The Scope of Agadatantra in Oncology

THE SCOPE OF AGADATANTRA IN THE MANAGEMENT OF CARCINOMA WITH SPECIAL REFERENCE TO SIREESHARISHTA, AN ANTI TOXIC PREPARATION IN THYROID CA – A CASE STUDY 

*Dr. Aswathy S., **Dr.Manju S.R

Changing trends in lifestyle, habits etc in the modern era leads to increase in morbidity. Due to rapid growth of industry, over increasing number of automobiles, use of pesticides in agriculture for high yield etc leads to environmental pollution. Industrial wastes pollute our air, water, land etc. These pollutants accumulate in human body and causes serious disorders. Pesticide intake is another area from which endangering the human health. In low concentration they may not cause any problem but they accumulate in the environment and build up a toxic concentration in food chains.

            The extensive use of chemical drugs, the use of pesticides and industrial pollution has proved to be causing diseases like cancer, skin diseases, allergic diseases, congenital deformities etc If we study the incidence of cancer and skin disease like psoriasis it shows an exponentially increasing pattern. Incident rate of this life threatening disease is increasing every year. In India nearly 2.5 million persons suffering from cancer at any given time. Around 70,000 new cases are added each year. The age adjusted mortality rate is 61 per 1, 00,000 males and 58 per 1, 00,000 females. In india, more people are stricken with cancer in this decade when compared to the earlier decades of last century. These all are due to this changing lifestyle, industrialization, use of pesticides and insecticides etc. We are frequently exposed to chemical carcinogens like poly cyclic hydrocarbons, nitrosamine and many others through the air we breathe and the things we consume. Adding substances food to increase the taste and palatability will cause cancer. Processing of food in high temperature will leads to the production of pyrogenic compounds like polycyclic aromatic hydrocarbons. Many of these compounds are now known to be potent mutagens and carcinogens.

            Ayurveda, the traditional system of India has an effective and well developed antitoxic treatment system. Agadathanthra, one of the 8 classical disciplines (Ashtanga) of Ayurveda deals with management of toxicity. If we deeply study the principles of Agadathanthra and the etiology of cancer like diseases we can infer that the diseases are mostly due to toxic substances which enter through food, air, water or medicine etc. Some of the toxin produces acute symptoms and some produces symptoms after a long time. If we consider Dooshivisha, Gara and Viruddhahara concepts of Agadathanthra most of the etiological factors and pathology of cancer come under these three headings.

Any kind of poison originating from inanimate or animate sources or any artificial poison (Kritrima visha) retained in the body after partial expulsion or which has provisionally undergone detoxification, by the anti-poisonous drugs, forest fire, the wind or the sun is termed Dooshivisha ( Latent poison)Due to the low potency of this poison, it usually won’t causes sudden death. And also due to the enveloping (avarana) action by Kapha, this low potency poisons is retained in the body for long period without producing any grave or fatal symptoms

Those substances which cause ‘utkleshya’ of the doshas but unable to remove it from the body constitutes Viruddha. It is also antagonistic to the dhatus. Those dravyas which are incompatible with the dhatu of the body are viruddha. Some act adversely due to their mutually contradictory properties, some by combinations, some by method of preparations, some by virtue of the place, time and dose and some by their nature. 

            According to Vagbhata, viruddha is so intimately related to ‘Amavisha’ that it leads to symptoms of poison. Ahara which is viruddha in nature is like visha and gara. Considering these we can infer that frequent exposure to carcinogens and unwholesome food habits are etiological factors of cancer. So we can treat this type of diseases effectively by the principles of Agadathanthra. Many antitoxic preparations are very effective in the management of Cancer, Psoriasis, Allergic rhinitis and bronchitis, Atopic dermatitis etc where an involvement of Visha (poison) in the etiology it may be extrinsic in the case of cancer or intrinsic in the case of atopic dermatitis and allergic bronchitis where IgE plays the roll. Agada preparations are also effective in the management of autoimmune disorders, toxoplasma etc.

            Here effectiveness of one such Agada formulation is described in detail with the help of a case study. Before going to the drug details we have to discuss the general management of Cancer. Because administration of Agadas along with general management gives more good result than administration of Agada alone. In all type of cancer visha in the form of Ama is present. So ‘Ama nirharana’ is the initial or first line management of all type of cancer. Sodhanam, Langhanapachanam and Langhanam are the treatment for prabhutha, madhyama and alpa dosha respectively. But in the case of cancer patient is very weak due to the disease. So sodhanam and langhanam should not be advisable. We can do mridulanghana and pachana, for that ‘Sasundilajapeya’ is given along with mild pachana oushadhas like Drakshadi Kashyam. After getting some ‘bala’ to the patient strong amapachana drugs like pachanamrutham Kashayam, Sapthasaram Kashayam etc can be given. Pathyakrama stated in Visha chikithsa should be followed. Because non-veg food, Guru Ahara, Oily foods etc. will increase the Ama and thereby help the progression of disease. There is a great need of Amino acids for the growth and proliferation of Tumour cells and also for Neovascularization (Angiogenesis) So all protein diet should be avoided. Peyadi is only advisable. Specific Agada preparations are given along with this treatment protocol.

            In the case of cancer fresh cases do not report to Ayurvedic physicians (exceptions are there). Only those who try modern aids such as Surgery, Chemotherapy and Radiotherapy come for Ayurvedic treatment. Chemotherapy and Radiotherapy will produce harmful toxic effects along with their beneficial effects. In Chemotherapy first few doses will act as therapeutic doses and it destroys the neoplastic cells and don’t cause much damage to healthy tissues. But further doses will cause serious damage to healthy tissues. Body fails to eliminate the excess drugs which lead to accumulation of these chemicals in the body and causes health problems for a long period. These chemicals are inexcretable and indigestible by our body systems which lead to production of Ama. The Ama produced shows the lakshanas of visha. In radiation therapy, the ionization of the water content of the cells will produce peroxide and other toxins which cause toxic effects on the body. In radiation there is ‘pitha’ vitiation also. In both radiotherapy and chemotherapy there will be anorexia, nausea, fatigue, malaise and drowsiness as acute symptoms. After some days along with the above symptoms there will be purpura, haemorrhage, mouth infection, ulceration of mouth and GI tract, diarrhoea, hair loss etc occurs. These all symptoms resemble the lakshanas of Ama, Gara and Dooshivisha. In such conditions we will have to resort treatment of dooshivisha, gara and Ama. Purification therapy followed by administration of Agada formulations and Rasayana therapy are useful. Moorvadi choornam stated in garaprakaram and vilwadi gulika give better result in reducing these symptoms. Kosathakyadi Yavagu (vega veganthara chikithsa), Dooshi vishari Agada etc may give good results in these conditions. Dooshi vishari Agadam can be used as a rasayana after purification therapy. Durva ghrutham mentioned in mandalivisha prakarana is very effective in reducing the harmful symptoms of radiation therapy. It can use both internally and externally. But internal use is advisable only after getting proper ‘agni deepthi’. Kalyanaka ghrutham also can be used. Paranthyadi thailam is very useful in healing of squamus cell carcinoma. It can also be used as a lepana for reducing the burning sensation produced by Radiation therapy.

 If suitable Agada formulation is used along with above stated general management it will give good result in the treatment of cancer. In this particular case we use Sireesharishta along with general drugs. Sireesharishta, an agada preparation which is indicated in all type of ‘Visha vyapad’ was used for this study. The main ingredient of Sireesharishta is the bark of Sireesha (Albizia lebbek), the most potent anti toxic drug. The other ingredients are Pippali, Priyangu, Kushta, Ela, Neelini, Nagakesara, Rajani and Darvi.

   Sireesha(Albizia lebebek) Courtesy:Nirmal Roberts,www.treknature.com

This drug is given to a lady of 30 years old presented with diffuse enlargement over left side of the neck, FNAC report showed Medullary thyroid CA in this area. She had lose of appetite, Loose stools, fatigue, pin prick sensations over affected side and left axillary region as associated symptoms. Her calcitonin level in blood (a tumour marker in thyroid carcinoma which helps in diagnosis and prognosis) was 12692 IU before the administration of the medicine. Sireesharishta was given to the patient for 30 days along with Annabhedi sindhooram, Chukkumthippalyadi gulika and sapthasaram kashayam for reducing the associated symptoms like fatigue, lose of appetite, chills and fever etc. Peyadikrama was followed strictly.

The medicines except Sireesharishta were changed according to the feedback from the patient. After one month the calcitonin level decreases to 8401 IU and enlargement of the neck also reduced. This study was conducted by Dr.C.D.Sahadevan, an eminent Ayurvedic physician in the field of Oncology. He uses principles of Agadathanthra in managing diseases like cancer, autoimmune disorders etc. This is a single case study we have to do this study in a large sample to find out the exact efficacy of this Agada. The aim of this paper is to show the potency of Agada preparations in the management of life threatening diseases. We, the Agada practitioners can do a lot of things in life threatening conditions.

                                                     Dr.C.D.Sahadevan

            Emergence of new treatment modalities like administration of ASV and lack of practical knowledge in practicing snake bite etc leads to decline of snakebite management in Ayurveda. This situation leads to produce some misconcepts among physicians that Agadathanthra is an outdated science now a day. As the practice of Agadathanthra does not much the treatment of snake poison alone, there is still ample scope for this branch of Ayurveda and its practice. We have to do lot of researches in antitoxic preparations and find out the diseases where the Agada can effectively use.

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*Final Year PG Scholar, Department of Agadathanthra, Govt. Ayurveda College, Thiruvananthapuram

**Professor and Head, Department of Agadathanthra, Govt. Ayurveda College, Thiruvananthapuram