CONTEMPORARY RELEVANCE OF TOXIC CONCEPTS OF AYURVEDA — Dr Gopikrishna S, Dr Megha KS and Dr Harisankar KT

CONTEMPORARY RELEVANCE OF TOXIC CONCEPTS OF AYURVEDA

A medical speciality is a branch of medical practice, which is focused on procuring skills to treat a defined group of patients and their diseases. The system of modern medical specialities evolved gradually during the 19th century. Throughout history, the most important division was into surgical and internal medicine. Like any other science, Ayurveda also contains speciality branches through which it offers the utmost benefit for diseased persons and helps to maintain a healthy body and mind. Ayurveda consists of Ashtanga or eight speciality branches. The classification of these eight branches is based on Nidana and Samprapti of a disease. When we go through the texts, the signs and symptoms of many diseases are similar, may it be any clinical condition seen through the perspective of any branch. But, when the treatment approach for those diseases is observed, they differ to one another and are primarily based on the respective Nidana and Samprapti. It is the root cause of the disease and the course of its progress which decides to which speciality care the patient needs to consult. Such methods of interventions yield more fruitful results, which can only be cherished through Ayurveda.

Agadatantra, is one among Ashtanga, which is commonly called ‘Visha Chikitsa. According to Chakrapani Datta’s commentary on the statement of Charaka Acharya in Chikitsa Sthaana 23rd chapter, the spectrum of diseases caused by Visha can be broadly classified into those symptoms produced by external exposure of toxins (dehasambandhi visha) and those produced after the intake of food materials(annadigata visha). Acharya has given equal importance to both exposures which signify the role of contaminated food intake in disease causation. Thus, it includes all diseases as explained in Nidana Sthaana where the toxin is one of the important causative factors (either from external exposure to a toxin or through the food) for disease manifestation. The modern system of medicine has started to quantify the significance of various kinds of toxin exposure (environmental and through food) and their relation to disease causation. Here more than the bacterial toxin load of food, other food additives and adulterants which gets mixed with food (colors, preservatives, sweeteners etc.) is more important. Various forms of exposure to toxins occur through different adhistana of visha (plant origin - Sthavara, animal origin – Jangama and mineral origin – dhatu) and artificial combination (Kritrimavisha). The importance of Agadatantra treatment principles in snakebite management and other insect bites which is effectively practices in many regions are beyond explanation. The areas least focused by Ayurveda physicians include the concept of Gara visha (Kritrima/ artificial), Dushivisha and Viruddha ahara in disease manifestation. Here Gara visha and Dushivisha can enter the body through both ways, through food and by other external sources.

Agadatantra

Sthavara and Jangama Visha

Based on their origin, they have been classified into two categories viz. Jangamavisha (animal poison) and Sthavaravisha (plant and mineral poisons). The sites of Sthavaravisha and Jangamavisha are narrated as ten and sixteen respectively.

Poisons, which originate from plants and minerals, are classified into ten types depending on the part of the plant. These are kanda (type of root), sara (exudate), niryasa (oleoresin), pushpa (flower), mula (root), phala (fruit), patra (leaf), twacha (skin), dugdha (milky exudates from the plants) and khanija (minerals). Poisons which originate from animals like snake venom, scorpion sting, rodents, dog, leech, and insect secretions and sting come under this type. Symptoms like dizziness, burning, oedema and loose motions are the generally developed clinical features. The role of treatment principles of Agadatantra in this area is very familiar and in use from time to time.

Gara Visha

This complex concept explains the method of accidental or deliberate poisoning by preparing different combinations which can either be with two poisonous compounds or by two non-poisonous compounds. Different modalities of administration were explained, of which, one is Ahara. It is said that such Gara visha causes varied clinical presentations. Since it is having the character kalanthara vipakitwam, it resides inside the body for an indefinite period and produces cumulative toxicity.

In the present era, Gara visha includes, wrong combination of medicines (adverse drug reaction), presence of harmful chemicals like pesticides in food materials, chemicals added in food processing and packing (artificial sweeteners, colors, preservatives) exposure to chemicals by the usage of cosmetics, footwears, ornaments etc. indicating the burden of toxin exposure. It also includes a few systemic illnesses which have a definite history of exposure to Gara. When we consider the disease manifestation in a person presented, Gara is not a diagnosis, but a cluster of symptoms which mimic an individual disease.

Viruddha Ahara

The concept of Viruddhaahara signifies the impor20 | Issue 7 | May-Jun 2021 | The Ancient Ayurveda tance of wrong combination of food materials which itself is not a diagnosis, but only a cause for disease formation. This concept comes under the non – poisonous combination of Gara visha. It is very important to correlate the mechanism as to how Viruddha Ahara is a cause of many metabolic disorders. It is also essential to know how certain food combinations interact with each other and create disease. Acharya Charaka clearly says that certain diet and its combinations, which interrupts the metabolism of tissue, which inhibits the process of formation of tissue, and which have the opposite property to the tissue are called as Viruddha Anna or incompatible diet.

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The food, which is wrong in combination, prepared through wrong processing, consumed in inappropriate quantity, and/or consumed during the incorrect time of a day and in the wrong season for a considerable period can lead to the diseases due to Viruddha Ahara.

According to Arunadatta’s commentary on the statement of Acharya Vagbhata in the 7th chapter of Sutra Sthaana, the diseases manifesting due to Viruddha ahara can present in an acute or chronic patterns like that of the intensity of Visha or Gara respectively. Here we can see the acute clinical conditions like Amavisha (Alasaka, Visoochika), Moorcha and various surgical emergencies that may arise due to them (peritonitis and septicaemia can be considered). At times the condition can be fatal. It can also be presented as chronic clinical conditions like Kushta, Grahani and Sotha.

Dushivisha

The concept covers the area of cumulative toxicity. Day to day exposures to these chemicals (dust, gases, metals and other chemicals) accumulates in the body and act as Dushivisha. It signifies the regular exposure to these chemicals (gradually increases the toxic concentration in blood). The role of environmental toxicants is yet to be identified. Dushivisha is any intrinsic toxin (a Sthavara, Jangama or Samyoga/ Kritrima visha) which had already entered the body and has been manifesting a recurrent symptom complex.

A clinical condition is only fit to be called a Dushi visha origin, if it has not been eliminated by proper treatment, resides inside the body in deeper tissues in dormancy (Kaphavrtatva) for years together (Varsha gananubhandhi) and manifests as a disease when suitable conditions arise. Thus, the symptoms produced by Gara visha and Dushivisha will be similar, the only difference being, Gara visha lakshana are the manifestation on the first exposure to a toxin and Dushivisha requires repeated exposures and manifestations. It is to be noted that all the Acharyas have not enlisted the diseases caused by Dushivisha. The manifestations have been brought under the umbrella of the site of affliction and Dhatu pradoshaja Vikara (according to the Sthaana samshraya of Dushi visha).

At present time Chronic neurotoxicant exposure (lead, opioid analgesic drugs, aluminium, copper, industrial gases, organophosphates, insecticides, well water drinking and pesticides) requires weeks to years and in some cases, decades to produce cell dysfunction and cell death that result in detectable neurological alterations and may result in neurodegeneration, meaning the loss of structure or function of neurons. Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and Amyotrophic Lateral Sclerosis are some of the diseases identified by modern scientists with a positive correlation of disease manifestation and environmental toxin exposure. Likewise human exposure to certain chemicals (benzene, halocarbons, ketones, nitrosamines) induces inflammatory states that may end up in diseases like nephritis, hepatitis, scleroderma etc due to the production of reactive oxygen species. Even during the pregnancy period, exposures to harmful environmental contaminants can cause permanent and irreversible anatomical, functional and metabolic changes in the body of the mother and fetus. Chronic, non-communicable diseases (NCDs) linked to early environmental exposures include disorders of neurobehavioral development, adult and pediatric asthma, hypertension, obesity, diabetes, cardiovascular disease and cancer. At present time we can explain these factors under the term Dushivisha.

The importance of dushivisha, is that when a disease has Dushi visha as nidana the treatment should invariably include removal of toxicity through shodhana followed by samana medicines and then by rasayana for a better longevity. Here lies the importance of the concepts of Agadatantra. Since the diseases presented by the patients will be similar, but it can easily misguide the physician and the content of visha will get unnoted. So, whenever a disease does not respond to conventional treatments, an element of Visha can be considered.

A few clinical conditions which have Visha as a nidana include: 1. Agantuja Jwara (presently Covid-19 and includes fever in all kinds of infective conditions) and the cases with recurrent fever (Punaravartaka Jwara) 2. Pandu- Gara is mentioned as a nidana and while explaining the treatment Acharya has mentioned

Dadimadi Ghritam which is having Vishaghna property also. 3. Udavarta- one of the nidana is Gara. 4. Udara- In ascitis like conditions, one of the nidana is Gara.

In the present era, Chronic neurotoxicant exposure, food, which are wrong in combination, presence of harmful chemicals like pesticides in food materials hold a major share in the manifestation of diseases. If we consider the above concepts of Agadatantra while eliciting and evaluating the history most of the etiological factors and pathogenesis of diseases which visit our hospitals have relevance. With all these factors, Agadatantra is of paramount importance in today's world. This branch of Ayurveda is important in all the areas of human life beyond just being considered as the treatment of bites and stings.

Dr. Gopikrishna S

Asst. Professor, Dept. of Agadatantra, VPSV Ayurveda College, Kottakkal

Dr. Megha KS

II MD Scholar, Dept. of Agadatantra, VPSV Ayurveda College, Kottakkal

Dr. Harisankar KT

I MD Scholar, Dept. of Agadatantra, VPSV Ayurveda College, Kottakkal