Punarnava

Botanical names: Boerhavia repens, B. diffusa, Nyctaginaceae

Other names: Svethapunarnava, Raktapunarnava, (S), Sant, Gadahpurna (H), Mukkurattai (T), Red Spiderling, Spreading Hogweed (E)

Botany: Punarnava is a herbaceous perennial with a large root and highly branched stems that are prostrate or ascending to a height of up to a meter. The leaves are simple, ovate-oblong, acute or obtuse at the tip and rounded or sub-cordate at the base, glabrous above, white with minute scales below. The small rose or white colored flowers are borne in small umbels arranged in corymbone, axillary and terminal panicles, giving way to a detachable indehiscent seed with a thin pericarp. Punarnava is found throughout the subcontinent of India as a weed of wastelands and roadsides, and is also found in similar tropical and subtropical environs in Africa and the Americas. The Sanskrit name Svethapunarnava refers to B. repens (with white flowers), whereas Raktapunarnava refers to B. diffusa (with red flowers) (Kirtikar and Basu 1935, 2045; Warrier et al 1994, 281).

Part used: Roots, aerial parts.

Dravyaguna: The various nighantus typically differentiate between Svethapunarnava and Raktapunarnava, and based on this, provide differing and sometimes contradictory accounts of the dravyguna.

• Rasa: tikta, madhura, katu, kashaya (Svethapunarnava); tikta (Raktapunarnava)

• Vipaka: madhura (Svethapunarnava); katu (Raktapunarnava)

• Virya: ushna, ruksha (Svethapunarnava); shita, laghu (Raktapunarnava)

• Karma: dipana, bhedana (Svetapunarnava), stambhana (Raktapunarnava), sulaprashamana, krimiaghna, chedana, svasahara, mutravirechana, shotahara, hrdaya, vishaghna, artavajanana, rasayana, tridoshahara; the Bhavaprakasha states that Raktapunarnava increases Vata (Srikanthamurthy 2001, 265; Dash 1991, 57-8; Kirtikar and Basu 1935, 78; Warrier et al 1994, 283).

Constituents: Among the first constituents isolated from Punarnava was the sulfate of an alkaloid named punarnavine, and since then a variety of constituents have been described, including rotenoid analogues (boeravinone A-F, punarnavoside), lignans (liriodendrin, syringaresinol mon-B-D-glucoside), xanthones (boerhavine, dihydroisofuranoxanthone), C-methylflavone, hentriacontane, ?-sitosterol, ursolic acid, potassium nitrate, and amino acids (Williamson 2002, 76; Yoganarasimhan 2000, 547-8; Kapoor 1990, 79).

Medical research:

Immune: Researcher examined the in vitro immunomodulatory properties of Boerhaavia diffusa in a series of tests including human natural killer (NK) cell cytotoxicity, nitric oxide (NO) production in mouse macrophage cells, RAW 264.7, interleukin-2 (IL-2), tumor necrosis factor-? (TNF-?), intracytoplasmic interferon-gamma (IFN-gamma) and expression of various cell surface markers on human peripheral blood mononuclear cells (PBMCs). The ethanolic extract of B. diffusa roots was found to inhibit human NK cell cytotoxicity, the production of NO in mouse macrophage cells, and the release of IL-2 and TNF-alpha in human PBMCs. Intracytoplasmic IFN-gamma and cell surface markers such as CD16, CD25, and HLA-DR were not affected (Mehrotra et al 2002).

Hepatoprotective: An aqueous extract of the roots of Boerhavia diffusa provided protection against poisoning with carbon tetrachloride in rats and mice, increasing bile flow and restoring serum parameters of GOT, GPT, ACP and ALP, but not GLDH and bilirubin (Chandan et al 1991).

Pyelonephritis: Researchers studied the effects of Boerhavia diffusa in experimental models of pyelonephritis induced by injecting E. coli into the kidney of rats. A significant reduction in the bacterial count and kidney damage was observed in the treatment group, as compared to controls. Marked regenerative changes were also observed in tubular parenchyma as judged by mitotic indexes in the treated group of animals compared to controls (Singh et al 1986).

Behaviour and stress: Researchers assessed the neuropsychopharmacological and anti-stress profile of Boerhavia diffusa in a series of tests, including modification of open field behaviour (OFB), pentobarbitone sleeping time, amphetamine antagonism restraint stress (3 hours), behavioural despair stress model (FST) and swimming stress induced gastric ulceration (5 hours). Researchers noted a significant dose-dependent decrease in OFB (stressed & unstressed animals), a reduction in the total immobility period, potentiation of reserpine induced enhanced immobility period,OFB potentiation of pentobarbitone sleeping time, and antagonism of amphetamine hyperlocomotion. B. diffusa also reduced severity and numbers of gastric ulcers in swimming stress model (Sharma et al 1990).

Diabetes: Researchers investigated the hypoglycemic effects of an aqueous extract of Boerhavia diffusa leaves in alloxan-induced diabetic rats. The extract was shown to produce a non-dose related decrease in blood glucose levels, with an onset of action in less than 2 hours, peaking at 6 hours and lasting for over 8 hours after oral administration (Chude et al 2001).

Amoeboiasis: A polyherbal formula containing Boerhavia diffusa, Tinospora cordifolia, Berberis aristata, Terminalia chebula and Zingiber officinale was studied in experimental amoebic liver abscess in golden hamsters and in immunomodulation studies. The formulation was found to have a maximum cure rate of 73% at a dose of 800 mg/kg/day in hepatic amoebiasis. In immunomodulation studies humoral immunity was enhanced as evidenced by the haemagglutination titre. T-cell counts remained unaffected in the animals treated with the formulation but cell-mediated immune response was stimulated as observed in the leukocyte migration inhibition (LMI) tests (Sohni and Bhatt 1996).

Toxicity: The LD₅₀ for an ethanolic extract of the root and whole plant is 1000mg/kg in adult albino rates (Williamson 2002, 77).

Indications: Dyspepsia, gastritis, ulcer, constipation (Svethapunarnava), diarrhea and dysentery (Raktapunarnava), intestinal parasites, fistula, jaundice, cirrhosis, splenomegaly, fever, cough, bronchitis, asthma, pleurisy, urinary tenesmus, renal diseases, gonorrhea, edema, ascites, scrotal enlargement, hemorrhage, scabies, lumbago, myalgia, leucorrhea, dysmenorrhea, heart disorders, heart valve stenosis, anemia, epilepsy, debility and fatigue, ophthalmia

Contraindications: Pregnancy; the Bhavaprakasha states the Raktapunarnava is contraindicated in Vatakopa conditions. Due to its potential GABAnergic activity Punarnava may be contraindicated with concurrent use of tranquilizers, antidepressant and antiseizure drugs. Nadkarni states that in high doses Punarnava may act as an emetic (1954, 207).

Medicinal uses: Punarnava is an important rasayana dravyas in Ayurvedic medicine, indicated by the translation of its Sanskrit name, ‘once again new.’ For this purpose Punaranava can be taken as a milk decoction, 10-24 grams of the root taken twice daily. The potent rejuvenating properties of Punaranava root are also made use of in a variety of rejuvenating formulae, including the famous lehya Chyavanaprash. Punarnava however also has a number of more mudane uses, especially for its ability to correct diseases of the urinary tract and treat edema. As a simple remedy for cystitis the svarasa or churna of Punarnava can be taken, 10-15 mL of the juice, or 3-5 grams of the powder, thrice daily until symptoms are gone. In the treatment of edema 10-15 mL of the fresh juice of the leaves can be mixed with a small amount of Maricha (Piper nigrum) or Shunthi (Zingiber officinalis), taken twice daily for several weeks. The fresh juice is also taken in jaundice and in menstrual disorders. Lt. Col. Chopra found that Punarnava was efficacious in the treatment of edema and ascites due to early cirrhosis and peritonitis, using a liquid extract prepared from either the dry or fresh plant material of Svetapunarnava (Nadkarni 1954, 205). Nadkarni adds that Punarnava is equally effective in edema secondary to heart disease from stenosis of the valves, in pleurisy and in other edematous conditions (Nadkarni 1954, 205). In most cases Punarnava is used in polyherbal formulations to treat edema and other conditions. In the treatment of edema as well as colic, bloating, flatulence, constipation, hemorrhoids, intestinal parasites, and anemia, the Chakradatta recommends Punarnavamandura, comprised of equal parts Punarnava, Trivit, Shunthi (Zingiber officinalis), Pippali, Maricha (Piper nigrum), Vidanga, Devadaru, Chitraka, Pushkaramula (Inula helenium root), Haridra, Danti (Baliospermum montanum), Chavya (Piper chaba), Indrayava, Katuka, Pippalimula (Pippali root) and Musta, decocted in cow’s urine (Sharma 2002, 118-9). Another formula called Punarnavadi taila is mentioned by the Bhavaprakasha in the treatment of urinary calculi, muscle pains and hernia associated with the aggravation of Kapha and Vata, used in vasti (enemata) and internally (Srikanthamurthy 2000, 481). A decoction of Punarnava, Devadaru, Haritaki and Guduchi combined with Guggulu is stated to be effective in abdominal enlargement (udararoga), as well as intestinal parasites, obesity, anemia, edema and skin diseases (Sharma 2002, 346). Similarly, a combination of Punarnava, Devadaru, Guduchi, Patha (Cissampelos pariera), Bilva, Gokshura, Brhati (Solanum indicum), Kantakari, Haridra, Daruharidra, Pippali, Chitraka and Vasaka, reduced to a fine powder and taken with cow’s urine is used in abdominal enlargement secondary to intestinal parasites (Sharma 2002, 347). In Vataja forms of edema a combination of Punarnava, Shunthi, Eranda (Ricinus communis) and Brhati (Solanum indicum) is stated by the Chakradatta to be efficacious (Sharma 2002, 357). As a topical therapy for edema the Sharangadhara samhita recommends Punarnavadi lepa, prepared by combining equal parts powders of Punarnava, Daruharidra, Shunthi, Siddhartha (Brassica compestris) and Shigru (Moringa pterygosperma) with rice water (Srikanthamurthy 1984, 236). Given the ability of Punarnava to mobilize kidney function, and the importance this is given to promote the elimination of metabolic wastes in joints and muscles, Punarnava is also used to treat inflammatory joint disease, including gout and rheumatoid arthritis. To this extent the Chakradatta recommends a formula called Shatyadi kvatha, comprised of a decoction of Punarnava with a paste of Shati (Hedychium spicatum) and Shunthi (Zingiber officinalis), taken every day for at least one week (Sharma 2002, 246). Similarly, the Bhavaprakasha advocates a complex formula called Punarnava guggulu in the treatment of gout, hernia, sciatica, muscular atrophy and inflammatory joint disease (Srikanthamurthy 2000, 408). In the treatment of internal abscesses the Sharangadhara samhita recommends a decoction of Punarnava and Varuna (Crataeva religiosa) (Srikanthamurthy 1984, 71). Punarnava is also valued in ophthalmic disorders, the Sharangadhara samhita recommending a collyrium (anjana) for itching, prepared by mixing the churna with milk; mixed with honey to treatment ophthalmic discharges; with ghee for corneal wounds; with taila for poor vision; and with rice water (kanjika) for night blindness (Srikanthamurthy 1984, 269). In the treatment of alcoholism the Chakradatta recommends a decoction of Punarnava to restore ojas (Sharma 2002, 179). In the treatment of diabetes Punarnava can be combined with Shilajitu and Guduchi. Punarnava is also consumed as a nourishing vegetable in India, rich in vitamins and minerals, and has undergone investigation for its potential in famine relief (Smith et al 1996)

Dosage:

• Churna: 3-5 g b.i.d.-t.i.d.
• Svarasa: fresh herb, 10-15 mL b.i.d.-t.i.d.
• Kvatha: dried root, 60-120 mL b.i.d.-t.i.d.
• Tincture: dried root, 1:3, 45%; 2-5 mL b.i.d.-t.i.d.