A.D.R. IN APAKVA BHASMA SEVANA AND ITS MANAGEMENT

Rasashastra is the branch of Ayurvedic pharmaceutics concerned with processing metals, minerals, and poisonous substances — grouped as Maharasa, Uparasa, Sadharana rasa, and Dhatus — into a form fit for internal administration, known as Bhasma. The nano-sized particles of Bhasma increase surface area, enhance bio-solubility, and improve the rate of dissolution and bioavailability, allowing quick therapeutic results at a comparatively lower dose. Preparation of Bhasma involves classical pharmaceutical procedures such as Shodhana and Marana, and occasionally Amriteekarana and Lohiteekarana, followed by the confirmatory tests (Siddha Pareeksha) described in the classics. A Bhasma that fails these tests is termed Apakva Bhasma, and its consumption can lead to Adverse Drug Reactions (ADR). This review compiles information from classical Ayurvedic textbooks and published research articles to document the Apakva Bhasma Sevana Doshas — the classically described adverse effects of improperly processed Bhasma — for major Bhasmas including Abhraka, Swarna Makshika, Haratala, Manahshila, Rajata, Lauha, Vanga, Naga, and Yashada, along with their classically prescribed management (Cikitsa). Findings from modern toxicity studies on several of these Bhasmas are also reviewed. Standardisation of raw-material selection, Shodhana, Marana, and adherence to the Siddha Lakshanas and Siddha Pareekshas at every stage are essential to ensure the safety of Bhasma preparations. Since the Siddha Pareeksha of dispensed medicines is not routinely performed by the prescribing physician, awareness of the symptoms of Apakva Bhasma Sevana and their management remains essential for safe clinical practice.

• S N Mishra. Textbook of Ayurveda Rasashastra. Chaukhambha Orientalia, Varanasi: Reprint, 2007; 12.
• Edwards IR, Aronson JK. ADR: definition, diagnosis and management. Lancet, 2000 Oct 7; 356(9237): 1255–9. doi:10.1016/S0140-6736(00)02799-9. PMID: 11072960.
• ASHP. Guidelines on Adverse Drug Reaction Monitoring and Reporting, 1995. American Journal of Health-System Pharmacy 52: 417–19. (Medication Misadventures – Guidelines).
• Paul S, Chugh A. Assessing the role of Ayurvedic Bhasma as ethno-nanomedicine in the metal-based nanomedicine patent regime. J Intellect Prop Rights, 2011; 16: 509–15.
• Chaudhary A. Ayurvedic Bhasma: nanomedicine of ancient India – its global contemporary perspective. J Biomed Nanotechnology, 2011; 7(1): 68–69.
• Sahoo SK, Praveen S, Pan JJ. The present and future of nanotechnology in human health care. Nanomedicine, 2007; 3(1): 20–31.
• Brown C, Bushell GR, Whitehouse M, et al. Nanogold pharmaceutics: (1) The use of colloidal gold to treat experimentally induced arthritis in rat models; (2) Characterisation of the gold in Swarna Bhasma, a microparticulate used in traditional Indian medicine. Gold Bull, 2007; 40: 245–50.
• Bhowmick TK, Suresh AK, Kane SG, Joshi AC, Bellare JR. Physicochemical characterisation of an Indian traditional medicine, Jasada Bhasma: detection of nanoparticles containing non-stoichiometric ZnO. J Nanoparticle Res., 2009; 11: 655–64.
• Satpute AD. Rasaratna Samuchaya. Chaukhambha Sanskrit Prathishthan: 2006; Chapter 8, verses 26–30.
• Asha Kumari, Premvati Tewari (Translation & Edition). Yogaratnakara. Chaukhambha Visvabharati: Varanasi, 2010; 4.
• Acharya Yashodhar. Rasaprakasha Sudhakara (Translated by S.N. Mishra). Chaukhambha Orientalia; Varanasi: 2004, Chapter 5, verse 5.
• Dattatreya Anand Kulkarni. Rasaratna Samuchaya (Vigyan Bodhini), Vol.1. Meharchand Lachhmandas Publications, Chapter 2, verse 13.
• Madhava. Ayurveda Prakasha (Ed. Mishra Gulraj Sharma), 2nd edn, 2007. Chaukhambha Sanskrit Series, Varanasi, Chapter 2, verse 105.
• Mukherji Pandit Bhudev. Rasajalanidhi (Deva Sharma Bhudev), Vol.2, 2004. Chaukhambha Orientalia, Varanasi, p.296.
• Harish Gopinath, Murughesh Shivashankar. A study on toxicity and anti-hyperglycaemic effects of Abhraka Bhasma in rats. Journal of Ayurveda and Integrative Medicine, Vol.12, Issue 3 — Abhraka Bhasma did not show any toxic effects even at a high dose.
• Choube Dattaram. Brihat Rasaraja Sundara, 3rd edn, 2000. Chaukhambha Orientalia, Varanasi, p.544.
• Vaishya Shyama Sundaracharya. Rasayana Sara, Vol.1, 6th edn, 1997. Krishnadas Academy, Varanasi, p.290.
• Jomon T Joshy, Ashok Kumar. Toxicity study of two iron-containing Bhasmas, Swarna Makshika and Kaseesa Bhasma. P.G. Thesis, Department of Pharmacology, Dr M.G.R. University, Chennai, 2012 — the drug was found to be non-toxic at its classical dose.
• Madhava. Ayurveda Prakasha (Ed. Mishra Gulraj Sharma), 2nd edn, 2007. Chaukhambha Sanskrit Series, Varanasi, Chapter 2, verse 177.
• Mukherji Pandit Bhudev. Rasajalanidhi (Deva Sharma Bhudev), Vol.2, 2004. Chaukhambha Orientalia, Varanasi, p.169.
• Mondal S, Palbag S, Gautam. Toxicological study of arsenic-containing Ayurvedic drug Hartal Bhasma. J Ayu Herb Med, 2016; 2(3): 82–85.
• Dattatreya Anand Kulkarni. Rasaratna Samuchaya (Vigyan Bodhini), Vol.1. Meharchand Lachhmandas Publications, Chapter 5, verse 19.
• Vaishya Shyama Sundaracharya. Rasayana Sara, Vol.1, 6th edn, 1997. Krishnadas Academy, Varanasi, Dhatu Shodhana Marana Prakarana, verse 26.
• Madhava. Ayurveda Prakasha (Ed. Mishra Gulraj Sharma), 2nd edn, 2007. Chaukhambha Sanskrit Series, Varanasi, Chapter 3, verse 92.
• Vaishya Shyama Sundaracharya. Rasayana Sara, Vol.1, 6th edn, 1997. Krishnadas Academy, Varanasi, Dhatu Shodhana Marana Prakarana, verse 40.
• Prajapati PK, Prashant Kumar, Sarkar R. Safety and toxicity profile of some metallic preparations of Ayurveda. Ancient Science of Life, 2006; 25(3&4): 57–63.
• Madhava. Ayurveda Prakasha (Ed. Mishra Gulraj Sharma), 2nd edn, 2007. Chaukhambha Sanskrit Series, Varanasi, Chapter 3, verse 228.
• Mukherji Pandit Bhudev. Rasajalanidhi (Deva Sharma Bhudev), Vol.3, 2004. Chaukhambha Orientalia, Varanasi, p.63.
• Namrata Joshi, Manoj Kumar Daksh, et al. Toxicity study of Lauha Bhasma in albino rats. Anc Sci Life, 2016; 35(3): 159–166 — no untoward effect of Lauha Bhasma at therapeutic dose and at a dose five times the therapeutic dose, proving safety; alteration in some biochemical parameters and histopathology was seen at the highest dose.
• Vaishya Shyama Sundaracharya. Rasayana Sara, Vol.1, 6th edn, 1997. Krishnadas Academy, Varanasi, Dhatu Shodhana Marana Prakarana, verses 172–173.
• Nagaraj V, Joshi D, et al. Toxicity studies on Vanga Bhasma. Ancient Science of Life, 1984; 4(1): 32–35. — no acute toxic effect on the GIT, pancreas, or liver.
• Madhava. Ayurveda Prakasha (Ed. Mishra Gulraj Sharma), 2nd edn, 2007. Chaukhambha Sanskrit Series, Varanasi, Chapter 3, verse 179.
• Vaishya Shyama Sundaracharya. Rasayana Sara, Vol.1, 6th edn, 1997. Krishnadas Academy, Varanasi, Dhatu Shodhana Marana Prakarana, verse 207.
• M. Dash. Toxicity study of Naga Bhasma with special reference to Ayurvedic measures for toxicity eradication. Int J Pharm Biol Arch, 2012.
• Vaishya Shyama Sundaracharya. Rasayana Sara, Vol.1, 6th edn, 1997. Krishnadas Academy, Varanasi, Dhatu Shodhana Marana Prakarana, verse 212.