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International Journal of Pharma and Bio Sciences
A COMPREHENSIVE REVIEW ON TRIVRIT [OPERCULINA TURPETHUM SYN.
IPOMOEA TURPETHUM]
KOHLI K R1, *NIPANIKAR S U2 AND KADBHANE K P3
1. Director of Ayurveda, Maharashtra State, Govt. Dental College Building, 4th Floor, St. George Hospital
Compound, Mumbai, Pin-400001, Tel: +9122-24947144, Email: krkohli@rediffmail.com
2. *R. A. Podar Medical College (Ayu) and M. A. Podar Hospital, Dr. Annie Besant Road, Worli, Mumbai-
400018. Tel: +91-9321749026, Email: drsunipanikar@rediffmail.com
3. R. A. Podar Medical College (Ayu) and M. A. Podar Hospital, Dr. Annie Besant Road, Worli, Mumbai -
400018. Tel: +91-9049871585, Email: inspirekk@rediffmail.com
*Corresponding Author drsunipanikar@rediffmail.com
ABSTRACT
Trivrit (Operculina turpethum syn. Ipomoea turpethum) is commonly used since centuries in
Ayurvedic system of Medicine to treat fevers, edema, ascites, anorexia, constipation, hepatosplenomegaly,
intoxication, haemorrhoids, fistula, anemia, obesity, abdominal tumors, ulcers/wounds,
worm infestation, pruritus and other skin disorders. It is the best amongst the herbs used for
Virechana (i.e. therapeutic purgation), one of the procedures of Ayurvedic Panchakarma therapy.
This review comprehensively incorporates the phramacognosy, medicinal uses, and pharmacology of
O. turpethum. Few preclinical studies done on Operculina turpethum have shown that it possesses
anti-inflammatory, anticancer, cytotoxic, antisecretory, ulcer protective, hepatoprotective, &
antibacterial activities. Some preliminary clinical studies have reported laxative, anti-inflammatory,
analgesic, anti-helminthic and anti-arthritic effects of its crude root powder. The herb merits further
research as it may be a source of potential anticancer and anti-rheumatic agent(s). As the plant
Operculina turpethum is endangered, also prompt attention needs to be given to protect it from
extinction.
KEY WORDS
Trivrit, Operculina turpethum, Purgative, Anticancer, Antirheumatic.
INTRODUCTION
Trivrit is an important herb, used in ayurvedic
system of medicine since ages. Root bark, root,
stem, and leaves of this herb have high medicinal
value.[1] Root of Trivrit is the vital ingredient of
Avipattikar Churna, which is used in South East
Asia on large scale for the treatment of skin
disorders, acid peptic disorders, & constipation.
In Ayurveda, Trivrit has been included in the
group of ‘ten purgative herbs’ (i.e. Bhedaniya
Mahakashaya), group of ‘ten antidote herbs’
(i.e. Vishaghna Mahakashaya), group of ‘ten
herbs supportive for therapeutic enema’ (i.e.
Ashthapanopag Mahakashaya),[2] group of
‘colon cleanser, antitumor & antidote herbs’
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(i.e. Shyamadi Gana), and in the group of ‘herbs
eliminating the toxins (i.e. vitiated Doshas) from
lower half of the body’ (i.e. Adhobhagahar
Gana).[3] Root bark of Trivrit is typically
administered in powder form with number of
vehicles such as fermented rice water (Kanji) ,
milk, cereal water, Triphala, black paper,
sugarcane juice, cow’s urine, goat’s urine, sheep’s
urine etc [4] as a therapeutic purgative agent for
the treatment of GI disorders, skin disorders,
ascites and various cancers.[5]
Trivrit has two varieties as Aruna or Shweta (i.e.
having whitish or reddish coloured root) & Shyama
(i.e. having blackish root).[1] The botanical name of
Aruna or Shweta Trivrit is Operculina turpethum
(L.) Silva Manso (syn. Ipomoea turpethum), while
that of Shyama is Ipomoea petaloides chois.[6]
Aruna or Shweta Trivrit is the best amongst the
herbs used for Virechana (therapeutic
purgation).[7] Shyama, with its drastic purgative
action, can treat the conditions like intoxication &
abdominal tumors.[8] However, Shyama is inferior
in properties and can cause fainting, burning
sensation, giddiness, confusion, chest pain and
roughness of throat and hence is rarely used in
medicine.[6]
In spite of consistent use of Trivrit in Ayurvedic
medicine since centuries, the herb is little known
to the research community. It may be due to lack
of availability of adequate information on the plant
on global level. Though few researches have been
done, Operculina turpethum is under explored
herb.
BOTANICAL DESCRIPTION
Taxonomical Classification-
Kingdom: Plantae
Subkingdom: Tracheobionata, vascular plants
Superdivision: Spermatophyta, seed plants
Division: Angiosperma
Class: Dicotyledons
Order: Solanales
Family: Convolvulaceae
Genus: Operculina
Species: O. turpethum (L.) Silva Manso
Binomial name: Operculina turpethum (L.)
Silva Manso.[9-10]
Synonyms -
Latin- Ipomoea turpethum (L.) R. Br.,
Convolvulus turpethum L. (basionym),
Convolvulus ventricosus Bertero [≡ Operculina
turpethum var. ventricosa], Merremia
turpethum (L.) Rendle, Operculina ventricosa
(Bertero) Peter;[9] Sanskrit- Shveta, Tribhandi,
Trivruta, Triputa, Sarvanubhuti, Sarala,
Nishotra, Kalaparni, Nandi, Kalameshi,
Rechani, Kutarana, Bhandi, Palindi,
Ardhachandra, Sushenika, Masurvidala,
Kaulkaushiki, Kalameshika, Shyama;[1]
English-Turpeth root, Indian jalap,[8]
Transparent wood-rose;[9] French- Turbith
vegetal;[8] German- Turpeth Trichterwinde;[8]
Hindi- Pithori, Nakpatra, Nishut, Nishoth;[8]
Arabic- Turband, Thurbud;[8]Chinese- he guo
teng.[10]
Geographical distribution:
O. turpethum is native to Asia (India, Nepal,
Bangladesh, Pakistan, Shri Lanka, China,
Taiwan, Myanmar, Thailand, Indonesia,
Malaysia, Papua New Guinea, & Philippines),
Africa (Kenya, Tanzania, Mozambique,
Zimbabwe, Madagascar, Mauritius & Reunion)
& Australia while is naturalised in West
Indies.[9, 11-12] Unfortunately, with the rapidly
shrinking natural habitat, this important
medicinal plant is dying out in many parts of
the world.[12-16]
Morphology:
O. turpethum is a stout perennial climber that
exudes a milky juice when cut, with long fleshy
roots and long twisting pubescent stems that
are angled, winged which become very tough
and brown when old. The leaves are simple,
pubescent on both sides and variable in shape,
cordate or truncate at base 5-10 cm long and
1.3- 7 cm wide. The flowers are white,
campanulate, sepals long, borne in cymes of
few flowers, giving way to globose capsules
enclosed within overlapping brittle sepals. The
capsules is rounded, being 1 to 1.5 centimeters
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in diameter, and contains normally 4 black, smooth
seeds. Roots of Trivrit occur in pieces, 1.5-15 cm
long, 1-5 cm in diameter, usually unbranched,
cylindrical, elongated, bearing thin rootlets; thicker
pieces, occasionally split and show central wood
portion; surface dull grey, reddish-grey to light
brown, showing deep furrows or longitudinal
wrinkles giving a rope-like or columnar
appearance; transversely cut surface shows thick,
whitish bark and light yellow centre; fracture in
bark, short; in wood, fibrous. [11]
STANDARDIZATION
Organoleptic properties –
Odour of roots is indistinct, taste is slightly
pungent and nauseating when kept in mouth for
some time. Mature roots of O. turpethum give
grayish to light brown coloured powder. [11]
Physical properties –
Fine powder of Trivrit root bark should give nil
foreign matter, total ash not more than 10 %,
acid-insoluble ash not more than 1.5 %, alcoholsoluble
extractive not less than 10 % and watersoluble
extractive not less than 8 %.[11]
Thin Layer Chromatography (TLC)–
TLC of the alcoholic extract of O. turpethum on
Silica gel 'G' plate using Toluene: Ethylacetate
(9:1) shows under UV (366 nm) three fluorescent
zones at Rf. 0.08, 0.21 (both light blue) and 0.58
(blue). On exposure to Iodine vapour seven spots
appear at Rf. 0.21, 0.41, 0.49, 0.58, 0.71, 0.90
and 0.97 (all yellow). On spraying with Vanillin
Sulphuric acid reagent and heating the plate for
ten minutes at 110°C seven spots appear at Rf.
0.21, 0.41, 0.49 (all light violet), 0.58, 0.70, 0.90
and 0.97 (all violet).[11]
Phytochemistry-
Root bark of Trivrit is rich in turpeth resin
consisting of 10% ‘turpethin’ which is a glycoside
analogue of Jalapine and Convolvulin and is
insoluble in ether, benzine, carbon sulphide and
essential oils. Under the action of alkaline bases,
thurpethin is transformed into turpethic acid, while
it gets converted into turpetholic acid, Glucose
and fructose in presence of hydrochloric acid.[8]
Trivrit also contains Turpethinic acids- A, B, C,
D, & E,[17] some ether soluble resin, volatile oil,
albumin, starch, lignin salts, ferric oxide,
Scopoleptin, Betulin, lupiol & beta- sitosterol.[8,
17-18] Turpethin is mainly responsible for
purgative action of Trivrit and is an excellent &
relatively safer substitute for jalap.[8]
AYURVEDIC PHARMACOLOGY
In Ayurveda, Charaka have devoted a separate
chapter on description of Trivrit including
method of its collection, processing,
contraindications, indications, dosage and
therapeutic use of its ‘one hundred & ten’
purgative formulations.[4]
Properties Described in Ayurvedic Texts:
As per Ayurvedic Pharmacopoeia of India,
Trivrit has sweet (Madhura), pungent (Katu),
bitter (Tikta), & astringent (Kashay) tastes
(Rasa); is hot in potency (Veerya); gives
pungent (Katu) effect after metabolism
(Vipaka); and possesses properties (Guna) like
lightness (Laghu), dryness (Ruksha), & warmth
(Ushna). With these properties, it eliminates
Kapha & Pitta and exaggerates the Vata. It
also easily and safely eliminates the body
wastes (Sukhavirechan), and pacifies fever
(Jvarahar).[1, 4, 11]
Medicinal Uses:
In Ayurveda, root of Trivrit is used internally to
treat fevers, anorexia, edema, anemia, ascites,
constipation, hepato-splenomegaly, hepatitis,
intoxication, abdominal tumors, ulcers,
wounds, worm infestation, pruritus and other
skin disorders.[11] Root is also administered to
treat obesity, haemorrhoids, cough, asthma,[5]
dyspepsia, flatulence, paralysis, gout,
rheumatism, melancholia, scorpion sting, and
snake bites.[8] The paste of root powder of
Trivrit is used topically to treat vitiligo & other
skin disorders, alopecia, cervical
lymphadenitis, haemorrhoids, fistulas, ulcers, &
chancres.[20- 21] Oil extracted from the root bark
of Trivrit is used in skin diseases of a scaly
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nature.[19] A processed ghee with Trivrit or fresh
juice of Trivrit leaves is dropped into the eyes to
treat diseases like corneal opacity or ulcer and
conjunctivitis. Root powder of Trivrit mixed with
ghee and honey is also used to treat
hematemesis, tuberculosis & herpes.[1]
Ayurvedic Formulations:
There are at least 135 herbal and herbomineral
formulations used in Ayurvedic medicine,
which contain Trivrit as their vital ingredient.[4]
The concise list of commonly used
formulations and their indications[22-27] is given
in Table 1.
Table 1
Common Ayurvedic Formulations of Trivrit with their Indications
Sr No. Formulations Indications / Uses
1 Trivrit Avaleha GI disorders, hepato-spleenomegaly, abdominal tumors
2 Panchasama Churna Flatulence, constipation, anorexia, dysentery
3 Alambushadi Yoga Ascites, edema, arthritis
4 Malashodhak Churna Constipation, flatulence
5 Avipattikar Churna Acid peptic disorder, constipation
6 Abhayadi Modak Constipation, therapeutic purgative
7 Agnimukh loha Anaemia, edema, haemorrhoids, & GI disorders
8 Kalyanak Gud GI disorders, tumors, ascites, edema, & skin diseases
9 Vyoshadi Gutika GI disorders, debility, vertigo, urinary disorders
10 Narach Churna Ascites
11 Sukhavirechak
Churna
Habitual constipation
12 Tryushanadi Churna Abdominal tumor, chest pain
13 Haridra Khanda Urticaria & other skin disorders
14 Punarnavadi
Mandoor
Anaemia, ascites, edema, hepatospleenomegaly
15 Mahamanjishthadi
Kwath
Skin disorders, Paralysis, Elephantiasis, wounds
16 Trivritadi Kalka Worm infestation
17 Kaishore Guggulu Musculoskeletal disorders, skin ailments, diabetes,
wound, ascites
18 Aragwadhadi Kwath Anticarminative, laxative & colon cleanser
19 Chandraprabha Vati U r i n a r y & m u s c u l o s k e le t a l d i s o r d e r s
20 Ashwagandharishta Anxiety, stress, sexual or general debility
21 Bharangyadi Kwath Flu, asthma, pneumonia
22 Trivritadi Modak Respiratory disorders, backache
23 Trivrit Arishta Abdominal tumor, edema, anaemia, & sprue
24 Vachadi Lepa Topically for skin disorders, alopecia, lymphadenitis, &
fistula
25 Jambvadi Taila Topically for wounds and Gonorrhea (genital ulcers)
Dosage as per Ayurveda:
For therapeutic purgation (viz. Virechana),
maximum 10-12 gm paste of root bark of Trivrit is
administered in the morning on empty stomach,
along with fermented rice water or milk.[28] This
dose generally produces 10 to 30 loose motions
as a part of body cleansing.[29] As a palliative
therapy, 1-3 gm of drug is used in powder
form.[1] However, the dose needs to be
individually tailored as severity of purgative
action can vary from person to person and
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overdosing may lead to serious complications.[28]
Safety aspects, contraindications &
precautions–
Trivrit should not be used in pregnancy, in children
below 12 years of age, in elderly, in physically or
mentally weaker persons, and in persons suffering
from diarrhea, bleeding per rectum, rectal
prolapse, or fecal incontinence.[30] Trivrit may act
as an abortificient when used in pregnant ladies.
Use in children or in physically or mentally weaker
persons or overdose of Trivrit may lead to
complications like excessive purgative activity,
bleeding per rectum, vomiting, abdominal pain,
chest pain, dehydration, hypotension, vertigo,
confusion, shock, & unconsciousness.[31]
TOXICITY STUDIES
In an acute toxicity study (Rajashekar M et al;
2006), healthy albino mice of either sex were
divided into eight different groups of six animals
each. Animals of the group 1 received acacia
suspension (0.5 ml orally) while the animals of
group 2 to 8 received suspension of root of O.
turpethum at 10, 30, 100, 200, 400, 600, 800
mg/kg dose levels respectively. The animals were
observed at 0, ½, 1, 2 and 4 hours after the
administration for acute effect and mortality. The
observation was continued for one week for the
delayed effects and mortality. Results revealed
that there were no treatment related deaths or any
toxic effects in any of the groups.[32]
In another acute toxicity study (S. V. Suresh
Kumar et al; 2006), an ethanolic extract of
O.turpethum, when administered in different
groups of Wistar rats of either sex in doses
ranging from 100-2000 mg/kg, produced no
lethality in any of the groups. Also the extract did
not produce any alterations in liver function
markers like SGOT, SGPT, serum alkaline
phosphatage and serum bilirubin[33]
PHARMACOLOGICAL ACTIVITIES
Antisecretory and Ulcer protective activity-
Rajashekar M., et.al. (2006) found that oral
administration of O. turpethum and its
polyherbal formulation Avipattikar churna is
effective in reducing gastric acid content,
gastric ulcer, hyperacidity & related GIT
disturbances in albino rats.[32]
Anti-inflammatory activity-
An experimental study was carried out
(Rajashekar M et al; 2006) to evaluate the
effect of oral administration of root powder of
O. turpethum and its polyherbal formulation
Avipattikar churna on rat paw edema in albino
rats. Results indicated that pretreatment with
the root powder of O. turpethum and
Avipattikara churna (100 mg/kg body weight)
reduced the formalin induced edema volume to
the extent of 36.45% and 27.11%
respectively.[32]
Hepatoprotective activity -
In an experimental study (S. V. Suresh Kumar
et al; 2006), effect of ethanolic extract of O.
turpethum was assessed in paracetamol
(PCM) induced hepatotoxicity in Wistar rats.
PCM intoxication in normal rats elevated the
serum levels of SGOT, SGPT, Alkaline
phosphatage and bilirubin significantly,
indicating acute centrilobular necrosis. The rats
treated with ethanolic extract of O. turpethum
showed a significant reduction in all four
biochemical parameters which was
comparable with that of silymarin. The
histopathological profile of the rat treated with
ethanolic extract showed no visible
deteriorations confirming the safety of the
extract at 200 mg /kg body weight.[33]
In other three experimental studies (Vaidya
Balendu Prakash et al; 2010), an Ayurvedic
herbomineral formulation (i.e. Prak-20)
containing O. turpethum root powder as one of
its ingredients showed significant
hepatoprotective activity against CCl4 induced
liver toxicity in Rats.[34]
Antimicrobial activity -
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Three compounds H-1 ($-sitosteryl-$-D
glucoside), H-2 (22, 23-dihydro-"-spinosteryl
glucoside) & CH-2 (salicylic acid) isolated from the
chloroform extract of stem of Ipomoea turpethum
(Synonym- O. turpethum) and the crude extracts
of the same plant prepared in petroleum ether,
chloroform and ethyl acetate were screened (Md.
Harun-or-Rashid et al; 2002) against thirteen
pathogenic bacteria for their antibacterial
activities. The minimum inhibitory concentration
(MIC) of the isolated compound CH-2 was also
measured against Bacillus subtilis, Shigella
dysenteriae, Sarcina lutea and Escherichia coli.
The values were found to be between 128 and
256 μg/ml. In this investigation, crude extracts and
isolated compound CH-2 of O. turpethum showed
significant antibacterial activity but were less
potent than that of standard kanamycin whereas
compound H-1 & H-2 showed little activities. The
results of this study justify the traditional use of
this plant in the management of microbial
infection. [35]
Another study (M. Jahangir Alam et al; 2010) was
done to evaluate the antibacterial activities of
ethanol extract and petroleum ether extracts of O.
turpethum leaves on two Gram positive (viz.
Bacillus subtilis, Streptococcus haemolytica), and
three Gram negative bacteria (viz. Pseudomonas
aeruginosa, Shigella sonnei & Shigella
dysenteriae). Antibacterial activity was tested by
disc-diffusion method. Activity was compared with
those of ampicillin, neomycin as positive control
and with ethanol & petroleum ether as negative
control. Findings revealed that ethanol extracts
showed a significant inhibition against pathogenic
bacteria while petroleum ether extract did not
show significant zone of inhibition. The MIC value
of extracts ranged from 0.13 to 0.75 mg / ml;
ethanol extracts had lower MIC values than
petroleum ether extract.[19]
Anticancer and Antioxidant activities:
Antioxidant activity of methanolic extract of O.
turpethum stems (100 mg/kg for 45 days) on 7,12
dimethylbenz(a)anthracene (DMBA) induced
breast cancer was investigated in female
Sprague-Dawley rats (C. Anbuselvam et al;
2007). A significant increase in lipid
peroxidation levels were observed in tested
samples of cancer induced rats while the
activities of enzymatic antioxidants such as
Superoxide dysmutase, catalase, glutathione
peroxidase and nonenzymatic antioxidants like
glutathione, ascorbic acid and alpha tocopherol
were decreased in cancer bearing animals
when compared to controlled animals. A
significant (P- 0.05) increase in breast tumor
weight was observed in DMBA group while
breast tumor weight decreased significantly in
combination of DMBA and O. turpethum
extract group. Investigators of this experiment
recommended the use of the bioactive
compounds from O. turpethum as a
supplementary to anticancer medicines.[36]
Cytotoxic activity -
Alluri V. Krishnarajua et al (2005) carried out
Brine shrimp (Artemia salina) lethality bioassay
to investigate the cytotoxicity of aqueous
extract of O. turpethum. The extract showed
moderate brine shrimp lethality and the LC 50
value was found to be 81 (lower than 100).
This significant lethality is an indicative of the
presence of potent cytotoxic components in the
herb which merit further investigation for its
antitumor activity.[37]
In another study (Md. Harun-or-Rashid et al;
2002), the cytotoxic activity of the crude,
chloroform and ethyl acetate extracts of
Ipomoea turpethum and its isolated compound
CH-2 was determined by the Brine shrimp
lethality bioassay. The LC50 values of these
substances were found to be 56.23, 199.53
and 31.62 μg/ml, respectively. Ethyl acetate
extract was found to be much more cytotoxic
than chloroform extract. The cytotoxic action of
a drug was exhibited by disturbing the
fundamental mechanisms concerned with cell
growth, mitotic activity, differentiation and
function. Although the exact mechanism of
cytotoxic action of these extracts could not be
explained by the study, the results indicate that
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the Ipomoea turpethum extract may be a potential
chemotherapeutic agent.[35]
CLINICAL TRIALS
Some open label clinical studies have reported
laxative, anti-inflammatory, analgesic, antiarthritic
and anti-helminthic effects of root powder
of O. turpethum.[38-40] However, authors of this
review could not trace electronically published
randomized comparative clinical trial on the herb.
In an open, uncontrolled clinical study (Shailej
Gupta; 2009), powder of Trivrit roots administered
as a single dose of 30 gm with fermented rice
water (Kanji) for Virechana procedure produced
strong purgation in 30 patients of Amavata i.e.
Rheumatoid Arthritis. This purificatory procedure
produced statistically significant improvement in
the subjective parameters like joint pain, stiffness,
swelling, tenderness, and in global assessment for
overall improvement. Also there was a statistically
significant reduction in the ESR values in the
study patients.[38] However it should be noted that
Virechana with Trivrit powder can’t be
recommended for each and every patient of
Rheumatoid arthritis as there are number of
contraindications for the procedure. Many patients
may not tolerate one time dose of 30 Gms Trivrit
powder. Shyju Ollakkod (2004) evaluated the
effect of ‘Alambushadi Yoga’ (polyherbal
formulation having Trivrit as its main ingredient) in
27 subjects of Rheumatoid arthritis (RA). Subjects
were equally divided in three groups. Subjects
from group A received oral Alambushadi yoga,
subjects from group B received Dhanyamla
Kayaseka (fomentation with fermented cereal
water) while subjects from group C received
combination of oral Alambushadi yoga &
Dhanyamla Kayaseka for 21 days. The complete
remission in the symptoms of RA was registered
in 3 patients from group C, in 2 patients from
group B and in 1 patient from group A. Good
response in symptoms of RA was noted in seven
patients from group A, in five patients from group
B and in four patients from group C. Moderate
response in the symptoms of RA was noted in one
patient in group A, two patients each in group B
and group C. No major side effects were
reported in any subjects during the period of
this study.[39]
In a clinical study (Nusrat Parveen et al; 2004),
administration of Unani Remedy- ‘Qurs
Deedan’ (having Ipomoea turpethum as its
main ingredient) in a dose of two tablets daily
at bedtime for 30 days in patients of ascariasis
caused clearance of A. lumbricoides ova from
the stool samples and relief from clinical signs
& symptoms of worm infestation in most of the
patients.[40]
CONCLUSION
Trivrit (O. turpethum) is an important medicinal
plant, which is safely & effectively used to treat
various disorders in Ayurvedic system of
Medicine since centuries. Few toxicity studies
done in rodents have confirmed the safety of
both crude powder and extract of O.
turpethum. There are preliminary reports of
antisecretory, ulcer protective, antiinflammatory,
hepatoprotective, antibacterial,
anticancer, & cytotoxic activities of the herb.
Though few clinical studies have reported
efficacy and safety of Trvrit in some patients of
rheumatoid arthritis and ascariasis, there is a
need of randomised, controlled clinical studies
to confirm its efficacy and safety. Such
evidence is needed to provide scientific
credence to the folklore use of traditional
Ayurvedic medicines like Trivrit and even be
helpful in the development of future drugs or
treatment modalities for diseases like
rheumatoid arthritis and cancer. As the O.
turpethum is endangered, a prompt attention
needs to be given to protect the plant from
extinction.
ACKNOWLEDGEMENTS
The Authors sincerely thank Dr. Gajanan
Pawar (Lecturer, Dept. of Dravyaguna, Dr. D.
Y. Patil Ayurvedic Medical College, Navi
Mumbai) for his kind help in providing few
references.
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