Malaise is a symptom of psychosomatic origin characterized by a general feeling of illness or lack of well-being and may be accompanied by discomfort, fatigue, lassitude, restlessness, loss of strength and lack of interest and drive. This symptom is usually a vague sense of ill-being and exhaustion seen in patients suffering from any significant febrile infection and metabolic or chronic disease.

The mechanism of development of malaise is not fully understood and probably it may result from excessive presence of reactive molecules called free radicals. These molecules cause oxidant injury to the body cells and inadequate supply of antioxidants in the diet lead to a decline in the levels of antioxidants with increasing age. The onset of malaise may be sudden or staggering depending upon the nature of the underlying disease.

Malaise associated with other symptoms indicates significant illness. The following is the list of conditions that mostly cause malaise:

• (1) Acute infectious diseases like pneumonia, influenza, and viral fever.
• (2) Chronic infectious diseases like AIDS, parasitic disease, hepatitis and tuberculosis.
• (3) Organ-specific chronic diseases like heart failure, obstructive lung disease, kidney failure and liver disease.
• (4) Autoimmune diseases like rheumatoid arthritis, sarcoidosis, and systemic lupus erythematosus.
• (5) Endocrinal disorders like diabetes mellitus, dysfunction of the thyroid and adrenal glands.
• (6) Various cancers like leukaemia, lymphoma, colon cancer and solid malignant tumours.
• (7) Severe anaemia.
• (8) Mental illness such as depression.
• (9) Medication with anti-convulsant, anti-histaminic, psychotropic and beta-blocker drugs and multi-drug treatments.

Certain herbal medicines called Rasayana in Ayurveda are proven to have excellent anti-oxidant, immune-enhancer, anti-infective, anti-degenerative and anti-stress effects. Ashvagandha is one such medicinal herb, which helps in many ways in the restoration and maintenance of health and vitality and to reinforce the psychosomatic mechanisms involved in preventing and treating malaise of varied origin.

Ashvagandha Powder (Withania somnifera Dunal.)

Ashvagandha is a perennial shrub, found in waste lands, cultivated fields and open grounds throughout India. It is widely cultivated in India. The roots are collected in winter, washed and cut into short pieces. Ashvagandha is one of the most commonly used medicinal plants in Indian medicine for a varied range of physical and psychological ailments. It finds mention in almost all classical compendia of Indian medicine, particularly in the context of rejuvenation therapy. The plant is best known for its tonic, antistress and vigour- and vitality-enhancing properties. The root of the plant is used as such in powder form or in combination with other medicinal plants in various kinds of formulations mentioned in official formularies and pharmacopoeia of India. A lot of scientific work has been done on Ashvagandha proving it to be useful as an immunomodulator, antioxidant and adaptogenic. Due to these very beneficial effects, Ashvagandha is preferred for adjuvant use in the management of various psychosomatic, infectious and drug-induced ailments and nutritional deficiency states with malaise as a main symptom. Ashvagandha improves tissue vitality, physical and mental endurance and neuromuscular strength.

Composition

Ashvagandha powder consists of dried mature roots of Withania somnifera Dunal.

English name	Winter cherry
Latin name	Withania somnifera Dunal.
Family	Solanaceae
Parts used	Root

Main chemical constituents

Alkaloids and withanolides.

Quality standards

Identity, purity and strength of Ashvagandha root are determined on the following basis:

Foreign matter	Not more than 2%
Total ash	Not more than 7%
Acid-insoluble ash	Not more than 1%
Alcohol-soluble extractive	Not less than 15%
Assay of total alkaloids	Not less than 0.2%

Method of preparation

• (1) Dried roots of Ashvagandha are cleaned and ground into fine powder.
• (2) The powder is filtered through mesh size 85 to remove fibers and coarse particles and then kept in an airtight jar or polythene bag away from moisture.
• (3) The potency of well-preserved Ashvagandha powder is retained for one year.

Dosage form

Cream-coloured fine powder.

Therapeutic properties

• (1) Ashvagandha is a tonic, anti-stress, adaptogenic, somniferous, stimulant, vitalizer, aphrodisiac and immuno-enhancer.
• (2) Pharmacological studies have confirmed its immuno-modulatory, cyto-protective, anti-oxidant and anti-ageing properties.

Dose and mode of administration

• (1) The dose for adults of Ashvgandha powder is three to six grams and for children the dose is 500 mg to 1g to be taken twice a day, with honey or warm milk before meals. It is advisable to first mix Ashvagandha powder properly with an equal amount of honey and the mixture to be swallowed with sips of milk.
• (2) Alternatively, boil a single dose of Ashvagandha powder in four times milk and eight times water till milk remains. If needed, add sugar to the medicated milk and drink it lukewarm. Every dose of Ashvagandha powder has to be freshly boiled with milk and water.

Indications and uses

Ashvagandha powder is useful in malaise, debility, impotence, neurasthenia, mental stress and fatigue.

Precautions and safety aspects

• (1) Malaise persisting for more than a week must be properly investigated and the underlying cause should be ascertained before starting Ashvagandha.
• (2) Concomitant use of alcohol and psychotropic drugs should preferably be avoided while using Ashvagandha powder.
• (3) Individuals with hot constitution should take a smaller dose of Ashvagandha and should avoid excessive consumption of hot beverages, sour, spicy and stimulant foods.
• (4) Ashvagandha powder is generally considered as safe. Used in a dose of up to 9 grams per day for four weeks, it is reported to be well-tolerated.
• (5) Larger doses of Ashvagandha may possess abortifacient property and thus contraindicated during pregnancy. Even normal dose should be given to pregnant women under medical supervision.
• (6) It is safe for the baby if a nursing mother is taking Ashvagandha.

References

• (1) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 3. New Delhi: Central Council for Research in Ayurveda and Siddha, 2001. p. 91-92.
• (2) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol.1. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 2001. p. 16.
• (3) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part1 Vol.1. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 2001. p 15.
• (4) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 3. New Delhi: Central Council for Research in Ayurveda and Siddha, 2001. p. 89, 91-92.

Further reading

• (1) Chopra RN, Nayar SL, Chopra IC. Glossary of Indian medicinal plants. New Delhi: Publications and Information Directorate, Council of Science and Industrial Research, 1986.
• (2) Chunekar KC. Bhavaprakasha Nighantu. Varanasi: Chaukhambha Bharati Academy, 1982.
• (3) Indian herbal pharmacopoeia: a joint publication of Regional Research Laboratory, Jammu Tawi. Vol. I. Mumbai: Indian Drug Manufacturers’ Association, 1998.
• (4) Warrier, PK et al. Eds. Indian medicinal plants. Vol. V. Madras: Orient Longman Ltd., 1997.
• (5) Khare CP. Indian medicinal plants. New Delhi: India Springer (India) Pvt. Ltd., 2007.
• (6) Kirtikar KR, Basu BD. Indian medicinal plants. Vol. 3. Allahabad: LM Basu, 1988.
• (7) Panda S, Kar A. Evidence for free radical scavenging activity of Ashvagandha root powder in mice. Indian J. Physiol. Pharmacol. 41(4), 1997.
• (8) Puri HS. Rasayana: Ayurvedic herbs for longevity and rejuvenation. London: Taylor & Francis. 2003.
• (9) Sharma PV. Classical uses of medicinal plants. Varanasi: Chaukhambha Visvabharati,1996.
• (10) Shastri AD. Bhaishajyaratnavali. Varanasi: Chaukhambha Sanskrit Sansthana, 1981.
• (11) Singh RH, et al. Depressive illness: a therapeutic evaluation with herbal drugs. J. Res. Edu. Ayur. Siddha. 11, 1990.

Source: Traditional Herbal Remedies for Primary Health Care - WHO