Headache is defined as a pain in the head or upper neck. Headache can be a symptom of an underlying serious disease or it can be a disease itself. Headache can be due to many causes. Common benign causes of headache include: migraine, refractory error, mental tension, sinusitis, flu, viral fever, typhoid, etc. Some of the serious and lifethreatening causes of headache include cerebral haemorrhage, subarachnoid haemorrhage, intracranial space occupying lesions (tumour), acute and chronic meningitis, brain abscess, etc. Trigeminal neuralgia can be a difficult and intractable cause of headache though not life threatening. Sudden and severe headache associated with symptoms like high fever, vomiting, convulsion, visual symptoms, stiffness in the neck and loss of consciousness warrant urgent medical attention.

Mild to moderate headache without any specificity can be managed with simple remedies such as Pippalimoola, which is specifically documented for the management of headache in Ayurvedic pharmacopoeia, Ayurvedic formulary and in various classical texts.

Pippalimoola (Root of Piper longum Linn.)

Pippalimool means roots of Pippali (long pepper) plant. The roots are perennial, woody, and aromatic and are used in powder form with warm water, milk or preferably with ghrita (clarified butter). Many references regarding the therapeutic use of Pippalimoola are available in ancient classical Ayurvedic texts for its carminative, antispasmodic and sedative actions. Use of ghrita with Pippalimool is emphasized because of its ability to negate hot and dry properties of Pippalimool and facilitate drug action for alleviation of vitiated Vata dosha, which is considered as the underlying bio-humour responsible for the causation of headache. Ghrita is also known to be beneficial for mental faculties and recommended for use alone or with medicinal formulations for psychological problems including stress-induced headache, disturbed sleep and impaired mental concentration.

Composition

Pippalimoola powder consists of roots of Pippali

English name	Long Pepper
Latin name	Piper longum Linn.
Family	Piperaceae
Part used	Fruit

Main chemical constituents

Alkaloids (Piperine, Piperlongumine, Piperlonguminine, etc.), essential oils.

Quality standards

Foreign matter	Not more than 2%
Total ash	Not more than 5.5%
Acid-insoluble ash	Not more than 0.2%
Alcohol-soluble extractive	Not less than 4.0%
Water-soluble extractive	Not less than 12%

Method of preparation

• (1) Take 40 grams of dried roots of Pippali. Dry it further for removing moisture for easy powdering. Roots should not have been collected more than one year ago.
• (2) Grind the roots in a grinder or pulverizer till fine powder is obtained.
• (3) Filter the powder through mesh size 85.
• (4) Keep the powder in a dry and air-tight plastic or glass container.

Dosage form

Reddish-brown to creamy-grey bitter powder.

Therapeutic properties

The roots of Pippali have thermogenic, tonic, diuretic, purgative expectorant, anthelmintic, stomachic, digestive, emmenagogue, anti-bacterial, anti-inflammatory, central nervous system stimulant, antispasmodic, and analeptic properties.

Indication and uses

Headache, insomnia, cough, cold, and chronic bronchitis.

Dose and mode of administration

Dose of the powder for adults is 2 to 3 grams and for children it is 250 mg to 500 mg, to be taken twice daily, preferably on an empty stomach mixed with 3 to 5 gm of ghee or butter or honey and followed by warm water or milk.

Precautions and safety aspects

• (1) No toxic effect or adverse reaction is reported with recommended dose of Pippali root powder.
• (2) Pippali root should be used with caution in the first trimester of pregnancy. However, it is safe for the baby if a nursing mother is taking this medication.
• (3) Pippalimool is hot in nature, so should be used with caution in summer and by hot temperament individuals and menstruating women.
• (4) During medication with Pippalimool, diet should be simple, easily digestible and free from spicy and pungent-bitter-astringent food items.

References

• (1) India, Ministry of Health & Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol. II. New Delhi: Department of Indian Systems of Medicine & Homeopathy. 2001. p. 134.
• (2) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 3. New Delhi: Central Council for Research in Ayurveda & Siddha, 2001. p. 473.

Further reading

• (1) Atmaram et al. The Wealth of India. Vol. 8. New Delhi: Council of Scientific & Industrial Research, 2003.
• (2) Shastri Brahmashankar, Vaishya Ruplal. Eds. Bhavaprakasha nighantu. Part 1. Varanasi: Chaukhambha Sanskrit Sansthana, 1999.
• (3) Gupta AK. Quality standards of Indian medicinal plants. Vol.1. New Delhi: Indian Council of Medical Research, 2003.
• (4) Kirtikar KR, Basu BD. Indian medicinal plants. Vol. III. Allahabad: L.M. Basu, 1981.

Source: Traditional Herbal Remedies for Primary Health Care - WHO