Metallic preparations of Ayurveda: A boon to the ailing humanity.

Sir,

We read with great interest the case report entitled “acute renal failure secondary to ingestion of ayurvedic medicine containing mercury”.[1] Though this article highlights newer aspects of certain drugs; there are few aspects that need to be addressed.

A drug can be panacea or poison. Drugs fulfilling the criterion of a standard drug will become panacea, if it is used properly. In contrast, a poorly prepared or manufactured drug might prove to be a poison. Classics of Ayurveda do mention the hazards of drugs that are not properly manufactured. Seers have prescribed specific processing techniques (such as Shodhana and Marana etc.) for metals and minerals that remove hazardous properties from these drugs. These processed metals/minerals are familiarly known as Bhasmas in Ayurveda and are utilized in therapeutics. There is no sufficient evidence in the appeared article to confirm the nature, contents, processing details etc., of the prescribed medicine. Based on these lacunae, one cannot group the drug under the category of “Ayurveda.” Such medicines may fall under the definition of spurious or misbranded or adulterated drugs.[2]

As per the principles of Ayurveda, all the preparations are not recommended for all patients. The indications, dose, to whom to give and to whom not to give, what should be the vehicle, what are the diseases, where they are not recommended etc., are the major factors always considered by an Ayurvedic Physician before they recommend metallic products to their patients. These preparations are to be administered orally in specified quantities with great caution along with requisite Anupana (vehicles) such as ghee, milk, honey etc., In the absence of Anupana, adverse reactions are likely.[3] Whether these guidelines were followed or not is not highlighted in the published article. Ayurvedic Physician is the registered authority, who has been trained in that specific field as per the syllabus provided by Central Council for Indian Medicine, a body of Department of AYUSH, Ministry of Health and Family Welfare, Government of India. We are not sure about the identity of the healer referred in the current study.

A huge number of studies have been carried out on the usefulness of metallic preparations. Makaradhwaja (prepared in the presence of mercury, gold and sulfur) is reported to improve the quality of life and attributed with anti-stress activity.[4] Rasa sindhura (prepared in the presence of mercury and sulfur) is proven to increase life-span and fecundity of Drosophila.[5] Certain herbomineral preparations with mercury as a component were proven to be safe and efficacious like Garbhachintamani rasa that has shown to improve hepatic functions,[6] Mahamrutyunjaya rasa is proven to be cardiotonic,[7] Arogyavardhini vati, another herbomineral preparation is found to be safer at higher therapeutic dose levels.[8] Bhasmas of Abhraka (mica), Mandura (iron) and herbomineral formulations such as Swasa Kuthara rasa (containing mercury, sulfur) and Smriti Sagara rasa (mixture of metals) were reported to be free from genotoxicity.[9] Such reports are to be referred by the learned authors prior to targeting an age old system of medicine, the legacy of the nation.

This article indirectly clears the need of attention towards generating awareness on “Promoting rational use of medicines in particular to ayurvedic drugs.” The impact of such reports in a leading scientific journal like Indian Journal of Nephrology is a serious matter as it may unnecessarily cause disrepute to the system of Ayurveda.