering from anxiety
experienced ED as well7. Festosterone is actually found in both men and womenjust at lower
levels in women. Reduced testosterone levels associated with age or conditions that because
hormonal imbalances are associated with loss of libido for both genders and are also linked to
erectile dysfunction (ED) in men. Ashwagandha not only deals with testosterone level but also
helps in anxiety and depression which ultimately leads to management of erectile dysfunction.
Ashwagandha has shukra janan and shukra Vardhan properties. Ashwaganha is not only a potential
aphrodisiac drug but also helps in in improving cardiorespiratory endurance and in menopausal
syndrome. Ashwaganda is best known for its powerful adaptogenic properties, meaning that it
helps mind and body adapt better to stress. It provides nourishment to the nerves and helps in
improving nerve function which helps to maintain a person to be calm during stressful and
threatened situations. It is also good for people who do physical labour or exercise a lot, to help
the body adapt to physical stress. Ashwagandha is a Rasayana, i.e., it acts as an overall tonic which
help the one to achieve greater vitality and longevity. It helps to nourish all the bodily tissues i.e.,
Dhatus, including the joints and nerves. It is also a Medhya Rasayana, and it enhances Dhi, Dhriti
and Smriti. Ashwagandha nourishes the Psycho neuro immune response (called PNI) and crucial
mind-body connection and it helps to coordinate between the mind and senses, as well, which is
essential for good quality sleep. It balances the mind (Prana Vata). It increases the Ojas which is
the master coordinator between the body and consciousness. Ashwagandha enhances virility and
has aphrodisiac properties, especially for men.
Conclusion
Ashwagandha can stimulate production of testosterone and considered the potential aphrodisiac
drug in Ayurveda. Studies shown that Ashwagandha is also a proven stress reliever and also
effective in treatment of both anxiety and depression and also helps in improving
cardiorespiratory endurance, menopausal syndrome and erectile dysfunction.
References
1. Pole, Sebastian. Ayurvedic Medicine: The Principles of Traditional Practice. Churchill
Livingston; 2006. 133-134.
2. Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F,et al.
Guidelines on male sexual dysfunction: Erectile dysfunction and premature ejaculation.
Eur Urol 2010;57:804-14.
3. Vaidya Yadavji Trikamji Acharya and Narayan Ram Acharya Kavyatirtha. Susruta Samhita
of Susruta with Nibandha Sangraha Commentary. Varanasi: Chaukhambha Orientalia;
Su.Chi.26/9-10, 2005. p.497
4. Irjalili MH, Moyano E, Bonfill M, Cusido RM, Palazon J. Steroidal lactones from Withania
somnifera, an Ancient plant for Novel medicine. Molecules 2009;14:2373-93.
International journal of basic and applied research
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5. Choudhary, B., Shetty, A., & Langade, D. (2015). Efficacy of Ashwagandha (Withania
somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults.
AYU (An International Quarterly Journal of Research in Ayurveda), 36(1), 63.
6. Modi, M., Donga, S., & Dei, L. (2012). Clinical evaluation of Ashokarishta, Ashwagandha
Churna and Praval Pishti in the management of menopausal syndrome. AYU (An
International Quarterly Journal of Research in Ayurveda), 33(4), 511.
7. Etiology and management of sexual dysfunction. Nagaraj, Anil Kumar, et al., et al. [ed.]
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Chapter
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Article
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Introduction: Ashwagandha (Withania somnifera [L.] Dunal) has been traditionally used for various actions ranging from vitalizer, improve endurance and stamina, promote longevity, improve immunity, and male and female fertility. However, clinical studies are needed to prove the clinical efficacy of this herb, especially in cardiovascular endurance and physical performance. Aims: This prospective, double-blind, randomized, and placebo-controlled study evaluated the efficacy of Ashwagandha roots extract in enhancing cardiorespiratory endurance and improving the quality of life (QOL) in 50 healthy male/female athletic adults. Materials and methods: Cardiorespiratory endurance was assessed by measuring the oxygen consumption at peak physical exertion (VO2 max) levels during a 20 m shuttle run test. The World Health Organization self-reported QOL questionnaire (physical health, psychological health, social relationships, and environmental factors) was used to assess the QOL. Student's t-test was used to compare the differences in a mean and change from baseline VO2 max levels, whereas Wilcoxon signed-rank test was used to assess changes in QOL scores from baseline in the two groups. Results: There was a greater increase from baseline (P < 0.0001) in the mean VO2 max with KSM-66 Ashwagandha (n = 24) compared to placebo (n = 25) at 8 weeks (4.91 and 1.42, respectively) and at 12 weeks (5.67 and 1.86 respectively). The QOL scores for all subdomains significantly improved to a greater extent in the Ashwagandha group at 12 weeks compared to placebo (P < 0.05). Conclusion: The findings suggest that Ashwagandha root extract enhances the cardiorespiratory endurance and improves QOL in healthy athletic adults.
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Withania somnifera, commonly known as Ashwagandha, is an important medicinal plant that has been used in Ayurvedic and indigenous medicine for over 3,000 years. In view of its varied therapeutic potential, it has also been the subject of considerable modern scientific attention. The major chemical constituents of the Withania genus, the withanolides, are a group of naturally occurring C 28 -steroidal lactone triterpenoids built on an intact or rearranged ergostane framework, in which C-22 and C-26 are appropriately oxidized to form a six-membered lactone ring. In recent years, numerous pharmacological investigations have been carried out into the components of W. somnifera extracts. We present here an overview of the chemical structures of triterpenoid components and their biological activity, focusing on two novel activities, tumor inhibition and antiangiogenic properties of withaferin A and the effects of withanolide A on Alzheimer's disease. The most recent attempts in biotechnological production of withanolides are also discussed.
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Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent male sexual dysfunctions. To present the updated version of 2009 European Association of Urology (EAU) guidelines on ED and PE. A systematic review of the recent literature on the epidemiology, diagnosis, and treatment of ED and PE was performed. Levels of evidence and grades of recommendation were assigned. ED is highly prevalent, and 5-20% of men have moderate to severe ED. ED shares common risk factors with cardiovascular disease. Diagnosis is based on medical and sexual history, including validated questionnaires. Physical examination and laboratory testing must be tailored to the patient's complaints and risk factors. Treatment is based on phosphodiesterase type 5 inhibitors (PDE5-Is), including sildenafil, tadalafil, and vardenafil. PDE5-Is have high efficacy and safety rates, even in difficult-to-treat populations such as patients with diabetes mellitus. Treatment options for patients who do not respond to PDE5-Is or for whom PDE5-Is are contraindicated include intracavernous injections, intraurethral alprostadil, vacuum constriction devices, or implantation of a penile prosthesis. PE has prevalence rates of 20-30%. PE may be classified as lifelong (primary) or acquired (secondary). Diagnosis is based on medical and sexual history assessing intravaginal ejaculatory latency time, perceived control, distress, and interpersonal difficulty related to the ejaculatory dysfunction. Physical examination and laboratory testing may be needed in selected patients only. Pharmacotherapy is the basis of treatment in lifelong PE, including daily dosing of selective serotonin reuptake inhibitors and topical anaesthetics. Dapoxetine is the only drug approved for the on-demand treatment of PE in Europe. Behavioural techniques may be efficacious as a monotherapy or in combination with pharmacotherapy. Recurrence is likely to occur after treatment withdrawal. These EAU guidelines summarise the present information on ED and PE. The extended version of the guidelines is available at the EAU Web site (http://www.uroweb.org/nc/professional-resources/guidelines/online/).
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Ayurvedic Medicine brings the unique theories and traditions of Ayurveda alive so that they are accessible to the complementary health practitioner of today. This book offers a clear, accessible and yet detailed guide to Ayurvedic herbalism. It encompasses a brief history of the growth of Ayurveda , a discussion of its fundamental principles, treatment strategies as well as the energetic approach of traditional Ayurvedic herbal pharmacy and pharmacology. It also emphasizes the importance of using sustainably harvested herbs in clinical practice. The introductory theoretical chapters complement the core of the book that includes over 100 plant profiles of Ayurvedic herbs and 50 traditional formulas. It is a clinical manual as well as a reference book, which relates classical Ayurvedic teachings to modern herbal medicine as well as specific bio-medical conditions. The herbalmaterial medicaof Ayurveda is discussed, along with traditional ayurvedic energetics, in way that is accessible to the western complementary practitioner. Uniquely styled plant profiles include information on over 100 herbs and 25 formulas. The Ayurvedic theory of clinical treatment is clearly presented, as well as its application. Material represents a blend of traditional medicine with modern research, combining pure Ayurveda with modern phytotherapy and bio-medicine. Coverage of each plant includes details on growing habitat and special characteristics. Practical step-by-step instructions explain how to prepare herbal medicines in the unique Ayurvedic style oils, creams, ghees, jams, etc. Photos are provided of both the freshly growing herbs and dried samples. Authored by an experienced Medical Herbalist, Ayurvedic practitioner, and passionate herb grower well-versed in the classical Ayurvedic texts and contemporary writings.
Etiology and management of sexual dysfunction
  • Anil Nagaraj
  • Kumar
Etiology and management of sexual dysfunction. Nagaraj, Anil Kumar, et al., et al. [ed.]
Mangalore: Light House Polyclinic
Bevinje Srinavas Kakkilaya. 2, Mangalore: Light House Polyclinic, September 8, 2009, Online Journal of Health and Allied Sciences: Cogprints, Vol. 8, pp. 1-11. ISSN: 0972-5997.