Int J Ayu Pharm Chem REVIEW ARTICLE www.ijapc.com e-ISSN 2350-0204

Cancer in Perspective of Dooshivisha (Latent Poisoning) w.s.r. to Possible Role of Dooshivishari Agada in Treating Cancer S. Chalakh*

*Dept of Agadtantra, MGACH & RC Salod (H),Wardha, MS, India

ABSTRACT With modernisation & urbanisation every individual is frequently exposed to many toxic substances like polycyclic hydrocarbons, nitrosamine, pyrogenic compound & many other which are now known to be potent mutagens & carcinogens. These carcinogens enter in the body through air, water, radiation, drugs, cosmetics & different food product resulting in manifestation of sever disease such as cancer. After studying the etiological factor of cancer in view of as well as modern medicine, it is seen that most of the etiological factor & pathology of cancer can be correlated to Dooshivisha which is latent stage of poison explained under the one of disciple of Ayurveda. Dooshivishari Agad is one of the formulation mentioned for the management of Dooshivisha. After reviewing the experimental study of herbs in Dooshivishari Agad it is found that all these herbs are useful in anticancer therapy so formulation may be much more effect due to the synergistic action. Integrated approach of modern medicine with Ayurvedic principle is the time need. Application of management of Dooshivisha in this context may be the new horizon for cancer patient. So this review is taken to study cancer & its management in context of Dooshivisha.

KEYWORDS Cancer, Carcinogen, Dooshivisha, Ayurveda, Dooshivishari Agad

Greentree Group Publishers Received 07/08/18 Accepted 27/08/18 Published 10/09/18 ______

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INTRODUCTION mutagens & carcinogens. These Cancer is the one word which is very scary carcinogens enter in the body through air , for every human beings. Every year about water, radiation, drugs, cosmetics & 8,00,000 new cancer patients get registered different food product. These increase the with the national cancer registry program in risk of cancer by altering cellular India1. Cancer is the second leading cause metabolism or damaging DNA directly in of death next to cardivovascular diseases2. cells, which interferes with biological The world‘s population is expected to be processes, and induces the uncontrolled, 7.5 billion by 2020 and approximations malignant division, ultimately leading to predict that about 15.0 million new cancer the formation of tumors. Usually, severe cases will be diagnosed, with deaths of DNA damage leads to programmed cell about 12.0 million cancer patients3. Cancer death, but if the programmed cell death is one of the leading causes of death in pathway is damaged, then the cell cannot 6 India, with about 2.5 million cancer prevent itself from becoming a cancer cell . 7 patients, one million new cases are added Carcinogens (Table 1): every year and with a chance five times A carcinogen is any substance that rising up to 20254.Though heredity plays its promotes the formation of cancer. This may role in causing cancer but that include only be due to the ability to damage the genome 5% of cancer cases, non -heredity factors or to the disruption of cellular metabolic such as life style, food, level of physical processes.Two types of carcinogenic activity, personal hygiene, environmental mechanisms have been identified. One is pollution are the major causing factors5 . genotoxic that alter genes through Cancer is a disease in which normal cells interaction with DNA and other is are damaged and do not undergo epigenetics. Genotoxic are of three types: programmed cell death as fast as they • Direct or primary carcinogens: divide via mitosis .Today due to Chemicals that act without any modernisation & urbanisation each & every bioactivation; for example, individual is frequently exposed to many bis(chloromethyl) ether, ethylene toxic substances which are mostly dibromide, and dimethyl sulfate. carcinogenic. Polycyclic hydrocarbons, • Procarcinogens: Chemicals that require nitrosamine , pyrogenic compound & many biotransformation to activate them to a other which are now known to be potent carcinogen; for example, vinyl chloride and 2-naphthylamine. ______

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• Inorganic carcinogen: Some of these are • Hormone: Usually is not genotoxic, but preliminarily categorized as genotoxic due alters endocrine balance; often acts as to potential for DNA damage. Other promoter (e.g. DES and estrogens). compounds in the group may operate • Immunosuppressor: Mainly stimulates through epigenetic mechanisms. virally induced, transplanted, or metastatic • Epigenetic: These are carcinogens that do neoplasms by weakening host's immune not act directly with genetic material. system (e.g., antilymphocytic serum, used Several types are possible:Cocarcinogen: in organ transplants). Increases the overall response of a Genotoxic carcinogens are sometimes carcinogen when they are administered effective after a single exposure, can act in together; for example, sulfur dioxide, a cumulative manner, or act with other ethanol, and catechol. genotoxic carcinogens which affect the • Promoter: Increases response of a same organs. Some epigenetic carcinogens, carcinogen when applied after the however, only cause cancers when carcinogen but will not induce cancer by concentrations are high and exposure long. itself; for example, phenol and dithranol. The implication is that while there may be • Solid-state: Works by unknown a "safe" threshold level of exposure for mechanism, but physical form vital to some carcinogens,others may have "zero" effect; for example, asbestos and metal threshold; that is, one molecule of the foils. chemical can induce a cancer8. Table 1 Common carcinogen involving occupation9 Carcinogen Associated cancer sites or Occupational uses or sources types Arsenic & its compound Lung ,Skin Smelting byproduct ,Haemangiosarcoma Component of:  Alloys  Electrical and semiconductor devices  Medications (e.g. melarsoprol)  Herbicides  Fungicides  Animal dips  Drinking water from contaminated aquifers. Asbestos Lung, Gastrointestinal tract Not in widespread use, but found in:

 Constructions  Roofing papers  Floor tiles  Fire-resistant textiles  Replacement friction linings for automobiles still may contain asbestos

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Benzene Leukemia, Hodgkins  Light fuel oil lymphoma  Former use as solvent and fumigant  Printing  Lithography  Paint  Rubber  Dry cleaning  Adhesives  Coatings  Detergents Beryllium & its compound Lung  Missile fuel  Lightweight alloys  Aerospace applications  Nuclear reactors Cadmium & its compound Prostate  Yellow pigments  Phosphors  Solders  Batteries  Metal paintings and coatings Hexavalent Lung  Paints chromiumcompound  Pigments  Preservatives IC engine exhaust gas Lung, Bladder Exhaust gas from engine Ethylene oxide Leukemia  Ripening agents for fruits& nuts  Rocket propellant  Fumigant for foodstuffs and textiles  Sterilant for hospital equipment Nickle Nose,Lung  Nickel plating  Ferrous alloys  Ceramics  Batteries  Stainless-steel welding byproduct Radon & its decay product Lung  Uranium decay  Quarries and mines  Cellars and poorly ventilated places Vinyl chloride Haemangiosarcoma, liver  Refrigerant  Production for polyvinyl chloride  Adhesive for plastics  Former use in pressurized containers Involuntary smoking Lung (Passive smoking) Radium ,Plutonium Bone ,Liver Nuclear fuel processing Radium dial manufacturing.

There are some other carcinogenetic agent radiation from the sun and UV which include Gasoline (contains lamps,Alcohol (causing head and neck aromatics) Alkylating antineoplastic agents cancers),Other ionizing radiation (X-rays, (e.g. mechlorethamine) other alkylating gamma rays, etc.) These carcinogenetic agents (e.g. dimethyl sulfate), Ultraviolet agents cause four main types of cancer, ______

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lung cancer, breast cancer, colon cancer & medicine which is very effective but on stomach cancer. other side it produces harmful toxic effects. Concept of Dooshivisha : So to minimise the toxic effect of this Agadtantra is a specialised branch of therapy & for the improvement of quality of Ayurveda which deals with the life in cancer patient, integrated approach of management of toxicity. This specialised modern medicine with Ayurvedic principle branch has given the novel concept of is the time need. Exposure & deposition of Dooshivisha which is a transformable state carcinogenic substance is lead to cancer of Visha (Toxins) which can be attained by which ultimately the type of chronic any type of poison, if it is not eliminated toxicity. So removal of toxin from body from the body completely. Ancient seers may be effective for the treatment of describe that it is part of poison originating cancer.Liver, skin, kidney, and lung are the from inanimate or animate or artificial major detoxification centers of the body source which retained in the body after and in a cancer patient this toxin clearance partial expulsion or which are provisionally mechanism get compromised. In Agdtantra undergone detoxification, by the anti- in the context of Dooshivisha antitoxic poisonous drug but not completely treatment modalities is prescribed that eliminated from body .Due to low potency includes Vaman (emesis) which eliminate and also due to enveloping (awarana) action the toxin deposited in the body and after by kapha, it does not cause sudden death. It Vamana Dooshivishari agada, which is one is retained in the body for a long period of the formulations mentioned for the without producing any grave or fatal management of the Dooshivisha, is to be symptoms. It slowly vitiates the & administered . then vitiates rasa-raktadi dhatu (tissue). Pharmacokinetics of Vamana: Poison are Same pathology is seen in cancer. After mainly fat soluble in nature, by the oleation long term exposure to carcinogenic therapy which is carried out before Vamana substances, Rasaraktadi Dhatu (tissue) get ,these toxic substances dissolve into oil & vitiated which causes the mutation of the toxin which are firstly present in cells10. cytoplasm of cell now become membrane Management of cancer in terms of bound. After oleation, swedana Dooshivisha: (fomentation) is carried out due to which Radiotherapy & chemotherapy are the line cell permeability changes leading to of treatment for cancer in conventional excretion of fat soluble protein bound toxin ______

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into circulation. Due to emetic agents CTZ mesenteric vein, microvasculature of vellus (emetic center- chemoreceptor trigger increased the secretion in gut. By this zone)centre get activated with the mechanism the toxin which excretes into stimulation of vagus nerve. Vasodilatation circulation is expelled into lumen of gut11. of portal vein, superior & inferior Table 2 Pharmacological activity of ingredients of Dooshivishari Agad Sr no. Drug name Botanical name Pharmacological action in terms of cancer 1 Pimpali Piper longum Immunomodulatory 12 Hepatoprotective Anti-cancer activity 13 Anti-oxidative, anti-apoptotic, and restorative ability against cell proliferative mutagenic response 14 2 Dhyamaka Cymbopogon martini Antioxidant 15 3 Jatamansi Nardostachys jatamansi Hepatoprotective Activity16 Antioxidant Activity 17 Antiestrogenic activity 18 4 Ela Elattaria Cardamum Anticancer Activity 19 Antioxident Activity 20 5 Lodhra Symplocos racemosa Anticancer activity 21-22 Antioxidant Activity23 Hepato-protective activity24 6 Katunatam/shyonak Oroxylum indicum Hepato-protective activity 25 Anticancer activity 26-30 Immuno-stimulating activity31 Gastro-protective 32 7 Tagar Valeriana wallichii Radio-protective activity33 Anti-oxident 34 Cytotoxic activity 35 8 Kuth Saussurea lappa. Anti-cancer activity 36-39 Immuno-modulatory activity40 Hepato-protective 41 Angiogenesis activity42 9 Mulethi Glycyrrhiza glabra Antioxidant 43 Linn. Hepato-protective 44-45 Anticancer Activity46-47 Immunomodulator 48 10 Chandan Pterocarpus santalinus Hepatoprotective 49 Linn. f. Antioxident 50 Anticancer Activity 51-53 11 Suvarchika Potassium nitrate 12 Gairik Red ochre

DISCUSSION symptoms representative of underlying Cancer is not simply localized lumps and systemic dysfunction. There are many bumps that we have been programmed to causative factors, including emotional accept through the years. Cancer can partly stress, diet, drugs and chemicals, infections, be viewed as a degenerative process with genetic mutation and environmental ______

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pollutants. Out of this various factors neoplastic cell, it also damages healthy various chemicals slowly get deposited in tissue, body fails to eliminate the excess the body and act as carcinogenic. drugs which leads to accumulation of these Dooshivisha is a remaining portion of chemical as in the body & cause health specific poison after the completion of problems of long period. These chemicals treatment or cumulative nature of poison are in-excretable & indigestible. Due to that get deposited in body and damage the these therapy there is anorexia, nausea, cell. After reviewing the causative factor of fatigue, malaise and drowsiness as acute cancer it is found that all get categorized symptoms. After someday there is under the heading of Dooshivisha that is ulceration of mouth & GI tract ,diarrhea, artificial poison. This poison cumulatively hair loss etc. occurs . All these symptoms deposited in particular (Dhatu) tissue then resembles with the symptoms of that tissue is more prone to produce cancer. Dooshivisha. So while treating the cancer Weakened dhatus and dhatu agnis were patient along with this therapy if integrated highlighted as important Ayurvedic approach of Dooshivisha is applied then it concepts in the pathophysiology of cancer. may be fruitful. The Vaidyas suggested that when the Dooshivsha is managed by detoxification of dhatus are weakened, that patients are body with Vaman along with vulnerable to disease and that in particular administration of Dooshivishari Agada . a weakened dhatu (Harmones & For cancer management the formulation enzymes) predisposes them to cancer in that needed is having property which dhatu. This concept is unique to Ayurveda. strengthen the immune system ,prevent the However, a parallel exist in biomedicine, in spread of cancerous cell, create a which particular tissues (e.g., sites in the environment that is unfavorable for cancer aerodigestive tract after tobacco exposure) growth that means high oxygen level, are vulnerable to cancer54. detoxifying the body ,fighting free radicles The conventional treatment of surgery, that cause mutational changes. After radiation and chemotherapy has been the reviewing pharmacological activity of cornerstone of cancer treatment over the Dooshivishari Agad it is found that it past 50 years. Today, the clinical success of fulfills all the criteria which are needed for these treatments has reached a ceiling but the management of cancer. Herbs of along with their toxic effect. In Dooshivishari Agada has individually chemotherapy along with destroying proved this activity. So synergistic effect of ______

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this formulation will be much more effective in cancer patient.

CONCLUSION Management of cancer & its prevention can be done effectively if Ayurvedic approach of Dooshivisha is applied for the cancer management. Properties and individual actions of ingredients of Dooshivishari Agada represent its possible utility in management of cancer, however experimental study has to be carried out to establish them on scientific ground.

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