BALASARVANGAM – A DIVINE ELIXIR

Dr. Janani Remyaprabha Jnana Thapaswini, BAMS, MD

Vice-Principal, Santhigiri Ayurveda Medical College

Ayurveda visualizes management of any disease, based on the concept of Tridosha. There are umpteen number of  kalpas  mentioned in treatises of ­Ayurveda for treating various diseases. In ­addition to the classical ­medicine  anubhtha yoga  also use extensively in  clinical practice. Balasarvangam is also one among such anubutha yoga ­designed by the great vaidyas of that period under the supervision of  our Guru Navajyothi Sree Karunakara Guru which was later procured drug license under proprietary medicine category. Bala sarvangam muukkuttu is an oil based poly herbal formulation produced and marketed by  santhigiri ayurveda and siddha vaidya sala. It is effective as anti inflammatory, antiviral medicine. It is found to be effective in acute respiratory diseases with raised ESR, neurological diseases, CVA -initial stage, Rheumatoid arthritis.Bala sarvangam mukkoottu has 39 ingredients and most of those have Anti Inflammatory, ­Immunomodulatory and Antiviral potentials.

CLINICAL EXPERIENCE

Since the early 90’s  Balasarvangam was  extensively practised by the physicians of Santhigiri hospitals for treating various neurological, respiratory ailments and also in some arthritis. One among such cases, I would like to highlight here. One day in our OPD  a 51 yr old male  presented low grade fever,  productive cough , chest congestion. His blood test was taken and ESR was found to be 125 mm/ hr and total count was in the upper limit. Since he is allergic to allopathy drugs, we decided to give ayurvedic management. Balasarvangam was advised 20 drops twice daily  with honey for 7 days with strict pathya. He was restricted even to the usage of cold water for his primary needs, In Ahara, rice ­prepared food stuffs such as ­Idiyappam , Kanji, Puttu etc. was allowed. Curd, Black Gram etc. were ­completely avoided on those days.7 days medicine was continued and Pathyam was followed  for 12 days. Later on 13 th day. ESR was again checked  it was  80 mm/hr and the patient was symptomatically better. Selection behind selecting Balasarvangam  instead of any kashayam , he was reluctant to take kashayam , lehyam

On observations , it is found that  Balasarvangam is highly effective in vata kapha diseases. Clinical experience shows that  Balasarvangam is a good remedy in Vata Kaphaja Gridhrasi, Hypothyroidism, Granthi, Athersclerosis, Amavata ( In ama avastha), Respiratory complaints such as vata kaphaja , kasa( productive cough ), CVA ( not in hemorrhagic stroke.).Its immunomodulatory action is yet to be studied but based on the observation  incidence  of seasonal attacks , viral  arthritis and other viral diseases etc was less in the people who takes Balasarvangam.

In Gridhrasi (IVDP) after initial shodhana chikitsa  balasarvangam can be given  as samana aushadha with gulggulu tiktaka ghrtham  for 41 days. It  is observed that the numbness  persisted  even after the  shodhana chikitsa was completely reduced. In vata kaphaja kasa agsthya rasayana with balasarvangam is advisable .It is not advised in paittika vikaras .In rakta arsas, paittika asrgdharaetc  it causes  excess  bleeding. In rheumatoid condition, if  pitta and rakta are in  vitiated stage , the usage of balasarvangam causes burning sensation and also it further increases the  rheumatic condition. In menopausal period also  balasarvangam is not advisable.

PHARMACODYNAMICS

Balasrvangam due to its Teekshna Guna, Snigdha, Ushna, Tikta Kashaya Rasa it is Sroto Sodhana, Vata Kapha Hara, Medohara, Deepana, Pachana, Medohara.

BACKGROUND RESEARCH REVELATIONS

Ardraka is reported to be useful in treating inflammation and rheumatism. It is useful in treating chronic inflammation because it partially inhibits two important enzymes that play a role in inflammation cyclooxygenase (COX) and 5-lipoxygenase (LOX). Thomson et. al. 2002 examined that ginger administered orally (500 mg/kg) caused significant changes in the serum PGE2 and suggested that ginger could be used as an antithrombotic and anti-inflammatory agent. Many studies have been revealed that ginger has a strong analgesic effect due to its chemical constituent Gingerol and its derivatives, especially 8-paradol, have been reported to be more potent antiplatelet and cyclo-oxygenase-1 (COX-1) inhibitors than aspirin [12].

Lasoona appears to enhance the ­functioning of the immune system by stimulating certain cell types, such as macrophages, lymphocytes, natural killer (NK) cells, dendritic cells, and eosinophils, by mechanisms including modulation of cytokine secretion, immunoglobulin production, phagocytosis, and macrophage activation. Immunoregulation by garlic extracts  can contribute to the treatment and prevention of pathologies such as obesity, metabolic syndrome, cardiovascular disorders, gastric ulcer, and even cancer [13].

Methanol extract of the Nirgundi was standardized in terms of total polyphenols. The standardized extract in a dose of 100 mg/kg caused a comparable reduction in edema with that of diclofenac sodium (25 mg/kg) when evaluated for antiinflammatory activity by carrageenan-induced rat paw oedema method. The extract also exhibited a strong free radical scavenging activity by 1,1-diphenyl-2-picrylhydrazyl method and caused a significant reduction in the formation of thiobarbituric acid reacting substances when evaluated for its lipid per-oxidation inhibitory activity. The results strongly suggest that radical quenching may be one of the mechanisms responsible for its anti-inflammatory activity [14].

Different parts of the Vitex negundo   have anti-inflammatory and anti-arthritic activity. The anti-inflammatory action is attributed to an inhibitory action on prostaglandin (PG) biosynthesis [15].The leaves have an anti-inflammatory and analgesic action that is mediated by inhibition of PG synthesis, antihistamine, membrane stabilizing and antioxidant activities[15] [16]. Vitex negundo is the richest source of stable vitamin C and therefore acts as one of the best ­anti-inflammatory agents and improves immunity.

An extract  of Myristica fragrans was prepared from the sample. Cell viability assay – MTT Assay was performed, and Raw cell line 247 was used to study the anti-inflammatory potential of the extract. A gradual decrease in the number of inflammatory cells as the concentration of the extract was increased was observed in the inflammatory cell line. The cell viability, which was 7.08% when the concentration of the extract was 1ng increased up to 30.6% when the concentration of the extract was increased up to 100ug. The MTT assay test on a raw cell line 247 showed that the Myristica fragrans extract exhibits some level of the anti-inflammatory property [17].

Lipids may serve as biomarkers of some diseases, but they can also provide endogenous therapeutic effects for certain pathological conditions. Current uses and possible clinical benefits of various lipids (fatty acids, steroids, triglycerides, and phospholipids) in cancer, infectious, inflammatory, and neurodegenerative diseases are presented. Lipids can also be conjugated to a drug molecule, accomplishing numerous potential benefits, one being the improved treatment effect, due to joined influence of the lipid carrier and the drug moiety. In addition, such conjugates have increased lipophilicity relative to the parent drug. This leads to improved drug pharmacokinetics and bioavailability, the ability to join endogenous lipid pathways and achieve drug targeting to the lymphatics, inflamed tissues in certain autoimmune diseases, or enable overcoming different barriers in the body. Altogether, novel mechanisms of the lipid role in diseases are constantly discovered, and new ways to exploit these mechanisms for the optimal drug design that would advance different drug delivery/therapy aspects are continuously emerging [18].

Pilot Study of Balasarvangam – An Interim Report

Based on  the clinical observations,  an initial  pilot study is ongoing to explore the therapeutic potentials of the drug. Study was planned for 6 months. Patients were selected on the basis of haematological and clinical findings. Patients with Raised ESR and CRP are considered as inclusion criteria along with the clinical symptoms like Pain, Joint Stiffness, Oedema etc. Based on this minimal inclusion criteria, 23 patients were selected and they were given the medicine, and were continuously monitored and assessed on stipulated ­intervals for the past two months.

At the end of the 1st month of study,  it has been found that the signs and symptoms of rheumatic complaints, especially the signs of inflammations like swelling and pain, in the study participants were reduced.

As a general inflammatory marker, ESR of 69.17% of the total study participants with above normal ESR levels were decreased, similarly it has been found that the level of CRP in 56.52% has declined. Observed trend in the values of ESR and CRP are elucidated in the chart below:

Conclusion

In Ayurveda purview, Balasarvangam is an excellent  Oushadha in treating chronic Vata Kaphaja ­Vikaras, Kapha Hanubandha,Vata Vyadhi, Vata Kaphaja- Prana Vaha Sroto Vikara.

Based on the interim observation from the continuing pilot study, the Balasarvangam has shown hopeful potential in reducing the clinical signs/symptoms and laboratory markers of inflammation. However this is not conclusive data on the drug, as the study is continuing further with the aim of exploring more on the ­wonderous medicine.

References

12. Dr. Bhavna singh, Prof. (Dr.) S.D. Upadhyaya; Zingiber Officinale: Maha-aushdha of Ayurveda. World Journal of Pharmaceutical Research sjif impact factor 5.990 volume 5, issue 2, 401-409. Review article issn 2277– 7105,
13. Rodrigo Arreola, Saray Quintero-Fabián, Rocío Ivette López-Roa, Enrique Octavio Flores-Gutiérrez, Juan Pablo Reyes-Grajeda, Lucrecia Carrera-Quintanar, and Daniel Ortuño-Sahagún, Immunomodulation and Anti-Inflammatory Effects of Garlic Compounds,Journal of immunology research,Review Article ,Volume 2015 |Article ID 401630 | 13 pages | https://doi.org/10.1155/2015/401630;
14. Kulkarni RR,Virkar AD,D’mello P,Antioxidant and Antiinflammatory Activity of Vitex negundo,­Indian jouranal of pharmaceutical sciences.­PMCID: ­PMC304089PMID: 213694592,2008 Nov-Dec; 70(6): 838–840;
15. Kumar D, Kumar R, Sharda K. Medicinal ­property of ­Nirgundi. Journal of Pharmacognosy and ­Phytochemistry 2018;SP1:2147-2151;
16. Dharmasiri MG, Jayakody JR, Galhena G, et al. Anti-inflammatory and analgesic activities of mature fresh leaves of Vitex negundo. J Ethnopharmacology 2003 Aug;87(2-3):199-206 .eMediNexus,  27 ­November 2018;
17. Farhat yaasmeen sadique basha, Rajesh kumar.s, Lakshmi .T.Department of pharmacology, saveetha dental college , saveetha university , chennai , Tamil Nadu, Anti inflammatory activity of Myristica fragrans.India.Indian jouranal of pharmaceutical sciences. https://doi.org/10.26452/ijrps.v10i4;
18. Markovic M,Ben-Shabat S,Aponick A,Zimmermann EM,, Arik Dahan,Lipids and Lipid-Processing Pathways in Drug Delivery and Therapeutics, international journal of molecular sciences.PMCID: PMC7247327,PMID: 32375338Published online 2020 May 4. doi: 10.3390/ijms21093248.