Related Articles

Context

Lead, mercury, and arsenic have been detected in a substantial proportion of Indian-manufactured traditional Ayurvedic medicines. Metals may be present due to the practice of rasa shastra (combining herbs with metals, minerals, and gems). Whether toxic metals are present in both US- and Indian-manufactured Ayurvedic medicines is unknown.

Objectives

To determine the prevalence of Ayurvedic medicines available via the Internet containing detectable lead, mercury, or arsenic and to compare the prevalence of toxic metals in US- vs Indian-manufactured medicines and between rasa shastra and non–rasa shastra medicines.

Design

A search using 5 Internet search engines and the search terms Ayurveda and Ayurvedic medicine identified 25 Web sites offering traditional Ayurvedic herbs, formulas, or ingredients commonly used in Ayurveda, indicated for oral use, and available for sale. From 673 identified products, 230 Ayurvedic medicines were randomly selected for purchase in August–October 2005. Country of manufacturer/Web site supplier, rasa shastra status, and claims of Good Manufacturing Practices were recorded. Metal concentrations were measured using x-ray fluorescence spectroscopy.

Main Outcome Measures

Prevalence of medicines with detectable toxic metals in the entire sample and stratified by country of manufacture and rasa shastra status.

Results

One hundred ninety-three of the 230 requested medicines were received and analyzed. The prevalence of metal-containing products was 20.7% (95% confidence interval [CI], 15.2%–27.1%). The prevalence of metals in US-manufactured products was 21.7% (95% CI, 14.6%–30.4%) compared with 19.5% (95% CI, 11.3%–30.1%) in Indian products (P=.86). Rasa shastra compared with non–rasa shastra medicines had a greater prevalence of metals (40.6% vs 17.1%; P=.007) and higher median concentrations of lead (11.5 μg/g vs 7.0 μg/g; P=.03) and mercury (20 800 μg/g vs 34.5 μg/g; P=.04). Among the metal-containing products, 95% were sold by US Web sites and 75% claimed Good Manufacturing Practices. All metal-containing products exceeded 1 or more standards for acceptable daily intake of toxic metals.

Conclusion

One-fifth of both US-manufactured and Indian-manufactured Ayurvedic medicines purchased via the Internet contain detectable lead, mercury, or arsenic.

Preparation of bhasma (calcined powder of metal/minerals) includes various processing steps like purification (Shodhana), levigation (Bhavana),calcinations cycle(Marana), improving quality and removing blemishes (Amritikarana) etc, processing of bhasma aims at formation of herbo-mineral complex molecule which can act in minimal dosage, palatable, easy for assimilation, highly efficacious with minimal or no complication. Although the most important equipment mentioned for Marana i.e. cow dung cakes and some type of woods are not only difficult to collect but also expensive and create pollution during puta and it's difficult task to give controlled heat in traditional method. Hence, a Modified Portable Bhasma Nirman Yantra (MPBNY) was prepared for puta (equipment for calcination) procedure which is easy to handle, portable and facilitate to supply controlled heat. A comparative study was conducted on Kasisa Bhasma prepared by traditional method and by using MPBNY with special reference to physico-chemical properties. The prepared Kasisa Bhasma was subjected to modern analytical parameters such as A.A.S. (Atomic Absorption Spectroscopy), X.R.D. (X-ray Diffraction) and Ayurvedic parameters eg. Rekhapurnatva (bhasma should enters in between lines of finger), Varitaratva (bhasma should float on the surface of water), Niramlatva (bitter less), Apunarbhava (bhasma should not regain its metallic nature after strong heating with jiggery, Abrus precatorius linn., honey and ghee) and Niruttha (bhasma should not regain its metallic nature after strong heating with silver). It was observed that Kasisa Bhasma of both methods possesses similar organoleptic as well as physico-chemical properties.

Ayurveda is a unique system of medicine which uses metals and minerals in the form of bhasma (fine powder obtained through calcinations). Mandura is one of such mineral having various therapeutic uses. An effort has been made in the present study to characterize raw and processed Mandura using sophisticated analytical tools as a step forward to standardization. Mandura bhasma was prepared following references of Ayurvedic classics. To assure the quality of the prepared bhasma, Rasa Shastra quality control tests like rekhapurnatvam (particles enter into furrows of human hand), varitara (floating of product particles on water), irreversible etc., were used. Bhasma fulfilling these tests was analyzed using X-ray Diffraction (XRD) analysis. This revealed that raw Mandura contained Fe2Si04, and Mandura bhasma contained Fe2O3 and SiO2. Scanning Electron Microscopy (SEM) studies showed that the grains in Mandura bhasma were uniformly arranged in agglomerates of sizes 200-300 nm as compared to the raw Mandura, which showed a scattered arrangement of grains of sizes 10-2 microns. It may be concluded that this conversion of raw Mandura, a complex compound, into a mixture of simple compounds having nano-sized particles is due to the particular process of calcination employed.

Shukti is an important component of Sudha Varga, which is considered as the latest class in the field of Rasa Shastra. Two types of Shukti have been mentioned in Rasa Shastra texts i.e. Jala Shukti and Mukta Shukti according to the availability. In present study, an attempt has been made to develop a standard manufacturing procedure (SMP) of Jala Shukti Bhasma and Mukta Shukti Bhasma. Five batches of Jala Shukti Bhasma and Mukta Shukti Bhasma were prepared and standardization was attempted by maintaining batch manufacturing records of individual batches. During pharmaceutical procedures like Shodhana, Bhavana, Marana, etc. due care of temperature, its duration, percentage of weight gain or loss and the cost factor of the end product, etc. were considered. The average weight loss observed was 12.08 g i.e. 2.42% and 14.62 g i.e. 2.92% during Jala Shukti and Mukta Shukiti Shodhana respectively. Average weight loss found was 38.94 g i.e. 7.79% in Jala Shukti Bhasma while in Mukta Shukti Bhasma, it was 35.24 g i.e. 7.05%. At the end of the pharmaceutical procedure, it was found that Mukta Shukti Bhasma is 2.8 times costlier than Jala Shukti Bhasma.

Background:

Rasashastra is a branch which deals with the pharmaceutics of Rasaoushadhis. Bhasmas are one among such Rasaoushadhis which are known for their low doses and fast action. A verse from Rasaratnasamuchchaya says that the bhasma prepared by using Mercury as media is of best quality.

Materials and Methods:

Following this principle, Yashadabhasma (Zinc calx) was prepared by subjecting it to Samanya shodhana (general purification method for all metals), Vishesha shodhana (specific putification method for Zinc), Jarana (roasting) and Marana (incineration) with Parada(Mercury) as a media under Gajaputa (classical heating system with 1000 cowdung cakes).

Results and Conclusion:

Yellow colored Yashadabhasma which passed all the classical bhasmaparikshas (tests for properly prepared calx) was obtained after two putas. The bhasma did not pass Nishchandratva(free from shining particles) test after 1stputa but was passed after giving it 2ndputa.

Rasa Shastra is a branch of Ayurveda which deals with the processing of minerals and metals having therapeutic importance. Rajata comes under the group of metals having high therapeutic value. Minerals and metals are mostly used in the form of Bhasma. During the medieval period Rasacharyas extensively worked and developed a number of processing methods for a single drug. They all are standard manufacturing procedures (SMP) which ensure the quality, safety, efficacy and reproducibility of the product. Earlier Ayurvedic physicians were producing medicines by themselves according to their need. Now a day, due to commercialization of Ayurvedic medicines and ignorance of classical methods, quality of drugs has deteriorated. Presently, the demand of Ayurvedic drugs in the global market is increasing day by day. Hence it is the need of time to develop SMP for Ayurvedic products for global acceptability. This paper aims at providing SMP for the manufacture of Rajata Bhasma and also attempts to study the effect of Shodhana process on Rajata. Rajata was obtained from the local market of Varanasi. Rajata Bhasma was prepared and it was observed that during the preparation of Rajata Bhasma, use of Muffle Furnace instead of conventional Puta is more advantageous due to better temperature control. Use of mercury and sulphur together acts as best medium in the preparation of Rajata Bhasma.

This paper examines the backgrounds and motivations of persons trained or training as Ayurvedic practitioners at two London-based institutions offering Ayurveda programmes at undergraduate and postgraduate levels. It draws upon in-depth interviews with individuals at various stages of their training and practice in order to examine the paths that bring them to Ayurveda, their motivations for undergoing training, and the ways in which they apply their knowledge of Ayurveda during and after their training period. The findings here corroborate what other scholars have demonstrated in the case of Asian traditions like Yoga and Ayurveda in the West; these traditions have inevitably undergone shifts in meaning by virtue of their assimilation into the Western, in this case British, holistic health milieu. Most significant in Ayurveda's case is the shift away from a preoccupation with remedial medicine (the bedrock of mainstream Ayurveda in modern South Asia), to a focus on self-knowledge and self-empowerment as a path to ‘holistic healing’ (understood to address mental and spiritual, not just physical, wellbeing). Even though the Ayurvedic curriculum transmitted at the educational institutions in London is based largely on that taught at Ayurveda colleges in India, the completely different orientations and dispositions of students in Britain (as compared to their South Asian counterparts) ensures that the Ayurveda they go on to apply and practise is radically different – this is ‘spiritualised’ Ayurveda, in radical contrast to the ‘biomedicalised’ version obtaining in modern mainstream South Asian contexts.

Sasang constitutional medicine (SCM), traditional Chinese medicine (TCM) and Ayurveda are three different forms of Asian traditional medicine. Although these traditions share a lot in common as holistic medicines, the different philosophical foundations found in each confer distinguishing attributes and unique qualities. SCM is based on a constitution-based approach, and is in this way relatively more similar to the Ayurvedic tradition than to the TCM, although many of the basic SCM theories were originally derived from TCM, a syndrome-based medicine. SCM and TCM use the same botanical materials that are distributed mainly in the East Asian region, but the basic principles of usage and the underlying rationale are completely different from each other. Meanwhile, the principles of the Ayurvedic use of botanical resources are very similar to those seen in SCM, but the medicinal herbs used in Ayurveda generally originate from the West Asian region which displays a different spectrum of flora.

Arsenic and lead have been found in a number of traditional Ayurvedic medicines, and the practice of Rasa Shastra (combining herbs with metals, minerals and gems), or plant ingredients that contain these elements, may be possible sources. To obtain an estimate of arsenic and lead solubility in the human gastrointestinal tract, bioaccessibility of the two elements was measured in 42 medicines, using a physiologically-based extraction test. The test consisted of a gastric phase at pH 1.8 containing organic acids, pepsin and salt, followed by an intestinal phase, at pH 7 and containing bile and pancreatin. Arsenic speciation was measured in a subset of samples that had sufficiently high arsenic concentrations for the X-ray absorption near edge structure analysis used. Bioaccessible lead was found in 76% of samples, with a large range of bioaccessibility results, but only 29% of samples had bioaccessible arsenic. Lead bioaccessibility was high (close to 100%) in a medicine (Mahayograj Guggulu) that had been compounded with bhasmas (calcined minerals), including naga (lead) bhasma. For the samples in which arsenic speciation was measured, bioaccessible arsenic was correlated with the sum of As(V)–O and As(III)–O and negatively correlated with As–S. These results suggest that the bioaccessible species in the samples had been oxidized from assumed As–S raw medicinal ingredients (realgar, As4S4, added to naga (lead) bhasma and As(III)–S species in plants). Consumption at recommended doses of all medicines with bioaccessibile lead or arsenic would lead to the exceedance of at least one standard for acceptable daily intake of toxic elements.

Iron is one among the major metals present in the earth's crust and is essential for sound sustenance of human body. Its deficiency leads to various health ailments. Contemporary medicine advises iron supplements in iron deficiency anemia. Ayurvedic classics also quote significant information about administration of iron. Lauha Kalpas are the unique compound herbo-mineral formulations where iron (Lauha) is used as a major ingredient. Relevant literature (Bhaishajya Ratnavali, Charaka Samhita, Rasendra Sara Samgraha etc.) reviewed to gather information about Lauha Kalpas. Critical analysis of these Lauha Kalpas reveals that ancient seers administered iron in a better acceptable form. Unlike popular understanding these are not only Khalviya preparations; but Churna (powders), Avaleha (confectionaries), Rasakriya (solidified decoctions), and Putapaka (incinerated) form of preparations are also found. Apart from solid dosage forms, semisolid dosage forms mentioned in classics are very much useful. Unfortunately most of the formulations are not found in the market. Hence Pharmaceutical firms may bring these unique dosage forms in to the market to supply the healthcare needs of the community. It is interesting that iron preparations are used in Ayurveda in different medical conditions apart from anemia (Pandu). This leaves a scope for further researches on different dosage forms of iron and their indications.

At present there are effective drugs in eradicating microfilariae but treatments to control the progression of manifested filariasis, periodic adenolymphangitis (ADL) and lymphedema are not available in conventional system of medicine. So far National Ayurveda Research Institute for Vector-borne diseases, Vijayawada, has conducted many clinical trails on manifested filariasis patients with the classical Ayurvedic herbal, herbo-mineral drugs and found significant results on ADL, lymphedema and other acute and chronic clinical manifestations. An effort has been made to find the effect of Kuberaksha Patra Churna [Caesalpinia bonduc (L.) Roxb.], Vriddhadaru Mula Churna [Argyreia nervosa (Burm.f.) Boj.] and Kandughna Taila (oil prepared from 10 Ayurvedic drugs) in manifested filarial patients. Based on inclusion criteria 133 patients were included in three groups (45 in Gr.I, 45 in Gr.II and 43 in Gr.III) and 120 patients completed the study (40 in each group). In Gr. I Argyreia nervosa (Burm.f.) Boj. root powder, Caesalpinia bonduc (L.) Roxb. leaf powder mixed equally was given in the dose of 5 g twice a day for 30 days. In Gr.II along with Gr. I internal drugs Kandughna Taila was applied externally in sufficient quantity once a day for 30 days. Gr. III is a control study with Ayurvedic established drug ‘Nityananda Rasa’ 1 tablet thrice daily for 30 days. Group I and II drugs showed highly significant effect on lymphedema, lymphadenitis, lymphangitis, pain, tenderness, heaviness, deformity, fever and rigors (P<0.0001). Group III drug showed highly significant (P<0.0001) effect on lymphedema, deformity and heaviness; statistically significant (P=0.0018) on pain and tenderness; Significant effect on fever (P=0.0290), rigor (P=0.0290) and in lymphangitis (P=0.0384) and non-significant effect on lymphadenitis (P=0.1033). On statistical analysis effect of treatment on Hb and eosinophil count was found non-significant in three groups. On ESR, effect of treatment was found significant in Gr. III and non-significant in Gr. I and Gr. II.

The word Rasashaastra literally means the “Science of Mercury”. It is a specialized branch of Ayurveda dealing mainly with materials which are known as ‘Rasa dravyaas’. The products dealt under this discipline are an important component of Ayurvedic therapeutics. Considering the importance of this discipline in Ayurvedic therapeutics and the fact that there is dearth of comprehensive review on the subject an attempt has been made in this review to provide a brief but all encompassing coverage of different aspects related to it. The subjects covered in the review are: historical background of the evolvement of Rasashaastra as a specialized branch during different time periods; different aspects of classification ‘Rasa dravyaas’; processing of metal and mineral products with a note on the methods used during different time periods; information about methods of pre and post preparation procedures for different kinds of ‘Rasa dravyaas’; importance of mercury in Ayurveda, its processing methods and different preparations along with therapeutic indications. In addition attempt has been made to provide basic information on the metal and mineral based preparations mentioned in Ayurvedic Formulary of India; recent development in the field of Rasashaastra and future requirements for the proper development of the discipline. The main focus is to familiarize the readers, from non-ayurvedic background, on different aspects of this specialized discipline.

Mother and child care has been described in great detail in Ayurveda. All basic principles of Ayurveda need to be applied to deal with the problems of maternal and foetal mortality. Rules of Ahara (diet), Vihara (lifestyle), Sadavrutta (moral conduct), along with varied therapies are used in tackling the various problems. There is need to take an in depth view at causes. Major changes in lifestyle may be required. Uses of various Ayurvedic formulations like various ghrtas and tailas (ghees and oils) have given wonderful results. Ayurveda aims at producing “Supraja” or healthy progeny. Ayurveda provides answers to some of the most worrying problems facing doctors today.

In the present research paper, the work done on pharmaceutical study of Lauha Bhasma conducted in the Department of Rasa Shastra under the postgraduate research programme is being presented. The pharmaceutical processing of Lauha Bhasma was performed by following samanya shodhana, vishesha shodhana and marana of Lauha. Under the process of marana, three specific pharmaceutical techniques were followed, viz. bhanupaka, sthalipaka and putapaka. During the putapaka process, an electric muffle furnace (EMF) was used. The temperature of puta was studied in two batches, viz. in Batch I, a temperature of 800°C was maintained whereas in Batch II, a temperature of 600°C was maintained. The purpose behind selecting two temperatures was to validate the process of marana of Lauha and to determine an ideal temperature for the preparation of Lauha Bhasma in EMF. It is found that after 20 puta at a temperature of 600°C, the Lauha Bhasma was prepared properly. The entire characteristic of Lauha Bhasma, like “pakwa jambu phala varna,” varitar, etc. was attained at 600°. At a temperature of 800°C, the process could not be carried out smoothly. The pellets turned very hard and brassy yellow in color. The desired color was attained only after decreasing the temperature in further puta.

Gandhaka Rasayana is frequently used in the management of different skin disorders (Kushtha). It is a herbo-mineral preparation prepared by Shuddha Gandhaka Bhavit with 11 herbal drugs in a serial manner for eight times each. Therefore, it was used as a model drug and four samples were prepared by adopting different methods and media. The physicochemical parameters were evaluated. The effect of increasing the number of Bhavana (lavigation) on particle size of the drug was examined. Similarly, an attempt was also made to differntiate the structure (surface anatomy) of the drug with Bhavana and without Bhavana by using a very sophisticated x-ray photo electron spectrometer (XPS) study. Overall, a remarkable difference was observed in the samples with Bhavana and without Bhavana.

Swarna makshika [SM], a mineral having various therapeutic uses, has been used since long in Ayurveda. The present study was conducted to generate a fingerprint for raw and processed SM using techniques which can be used by pharmacies. Powdered SM was heated in an iron pan by adding lemon juice for 3 days, till liberation of sulfur fumes stopped. Bhasma of this shuddha SM was obtained by triturating it withit with shuddha gandhaka and lemon juice. It was then subjected to heat in 09* putas, and for firing in each puta, 4 kg cow dung cakes were used. To assure the quality of bhasma, rasa shastra quality control tests like nischandratva, varitara, amla pariksha, etc., were used. After the bhasma complied with these tests, the bhasma was analyzed using X-ray Diffraction (XRD) analysis of raw SM and SM bhasma revealed that raw SM contains CuFeS2, and SM bhasma contains Fe2O3, FeS2, CuS and SiO2. Scanning Electron Microscope (SEM) studies showed that the grains in SM bhasma were uniformly arranged in agglomerates of size 1-2 microns as compared to the raw SM which showed a scattered arrangement of grains of size 6-8 microns. It may be concluded that raw SM is a complex compound which gets converted into a mixture of simple compounds having very small particle size after the particular process of marana. This is the first report of fingerprinting of SM bhasma prepared using this particular method.

Background:

Pulmonary tuberculosis (PTB) is an age old disease described in Vedic Medicine as ‘Yakshma’. Later on, in Ayurveda it earned a prefix and found way into mythology as ‘Rajayakshma’. After the discovery of streptomycin, the therapeutic management of PTB received a major breakthrough. The treatment module changed remarkably with the formulation of newer anti-tubercular drugs (ATD) with appreciable success. Recent resurgence of PTB in developed countries like United States posed a threat to the medical community due to resistant strains. Consequently, WHO looked toward traditional medicine. Literature reveals that Ayurvedic treatment of PTB was in vogue in India before the introduction of ATD with limited success. Records show that 2766 patients of PTB were treated with Ayurvedic drugs in a tertiary care hospital in Kolkata in the year 1933-1947.

Objectives:

To evaluate the toxicity reduction and early restoration by adjunct therapy of Ayurvedic drugs by increasing the bio-availability of ATDs.

Materials and Methods:

In the present study, treatment response of 99 patients treated with ATD as an adjunct with Aswagandha (Withania somnifera) and a multi-herbal formulation described in Chikitsa-sthana of Charaka samhita i.e. Chyawanprash were investigated. Hematological profile, sputum bacterial load count, immunoglobulin IgA and IgM, blood sugar, liver function test, serum creatinine were the assessed parameters besides blood isoniazid and pyrazinamide, repeated after 28 days of treatment.

Results:

The symptoms abated, body weight showed improvement, ESR values were normal, there was appreciable change in IgA and IgM patterns and significantly increased bioavailability of isoniazid and pyrazinamide were recorded.

Conclusion:

This innovative clinical study coupled with empowered research may turn out to be promising in finding a solution for the treatment of PTB.

Novel drug delivery system is a novel approach to drug delivery that addresses the limitations of the traditional drug delivery systems. Our country has a vast knowledge base of Ayurveda whose potential is only being realized in the recent years. However, the drug delivery system used for administering the herbal medicine to the patient is traditional and out-of-date, resulting in reduced efficacy of the drug. If the novel drug delivery technology is applied in herbal medicine, it may help in increasing the efficacy and reducing the side effects of various herbal compounds and herbs. This is the basic idea behind incorporating novel method of drug delivery in herbal medicines. Thus it is important to integrate novel drug delivery system and Indian Ayurvedic medicines to combat more serious diseases. For a long time herbal medicines were not considered for development as novel formulations owing to lack of scientific justification and processing difficulties, such as standardization, extraction and identification of individual drug components in complex polyherbal systems. However, modern phytopharmaceutical research can solve the scientific needs (such as determination of pharmacokinetics, mechanism of action, site of action, accurate dose required etc.) of herbal medicines to be incorporated in novel drug delivery system, such as nanoparticles, microemulsions, matrix systems, solid dispersions, liposomes, solid lipid nanoparticles and so on. This article summarizes various drug delivery technologies, which can be used for herbal actives together with some examples.

In Ayurveda many formulations are described which milk is used as a solvent for extraction of medicinal principles present in the herbs. The rationale of this technique is analysed in this article from the standpoint of pharmaceutical sciences.

Background

Ayurveda represents the traditional medicine system of India. Since mechanistic details of therapy in terms of current biology are not available in Ayurvedic literature, modern scientific studies are necessary to understand its major concepts and procedures. It is necessary to examine effects of the whole Ayurvedic formulations rather than their “active” components as is done in most current studies.

Methods

We tested two different categories of formulations, a Rasayana (Amalaki Rasayana or AR, an herbal derivative) and a Bhasma (Rasa-Sindoor or RS, an organo-metallic derivative of mercury), for effects on longevity, development, fecundity, stress-tolerance, and heterogeneous nuclear ribonucleoprotein (hnRNP) levels of Drosophila melanogaster using at least 200 larvae or flies for each assay.

Results

A 0.5% (weight/volume) supplement of AR or RS affected life-history and other physiological traits in distinct ways. While the size of salivary glands, hnRNP levels in larval tissues, and thermotolerance of larvae/adult flies improved significantly following feeding either of the two formulations, the median life span and starvation resistance improved only with AR. Feeding on AR or RS supplemented food improved fecundity differently. Feeding of larvae and adults with AR increased the fecundity while the same with RS had opposite effect. On the contrary, feeding larvae on normal food and adults on AR supplement had no effect on fecundity but a comparable regime of feeding on RS-supplemented food improved fecundity. RS feeding did not cause heavy metal toxicity.

Conclusions

The present study with two Ayurvedic formulations reveals formulation-specific effects on several parameters of the fly's life, which seem to generally agree with their recommended human usages in Ayurvedic practices. Thus, Drosophila, with its very rich genetic tools and well-worked-out developmental pathways promises to be a very good model for examining the cellular and molecular bases of the effects of different Ayurvedic formulations.

Several arguments have been forwarded for the stagnation of Ayurveda, and most of these focus on the discrimination that Ayurveda faces under Mughal and then under British rule. Even for Ancient India, the halcyon portrait of Ayurveda synergetically related with religion and politics during the period, as has been portrayed in many books of history and in countless lores, is false. This paper then deals with the interaction between the State and Ayurvedic medicine in ancient India.

In Ayurvedic therapeutics, drug therapy is given prime importance. There is a very well developed sub-discipline entirely devoted to drug formulations known as “Bhaisajya Kalpanaa”. Considering its importance, different aspects of this discipline have been presented in this review to familiarize the readers, especially those who have just started studying Ayurveda, with concept of ayurvedic pharmaceutics. The Ayurvedic drug formulation is based on what is known as “Pancavidha Kasaaya” concept. According to this concept there are five basic forms of formulation known as 1-‘Swarasa’ the expressed juice, 2-‘Kalka’, a fine paste obtained by grinding fresh or wet grinding dried plant material 3- ‘Kwaatha’, the decoction, 4- ‘Sheeta’ or ‘Hima’, the cold water infusion and 5- ‘Faanta’, the hot water infusion. Different aspects of their preparation and use have been discussed. Further from the above basic forms, a number of other formulations are derived; a brief description of each of them has been given along with brief outlines of drug formulations meant for specific routes. The third part of the review is devoted to discussion of influence of different factors on the expression of pharmacological activity.

The potential of Ayurvedic philosophy and medicines needs to be recognized and converted into real life treatment paradigm. This article describes a comprehensive therapeutic approach used in Ayurveda and modern medicine to treat arthritis. We present concise summary of various controlled drug trials carried out by us to validate standardized Ayurvedic drugs using modern medicine protocol to treat Rheumatoid Arthritis and Osteoarthritis knees. Several of the latter are published. The trials consistently demonstrate excellent safety of Ayurvedic medicines but often fail to unequivocally show superior efficacy. Some key findings of a recently unpublished trial in OA knees are also presented to show equivalence between Ayurvedic medicine and celecoxib and glucosamine, and we speculate that equivalence trials may be a way forward. The data from the trials also supports the Ayurvedic ‘Rasayana’ concept of immune-modulation and healing. We need to interpret logic of Ayurveda when, adopting modern science tools in drug development and validation and much research is required. Validation of Ayurvedic medicines using the latter approach may lead to an evidence based Ayurveda – Modern Medicine interface. Also, in pursuit of finding better treatment solutions, we ought to step beyond the realm of only drugs and attempt validation of comprehensive specific treatment package as per classical Ayurveda. Finally, validation of a combined (Ayurveda and modern medicine) therapeutic approach with superior efficacy and safety is likely to be a major leap in overcoming some of the current frustrations to treat difficult disorders like arthritis using only modern medicines.

Pharmacovigilance is a corrective process originating in pharmaco-epidemiology. The 1997 Erice Declaration, presented at the World Health Organisation, became the basis on which the concept was implemented internationally for conventional systems of medicine. The increasing international acceptance of Ayurveda, led regulators to implement a similar program for Ayurveda, particularly as some medical professionals, scientists and members of the public reported adverse reactions after taking Ayurvedic formulations. The World Health Organisation therefore persuaded the Department of AYUSH, Ministry of Health and Family Welfare, Government of India, to implement a pharmacovigilance program for Ayurveda, as a means to ensuring the safety and efficacy of Ayurvedic medicines. After a year of due diligence, the pharmacovigilance program was launched nationally on 29 September 2008. Since that time, Ayurveda, Siddha and Unani medicines have been monitored according to the provisions of a protocol prepared by the National Pharmacovigilance Resource Centre, IPGTRA, Jamnagar, and approved by Department of AYUSH. The program was reviewed, first, on 21st January 2009 by the National Pharmaco-vigilance Consultative Committee for ASU drugs (NPCC-ASU), and again, on 15 Feburary, 2010, when an evaluation meeting effectively rubber stamped the program. Among the outcomes of these meetings were several suggestions of measures to improve the program’s efficiency. Recent developments include the constitution of pharmacovigilance centers at all Ayurveda Teaching institutes and research centers.

Sandhana kalpana (biomedical fermented formulations) are one of the best dosage forms of Ayurveda in practice since thousands of years. In order to prepare these medicaments, certain sets of conditions are prearranged, which lead to fermentation. Thus, products bequeath with self-generated ethyl alcohol, which potentiate these preparations (Asava–Arishta), pharmaceutically and therapeutically. Commonly, medicinal and commercial components of these formulations are prompting many researchers to contribute in manufacturing, quality control, safety, and efficacy of these formulations. To cope up with this, literature related to Asava–Arishta has been surveyed from the Vedic period to recent publications of Government of India, ie, Ayurvedic Formulary of India, and presented briefly here. In this review paper, we have discussed pioneering facts such as nature and amount of carbohydrate, type of containers, optimum temperature, variety and relevance of initiator of fermentation, manufacturing, regulatory rules, and business aspects of Asava-Arishta. After going through this basic information, any academician or researcher may show a way to further strengthen this dosage form.