Various toxins and cemicals affect the GIT. They are analysed from an Ayurvedic point of view

1. CHEMICALS &
TOXINS AFFECTING
GUT AND
AYURVEDIC
MANAGEMENT

2. Modes of poisoning
• Ingestion (most common),
• Inhalation,
• Dermal contact,
• Envenomation, and
• Transplacental exposure.

3. Ingestion
• Inadvertent, Unintentional,
Exploratory
• Most common in children of age 1-5
years (exploring tendency, pica).
Elder: Suspect child/drug abuse
• Most common toxins: Iron (earlier),
detergent pods
• Triggering factors: Environmental and
familial stress (poor attention, second
baby, etc.)

4. Common toxins in
pediatrics
Pediatric Toxicology; Specialized Approach to the
Poisoned Child, Diane P. Calello, Fred M. Henretig.
Substance category Percentage
Cosmetics and personal care products 14
Analgesics 10
Cleaning products 9
Foreign bodies, toys, and Topical preparations 7
Vitamins, Antihistamines 4
Pesticides, Cold and cough medications, Antimicrobials, Gastrointestinal
medications, Plants
3

5. Special considerations in pediatric
poisoning:
• Higher body surface area/weight ratio,
• Increased skin perfusion & skin hydration → dehydration,
insensible water loss ↑
• High BMR, low reserve → hypoxia, respiratory failure ↑
• Acid-base disturbances ↑
• Poor predictability of impending cardiac failure

6. Presentation Toxin
Cramps OPC, arsenic
Diarrhea Antibiotics, iron, boric acid
Constipation Narcotics, botulism, codeine, lead
Hematemesis Corrosives, iron, salicylates and aminophylline
Oral and Gastrointestinal presentations of
toxins
Presentation Toxin
Dry mouth Anticholinergics, antihistamines, amphetamines
Salivation OPC, corrosives, salicylates
Burns Corrosives, oxalate-containing plants

7. Toxidromes/Toxic syndromes
(Category-specific symptoms of poisons)
IAP Textbook of Pediatrics Seventh Edition, Chapter 17, 17.2

8. Toxidromes
and lab
findings

9. Approach to a poisoned child:
Diagnosis
History
Physical examination
Toxidrome identification
Airway
Breathing
Circulation
Decontamination
Enhanced elimination
Focused therapy
Get toxicology center help
Poisoned child

10. Removal of toxin from GIT: Western
methods
Method Drug used Contraindications
Emesis Ipecac syrup Corrosives, hydrocarbons, sharp
foreign bodies, low Glasgow
score, <6 months
Gastric lavage Cold water Hydrocarbon poisoning
Whole bowel irrigation Polyethylene glycol Perforation and ileus
Activated charcoal Wood, coconut, petroleum Ileus, intestinal obstruction
(ineffective in heavy metals, iron,
hydrocarbons)
• Followed by Antidote specific therapy

12. Normal
substances
attaining
Viṣatva

13. • Atisāraṃ (Āśukāri)
• Grahaṇī (Cirakāri)
• Arśas (Structural > Functional)
• Udāvartaṃ (Structural <
Functional)
• Chardiḥ
Āmaṃ, Ajīrṇaṃ
Gulmaṃ,
Alasakaṃ
Viṣūcikā
GASTRO-INTESTINAL PATHOLOGIES IN AYURVEDA

14. • Śamana
• Pratyauṣadha
• Śodhana
• Annarakṣā
• Viṣa-lakṣaṇa
Prevention,
screening
(Toxin-
focused)
Detoxification
(Body-
focused)
Pacification
(Body-
focused)
Antidotes
(Toxin-
focused)
ROLE OF AYURVEDA

15. Prevention of food poisoning:
Food screening: Annarakṣā
• Change from normal morphological features: Smell, taste, etc.
• Fast ripening, decaying too fast (now even too slow!)
• Formation of lines, bubbles, etc. in food.
• Child focused:
• Proper parenting, training and resolving mouthing at earliest.

16. Symptoms of
Āmāśayagata Viṣa &
Management
Clinical features:
• Mūrccha, Chardi, Atisāra, Ādhmāna,
Dāha, Vepathu, Indriyavaikr̥tya
Management
• Vamana
• Alābu, Vilva, Kośātakīphala, Dadhi/
Udaśvit/ Taṇḍulāmbu
• (Su. Ka. 1/41)

17. Symptoms of Pakvāśayagata
Viṣa & Management
Clinical Features:
• दाहं, मूर्च्ाा, अतीसारं, तृष्णा, इन्द्रियवैकृतम्, आटोपं, पाण्डुता, कार्श्यं
Management
• Virecana with Nīlinīphala and ghr̥ta
• Dūṣīviṣāri with Dadhi or Madhu

18. • Practical Virecana in children: Anulomana/Koṣṭhaśuddhi
• पानीयं वाऽल्पकं शृतम्|
• धारयेन धारयशुण्ठीभयां कण्टकाररकयाऽथवा||८६||
• अरते भक्तस्य मध्ये वा वातवर्चोनुलोमनम्| (A. Hr̥. Arśa cikitsā)
• Āragvadha – Koṣṭhaśuddhikaraṃ paraṃ, indicated from 4-12 yrs.
• Harītaki

19. Measures and recommendations
• हृदयावरणं – Important measure to be
adopted
• Ghee, curd, milk, honey, cold water.
• Grain: Śāli, Kodrava, etc.
• Vegetables: Paṭola, Kūśmāṇḍa, Kāravella
• Fish: Pickerel, others must be avoided
• Meat: Birds (cuckoo, peacock, etc.)

20. Etiology of developing Dūṣīviṣa
• Appropriately but incompletely treatment of poisoning
• Chronic, unidentified toxin ingestion
• Mild toxins, accumulating over time
• Seasonally, regionally manifesting toxins

21. Spectrum of clinical presentations:
Dūṣīviṣa
• General: Recurrent fever, extremity edema, emaciation,
ascites
• GIT disorders: Indigestion, anorexia, abdominal distension,
vomiting, diarrhea
• Dermatological: Skin rashes, discoloration, urticaria, psoriasis
• Behavioral issues, speech issues, other Dhātukṣaya
presentations, etc.
• General features: Āmāśaya: Kapha-Vāta, Pakvāśaya: Vāta-Pitta

22. Management of Dūṣīviṣa
• Svedana
• Vamana and Virechana
• Dūṣīviṣāri Agada with honey

23. Pediatric specialties in Viṣacikitsā
Ārogyakalpadruma has a separate section of Pediatric
toxicology
• श्वेतपारन्द्रतकामूलं क्षीरे न्द्पष्ट्वावलोन्द्लतम् । त्र्यक्षयाा नीलकण्ठस्य संजप्तं गरनाशनम् ॥
• Vamana → Urdhvakāya and Virecana for Adhaḥkāya.
• Features difficult to deduce, hence
• Nīlī (Indigofera tinctoria) ground in milk applied over
abdomen.
• If it fails to dry above abdomen – Viṣa is located at Āmāśaya,
vice versa.
• For lower age groups, Śamana is the most feasible option.

24. Pacification (Śamana)
Specific formulations Commercially available substitute
Niśādvaya + Taṇḍulīyaka + Gr̥hadhūma Rajanyādi cūrṇa
Hiṅgu + Saindhava + Arkapatra Hiṅgvaṣṭaka cūrṇa
Nīlī (Indigofera tinctoria) + Kṣīra -
Harītakī + Lodhra + Nimba + Hiṅgu -
Single drugs with Viṣahara properties
Kaiṭarya (specific for Gut) Mañjiṣṭhā
Śirīṣa Ativiṣā
Tulasī Rāsnā

25. Formulations
Kaṣāyas
• Paṭolakaṭurohiṇyādi
• Āragvadhādi
• Pāṭhākarañjādi
Guṭikās
• Vilvādi
• Dūṣīviṣāri
Cūrṇa
• Rajanyādi
• Hiṅgvaṣṭaka
• Avipatti

26. Antidotes or Pratyauṣadhas
• General principle: Śodhana dravya for the toxin can be used
Specific:
• Mercury containing: Kūśmāṇḍa rasa/Jambīra rasa+ Sita
• Sulphur containing: Candana + Takra
• Iron: Triphalā/other therapeutic Amla dravyas
Pica:
• Wall flakes – Eraṇḍa taila + Stanya
• Rice – Kaiṭarya, Saindhava, Śuṇṭhi

27. Rasa-wise general antidotes
Rasa of toxin Antidotes
Madhura Trikaṭu
Amla Śuṇṭhi, Ela, Sitā
Lavaṇa/Kṣāra Kṣīra, Sitā
Kaṭu Ghr̥ta, Sitā
Tikta Drākṣā phala
Kaṣāya Yavakṣāra

28. SWOT Analysis of Ayurveda’s possibilities
• Strengths:
• Chronicity, Dūṣīviṣa
• Avega conditions, mild vegāvasthas
• Safe Śodhana methods and natural antidotes
• Weaknesses:
• Toxin-specific diagnosis, Vegāvasthā, Emergencies

29. THANK YOU!