Keetmari (Aristolochia bracteolata): A Comprehensive Review in Ayurveda

1. Most Accountable Disease in Ayurveda: Krimi Roga (Parasitic Infestations)

Introduction to Krimi Roga in Ayurveda: Krimi Roga refers to worm infestations or parasitic infections. These can be either intestinal (like helminthiasis), skin-related, or blood-related infestations. According to Ayurveda, Krimi are of two types: ‘Bahya’ (external) and ‘Abhyantara’ (internal). Abhyantara Krimi are further classified based on their origin from different doshas and dhatus, namely Purishaja (from feces), Raktaja (from blood), and Kaphaja (from kapha).

Medicinal Actions of Keetmari in Krimi Roga:

• Krimighna (antiparasitic): The primary use of Keetmari in Ayurveda is as a Krimighna Dravya. It is known to destroy and expel worms from the digestive tract.

• Kusthaghna (anti-dermatosis): Treats skin diseases arising from parasitic infestation.

• Shothahara (anti-inflammatory): Reduces inflammation associated with worm infestation.

• Raktashodhaka (blood purifier): Acts on raktaja krimi by purifying the blood.

• Vishaghna (detoxifier): Neutralizes toxins released by parasites.

Pathology in Ayurveda: Krimi Roga is caused due to improper digestion (mandagni), leading to the accumulation of ama (toxins), and vitiation of doshas (especially Kapha and Pitta). These create a favorable environment for krimi (worms). In the intestines, these cause pain, indigestion, bloating, and nutritional deficiency.

Dosha and Dhatu Involvement:

• Dosha: Predominantly Kapha and Pitta.

• Dhatu: Rasa, Rakta, and Purisha.

Pharmacognosy of Keetmari (Aristolochia bracteolata):

• Botanical Name: Aristolochia bracteolata Lam.

• Family: Aristolochiaceae

• Common Names: Bracteated birthwort, Worm killer

• Ayurvedic Names: Keetmari, Kitamari, Krimighni

• Part Used: Leaves and roots

• Taste (Rasa): Tikta (bitter), Katu (pungent)

• Post-digestive Taste (Vipaka): Katu

• Potency (Virya): Ushna (hot)

• Effect on Doshas: Pacifies Kapha and Vata

Mode of Action in Krimi Roga:

• The tikta and katu rasa along with ushna virya create an environment hostile to worms.

• It promotes digestion and removes ama, thus reducing the krimi’s breeding ground.

• Its Vishaghna property helps neutralize toxins released by parasites.

• It enhances Pachaka Agni (digestive fire), helping eliminate worms through proper digestion and metabolism.

2. Names in Different Languages:

• Sanskrit: Keetmari, Krimighni

• Hindi: Kitmari, Keetnashak

• Tamil: Aduthinnaapaalai

• Telugu: Gadida Pala

• Malayalam: Aduthinnaappala

• Kannada: Aduthinne

• English: Bracteated Birthwort, Worm killer

• Arabic: Khatmi Safra (colloquial uses)

3. Chemical Constituents:

• Aristolochic acid (major constituent with antihelminthic properties)

• Bractin A and B

• Sesquiterpenes

• Alkaloids

• Flavonoids

• Steroids

• Glycosides

• Tannins

• Saponins

4. Minimum 10 Diseases and Conditions Where Keetmari is Used:

1. Krimi Roga (Parasitic Worms): Expels intestinal worms and cleanses the digestive tract.

2. Kustha (Skin Diseases): Used externally in eczema, scabies, and fungal infections.

3. Vrana (Wounds): Aids in wound healing due to its antimicrobial and anti-inflammatory nature.

4. Arbuda (Tumors): Applied in herbal protocols for managing early-stage benign tumors.

5. Shotha (Swelling/Inflammation): Reduces inflammation in chronic conditions.

6. Vrischika Dansha (Scorpion sting): Used traditionally as an antidote to insect and scorpion bites.

7. Visharpa (Erysipelas): Helps in eradicating bacterial infections of the skin.

8. Prameha (Urinary Disorders): Supports urinary tract health by purifying blood and reducing infection.

9. Kasa (Cough): In small doses, used in formulations to reduce Kapha-related respiratory issues.

10. Arshas (Piles): Its anti-inflammatory and deworming properties help in managing worm-related piles.

5. Ayurvedic Medicines Containing Keetmari as an Ingredient:

1. Krimimudgar Ras

2. Vidangaadi Churna

3. Panchatikta Ghrita Guggulu

4. Krumikuthar Ras

5. Keetmari Taila

6. Nimbadi Churna

7. Mahatikta Ghrita

8. Patoladi Kashaya

9. Khadirarishta

10. Aragvadhadi Kashaya

These classical formulations use Keetmari either for its Krimighna or Kusthaghna properties.

6. Home Remedies Using Keetmari:

• For Skin Infections: Fresh leaves are crushed and made into a paste. Applied externally on scabies, eczema, and fungal infections.

• For Worm Infestation: A decoction of the leaves is prepared with warm water and taken under supervision to kill intestinal worms.

• For Wound Healing: Paste of leaves mixed with turmeric can be applied on infected wounds to reduce pus and promote healing.

• For Scorpion Bite: Leaf paste applied over the sting site helps draw out poison and reduce pain.

Note: Internal use must always be under Ayurvedic physician guidance due to potential toxicity of aristolochic acid.

7. Harmful Effects and Contraindications:

• Nephrotoxicity: Aristolochic acid is known to cause kidney damage and should be used cautiously.

• Carcinogenic Potential: Long-term use has been linked to increased risk of urothelial cancers.

• Pregnancy: Contraindicated in pregnant and lactating women.

• Children: Not recommended for children unless under strict supervision.

• Dosage: Only therapeutic doses under a qualified practitioner should be considered.

8. Relevance as Krimighna Dravya in Ayurveda:

Keetmari is classified under Krimighna Mahakashaya in Ayurveda due to its intense anti-parasitic properties. It is mentioned in various classical texts as an effective herb for both internal and external krimi rogas. Its strong tikta-katu rasa and ushna virya disrupt the habitat of worms, kill them, and expel them from the body while also purifying the channels (srotas).

In Charaka Samhita and Sushruta Samhita, formulations targeting krimi include herbs with similar properties as Keetmari. It is also considered a potent herb in Krimi Chikitsa, where Ama-pachana (detoxification) and Krimighna dravyas are recommended.

Conclusion: Keetmari (Aristolochia bracteolata) stands as a powerful medicinal herb in Ayurvedic science, especially revered for its action against krimi (worms). Though toxic in large doses and requiring cautious administration, its role as a krimighna, kusthaghna, and shothahara dravya makes it invaluable in Ayurvedic formulations. With proper processing and dosage under expert supervision, it remains an important herbal tool in Ayurvedic parasitology and dermatology.