Wounds are commonly encountered. Though extremely common, without proper and timely intervention, they may get complicated leading to sepsis, septicaemia and scarring. Wounds are due to various types and intensity of physical injury wherein the skin is torn or punctured or a contusion is formed due to blunt force. Accordingly, a wound is called open when the skin is breached due to injury and closed when there is no tearing or cutting of skin. A wound is considered minor when it is superficial, away from natural orifices, with minor or no bleeding and not caused by a tool or instrument or animal.

Other types of wounds including stab and gunshot wounds and those with doubtful background are considered as major or severe and must receive proper medical attention. In severe open wounds, the risk of blood loss and infection is high. Such wounds need to be cleaned and covered until medical help is provided. Internal wounds are comparatively dangerous as the extent of damage to the tissues is not known.

Here, the term wound is confined to external and superficial injuries including incised wounds, lacerations, abrasions, puncture wounds, contusions and mild haematoma. If not severe and complicated, wounds can be successfully managed with simple traditional medical care making use of Haridra.

Haridra (Curcuma longa Linn.)

Haridra is a well established medicinal plant of Indian medicine known for its wound healing properties. Classical medical literature is replete with the uses of turmeric and adequate evidence is available for its antiseptic, anti-inflammatory, anti-bacterial and anti-allergic properties. The earliest reference to turmeric with its indications for skin diseases and wounds is found in Ayurvedic text Charaka Samhita. Use of turmeric is recommended for facilitating wound healing in para-surgical procedures prescribed in Ayurveda such as leech therapy for chronic wounds and Kshara Sutra therapy for piles and fistula. Turmeric is the most common household medicine for first-hand management of injuries and wounds. Its juice, paste, powder, decoction and various formulations are used externally and internally. Haridra is dried rhizome, like that of ginger, of a perennial herb of Zingiberaceae plant family, which is extensively cultivated in all parts of India and harvested between October to April when the lower leaves of the plant turn yellow. The rhizomes are boiled and then dried and the skin peeled off. Turmeric is available in the market both in raw and powder forms. Powdered Haridra is an essential commodity in Indian homes used as a condiment in almost all sorts of cooking.

Composition

Haridra powder is made of a single herbal ingredient Haridra.

English name	Turmeric
Latin name	Curcuma longa Linn.
Family	Zingiberaceae
Plant part used	Rhizome

Main chemical constituents

Curcuminoids including yellow colouring principal, curcumin, and an essential oil with high content of bisabolane derivatives.

Quality standards

For quality assurance of turmeric rhizome, the following parameters are recommended in the Ayurvedic Pharmacopoeia of India.

Foreign matter	Not more than 2%
Total ash	Not more than 9%
Acid-insoluble ash	Not more than 1%
Alcohol-soluble extractives	Not less than 8%
Water-soluble extractives	Not less than 12%
Volatile oil	Not less than 4% volume/weight.

Quality testing of turmeric is done by adding concentrated sulphuric acid or mixture of concentrated sulphuric acid and alcohol to the powdered turmeric. Appearance of deep crimson colour confirms the quality.

Method of preparation

• (1) Powder of turmeric is prepared by grinding dried rhizomes in a grinder or pulverizer and then sieved through mesh size 80. The powder should be kept in a clean container and stored in a dry area away from direct sunlight.
• (2) Decoction of turmeric for washing wounds is made by boiling 10 grams of powder in 200 millilitres of water till one fourth liquid remains.
• (3) Paste for application over the wound is prepared by mixing 5 to 10 grams of turmeric powder in an equal amount of clean water.

Dosage form

Yellow-coloured fine powder, decoction, and paste.

Therapeutic properties

Haridra has anti-inflammatory, blood purifying, anti-allergic, antibacterial, anti-fungal, anti-protozoal, demulcent and wound-healing properties.

Dose and mode of administration

Haridra may be used simultaneously for washing the wound, application as paste on wound and orally in the following ways and dose schedule:

• (1) For oral use the dose of turmeric powder for adults is 2 to 5 grams and for children it is 1 to 2 grams or juice of fresh turmeric in the dose of 10 to 20 millilitres for adults and 5 to 10 ml for children. It is administered twice daily with water or honey.
• (2) Wash the wound twice daily with turmeric decoction.
• (3) Apply a thin paste of turmeric over the wound and keep it for 8 to 10 hours and then remove by gently washing the affected part with luke warm water. Alternatively, the wound is dressed with gauze soaked in turmeric decoction or juice or mixture of turmeric and mustard oil or honey. A new dressing should be used after cleansing the wound.

Indications and uses

• (1) External and internal use of turmeric is indicated in acute and chronic wounds with not much damage to the tissues.
• (2) Sepsis, allergic reaction, inflammation and skin discoloration around the wound are also manageable with oral use and topical application of turmeric.

Precautions and safety aspects

• (1) Due care must be taken to keep the wound clean and dry. It is advisable to use turmeric decoction for washing the wound.
• (2) Frank bleeding and pus discharge from the wound should be attended to properly.
• (3) Treatment with turmeric may be stopped if it does not yield beneficial effects in a couple of days.
• (4) Being regularly used as a food item, turmeric is considered safe and no toxic or adverse effects are reported of its long-term use. However, its oral use in children and pregnant women should be done under medical supervision. It is safe for the baby if a nursing mother is taking this medication.
• (5) Persons receiving aspirin and warfarin should take turmeric with caution since their combination may cause bleeding.
• (6) Side effects with turmeric may occur with use of more than the recommended doses. In that case, it may cause stomach upset or other gastrointestinal problems such as diarrhoea.
• (7) As turmeric is bitter in taste and may induce nausea or vomiting, it is better not to consume the powder on an empty stomach.
• (8) Persons suffering from bile duct blockage, blood-clotting disorder and stomach ulcers should not take turmeric in excessive quantity.

References

• (1) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 1. New Delhi: India Central Council for Research in Ayurveda and Siddha, 2000. p. 154.
• (2) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I Vol. I. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2001. p. 45.
• (3) Sharma PC, Yelne M.B, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 1. New Delhi: Central Council for Research in Ayurveda and Siddha, 2000. p. 152, 154.

Further reading

• (1) Ayurveda and its scientific aspects. New Delhi: Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy and Council of Scientific and Industrial Research, 2006.
• (2) Bhavamishra. Bhavaprakasha Nighantu. Edited by Pandey GS. Varanasi: Chaukhambha Bharati Academy, 1999.
• (3) Indian herbal pharmacopoeia. Vol. I. Jammu-Tawi: Regional Research Laboratory, Council for Scientific and Industrial Research; Mumbai: Indian Drug Manufacturers Association, 1998.
• (4) Khare CP. Indian medicinal plants. New Delhi: Springer (India) Pvt. Ltd., 2007.
• (5) Khung N, Rastogi G, Grover JK. Anti-inflammatory and analgesic activities of Curcuma longa. Indian J. Pharmacology. 18(1), 1998.
• (6) Sharma PV. Dravyaguna Vignana. Vol. II. Varanasi: Chaukhambha Bharati Academy, 2001.

Source: Traditional Herbal Remedies for Primary Health Care - WHO