Punarnava

Puffy face and ankles, sluggish urine output, and a heavy, lethargic feeling, especially in a patient with liver or kidney weakness

Pale, anemic patient with swollen legs and a poor appetite who cannot tolerate iron

Ascites or pedal edema in chronic liver disease where a gentle non-depleting diuretic is wanted

Overview. Boerhavia diffusa is a spreading perennial herb of the four o'clock family with small pink flowers, found on waste ground across tropical India, Africa, the Americas, and the Pacific. The thick taproot is the main medicine, though the whole plant is used. Its Sanskrit name punarnava, 'that which renews itself', refers to its habit of springing back with the monsoon and to its reputation as a rejuvenator. It is the leading Ayurvedic remedy for swelling (shotha) and the base of classical preparations such as Punarnavadi kwath and Punarnava mandur.

Overview. Boerhavia diffusa is a spreading perennial herb of the Nyctaginaceae with small pink flowers and a thick fleshy taproot, found as a weed of roadsides, fields and waste ground across the plains of India and throughout the tropics. It dies back in the dry season and springs up again with the monsoon, which gives it the Sanskrit name Punarnava, the plant that renews itself. Ayurveda uses the root and whole plant as its leading remedy for swelling and fluid retention, a diuretic and rejuvenative that also supports the liver, kidneys and blood.

Clinical Notes. Punarnava is the first herb to consider when fluid is accumulating: edema of the legs and face, ascites, or the puffiness of early kidney disease. Unlike pharmaceutical diuretics it does not strip the patient; it moves water while mildly supporting liver and kidney tissue, so it is given for weeks or months rather than days.

Clinical Notes. The Ayurvedic practitioner reaches for Punarnava whenever there is shotha, the soft swelling of retained fluid, whether it sits in the ankles, the abdomen, the face or around the joints. It is a warming diuretic that also kindles digestion, so it suits the kapha patient with edema, heaviness, low appetite and a pale coated tongue; the classical texts describe the fresh plant cooked as a vegetable for this picture.