Nagaramritadi Kashaya – Ingredients, Preparation, Ayurvedic Properties, Indications & Dosages

Introduction

Nagaramritadi Kashaya is an Ayurvedic polyherbal decoction prepared from nine herbal ingredients: Shunthi (Zingiber officinale), Guduchi (Tinospora cordifolia), Bhunimba (Andrographis paniculata), Bilva (Aegle marmelos), Hribera (Pavonia odorata), Kutaja (Holarrhena pubescens), Musta (Cyperus rotundus), Ativisha (Aconitum heterophyllum) and Ushira (Vetiveria zizanioides). The formulation is indicated for Jvaratisara (diarrhoea occurring with fever). Its combination of herbs is used where fever, altered bowel movements and digestive impairment are seen. The decoction is prepared by boiling the coarse herbal powder in water until the liquid is reduced to one-eighth of its initial volume.

Classical Reference

नागरामृतभूनिम्बबिल्ववालकवत्सकैः ।
समुस्तातिविषोशीरैर्ज्वरातिसारहृज्जलम् ॥ (Sahasrayogam)

A decoction prepared from Shunthi (Zingiber officinale), Guduchi (Tinospora cordifolia), Bhunimba (Andrographis paniculata), Bilva (Aegle marmelos), Hribera (Pavonia odorata), Kutaja (Holarrhena pubescens), Musta (Cyperus rotundus), Ativisha (Aconitum heterophyllum) and Ushira (Vetiveria zizanioides) is described for Jvaratisara (diarrhoea with fever).

Ingredients

All nine herbal ingredients are taken in equal proportions.

1. Shunthi (Zingiber officinale) — 1 part
2. Guduchi (Tinospora cordifolia) — 1 part
3. Bhunimba (Andrographis paniculata) — 1 part
4. Bilva (Aegle marmelos) — 1 part
5. Hribera (Pavonia odorata) — 1 part
6. Kutaja (Holarrhena pubescens) — 1 part
7. Musta (Cyperus rotundus) — 1 part
8. Ativisha (Aconitum heterophyllum) — 1 part
9. Ushira (Vetiveria zizanioides) — 1 part
10. Water — 16 parts

Method of Preparation

• Clean the ingredients and prepare a coarse powder of the prescribed plant parts.
• Combine equal quantities of all nine ingredients.
• Add water in a quantity sixteen times the combined quantity of the herbal mixture.
• Boil over a controlled flame until the liquid is reduced to one-eighth of its initial volume.
• Filter the decoction through a clean cloth to remove the solid particles.
• Use the freshly prepared Kashaya (decoction) in a lukewarm state.

Proper identification of the ingredients and controlled preparation are essential for effective medicinal effects.

Dose and Administration

• Dose: 40 ml per administration.
• Frequency: Twice daily (BD), as specified for the formulation.
• Route: Oral administration.
• Form: Lukewarm decoction.

The prescribing physician should determine the duration according to the patient’s age, strength, symptom severity and response. The stated dose should not be interpreted as suitable for every patient, particularly children or individuals experiencing significant fluid loss.

Ayurvedic Properties of the Ingredients

1. Shunthi (Zingiber officinale)

Shunthi (Zingiber officinale) is described as having Katu Rasa (pungent taste), Laghu Guna (light quality), Snigdha Guna (unctuous quality), Ushna Virya (heating potency) and Madhura Vipaka (sweet post-digestive effect). Its Ayurvedic actions include Dipana (stimulation of digestive capacity) and Pachana (digestion of Ama, or incompletely processed metabolic material).

2. Guduchi (Tinospora cordifolia)

Guduchi (Tinospora cordifolia) is described as having Tikta Rasa (bitter taste) and Kashaya Rasa (astringent taste), with properties that include Dipana (stimulation of digestive capacity) and Jvarahara (fever-relieving action) in Ayurvedic texts. It is an important ingredient in formulations intended for conditions involving fever.

3. Bhunimba (Andrographis paniculata)

Bhunimba (Andrographis paniculata) is predominantly described as Tikta Rasa (bitter taste). Its Ayurvedic profile includes Dipana (stimulation of digestive capacity), Pachana (digestion of Ama) and Jvarahara (fever-relieving action).

4. Bilva (Aegle marmelos)

Bilva (Aegle marmelos) is used in Ayurvedic preparations for bowel disturbances. Its fruit is described as having Grahi (stool-binding or stool-consolidating) and Dipana (stimulation of digestive capacity) actions. The exact plant part used in this particular decoction should be verified.

5. Hribera (Pavonia odorata)

Hribera (Pavonia odorata) is described as having cooling and aromatic properties in Ayurvedic texts. It is used in formulations for fever and symptoms involving increased body heat. Its inclusion adds a distinct component to the combination of digestive and fever-alleviating herbs.

6. Kutaja (Holarrhena pubescens)

Kutaja (Holarrhena pubescens) is described as having Tikta Rasa (bitter taste), Kashaya Rasa (astringent taste), Laghu Guna (light quality) and Ruksha Guna (dry quality). Its Ayurvedic actions include Grahi (stool-consolidating action), making it an important ingredient in formulations prescribed for diarrhoea.

7. Musta (Cyperus rotundus)

Musta (Cyperus rotundus) is described as having Tikta Rasa (bitter taste), Katu Rasa (pungent taste) and Kashaya Rasa (astringent taste). Its Ayurvedic actions include Dipana (stimulation of digestive capacity) and Pachana (digestion of Ama). It is used in formulations for digestive disturbances and altered bowel function.

8. Ativisha (Aconitum heterophyllum)

Ativisha (Aconitum heterophyllum) is described as having Tikta Rasa (bitter taste), Katu Rasa (pungent taste), Laghu Guna (light quality) and Ruksha Guna (dry quality). Its Ayurvedic actions include Dipana (stimulation of digestive capacity), Pachana (digestion of Ama) and Jvarahara (fever-relieving action).

9. Ushira (Vetiveria zizanioides)

Ushira (Vetiveria zizanioides) is described as having cooling properties in Ayurvedic books. Its inclusion provides a distinct cooling component in a formulation intended for fever accompanied by diarrhoea. The prescribed plant part is the root.

Pharmacological Profile

The formulation’s main indication is Jvaratisara (diarrhoea with fever). Its Ayurvedic profile can be summarised through the following actions:

• Jvarahara (fever-relieving action): Describes the formulation’s intended role in fever.
• Pachana (digestion of Ama): Addresses Ama within the Ayurvedic explanation of impaired digestive function.
• Dipana (stimulation of digestive capacity): Focuses on Agni (digestive and metabolic capacity).
• Grahi (stool-consolidating action): Particularly relevant to ingredients such as Kutaja (Holarrhena pubescens) and Bilva (Aegle marmelos), depending on the plant part used.

These are Ayurvedic pharmacological descriptions and should not be treated as proof of the efficacy of the complete formulation in modern clinical practice.

Jvaratisara

Jvaratisara (diarrhoea with fever) presents with two important clinical features: elevated body temperature and frequent loose stools. Ayurvedic assessment considers Agni (digestive and metabolic capacity), Dosha (functional regulatory principles), stool characteristics, appetite, thirst and the patient’s strength. Fever accompanied by diarrhoea can also occur in infections and other conditions requiring medical assessment. The underlying cause, severity, and degree of dehydration must therefore be evaluated before selecting treatment.

Ayurvedic Mode of Action

Nagaramritadi Kashaya combines ingredients described in Ayurveda for fever management and digestive support. Guduchi (Tinospora cordifolia), Bhunimba (Andrographis paniculata) and Ativisha (Aconitum heterophyllum) provide the fever-directed and digestive components of the formulation. Kutaja (Holarrhena pubescens), Bilva (Aegle marmelos) and Musta (Cyperus rotundus) form the bowel-focused component, while Shunthi (Zingiber officinale), Hribera (Pavonia odorata) and Ushira (Vetiveria zizanioides) provide additional properties described in Ayurvedic texts.

Pathya and Apathya

Pathya (suitable measures)

• Maintain fluid intake and use oral rehydration solution to replace fluid and electrolyte losses.
• Eat small portions of easily tolerated food.
• Monitor urine output, stool frequency, and temperature.
• Seek medical guidance if symptoms persist or worsen.

Apathya (measures to avoid)

• Avoid alcohol and foods that worsen gastrointestinal symptoms.
• Avoid prolonged fasting during diarrhoea.
• Do not rely on herbal decoction alone when dehydration is present.
• Avoid self-adjusting the dose or combining multiple medicines without professional advice.

Precautions

• Use authenticated, quality-controlled ingredients, particularly Ativisha (Aconitum heterophyllum).
• The decoction should be prescribed by a qualified practitioner.
• Children, pregnant or breastfeeding individuals, and people taking other medicines require professional assessment before use.
• Blood in the stool, severe abdominal pain, persistent vomiting, high fever, reduced urination or marked weakness warrants prompt medical care.

Conclusion

Nagaramritadi Kashaya is a nine-ingredient Ayurvedic decoction described for Jvaratisara (diarrhoea with fever). It contains Shunthi (Zingiber officinale), Guduchi (Tinospora cordifolia), Bhunimba (Andrographis paniculata), Bilva (Aegle marmelos), Hribera (Pavonia odorata), Kutaja (Holarrhena pubescens), Musta (Cyperus rotundus), Ativisha (Aconitum heterophyllum) and Ushira (Vetiveria zizanioides). Its Ayurvedic rationale combines fever-directed, digestive, and bowel-focused actions. Accurate ingredient identification, appropriate preparation, and clinical assessment are essential for responsible use.