Basics: A verse in aSTAGgahRdayam introduces the whole world as a pharmacopoeia that rests on the applicatory acumen of the physician. It says that there is nothing in this world, not even sand and dust, that is non-medicinal. This concept is rooted in the understanding of the constitutional make-up of everything that is “being”, as caused by the five great Elements. The body, the plants, the metals and the minerals are all made of these in proportional variations. Thus we see good physicians using plants, precious stones and cow’s urine with equal regard and efficacy. There is only one category of things that is available in the world – that is medicinal. Metals, like plants, thus become part of Ayurveda pharmacopoeia. Logic: Paracelsus, a Swiss physician, said in the 16th century: “The right dose differentiates between a poison and a remedy”. Ayurveda too advocates the same – a properly used poison acts as ambrosia and improperly-used ambrosia acts as a poison. In the context of mercury, it is told that a pure sample kills death and fever, while an impure one is poisonous. Procedures are then explained to make an impure sample pure and fit to be used as a medicine. The pharmacological information did not just end with the saying that everything in the world is medicinal. It also covered the procedures to make toxic things not only non-toxic, but also medicinally potent.
Ethics: Metals also had lot of mythological significance – gold is considered as the semen of God of Fire, silver as the tears and mercury as the semen of Lord Siva, sulphur as the menstrual blood of Goddess Parvati. This belief, strong in the practitioner, makes him essentially truthful and righteous in preparing and practicing this style of Ayurveda. A flaw in the processing or prescription is believed to bring ill-effect not only to the patient and the physician’s fame, but also to his/her future generations. This worked more like a quality control measure of spiritual dimension. Practice: Out of the 23 heavy metals, Ayurveda uses arsenic, copper, gold, iron, lead, mercury, and zinc commonly. Elaborate procedures- like the general and specific purification processes, incineration processing and biologization - are mentioned in the texts to make them pure, edible and having enhanced potency. Mercury, for example, undergoes eight levels of processing, lasting for weeks, before it qualifies as a medicinally useful one. The final product, bhasma in dust form, undergoes further stringent quality check. This includes checking the particle size and convertibility to metal. Bhasma that is very fine, from which metal cannot be extracted by any means, which ensures complete conversion of the metal to a non-metal form only, is administered. Adaptations of modern technological help in these procedures ensure higher purity and quality.
Traditional quality control is nowhere evident like this as in the case of metallic preparations. Proper guidelines are set in the selection of raw materials, purification, processing and administration.
The guidelines that are strictly followed in the administration are:
Minimal Dose: Such medicines are prescribed in milligrams, and decided based on the strength and age of the patient. Shortest Duration: They are not prescribed for longer period, to avoid any chance even for cumulative effect, as told in the case of chronic exposure. Organic medium: They are administered by mixing with natural organic media like honey, ghee, milk, herbal juices etc that further reduces the risk of toxicity. Rules: AYUSH (Department of Ayurveda, Yoga, Unani, Siddha and Homeopathy, India) issued an order stating that the testing for heavy metals is mandatory for export purpose, in respect of every batch and that the permissible limits of the metals will be as recommended by WHO. (In case of arsenic, cadmium and lead. In case of mercury, the permissible level will be 1 ppm).
Apprehensions: A study “Heavy metal content in Ayurvedic herbal medicine products” was published in the 2004 December issue of the Journal of American Medical Association (JAMA) triggered a fear wave causing a few countries to ban the use of Ayurveda medicines, and many individuals to reject Ayurveda treatment under the wake of suspicion. The impact that the article created persists even after two years. This particular study is refuted thus:
Heavy metals become toxic when they are not metabolized by the body and accumulate in the soft tissues. Finest particles of such preparations when mixed in suitable organic medium will not get indigested or accumulated.
Ayurvedic formulations have synergistic effect; one should not conclude about the effect merely with the presence of 1 or 2 ingredients.
The study was not able to conclusively ascertain the metal’s chemical forms which can impact bioavailability and toxicity, especially so in the case of mercury.
The data is limited and cannot be generalized to all herbal medicinal products.
The study was more on the “quantity” of the metals and not the “quality” – i.e. whether the available quantity is of toxic quality or not.
Painfully, in India, the political and media power, which are supposed to stand for truth, only contributed to strengthen that negative impact.
Truth: Metals that are now “feared” in Ayurveda medicines are also there in Bombay-mix, frozen prawns and Soya sauce. Thimerosal, a mercury containing compound is used a preservative used in vaccines, which are often the single largest source of mercury exposure post-natally. 9,000 chemicals are said to be currently included in the personal care products, without we being sufficiently protected against their potential toxicity. Are we going to stop any of them?
It should be understood that there is nothing that is universally good or universally bad. If improper, the use of even a common food item or plain drinking water can be harmful. It is up to us to understand each from a wider perspective and use them correctly and ethically.
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