Indian Journal of Traditional KnowledgeVol. 3(3), July 2004, pp. 240-246

Pharmaceutical, physico-chemical and clinical study on"Shuddha Manahshila" with special reference to Kasa Roga

Atul Kumar

TKDL, National Institute of Science Communication and Information Resources, CSIR,New Delhi 110012

E-mail: atulkumar@niscair.res.in;akumar51@rediffmail.com

Received 16 January 2004; revised 24 March 2004

Manahshila (Realgar; Arsenic disulphide- AS2S2), a bright red-orange coloured mineral, isa compound of arsenic and sulphur in 2:2 ratio, which has been described under Uprasa Vargain Rasa Shastra of Ayurveda. It is found in ore form in nature and can also be made artificially.Manahshila is one of the mineral drugs that has history of usage as old as Vedic period. InRigveda, its usage has been mentioned for environmental purification; whereas, in Athrvavedaand Purana Granthas, its externo-internal usage is mentioned. Manahshila can therapeuticallybe used only after Shodhana (purification & detoxification). In the present study, the drug wasprepared by processing (Bhavita) from approved are of Manahshila with Adraka Svarasa (gin-ger juice) for 7 days to make the drug more potent for Kasa Raga (cough/bronchitis). Thephysico-chemical parameters of the prepared drug were also established for the first time bycomparing them with the crude drug, which was novel from pharmaceutical point of view. Theclinical study of the drug was performed in 25 patients, at a dose of 10-25 mg, three times a day,for one month, with the adjuvant of Madhu (honey). The drug gave good results, particularly inVataja Kasa (eosinophilia).

Keywords: Ayurvedic drugs, Shuddha Manahshila, Standardization, Kasa raga, Cough,Bronchitis.

IPC Int Cr.7; A61K 33/36; A61K 33/04; A61K 35/78; A61K 35/12; A61P 11100; A61P 11114;A61P 11108; A61P ll/06; A61P 29/00;A61P 37/08.

Manahshila, also nown as Mainsil,Warangana, Jharanikha surkha, Realgaror Red orpiment, is a deep red, lustrousmonoclinic crystalline solid. On rubbingor crushing, it changes into a red-orangecoloured fine powder. Manahshila (Arse-nic disulphide, As2S2), occurs in nature asa mineral and can also be prepared artifi-cially by fusing 49 parts Shuddha MaZZa(purified arsenic) and 16 parts Shuddha

Gandhaka (purified sulphur) by process-ing in a Damaru Yantra (specific instru-merit)",

In Rasa Shastra, Manahshila has beendescribed under Uprasa Varga. InCharaka', Sushruta3 and Vagabattd', ithas been described under Parthiva(Bhauma) Dravya Varga; while Sharan-gadhara' placed it under Upadhatu andUparasa Varga. Manahsila is one of the

ATULKUMAR: "MANAHSHILA" AND KASA ROGA 241

Ranjana (colouring agent for metals) inRasa Shastra9,I,IO,ll.

Manahshila of three varieties has beendescribed in most of the Rasa Shastratreaties, viz. Shyamangi, Kanaviraka andKhandakhya', However, the Khandakhyavariety of Manahshila is widely acceptedfor therapeutic usage and also for SatvaPatana (preparation of metallic extract ofmineral ore).

Manahshila (Realgar) is used only inShuddha (purified & detoxified) state forthe therapeutic purposes as internal medi-cine. With reference to the treatment ofSvasa and Kasa use of drug ShuddhaManahshila has been described in variousRasa Yoga preparations, such as Rajam-riganka Rasa, Trailokyachintamani Rasa,Shilasindura, Samirapannaga Rasa andShvasakuthara Rasa, Moreover, there arereferences for the use of Manahshila inKasa Roga but it has not been used so farindependently as a single drug. Therefore,a study was undertaken to use ShuddhaManahshila as single drug for the treat-ment of Kasa Roga.

Shodhana of Manahshila is usuallycarried out by trituration with Ardraka(Zingiber officinale Rosc.) Svarasa, Bi-jaura Nimbu (Citrus medica Linn.)Svarasa, Agstya(Sesbania grandifloraPoir.) Svarasa, Jayanti (Sesbania sesbanMerr.) Svarasa, Bhrngaraja (Ecipta albaHassk.) Svarasa and Lime water etc. Inthe present study Ardraka Svarasa wastaken because Ardraka itself is used inthe treatment of Kasa Roga and a numberof references are available for shodhanaof Manahshila with Ardraka Svarasa inRasa Shastra treatises9,I,IO,II. In thepresent study Shuddha Manahshila was

mineral drugs that has been known tomankind since Vedic period, where itspsychological and therapeutic uses werewell known. In Rigveda', it has been de-scribed as Rakshoghna (disinfec-tantlbiocidal) drug in physical and mentaldiseases, where it was used for purifica-tion of environment. In Yajurveda andAtharvaveda'; its usage has been men-tioned in Agni Vayu Havana Chikitsa,Bhutonmada Chikitsa (treatment of idio-pathic psychotic syndrome) and KarmajaVyadhi Nirodha. In Boddha Sahitya, Vi-naya Pitaka, it has been mentioned asAnjana (ophthalmic medication) andDhruma Varti (medicated smoke); inAgni Purana as Kusthaghna Lepa (antidermal-diseases/ anti-leprotic paste forlocal application/ointment); and in Kau-tilya Arthashastra as Agni Churna forfireworks.

m~a

is'a~.tolaIy

~~te

ye In Samhitas, viz. Charakai, Sushruta',

Yagbhauo", Harita, Bhela and Kashy-apa', its externo-internal usages werementioned in various diseases, such asHikka (hiccough), Svasa (dyspnoea),Kasa (cough/bronchitis), Chardi (eme-sis), Kustha (leprosy and other dermato-ses) etc. In Rasa Shastra treatises, it wasused in the preparations of Dhruma Varti(medicated smoke), Ghrta (medicatedclarified butter/fat based formulations),Taila (medicated oil), Lepa (paste for lo-cal application/ointment), Curna Nasya(powdered nasal insufflation), Anjana(ophthalmic medication) and in variousRasa Yoga (organo-mineral/mineralpreparation). It has also been used forRasa Karma (processing of organo-mineral/mineral preparation) and Dhatu

ocess-nstru-

beenIn

a4, it

thivaran-andf the

standardized and evaluated for itsphysico-chemical parameters, along withits clinical study in patients of KasaRoga.

MethodologyPharmaceutical Study

The drug was prepared by takingKhandakhya variety of Manahshila (400g). It was processed (triturated) 7 timeswith Ardraka Svarasa (ginger juice) for 7days 1. At the end of processing, an orangecoloured, smooth, heavy, powder, theShuddha Manahshila (pure realgar) wasobtained. It was noted that the weight ofShuddha Manahshila was increased by27.5% (110 grammes) after the comple-tion of Shodhana (purification & detoxi-fication)!', as shown in Table l.

Physico-Chemical AnalysisMany physical and chemical changes

occur during the processes of making thedrug Shuddha Manahshila. Various stepsinvolved in drug standardization havebeen applied to Suddha Manahsila, asshown in Figure 1.

Standardization of "Shuddha Manahshila"A very fine orange powder (s,.huddha

Manahshila) obtained after Shodhana ofManahshila, as mentioned in The Ayur-vedic Formulary of Indial2, was used forphysico-chemical study.

242 INDIAN J TRADITIONAL KNOWLEDGE, VOL 3, No. 3, JULY 2004

: Orange: Pleasant pungent: Agreeable bitter: Heavy & smoothpowder

The physico-chemical parameters 13 ofthe drug, Shuddha Manahshila are asfollows:

: 4.9544 %, w/w: 4.1978 %, w/w: 0.5008%, w/w

: The quantitativeelement studywas carried outthrough Atomicabsorptionspectroscopy andInductive coupleplasma(Instrumentalelement test)"; asshown in Table 2.

: Kasa (cough!bronchitis)

: 10-25 mg

Table 1 - Weight differentiations of pharmaceutical processing of Manahsila

Weight of Weight Of Increase Percentage of weightManahshila Manahshila in weight of prepared increase in preparedcrude drug prepared drug drug drug

(before processing) -(after processing)

400 Grarnmes 510 Gramrnes 110 Gramrnes 27.5%

Chemical parameters:Qualitative analysis

Identification: Yielded the reaction charac-teristics of Arsenic (As) & Sulphur (S)14.15.Quantitative analysisLoss on drying at 1l0"C : 0.5325%, w/wLoss on ignition at 450- : 95.0686%, w/w550°CAsh valueWater insoluble ashAcid insoluble ashSpecial quantitativeanalysisElemental study

Physical parameters:

ColourOdourTasteTouch

Therapeutic indication

Dose

Sl3 ofe as

gentter~oth

rarac-

w

e

ic

andIe

• ase2.

ATULKUMAR: "MANAHSHILA" AND KASA ROGA 243

Figure 1-[A] Manahshila or Realgar (Crude drug)[B] Shodhana of Manahshila (Processing or triturating of drug)[C] Shuddha Manahshila (Prepared drug)

244 INDIAN J TRADITIONAL KNOWLEDGE, VOL 3, No. 3, JULY 2004

Table 2 - Percentage of element analysis insample "0" & "A" of Manahshila

Analyzed Sample "0" Sample "A"elements Manahsila Suddha

(crude drug) Manahsila(prepared

drug)

Arsenic (As) 7.2989 % 7.0149 %

Sulphur (S) 17.000 % 12.9000%

It is clear from the above physico-chemical study that many physical andchemical changes occurred in the drugafter it was processed (triturated) withArdraka Svarasa. The drug became de-toxified and made the drug more potent.Moreover, the inorganic state of drugchanged into organic state.

Clinical StudyThe clinical study of Shuddha

Manahshila was performed on 25 pa-tients, at O.P.D. & Indoor Department ofKaya Chikitsa, Rishikul GovernmentState Ayurvedic College & Hospital,Hardwar, Uttaranchal. The study was car-ried out in a particular "Proforma", inwhich the selection of registered patientsof Kasa Raga was done according to pa-rameters of their definite symptoms ofKasa, pathological tests and other diag-

nostic examinations. The therapeutic ef-fect of the drug was observed after 4weeks of treatment. The effect of the drugwas assessed in weekly follow-ups for 4weeks, using the above-mentioned pa-rameters. After follow-ups or cure of thedisease, whichever is earlier, data werecollected and analyzed statistically.The drug: Shuddha Manahshila9

•1

Dose of drug: For adult - 25 mg, threetimes a day, with the adju-vant of honey.For child - 10 mg, threetimes a day, with the adju-vant of honey.

The clinical effects of ShuddhaManahshila on the patients of Kasa Ragawere observed for 4 weeks.

ResultsDuring the treatment of Kasa Raga, the

patients observed for the complications I 0

of Manhashila, such as Vamana (vomit-ing), Trisna (polydipsia/excessive thirst),Mandagni (dyspepsia/loss of appetite),Malabaddhata (constipation) and MutraVikara(diseases of the urinary system)etc., showed no complications.

The clinical effects of ShuddhaManahshila on the patients of Kasa Raga

Table 3--Result of clinical study of Shuddha Manahshila on patients of Kasa Roga

S.N. ResultsMale

I. Cured 10

2. Improved 3

3. Not Improved

Total 14

No. of patients PercentageFemale Total no. of patients

9 76%

16%

19

4

2

258%

100%11

f-4g4

el-'

el-'

aa

eo

I,I,

2

2

ATULKUMAR: "MANAHSHILA" AND KASA ROGA 245

were observed on the basis of progress oftheir symptoms of Kasa and pathologicaltests, e.g. TLC, DLC, Hb% and E.S.R.parameters 17, every week for 4 weeks ofdrug treatment. The prognosis was ob-served on the basis of subjective & ob-jective relief.

76% patients of Kasa Raga were curedand 16 % improved with the treatment ofShuddha Manahshila; however, 8% didnot show any change in their conditionsas shown in Table 3. Differential leuco-cytes counts (DLC) were carried out as apart of clinical study. In Ayurveda, VatikaKasa is correlated with eosinophiliccough and according to modern medicine,eosinophills count usually rises duringrespiratory ailments". The effect of thedrug was studied with respect to eosino-phills percentage change in one-weekinterval. Out of 25 patents of Kasa Raga,eosinophills percentage reduced signifi-cantally in 20 patients, no significantchange was observed in 3 patients anddata could not be collected from 2 pa-tients, as they did not continue the treat-ment.

Shuddha Manahshila gave a goodprognosis in the patients of Vatika Kasa(coughlbronchitis with Vata predomi-nance-eosinophilia) in comparisons toother types of Kasa, which were observedon the basis of subjective and objectiveimprovement.

ConclusionDuring the present clinical study of

Shuddha Manahshila on the patients ofKasa Raga, no side effect of the drug wasnoticed. Shuddha Manahshila, whengiven to patients of Kasa Raga at the dose

of 10-25 mg, three times a day for 4weeks, with the adjuvant of honey, gavegood result particularly in Vatika Kasa(eosinophilia). Shuddha Manahshila, ifused in appropriate dose on the patientsof Kasa Raga, has a potential for becom-ing the drug of choice.

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