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Introduction

Ayurveda, the most ancient medical science, has given Trisutras, namely, Hetu (causative factor), Linga (signs and symptoms), and Aushadhi (treatment). Our Science has always believed that there will be rhythmic changes in the predominance of bodily doshas with time. Hence when a medicine is given it is equally important to take into consideration Vaya, Agni Bala, Rogi bala, Roga bala, Ritu etc. Bhaishajya kala are the essential tools for administration.

               The time of administration of medicine is equally important as the timed dosage is surely going to work on the vitiated doshas and restore their normal balance.  The relation between Kaal and Aushada is well established in our classics by all the Acharyas. Acharya Sushrut has elaborately described the different timings of aushadhi sevan kaal. While Sharangdhar describes five aushadhi sevan kaal. The relation has been dosha, rog and rugna is neglected nowadays, especially while administering medicine. Such negligence may be one of the therapy, as the Aushadha Dravya fails to show its complete effect. In Ayurveda Bhaishajya Kaal are described in relation to food, they are meant mainly  Shamana Chikitsa while some kaal are prescribed for Shodhan chikitsa like for eg Vaman or Virechan karma. The   root of administration of medicine in  all kala is oral. The pharmaco-kinetics and pharmaco-dynamics of Ayurvedic medication is directly affected by biological activities of the body. The effectiveness of many drugs depends on the dosage, Anupana and the timing of administration in Ayurveda it has mentioned that predictable variations in bodily functions during day, season and age alters the severity of disease symptoms, results of diagnostic test and effects of other therapies. Different Aushada sevana kalas are mentioned by different Acharyas which are highlighted below Charaka, Sushruta, Ashtang ,hridayam, Sharangadhar, Ashtang sangraha .

In ayurveda there are various times mentioned for taking medicines.

There are 10 specific time durations that are indicated for medicinal intake according to Acharaya Charak and Susruta.(1)

1. Abhakta (Before meals just after rising up in the morning)
2. Pragbhakta (Just before taking the meals)
3. Adhobhakta (Just after the meals)
4. Madhayabhakta (In between the meals)
5. Antrabhakta (Between two meals)
6. Sabhakta (with meals / cooked with needs)
7. Samudga (between laghu diet and meals)
8. Muhurmuha (with or without meals and given frequently)
9. Sagrasa (mixed with meals)
10. Grasantar (between two gulps of meals)
11. Naish (just before sleep or going to bed).

Following are the main times described for medicine intake.

TIME FOR TAKING MEDICINE:
All these time durations are related with the disease specific way of taking meals because the medicaments at the time of Charka and others were much dependent upon meals. As the processing of medicine advanced at the time of sharangdhar the aushdhai sevan kaal (medicine intake time) was reduced from 10 times into 5times, which are as follows: -
1. First Aushadhi Sevan Kaal

In the early morning (empty stomach when the previous night consumed food is digested )
especially in Panchkaram patients medicine for Virechan karma medicine for pitta elimination  is given in the morning likewise for vaman it is given in morning for kapha elimination Patients desiring weight loss are also given medicine at this time (2) 

2. Second Aushadhi sevan kaal

Aushadi sevan kaal before meals. For patients who are having apan vayu, vikruti medicine is given before meals. Aruchi patients are also given medicine during this time. Saman vayu vikruti medicine is given in between the meal to boost digestion. Vyan vayu prakopa medicine is given at the end of the meal. Patients suffering from Hicca, Convulsions, and tremors are given medicine before the food and after the food (3)

3. Third Aushadhi sevan kaal

Udan vayu dusti gives rise to Swarbhang like vyadhis. In such diseases medicine is given in evening during the time of meal or in between two boluses of food, but in Pran vayu dusti medicine is given after the meals in the evening. (4)

 4. Fourth Aushadhi sevan kaal

 Frequent and continuous as in an emergency. Usually, medicine is given along with some food. For eg Trushna, Chhardi, Hicough Swas, and in certain toxicity this kaal is prescribed. (5)

5. Fifth Aushadhi sevan kaal

At bed times before sleep. Disease above the shoulder region like that of the eyes, nose, ear, and  throat are given medicine in this kaal. Medicine is administrated without food. It does bruhan and lekhan depending upon the nature of medicine. Medicine can do pachan and shaman if given in this kaal. (6)

This is because of the medicament at times of Susruta & Charka are much dependent upon food / diet. A proper plan of diet plays an important role in treatment of disease. Nidanparivarajan is first step in treatment of any disease. But a major point to be kept in consideration is that the times of medicinal intake by Acharaya Susruta are disease-specific and can be very much useful in supplementary diet therapy for a variety of symptoms. As we will see that for different diseases different medication times is stated along with the way of taking it with meals. (7), (8)

1)Abhakta: - (Early morning empty stomach often after awaking)-

All the kashaya Category medicine (containing Kashaya Rasa) must be taken at this time, for diseases due to elevated pitta & kapha dosha, They are heavy and need strong Agni to digest them Lekhanartha (scraping) and Utklishta Kapha Pitta ,Kapha Udreka Avastha Gata Kaal for Vaman (Emesis) and Virechan karma purpose this time is most suitable. Amashaya gat kaphautklesha can be treated if medicine given at this time. Lekhan karma can be best achieved if medicine administrated this kaal. (9)

But as far as children, females, old aged ones, and weak patients are concerned medicine administration should be given with caution as strong medicine can cause weakness and dizziness

2)Pragbhakta (medicines taken just before meals)

Aushadh sevan kaal Administration kaal Indications Pragbhakta before meals - Apana Vata Vikruti Gudagata (situated in anus) Vata, Aged, children, Bhiru (panic), Krishanga (emaciated), weak - For strengthening lower part of the body, diseases of lower half of the body - Obesity Medicine taken in pragbhakta kaal, it become quickly digested, does not harm the strength of the body, hence medicine should be given before food for the aged, children, fearful, emaciated and women. It destroys the Doshas situated in Amashaya (stomach). Medicine given at this time easily gets absorbed as it gets digested along with food. Patients having a desire for weight gain can take medicine at this kaal. A general tip for digestion is pragbhakta medication by taking salt and ginger pieces before meals.

3) Adhobhakta: - (Just after meals)

Medicines taken just after meals are known to be adhobhakta. All the medicines taken Adhobhakta are tend to increase obesity. Generally, adhobhakta medication is meant in Kaphaja Vyadhi (diseases due to vitiated kapha). In Vyan Vayu Vikaruti medicine should be given after lunch  (For disease due to Vyanvaya i.e. Upper Respiratory Tract related complications/symptoms Adhobhakta medication is useful.
In the same manner in Udan Vaya Vikaruti medicine to be given after dinner in the evening time It means medication after meals at morning and evening or lunch & dinner respectively for Vyan and udan vayu dusti. Patients having desire for weight gain can take medicine at this kaal

4) Mhadhaybhakta: - (Medicines that are taken after half of the meal and than the rest meals are taken).
This specific medication time is set for medicines used in saman vayu vikaar (diseases due to saman Vayu or complete general pathto-physiological signs & symptoms). This medication is useful in treating Koshthagat doshas and pitta vikara (diseases due to pitta/bile).

5) Antrabhakta: - (Medicines taken in between two meals / or after digestion of meal).
Such medication time is after 4 to six hour of meals as the meals are digested and then medicine is taken. These types of medicines are deepan (Appetizer) and pathya (digestive). Also useful in Vyan vayu vikars. Medicine can be safely administrated to Old people, weak people and small children

6) Sabhakta: Medicine given mixed or cooked with meals

If medicines are added with the cooked food then it is called sabhakta. This is used to give medicine to children, females and those who hate to take medicines. The yavagu, vilepi and other diet preparations are good example of this type of medicine. Medicine given at this time works on whole body. They act hrudya, deepan and increase manobala

7) Samudoga: -
The medicine that is taken between laghu diet. After taking a brunch the medicine is given and then full diet is taken. This type of medicine practice is useful in convulsions, tremors, Hiccough  and other related sign symptoms.

8) Muhurmuha: (Repetitive dosage of medicine along with food or without food)

As in medical emergencies frequent medication is done. In the same way in Asthmatic conditions, poisoning, vomiting, thirst and bronchial aggression repetitive medication is indicated in ayurveda text as muhurmuha.

9) Sagraasa: Medicine to be taken with each bolus of food)

Any medicine when taken with one and more gulps of food is called sagraas. This medication is useful in diseases related with pran vayu and agni dusti. Upper Respiratory Tract & thoracic Cavity complications can be given medicines at this kaal. Appetizers, Aphrodisiacs, are taken in the above manner. Very effective in weak agni. Churna, Vati and leha can be given in this kaal.

10) Grasantar: Medicine to be taken in between two bolus of food.

This medication idea is very much useful in Cardiac diseases and Asthmatic conditions. The avaleha used in swasa (Asthma) are best useful when taken in this manner.

11) Naish: - (Medications to be taken in might).

Vagbhata described this medication time. All those medicines taken before going to bed are called Naish.Nishi: Synonyms Swapnakale, Ratri. Aushadh sevan kaal Administration time Indications Nishi at night or at the time of sleep Urdhwajatrugata Vikara (diseases above the neck) Aushadha should be administered at the time of sleep. According to Ayurveda one should go to sleep after the digestion of the evening food. Hence medicine should be administered after the digestion of evening food. Thus, this becomes second Antara Bhakta according to Indu, and it is indicated in Urdhwa Jatru Gata Vikaras. Urdhwajatru is the site of Prana Vata. Thus, medicine administered in this Kaal acts over Prana Vata.

Discussion

Acharya Vagabhat and Acharya Sushrut have described at length the aushadhi sevan kaal.  Acharya Sushrut has described the timings and properties of each aushadhi sevan kaal. To be more precise has mentioned the types of vata also which can be treated when medicine given at that time. In Sharangdhar Samhita the 10 timings of aushadhi sevan kaal where consolidated to five. More emphasis is given to the disease in sharangdhar Samhita as compare to Sushrut Samhita where more importance is given to dust dosha. For eg drug sitophaladi churna can be given at Naish kaal for urdhwagat rogas whereas if given after meals can aid pachan of doshas.

Conclusion

Great importance has been granted in the academic study of chronotropy.  Proper and perfect diagnosis of dosha and dusit dhatu and the use of proper time selection for the administration of medicine can give success to a great extent. It’s a subject of research. Ayurved therapy is much more oriented on the time of administration of the drug. Different administration gives different results with the same medicine.