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Efficacy of Herbomineral
formulations in dermatological
practice
Dr. Sathyanarayana B, M.D. Ayu
Principal
Muniyal Institute of Ayurveda Medical Sciences,
MANIPAL
bhaishajya@yahoo.com
Introduction:
• The skin is the largest organ of the human body, which protects us
against mechanical, chemical and biological hazards.
• The 21st Century, with its continuous changing life styles, environment
and dietary habits has made man as main victim of many diseases
including skin diseases.
• The patients always experience physical, emotional & socioeconomic
embarrassment in the society.
• Normally, 10 – 15% of the General Practitioners work is with skin
disorders and it is the second commonest cause of loss of work.
• Dermatology is the branch of medicine dealing
with the skin and its diseases , a unique specialty
with both medical and surgical aspects.
• Dermatosis (plural dermatoses), is defined as
“any disease of the skin,” and, while thousands of
skin disorders have been described, only a small
number account for most visits to the doctor.
Introduction:
• Dermatology is a very dynamic subject with multiple
advances in various fields including –
• dermatosurgery,
• dermatopathology,
• genetics and molecular research,
• melanocyte research,
• Lasers,
• cosmetic dermatology, etc.
Introduction:
• Availability of various new therapies including
lasers, botox, dermal fillers, biologicals, and
immunoglobulins for treatment of various
disorders have created a lot of excitement among
the young dermatologists although the senior
and eminent dermatologists still prefer to restrict
themselves to the time-tested older therapies
Introduction:
• Antibiotic resistance, diabetes, asthma,
eczema etc. have surfaced in epidemic
proportions, perhaps as a result of winning
the battle against infection.
• This has encouraged votaries of alternative
paradigms .
Introduction:
• Now a days, modern science reach top of the hill
by great advance particularly in dermatology as
topic is concerned and also availability of
powerful antibiotics, antifungal, antihistaminic,
steroids, etc. but better management could not
be searched out till today.
• Few drugs are available for symptomatic relief
only.
• Their indiscriminate use is most undesirable.
• Nowadays, whole world is gradually turning
towards Ayurveda for safe and complete cure of
diseases.
‘Ayurvedic dermatology’
• Ayurveda has discussed all skin disease under
the umbrella of Kushtha, in other word it can
be listed as ‘Ayurvedic dermatology’.
• It is not a vis-à-vis correlation but one can
cover up all dermatological manifestations
under 18 subtypes of Kushtha.
• However, the conditions like-
• Shwitra, Kilaasa
• Sheetapitta, Udarda, Kotha
• Visarpa
• Kshudraroga like, Neelika, Vyanga, tilakaalaka,
Yuvaanapidikaa, padmineekantaka etc.
• Sheetalee, Masoorikaa etc. also are to be considered
under skin diseases
‘Ayurvedic dermatology’
AYURVEDIC MANAGEMENT
• Efficacy of Shodhana therapy in treating chronic
dermatological afflictions is well established.
• However, Shamana therapy is also equally important.
• Especially in general clinical practice, physicians largely
depend on Shamana therapy (both external and
internal) while treating skin diseases.
• Even after Shodhana, Shamana Chikitsa is essential.
• Among hundreds of Ayurvedic formulations used in
treating skin diseases, Rasayogas or herbo-mineral
formulations have a unique role and a clear edge over
pure herbal formulations.
• It is a known fact that Rasoushadhi are superior to
Kashthoushadhi owing to their small dose, quick
action, easy palatability and long shelf life .
• Several experienced doctors over several years
in their clinical practice have observed and are
confident regarding the excellent efficacy of
Rasoushadhi in managing challenging, chronic
skin diseases like eczema, psoriasis etc.
Contact dermatitis
HOUSEWIFE DERMATITIS
Nummular dermatitis
Atopic dermatitis or eczema
Seborrhoeic dermatitis
Stasis dermatitis
DERMATOPHYTOSIS(TINEA)
ONYCHOMYCOSIS(TINEA UNGUINUM)
TINEA CORPORIS
TINEA CRURIS
TINEA CAPITIS
TINEA PEDIS
TINEA BARBAE
TINEA MANUS(MANUUM)
TINEA VERSICOLOR
PITYRIASIS(TINEA) VERSICOLOR
TINEA ROSEA
PITYRIASIS ROSEA
TINEA NIGRA
PSORIASIS
SCALP PSORIASIS
NAIL PSORIASIS
GUTTATE PSORIASIS
PLAQUE PSORIASIS PUSTULAR PSORIASIS
INVERSE PSORIASIS
ICTHYIOSIS
IMPETIGO
ECTHYMA
PEMPHIGUS VULGARIS
URTICARIA
RHAGADES-CRACKED HEELS
VITILIGO
Distribution patterns in vitiligo
Rasadravya-Mercurial medicaments
useful in dermatological conditions:
• The materials described in Rasashastra have been classified under several
categories like- Maharasa,
• Uparasa,
• Sadharana Rasa,
• Dhatu,
• Upadhatu,
• Ratna,
• Uparatna,
• Sudhavarga,
• Sikatavarga etc.
• Some of the raw materials (metal/mineral/plant
product/animal product) mentioned under these
categories have their special application in healing skin
ailments.
• Their mode of action may vary from antimicrobial to
immune modulation.
• However, they are proven to be potent and efficacious
in managing dermatological conditions.
EXAMPLES
GANDHAKA(SULPHUR)
GAIRIKA(HAEMATITE)
KAASEESA
• GREEN VITRIOL
• FeSO4.7H2O
KAANKSHEE
• ALUNITE
• POTASH ALUM
HARATAALA(YELLOW ORPIMENT
As2S3
PATRATAALA
PINDATAALA
MANAHSHILAA
REALGAR(As2S2)
RASANJANA (MILK EXTRACT OF
BERBERIS ARISTATA)
PUSHPANJANA(ZnO)
KAMPILLAKA
(MALLOTUS PHILLIPINENSIS)
• “Phalaraja (glands and hairs of the fruits)”
GIRISINDURA (MONTROYDITE-HgO)
NAGASINDURA( TRIPLUMBIC TETROXIDE)
Pb3O4
MRDDAARASHRNGA(LITHARGE-PbO)
Occasionally,
• Parada (mecury),
• Hingula(cinnabar),
• Kapardika(cowries),
• Shilajatu (asphaltum),
• Tamra (copper),
• Kansya (bronze) etc are also used.
MOST IMPORTANT AND WIDELY USED
ARE:
Gandhaka (Sulfur):
• This is the most popular and widely used rug in
treating skin diseases in the form of various
formulations meant for external and internal use.
• Its special efficacy in treating the conditions like
Pama (scabies), Dadru (teniasis), Vicharchika
(eczema) are well established.
• Gandhaka acts as immune modulator,
antimicrobial and antibiotic
Gairika(Haematite):
• This drug is popularly being used in the conditions
like urticaria and allergic skin manifestations that can
be correlated with the conditions like Shitapitta,
Udarda and Kotha.
• This Pittahara, Rakta shodhaka and Rakta Prasadaka
drug is found to be having antihistamine like action.
Haratala(Yellow orpiment) :
• This is most potent among the Rasadravya in treating the chronic,
challenging skin diseases.
• Its formulations like Rasamanikya, Tala Sindura, Talakodaya Malahara
etc have been clinically established to be the wonder drugs in treating
the conditions like eczema, psoriasis, lichen planus etc.
• Haratala being the trisulfide of arsenic is a potent immune
suppressant and antimicrobial.
• However, it should be used cautiously, in right dose, with right vehicle
and after proper detoxifying and processing techniques.
Table 1 : List of Rasayogas popularly used in
dermatological practice:
S.No. Name of the product Chief ingredients Dose Anupana Indications
1. Arogyavarddhanee Vatee
Katuki, Kajjalee, Loha
Bhasma, Abhraka
Bhasma, Tamra
Bhasma, Shuddha
Shilajatu, Shuddha
Chitraka, Triphala,
Shuddha Guggulu etc. 500 – 750 mg Jala Sarva Kushtha
2. Gandhaka Rasayana
Shuddha Gandhaka,
Godugdha,
Chaturjataka,Guduchi,
Triphala, Bhrngaraja,
Ardraka.. 0.5-1 gm
Sita, Jala,
Ksheera Sarva Kushtha
3. Rasamanikya Shuddha Patra Tala 60 – 120 mg Madhu and Ghrta
Sphutita and Galita
Kushtha, Vicharchika
4. Laghu Suta Shekhara Rasa Gairika, Shunthi.. 0.5-1 gm
Sita, Jala, Ardraka
Swarasa Sheeta Pitta
5. Galat Kushthari Rasa
Kajjalee, Tamra
Bhasma, Loha
Bhasma, Abhraka
Bhasma, Shuddha
Shilajatu, Shuddha
Chitraka, Triphala,
Shuddha Guggulu,
Karanja Beeja etc. 500 – 750 mg Madhu and Ghrta
Karna Nasa Galita
Kushtha
6. Talakeshvara Rasa
Kajjalee, Haratala,
Bakuchi Churna
etc.
500 – 750
mg Jala Shvitra Kushtha
7. Shashilekha Vati
Kajjalee, Tamra
Bhasma, Bakuchi
Kvatha
250 -500
mg
Bakuchi taila
and Madhu Shvitra Kushtha
8. Shvetari Rasa
Kajjalee, Triphala,
Bhrngaraja,
Bakuchi,
Bhallataka, Nimba
Beeja majja
500 – 750
mg Madhu, Ghrta Shvitra Kushtha
9. Krshnamanikya Rasa
Kajjalee, Loha
Bhasma, Tamra
Bhasma, Shuddha
Vatsanabha 125-250 mg
Madhu and
Pippalee
churna Sarva Kushtha
10. Vyadhiharana Rasa
Kajjalee, Arka
ksheeramardita
Rasakarpura,
Haratala,
Navasadara.. 60-125 mg
Madhu,
Ghrta and
Pippalee
churna Sarva Kushtha
11. Amrtankura Louha
Kajjalee,
Triphala, Loha
Bhasma, Tamra
Bhasma,
Abhraka
Bhasma,
Shuddha
Bhallataka,
Guggulu, Ghrta
500-750
mg
Jala,
Ksheera,
Narikela Jala Sarva Kushtha
12.
Nageshvara-Naga
Bhasma
Naga, Tila Taila,
Shveta Kasisa,
Kajjalee,
Chincha Tvak
churna
500-750
mg
with equal
quantites of
tvak,
devadaru
and bakuchi
churna Galat Kushtha
13.
Siddha Haratala
Bhasma
Mahishee Mutra,
Churnodaka,
Sharapunkha
etc, treated
Haratala
Bhasma 60-120 mg
Madhu and
Ghrta
Galatkushtha,
Shveta Kushtha
14. Haratala Bhasma
Prepared by
processing with
Punarnava 60-120 mg
Madhu and
Ghrta,
Ksheera etc.
Kandu, Kushtha,
Galatkushtha
Table 2: List of selected herbo-mineral
products for external application:
S.No. Name of the product Chief ingredients Indications
1. Chandamāruta Lepam
Hingula,
Rasakarpura,
Souvira, Gandhaka.
Kitibha, Pundarika,
Sidhma, Kakana
2. Rasottamadi Lepam
Kajjali, Sindura,
Manahshila,
Jeerakadwaya,
Haridradwaya..
Pama, Kandu,
vicharchika
3 Sinduradi Lepa
Rasa sindura, rasa
Karpura,
Mrddarashrnga,
Madhucchishta,
Narikela Taila
Vicharchika, Vipadika,
Vrana, Kandu
[a] Lepa:
S.No. Name of the product Chief ingredients Indications
1.
Dadru Vidravana
Malahara
Gandhaka, Siktha Taila, Shuddha
Tankana, Chakramarda, Laksha Dadru
2.
Darunanashaka
Malahara
Tuttha, Kampillaka, Shvata Khadira,
Gairika, Surya Kshara. Darunaka
3. Gairikadya Malahara
Gairika, Haridra, Sindura, Siktha
taila Kandu, Daha, Vrana
4. Gandhakadya Malahara
Gandhaka, Siktha Taila, Girisindura,
Tankana, Karpura Pama
5. Hinguladya Malahara Siktha Taila, Sindura, Darada
Phiranga Vranahara,(in
ulcerative, infected skin
diseases)
6. Hingulamrta Malahara
Siktha Taila, Sindura, Darada,
Tankana, Karpura
Vrana Shodhana-Ropan(in
ulcerative, infected skin
diseases)
7. Kajjalikodaya Malahara
Kajjali, Siktha Taila, Mrddarashrnga,
Kampillaka, Tuttha
Vrana Shodhana-Ropan(in
ulcerative, infected skin
diseases)
8. Kitibhari Malahara
Tuttha, Haratala, Manahshila,
Kajjalee, Samudraphena, Kharpara,
chakramarda Beeja, Vatsanabha,
Dhattura Beeja, Tankana, Dadru, Pama, Kitibha
9. Kampillaka Malahara Kampillaka, Siktha Taila Vicharchika
[b] Malahara
Malahara(continued…)
10.
Mrddrashrngadya
Malahara
Mrddarashrnga, Siktha
Taila Pama, Kandu, Vipadika.
11. Pamahara Malahara
Kajjali, Tuttha,
Jeerakadwaya,
Sindura, Maricha,
Dhouta Ghrta Pama, Kacchu
12. Rasapushpadya Malahara
Rasapushpa, Siktha
Taila Chirodbhuta Vicharhika
13. Siduradya malahara
Sindura, Siktha taila,
Tankana
Vrana Shodhana-
Ropana
14. Talakodaya Malahara
Taala, Sindura,
Gairika, Kajjali, Siktha
taila
Vicharchika, Dadru,
Pama..
15. Tankanamrta Malahara
Shuddha Tankana,
Siktha taila, Sarjika.. Dushta Vrana
16. Tutthakadya Malahara
Tuttha, Ghrta, rala,
Khatika..
Vrana Shodhana-
Ropan(in ulcerative,
infected skin diseases)
17. Tutthamrta Malahara Tuttha, Siktha taila Chira Samutthita Pama
18. Yashadamrta Malahara
Yashada Pushpa,
Siktha Taila
Vicharchika, Vrana,
Dagdha Vrana
S.No. Name of the product Chief ingredients Indications
1. Kasisa Drava Kasisa, Jala Vicharchika, Kandu.
2. Rasakarpura Drava Rasakarpura, Jala…
Hasta paada
smaraagaara
gehaadigata
bhutanut, Phiranga
Vrana
[c] Draava:
S.No. Name of the product Chief ingredients Indications
1. Gandhaka Taila/Druti
Gandhaka, Trikatu,
Tila Taila
Kshudra Kushtha,
Visarpa
2. Kasisadi Ghrta
Kasisa, Haratala,
Manahshil, Haridra,
Chakramarda,
Ghrta..
Pama, Vicharchika,
Dadru
3. Sinduradya Taila
Girisindura,
Sarshapa Taila,
Tuttha, Nisha, Arka
Patra
Pama, Vicharchika,
Visphota, Kshata,
Kandu
[d] Taila/Ghrta:
Table 3: Kushtha specific Rasayogas:
S.No. Type of Kushtha Medicines Dose Anupana Sevana Kala
1. Vatajah (kapalam) Haratala Bhasma 60-120 mg
Ghrta and
Sharkara
Adhobhaktam,
twice daily
2.
Pittajah
(Oudumbaram)
Tala Bhasma
Mishranam* 60-120 mg
Ghrta and
Sharkara
Madhyebhaktam
twice daily
3. Kaphajah (Mandalam) Arogyavarddhanee 500-750 mg
Ghrta and
Madhu
Pragbhaktam
twice daily
4.
Vatapittajah
(Rshyajihvam) Arogyamishranam** 0.5-1gm
Ghrta and
Sharkara
Antarabhaktamt
wice daily
5.
Kaphapittajah
(Pundareekam) Chandamaruta Lepa Q.S.-ext
with
Navaneeta
External
application
twice daily
6.
Vatakaphajah
(Sidhmam) Chandamaruta Lepa Q.S.-ext
with
Navaneeta
External
application
twice daily
* Tala Bhasma Mishranam: A mixture of Tala Bhasma 1 part, Mouktika Bhasma1 part and Kamadugha 8 parts
7. Tridoshajah (Kakanam) Chandamaruta Lepa Q.S.-ext with Navaneeta
External
application
twice daily
8. Kaphajah (Vicharchika) Arogyamishranam** 0.5-1gm Khadirarishta
Antarabhakta
mtwice daily
9.
Vatakaphajah
(Vaipadikam, Alasakam)
Rasamanikya 60 – 120 mg
Madhu and
Ghrta
Adhobhaktam,
twice daily
Sinduradi Lepa QS-ext directly appled twice daily
10.
Kaphapittajah (Dadru,
Charmadala, Pama,
Kacchu, Shataru)
Arogyamishranam** 0.5-1gm
Manjishthadi
Kvathah
Antarabhakta
mtwice daily
Gandhaka Drutih 2-5 drops Godugdha
Antarabhakta
mthrice daily
11.
Vatapittaja (Ekakushtha,
Charma, Kitibha)
Gandhaka
Rasayanam 0.5-1gm
Ghrta and
Sharkara
Adhobhaktam,
twice daily
12. Shvitram
Arogyavarddhanee 500-750 mg
Ghrta and
Sharkara
Adhobhaktam
twice daily
Shashilekha Vati 250 -500 mg
Bakuchi taila
and Madhu
Adhobhaktam
twice daily
**Arogyamishranam: A mixture of Arogya varddhanee and Chandraprabhaa in equal quantities
Popular and time tested rasayogas in
dermatological practice
• 1. Arogyavarddhanee Vatee:
• This is a wonder drug in treating skin diseases.
• The presence of ingredients like Katuki, Shilajatu, Tamra Bhasma, Guggulu and
Kajjalee made its action multidimensional.
• It is Rata shodhaka and Pittasaraka.
• It improves digestion and metabolism.
• Its hepatoprotective effect, laxative action has made its action unique in the
management of multiple types of skin diseases.
• It also improves the health of skin.
• It is found to be more efficacious when used in early stages of skin diseases.
Arogyavarddhanee Vatee:
• It is advised to use this product for a period of 48 days (one
Mandala) for optimum results
• Its main action is on liver and intestines.
• It helps to eliminate toxins from the body.
• It can be used in any type of skin diseases and in any stage.
• But, it may not be so effective when the disease is deep
seated, presented with severe excoriation, ulceration and
pain where other products are to be essentially added.
Gandhaka Rasayana:
• This product is a very useful medicine in a variety of
dermatological conditions and hence rightly quoted
as effective in Ashtadasha Kushtha
• Here also most important is the quality of the
product which is ensured by strict adherence to the
GMP norms by following SOP.
• All 83 Bhavana should be properly given.
• It is essential to mix the final product with equal
quantity of Sita so that it acts as Rasayana and can be
used safely in therapeutically effective dose.
• This product is highly efficient anti bacterial and
immune modulator and can be used in all the types of
skin diseases.
• However, its efficacy is most appreciated in the
conditions like eczema, ecthyma, taeniasis, skin diseases
with secondary infections etc.
Rasamanikya:
• This is a very potent and effective product in treating skin diseases.
• Its efficacy is proved even in treating leprosy.
• It is an arsenic compound prepared by using Shuddha Patratala.
Rasamanikya is an extensively evaluated product chemically,
toxicologically and clinically.
• It is mainly useful in Vatakaphaja Kushtha.
• Its potent antimicrobial and immune modulating effects have made it
a drug of choice in treating the conditions like psoriasis, chronic
eczema and leucoderma.
RASAMANIKYA
• Its dose should be 60-120 mg and should always be
used with appropriate Anupana like Madhu and Ghrta.
• It can be divided into accurately divided dosage
packets and dispensed to the patient or it can be
homogenously and uniformly distributed in herbal
diluents (like Triphala Churna, Guduchi Sattva etc) and
used.
Laghu Suta Shekhara Vatee:
• Chief constituents of this product are Shuddha Gairika
and Shunthi.
• This product even though is indicated in Amplapitta, is
being used popularly by Ayurvedic practitioners in the
management of skin diseases.
• Gairika is known Pittahara and Rakta prasadaka drug
and efficacy of Shunthi in treating Shita Pitta is
classically referred and clinically established.
Laghu Suta Shekhara Vatee
• This product is found to be having potential
antihistamine like action and hence being used
successfully in treating allergic skin manifestations
especially the Urticaria.
• It also helps to dry up the secretions quickly. Hence,
Laghu Suta Vatee can be effectively employed to relieve
the symptoms of itching and discharge in any of the
dermatological conditions.
RESEARCH FINDINGS
SHUDDHA GANDHAKA
• Dr. Yogeesha Acharya from SDM College of Ayurveda from
the department of Kayachikitsa evaluated the effect of
Gandhaka Churna in Vicharchika/atopic dermatitis.
• He administered Shuddha Gandhaka Churna at a dose of
500 mg BD, before food with 100 ml of milk as Anupana for
28 days.
• Marked relief in clinical symptoms like itching, discharge,
pidaka, ruja and discoloration were observed
GANDHAKA DRUTI-TAILA
• The clinical study suggests that, the use of
Gandhaka Druti and Gandhaka Taila in Pama as
external application markedly subsidizes lesion
and itching.
• Thus, Druti and Taila can be safely used in
treatment of skin diseases especially in Pama.
Shankar Rao. CLINICAL EVALUATION OF GANDHAKA DRUTI AND GANDHAKA TAILA IN
SCABIES: A COMPARATIVE CLINICAL STUDY , UJAHM 2014, 02 (01): Page 38-40
Title of
the
Article/
Research
work
COMPARATIVE CLINICAL EVALUATION OF GANDHAKA DRUTI AND
GANDHAKA TAILA IN SCABIES
Journal e-Journal Rasamruta | Year : 2013 | Volume : 5 | Issue : 34 | Page : 1-5
Author(s) 1. Dr. Pranit Ambulkar and 2.Dr. K. Shankar Rao
The present study is aimed to evaluate the clinical efficacy of Gandhaka Taila and
Gandhaka Druti on scabies.
For this single blind clinical trial, patients diagnosed for scabies were divided in two
groups ‘A’ and ‘B’. Group ‘A’ received Gandhaka Druti for local application and 500mg
Gandhaka Rasayana in two divided doses per day internally; while group B received
Gandhaka Taila for local application and Gandhaka Rasayana 500 mg in two divided doses
per day internally.
The duration of study was twenty one days. The subjective and objective observations
were evaluated statistically.
The results suggested that both the drugs are effective in scabies, but Gandhaka Taila
was slightly more effective which is significant statistically.
Title of
the
Article/
Research
work
EFFICACY OF GANDHAKA YOGA IN PAMA - A CLINICAL STUDY
Journal e-Journal Rasamruta | Year : 2011 | Volume : 3 | Issue : 47 | Page :
Author(s)
1.Dr. Sanjay B. Sawal, 2.Dr. S. S. Vaidya, 3.Dr. R. S. Hiremath,
4.Dr. Vikas Saroch,
Gandhaka yoga included main drugs as Gandhaka (sulphur), Sarshapa
taila (mustard oil). All the drugs having kushthaghna properties.
Scabies (Pama) affects all races and social classes worldwide.
To evaluate its efficacy this study was carried out and it reveals the
effects of Gandhaka yoga which gives 90% relief in case of itching
and exhibit 95% relief in oozing.
GANDHAKA RASAYANA
• Gandhaka rasayana had an antifungal effect
against candida albicans.
• MIC and MFD was estimated to be 5ml of BHI
broth containing candida albicans
Dr. Prasanna kumar et al, IN-VITRO ANTIFUNGAL ACTIVITY OF GANDHAKA RASAYANA, unpublished
Reshma M. Saokar et.al, Screening of Antibacterial and Antifungal Activity of
Gandhaka Rasayana- an Ayurvedic Formulation , International Journal of Recent
Trends in Science And Technology, ISSN 2277-2812 E-ISSN 2249-8109, Volume 8, Issue
2, 2013 pp 134-137
• Results: Gandhaka Rasayana solutions in different concentrations showed a
significant zone of inhibition against three strains of bacteria (22-30mm) and four
strains of fungi (16-25mm) when compared to Fluconazole (22mm) and control. As
Gandhaka Rasayana contains Fe (433.84), Cu (32.77), Ni (10.32) Zn (10.32), Ca
(0.84%), Na (0.17%), As (12.14), triclinic cells, carbohydrates, steroids and tannins
it may contribute to promote positive health and vigour by increasing the
immunity, thus making the body resistant against disease causing factors.
• Conclusion: Gandhaka Rasayana showed a significant antibacterial and
antifungal activity, but antibacterial activity was significant compared to
antifungal activity.
• In a clinical study, 15 patients of Psoriasis vis-à-vis Ekakushtha
were administered Rasamanikya at a dose of 125 mg with
honey and ghee, twice daily for 28 days and the results were
highly encouraging with the remission in the symptoms as
follows: Aswedanam 90%, Mahavastu 70%, Kandu 100%,
Matsyashakalopam 75%. (Srimannarayana et.al.)
• There was no elevation of serum arsenic level even after a
month’s treatment.
RASAMANIKYA
• Here, Anupana is very crucial and Rasamanikya has to be
administered with honey and ghee.
• Mild to moderate fatty changes to liver was significant and
decreased liver weight, increased cholesterol and decreased
blood sugar level were reported in earlier (D.K.Mishra et al)
when it is given with water, in present study it is given with
honey and ghee and proven safe.
RASAMANIKYA
RASAMANIKYA
• The present study of antimicrobial activity of Rasamanikya reveals that
the drug have got good antimicrobial property against selected microbes.
• This study supports the therapeutic potential of the drug as it has
inhibited the growth of microorganisms responsible for different diseases.
• However, proper understanding of Ayurveda and further developing the
appropriate models and parameters for study of pharmacological
activities of the Ayurvedic drugs is necessary.
Poonam Kumari, RS Hiramath, Antimicrobial activity of Rasamanikya against different
pathogenic microbes w.s.r. to skin disease, Anc Sci Life. 2013 Jan; 32(Suppl 2): S11.
RASAPUSHPA
• Dr Anitha H evaluated the antimicrobial
potential of Rasapushpa during her
dissertation work carried out at DGM
Ayurveda college Gadag.
• Rasapushpa had shown mild antibacterial
activity but marked antifungal activity
Rasottamadi Lepa
• Two sets of medicines:- (1) Shvetari rasa for internal and
Gajalindajadi varti for external and (2) Dhatryadi curna
internal and Avalguja bijadi varti external was clinically
experimented and found effective in this disease.
• However , group (2) showed better results
Meena M.S. et.al., A Clinical study of Shwitra (Vitiligo), Journal
of Ayurveda, VaLl No.1 Jan-Mar 2007,6-38
• Patients of Shwitra (vitiligo) when treated with
Shwitra kusthari Rasa and Aargvadhadaya tail have
shown best result without producing any side effects.
• Therefore, if can be concluded that Shwitra kusthari
Rasa and Aargvadhadaya taila therapy is a potent
remedy for the managment of Shwitra vis-à-vis
vitiligo.
YASHADAMRITA MALAHARA
• Dr Sobagin M.V. from the department of Rasashastra from
DGM Ayurveda college Gadag worked on “The preparation,
Physico-chemical analysis of Yashadamrita Malahara and
Sindhooradi Taila and comparative clinical study on
Vicharchika (Eczema)”
• By clinical study and statistical value it is proved that
Yashadamrita malahara is choice remedy in sravi
Vicharchika and Sindhooradi taila in rooksha Vicharchika
Shankha Bhasma in Yuvana Pidika
• A combination of oral administration Shankha
Bhasma in a dose of 250 mg t.i.d (capsule) and
Yuvana pidikahara lepa(Lodhra, dhanya, vacha)
was found to be very effective
Rameshchandra Arun,Shankha Bhasma evam Yuvana-Pidika Lepa ka Nirmanatmaka
evam Yuvana-Pidika Vyadhi par Prabhavatmaka Adhyayan. PG disertation, IPGT and
RA, Jamnagar, 2002
RASAKARPURA
• Dr Suvarna P Nidagundi evaluated the
antimicrobial potential of Rasakarpura during her
dissertation work carried out at DGM Ayurveda
college Gadag, Rasakarpura had shown a less
significant activities for all bacteria except E.coli
but significant antifungal activity
Title of the
Article/
Research
work
THE EFFECT OF RASAKARPURA DRAVA ON KSHUDRA KUSTHA
Journal
International Journal of Ayurvedic Medicine | Year : 2011 | Volume : 2 | Issue : 2
| Page : 81-92
Author(s) Neky Mehta, 1.B. J. Patgiri, 2.B. Ravishankar, 3.P.K.Prajapati
Rasakarpura, a Nirgandh type of Kupipakva Rasayana, used to cure skin disease.
Rasakarpura was prepared as per the reference of Rasatarangini 6/65-71.
It is prepared with Parada (mercury), Sandra Gandhakamla (concentrated
sulphuric acid) and Saindhava Lavana (rock salt) in the ratio of 1: 1 ½ and
approx 1 ½ .
The clinical study was carried out on 80 patients of Kshudra Kustha by using
Rasakarpura Drava (0.1 % solution in distilled water) and same was compared
with a standard drug i.e. Gandhaka Malahara.
The obtained results of clinical trial suggest that both drugs have highly
significant result on the cardinal symptoms of Kshudra Kustha.
• Dr Shraddha worked on Rasakarpura Drava prepared
from Bhutaghna Chakrika for its antimicrobial activity.
• The product was highly effective against both gram
positive and negative bacteria, showing better results
than standard drugs even after serial dilution.
• It was found to be very effective even against MDR
strains.
• However antifungal action was very mild.
RASAKARPURA DRAAVA
List of Poisonous substances of mineral origin
under Schedule-E6 and some of their
aushadha yogas
S.No. Name of Drug Chemical Name Aushadhayoga
1. Gauripashana Arsenic Sameerpannag
rasa,Mallasindura
2. Haratala Arsenic trispulphide Kasturibhairava rasa,
Taalkeshwara rasa
3. Parada Mercury Rasa parpati, Rasa sindoora
4. Rasakarpura Subchloride of mercury Used as formulation itself,
Rasakarpura drava
5. Tuttha Copper sulphate Mahamrityunjaya rasa,
Jatyadighrita
6. Hingula Cinnabar Hinguleshwara rasa,
Anandbhairava rasa
7. Sindura Red oxide of Lead Sinduradilepa
8. Girisindura Red oxide of Mercury Paadadari malhara
Important factors related to
Rasaushadhi administration:
a. Dose (Proper/Lesser/Overdose or excessive dose)
b. Time (Appropriate/Inappropriate)
c. Mode/Vehicle (Anupana) for drug administration (Appropriate/Inappropriate)
d. Diet and Routine management (Pathya/Apathya)
e. Shelf life (Saviryata avadhi)
f. Processing
g. Parameters for Testing
h. Identification
i. Authentication/Approved variety
j. Concept of Prakriti (Constitution)
k. Over the counter (OTC) use of Medicines
l. Lack of proper Knowledge
The risk related to toxic effects of Rasaushadhi can
be considerably reduced by use by following:
• Good Collection Process (GCP),
• Good Manufacturing Process (GMP)
• Good Laboratory Practice (GLP) for quality control
• Quality assurance for good quality processed
medications
• Following various guidelines mentioned in Ayurveda
classics related to administration of drugs.
Factors to be considered while using
Rasayoga in clinical practice:
• The quality of the product should be
ascertained (adequate information about the
source of supply including the quality
standards maintained by the company should
be known) to be confident about the safety
and efficacy of the product.
• The dose of the drug must be appropriate.
• By considering all the factors like classical
guidelines, age of the patient, sex of the patient,
time of administration, potency of the drug, form
of the drug etc, ideal dose is to be fixed to avoid
any untoward effects (especially in arsenic
compounds).
Factors to be considered while using
Rasayoga in clinical practice:
• A proper vehicle is to be used (honey, ghee,
milk, butter, specific herbal juice, decoction
etc.) to get desired efficacy and also the
safety. eg; if Rasamanikya is given with water
instead of honey and ghee (as mentioned in
the text) it may show mild toxic symptoms
Factors to be considered while using
Rasayoga in clinical practice:
• Course or duration of the treatment is also crucial in
the case of Rasoushadhi.
• Some Rasoushadhi (especially arsenic compounds)
may have cumulative toxic effects if are used for
considerably prolonged period
• Pathyapathya mentioned during the administration of
particular Rasayoga should be strictly followed.
Factors to be considered while using
Rasayoga in clinical practice:
Summary and conclusion:
• The classical references, clinical experiences, pharmacological and
clinical studies carried out in various centres have confirmed the
efficacy of Rasyogas in dermatological practice.
• They have a clear edge over pure herbal formulations especially in
treating chronic persisting skin diseases like psoriasis, lichen planus,
eczema etc.
• This is because of their potency, strong antimicrobial, antihistaminic
and immune modulating actions.
• Unfortunately, only a limited number of Rasayogas are being used in
clinical practice.
• It is essential for clinical practitioners to explore the possibilities of
using more and more herbo-mineral preparations in treating
dermatological afflictions.
• However, one should be careful regarding the quality of the product
with special reference to SOP of production and final quality
specification.
• If these are within acceptable limits one need not worry about the
safety of the product as several multi centric studies carried out on
toxicity of herbomineral products have proved their safety beyond
doubt.
Summary and conclusion:
CONCLUSION
rÉjÉÉ ÌuÉwÉÇ rÉjÉÉ zvÉx§ÉÇ rÉjÉÉÅÎalÉUvÉÌlÉrÉïjÉÉ |
iÉjÉÉæwÉkÉqÉÌuÉ¥ÉÉiÉÇ ÌuÉ¥ÉÉiÉqÉqÉ×iÉÉåmÉqÉqÉç ||-
MüÉ.ÎZÉ
rÉÉåaÉÉSÌmÉ ÌuÉwÉÇ iÉϤhÉÇ
pÉåwÉeÉqÉqÉ×iÉÉåmÉqÉqÉç |
pÉåwÉeÉÇ cÉÉÌmÉ SÒrÉÑï£Çü iÉϤhÉÇ xqmɱiÉå
References:
• Random House Webster’s Unabridged Dictionary. Random House, Inc. 2001. Page 537. ISBN 037572026.
• James, William; Berger, Timothy; Elston, Dirk (2005). Andrews’ Diseases of the Skin: Clinical Dermatology (10th ed.).
Saunders. ISBN 0721629210.
• Marks, James G; Miller, Jeffery (2006). Lookingbill and Marks’ Principles of Dermatology (4th ed.). Elsevier Inc. ISBN 1-4160-
3185-5.
• http://dermnetnz.org/dermatologist.html
• http://www.aad.org/public/specialty/what.html
• http://www.dermcoll.asn.au/public/what_is_a_dermatologist.asp
• Devinder Mohan Thappa, Rashmi Kumari, Emergence of dermatology in India, Indian Journal of Dermatology, Venereology
and Leprology, Page 86-92, Volume 75, Issue 1, 2009
• Brig YK Sharma, Col MPS Sawhney+, Dermatology : the past Milestones and the future Crosscurrents, MJAFI 2004; 60 : 151-
156
• Brig YK Sharma, Col MPS Sawhney+, Dermatology : the past Milestones and the future Crosscurrents, MJAFI 2004; 60 : 151-
156
• Krishna Gopala Bhatta, hindi commentary by Indradeva Tripathi, Rasendra Sara Sangraha, Chaukhambha orientalia, II edition
1998
• Acharya Vagbhata, Rasa Ratna Samuchaya Hindi translation by Dr. Indradeva Tripathi, Chaukhamba Orientalia, Varanasi
• Acharya Sri Madhava, Ayurveda Prakasha, By Shri Gulraj Sharma Mishra And Pandit Shiva Sharma, 4th Edition-1994,
Chaukhambha Bharati Academy, Varanasi
• Shri Govind Dasa, Bhaisajya Ratnavali By Shri Kaviraja Ambikadatta Shastri Ayurvedacharya, 19thEdition 2008
• Anonymous, Ayurvedic Formulary of India, Part II, 16:53, Second edition, Govt. of India, Ministry of Health and Family
welfare, AYUSH dept., 2003
• Krishna Gopala Bhatta, hindi commentary by Indradeva Tripathi, Rasendra Sara Sangraha, 2/3-5, Chaukhambha orientalia, II
edition 1998
• Sri Gopala Krishna, Rasendra Sara Sangraha By Dr.Ashok D Satpute 1st Edition 2003 Chowkhamba Krishnadas Academy ,
Varanasi
Thank You

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Efficacy of herbomineral formulations in dermatological conditions

  • 1. Efficacy of Herbomineral formulations in dermatological practice Dr. Sathyanarayana B, M.D. Ayu Principal Muniyal Institute of Ayurveda Medical Sciences, MANIPAL bhaishajya@yahoo.com
  • 2. Introduction: • The skin is the largest organ of the human body, which protects us against mechanical, chemical and biological hazards. • The 21st Century, with its continuous changing life styles, environment and dietary habits has made man as main victim of many diseases including skin diseases. • The patients always experience physical, emotional & socioeconomic embarrassment in the society. • Normally, 10 – 15% of the General Practitioners work is with skin disorders and it is the second commonest cause of loss of work.
  • 3. • Dermatology is the branch of medicine dealing with the skin and its diseases , a unique specialty with both medical and surgical aspects. • Dermatosis (plural dermatoses), is defined as “any disease of the skin,” and, while thousands of skin disorders have been described, only a small number account for most visits to the doctor. Introduction:
  • 4. • Dermatology is a very dynamic subject with multiple advances in various fields including – • dermatosurgery, • dermatopathology, • genetics and molecular research, • melanocyte research, • Lasers, • cosmetic dermatology, etc. Introduction:
  • 5. • Availability of various new therapies including lasers, botox, dermal fillers, biologicals, and immunoglobulins for treatment of various disorders have created a lot of excitement among the young dermatologists although the senior and eminent dermatologists still prefer to restrict themselves to the time-tested older therapies Introduction:
  • 6. • Antibiotic resistance, diabetes, asthma, eczema etc. have surfaced in epidemic proportions, perhaps as a result of winning the battle against infection. • This has encouraged votaries of alternative paradigms . Introduction:
  • 7. • Now a days, modern science reach top of the hill by great advance particularly in dermatology as topic is concerned and also availability of powerful antibiotics, antifungal, antihistaminic, steroids, etc. but better management could not be searched out till today.
  • 8. • Few drugs are available for symptomatic relief only. • Their indiscriminate use is most undesirable. • Nowadays, whole world is gradually turning towards Ayurveda for safe and complete cure of diseases.
  • 9. ‘Ayurvedic dermatology’ • Ayurveda has discussed all skin disease under the umbrella of Kushtha, in other word it can be listed as ‘Ayurvedic dermatology’. • It is not a vis-à-vis correlation but one can cover up all dermatological manifestations under 18 subtypes of Kushtha.
  • 10. • However, the conditions like- • Shwitra, Kilaasa • Sheetapitta, Udarda, Kotha • Visarpa • Kshudraroga like, Neelika, Vyanga, tilakaalaka, Yuvaanapidikaa, padmineekantaka etc. • Sheetalee, Masoorikaa etc. also are to be considered under skin diseases ‘Ayurvedic dermatology’
  • 11. AYURVEDIC MANAGEMENT • Efficacy of Shodhana therapy in treating chronic dermatological afflictions is well established. • However, Shamana therapy is also equally important. • Especially in general clinical practice, physicians largely depend on Shamana therapy (both external and internal) while treating skin diseases. • Even after Shodhana, Shamana Chikitsa is essential.
  • 12. • Among hundreds of Ayurvedic formulations used in treating skin diseases, Rasayogas or herbo-mineral formulations have a unique role and a clear edge over pure herbal formulations. • It is a known fact that Rasoushadhi are superior to Kashthoushadhi owing to their small dose, quick action, easy palatability and long shelf life .
  • 13. • Several experienced doctors over several years in their clinical practice have observed and are confident regarding the excellent efficacy of Rasoushadhi in managing challenging, chronic skin diseases like eczema, psoriasis etc.
  • 47. Rasadravya-Mercurial medicaments useful in dermatological conditions: • The materials described in Rasashastra have been classified under several categories like- Maharasa, • Uparasa, • Sadharana Rasa, • Dhatu, • Upadhatu, • Ratna, • Uparatna, • Sudhavarga, • Sikatavarga etc.
  • 48. • Some of the raw materials (metal/mineral/plant product/animal product) mentioned under these categories have their special application in healing skin ailments. • Their mode of action may vary from antimicrobial to immune modulation. • However, they are proven to be potent and efficacious in managing dermatological conditions.
  • 56. RASANJANA (MILK EXTRACT OF BERBERIS ARISTATA)
  • 58. KAMPILLAKA (MALLOTUS PHILLIPINENSIS) • “Phalaraja (glands and hairs of the fruits)”
  • 62. Occasionally, • Parada (mecury), • Hingula(cinnabar), • Kapardika(cowries), • Shilajatu (asphaltum), • Tamra (copper), • Kansya (bronze) etc are also used.
  • 63. MOST IMPORTANT AND WIDELY USED ARE:
  • 64. Gandhaka (Sulfur): • This is the most popular and widely used rug in treating skin diseases in the form of various formulations meant for external and internal use. • Its special efficacy in treating the conditions like Pama (scabies), Dadru (teniasis), Vicharchika (eczema) are well established. • Gandhaka acts as immune modulator, antimicrobial and antibiotic
  • 65. Gairika(Haematite): • This drug is popularly being used in the conditions like urticaria and allergic skin manifestations that can be correlated with the conditions like Shitapitta, Udarda and Kotha. • This Pittahara, Rakta shodhaka and Rakta Prasadaka drug is found to be having antihistamine like action.
  • 66. Haratala(Yellow orpiment) : • This is most potent among the Rasadravya in treating the chronic, challenging skin diseases. • Its formulations like Rasamanikya, Tala Sindura, Talakodaya Malahara etc have been clinically established to be the wonder drugs in treating the conditions like eczema, psoriasis, lichen planus etc. • Haratala being the trisulfide of arsenic is a potent immune suppressant and antimicrobial. • However, it should be used cautiously, in right dose, with right vehicle and after proper detoxifying and processing techniques.
  • 67. Table 1 : List of Rasayogas popularly used in dermatological practice: S.No. Name of the product Chief ingredients Dose Anupana Indications 1. Arogyavarddhanee Vatee Katuki, Kajjalee, Loha Bhasma, Abhraka Bhasma, Tamra Bhasma, Shuddha Shilajatu, Shuddha Chitraka, Triphala, Shuddha Guggulu etc. 500 – 750 mg Jala Sarva Kushtha 2. Gandhaka Rasayana Shuddha Gandhaka, Godugdha, Chaturjataka,Guduchi, Triphala, Bhrngaraja, Ardraka.. 0.5-1 gm Sita, Jala, Ksheera Sarva Kushtha 3. Rasamanikya Shuddha Patra Tala 60 – 120 mg Madhu and Ghrta Sphutita and Galita Kushtha, Vicharchika 4. Laghu Suta Shekhara Rasa Gairika, Shunthi.. 0.5-1 gm Sita, Jala, Ardraka Swarasa Sheeta Pitta 5. Galat Kushthari Rasa Kajjalee, Tamra Bhasma, Loha Bhasma, Abhraka Bhasma, Shuddha Shilajatu, Shuddha Chitraka, Triphala, Shuddha Guggulu, Karanja Beeja etc. 500 – 750 mg Madhu and Ghrta Karna Nasa Galita Kushtha
  • 68. 6. Talakeshvara Rasa Kajjalee, Haratala, Bakuchi Churna etc. 500 – 750 mg Jala Shvitra Kushtha 7. Shashilekha Vati Kajjalee, Tamra Bhasma, Bakuchi Kvatha 250 -500 mg Bakuchi taila and Madhu Shvitra Kushtha 8. Shvetari Rasa Kajjalee, Triphala, Bhrngaraja, Bakuchi, Bhallataka, Nimba Beeja majja 500 – 750 mg Madhu, Ghrta Shvitra Kushtha 9. Krshnamanikya Rasa Kajjalee, Loha Bhasma, Tamra Bhasma, Shuddha Vatsanabha 125-250 mg Madhu and Pippalee churna Sarva Kushtha 10. Vyadhiharana Rasa Kajjalee, Arka ksheeramardita Rasakarpura, Haratala, Navasadara.. 60-125 mg Madhu, Ghrta and Pippalee churna Sarva Kushtha
  • 69. 11. Amrtankura Louha Kajjalee, Triphala, Loha Bhasma, Tamra Bhasma, Abhraka Bhasma, Shuddha Bhallataka, Guggulu, Ghrta 500-750 mg Jala, Ksheera, Narikela Jala Sarva Kushtha 12. Nageshvara-Naga Bhasma Naga, Tila Taila, Shveta Kasisa, Kajjalee, Chincha Tvak churna 500-750 mg with equal quantites of tvak, devadaru and bakuchi churna Galat Kushtha 13. Siddha Haratala Bhasma Mahishee Mutra, Churnodaka, Sharapunkha etc, treated Haratala Bhasma 60-120 mg Madhu and Ghrta Galatkushtha, Shveta Kushtha 14. Haratala Bhasma Prepared by processing with Punarnava 60-120 mg Madhu and Ghrta, Ksheera etc. Kandu, Kushtha, Galatkushtha
  • 70. Table 2: List of selected herbo-mineral products for external application: S.No. Name of the product Chief ingredients Indications 1. Chandamāruta Lepam Hingula, Rasakarpura, Souvira, Gandhaka. Kitibha, Pundarika, Sidhma, Kakana 2. Rasottamadi Lepam Kajjali, Sindura, Manahshila, Jeerakadwaya, Haridradwaya.. Pama, Kandu, vicharchika 3 Sinduradi Lepa Rasa sindura, rasa Karpura, Mrddarashrnga, Madhucchishta, Narikela Taila Vicharchika, Vipadika, Vrana, Kandu [a] Lepa:
  • 71. S.No. Name of the product Chief ingredients Indications 1. Dadru Vidravana Malahara Gandhaka, Siktha Taila, Shuddha Tankana, Chakramarda, Laksha Dadru 2. Darunanashaka Malahara Tuttha, Kampillaka, Shvata Khadira, Gairika, Surya Kshara. Darunaka 3. Gairikadya Malahara Gairika, Haridra, Sindura, Siktha taila Kandu, Daha, Vrana 4. Gandhakadya Malahara Gandhaka, Siktha Taila, Girisindura, Tankana, Karpura Pama 5. Hinguladya Malahara Siktha Taila, Sindura, Darada Phiranga Vranahara,(in ulcerative, infected skin diseases) 6. Hingulamrta Malahara Siktha Taila, Sindura, Darada, Tankana, Karpura Vrana Shodhana-Ropan(in ulcerative, infected skin diseases) 7. Kajjalikodaya Malahara Kajjali, Siktha Taila, Mrddarashrnga, Kampillaka, Tuttha Vrana Shodhana-Ropan(in ulcerative, infected skin diseases) 8. Kitibhari Malahara Tuttha, Haratala, Manahshila, Kajjalee, Samudraphena, Kharpara, chakramarda Beeja, Vatsanabha, Dhattura Beeja, Tankana, Dadru, Pama, Kitibha 9. Kampillaka Malahara Kampillaka, Siktha Taila Vicharchika [b] Malahara
  • 72. Malahara(continued…) 10. Mrddrashrngadya Malahara Mrddarashrnga, Siktha Taila Pama, Kandu, Vipadika. 11. Pamahara Malahara Kajjali, Tuttha, Jeerakadwaya, Sindura, Maricha, Dhouta Ghrta Pama, Kacchu 12. Rasapushpadya Malahara Rasapushpa, Siktha Taila Chirodbhuta Vicharhika 13. Siduradya malahara Sindura, Siktha taila, Tankana Vrana Shodhana- Ropana 14. Talakodaya Malahara Taala, Sindura, Gairika, Kajjali, Siktha taila Vicharchika, Dadru, Pama.. 15. Tankanamrta Malahara Shuddha Tankana, Siktha taila, Sarjika.. Dushta Vrana 16. Tutthakadya Malahara Tuttha, Ghrta, rala, Khatika.. Vrana Shodhana- Ropan(in ulcerative, infected skin diseases) 17. Tutthamrta Malahara Tuttha, Siktha taila Chira Samutthita Pama 18. Yashadamrta Malahara Yashada Pushpa, Siktha Taila Vicharchika, Vrana, Dagdha Vrana
  • 73. S.No. Name of the product Chief ingredients Indications 1. Kasisa Drava Kasisa, Jala Vicharchika, Kandu. 2. Rasakarpura Drava Rasakarpura, Jala… Hasta paada smaraagaara gehaadigata bhutanut, Phiranga Vrana [c] Draava:
  • 74. S.No. Name of the product Chief ingredients Indications 1. Gandhaka Taila/Druti Gandhaka, Trikatu, Tila Taila Kshudra Kushtha, Visarpa 2. Kasisadi Ghrta Kasisa, Haratala, Manahshil, Haridra, Chakramarda, Ghrta.. Pama, Vicharchika, Dadru 3. Sinduradya Taila Girisindura, Sarshapa Taila, Tuttha, Nisha, Arka Patra Pama, Vicharchika, Visphota, Kshata, Kandu [d] Taila/Ghrta:
  • 75. Table 3: Kushtha specific Rasayogas: S.No. Type of Kushtha Medicines Dose Anupana Sevana Kala 1. Vatajah (kapalam) Haratala Bhasma 60-120 mg Ghrta and Sharkara Adhobhaktam, twice daily 2. Pittajah (Oudumbaram) Tala Bhasma Mishranam* 60-120 mg Ghrta and Sharkara Madhyebhaktam twice daily 3. Kaphajah (Mandalam) Arogyavarddhanee 500-750 mg Ghrta and Madhu Pragbhaktam twice daily 4. Vatapittajah (Rshyajihvam) Arogyamishranam** 0.5-1gm Ghrta and Sharkara Antarabhaktamt wice daily 5. Kaphapittajah (Pundareekam) Chandamaruta Lepa Q.S.-ext with Navaneeta External application twice daily 6. Vatakaphajah (Sidhmam) Chandamaruta Lepa Q.S.-ext with Navaneeta External application twice daily * Tala Bhasma Mishranam: A mixture of Tala Bhasma 1 part, Mouktika Bhasma1 part and Kamadugha 8 parts
  • 76. 7. Tridoshajah (Kakanam) Chandamaruta Lepa Q.S.-ext with Navaneeta External application twice daily 8. Kaphajah (Vicharchika) Arogyamishranam** 0.5-1gm Khadirarishta Antarabhakta mtwice daily 9. Vatakaphajah (Vaipadikam, Alasakam) Rasamanikya 60 – 120 mg Madhu and Ghrta Adhobhaktam, twice daily Sinduradi Lepa QS-ext directly appled twice daily 10. Kaphapittajah (Dadru, Charmadala, Pama, Kacchu, Shataru) Arogyamishranam** 0.5-1gm Manjishthadi Kvathah Antarabhakta mtwice daily Gandhaka Drutih 2-5 drops Godugdha Antarabhakta mthrice daily 11. Vatapittaja (Ekakushtha, Charma, Kitibha) Gandhaka Rasayanam 0.5-1gm Ghrta and Sharkara Adhobhaktam, twice daily 12. Shvitram Arogyavarddhanee 500-750 mg Ghrta and Sharkara Adhobhaktam twice daily Shashilekha Vati 250 -500 mg Bakuchi taila and Madhu Adhobhaktam twice daily **Arogyamishranam: A mixture of Arogya varddhanee and Chandraprabhaa in equal quantities
  • 77. Popular and time tested rasayogas in dermatological practice • 1. Arogyavarddhanee Vatee: • This is a wonder drug in treating skin diseases. • The presence of ingredients like Katuki, Shilajatu, Tamra Bhasma, Guggulu and Kajjalee made its action multidimensional. • It is Rata shodhaka and Pittasaraka. • It improves digestion and metabolism. • Its hepatoprotective effect, laxative action has made its action unique in the management of multiple types of skin diseases. • It also improves the health of skin. • It is found to be more efficacious when used in early stages of skin diseases.
  • 78. Arogyavarddhanee Vatee: • It is advised to use this product for a period of 48 days (one Mandala) for optimum results • Its main action is on liver and intestines. • It helps to eliminate toxins from the body. • It can be used in any type of skin diseases and in any stage. • But, it may not be so effective when the disease is deep seated, presented with severe excoriation, ulceration and pain where other products are to be essentially added.
  • 79. Gandhaka Rasayana: • This product is a very useful medicine in a variety of dermatological conditions and hence rightly quoted as effective in Ashtadasha Kushtha • Here also most important is the quality of the product which is ensured by strict adherence to the GMP norms by following SOP. • All 83 Bhavana should be properly given.
  • 80. • It is essential to mix the final product with equal quantity of Sita so that it acts as Rasayana and can be used safely in therapeutically effective dose. • This product is highly efficient anti bacterial and immune modulator and can be used in all the types of skin diseases. • However, its efficacy is most appreciated in the conditions like eczema, ecthyma, taeniasis, skin diseases with secondary infections etc.
  • 81. Rasamanikya: • This is a very potent and effective product in treating skin diseases. • Its efficacy is proved even in treating leprosy. • It is an arsenic compound prepared by using Shuddha Patratala. Rasamanikya is an extensively evaluated product chemically, toxicologically and clinically. • It is mainly useful in Vatakaphaja Kushtha. • Its potent antimicrobial and immune modulating effects have made it a drug of choice in treating the conditions like psoriasis, chronic eczema and leucoderma.
  • 82. RASAMANIKYA • Its dose should be 60-120 mg and should always be used with appropriate Anupana like Madhu and Ghrta. • It can be divided into accurately divided dosage packets and dispensed to the patient or it can be homogenously and uniformly distributed in herbal diluents (like Triphala Churna, Guduchi Sattva etc) and used.
  • 83. Laghu Suta Shekhara Vatee: • Chief constituents of this product are Shuddha Gairika and Shunthi. • This product even though is indicated in Amplapitta, is being used popularly by Ayurvedic practitioners in the management of skin diseases. • Gairika is known Pittahara and Rakta prasadaka drug and efficacy of Shunthi in treating Shita Pitta is classically referred and clinically established.
  • 84. Laghu Suta Shekhara Vatee • This product is found to be having potential antihistamine like action and hence being used successfully in treating allergic skin manifestations especially the Urticaria. • It also helps to dry up the secretions quickly. Hence, Laghu Suta Vatee can be effectively employed to relieve the symptoms of itching and discharge in any of the dermatological conditions.
  • 86. SHUDDHA GANDHAKA • Dr. Yogeesha Acharya from SDM College of Ayurveda from the department of Kayachikitsa evaluated the effect of Gandhaka Churna in Vicharchika/atopic dermatitis. • He administered Shuddha Gandhaka Churna at a dose of 500 mg BD, before food with 100 ml of milk as Anupana for 28 days. • Marked relief in clinical symptoms like itching, discharge, pidaka, ruja and discoloration were observed
  • 87. GANDHAKA DRUTI-TAILA • The clinical study suggests that, the use of Gandhaka Druti and Gandhaka Taila in Pama as external application markedly subsidizes lesion and itching. • Thus, Druti and Taila can be safely used in treatment of skin diseases especially in Pama. Shankar Rao. CLINICAL EVALUATION OF GANDHAKA DRUTI AND GANDHAKA TAILA IN SCABIES: A COMPARATIVE CLINICAL STUDY , UJAHM 2014, 02 (01): Page 38-40
  • 88. Title of the Article/ Research work COMPARATIVE CLINICAL EVALUATION OF GANDHAKA DRUTI AND GANDHAKA TAILA IN SCABIES Journal e-Journal Rasamruta | Year : 2013 | Volume : 5 | Issue : 34 | Page : 1-5 Author(s) 1. Dr. Pranit Ambulkar and 2.Dr. K. Shankar Rao The present study is aimed to evaluate the clinical efficacy of Gandhaka Taila and Gandhaka Druti on scabies. For this single blind clinical trial, patients diagnosed for scabies were divided in two groups ‘A’ and ‘B’. Group ‘A’ received Gandhaka Druti for local application and 500mg Gandhaka Rasayana in two divided doses per day internally; while group B received Gandhaka Taila for local application and Gandhaka Rasayana 500 mg in two divided doses per day internally. The duration of study was twenty one days. The subjective and objective observations were evaluated statistically. The results suggested that both the drugs are effective in scabies, but Gandhaka Taila was slightly more effective which is significant statistically.
  • 89. Title of the Article/ Research work EFFICACY OF GANDHAKA YOGA IN PAMA - A CLINICAL STUDY Journal e-Journal Rasamruta | Year : 2011 | Volume : 3 | Issue : 47 | Page : Author(s) 1.Dr. Sanjay B. Sawal, 2.Dr. S. S. Vaidya, 3.Dr. R. S. Hiremath, 4.Dr. Vikas Saroch, Gandhaka yoga included main drugs as Gandhaka (sulphur), Sarshapa taila (mustard oil). All the drugs having kushthaghna properties. Scabies (Pama) affects all races and social classes worldwide. To evaluate its efficacy this study was carried out and it reveals the effects of Gandhaka yoga which gives 90% relief in case of itching and exhibit 95% relief in oozing.
  • 90. GANDHAKA RASAYANA • Gandhaka rasayana had an antifungal effect against candida albicans. • MIC and MFD was estimated to be 5ml of BHI broth containing candida albicans Dr. Prasanna kumar et al, IN-VITRO ANTIFUNGAL ACTIVITY OF GANDHAKA RASAYANA, unpublished
  • 91. Reshma M. Saokar et.al, Screening of Antibacterial and Antifungal Activity of Gandhaka Rasayana- an Ayurvedic Formulation , International Journal of Recent Trends in Science And Technology, ISSN 2277-2812 E-ISSN 2249-8109, Volume 8, Issue 2, 2013 pp 134-137 • Results: Gandhaka Rasayana solutions in different concentrations showed a significant zone of inhibition against three strains of bacteria (22-30mm) and four strains of fungi (16-25mm) when compared to Fluconazole (22mm) and control. As Gandhaka Rasayana contains Fe (433.84), Cu (32.77), Ni (10.32) Zn (10.32), Ca (0.84%), Na (0.17%), As (12.14), triclinic cells, carbohydrates, steroids and tannins it may contribute to promote positive health and vigour by increasing the immunity, thus making the body resistant against disease causing factors. • Conclusion: Gandhaka Rasayana showed a significant antibacterial and antifungal activity, but antibacterial activity was significant compared to antifungal activity.
  • 92. • In a clinical study, 15 patients of Psoriasis vis-à-vis Ekakushtha were administered Rasamanikya at a dose of 125 mg with honey and ghee, twice daily for 28 days and the results were highly encouraging with the remission in the symptoms as follows: Aswedanam 90%, Mahavastu 70%, Kandu 100%, Matsyashakalopam 75%. (Srimannarayana et.al.) • There was no elevation of serum arsenic level even after a month’s treatment. RASAMANIKYA
  • 93. • Here, Anupana is very crucial and Rasamanikya has to be administered with honey and ghee. • Mild to moderate fatty changes to liver was significant and decreased liver weight, increased cholesterol and decreased blood sugar level were reported in earlier (D.K.Mishra et al) when it is given with water, in present study it is given with honey and ghee and proven safe. RASAMANIKYA
  • 94. RASAMANIKYA • The present study of antimicrobial activity of Rasamanikya reveals that the drug have got good antimicrobial property against selected microbes. • This study supports the therapeutic potential of the drug as it has inhibited the growth of microorganisms responsible for different diseases. • However, proper understanding of Ayurveda and further developing the appropriate models and parameters for study of pharmacological activities of the Ayurvedic drugs is necessary. Poonam Kumari, RS Hiramath, Antimicrobial activity of Rasamanikya against different pathogenic microbes w.s.r. to skin disease, Anc Sci Life. 2013 Jan; 32(Suppl 2): S11.
  • 95. RASAPUSHPA • Dr Anitha H evaluated the antimicrobial potential of Rasapushpa during her dissertation work carried out at DGM Ayurveda college Gadag. • Rasapushpa had shown mild antibacterial activity but marked antifungal activity
  • 96.
  • 98. • Two sets of medicines:- (1) Shvetari rasa for internal and Gajalindajadi varti for external and (2) Dhatryadi curna internal and Avalguja bijadi varti external was clinically experimented and found effective in this disease. • However , group (2) showed better results
  • 99. Meena M.S. et.al., A Clinical study of Shwitra (Vitiligo), Journal of Ayurveda, VaLl No.1 Jan-Mar 2007,6-38 • Patients of Shwitra (vitiligo) when treated with Shwitra kusthari Rasa and Aargvadhadaya tail have shown best result without producing any side effects. • Therefore, if can be concluded that Shwitra kusthari Rasa and Aargvadhadaya taila therapy is a potent remedy for the managment of Shwitra vis-à-vis vitiligo.
  • 100. YASHADAMRITA MALAHARA • Dr Sobagin M.V. from the department of Rasashastra from DGM Ayurveda college Gadag worked on “The preparation, Physico-chemical analysis of Yashadamrita Malahara and Sindhooradi Taila and comparative clinical study on Vicharchika (Eczema)” • By clinical study and statistical value it is proved that Yashadamrita malahara is choice remedy in sravi Vicharchika and Sindhooradi taila in rooksha Vicharchika
  • 101. Shankha Bhasma in Yuvana Pidika • A combination of oral administration Shankha Bhasma in a dose of 250 mg t.i.d (capsule) and Yuvana pidikahara lepa(Lodhra, dhanya, vacha) was found to be very effective Rameshchandra Arun,Shankha Bhasma evam Yuvana-Pidika Lepa ka Nirmanatmaka evam Yuvana-Pidika Vyadhi par Prabhavatmaka Adhyayan. PG disertation, IPGT and RA, Jamnagar, 2002
  • 102. RASAKARPURA • Dr Suvarna P Nidagundi evaluated the antimicrobial potential of Rasakarpura during her dissertation work carried out at DGM Ayurveda college Gadag, Rasakarpura had shown a less significant activities for all bacteria except E.coli but significant antifungal activity
  • 103. Title of the Article/ Research work THE EFFECT OF RASAKARPURA DRAVA ON KSHUDRA KUSTHA Journal International Journal of Ayurvedic Medicine | Year : 2011 | Volume : 2 | Issue : 2 | Page : 81-92 Author(s) Neky Mehta, 1.B. J. Patgiri, 2.B. Ravishankar, 3.P.K.Prajapati Rasakarpura, a Nirgandh type of Kupipakva Rasayana, used to cure skin disease. Rasakarpura was prepared as per the reference of Rasatarangini 6/65-71. It is prepared with Parada (mercury), Sandra Gandhakamla (concentrated sulphuric acid) and Saindhava Lavana (rock salt) in the ratio of 1: 1 ½ and approx 1 ½ . The clinical study was carried out on 80 patients of Kshudra Kustha by using Rasakarpura Drava (0.1 % solution in distilled water) and same was compared with a standard drug i.e. Gandhaka Malahara. The obtained results of clinical trial suggest that both drugs have highly significant result on the cardinal symptoms of Kshudra Kustha.
  • 104. • Dr Shraddha worked on Rasakarpura Drava prepared from Bhutaghna Chakrika for its antimicrobial activity. • The product was highly effective against both gram positive and negative bacteria, showing better results than standard drugs even after serial dilution. • It was found to be very effective even against MDR strains. • However antifungal action was very mild. RASAKARPURA DRAAVA
  • 105. List of Poisonous substances of mineral origin under Schedule-E6 and some of their aushadha yogas S.No. Name of Drug Chemical Name Aushadhayoga 1. Gauripashana Arsenic Sameerpannag rasa,Mallasindura 2. Haratala Arsenic trispulphide Kasturibhairava rasa, Taalkeshwara rasa 3. Parada Mercury Rasa parpati, Rasa sindoora 4. Rasakarpura Subchloride of mercury Used as formulation itself, Rasakarpura drava 5. Tuttha Copper sulphate Mahamrityunjaya rasa, Jatyadighrita 6. Hingula Cinnabar Hinguleshwara rasa, Anandbhairava rasa 7. Sindura Red oxide of Lead Sinduradilepa 8. Girisindura Red oxide of Mercury Paadadari malhara
  • 106. Important factors related to Rasaushadhi administration: a. Dose (Proper/Lesser/Overdose or excessive dose) b. Time (Appropriate/Inappropriate) c. Mode/Vehicle (Anupana) for drug administration (Appropriate/Inappropriate) d. Diet and Routine management (Pathya/Apathya) e. Shelf life (Saviryata avadhi) f. Processing g. Parameters for Testing h. Identification i. Authentication/Approved variety j. Concept of Prakriti (Constitution) k. Over the counter (OTC) use of Medicines l. Lack of proper Knowledge
  • 107. The risk related to toxic effects of Rasaushadhi can be considerably reduced by use by following: • Good Collection Process (GCP), • Good Manufacturing Process (GMP) • Good Laboratory Practice (GLP) for quality control • Quality assurance for good quality processed medications • Following various guidelines mentioned in Ayurveda classics related to administration of drugs.
  • 108. Factors to be considered while using Rasayoga in clinical practice: • The quality of the product should be ascertained (adequate information about the source of supply including the quality standards maintained by the company should be known) to be confident about the safety and efficacy of the product.
  • 109. • The dose of the drug must be appropriate. • By considering all the factors like classical guidelines, age of the patient, sex of the patient, time of administration, potency of the drug, form of the drug etc, ideal dose is to be fixed to avoid any untoward effects (especially in arsenic compounds). Factors to be considered while using Rasayoga in clinical practice:
  • 110. • A proper vehicle is to be used (honey, ghee, milk, butter, specific herbal juice, decoction etc.) to get desired efficacy and also the safety. eg; if Rasamanikya is given with water instead of honey and ghee (as mentioned in the text) it may show mild toxic symptoms Factors to be considered while using Rasayoga in clinical practice:
  • 111. • Course or duration of the treatment is also crucial in the case of Rasoushadhi. • Some Rasoushadhi (especially arsenic compounds) may have cumulative toxic effects if are used for considerably prolonged period • Pathyapathya mentioned during the administration of particular Rasayoga should be strictly followed. Factors to be considered while using Rasayoga in clinical practice:
  • 112. Summary and conclusion: • The classical references, clinical experiences, pharmacological and clinical studies carried out in various centres have confirmed the efficacy of Rasyogas in dermatological practice. • They have a clear edge over pure herbal formulations especially in treating chronic persisting skin diseases like psoriasis, lichen planus, eczema etc. • This is because of their potency, strong antimicrobial, antihistaminic and immune modulating actions. • Unfortunately, only a limited number of Rasayogas are being used in clinical practice.
  • 113. • It is essential for clinical practitioners to explore the possibilities of using more and more herbo-mineral preparations in treating dermatological afflictions. • However, one should be careful regarding the quality of the product with special reference to SOP of production and final quality specification. • If these are within acceptable limits one need not worry about the safety of the product as several multi centric studies carried out on toxicity of herbomineral products have proved their safety beyond doubt. Summary and conclusion:
  • 114. CONCLUSION rÉjÉÉ ÌuÉwÉÇ rÉjÉÉ zvÉx§ÉÇ rÉjÉÉÅÎalÉUvÉÌlÉrÉïjÉÉ | iÉjÉÉæwÉkÉqÉÌuÉ¥ÉÉiÉÇ ÌuÉ¥ÉÉiÉqÉqÉ×iÉÉåmÉqÉqÉç ||- MüÉ.ÎZÉ rÉÉåaÉÉSÌmÉ ÌuÉwÉÇ iÉϤhÉÇ pÉåwÉeÉqÉqÉ×iÉÉåmÉqÉqÉç | pÉåwÉeÉÇ cÉÉÌmÉ SÒrÉÑï£Çü iÉϤhÉÇ xqmɱiÉå
  • 115. References: • Random House Webster’s Unabridged Dictionary. Random House, Inc. 2001. Page 537. ISBN 037572026. • James, William; Berger, Timothy; Elston, Dirk (2005). Andrews’ Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. ISBN 0721629210. • Marks, James G; Miller, Jeffery (2006). Lookingbill and Marks’ Principles of Dermatology (4th ed.). Elsevier Inc. ISBN 1-4160- 3185-5. • http://dermnetnz.org/dermatologist.html • http://www.aad.org/public/specialty/what.html • http://www.dermcoll.asn.au/public/what_is_a_dermatologist.asp • Devinder Mohan Thappa, Rashmi Kumari, Emergence of dermatology in India, Indian Journal of Dermatology, Venereology and Leprology, Page 86-92, Volume 75, Issue 1, 2009 • Brig YK Sharma, Col MPS Sawhney+, Dermatology : the past Milestones and the future Crosscurrents, MJAFI 2004; 60 : 151- 156 • Brig YK Sharma, Col MPS Sawhney+, Dermatology : the past Milestones and the future Crosscurrents, MJAFI 2004; 60 : 151- 156 • Krishna Gopala Bhatta, hindi commentary by Indradeva Tripathi, Rasendra Sara Sangraha, Chaukhambha orientalia, II edition 1998 • Acharya Vagbhata, Rasa Ratna Samuchaya Hindi translation by Dr. Indradeva Tripathi, Chaukhamba Orientalia, Varanasi • Acharya Sri Madhava, Ayurveda Prakasha, By Shri Gulraj Sharma Mishra And Pandit Shiva Sharma, 4th Edition-1994, Chaukhambha Bharati Academy, Varanasi • Shri Govind Dasa, Bhaisajya Ratnavali By Shri Kaviraja Ambikadatta Shastri Ayurvedacharya, 19thEdition 2008 • Anonymous, Ayurvedic Formulary of India, Part II, 16:53, Second edition, Govt. of India, Ministry of Health and Family welfare, AYUSH dept., 2003 • Krishna Gopala Bhatta, hindi commentary by Indradeva Tripathi, Rasendra Sara Sangraha, 2/3-5, Chaukhambha orientalia, II edition 1998 • Sri Gopala Krishna, Rasendra Sara Sangraha By Dr.Ashok D Satpute 1st Edition 2003 Chowkhamba Krishnadas Academy , Varanasi