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Introduction

Ayurveda lays stress on positive health, a blend of physical, mental, Social, moral and spiritual welfare and this holistic medical science considers three important factors while dealing with the health and disease i.e. Ousadha (Drug & therapies), Ahara (Diet) & Vihara (Practices). 1 Ayurveda has recognized that the body is the result or an outcome of the food we eat. Showing the importance of food Acharya charaka has described that the life of all living things is food and the entire world seeks food. Complexion, clarity, good voice, long life, understanding, happiness, satisfaction, growth, strength and intelligence are all established in food2. The Pathya is the one which keeps the person healthy, maintains normal body functions, leads to proper functioning of the organs, nourishes the mind and intellect, prevents diseases and at the same time corrects the irregularities that may occur in the body.  Pathya (wholesome) is that which is not detrimental to the patha (the srotasa or passage of the body) and is also liked/ pleasing to the mind (psyche) and that which is detrimental to the body and unlike by the mind is apathy (unwholesome thus is not at all) desirable. However, wholesomeness or unwholesomeness of substances are not their inherent qualities /properties, as those depends upon dose, time, preparation/methods of processing, place or habitat, body and variation according to status of dosas which alter the properties of substances which are generally seen. The substances which are not detrimental/healthy and elimination of ailments of diseased is pantha , thus pathya may be considered as that not diverted from this path  The substance / article not detrimental/ harmful to the mind and body is pathya. 3 Thus the natural characters/ inherent properties of substances and also dose etc. factors influencing those have been mentioned. The one physician desirous of success should initiate the therapeutic measures taking into account both those. Besides prescribing the medicines, Ayurveda recommends some prophylactic and interventional diet which also plays a major role in the prevention and management of the disease.

Rasashastra literally means the “Science of Mercury”, is a specialized branch of Ayurveda dealing mainly with materials which are known as „Rasa dravya?. It mainly includes metals, minerals, gemstones and their processing. The parada or rasa is one among the important rasa dravya. The indications, dose, vehicle, period of drug administration, interval or duration of treatment, disease diagnosed, nature or Prakruti of patient, pathya-apathya etc. are major factors which should always be considered by the physician before they recommend these Rasaushadha dravya’s to the patients.4

As we all know most of the rasa drugs are toxic in raw form, so  these are pass through  extensive  processing  before  they  are declared  fit  for  internal  use.  These  are  first  purified  and then  burnt  several  times  and  converted  to ‘Bhasma’.  Each time  before Marana,  the  metallic  powders  are  processed with  fresh  herbal  juices  to  neutralize  their  toxic  effects. Ayurvedic formulations    containing    these    heavy    metals    produce different effects like enhancement of bio-availability to the cell, act as carriers for active ingredients and as catalysts. Even  though  the  drugs  are  in assimilable forms, there  should  be  suitable  vehicles  for  its  absorption.  Here comes the importance of ‘Pathyapathyas’ while using these metallic forms. A detailed description about the ‘Pathya-apathyas’are also available in the classics.  Suitable Pathyas are necessary while using these rasa drugs for proper absorption   of   drug,   to   reduce   its   adverse   effects, and   to increase its bio-availability etc.5 Pathya-apathyas has two main aspects; one is disease wise and other is drug wise. Disease wise Pathya-apathyais similar in Kashtoushadies (Herbal) and Rasoushadies (metals    and minerals). Drug wise Pathya-apathya differs in Rasaushadhi because some of the drugs are corrosive and toxic. The different treatise of Rasashastra emphasises in detail about pathya- apathya during rasa bhasma sevana and different rasaushadhis  sevan

Table : 1 Pathya Apathya during Rasa sevan by different authors

Apathya ahara during rasa bhasma sevana: Atyashana (over eating), Atipana (excess drinking), Adhmanahara (food that cause bloating), Kakarashtaka gana (chelating agents), Kulattha (horse gram), Atasi taila (linseed oil), Chitra taila, Tila (sesame oil), Masha (black gram), Masooraka (red lentils), Kapotha mamsa (meat of pigeon), Kanjika (sour gruel), Takranna (buttermilk rice), Kukkuta mamsa (meat of hen), Lavana, amla, katu, tikta ahara (salt, sour, pungent and bitter foods), Pittala patra (usage of bronze vessels), Badara (jujube fruit), Narikela (coconut), Saindhava lavana (rock salt), Sauvarchala lavana (black salt), Naranga (lemon), Kanchanara (Bauhinia varigata), Bruhati (Solanum indicum), Bilva (Aegle marmelos), Kushmanda (pumpkin), Vetagra (Bambusa arundinacea), Karpoora (Camphor), Karavellaka (Bitter gourd), Nishpava (Vigna unguiculata), Sarshapa (mustard seed), Sahakara, Surasava (Alcoholic preparations), Anupa mamsa (meat of animals residing in wet lands), Dhanyamla (sour liquids), Guru vishtambi ahara (heavy and dry foods), Teekshnoshna ahara (hot and pungent food), Lavanadhikam (food mixed with more salt), Sandhyajya annam (food that is kept overnight), Keshadi Rustam (food contaminated by hair), Kritasheetha ushnam (reboiled food), Shakhavarannai bahulam (food with more leafy vegetables than rice), Atyambupana (drinking excessive liquids), Svadu heenam (tasteless food), Vinashta dugdha (spoilt milk), Amahara (improperly cooked food), Dagdhahara (burnt food).

Apathya vihara during Rasa Bhasma Sevan:  Atinidra (excessive sleeping), Atijaagarana (not sleeping at proper times), Ati stree prasanga (over indulgence with women) Shushka vada (unnecessary debates) Jalakreeda (swimming), Paryatana (roaming around) Vatakaraka vastu sevana (food that vitiates vata dosha), Na kshudha (fasting), Na ajeerna (over eating leading to indigestion)

Apathya Manasika vikara during Rasa Bhasma Sevan: Atikopa (anger) Maha harsha (laughter), Atidukha (agony), Atichinta (excessive thinking), Atispruha (over consciousness) Pathya ahara during rasa bhasma sevana: Dugdha (milk), Shaali Anna (rice), Mudga (green gram), Ghrita (ghee), Punarnava, Meghanada, Vastuka along with saindhava, shunti, musta and padmamoola, Godhuma (wheat preparations), Purana shaali (old rice), Dadhi (curd), Hamsodaka (water), Mudgayusha (green gram soup), Takram hitam snehagatam (butter milk without fat), Pushpa (flowers), Sarva phala madhuram (sweet fruits), Sarvam madhuram (sweet substances), Pakayukta mamsa sharkaram (properly prepared meat and sugar preparations).

               Pathya vihara during rasa sevana: Mantrajapa (chanting mantra), Abhyanga with bala, Narayana taila (oil message), Uvattana (fine powder message with sugandhi dravyas), Sukhoshna jala snana (bathing with luke warm water). Pathya manasika vikaras include Satyavachana (speaking truth) and other pathya are Shiva pooja (worship lord Shiva) and Atmanjana (self-realisation). Pathya jala mentioned are Divyantariksha (rain water), Dhunija (river water), Kaupa (well water), Svayam vishirnadi (river water), Silatalodbhava (springs from mountains), Tadagaja (lake water), Sarasa (pond water), Audbhida (spring water).6

Table : 2 Pathya Apathya  during rasa dravyas  sevana.

Table 3:  Pathya during Visha sevan

Table 4: Pathya Apathy during Rasaushadhis

During intake of parpati old rice, patola, baingana, and milk should be taken as wholesome diet. If in early treatment milk is not suitable then patient should be advised to take lava, titar laghu masa for bala vrudhi. If there is shotha then water and salt are considered apathy but if feels thrusty then tender coconut water can be given. Even in hot region water should not be stopped26. According to Ayurveda Prakash water intake should not be done and even contact with water should be avoided.[27]

Discussion

Many medicines have powerful ingredients that interact with the human body in different ways. Diet and lifestyle can sometimes have a significant impact on drugs. Interactions between food and drugs may inadvertently reduce or increase the drug effect. Some commonly used herbs; fruits as well as alcohol may cause failure of the therapy up to a point of to serious alterations of the patient’s health. The majority of clinically relevant food-drug interactions are caused by food-induced changes in the bioavailability of the drug. The interaction of natural products and drugs is a common hidden problem encountered in clinical practice. Several fruits and berries have recently been shown to contain agents that affect drug-metabolizing enzymes.

Drug interactions can alter the pharmacokinetics and/or pharmacodynamics of a drug.  Drug interactions (DIs) represent an important and widely under recognized source of medication errors28. Diet alone cannot and should not replace medicine in all circumstances but certain diet plans are scientifically supported to help prevent many chronic diseases. Food is known to affect drug absorption by delaying gastric emptying time, altering gastrointestinal pH, stimulating bile flow, increasing splanchnic blood flow, or physically interacting with drugs29.  The  rationale  behind  the  selection  of Ahara and Vihara as Pathya or Apathya mainly depends on their  properties  like  Rasa,  Guna,  Veerya,  Vipaka, Prabhava etc  Suitable Pathyas are  necessary  while  using  these  rasa  drugs  for proper absorption of drug, to reduce its adverse  effects, and to increase  its  bio-availability  etc. Also most    of    the Pathya dravyas will    increase    the    bio-availability of  particular  drug  and  thereby  speed  up  its action  on  target  organs. Pathya apathya explained under specific formulations acta as anupana as well as help in pharmacokinetics of the drug. Some drugs are mentioned as pathya they may act as antagonists for the main drug for example Shilajit is considered as a good rasayana drug. But it produces some untoward effect when administered along with some drugs like kulatha and drugs having vidahi and guru ahara. Shilajit and kulatha possess opposite gunas. Intake of both the drugs at the same time causes untoward effect. Also Kulattha is considered as Ashmarighna (Stone removing) hence it may remove out the Shilajatu before its proper absorption hence; usage of kulatha is contraindicated or considered apathya in the treatment of Shilajit30. In Aphathya vihar Snana during rasa sevan is mentioned but it can be done on 2nd-4th days. Most of the Pathya drugs possess Madhura rasa, Seetha veerya, Madhura vipaka, Snigdha guna and Tridosha samana properties. These help for easy absorption of drug or make body fit to absorb the drug. Dietary factors affect heavy metal uptake. Some Dravyas are essential for the absorption of a particular drug.31  The  group  of  fruits  and  vegetables  (Shaka)

having  their  Sanskrit  name  starting  with  ‘KA’,  are called  as  Kakaradi  Gana. Among Apathyas most of the classical texts  has given more importance to the ‘Kakaradi  Gana’. The  group  of  fruits  and  vegetables  (Shaka) having  their  Sanskrit  name  starting  with  ‘KA’,  are called  as  Kakaradi  Gana, which are  apathya in Rasasevan.  The Rasaushadhis basically given as a treatment in disease condition where patients mostly have low digestive fire. But most of the dravyas (Drugs) mentioned under  the Kakaradi gana are heavy (Guru) and may be difficult to digest.

Also most  of  the  drugs  of  the  Kakaradigana  like Kushmanda  (Ash  gourd),  consist  of  Sara  guna (purgative property). This may result in less time for the absorption in the intestine.  So  when any  Rasakalpa  if consumed with this substance, the medicine will excrete out  of  the  body  with  less  absorption  and  thus  may  not show  the  expected  result  on  the  body. Hence these drugs have said to be contraindicated while the Rasasevana is in process. This   can be consumed once the Rasasevana kala completed and this may help for chelating the unwanted drug deposited in the body during the Rasasevan.  32

Conclusion

More attention should be paid to pathya along with the treatment, so that maintenance of well-being and the restoration of health are achieved through ahara (food) and vihara (lifestyle) Pathya apathy is to be followed to ensure maximum efficacy of the medicines in curing a disease. The Kakaradi gana dravyas are not contraindicated in all the Rasa formulations.  But still it will be better to avoid the Kakaradi Gana during Rasa sevana kala to get more efficacies.  Specific dravyas are mentioned as pathya or apathya for specific drugs, which has its own significance, but equally the pathya apathy specified for particular disease are also to be followed along with this which are mentioned in classical texts, to reduce its adverse effects, to increase its bioavailability and efficacy etc. Hence this review may prove to be helpful to provide a different aspect of pathya apathy during rasa sevan and also while different Rasaushadhis sevan.