Cardiac poison- which affects the heart directly and indirectly. Upavishas and Mahavisha in Ayurveda.

1. CARDIAC POISON
Dr. ANU MARIAM VARGHESE
1st MD Scholar
Dept. of Agadatantra
Govt. Ayurveda College TVM

2. CARDIAC POISON
• Cardiotoxic plants come under the systemic type in the classification of poison. The
cardiotoxic plants are
• Aconite
• Oleander
• Suicide tree (Odollam)
• Yew
• Azalea
• Death camas
• False hellebore
• Forglove
• Lily of the valley
• Meadow saffron
• Mountain laurel
• Rhododendron

3. • Among these Oleander(Karaveera), Aconite(Vatsanabha), Suicide tree
(Odollam) ,Digitalis are generally seen here in India.
• In our nigandus and in the Rasagranthas these are classified under the group
Upavisha and Mahavisha.

4. MAHAVISHA
In Bhava-Prakash Nighantu ,Raja Nighantu and Rasaratna Samuchayam,
five types and in Rasatarangini , nine types of mahavisha are mentioned.
Sringikam kalakootam cha vatsanabham cha sakthukam
Pitham cha vishavargo ayam sa vara: parikeerthitha: II
(RRS)

5. UPAVISHA
Upa means Samana or Tulya to visha or establishing its properties as quickly as visha.
Sub-poisonous plants comes under upavisha group, there were no indication about
these upavisha in treatise of samhithas period. Detailed description about these plants are
getting from Rasa literature and Nighantus.
In the Bhava-Prakash Nighantu & Rasaratna Samuchayam, seven types and in
Rasatarangini , eleven types of upavisha are mentioned.

6. “Arkaksheeram snuhiksheeram langalin karaveerkah
Gunjaahipheno dhaturah saptopavishajayah”
(BP)
“Langali vishamushticha karaveero jaya thatha
Neelaka kanako arkasya vargo hi upavishathmaka”
(RRS)
“Vishathindukabheejam tu ahiphenacha rechakam
Dhatturabheejam vijaya gunja bhallatakahvaya
Arkasheeram snuhiksheeram langali karaveerakam
Samakhyatho gano ayam tu bhudairupavishabhidha:”
(RT)

7. Name : Karaveeram
Class Adhishtana : Cardiac poison
Name in Sanskrit : Karaveeram Malayalam : Arali
Botanical name : Nerium indicum Family : Apocynaceace
Morphology
General : Large evergreen ornamental shrub
Leaf &Stem : Long lanceolate leathery leaves.
Flower & Fruit : Clusters of pink or white flowers, cylindrical fruit capsule
Seed & Root : Numerous seeds

8. • Poisonous Parts(s) : All part especially the root
• Chemical Constituents : Oleandrin, Neriin, Folinerin, Rosagenin,Digitotoxin
leaves contain oxalate crystals
• Fatal dose : 5-15 leaves, 15g of root, 8-10 seeds
• Fatal time : within 24 hrs
• Toxic symptoms : Nausea, Vomiting, Gastro intestinal symptoms, Tachycardia,
ventricullar fibrillation, AV blocks, Drowsiness, Coma, Death
due tocardiac failure.
• Treatment : Stomach wash, ECG monitoring & BP , correction of
electrolyte & fluid balance, Syumptomatic treatment.

9. • Antidote : Milk with sugar,Hareetaki
• Postmortem signs : No specific features, GI tract mucosa is congested,
petechiae are often seen on heart, results putreifaction so
can be easily identified
• Detoxification Method : Roots were boiled in cow’s milk for 3 hrs in dolayantra
then washed in hot water.
• Medical Dose : Root powder 30-150 mg(Tincture 10-15 chops)
• Ayurvedic formulations : Karaveeradi tailam- Syphilitic ulcers, skin diseases. Karaveeragadam-Sarpavisha
prathishedam -AH
• Ayurvedic Properties :
Rasa : Katu, thikta Guna : Laghu,rooksha
Veerya : Ushna Vipaka :katu
Prabhava : Karma : kaphvatahara

10. Name : Karaveeram
Class Adhishtana : Cardiac poison
Name in Sanskrit : Karaveeram Malayalam : Arali
Botanical name : Cerbera thevetia Family : Apocynaceace
Morphology
General : Large evergreen ornamental shrub
Leaf &Stem : Longish(about 15 cm long) pointed leaves yeilding a milky sap.
Flower & Fruit : Yellowish funnel-shaped flowers, diamond or clam shaped fruit.
Seed & Root : 2-4 seeds in its stony inner section

11. • Poisonous Parts(s) : All part especially seeds and root, more toxic than white
oleander
• Chemical Constituents : Cerberin, Nerifolin, Peruvoside, Ruvoside, Thevetin A&B
• Fatal dose : 15-20g of root, 8-10 seeds
• Fatal time : within 24 hrs
• Toxic symptoms : Bradycardia with AV block, hypotension, lethargy, dizziness,
GI stress, Convulsions, electrolyte disturbances, coma
• Treatment : Stomach wash, ECG monitoring & BP , correction of
electrolyte & fluid balance, Symptomatic treatment.

12. • Antidote : Milk with sugar,Hareetaki
• Postmortem signs : No specific features, GI tract mucosa is congested,
petechiae are often seen on heart, results putreifaction so
can be easily identified
• Detoxification Method : Roots were boiled in cow’s milk for 3 hrs in dolayantra
then washed in hot water.
• Medical Dose : Root powder 30-150 mg(Tincture 10-15 chops)
• Ayurvedic formulations : Karaveeradi tailam- Syphilitic ulcers, skin diseases. Karaveeragadam-Sarpavisha
prathishedam -AH
• Ayurvedic Properties :
Rasa : Katu, thikta Guna : Laghu,rooksha
Veerya : Ushna Vipaka :katu
Prabhava : Karma : kaphvatahara

13. Name : Vathsanabhi
Class Adhishtana : Cardiac poison
Name in Sanskrit : Vatsanabi Malayalam : vatsanabi
Botanical name : Aconitum ferox Family : Rananculaceae
Morphology
General :Annual or Perennial 2-6 feet shrub
Leaf &Stem : Dark green like Vitex negundo
Flower & Fruit : Blue coloured with terminal spike of helmet shape
Seed & Root : Dry root is conical, tapering shriveled with longitudinal wrinkles. 5-
10 cm long, 1-2 com thick

14. • Poisonous Parts(s) : All parts, but the root is most toxic
• Chemical Constituents : Pseudoaconite, Aconine, Nepelline,hypoaconitine,
mesoaconitine.
• Fatal dose : 4mg of Aconite, 1g of root Fatal time : 6hrs
• Toxic symptoms : Leaves& flowers are handled-tingling &numbness
• Treatment : Stomach wash, Animal charcoal is given, Atropine 5mg
to 1 mg administration, symptomatic treatment.
• Antidote : Milk/Ghee. Triphala Kashaya or Maricha Kashaya.
• Postmortem signs : mucosa of GIT congested, petechiae are often seen in
heart
• Detoxification Method : Cut into small pieces and put in Gomutra for 3 days
and keep in sunlight. This should be changed daily.

15. • Medical Dose :Purified 15mg [children and pregnant should not
be used]
• Ayurvedic formulations : Nabinirvishadi gulika- jyotsnika
• Ayurvedic Properties :
Rasa : Madhura Guna :Laghu, Rooksham
Veerya : Ushna Vipaka :Madhura
Prabhava : Karma : Kapha-Vatahara

16. ODALLUM
Name : Odallum
Class Adhishtana : Cardiac poison
Name in Sanskrit : Malayalam : Othalanga
Botanical name : Cerbera odallum Family : Apocynaceae
Morphology
General : Small plant or shrub that grows wild all over India.
Leaf &Stem : Leaves are dark-green, fleshy and lanceolate.
Flower & Fruit : fruits resembles unripe mangoes.flowers are white like jasmine
Seed & Root : Seed is flattened and ovoid and contains two kernels

17. • Poisonous Parts(s) : Kernel of fruit
• Chemical Constituents : Cerberin, cerberetine.
• Fatal dose :kernel of one fruit Fatal time : 1-2 days or more
• Toxic symptoms : Nausea,vomiting, hyperkalemia, severe retching
Sinus bradycardia, ECG abnormalities,collapse and
death from heart failure
• Treatment :Stomach wash, Atropine 5 mg, correction of
electrolyte & fluid balance, Symptomatic treatment.
• Antidote :
• Postmortem signs : Eyes congested,Lungs congested and oedematous
subepicardial,sunendocardial and subpleural petechia.

18. DIGITALIS
Name : Digitalis
Class Adhishtana : Cardiac poison
Name in Sanskrit : Hritpatri Malayalam : Hritpatri
Botanical name : Digitalis purpurea Family : Plantaginaceae
Morphology
General : Herbaceous biennial shrub grows in the colder region.
Leaf &Stem : Leaves are ovale, lanceolate
Flower & Fruit : Flower yellowish white, Fruits small containing plenty of seeds.
Seed & Root : Plenty of seeds

19. • Poisonous Parts(s) : Allpart are poisonous
• Chemical Constituents : Digitoxin, digoxin, digitalin, digitonin(glycosides)
• Fatal dose :15-30 mg. of digitalin,4 mg digitoxin,leaf 2 mg
• Fatal time :1-24 hrs
• Toxic symptoms : Anorexia, Nausea,vomiting,ventricular tachycardia and fibrillation
headache, fatigue, transient amblyopia, death from CV Collapse
• Treatment :Stomach wash, Bowels should evacuated, Potassium salts to reduce
tachyarrhythmia, Trisodium EDTA lower serum calcium.
Activated charcoal repeated doses, Symptomatic treatment.
• Antidote :
• Postmortem signs : Not characteristic, slight inflammation of gastric mucosa and
fragments of leaves may found in alimentary canal.

20. THANK YOU