|Year : 2022 | Volume
| Issue : 2 | Page : 120-126
Synoptic review on Amavatari Rasa: A herbomineral formulation for rheumatoid arthritis
Sonam S Bhinde, Biswajyoti J Patgiri
Department of Rasa Shastra and Bhaishjya Kalpana Including Drug Research, ITRA, Jamnagar, Gujarat, India
|Date of Submission||03-Feb-2022|
|Date of Acceptance||03-Mar-2022|
|Date of Web Publication||28-Jun-2022|
Sonam S Bhinde
Department of Rasa Shastra and Bhaishjya Kalpana Including Drug Research, ITRA, Jamnagar 361008, Gujarat
Source of Support: None, Conflict of Interest: None
Amavatari Rasa (AR) is a well-known Kharaliya Rasayana that is frequently used in various diseases including Amavata (rheumatoid arthritis). AR has not been mentioned in Bruhattrayi and described by Rasendra Chintamani by Dhundhukanatha in 15th century for the first time, and amended for many times till today. Because of its efficacy and demand in clinical settings, many pharmaceutical companies are preparing this formulation and easily available in the market. But it is important to know details of the medicines one using in their clinical practice. This study was planned to get thorough idea related to its composition, method of preparation, therapeutic uses, organoleptic and physico-chemical parameters through various references. Various Rasa classics having same ingredients of AR or having name as Vatari Rasa or AR with different ingredients were reviewed. Rasapanchaka (Ayurveda principles of drug action) and Dosha Karma (therapeutic action) of ingredients were compiled from Bhavaprakash Nighantu. Available published articles were searched through Research gate, J-gate, Google scholar, Dhara and Pubmed for its organoleptic and analytical parameters. It was found that AR has been described in 12 classical texts. Among these texts, AR has been mentioned by different names and ingredients in nine texts. Dose for AR is given as 6 Gunja (750 mg), whereas Vatari Rasa is given as 1 Karsha (12 g). Difference in Anupana (liquid to be taken along with medicine) was also found in Vatari Rasa and AR. Screening through various texts revealed that references related to AR are available in 12 texts with few modifications inferring its efficacy in mentioned diseases since many years. This work may prove a torch bearer for future research works on Amavatari Rasa.
Keywords: Amavatari Rasa, Gutika, Kharaliya Rasayana, Rheumatoid arthritis, Vati
|How to cite this article:|
Bhinde SS, Patgiri BJ. Synoptic review on Amavatari Rasa: A herbomineral formulation for rheumatoid arthritis. J Indian Sys Medicine 2022;10:120-6
| Introduction|| |
Metals and minerals are the integral part of Ayurvedic therapeutics and in vogue since ages. Rasashastra is one of the advanced branches of Ayurveda that deals with the conversion of metals and minerals into Rasaushadhi (herbomineral drug). They are prepared by different methods and Kharaliya Rasayana is one among them. Amavatari Rasa (AR; mercury-containing herbomineral drug) is a type of Kharaliya Rasayana, which is being used as a drug of choice for the management of Amavata (rheumatoid arthritis). It is being manufactured by many good manufacturing practice-approved pharmaceutical companies such as Arya Vaidya Nilayam, Baidyanath, Dhootapapeshvara, and Patanjali in the commercial market since long. AR has been first described in Rasendra Chintamani by Dhundhukanatha in fifteenth century AD. It helps in the management of Ama (undigested food), which is the prime cause of arthritis.
It is important to know thoroughly about the medicine used by a doctor to cure the disease properly. Hence, this article aimed to get a thorough idea related to its composition, method of preparation, therapeutic uses, and organoleptic and physicochemical parameters through various references.
| Materials and Methods|| |
A review of various classical texts was carried out to find out the classical references of AR. References of AR and Amavatari Vati (AV) were found and compiled from Rasendra Chintamani, Rasendra Kalpadruma, Rasaratna Sammuchaya, Rasakamdhenu, Bhaishjya Ratnavali, Rasendrasambhava, Rasajalanidhi, Bharatbhaishjya ratnakara, Sahastrayoga, Rasayogasagar, Ayurvedasarasangraha, and Ayurvedic Formulary of India. Reference of Bhaishajya Ratnavali was considered as a standard comparator as it is adopted in AFI.
Along with the review of AR, Rasapanchaka (Ayurveda principles of drug action) of its ingredients and Dosha Karma (therapeutic action) were compiled from Bhavaprakasha Nighantu.
For organoleptic and physicochemical parameters of AR, original research articles were searched from Research gate, J-gate, Google Scholar, Dhara, and PubMed with keywords Amavatari Rasa or Vatari Rasa. One article was found to have these parameters.
| Result and Discussion|| |
History of formulation
This formulation is not described in Bruhattarayi. Rasendra Chintamani (fifteenth century) has described this formulation under the name of AR for the first time. But this formulation appears in Rasaratna Sammuchaya (thirteenth century) by the name of Vatari Rasa. Later on Rasendrasara Sangraha (sixteenth century), Rasendrakalpadruma (sixteenth century), Bhavaprakasha (sixteenth century), Rasakamdhenu (sixteenth century), Bhaishajya Ratnavali (eighteenth century), Rasendra Sambhava (twentieth century), Rasajalanidhi (twentieth century), Bharat Bhaishajya Ratnakara (twentieth century), Sahastra yoga (twentieth century), Rasayoga Sagar (1927–1930), Ayurveda Sarasangraha, and AFI have described this formulation. This formulation has been named as Amavatari Vati-2, Amavatari Vati, Vatari Rasa, AR, Amavatari Gutika and Amavatari Vatika by these texts. It is mentioned with four different Anupana such as Eranda Taila, Erandmula Kwatha, lukewarm water, and Sunthi Kwatha. Changes in names, Anupana, dose and indication appeared in different texts have been mentioned in [Table 1].
References of different formulations composition under the name of Amavatari Rasa/Vati/Vatika: Preliminary it was found that there are multiple references in Ayurveda classics regarding AR. But after critical review, it was found that there are many variations. AFI-accepted AR was introduced in the classics by Rasendra Chintamani in fifteenth century AD with the name of Amavatari Vati-2. After that, many texts have given the same formulation with same or different name and some texts have given the name AR with different formulation as well. It is mentioned with three different set of the ingredients among them 1 is devoid of parada, still is named as AR.
These differences might be due to very popular name “Amavatari = Amavata (rheumatoid arthritis) + Ari (enemy),” the drug which cures the Amavata. Mercury being the important ingredient of this formulation, Rasa is being used as a suffix. During review, it was observed that few texts have different ingredient than AFI but still has given the name as AR/Vati/Vatika [Table 2].
|Table 2: Various references of Amavatari Rasa/Amavatari Vati having variations in ingredients|
Click here to view
Composition of AR
AFI-accepted AR comprises Shuddha Parada (processed mercury), Shuddha Gandhaka (processed sulfur), Haritaki (Terminalia chebula Linn.), Bibhitaki (Terminalia bellirica Linn.), Amalaki (Embelica officinalis Linn.), Shuddha Chitraka (Plumbago zylenica Linn.), Shuddha Guggulu (Commiphora wightii (Arn) Bhandari), and Eranda (Ricinus communis Linn.) Taila [Table 3].
This is to be prepared by Kharaliya method of preparation and hence end product remains in powder form.
Basic method of the preparation of AR
AR contains mercury as metal, Gandhaka as a mineral and other herbal drugs. It includes four major processes. The first process includes Shodhana of Parada, Gandhaka, Chitraka and Guggulu. In the second process, preparation of Kajjali by triturating Shodhita Parada and Shodhita Gandhaka, and preparation of the powder of Shodhita Chitraka, Guggulu, and Triphala. In the third process, mixing of Kajjali, Triphala powder, Chitraka powder, and Guggulu powder until it becomes homogenous. In the fourth step, addition and trituration of castor oil with powder mixture until it becomes saturated with oil. During AR preparation, the idea of Bhavana (with Eranda Taila) is to convert the free elements into compound form that have left during trituration of dry powders. It may also add some organic and inorganic trace element into the final compound to enhance therapeutic qualities of the compound. This mixing mechanism can be compared with geometric dilution.
It is important to notice that, during preparation of AR, Chitraka should also be used after Shodhana only. As per previous research, plumbagin percentage increases from 0.39% to 0.98% after Shodhana with Churnodaka. This result might be achieved because, plumbagin is soluble in alcohol, acetone, chloroform, benzene, and acetic acid and classical method is having water-based (Churnodaka) purification process and hence it spares plumbagin content and even increases the purity by removing impurities and unwanted water-soluble contents of Chitraka. Plumbagin is also proved to possess anticancer, antioxidant, and anti-inflammatory activity.
Rasapanchaka and Dosha Karma of ingredients of AR
Ingredients of AR and their Rasapanchaka (Ayurveda principles of drug action) and Dosha Karma (therapeutic action) are depicted in [Table 4]. Maximum Dravyas of this formulation possesses Ushna Virya, Madhura Vipaka. The source of the Rasapanchaka and Dosha Karma is Bhavaprakasha Nighaṇṭu except for Parada and Gandhaka [Table 4].
Ushna Virya and Madhura Vipaka of AR might be working to improve the reduced digestion (Mandagni) and impaired Vata, respectively, in patients of Amavata.
Published research works on AR
Total eight articles were found, out of which four were clinical, one was case study, one was pharmacognostical and pharmaceutical, and two were pharmacological study related [Table 5].
Available four clinical studies and a case study showed efficacy and safety of AR in Amavata. It was also observed by Bhat et al. that AR given with Valuka Sweda has more efficacy than alone AR. It was observed that AR without mercury is less effective than classical AR in the management of Amavata by Bhinde et al. This type of clinical study proves the safety and need of mercury in Rasa Shastriya preparation.
Bhinde et al. observed that organoleptic features of fine powder of AR were within the standard range. Loss on drying (LOD) was 0.5% w/w, total ash was 14.5% w/w, acid insoluble ash was 3.5%w/w, and pH 6.5 was obtained. High-performance thin-layer chromatography (HPTLC) showed a difference in results when the sample scanned at two wavelengths, that is, 254 nm and 366 nm having 14 and 12 spots, respectively. This shows the presence of definite phytochemicals in the powder and is helpful for the easy separation of these constituents.
Abhilasha et al. concluded that AR in Group V (2 TED) is more significant when compared to AR in Group IV (TED), which indicates that increasing the dose by two times improves the clinical outcome in Animal study. The factual evidence obtained by this experimental study concluded that this drug is having significant anti-inflammatory activity. Balkrishna et al. concluded that DAR (Divya Amavatari Rasa) is capable of reducing RA-related inflammation and associated clinical symptoms. Although synthetic drugs may produce rapid relief from RA-associated edema and pain, their long-term usage and effects on health have been always questionable. On the contrary, herbal formulations may have milder efficacious effects in modulating disease-associated symptoms; however, due to their nature-derived origin, and long-term historical use, no adverse effects are expected. In these lines, DAR presents a safer and more efficient therapeutic alternative treatment of RA disease.
These two pharmacology studies explored the biocompatibility, anti-inflammatory, and anti-arthritic efficacy of AR on animal models.
Need of further study
This review showed that AR is evaluated through preclinical and clinical studies for its efficacy but safety evaluation is not available till date. AR being mercury-containing herbomineral drug is very crucial to establish its quality parameters by its thorough evaluation through various physicochemical parameters with sophisticated tests such as ICPAES, CHNSO, FTIR, and LCMS. Although recent gazette indicated 5 years of shelf life for Rasa Yoga containing herbal drugs and Guggulu, specific shelf life of AR is still not available, and hence it is to be evaluated in future work.
| Conclusion|| |
AR was introduced by Rasendra Chintamani in Ayurveda pharmaceutics and this was repeated thereafter in various texts. Acharya had amended the basic formulation composition with different ingredients in different disease conditions accordingly, which indicates its clinical acceptance and efficacy. By keeping Bhaishajya Ratnavali as a standard comparator, difference in name, ingredients, Anupana and indications were noted in various texts. Most of the ingredients in AR have Vatakapha Shamaka and Tridoshahara properties, making them effective in the treatment of rheumatoid arthritis. Available clinical studies and case study showed efficacy and safety of AR in Amavata. Available two pharmacology studies explored the biocompatibility, anti-inflammatory, and anti-arthritic efficacy of AR on animal models. Hence, this review might help the clinician and researcher to get through idea of AR and pave the way for future study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]