Ayurvedic Bhasma in the Management of Pakṣāghāta (Hemiplegia): Clinical and Pharmacological Perspectives

Abstract

Introduction: Pakṣāghāta, described in Ayurveda as a Vāta-pradhāna Nanātmaja Vyādhi characterised by Ekadeśa-Stambha, Karmahāni, Gati-Saṅga, and Vakrikaraṇa, clinically correlates with hemiplegia, defined in contemporary medicine as paralysis of one side of the body due to an upper motor neuron lesion. Bhasma-based Rasaūṣadhis are traditionally advocated in Vātavyādhi for their Sūkṣma, Tīkṣṇa, Yogavāhī, Rasāyana, and Vāta-śāmaka properties; however, scientific evidence supporting their neurotherapeutic role remains limited.

Methods: A narrative review was undertaken using classical Ayurvedic texts, published analytical studies, experimental pharmacological research, and available clinical observations. Particular emphasis was placed on Swarna, Rajata, Abhraka, Loha, Hartala, and Mānaśilā Bhasmas. Additionally, one case of Abhighātajanya Pakṣāghāta managed with Pañcakarma and selected Rasaūṣadhis was analysed to demonstrate clinical application.

Results: Classical texts describe these Bhasmas as Medhya, Balya, Rasāyana, and Vāta-hara. Analytical studies indicate nano/submicron particle size, formation of organometallic complexes, and incorporation of phytoconstituents from the Śodhana–Māraṇa processes. Preclinical data suggest antioxidant, adaptogenic, and neuroprotective potential in specific preparations, although findings are heterogeneous and preparation-dependent. The clinical case demonstrated improvement in motor power, mobility, and sensory function under integrative management.

Discussion: While Ayurvedic literature provides a theoretical basis for using Bhasmas in Vātavyādhi including Pakṣāghāta, current scientific validation is insufficient to confirm clinical efficacy in hemiplegia. Improvement observed in the case likely reflects the combined influence of Pañcakarma procedures, physiotherapy, and natural neurological recovery. Rigorous pharmacological studies, standardised analytical characterisation, and controlled clinical trials are essential to substantiate traditional claims and define safety–efficacy profiles.