MS Sparsha
Long before the word “bioenhancer” entered the vocabulary of modern pharmacology, Ayurvedic physicians had been using a simple combination of black pepper, long pepper and ginger to make medicines work more effectively.
The combination was known as Trikatu. Its three ingredients—black pepper (Piper nigrum), long pepper (Piper longum) and ginger—were themselves regarded as medicinal substances and were traditionally used for ailments involving digestion and respiration, among others. But Ayurveda also recognised another property of such combinations through the concept of Yogavahi—a substance believed to act as a carrier and help another medicine produce a stronger effect.
For centuries, this remained largely an empirical observation. There was no modern pharmacological explanation for why one substance could apparently enhance the action of another.
The answer began to emerge in India in the twentieth century.
As early as 1929, a researcher named Bose had reported that vasaka, a traditional respiratory remedy, appeared to work more effectively when administered along with long pepper. The observation was significant, but the mechanism remained unexplained.
Decades later, scientists at the Regional Research Laboratory, Jammu, now the Indian Institute of Integrative Medicine, began investigating the phenomenon systematically.
At the centre of this work was C.K. Atal, then director of the laboratory, along with researchers including Usha Zutshi, who played an important role in the experimental studies.
Atal’s curiosity was triggered by a striking pattern in classical Ayurvedic formulations. In examining 370 formulations, he found that Piper longum occurred in as many as 210. Such repeated use as an adjunct suggested that there could be a pharmacological reason behind what appeared to be an established traditional practice.
The team decided to test the proposition scientifically.
Their experiments produced remarkable results. A 1981 study published in the Journal of Ethnopharmacology reported that Piper longum increased blood levels of the drug vasicine by about 233 per cent. In another experiment, piperine, the principal pungent compound in black pepper, more than doubled the blood levels of sparteine.
The researchers then went further.
A follow-up study in 1985 provided evidence that piperine interfered with the body’s drug-metabolising processes, helping explain why medicines administered with it could remain available in the bloodstream for longer or at higher concentrations.
Piperine itself was not a new discovery. It had been isolated from pepper as far back as 1819. The scientific contribution of Atal and his colleagues was different—and arguably more consequential: they helped establish experimentally why pepper could enhance the bioavailability and action of another drug.
Subsequent pharmacological research has refined that understanding, showing that piperine can affect drug-metabolising enzymes and transport mechanisms, including CYP3A4 and P-glycoprotein. Later studies also investigated its ability to increase the bioavailability of several drugs and compounds. One widely cited human study, for example, found a dramatic increase in the bioavailability of curcumin when administered with piperine.
The significance of this work, however, lies beyond pepper.
It demonstrates how a practice preserved in traditional medicine for centuries can sometimes contain an experimentally testable pharmacological principle. Ayurveda had long combined certain substances with medicines, but modern science demanded something more: controlled experiments, measurable blood concentrations and an explanation of the biological mechanism.
Indian scientists undertook precisely that exercise.
They did not merely repeat an ancient claim. They asked a modern scientific question: Was there actually something happening when long pepper or piperine was combined with another medicine?
The answer was yes.
The work of C.K. Atal, Usha Zutshi and their colleagues therefore occupies an unusual place in the history of Indian science. It did not suggest that every traditional medical claim must automatically be accepted as scientifically valid. Rather, it demonstrated something more valuable—that traditional observations can be subjected to rigorous scientific investigation, and that some may reveal mechanisms that modern pharmacology can understand and build upon.
From Trikatu and Yogavahi to piperine and bioavailability, this was a remarkable journey from an ancient medical practice to a modern pharmacological concept.
And behind that journey were Indian scientists who looked at an old observation, refused to leave it unexplained, and went looking for the evidence.
That is what makes them Unsung Heroes.
