Triphala is among the most common formulas used in Ayurvedic medicine. Comprised of the fruits of three trees, Indian gooseberry (Amalaki, Emblica officinalis), Belleric myrobalan (Vibhitaka, Terminalia belerica) and Chebulic myrobalan (Haritaki, Terminalia chebula), Triphala is mentioned throughout the ancient literature of Ayurvedic medicine as a tonifying blood cleanser and gentle laxative, highly prized for its ability to regulate the processes of digestion and elimination. Used by itself or in formulation, Triphala plays an essential role in the treatment of a wide variety of conditions.

Triphala is commonly available as a finely sieved powder that can be mixed with water, ghee (clarified butter) or honey, and can also be encapsulated. There are many methods of preparing Triphala, including medicated oils, decoctions, confections, and natural fermentations (asava/arishta). Ayurvedic medicine designates Triphala as a rasayana, a Sanskrit term given to those medicaments that improve general health and prolong life. For this purpose it is traditionally prescribed for up to a year in doses of 1 -? 2 grams taken twice daily, and may even be taken throughout one's life on a semi-regular basis to cleanse the tissues of the body, strengthen digestion, and sharpen the senses. Care must be taken when purchasing Triphala to ensure that the product is fresh, as powders are traditionally said to have a short shelf life.

Triphala is revered among the many other rasayanas in Ayurvedic medicine for its reliable and balanced activities. It is so safe to use and so highly valued for its efficacy that a common aphorism among many Ayurvedic practitioners is "when in doubt, use Triphala." Ancient authors noted that it contains every taste except salty, and acts to promote a state of balance between the humoral principles (i.e doshas) of Vata, Pitta, and Kapha. Each component of Triphala has a specific activity on a particular dosha: Amalaki fruit is considered to be a rasayana for Pitta (i.e. inflammation); Vibhitaka a rasayana for Kapha (i.e. congestion); and Haritaki as a rasayana for Vata (i.e. degeneration). Triphala is also considered to be malashodhana, removing (shodhana) the toxic wastes (mala) of poor digestion that remain in the body, called ama. The indications of ama include a thick greasy coating on the tongue, poor appetite, indigestion, constipation, joint pain, headache, orbital edema, sinus congestion, a feeling of coldness, mental confusion, and lethargy. The routine use of Triphala each morning is thought to detoxify the body and restore the integrity of the entire digestive tract, with a perfect balance between its astringent (wound-healing), demulcent (soothing), digestive, and laxative properties.

According to the Ayurvedic Formulary of India, Triphala is prepared by mixing equal parts Amalaki, Vibhitaka, and Haritaki, and is taken in dosages of 3 ?- 6 g, twice daily in the treatment of flatulence, constipation, diabetes and eye disease. This recipe may be altered however, dependent upon the needs of the individual. For example, in the treatment of a Vata disease such as constipation, the ratio of Haritaki to Vibhitaka and Amalaki would be increased so as to allow for a more laxative activity.

Regardless of these subtleties however, most practitioners will agree that in small doses (1 ? 2 g) Triphala churna is a rejuvenating alterative safe for long-term use, whereas in large doses (10 ?15 g) Triphala will typically have a laxative property, used for shorter periods of time. This laxative application is generally thought to be safe and effective even for geriatric and pediatric use because the rejuvenative properties of Triphala offset the potentially debilitating effects. Further, Triphala will not cause dependence unlike many laxatives, because it also strengthens and tones the musculature of the bowel.

The properties of Triphala also change according to the anupana (lit. "vehicle") with which it is consumed. An anupana (or anupan) is a substance that enhances the absorption of the remedy and directs towards the alleviation of a particular dosha or condition. The most common anupana includes ghee, honey, and warm water. In the treatment of Vata conditions, Triphala churna is best mixed with 2 parts ghee and one part honey, after which it is followed with warm water. Pitta conditions require only ghee to be used, and Kapha conditions benefit from honey as an anupana, followed by warm water after ingestion.

While Triphala is perhaps best known as digestive tonic, practitioners have long taken advantage of its powerful health-giving components to treat a wide range of disorders. For example, Triphala is an important medicine for eye health, especially blurred vision (due to early stages of refractory error or unknown causes), or inflammation in the fatty layer lining the orbit. It can be used as a powder or a paste (by mixing with ghee) or as a decoction. The finely filtered decoction or medicated oil can be applied as a morning eyewash. Triphala is used to prevent the development of a cataract, such as in diabetic patients, and to maintain the health of the crystalline lens of the eye once the cataract has been reduced and the eye-sight restored.

Due to its potent yet gentle healing properties, Triphala is gaining much popularity in the West. It is not too difficult to imagine that it will eventually take its place in medicine cabinets across the Western world, just as it has in India for the last few thousand years.