Ayurveda consists of many branches of which Agada Tantra is one of them, which deals with toxicology. Any substance which comes in contact with skin gets easily absorbed. So, in case, if any Visha (Toxin) comes in contact then for sure there will be consequences. My aim is to study these Dermatological manifestations occurring due to various Visha. For its management, various formulations are mentioned in Samhita. Among which Panchashirisha Agada is considered to be best in treating any Vishajanya condition. It has both Vishaghna and dermatological properties like Kushthghna, Kandughna, Twachya, Varnya, Shothaghna. It can be used both internally and externally. This review is an attempt to explore the role of Panchashirisha Agada in dermatological toxicity

Dr. Bhargavi S. Lakkakula

Dr. Rajendra D. Lambat

English

Journal of Ayurveda and Integrated Medical Sciences (JAIMS)

                                                      REVIEW ARTICLE Jan-Feb 2021  Journal of Ayurveda and Integrated Medical Sciences | Jan - Feb  2021 | Vol. 6 | Issue 1 279  Role of Panchashirisha Agada in Dermatological Toxicity w.s.r. to Visha - A Review Dr. Bhargavi S. Lakkakula1, Dr. Rajendra D. Lambat2 1Post Graduate Scholar, 2Head of Department, Dept. of Agadtantra Evam Vyavahara Ayurveda, Govt. Ayurved College, Nagpur, Maharashtra, INDIA.                  INTRODUCTION Filters are great, but great skin is better. Isn’t it? Yes beautiful skin has been admired in all the cultures, races and ages since the creation of universe. It is strong and uniform protective covering to the entire surface of the body. It is the largest organ of body forming 8% of the total body mass and its surface area varies with height and weight. It is the major site of contact between body and environment. In Ayurveda, skin is known as Twaka. It is known to be formed by Paka of Rakta Dhatu by its Dhatwagni in foetus.[1] It has Bhrajaka Pitta in it which absorbs any drug applied on it and which controls body temperature. Address for correspondence:  Dr. Bhargavi S. Lakkakula Post Graduate Scholar, Dept. of Agad Tantra Evam Vyavahara Ayurveda, Govt. Ayurved College, Nagpur, Maharashtra, INDIA.  E-mail: bhargavilakkakula15@gmail.com  Submission Date: 27/01/2021 Accepted Date: 18/02/2021 Access this article online Quick Response Code Website: www.jaims.in  Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CC-by-NC-SA Toxin in short is poisonous chemical which alters the normal physiology and leads to deterioration of health. Whenever this toxin enters the body it vitiates Rakta Dhatu mainly.[2] As Rakta and Twaka are connected to each other, effect of Visha on Rakta Dhatu can be directly seen on skin leading to Raktapradoshaj Vyadhi mentioned in Charaka Samhita Sutrasthana. This may further lead to dermatological toxicity. Toxins can enter body in the form of Sthvara Visha, Jangama Visha, Dushi Visha, Gara Visha, Amavisha. Bacterial skin manifestation, drug induced skin toxicity, occupational skin manifestation. This toxicity can be treated only by using Agadas internally and externally. I have chosen Panchashirisha Agada where all five parts of this plant are used; they are fruit, root, skin, flower and leaves. It can be used internally and externally. It is considered as one of the best medicine in treating toxicity. Shirisha has properties like Vishaghna, Kushthaghna, Kandughna, Tridoshahara which shows it has the capacity of treating dermatological manifestation caused due to Vishas. It is also been used in many Vishahara Yogas. This review is an attempt to explore the therapeutic effect of Panchashirisha Agada in skin toxicity. A B S T R A C T  Ayurveda consists of many branches of which Agada Tantra is one of them, which deals with toxicology. Any substance which comes in contact with skin gets easily absorbed. So, in case, if any Visha (Toxin) comes in contact then for sure there will be consequences. My aim is to study these Dermatological manifestations occurring due to various Visha. For its management, various formulations are mentioned in Samhita. Among which Panchashirisha Agada is considered to be best in treating any Vishajanya condition. It has both Vishaghna and dermatological properties like Kushthghna, Kandughna, Twachya, Varnya, Shothaghna. It can be used both internally and externally. This review is an attempt to explore the role of Panchashirisha Agada in dermatological toxicity. Key words: Visha, Shirisha, Panchashirisha Agada. Dr. Bhargavi S. Lakkakula et al. Role of Panchashirisha Agada in Dermatological Toxicity ISSN: 2456-3110                                                       REVIEW ARTICLE Jan-Feb 2021  Journal of Ayurveda and Integrated Medical Sciences | Jan - Feb  2021 | Vol. 6 | Issue 1 280  MATERIALS AND METHODS The references regarding the venomous bites and stings, skin manifestation due to minerals, medicines, etc will be collected from ayurvedic texts and available information and presented in this article. Sthavara Visha ▪ Corrosives: There may be excoriation of lips, corrosive stains on skin, in case of nitric acid skin later appears yellow in colour, there may be necrosis and gangrene of the local area.[3] ▪ Irritants: Erythematous patches, ulcers over affected skin, in case of arsenic poisoning- Rain-drop appearance of skin, Milk and Roses complexion of skin occurs, In case of Mercury poisoning, Pink disease acrodynia occurs, inflammation, oedema, vesication, burning sensation of skin.[4] Jangama Visha Sarpa Visha - Symptoms are mentioned according to Vegas[5,6,7] 1) Darvikara Sarpa - 1st Vega: Vitiation of Rakta Dhatu which leads to blackening of skin; sensation of ants crawling over skin. 2nd Vega: Vitiation of Mansa Dhatu which leads to more blackening of skin, swelling and cysts all over body. 3rd Vega: Secretions oozing out through wound. 2) Mandali Sarpa - 1st Vega: Vitiates Rakta Dhatu which leads to yellowish colour of skin. 2nd  Vega: Vitiates Mansa Dhatu  and locally there is yellowish discolouration, burning sensation and swelling, pain, necrosis , gangrene and appearance of haemorrhage. 3) Rajiman Sarpa - 1st vega: Vitiates rakta dhatu  which leads to hauripulation and whitening of skin. 2nd vega : vitiation of mansa dhatu leading to yellowish discolouration and cusing anasarca. 3rd vega : oozing through wound. ▪ Vrischik Visha -   Local irritation is characterised by redness, burning, pain radiating from the site, urticartia etc.[8] ▪ Alarka Visha -  Locally loss of sensation , blackish discolouration of blood, itching, burning sensation, discolouration of skin, swelling, cysts etc occurs.[9] ▪ Keeta Visha - Pricking pain and throbbing pain at the site of bite. Oozing of sensation, burning sensation, Visarpa, sometimes resembling of wound as Pakva Udumbar.(10) ▪ Mushaka Visha - Granthi, Shopha, Karnika, Mandala, Kitibha, Visarpa etc  [11] ▪ Loota Visha -  Kotha, Alpa Kandu, Shotha.[12] Dooshi Visha Poisons which constantly vitiates Rasa-Raktadi Dhatu due to the factors like Desha, Kala, Anna, Divasvapa etc is said to be Dushi Visha.[13] Whenever inanimate, animate or artificial poison doesn’t get eliminated from the body because either its old or remains in the body for longer time or whose poisonous potency is reduced due to anti-poisonous drugs is known as Dooshi Visha. Because of its low potency it cannot cause sudden death as it is enveloped by Kapha Dhatu.[14] Acharya Charaka  mentioned symptoms like Rakta Dhatu vitiation, Kitibha, Kotha, Kandu on skin.[15] Acharya Sushrut mentioned Mandala, Kotha, Asyashopha, Vaivarnya, Kushtha.[16] Vast concept of cosmetic poisoning comes under cumulative poisoning which can be correlated with Dooshi Visha. Chemicals accumulate over a period of time causing side effects leading to cumulative poisoning. For example Hydroquinone used in skin lightening is carcinogenic as it includes mercury in it. Many cosmetics cause dermatitis, skin infection and lower immune system. Gara Visha It is formed by combination of 2 or more than 2 poisonous or non-poisonous drugs which affects the body by vitiating the Doshas by acting fast or slow. It is mentioned in Samhita that human waste like Sweda, Artava, powder of insects, Virudh Aushadh Bhasma used to produce Gara Visha along with food. Gara Visha Adhisthana can be Anna, Pana, Dr. Bhargavi S. Lakkakula et al. Role of Panchashirisha Agada in Dermatological Toxicity ISSN: 2456-3110                                                       REVIEW ARTICLE Jan-Feb 2021  Journal of Ayurveda and Integrated Medical Sciences | Jan - Feb  2021 | Vol. 6 | Issue 1 281  Dantakashtha, Kasaya, Nasya, Dhuma, Anulepana, Utsadana, Parisheka, Anjana, Vastram, Shayya, Paduka and dermatological symptoms occur according to Adhishthana.[17] Aamvisha Viruddh Ahaar, Adhyashan, Ajirna are the causes of Aamvdosha which further leads to Aamvish and its symptoms are Vishaj.[18] Generally food whose qualities are similar to the qualities of Sharirik Dosha and opposite to Dhatu vitiate Strotas.[19] and indirectly disturbing Raktavaha Strotas. Viruddh Ahaar, Adhyashana, Ajirna leads to vitiation of Raktadhatu causing Raktapradoshaj Vyadhi.[20] Occupational Hazards Food service, cosmetology, health care, agriculture, cleaning, painting, mechanics, printing, construction are some of the occupations in which dermatological manifestations can occur. Occupational dermatitis is one of the major health problems with an estimated annual incidence of 1.89 mill/yr. example: pesticide related dermatitis, cement dermatitis, ulceration in industry workers etc.[21] Drug Induced Skin Disorders There are many drugs which shows skin manifestation such as – Erythematous eruption due to penicillin, anticonvulsant etc. Urticaria due to – NSAIDS, anticancer drugs. Vasculities – NSAIDS, Cephalosporins, sulphonamides, methotrexate etc.[22] Bacterial Infection of Skin Staphylococcus aureus is the most common cause of cutaneous and systemic infections. Impetigo, the most common bacterial infection in children. Dermal infection like erysipelas, cellulitis, necrostising fascitis.[23] Use of Shirisha in various Jangam Visha ▪ Snake poisoning - black pepper powder with Shirish flower juice for 7 days.[24] ▪ Rat poisoning - Shirish extract. Flower, fruit and bark with honey.[25] ▪ Topical application of paste prepared from Shirish Beej, Pippali, Arka is used in snake bite, spider sting, insect poisoning, rat poisoning and scorpion sting.[26] Gunadharma of Shirisha[27] Rasa Tikta, Kashaya, Madhura, Katu Guna Laghu, Tikshna, Rukshana Virya Sheeta Prabhava Tridosha, Properties of Shirisha In different Samhitas[28] Dhanvantari Nighantu  Described in Amradi Varga Properties- Vishaghna, Tridoshaghna, Kushthaghna, Kandughna, Twacha Roga Nashak, Shwasaghna, Kasaghna. Shodhal Nighantu Arshoghna, Vishaghna, Swedaghna ,Twacharoga Nashaka, Shophaghna, Visarpaghna. Kaidev Nighantu Mentioned in treatment of Visarpa, Shotha, Kasa, Vishaj Roga, Vrana. Bhavprakash Nighantu  Mentioned in Shotha, Visarpa, Kasa, Vishahara. Pharmacological properties of Shirisha are anti-asthamatic, effect on anaphylactic shock, anti- tussive, antimicrobial, anti- inflammatory, analgesic, immunomodulatory activity.[29] Panchashirisha Agada ▪ Acharya Charaka has mentioned Panchashirisha Agada as best in treating all types of Visha. It is used both internally and externally.[30] ▪ Acharya Sushruta has mentioned Panchashirisha Agada for treating Keetavisha.[31] DISCUSSION  Visha (toxin) is nothing but a chemical substance that alters the normal physiology of body. Acharya Vaghbhat has mentioned that Visha firstly enters in Dr. Bhargavi S. Lakkakula et al. Role of Panchashirisha Agada in Dermatological Toxicity ISSN: 2456-3110                                                       REVIEW ARTICLE Jan-Feb 2021  Journal of Ayurveda and Integrated Medical Sciences | Jan - Feb  2021 | Vol. 6 | Issue 1 282  Rakt Dhatu. Twacha being the by-product of Rakta Dhatu shows the consequences of Visha on itself leading to skin toxicity. Skin toxicity can be due to Sthavara Visha, Jangama Visha, Dooshi Visha, Gara Visha, Aamvisha, occupational hazards or due to drugs. Shirisha and its parts are used in various Agada Yoga to overcome Visha. It has many properties like Kandughna, Kushthaghna, Shothaghna, Tridoshghna, Vedanasthapana. It helps in pacifying Bhrajaka Pitta situated in Twacha thus directly removes Visha and stops spreading of Visha into Rakta.[32] Total Agada Yoga explained in Samhita with respect to Shirisha in Visha Chikitsa are 25 and in some context, they have not named the Yoga but explained as Vishahara Aushadhi for the management of both Sthavara as well as Jangama Visha.[33] CONCLUSION Skin being major part of body especially in today’s generation plays a major role for survival. So, skin toxicity will always be a curse if experienced by any individual. That is why its treatment is of greater importance. Acharya Charaka has mentioned Shirisha in Vishaghna Gana and titled Panchashirisha Agada as Pravara in all Vishas. It has been proved to have properties like anti- inflammatory, analgesic, immune- modulatory, anti- microbial which shows Shirisha Dravya has multiple properties along with its dermatological importance. Hence, I conclude that Panchashirisha Agada being Pravara in all Vishas has greater potency to overcome any skin toxicity caused by Vishas. REFERENCES 1. K Chillar, G Murakawa, Skin microflora and Bacterial Investigation of the Skin, Journal of Investigative dermatology Symposium Proceedings, Volume 6, Issue 3; Dec 2001, Page no:170-174. 2. Dr Ganesh Garde, Sartha Vaghbhata, Sharirasthana, Chaukhamba Surbharati Pratishthana, Reprinted edition – 2011, chapter 3rd, verse- 8; Pg no – 133. 3. 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Dr Ganesh Garde, Sartha Vaghbhata, Uttarsthana, Chaukhamba Surbharati Pratishthana, Reprinted edition – 2011, chapter 38th, verse- 10,11,13; Pg no – 473. 11. Dr Ganesh Garde, Sartha Vaghbhata, Uttarsthana, Chaukhamba Surbharati Pratishthana, Reprinted edition – 2011, chapter 37th, verse- 23; Pg no – 467. 12. Dr Anantaram Sharma, Sushrut Samhita, Kalpasthana, Chaukhamba Surabharti Pratishthana, Reprinted edition – 2015, chapter 7th, verse 8, pg no :567. 13. Dr Anantaram Sharma, Sushrut Samhita, Kalpasthana, Chaukhamba Surabharti Pratishthana, Reprinted edition – 2015, chapter 8th, verse 80, pg no :588. 14. Dr Anantaram Sharma, Sushrut Samhita, Kalpasthana, Chaukhamba Surabharti Pratishthana, Reprinted edition – 2015, chapter 2nd, verse 33, pg no :524. 15. Dr Anantaram Sharma, Sushrut Samhita, Kalpasthana, Chaukhamba Surabharti Pratishthana , Reprinted edition – 2015, chapter 2nd , verse 25-26, pg no :522- 523. 16. Vaidya V Kale, Charaka Samhita, Chikitsasthsana, Chaukhamba Sanskrut Pratisthana, First edition – 2014, chapter 23th, verse- 31, pg no- 534. Dr. Bhargavi S. Lakkakula et al. Role of Panchashirisha Agada in Dermatological Toxicity ISSN: 2456-3110                                                       REVIEW ARTICLE Jan-Feb 2021  Journal of Ayurveda and Integrated Medical Sciences | Jan - Feb  2021 | Vol. 6 | Issue 1 283  17. Dr Anantaram Sharma, Sushrut Samhita, Kalpasthana, Chaukhamba Surabharti Pratishthana, Reprinted edition – 2015, chapter 2nd, verse 30-32, pg no :534. 18. Dr Anantaram Sharma, Sushrut Samhita, Kalpasthana, Chaukhamba Surabharti Pratishthana, Reprinted edition – 2015, chapter 1st, verse 25-27, pg no :508. 19. Vaidya V Kale, Charaka Samhita, Chikitsasthsana, Chaukhamba Sanskrut Pratisthana, First edition – 2014, chapter 2nd , verse- 12, pg no- 563. 20. 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Vidyavati et al; Journal of Pharmaceutical and Scientific Innovation, A review on Vishaghna Shirish yogas, ISSN 2277-4572, 2018; 7(4).     *******************************  How to cite this article: Dr. Bhargavi S. Lakkakula, Dr. Rajendra D. Lambat. Role of Panchashirisha Agada in Dermatological Toxicity w.s.r. to Visha - A Review. J Ayurveda Integr Med Sci 2021;1:279-283.  Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2021 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  

Role of Panchashirisha Agada in Dermatological Toxicity w.s.r. to Visha - A Review

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Role of Panchashirisha Agada in Dermatological Toxicity w.s.r. to Visha - A Review

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