Bilwa (Aegle marmelos): A Classical Ayurvedic Panacea with Special Reference to Atisara (Diarrhea)

Introduction

Bilwa, commonly known as Bael in Hindi and Bengal quince in English, is one of the most revered medicinal plants in Ayurveda. Belonging to the Rutaceae family, it is considered sacred in Hindu tradition and is often offered to Lord Shiva. In Ayurveda, Bilwa is regarded as a Mahakashaya dravya due to its profound therapeutic effects, especially in gastrointestinal disorders. Its primary indication lies in treating Atisara (Diarrhea)—a condition where Bilwa’s Grahi (absorbent) and Deepana-Pachana (digestive-stimulant) properties come into full therapeutic potential.

Primary Indicated Disease: Atisara (Diarrhea)

Pathology of Atisara in Ayurveda

Atisara is defined in Ayurveda as the frequent passage of watery stool due to vitiation of Vata, Pitta, or Kapha doshas in the gastrointestinal tract. The primary cause is Agnimandya (weak digestion), which leads to improper digestion and the accumulation of Ama (toxins). This, coupled with dietary indiscretions, contaminated food, or infection, disturbs the balance of doshas, especially Vata, resulting in Drava Mala Pravritti (loose stools).

Types of Atisara:

1. Vataja Atisara – Dryness, abdominal pain, audible bowel sounds.

2. Pittaja Atisara – Burning sensation, fever, yellow stools.

3. Kaphaja Atisara – Mucus-laden, heavy, white stools.

4. Sannipataja – Mixed doshic symptoms.

5. Amaja Atisara – Due to undigested toxins, sticky and foul-smelling stools.

Medicinal Actions of Bilwa in Atisara

Bilwa, specifically its unripe fruit, is most effective in Atisara. Its actions are detailed below:

1. Grahi (Absorbent)

Bilwa increases the absorption capacity of the intestines, helping to solidify loose stools. It acts primarily on Apana Vata to restore colonic tone.

2. Deepana-Pachana (Appetizer & Digestive)

Bilwa stimulates Agni (digestive fire), reducing Ama formation. It balances Samana Vata and Pachaka Pitta to regulate digestion.

3. Stambhana (Astringent/Binding)

Bilwa’s Kashaya (astringent) and Tikta (bitter) rasa control excessive bowel movement, preventing further fluid loss.

4. Raktastambhaka

In Pittaja Atisara with blood traces, Bilwa acts as a haemostatic agent due to its cooling and astringent nature.

5. Krimighna (Antimicrobial)

Its Krimighna property eradicates intestinal worms or microbial overgrowth, which are common causes of chronic diarrhea.

6. Tridosha Shamana

While predominantly balancing Vata, Bilwa also pacifies Pitta and Kapha due to its Rasa, Virya, and Vipaka properties.

Pharmacognosy of Bilwa (Aegle marmelos)

Botanical Identity

• Scientific Name: Aegle marmelos

• Family: Rutaceae

• Part Used: Unripe fruit (mainly), leaves, root, bark

Microscopic and Macroscopic Features

• Fruit: Globose, hard shell, yellowish-brown with sweet, mucilaginous pulp.

• Leaves: Tripartite, aromatic, and shiny green.

• Bark: Greyish with a mucilaginous texture.

Pharmacognostical Tests

• Ash Value: ≤ 8%

• Extractive Value: Water-soluble > 20%

• Fluorescence Analysis: Positive under UV light due to coumarins.

Mode of Action in Ayurveda

Dosha Level

• Vata: Pacifies Apana and Samana Vata due to its Snigdha (unctuous) and Guru (heavy) properties.

• Pitta: Alleviates due to Sheeta Virya and Tikta Rasa.

• Kapha: Controlled by Kashaya Rasa and Laghu Guna.

Dhatu Level

• Rasa Dhatu: Improves absorption and corrects dysbiosis.

• Rakta Dhatu: Heals inflammation and reduces bleeding.

• Mamsa & Meda Dhatu: Supports rejuvenation post-illness.

Srotas (Channels)

• Primarily acts on Annavaha Srotas (digestive tract) and Purishavaha Srotas (excretory channels).

Vernacular Names of Bilwa

Chemical Constituents of Bilwa

• Alkaloids: Aegeline (antidiabetic), Marmelosin (antimicrobial)

• Coumarins: Imperatorin, Scopoletin (antioxidant)

• Tannins: Astringent action

• Flavonoids: Anti-inflammatory, anti-cancer

• Essential Oils: Carvone, D-limonene

• Mucilage: Soothing action on mucosa

10 Major Diseases/Conditions Where Bilwa is Useful

1. Atisara (Diarrhea)

As discussed above.

2. Grahani (Irritable Bowel Syndrome/IBD)

Bilwa strengthens intestinal tone and digestion, essential in Grahani caused by chronic Agnimandya.

3. Arsha (Piles)

Bilwa reduces inflammation, relieves constipation, and acts as a mild astringent—important in managing both bleeding and non-bleeding piles.

4. Jwara (Fever)

Due to its Tridosha pacifying and antipyretic action, Bilwa is included in formulations like Dashmoola Kadha.

5. Prameha (Diabetes)

Bilwa leaves contain aegeline and have proven hypoglycemic effects, making them beneficial in Kapha-dominant Prameha.

6. Krimi Roga (Worm Infestation)

Its Krimighna property helps eliminate intestinal parasites.

7. Shotha (Inflammation)

Its anti-inflammatory and cooling actions help reduce localized swelling and inflammatory bowel conditions.

8. Shwasa (Breathlessness/Asthma)

Its Kapha-pacifying and bronchodilatory action supports Shwasahara management, especially in allergic asthma.

9. Vrana (Wounds)

The leaves and bark paste of Bilwa promote wound healing, especially in Dushta Vrana due to their antimicrobial and anti-inflammatory action.

10. Amlapitta (Hyperacidity)

Bilwa balances Pitta, protects gastric mucosa, and is used with Shatavari in gastritis or acid reflux.

10 Ayurvedic Formulations Containing Bilwa

1. Bilwadi Churna – For Atisara, Grahani

2. Dashmoola Kwatha – General inflammation, postpartum recovery

3. Chandraprabha Vati – Urinary disorders

4. Bilvadi Avaleha – Respiratory and digestive complaints

5. Pancha Tikta Ghrita Guggulu – Autoimmune and inflammatory diseases

6. Bilvadi Lehyam – Diarrhea, appetite stimulant

7. Bilwa Taila – Ear infections, wound care

8. Mustadi Kwatha – Useful in IBS

9. Bilwadi Gutika – Dysentery and fever

10. Amlapitta Mishran – Hyperacidity

Home Remedies Using Bilwa

1. Bilwa Fruit Pulp (for Diarrhea)

• Take pulp of unripe Bilwa.

• Boil with water to prepare a decoction.

• Drink warm twice daily.

2. Bilwa Leaf Juice (for Diabetes)

• Crush 4-5 fresh leaves.

• Take with lukewarm water early morning.

3. Bilwa Root Paste (for Fever)

• Grind Bilwa root.

• Apply externally on forehead for antipyretic effect.

4. Bilwa Leaf Paste (for Wounds)

• Mix with turmeric and apply on chronic wounds.

5. Bilwa Bark Decoction (for Hemorrhoids)

• Decoction of bark with Nagkesar helps stop bleeding.

Harmful Effects and Contraindications

Though generally safe, Bilwa has a few limitations:

1. Constipation

Overuse of unripe Bilwa, especially in powder form, can cause severe constipation due to its Grahi property.

2. Pregnancy

Avoid unripe fruit in high doses as it can increase uterine contractions.

3. Chronic Hypothyroidism

The fruit has goitrogenic effects and should be monitored in such patients.

4. Medication Interaction

Can interact with hypoglycemic drugs, enhancing their action.

5. Hypersensitivity

Allergic reactions are rare but possible with leaf application.

Relevance of Bilwa as a Grahi Dravya in Ayurveda

Bilwa is prominently classified under Grahi Dravyas (absorbents) in Charaka Samhita. Grahi Dravyas have:

• Kashaya and Tikta Rasa

• Laghu, Ruksha Guna

• Sheeta Virya

• Katu Vipaka

They act by:

• Enhancing absorption in the intestines.

• Reducing fluid excretion from the colon.

• Strengthening Agni (digestive fire).

• Removing Ama without purgation.

In Bilwa’s case, it perfectly embodies these attributes and is highly effective in managing Grahani, Atisara, and Ama-related disorders.

Conclusion

Bilwa (Aegle marmelos) is a pharmacological jewel in Ayurveda. Among its many therapeutic properties, its use in Atisara (diarrhea) stands out as both classical and contemporary. Its broad pharmacological profile—ranging from Grahi and Deepana to Krimighna and Shothahara—makes it indispensable in the Ayurvedic pharmacopeia. From deep physiological alignment with Doshas and Dhatus to modern evidence-based applications, Bilwa’s significance continues to grow in preventive and curative medicine alike.