| Abstract|| |
Vajikarana or Vrishya chikitsa is a one of eight major specialty of the Ashtanga Ayurveda. This subject is concerned with aphrodisiacs, virility and improving health of progeny. As per Charak Samhita, by proper use of these formulations, one becomes endowed with good physique, potency, strength, and complexion and sexually exhilarated and sexually potent. This in turn is helpful in many common sexual dysfunctions, including Infertility, Premature Ejaculation and Erectile dysfunction. The therapy is preceded by living in strict compliance with the directions mentioned in Ayurvedic classics, various methods of body cleansing and other non-medicinal strategies like sexual health promoting conduct, behavior and diet. Certain individualized herbal and herbo-mineral combinations are administered as per the nature of a person according to the Ayurveda. Many limitations need to be considered before considering the use of theses therapy like lack of scientific studies, possibilities of adulteration in the herbal and herbo-mineral combinations available in market and possibilities of unexpected side-effects etc., The article calls upon initiating research in this area so that claims of ancient Ayurvedic texts could be substantiated and vajikaran therapy may be utilized by modern medicine.
Keywords: Aphrodisiac, sexual functioning improvement, vajikaran
|How to cite this article:|
Dalal P K, Tripathi A, Gupta S K. Vajikarana: Treatment of sexual dysfunctions based on Indian concepts
. Indian J Psychiatry 2013;55, Suppl S2:273-6
| Introduction|| |
Ayurveda (Ayu-life; veda-science), the science of life, prevention and longevity, is the oldest organized Indian medical system. Its fundamentals can be found in Hindu scriptures called the Vedas - the ancient Indian books of wisdom written over 5,000 years ago and it also incorporates wisdom from Upanishada, Samkhy and Yoga. It is a comprehensive medical system of body, mind and spirit.  Ayurveda is said to use the inherent principles of nature to help maintain health in a person by keeping the individual's body, mind, and spirit in perfect equilibrium with nature. Thus, Ayurveda is considered as more than a mere healing medical system. It is a science and art of appropriate living, which helps to achieve longevity. It can also guide every individual in the prevention of disease and long-term maintenance of health. Before the recent upsurge of traditional medicine in a global perspective, Ayurveda was persistently criticized for its ambiguity and philosophical tenets incomprehensible to researchers and clinicians of modern medicine. This perception has led to disinterest in Ayurveda which eventually and unfortunately has led the world to be deprived of many plausible advantages of traditional healthcare supportive to a total quality life. ,,
Caraka Samhita  states 'The healthy life has three main pillars-a balanced diet, proper sleep and a healthy sex and marital life.' The Ayurveda is also frequently referred as 'Ashtanga Ayurveda' as it has eight parts. These include following parts:
Understanding few more basic concepts relevant to vajikaran of Ayurveda will be important before initiating further discussion on Vajikarana.
- Kaya chikitsa: Internal and external treatments for the body.
- Bala chikitsa: Diseases related to infants
- Graha chikitsa: Healing of psychological problems
- Urdvanga chikitsa: Treatments related to the Ear, Nose and Throat region
- Salya chikitsa: Surgeries and operations
- Visha chikitsa: Toxicology
- Rasayana prakarana: Methods to rejuvenate the sapta dhatus (Seven Humors)
- Vajikarana or Vrishya chikitsa: Science of aphrodisiacs, virility and improving health of progeny
Tridosha theory:  The doctrine of 'Tridosha' is fundamental for Ayurveda. According to this theory, every human being is a unique phenomenon of cosmic consciousness. The three Dosha (humors) determines every individual's psychosomatic temperament and constitution. Tridosha represents the physiological functioning of a living body, which eventually is the property of its component material. Ayurvedic idea of disease and health is conceived around this concept by identifying a balance of Tridosha. Vata (ether plus air), Pitta (fire plus water) and Kapha (water plus earth) are called the Tridosha, meaning the three Dosha. The internal environment is governed by Vata-Pitta-Kapha (V-P-K), which is constantly reacting to the external environment. The wrong diet, habits, lifestyle, incompatible food combinations (e.g., milk and fish, melons and grain, yogurt and meat or cooked honey etc.), seasonal changes, repressed emotions and stress factors can all act either together or separately to change the balance of V-P-K. According to the nature of the cause, Vata, Pitta or Kapha undergoes aggravation or derangement that produces Ama (toxins). The master forms of biological humors Vata, Pitta and Kapha are respectively Prana, Tejas and Ojas. They form the vital essence of the three humors that sustain positive health. These three forces are key to vitality, clarity and endurance and prerequisite for healthy, fearless and confident state.
To stop the further production and removal of Ama, Ayurvedic literature suggests placing the patient on a proper diet together with an appropriate lifestyle, habits and exercise, and administering cleansing program like Panchakarma.
Ayurveda identifies seven vital tissues that provide nourishment, growth, and structure to the entire body. These tissues, called dhatus, have similarities to the major tissues identified by the modern science. These dhatus remain inside the human body in a proper equilibrium so that the body can function properly. It is said that any kind of disturbance or imbalance in their equilibrium causes ailments and diseases. The seven dhatus are Plasma (Rasa), Blood (Rakta), Muscle (Mamsa), Fat (Meda), Bone (Asthi), Bone marrow and nerve (Majja) and Reproductive fluid (Shukra).
Often, the sexual style of humans is compared to and is defined in terms of the animal sexual relationship style in the ancient Indian texts. The common examples used are:
- Chataka (Sparrow) - Multiple short span conjugations with production of small amount of semen.
- Gaja (Elephant) - Once in a while long time conjugation with abundant semen discharge.
- Vrusha (Bull) - Regular stable seasonal conjugation with more quantity Semen.
- Ashwa (Horse) - Regular forceful dynamic conjugation with average quantitative semen.
| Vajikaran|| |
In Sanskrit, Vaji means horse, the symbol of sexual potency and performance thus Vajikaran means producing a horse's vigor, particularly the animal's great capacity for sexual activity in the individual. Literally the Vajikaran is not exactly aphrodisiac but the current connotational meaning is same. 
As per Charak Samhita
By proper use of these formulations, one becomes endowed with good physique, potency, strength, complexion and sexually exhilarated and potent like an 8-year-old horse. 
"The man who seeks pleasure should resort to Vajikaran, i.e., vilification therapy regularly. The Vajikaran bestows contentment, nourishment, continuity of progeny and great happiness. The medicines or therapy by which the man becomes capable of sexual intercourse with the woman with great strength like a horse, which endears him to women and which nourishes the body of the person is known as Vajikaran. It is best promoter of strength and vigor." 
However, the main aim of Vajikaran is always successful copulation for healthy reproduction, with sexual pleasure being just an additional benefit; therefore it is considered a part of 'eugeny.' However, this therapy is also described under various sexual and reproductive disease i.e., Klaibya or Erectile dysfunctions, Bandhyatva or Infertitily, Shukraghata Vata or azospermia and premature ejaculation. ,
Vajikaran chikitsa requires living in strict compliance to the directions mentioned in Ayurvedic classics. It involves various methods of shodhan (body cleansing) through vaman (emesis), virechan (purgation) and swedan (sweating). After the Shodhan therapy, based on the prakriti of the individual's imbalance (doshic body constitution-Tridosha theory), certain herbal and herbo-mineral combinations are administered. Other components in the therapy involves improving health and pleasure in general like, massaging with medicated herbal oils and herbal baths, wearing of fragrant garlands, anointing the body with fragrant herbal pastes, listening to music, etc.
Who should not consume Vajikarana preparations?
As per Ayurveda, it is recommended that the person below 17 years of age and more than 70 years of age should not consume Vajikarana preparations. These preparations have to be consumed by "jitendriya purusha" or man who has control on his senses and desires. If Vajikarana preparations are consumed by "ajitendriya purusha" or man who has lost control over his senses and desire, he may prove harmful to society.
| Proposed Mechanism of Actions|| |
Vajikaran therapy is said to revitalize all the seven dhatus (body elements), therefore, restores equilibrium and health. Keeping in mind the concept of vajikaran as described in the texts of Ayurveda, it definitely offers a solution to minimize the shukra (sperm and ovum) defects and to ensure a healthy progeny. The experimental studies related to vajikaran therapy are scarce and generally lack scientific vigor.
Rasayan drugs acts inside the human body by modulating the neuro-endocrino-immune system. Vaajikaran rasayan is the special category of rasayan, which improve the reproductive system and enhance sexual function.  They act on higher center of the brain, i.e., the hypothalamus and limbic system. Vajikaran also claims to have anti-stress, adaptogenic actions, which helps to alleviate anxiety associated with sexual desire and performance. Chauhan et al. (2010)  in a study showed that administration of vajikaran rasayana viz. C. orchioides, A. longifolia and M. pruriens ethanolic extracts modulate the level of the pituitary hormones FSH and LH. This in parts can explain the positive effect of the herbs on sexual functioning.
| Vajikaran Formulations|| |
There are 100's of different formulations which are used for vajikaran. Some of the formulations are mentioned below which are used commonly.
| Vrihani Gutika|| |
This formulation is one of the highest potency. This formulation is prepared as under. 120 g each of Shara roots (roots of Saccharum munja), Ikshu roots (roots of Saccharum officinarium), Kandekshu (Asteracantha longifolia), Ikshuvalika (Hygrophila spinosa), Shatavari (Asperagus racemosus), Payasya (Holostemma rheedianum), Vidari (Diascorea bulbifera), Kantakarika (Solanum indicum), Jeewanti (Leptadonia reticulata), Jivak (substitute Pueraria tuberosa), Meda (substitute Asparagus racemosus), Vira (Aloe Vera), Rishbhak (substitute Pueraria tuberosa), Bala (Sida cordifolia), Riddhi (substitute Diascorea bulbifera), Gokshur (Tribulus terrestris), Rasna (Pluchea lanceolata), Kapikachchhu (Mucuna pruriens) and Punarnava (Boerhaavia diffusa) are mixed with 2.56 kg of new Black gram. To this 10.24 L of water is added and cooked till the volume is reduced to only one fourth. The pastes of Madhuk (Madhuca indika), Draksha (Vitis vinifera), Phalgu (Ficus hispida), Pippali (Piper longum), Kapikachchhu (Mucuna prurie), Shatavari (Asperagus racemosus) are added to it 2.56 kg juice each of Vidari (Pueraria tuberosa), Amalki (Emblica officinale), Ikshu (Saccharum officinarium) and Ghee (clarified butter) plus 10.24 L Milk is also added and cooked till all water is evaporated and only Ghee remains and filtered. 160 g powder each of Sugar and Vanshlochan (Bambusa erandinacia), Pippali (Piper longum) and 40 g Marich (Piper nigram), 20 g each of Twak (Cinnamomum zeyliicum), Ela (Ellataria cardamomum), and Nagkesar are added. 320 g Honey is added and mix is blended thoroughly. Boluses, each weighing 40 g are prepared to be used. The dose is individualized and mainly depends on the digestive capacity of the individual. 
| Vrishya Gutika|| |
This formulation is highly potent aphrodisiac. 2.56 kg Ghee (clarified butter) is added to 2.56 kg of juice of Vidari (Pueraria tuberosa) and cooked. 256 kg Ghee is added and cooked again. 6.4 kg each of Sugar, Vanshlochan (Bambusa erandinacia), and Honey, Ikshurak (Saccharum officinarium), Pippali (Piper longum) and Kapikachchhu seeds (Mucuna pruriens) are added. The boluses are prepared. The weight of bolus is dependent on the digestive capacity of the person. 
| Vajikaranam Ghritam|| |
This formulation specially enhances the strength of the male organ. 2.56 kg each of newly harvested black gram and Kapikachchhu (Mucuna pruriens) and 160 g each of Jeevak (substitute Pueraria tuberosa), Rishbhak (substitute Pueraria tuberosa), Vira (Aloe vera), Meda (roots of Asparagus racemosus), Riddhi (substitute Diascorea bulbifera), Shatavari (Asperagus racemosus), Madhuk (Madhuka indica) and Ashwagandha (Withania somnifera) are added in water and boiled to prepare decoction. 640 g Ghee, 6.4 L Milk, 640 ml juices each of Vidari (Pueraria tuberosa) and Ikshu (Saccharum officinarium) are added and the mix is cooked on mild-fire. This Ghee preparation should be mixed with 160 g each of Sugar, Honey, Vanshlochan (Bambusa erandinacia) and Pippali (Piper longum). The dose is 40 g before meals. 
| Upatyakari Shashtikadi Gutika|| |
This vajikaran formulation is said to be particularly useful for the enhancement of the fertility. The white shashtik rice is grinded with milk in mortar, sufficient to wet the rice. More milk is added and it is grinded. Then it is squeezed through fine cloth. The cow milk is added to it and the mix is cooked. The decoctions of seeds of Kapikachchhu (Mucuna pruriens) and Black gram are prepared separately and added to above mix.
The decoctions of Bala (Sida cordifolia), Mugdharni (Phaseolus trilobus), Mashparni (Teramnus labialis), Jeewanti (Leptadonia reticulata), Jeevak (substitute Pueraria tuberosa), Riddhi (substitute Diascorea bulbifera), Rishbhak (substitute Pueraria tuberosa), Kakoli (substitute Withania somnifera), Gokshur (Tribulus terrestris), Madhuk (Madhuka indica), Shatawari (Asperagus racemosus), Vidari (Pueraria tuberosa), Draksh (Vitis vinifera) and Kharjur (Phoenix dactylifera) are added to above mix and cooked. After cooling the powders of Wheat, Shali rice, Shashtik rice, Black gram and Vanshlochan (Bambusa erandinacia) are added in sufficient quantity so as to get solid mass. Honey and Sugar are added in sufficient quantity to make boluses of appropriate size, depending on the digestive capacity of the person. 
| Medadi Yog|| |
This preparation is said to help regain sexual prowess to older men. The 10 g each of Meda (roots of Asparagus racemosus), Payasya (Holostemma rheedianum), Jeevanti (Leptadonia reticulata), Vidari (Pueraria tuberosa), Kantakari (Solanum xanthocarpum), Gokshur (Tribulus terrestris), Ksheerika, Black gram, Wheat, Shali rice and Shashtik rice are cooked in 2.56 L of water till the volume is reduced to 2.56 L. This mix is filtered and Honey, Ghee and Sugar are added. 
| Limitations|| |
- The philosophical base of the modern medicine and Ayurvedic medicine is entirely different therefore many times it may be difficult to explain the theory in understandable terms for each other. This lack of communication increases the gap in collaboration of research or practice.
- There is lack of research and consensus among experts. The formulations have not been subjected to the rigorous scientific studies. Medications have not been standardized and may contain toxic substances or may be adulterated if proper purification processes have not been followed. Many of the mentioned herbs are difficult to obtain hence it seem difficult to prepare these formulation as per recommendations of the standard texts of Ayurveda.
- Most texts state that the medications are free from side effects however; this has been never tested in scientific studies. Authors have seen cases, where the patients have developed severe medical and psychiatric complications subsequent to use of Ayurvedic over the counter/prescribed medications.
| Conclusion|| |
Vajikaran is an important treatment modality as per Ayurveda and proposed benefits are manifold including increased sexual capacity, improving health of future progeny as well as in treatment of many common sexual disorders like infertility, erectile dysfunction and premature ejaculation. Differences in the philosophical base of the Ayurvedic science and modern medical science results into inability of effective collaboration between these researchers and practitioners. Lack of research as per current scientific standards is the main criticism of vajikaran. Lack of standardization of formulations and difficulty in getting unadulterated herbs are realistic intricacies in the utility of vajikaran preparations. Randomized controlled trials of theses formulations can be helpful in understanding efficacy, possible side effects and other treatment related parameters.
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P K Dalal
Prof. and Head, Department of Psychiatry, CSM Medical University (K. G. Medical University), Lucknow
Source of Support: None, Conflict of Interest: None