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Researches on Mercurial Preparations: the Prime Requirement for Their Acceptance in Medical World

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Researches on Mercurial Preparations: the Prime Requirement for Their Acceptance in Medical World [Downloaded free from http://www.ayujournal.org on Tuesday, January 30, 2018, IP: 120.62.14.24] AYU Access this article online Website: www.ayujournal.org DOI: 10.4103/0974-8520.175541 Invited Article Quick Response Code: Researches on mercurial preparations: The prime requirement for their acceptance in medical world J. Arunachalam Ex-Head, National Centre for Compositional Characterisation of Materials, Hyderabad, Telangana, India Abstract Ayurvedic and Siddha medicinal preparations containing mercury have been used over centuries in India. The recent WHO guidelines on the use of mercurials as well as actions by other international organizations into eliminating mercury in all forms have put the people practicing Rasa Shastra in a quandary. Active research in the mechanism of curative actions of mercurials is very much essential, to have widespread acceptance of the ancient practice. The toxicity of a substance depends on its bio‑availability; the chemical form in which it is present and the biochemical reactions it participates. Mercury is usually administered as mercuric sulfide (Rasasindura or Linga Chendooram) which has a KSP value of 10–54. Despite this extreme insolubility, how mercury becomes bio‑available under enzymatic conditions needs to be studied. Its bioaccumulation in critical organs and excretory pathways are to be ascertained. Research is also needed to establish whether Rasasindura or equivalent medicines induce the (excess) synthesis of sulfur containing biomolecules in human systems, which act as cell protectors against free radical‑induced cell damage. The antioxidants themselves could be the curative agents; mercury being just a catalyst. It may also be possible that the exposure to mercury, even in very small amounts, could lead to the synthesis of specific metallothioneins in the human system, helping to detoxify the mercury exposure. The author is of the opinion that Ayurvedic practitioners/researchers should carry out long‑term follow‑up studies on human patients. The superiority of mercury based Ayurvedic preparations, as against modern allopathic medicines, in providing rapid and long lasting cure for specific diseases needs to document and published. In the absence of such supportive research literature, the use of mercury will become untenable, even for medicinal purposes. Key words: Kajjali, Makaradwaja, mercurial preparation, mercury, Parpati, Rasasindura Introduction mercury medicines like Linga Chendooram exist in Siddha traditions. Ayurvedic and Siddha medicinal preparations containing All forms of mercury (vapor, inorganic salts, and organic forms) mercury have been prepared and used over centuries in are considered as toxic to human beings and in-depth reports India. Similar preparations exist in China and Japan too. exist detailing the deleterious effects of these various forms The preparatory methods are based on various classical texts both in animal studies and in humans inadvertently exposed and administered to patients along with various adjuvants to mercury. The Minamata episode in Japan and the poisonous depending on the type of disease. The types of diseases treated effects on children born to mothers who had consumed organic with mercurials range from tuberculosis to diarrhea. The mercury contaminated wheat in Iraq are well documented and mercury-containing preparations are many: Ayurveda has Kajjali, Parpati, Rasasindura, and Makaradhwaja, (which are essentially This is an open access article distributed under the terms of the Creative a combination of mercury and sulfur) and some medicines like Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the Garbhapala Rasa which have lower mercury contents. Similar author is credited and the new creations are licensed under the identical terms. For reprints contact: [email protected] Address for correspondence: Dr. J. Arunachalam, 302, Jyothi Pearl Apts, Srinivassa Nagar, Kapra, ECIL Post, How to cite this article: Arunachalam J. Researches on mercurial Hyderabad - 500 062, Telangana, India. preparations: The prime requirement for their acceptance in medical world. E-mail: [email protected] Ayu 2015;36:118-24. 118 © 2015 AYU (An International Quarterly Journal of Research in Ayurveda) | Official publication of Institute For Post Graduate Teaching & Research in Ayurveda,Jamnagar | Published by Wolters Kluwer - Medknow [Downloaded free from http://www.ayujournal.org on Tuesday, January 30, 2018, IP: 120.62.14.24] Arunachalam: Researches on mercurial preparations the recent outcry in the USA on the use of Thimerosal as a Bio‑availability of Mercury preservative of vaccines and the suspected link to autism in children, is the latest in the campaign against the use of mercury The ancients brilliantly overcame the problem of mercury in any form and at any dose levels for medicinal purposes. toxicity by severely reducing its bioavailability through the use The WHO mentions that exposure to mercury – even small of sulfur. They purified the raw mercury and sulfur through amounts – may cause serious health problems, and is a threat to many steps using plants and salts and standardized the the development of the child in utero and early in life; mercury administered form of mercury as HgS, one of the least soluble may have toxic effects on the nervous, digestive and immune substances. The KSP of HgS is 1 × 10–54. Thus, the quantum systems, and on lungs, kidneys, skin, and eyes; and mercury is of mercury ions that would be available on the administration considered by WHO as one of the top 10 chemicals or groups of mercury as sulfide can be much below the threshold of of chemicals of major public health concern (WHO fact sheet toxic limit (the use of arsenic, a toxic substance, again used No. 261, updated September 2013). Studies have indicated at as a highly insoluble sulfide, Rasamanikya, is illustrative of the least in animal experiments that mercury affects the nervous concern of the ancient sages over the detoxification efforts system and has been shown to accumulate in kidneys leading to needed, before declaring a substance as a medicine). However, atrophy and failure. The WHO/JECFA has set a limit of 4 µg/kg HgS may be more soluble in the gastrointestinal (GI) tract due bw for inorganic mercury.[1] This limit has been arrived at based to the action of digestive enzymes, changing pH conditions and complexation with other biomolecules present in the food. This on experiments using mercuric chloride (HgCl2), a soluble salt of mercury. The PTWI for methyl mercury it is 1.6 µg/kg bw. has to be determined upon by experimentation. The literature is also replete with toxicity suffered by patients Experiments on the bio-availability of various forms of who have consumed Ayurvedic preparations containing heavy mercury indicated the following percentages of absorption: metals particularly, mercury and lead. It is to be noted; however, Cinnabar <0.2% in GI, mercury vapor 80% in lungs and <0.01% that majority of these cases are due to self-medication by in GI, HgCl2 7–15% in GI and methyl mercury >95% in GI. the people and not under conditions of supervision under an The mercury thus adsorbed is found distributed to liver, kidney, Ayurvedic doctor. and spleen while mercury vapor and methyl mercury result [3] It is in this background, the claim of Ayurvedic and Siddha in accumulation in the brain. Autopsy studies on diseased humans in Greenland, exposed to mercury through food, have practitioners on the safety of their preparations containing shown accumulation in kidney, spleen and liver, with kidney mercury under therapeutic doses is viewed with suspicion by exhibiting highest accumulation.[4] Neurotoxicity induced by modern medicine. However, many journal publications in recent cinnabar in guinea pigs has also been reported.[5] times have appeared, based on animals (mice, rats, and dogs), reporting on the nontoxic effects of Ayurvedic and Siddha However, in the Indian context, all the animal studies have mercurial preparations and changes in biochemical parameters. invariably reported that Rasasindura has not been found toxic These studies can help evolve therapeutic doses for humans. under therapeutic doses;[6] even though no analytical studies on the accumulation of mercury in different organs (in animal The Need for Complete Chemical and studies) have been published from major Indian institutions. Reviews on beneficial applications of Rasasindura, on human Physical Characterization of the Mercurials patients,[7] as well as types of diseases it has been used have been published.[8] Much of the fear induced on the use of mercury is This dichotomous situation needs to be thoroughly examined due to the inability of the most common analytical to establish the safety associated with the Indian practices. methods, which report on the total elemental concentration,[2] (X-ray fluorescence, atomic absorption spectroscopy [AAS], inductively coupled plasma atomic Standardization of the Preparation and emission spectroscopy [ICP-AES]), and not on the exact Composition chemical form in which mercury is present. The exact chemical form in which mercury is present has also to be Assay of purified mercury analyzed by X-ray diffraction (XRD), which provides the Standard texts uniformly mention some 8 stages of purification information on crystalline structure and X-Ray photoelectron or mercury.[9] These steps are meant to remove natural Spectroscopy (XPS),
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