BHESHAJA MATRA FOR SHODHANA AND SHAMANA IN CHILDREN

BHESHAJA MATRA FOR SHODHANA AND SHAMANA IN CHILDREN

🔹 INTRODUCTION

• Bheshaja Matra refers to the dose of medicine administered to a child.

• In Ayurveda, appropriate dosage is critical, especially in children due to their delicate physiology (Bala).

• Dosage varies according to age, strength, digestion capacity, disease severity, and type of treatment (Shodhana or Shamana).

• The two primary therapeutic approaches in Ayurveda are:

  • Shodhana (Purificatory therapy)

  • Shamana (Palliative therapy)

🔹 GENERAL PRINCIPLES OF DOSAGE IN CHILDREN

• Children are considered physiologically immature; hence, Matra (dose) is always less compared to adults.

• Digestive strength (Agnibala), tissue development, and organ maturity must be evaluated before deciding the dose.

• Medicines should be:

  • Mild

  • Pleasant-tasting

  • Easy to digest

  • Given in appropriate vehicles (Anupana) such as honey, ghee, or milk.

📜 Relevant Shloka:

"नात्यल्पं नातिमात्रं वा बालानां भेषजं हितम्।
निरामं मारुतं स्थानं स्नेहैः पूतं प्रशस्यते॥"
(Aṣṭāṅgahṛdaya Uttarasthāna 1/9)
Translation: Neither too little nor too excessive dose is beneficial for children. Cleansed, unvitiated areas, and well-suited sneha (unctuous substances) are recommended.

🔹 CLASSIFICATION OF BHESHAJA MATRA

1. BASED ON AGE (Ayu-Matrā)

   • Dosage is calculated according to the child’s age using various Ayurvedic formulas.

   a. As per Ashtangahridaya:

   "षष्ठ्यंशो द्विवर्षस्य स्यात् दशमांशोऽथ पञ्चमात्।
   एकादशद्वादशभ्यां तु सप्तमांशोऽथ शोढनात्॥"
   (Aṣṭāṅgahṛdaya Uttarasthāna 1/16)
   Translation: One-sixth of adult dose for a 2-year-old; one-tenth for a 5-year-old; one-seventh for children aged 11 and 12 years during Shodhana.

   b. Modern Parallel (Young’s Formula):

   $$\text{Child dose} = \frac{\text{Age in years}}{\text{Age} + 12} \times \text{Adult dose}$$

2. BASED ON BODY WEIGHT (Weight-Based Dosing)

   • More common in modern pediatrics.

   • Clark’s Rule:

     $$\text{Child dose} = \frac{\text{Weight in lb}}{150} \times \text{Adult dose}$$

   • Fried’s Rule (for infants):

     $$\text{Child dose} = \frac{\text{Age in months}}{150} \times \text{Adult dose}$$

🔹 BHESHAJA MATRA FOR SHODHANA IN CHILDREN (PURIFICATORY DOSE)

• Shodhana involves removal of doshas through Panchakarma.

• Children are usually not subjected to intense Shodhana; if needed, mild forms like Mridu Virechana and Nasya are preferred.

• Dose is lesser than adults and decided cautiously considering age and strength.

Important Guidelines:

• Use mild purgatives like Draksha, Trivrit, Haritaki, Eranda taila in children.

• Use Matra Basti (small enema) or Mridu Virechana for children with strong digestion.

📜 Relevant Shloka:

"बालाः सदा मृदु प्रकृतयः स्नेहेनैव प्रशम्यन्ति।
न तु तिक्तोष्णतिक्ताद्यैः शोढ्यन्ते ते क्वचित्॥"
(Aṣṭāṅgahṛdaya Uttarasthāna 1/6)
Translation: Children are naturally mild in constitution and are treated preferably with sneha (oleation); bitter and hot drugs should not be used excessively.

🔹 BHESHAJA MATRA FOR SHAMANA IN CHILDREN (PALLIATIVE DOSE)

• Shamana is aimed at balancing doshas without expelling them.

• More frequently used in pediatric practice than Shodhana.

• Matra should be calculated considering:

  • Digestion capacity

  • Palatability

  • Disease type

  • Tolerance level

Examples:

• Arishta, Avaleha, Syrups in lower concentrations.

• Use of Madhu (honey) as Anupana helps mask bitterness.

📜 Relevant Shloka:

"द्रवाणां लघवां मात्रां, योजयेत् बाले हिताम्।
रसेन मधुरेणैव, न कदाचिदतिक्रमेत्॥"
(Bhaishajya Ratnavali – Bāla Roga Chikitsa)
Translation: Light dosage of liquids, preferably with sweet taste, is to be administered in children without exceeding limits.

🔹 FACTORS AFFECTING BHESHAJA MATRA IN CHILDREN

• Age (Vaya)

• Weight and Body Build (Sharira Pramana)

• Strength (Bala)

• Digestive Power (Agnibala)

• Disease Severity (Roga Bala)

• Drug Potency (Dravya Bala)

• Season (Kala) and Region (Desha)

🔹 MODERN PEDIATRIC PERSPECTIVE ON DOSING

• Pediatric dosage calculation is precise and depends on:

  • Weight (mg/kg/day)

  • Surface area (mg/m²/day) — more accurate than weight-based.

• Surface Area Formula (Mosteller):

  $$\text{BSA} (\text{m}^2) = \sqrt{\frac{\text{Height (cm)} \times \text{Weight (kg)}}{3600}}$$

• Pediatric formulations often come in:

  • Syrups

  • Suspensions

  • Drops

  • Suppositories

• WHO Guidelines: Emphasize correct pediatric formulations to avoid under/overdosing.