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=== Mode of action of aushadha ===
=== Mode of action of aushadha ===
<div style='text-align:justify;'>The action of the aushadha depends upon its potency.<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Sutra Sthana; Dravyarasagunaviryavipakavigyaniya Adhyaya: Chapter 40, Verse 5. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 195.</ref> [Su. Sa. Sutra Sthana 40/5] Some scholars believed the potency to be of two types (hot and cold) while others believed it to be of eight types (cold, hot, oily, dry, clear, slimy, mild and sharp). For example, mahatpanchamula (combination of roots of ''Aegle marmelos, Clerodendrum phlomidis, Oroxylum indicum, Stereospermum suaveolens'' and ''Gmelina arborea'') alleviate vata dosha due to their hot potency (since vata dosha is cold in property). Kulattha (''Dolichos biflorus'') and onion (''Allium cepa'') alleviate vata due to oily character (since vata is dry in property). Cane sugar (''Saccharum officinarum'') increases vata due to its cold potency. </div>
<div style='text-align:justify;'>The action of the aushadha depends upon its potency.<ref>Shastri A D, editor, (1st ed.). Commentary Ayurveda Tattva Sandipika of Ambikadutta Shastri on Sushruta Samhita, Sutra Sthana; Dravyarasagunaviryavipakavigyaniya Adhyaya: Chapter 40, Verse 5. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 195.</ref> [Su. Sa. Sutra Sthana 40/5] Some scholars believed the potency to be of two types (hot and cold) while others believed it to be of eight types (cold, hot, oily, dry, clear, slimy, mild and sharp). For example, mahatpanchamula (combination of roots of ''Aegle marmelos, Clerodendrum phlomidis, Oroxylum indicum, Stereospermum suaveolens'' and ''Gmelina arborea'') alleviate vata dosha due to their hot potency (since vata dosha is cold in property). Kulattha (''Dolichos biflorus'') and onion (''Allium cepa'') alleviate vata due to oily character (since vata is dry in property). Cane sugar (''Saccharum officinarum'') increases vata due to its cold potency. </div>
=== The action of aushadha is location specific ===
<div style='text-align:justify;'>The aushadha that is effective at one site in the body might not be as effective at other site.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 4. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref> The location of dosha in the body is specific and the diseases are most probably caused by aggravation of dosha at their native sites. Particular aushadha acts on particular dosha, hence the site of action of aushadha must be specific. Thus the site of aggravated dosha must be determined first. Reason of aushadha being location specific may be presence of specific receptors at specific sites. For example, beta-blockers act on the heart and reduce blood pressure as the receptors on which beta blockers acts (B1 receptors) are found in the heart.<ref>Arcangelo VP, Peterson AM (2006). Pharmacotherapeutics for advanced practice: a practical approach. Lippincott Williams & Wilkins. p. 205. ISBN 978-0-7817-5784-3. Retrieved September 7, 2010</ref><ref>James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E (February 2014). "2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.</ref><ref>Frishman WH, Cheng-Lai A, Nawarskas J (2005). Current Cardiovascular Drugs. Current Science Group. p. 152. ISBN 978-1-57340-221-7. Retrieved September 7, 2010.</ref></div>
=== The action of aushadha is individual specific<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 5. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.</ref> ===
<div style='text-align:justify;'>The individuals who are obese, very lean, whose muscles, blood, bones and other body parts are of unsteady mass, whose digestive fire is weak, who take less quantity of food or unwholesome food, are emaciated or exhausted of essence, cannot tolerate and bear the strong medicines. Hence such persons are to be treated with aushadha, that are soft and pleasant, gradually strong and heavy, and which do not create unhappiness due to exhaustion or disturb the dosha. Women, tender individuals and children are to be treated like this due to less endurance. <br/>In the same way, aushadha in low dose or of less efficacy administered in severe diseases or strong persons will be of little use and further disturb and aggravate the dosha and the disease.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 7. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424-425.</ref><br/>Ayurveda scholars quoted that children under 12 years should not be advised aushadha alone as the children are delicate. The use of aushadha alone may destroy their strength and longetivity. Use of aushadha alone should also be avoided in emaciated, old and short-tempered individuals suffering from loss of dhatu, indriya and ojas. This aushadha may destroy them in a way the sun desiccates small amount of water.<ref>Satyapala, editor, (1st ed.). Commentary Vidyotini of Kashyap Samhita, Khila Sthana; Bheshajyopakramaniya Adhyaya: Chapter 3, Verse 58-59. Varanasi: Chaukhamba Sanskrit Sansthan, 2015; 369.</ref><br/>These treatment protocols are practiced by ayurveda practitioners. The medicines that contains metals or are required in small doses like rasaushadhi, rasamanikya, etc. are avoided in very old, very young and emaciated individuals. The chidren are almost always administered the aushadha with anupana (liquid taken soon after medicine), bal chaturbhadra churna is administered to children along with honey. Customized or a person specific medicine, form, dose is a thrust area for research. </div>
=== Untoward effects of aushadha consumed in inappropriate doses ===
<div style='text-align:justify;'>The aushadha, its potency and doses should be determined after evaluating dosha, the strength of the disease, and the person. Even the use of emergency aushadha, or the aushadha with mild properties in greater doses, or treatments such as use of alkali or surgical instruments, may cause harm to patients of poor physical strength and stamina. When aushadha with doses or potency greater than the strength of disease are used, this aushadha may relieve the patient from the existing disease, but soon may generate diseases of opposite qualities. These aushadha may cause exhaustion, fainting, toxicity, delusion, and a decrease in strength; those more potent than the digestive capacity will produce exhaustion and poor digestion.<ref>Tripathi R.D., (1 st ed.). Commentary Saroj on Astanga Sangrah of Vridhavagabhata, Sutra Sthana; Bheshajavacharaniya Adhyaya: Chapter 23, Verse 6. Delhi: Chaukhamba Sanskrit Pratishthan, 2015; 424.<ref></br>The drug induced toxicity can be due to either of the four causes: hypersensitivity and related immunological reactions; off-target pharmacology; biological activation to toxic metabolites; and idiosyncratic toxicities.<ref>Liebler, D., Guengerich, F. Elucidating mechanisms of drug-induced toxicity. Nat Rev Drug Discov 4, 410–420 (2005). https://doi.org/10.1038/nrd1720<ref> For example, drug toxicity by drugs administered in high doses was observed in a study in which Lauha Bhasma and Mandura Bhasma were given five times (55 mg/kg) more than therapeutic dose (11 mg/kg) for a long duration (60 days) in albino rats. The signs observed in the rats were increase in body weight, blood sugar level, serum urea level, serum creatinine level, SGOT and serum alakaline phosphatase. Moderate fatty degenerative changes, diffuse necrosis, periportal necrosis, central vein congestion and sinusoidal dilatation was observed in Lauha bhasma treated group. Mild fatty changes and sinusoidal dilatation was observed in Mandur Bhasma treated group.<ref>Sarkar, Prasanta Kumar & Prajapati, Pradeep & Shukla, Vinay & Ravishankar, Basavaiah & Chaudhary, Anand. (2009). Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian journal of experimental biology. 47. 987-92.<ref></div>
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