Revisiting the potential of ksheerapaka formulation and its applications

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The proportion of the ingredients i.e. drugs: milk: water is indicated as 1:8:32, unless specifically mentioned otherwise. However, a revered ayurvedic physician Yadavji Trikamji Acharya, suggested a different proportion of ingredients in preparation of ksheerapaka as 1:15:15. [13] Certain formulations with a change in the proportion can be cited, for e.g. in rasona (garlic-Allium sativum Linn.) ksheerapaka indicated in ‘vaataja gulma’ or the vardhaman pippali ksheerapaka used as rasayana formulation and musta (Cyperus rotundus Linn) ksheerapaka indicated for the treatment of atisaara.[14, 15, 16] Apart from other formulations of ksheerapaka, a reference indicates the administration of plain cow milk or goat milk with water in the proportion of 1:5, cooked as per the process of ksheerapaka formulation without addition of any drugs.[17]

One also cites a different process mentioned in the classics wherein, the drugs are first boiled in water to prepare a kwatha (decoction), which is then used as one of the base ingredients for preparation of ksheerapaka. [18]
Different kinds of variations in the use of ‘prakshepa dravya’ (additives used after the recipe is prepared) are also mentioned, though the exact proportion of the additives is not indicated. These generally include substances like sugar, ghee, honey or jaggery which exhibit attributes that are in conjunction with the attributes of the resultant formulations, and are also meant to impart taste and flavor to the recipe to make it palatable.
Therapeutic potential of ksheerapaka formulation: This unique type of formulation is indicated for systemic administration as well as for panchakarma and allied therapies.
Indications for systemic administration of ksheerapaka:
The kshee...

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...a (fomentation therapies), as in parisheka (pouring of warm herbal decoctions for local fomentation) or nadi sweda (hot fomentation using a tube) is also indicated. [25, 26]
The texts indicate use of ksheerapaka formulations as netrya formulation or as eye drops, gandusha and for preparation of karnapoorana formulations (administration of medicines in the ear canal. [27, 28, 29]
Nutraceutic and pharmaceutical application: Ksheerapaka has great nutraceutic potential when administered as accompaniment along with medications – anupaana. [30]
Ksheerapaka being used as a bhavana dravya (~liquids added to medications by process of trituration) in the medicinal preparations for vaajikarana, as well as for the preparation of siddha vasa (oleaginous substance obtained as an extract from muscle tissue of animals) imparts added relevance to this unique formulation.[31, 29]

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