Use of opium and cannabis in the traditional systems of medicine in India

Sections

Introduction
Cannabis and opium in Unani Tibbi
Sanskrit names of cannabis and opium and their implications
Properties and actions described in Ayurveda and Unani Tibbi systems
II. Opium
Medicinal preparations of Ayurveda and Unani Tibbi systems that contain cannabis and/or opium, and their indications
Cultivation of the cannabis plant and the opium poppy in India
Use of cannabis and opium by sadhus
Should cannabis and opium be banned in the Ayurvedic and Unani practices?

Details

Author: Shri C. DWARAKANATH
Pages: 15 to 19
Creation Date: 1965/01/01

Use of opium and cannabis in the traditional systems of medicine in India

Shri C. DWARAKANATH Adviser in Indigenous Systems of Medicine, Government of India, Ministry of health, New Delhi

Introduction

Opium and cannabis have been employed as therapeutic agents by the Ayurveda and Unani Tibbi systems of medicine for over ten centuries. There is no direct evidence to show that these drugs were recognized by Ayurveda prior to the eighth century A.D. However, a reference in Vartika and Ashtadhyayi of Panini by Katyayana shows that bhang (cannabis) was known in India as early as the fourth and third centuries B.C. The uses of this drug have not been referred to in any contemporary works on medicine. Sushruta (surgeon, about the fourth century B.C.) stated that sura (alcohol) should be used before a surgical operation to produce insensibility to pain. Charaka - the internist - prescribed the administration of one or the other of the alcoholic drinks-viz., sura, sidhu, arishta, madhu, madira or asava - to a full-term pregnant woman, after the extraction of a dead foetus, with a view to making her insensible to pain. There is no reference in the works of these authorities to the use of cannabis or opium as analgesics. This leads to the conclusion that even though bhang (cannabis) was known during the contemporary period, it was not recognized as a therapeutic agent by surgeons and physicians of those times. References too pium are not available in the Vedas, Puranas and early Ayurvedic medical classics such as Charaka Samhita (third to second century B.C.), Sushruta Samhita (fifth to fourth century B.C.), the twin works of Vagbhata (fifth century A.D.) - viz., Ashtanga Hridaya and Ashtanga Samgraha.

References to both cannabis and opium appear in veterinary and medical works belonging to the twelfth to thirteenth centuries A.D. onwards. Jayaditya, in his work, Ashwavaidyaka - a treatise on the treatment of horses-makes a reference to opium. This work is considered to have been written some time during the twelfth and thirteenth centuries A.D. Sharangadhara Samhita, a compendium of therapeutics (thirteenth century A.D.), has included medicaments titrated with the fresh extract of bhang. Authoritative Ayurvedic works on materia medica such as Dhanwantari nighantu (eighth century A.D.), Madanapala nighantu (1374 A.D.) and Rajanighantu (1450 A.D.) have described the properties, actions and indications of both cannabis and opium. Bhavamishra (fifteenth century A.D.), a contemporary of Paracelsus, has in his compendium on medicine and therapeutics, Bhavaprakasha, described the properties, actions, indications and formulations of both cannabis and opium. Much later, Ayurvedic medical works have given increasing importance to these two drugs and included them in a large number of formulations.

The foregoing notwithstanding, Indian legends and traditions have associated cannabis and opium with the Shaivite and Shaktiya cults. Sadhus and yogis belonging to these cults have been known to use either cannabis or opium or both to induce concentration of mind towards meditation on the supreme being. Even so, bhang in particular, prepared in different forms, has been utilized in religious rituals by certain sections of people. In some parts of India, bhang prepared in the form of a syrup is consumed on such festive occasions as Holi and Shivaratri.

It would appear that cannabis and opium have also been employed by traditional folk medicine in the treatment of diseases even as early as the fourth to third century B.C. During the last two centuries, traditional folk medicine and the classical Indian medicine have become almost synonymous. Many drugs, including those containing cannabis and opium, have entered into the practice of classical Ayurveda.

Cannabis and opium in Unani Tibbi

The Unani Tibbi system would appear to have recognized cannabis and opium as therapeutic agents much earlier than Ayurveda did. The Ayurvedic system appears to have adopted cannabis and opium from Arabian medicine, which was brought to India round about the ninth century A.D. by the Muslims. Arabian medicine came to be known in India as "Unani Tibbi" in view of its Greek origin. Dioscorides (first century A.D.) had described both cannabis and opium, and he is seen to have made use of them for therapeutic purposes. Galien (138-201 A.D.) and Rhazes (865-925 A.D.) have given detailed descriptions of these drugs, their actions, therapeutics and uses. Authoritative Arabic and Persian medical works such as (1) Firdo usul-Hikmat and (2) Mujardat Quanan have not only described the properties of these drugs, but have also included a number of formulations containing them. It would appear that potions containing cannabis and linctus containing opium were popular in Arabia, Persia and Muslim India. The Unani Tibbi system of medicine in India has a large number of preparations containing these two drugs.

TABLE 1

Cannabis

SI. No.

Synonym

Properties and actions

1
Madini
Induces narcosis
2
Mohini
Causes mental confusion
3
Chapala
Causes vacillation of the mind
4
Bahuvadini
Causes excessive garrulousness
5
Harshini
Stimulates a pleasurable sensation and causes elation of mind
6
Ranjika
Causes excitement
7
Tandrakrit
Causes drowsiness
8
Vijaya
Causes a feeling of unconquerability
9
Trailokya vijaya
Causes a state of mind in which the subject feels that he is capable of conquering "the three worlds"
10
Virapatra
Potent leaf
11
Samvida manjari
Inflorescence causes garrulousness
12
Bhang
In excessive doses it arrests the functions of the brain

TABLE 2

Opium

SI No.

Synonym for niryasa (milky exudate)

Description

1
Ahiphena
Foam of snake. This refers to the milky 'juice of the poppy capsule
2
Aphuka
Derived from the Arabic word "aphyun"
3
Kashkhasa rasa
The juice of the opium poppy
4
Khaskhasaphala-kshira
Milky sap from Khaskhasaphala or poppy capsule
 
Synonyms of the plant
 
1
Tilabheda
Seeds resemble those of Sesamum indicum
2
Sukshmabija
Has minute seeds
3
Sukshma tandula
Has minute seeds
4
Subija
Contains many seeds
5
Lasatphala
Has shining fruits
6
Shubhra pushpa
Has bright flowers

Sanskrit names of cannabis and opium and their implications

Sanskrit names of cannabis and opium generally refer to their description, properties and actions, which are furnished in tables 1 and 2.

Properties and actions described in Ayurveda and Unani Tibbi systems

Ayurveda has described the properties and actions mentioned below of cannabis and opium exudate, poppy seeds and poppy capsules.

I. Cannabis (bhang)

Properties
Stimulates libido (kamada)
Bitter (tikta)
Causes mental confusion (mohavardhini)
Light (laghu)
Causes intoxication (mada- vardhini)
Penetrating (tikshna)
Promotes appetite, digestion and metabolism (vanhivi- vardhin)
Hot in potency (ushna)
Carminative and stomachic (pachani)
Actions
Binds the bowels ( grahini)
Hypnotic (nidraprada)
Causes biliousness (pittala)
Allays nervous irritability (vatajit)
Antiphlegmatic (kaphajit)
Promotes garrulousness (vagvi- vardhini)
 

Unni Tibbi to cannabis: has attributed the following actions to cannabis

Constipative (Quabiz)
Devitalising (mujafifmani)
Stomachic (muqavi mehda)
Anodyne (muskan alm)
Appetiser (mushtai)
Hypnotic (munawam)
Causes elation of mind
Anti-convulsive (dafe-a-tashanj)
(muferah)
Causes delirium (moras-hi-zan)
Aphrodisiac (nuqavi bah)
Intoxicant (mussakar)
Retentive (mumsik)
 

II. Opium

A. Opium (exudate)

Properties and actions
Causes nervous excitement
Tonic (balya)
(vatala)
Aphrodisiac (vrishya)
Antiphlegmatic (Shdlshmaghna)
Cleanses bodily impurities (shodhana)
Causes mental confusion (mohada)
Binds the bowels (grabi)
Promotes dryness (shoshana)
Causes biliousness (pittala)  

B. Poppy seeds

Properties and actions
Promotes lustre of the body (kantiprada)
Heavy (guru)
Enhances capacity to perform muscular work (viryaprada)
Tonic (balya)
Allays nervous excitement (vatajit)
Aphrodisiac (vrishya)
Causes the production of phlegm kaphamjangayati)

C. Poppy capsules

Property
Causes nervous excitement (vatakrit)
Dry (ruksha)
Causes garrulousness (vagvivardhini)
Cool in potency (shita)
Causes intoxication (madakrit)
Light (laghu)
Binds the bowels (grahi)
Bitter and astringent in taste (tikta, kashaya)
Causes dryness of the body (vishoshana)
Promotes taste (ruchya)
Promotes the utilisation of nutrition by the tissues (dhatunam shoshakam)
Actions
Impotency (pumsatva nashana)
Causes mental confusion (mohakara)

The Unani Tibbi has described the following actions of opium:

Analgesic (mudhadar)
Haemostatic (habis-ul-dam)
Hypnotic (munawam)
Retentive (mumsik)
Anodyne (musakan-e-ojah)
Febrifuge (dafia-to-mosmi)
Constipative (musadid qaliz)
 

It will be seen from the above that the Ayurvedic and Unani Tibbi systems had recognized the utility of cannabis and opium (milky exudate, seeds and capsules) in the treatment, among others, of conditions mentioned below:

Insomnia
Dysentery
Nervous irritability
Neuralgia
Dyspepsia
Neuritis
Diarrhoea
Rheumatic pains

It is seen, however, that while cannabis has been used to produce euphoria, opium was utilized more as a sedative, hypnotic, analgesic, and to bind the bowels in cases of diarrhoea and dysentery. The Unani system has, in addition, recognized the value of opium in the treatment of haemorrhages, especially haemoptysis.

Medicinal preparations of Ayurveda and Unani Tibbi systems that contain cannabis and/or opium, and their indications

Cannabis

I. The following are the Ayuredic formulations that contain cannabis with their indications:

SI. No.

Formulation

Indications

1.
Ajirnari rasa
Dyspepsia (Ajirna)
2.
Jwalanala rasa
"
3.
Vijaya rasa
"
4.
Agnikumara rasa
Dyspepsia (Ajirna)
5.
Narayana Churna
Diarrhoea (Atisara)
6.
Laghulayi churna
"
7.
Brihannayika Churna
"
8.
Jatiphaladi churna
"
9.
Vijavali
"
10.
Dadimavali
"
11.
Nagasundara rasa
"
12.
Trailokya sammohana rasa
"
13.
Brihad Gangadhara Churna
Chronic diarrhoea including sprue syndrome (Grahani)
14.
Nayika Churna
"
15.
Grahani shardula churna
"
16.
Talisadya churna
"
17.
Sauvarchaladi churna
"
18.
Madana modaka
"
19.
Jirakadi modaka
"
20.
Agni kumara modaka
"
21.
Kamawara modaka
"
22.
Grahanigajara vatika
"
23.
Agnikumara rasa
"
24.
Grahani kapata rasa
"
25.
Grahani gujakari rasa
"
26.
Grahani vajrakapata rasa
"
27.
Lakshmivilasa rasa
Nervous system diseases (Vata Vyadhi)
28.
Talakeshwara rasa .
"
29.
Sparshavataghna rasa
"
30.
Rasachandrika vati
Diseases of the head including neuralgic headaches, haemicrania etc. (Shiroaroga)
31.
Mahalakshmivilasa rasa
"
32.
Kaphachintamani rasa .
Phlegmogenous disorders (kapharoga)
33.
Amritvartika
Vitalisers (Rasayana)
34.
Manmathabra rasa
Aphrodisiacs
35.
Shakravallabha rasa
"
36.
Shrimanmatha rasa.
"
37.
Madana kamada rasa
"
38.
Kamawara modaka
"
39.
Rativallabha modaka
"
40.
Mahakamawara modaka
"
41.
Shrimadanananda modaka
"
42.
Madanodaya modaka
"
43.
Mopharava
"
44.
Naradiya lakshmivilasa rasa
"
45.
Karapaka
"
46.
Laghu pushpadhanva
"
47.
Uttama vajikarana
"
48.
Kamagnisandipana modaka
"

II. The following are a few important Unani formulations containing cannabis employed in the treatment of various diseases:

SI. No.

Formulation

Indications

1.
Hab-e-Tukme Bhang
Diarrhoea
2.
Safuf-e-garyan
Nocturnal emission
3.
Majun Falaskari.
Aphrodisiac
4.
Mufarreh Bhangiyan
"
5.
Roghan Bhang
"
6.
Hab-e-Kochak
Aphrodisiac
7.
Hab-e-Munayish
"
8.
Majum-e-falk saras
"

Opium

The following are the Ayurvedic formulations which contain opium and their indications:

SI. No.

Formulation

Indications

1.
Shankodara rasa
Diarrhoea
2.
Karpura rasa
"
3.
Ahipha vatika
"
4.
Mushti yoga
''
5.
Ahiphasava
"
6.
Kanakamuladi varti
"
7.
Lavanga dravaka
"
8.
Grahanigaja kari
Chronic diarrhoea including sprue syndrome (Grahani)
9.
Jatiphaladaya churna
"
10.
Brihad Gangadhara churna
"
11.
Agastyasutaraja rasa
"
12.
Grahanishardula rasa
"
13.
Markanda churna
"
14.
Dugdha vati
"
15.
Nidrodaya rasa
Insomnia (Nidranasha)
16.
Viryastamba Vati
Aphrodisiac
17.
Kapikachupaka
"
18.
Kaminividravana rasa
"

The following are the Unani formulations which contain opium and their indications:

SI. No.

Formulation

Indications

1.
Hab-e-Pechish
Dysentery
2.
Qurs-e-Musallas
Haemicrania
3.
Hab-e-Jadwar
Catarrh
4.
Bershasha
"
5.
Hab-e-Lubbul-khashkhash
"
6.
Shiyaf-e-Abyaz
Acute conjunctivitis
7.
Majun Muquiavi
Aphrodisiac
8.
Hab-e-Mumsik
"
9.
Majun muravhal-ul-Arwak
"

Cultivation of the cannabis plant and the opium poppy in India

Cannabis grows wild in India, especially in the Himalayan foot-hills and the plains extending from Kashmir in the west and Assam in the east, as well as those of Punjab, Bengal, Rajasthan and Kerala. It has not been cultivated to any great extent. According to a reliable estimate, the total area under cultivation in important centres such as Bengal, Bihar, and Madhya Pradesh may not exceed about 250 hectares. The cultivation is mainly to obtain hemp fibres and ganja.

The opium poppy, on the other hand, is generally a cultivated plant and does not occur in the state of nature. Historically speaking, the poppy plant is not indigenous to India. It was introduced in the country by Moslems and cultivated primarily along areas adjoining sea coasts and, much later, in the interior of the peninsula.

Pustaka Mestaka (Mestaka Paribhasha), a Marathi work belonging to the period of King Rajaram (1679-1700 A.D.), notes that "opium and tobacco are very subtle substances which are specially cultivated in large quantities in six-monthly crops". It is also seen that the cultivation of opium was encouraged during the Mughal period, specially in the reign of Emperor Akbar, who made it a state monopoly as it became a source of revenue. Abul Fazal, in his well-known work, Ain-e-Akbar, has recorded that it was cultivated in Fatehpur, Allahabad and Gazipur. Later, the monopoly cultivation of this drug was taken over by the East India Company. It would appear that until about a hundred years ago, Deccan had a major share in its cultivation.

Use of cannabis and opium by sadhus

In addition to Ayurvedic and Unani physicians who prescribe medicaments containing cannabis and/or opium for their patients, yogis and faqirs make free use of these drugs for altogether different purposes. Bona fide religious mendicants make use of cannabis, especially ganja, which they smoke as an aid to their meditation, concentration and other religious practices. This practice can be traced to a period earlier than the seventeenth century A.D. The Marathi poet, Madhva Munishwara (1733 A.D.), describing the life of yogis and jangamas (nomadic mendicants), has noted that they were addicted to cannabis - especially ganja - and opium. Addiction to these drugs is perhaps common among this class of people, whose number is not very significant.

Should cannabis and opium be banned in the Ayurvedic and Unani practices ?

The question whether these two drugs could be banned in Ayurvedic and Unani practice should take into consideration the fact that India lives in its 500,000 villages. The medical needs of over 80% of the population - especially the rural population - are attended to, almost exclusively, by the Ayurvedic physicians and Unani hakims, who play an important role in the rural community. Practitioners of modern scientific medicine generally prefer to practice in urban areas. It has been reckoned, proceeding on the basis that there is at least one Ayurvedic/Unani physician per village, that there are at least 500,000 Ayurvedic, including Unani, physicians in the country.

It will be seen from the number of Ayurvedic and Unani formulations that cannabis and opium are two important therapeutic agents which Ayurvedic and Unani physicians are employing currently in their practice, especially in the treatment of such conditions as enteritis, dysentery, chronic diarrhoeas, including sprue syndrome, painful states such as neuralgia, neuritis, rheumatism, insomnia, nervous disorders, etc. After a long period of use of cannabis and opium as anodyne, hypnotic, antispasmodic, etc., modern medicine has given them up and replaced them with better drugs which do not generally produce addiction. In the case of Ayurvedic and Unani systems, these drugs still continue to play an important role.

A committee appointed by the Government of India in 1958 to "Assess and Evaluate the Present Status of the Ayurvedic System" has estimated that the number of registered practitioners of the Ayurvedic system is 116,865. Of this number, a little over 30,000 practitioners are institutionally qualified. Their training includes elements of modern scientific medicine, and they are authorized by state governments to prescribe sedatives, hypnotics, analgesics, sulfa drugs and antibiotics included in the Pharmacopoeia of India. The remaining practitioners are not authorized by law to prescribe these drugs. A large bulk of the latter class are, therefore, entirely dependent on preparations which contain cannabis and/or opium for sedation, hypnosis, analgesia, binding the bowels in cases of diarrhoea and dysentery, etc. No doubt, these physicians also prescribe aphrodisiacs containing either cannabis or opium, or both. The question of the banning of the use of these two drugs by Ayurvedic and Unani physicians has to be considered in the light of what has been stated above.

The answers to this question are two - viz:

  1. These drugs should be allowed to be used by Ayurvedic and Unani physicians until such time as the benefits of modern medicine are extended to rural areas. Banning their use by the large mass of Ayurvedic and Unani physicians for therapeutic purposes may create a vacuum which may not be easily filled for a long time to come.

  2. If, however, it is considered necessary to ban these drugs, then these practitioners should be allowed to use modern drugs. It will be agreed that it is not desirable to permit the practitioners of the Ayurvedic and Unani systems who have no training in modern scientific medicine to prescribe sulpha drugs, antibiotics, hypnotics, tranquillizers, etc.

The question of addiction to cannabis and opium will not arise as long as these drugs are permitted to be employed for the purpose of treatment of disease only. The problem of aphrodisiacs containing cannabis and/or opium, manufactured and prescribed by practitioners, which generally lead to addiction and for which there is always a demand has, however, to be faced. It is considered that this problem can be effectively dealt with by the laws of the country such as the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954, and the Drugs and Cosmetics Act, 1940, as amended in 1964, to bring within its purview Ayurvedic and Unani drugs.