Introduction

Ayurveda is the most ancient science of life having a holistic health approach having a history of practice and use for over 3,000 years in Indian subcontinent. Ayurveda literally means (Ayur: Life; Veda: Science) science of life in Sanskrit, is not only a medical system but a way of life which aims at the holistic management of health and diseases widely practiced in Indian subcontinent and its concepts and approaches are considered to have been perfected between 2500-500 BC (1-3). The preparation of medicines i.e. pharmacy is an integral part of this science, and evolved from a very rudimentary form. The ayurvedic pharmaceutical preparations were evolved gradually from a simpler form to more complex forms based on plants and plant mineral combinations. Charaka Samhita contains a number of modified pharmaceutical preparations such as asava, arista, churna, avaleha, vatika, varti, taila, ghrita, lepa, mantha, arka etc (4)^.

India has an ancient heritage of traditional herbal medicine. With the emerging interest in the world to adopt to study the traditional system and to exploit their potentials based on different healthcare systems (5). The World Health OrganizationEstimates that about 80% of the populations living in the developing countries rely almost exclusively on traditional medicine for their primary health care needs (6). The use of herbal drugs for treating various diseases predates human history forms the origin of much of the modern medicine. Long before the advent of modern medicine, herbs are the mainstream remedies for nearly all ailments. People commonly diagnosed their own illness, prepared and prescribed their own herbal medicine, or bought them from the local medical store (7). Herbal medicines are being used increasingly as dietary supplements to fight or prevent common diseases (8).

The term churna may be applied to the powder prepared by a single drug or a combination of more drugs. If metals or minerals are used the prepared formulation is termed as bhasma or sindura. To prepare Kajjali, parada and gandhaka are mixed and other drugs are added. Drugs according to the formulation composition of the particular churna are collected, dried, powdered individually and passed through sieve number 85 to prepare a fine powder. They are mixed in the specified proportion and stored in well closed container. In general the aromatic drugs like asafoetida etc. should be fried before they are converted to fine powders. Specific care should be taken in case of salts and sugars. Formulations with hygroscopic components should not usually be prepared during rainy seasons. If so, specific precautions should be taken during storage. Churnas should be stored in air tight containers. Polyethylene and foil packing also provides damp proof protection. Special precaution for storage should be taken in cases of formulations with salts, sugars (4).

The herbal medicinal products were complex mixtures, which were originated from biological sources, great efforts were necessary to guarantee a constant and adequate quality. By carefully selecting the plant material and a standardized manufacturing process, the pattern and concentration of constituents should be kept as constant as possible, as this was a prerequisite for reproducible therapeutic results. The products were banned for consumption in the UK market include Karela tablets (made by Shriji Herbal Products), Karela capsules (Himalaya Drug Co), Yograi Guggal and Sudarshan tablets (both Zandu Pharmaceuticals), Shilajit capsules (Darbur India), SAFI liquid (Hamdard-WAKF) and Maha Sudarshan Churna Powder (supplied by Zandu Pharmaceuticals, D and K Pharmacy, Chhatrisha and Dabur, India) (9-11). The Mahasudarshan churna of Dabur and Zandhu was found to be contaminated with lead. Epidemiological studies of Ayurvedic Herbal Medicinal Products use and heavy metal toxicity in the United States and abroad are therefore warranted. Public health and community organizations should consider issuing advisories to current or previous Ayurvedic Herbal Medicinal Product users, encouraging them to consult their physicians about heavy metal screening. Physicians should also consider Ayurvedic Herbal Medicinal Products intake in the differential diagnosis of unexplained heavy metal toxicity. Current US law stipulates that regulations governing dietary supplements produced and sold domestically (DSHEA) should also be applied to dietary supplements imported into the United States (12).

The most of the traditional methods for preparation of herbo mineral complexes were very tedious and lengthy. Mass scale commercial production often tends to process a compromise that results adversely on its quality. This was the main reason of such heavy metal contaminations. The traditional preparations such as Mahasudarshan churna where metals were not the part of official formulation had shown high amount of toxic heavy metals. This was certainly a failure of the quality assurance system and a case of bad manufacturing processes. This was equally a failure of the regulatory system particularly the Indian that had not yet been able to evolve and enforce effective quality control and safety assurance of herbal medicines. Government of India had released GMPs herbal medicines that need to be implemented strictly. It will be unfair to convey a general message against ayurvedic or such traditional herbal medicines. In fact, ayurveda or traditional medicine has nothing to do with it(13).

Traditional Uses

The dose of Sudarshan Churna is 2-4 gm. Sudarshan Churna is used to treat Yakrt (Liver), Pliha vrddhi (Splenomegaly), Jvara (Fever), Visama jvara (Intermittent fever), Jirna jvara (Chronic fever), Gulma (Abdominal Lump) (14).

The list of ingredients of Sudarshan Churna and their therapeutic uses are listed in Table1.

Table1. Ingredients and Uses of Sudarshan Churna

Sr. No.	Common Name	Latin Name	Family	Therapeutic Uses
1.	Chirata	Swertia chirata Buch-Ham	Gentianaceae	Antipyretic, dyspepsia, cardio stimulant, astringent, stomachic,tonic, hypoglycemic agent, anti-inflammatory, hepatoprotective, antihelmintic, anticholinergic, anticonvulsant, antimalarial, CNS depressant, hypnotic, laxative, emollient, antimicrobial activity.
2.	Patolpatra	Trichosanthes dioica Roxb.	Cucurbitaceae	Wound healing, intermittent fever.
3.	Prshnparni	Ureria picta Desv.	Leguminosae	Antimicrobial, cough, antidote, antipyretic activity.
4.	Kaliyak	Jateorrhiza palmate Linn.	Menispermaceae	Diarrhea, abdominal pain, verminosis, fever, emesis, nausea, infection, hypertension, bronchitis, dyspepsia, digestive atony, bitter tonic, eupeptic.
5.	Haridra	Curcuma longa Linn.	Zingiberaceae	Antimicrobial, gastric ulcer, skin diseases , anti-inflammatory, antitumour, antidibetic, hypotensive, vasorelaxant, larvicidal, insect repellant, anti-mutagenic, hepatoprotective activity.
6.	Davdaru	Cedrus deodar Roxb, Loud	Pinaceae	Mast cell stabilizer, Histopathology, carminative, diaphoretic, antipyretic, pulmonary and urinary disorders, rheumatism, piles, kidney stones, astringent, antihyperglycaemic activity.
7.	Vacha	Acorus calamus Linn.	Araceae	Antimicrobial, dyspepsia, flatulence, cough, fever, piles, asthma.
8.	Motha	Desmodium trifiorum DC.	Fabaceae	Antimicrobial, Anti-ulcer, carminative, lactogogue, burns, itching, diarrhea, dysentery, cataracts, rheumatism, anthelmintic activity.
9.	Harr	Terminalia chebula, Retz	Combretaceae	Antimicrobial, fever, cough, diarrhea, gastroenteritis, skin diseases, urinary tract infection and wound infections, antiviral, Typhoid fever, hepatoprotective, anti-inflammatory, immunomudulatory, antioxidant, adaptogenic activity.
10.	Duralabha	Alhagi pseudalhagi Bieb. Desv	Leguminosae	Antiulcer activity.
11.	Kakrasinghi	Rhus succedonia Linn.	Anacardiaceae	Antioxidant, anticancer activity.
12.	Kantkari	Solanum xanthocarpum Schrad & Wendl	Solanaceae	Asthma, cough, seminal ejaculation, anthelmintic, itching, and fever and reduce fats.
13.	Sonth	Zingiber officinale Willd. Rosc	Zingiberaceae	Antimicrobial, cleanses the throat , tongue, dispels cardiac disorders and cures vomiting, cough, dyspnoea, anorexia, fever, anaemia, constipation, swelling, elephantiasis, dysuria, diarrhoea, cholera, dyspepsia, neurological diseases, diabetes, eye diseases, tympanitis, rheumatism, inflammation of liver, carminative, antioxidant activity.
14.	Triman	Legenaria siceraria (Mol)Standl	Cucurbitaceae	Antiulcer, fever, asthma, antihyperglycemic, antioxidant, antihyperlipidemic, cardio protective, immunomodulatory, analgesic, anti-inflammatory, diuretic, cytotoxic, hepato- protective, hyperthyroidism, hyperglycemia, lipid peroxidation activity.
15.	Pittapapra	Naregamala alata Linn	Meliaceae	Acrid, antipyretic, splenomegaly, cough, asthma, anaemia, chronic malarial fever, emetic, expectorant.
16.	Neem chal	Azadiracta indica A. Juss.	Meliaceae	Antimicrobial, anti-inflammatory, immunomodulatory, antitumour, Immunostimulation activity.
17.	Pipra mool	Piper longum Linn.	Piperaceae	Immunomodulatory, hypocholestremic, antiinflammmatory, antiasthamatic, hepatoprotective, thrombolytic, antioxidant, myocardial infarction, antimicrobial activity.
18.	Netrabala	Pavonia odorata Willd.	Malvaceae	Histopathology.
19.	Kapur kachri	Hedychium spicatum Ham.	Zingiberaceae	Carminative, vasodilator, digestive, antipyretic, vomiting, diarrhoea, Anti-inflammatory, pain, snake bite, asthma, foul breath, bronchitis, hiccough, Vomiting, diseases of blood, tonic to brain, antioxidant, antimicrobial, antispasmolytic activity.
20.	Puskarmul	Inula racemosa Hook. F.	Asteraceae	Antimicrobial, hyperglyceamic, expectorant, aphrodisiac activity.
21.	Vibhitaki	Terminalia belerica Roxb.	Combretaceae	Antimicrobial, antihypertensive, anemia, asthma, cancer, colic, constipation, diarrhoea, dysuria, headache, anti-inflammatory, rheumatism, antidiuretic, hepatoprotective, antihypercholesterolemic, abortifacient, antinociceptive, antisecretory activity.
22.	Murva	Marsdemia tenacissima. Wight and Arn	Asclepiadaceae	Antifertility, anticancer activity.
23.	Amla	Embilica officinale Gaerth.	Euphorbiaceae	Antibacterial, antioxidant, antifungal, antiviral, aperients, aphrodisiac, chelating agent, dental problems, cough, hiccough, asthma, antidiabetic, diuretic, leucorrhoea, antipyretic, astringent, Sore eyes, anti-ascorbutic, perfumery, nausea, mouth ulcer, carminative, stomachic, headache, antigonorrhoric, diarrhea, constipation, vitamin C deficiency.
24.	Giloy	Tinospora cordifolia Willd.	Menispermaceae	Antimicrobial, antipyretic, diuretic, heart problems, jaundice, skin diseases, dyspepsia, antigout, antileucorrhoric, aphrodisiac, antigonorrhoric, stomachic, antispasmodic, anti-inflammatory, stimulant, diuretic, emetic, antidiabetic, antiperiodic, antileprotic, antirheumantic and tonic.
25.	Kutki	Picrorrhiza kurrora Benth.	Scrophulariaceae	Antimicrobial, anti‐inflammatory, immunomodulatory, dyspepsia, antipyretic, liver diseases.
26.	Chitrak-	Plumbago zeylanica Linn.	Plumbaginaceae	Diarrhea, dysentery, abdominal disorders, peptic ulcers, piles, splenomegaly, hepatomegaly.
27.	Sagine	Moringa oleifecalam Lam.	Moringaceae	Antimicrobial, anticancer, bronchitis, antipyretic, anti-anemic, anti-hypertensive, cardiotonic, antidiabetic, hypoglycemia, diuretic, dysentery, diarrhea, astringent, gout, splenomegaly.
28.	Satawari	Asparagus racemosus Willd.	Liliaceae	Antimicrobial, gastric ulcer, dyspepsia, anti-inflammatory, immunomodulatory, antihepatotoxic, antineoplastic, aphrodisiac activity.
29.	Daruharidra	Berberis aristata DC.	Berberidaceae	Antimicrobial, anti-inflammatory, cardioprotective, immunostimulation, anticancer, jaundice, antipyretic, analgesic activity.
30.	Patanga	Didymocarpus pedicellata Willd.	Gesneriaceae	Diuretic, antiurolithiatic activity.
31.	Padma Kath	Nelumbeum speciosum Willd.	Nelumbonaceae	Antimicrobial, neurutropic, cardiotonic, dysentery, piles, antidibetic activity.
32.	Chir	Pinus roxburghil Sarj.	Pinaceae	Antimicrobial, diuretic, rubifacient, vermifuge, antirheumatic activity.
33.	Kush	Andropogon muricatus Retz.	Gramineae	Antiallergic, antispasmodic, diuretic, antipyretic activity.
34.	Dal Chini	Cinnamon cassia Blume.	Lauraceae	Antimicrobial, stimulant, carminative, antidiabetic, immunomodulatory, antioxidant, anti-inflammatory, antifungal, hypoglyceamic activity.
35.	Tejpatra	Cinnamomum inners Reinw.	Lauraceae	Carminative, stimulant, antipyretic, antirhumatic, diuretic, diaphoretic, deobstruent and lactagogue.
36.	Shal Parni	Desmodium gangaticum DC.	Leguminosae	Antimicrobial, abortifacient, diuretic, cardiotonic, expectorant, febrifuge, tonic, sedative, fever, chronic fever, cough.
37.	Azwoin	Ptychotis coptica DC.	Umbelliferae	Antispasmodic, stimulant, carminative, sore throat, bronchitis, antiseptic, antifungal, insecticide, anthelmintic activity.
38.	Atis	Aconytum heterophullum Wall.	Ranunculaceae	Antimicrobial, antidiarrheal, antidysentric, anti-inflammatory, antirheumatic, antiviral activity.
39.	Bilva	Aegle marmelos Corr.	Rutaceae	Anticancer, antimalarial, antibacterial, antimicrofilarial, antihyperlipidaemic, dysentery, cholera, constipation, antidiabetic, anti-inflammatory, antipyretic, analgesic, insecticidal, spermatorrhoea, antiepileptic, antileprotic, antiperoxidative, antiprotozoal, antiproliferative, antiulcer, cardiotonic activity.
40.	Kali Mirch	Piper nigrum Linn.	Piperaceae	Antiasthmetic, cough, heart diseases, throat inflammations, night blindness, urinary disorders, tooth and muscle aches, anti-inflammatory, snake bites, eye diseases, cholera, purgative, an antidote for poisons, aphrodisiac, analgesic, muscle relaxant, digestive stimulant, antiseptic, diuretic, sudorific, anxiolytic and hypnotic activity.
41.	Kurchi	Holarrhena antidysentrica Wall.	Apocynaceae	Antibacterial, diarrhea, dysentery, antipyretic, antioxidant, antifungal activity.
42.	Mulethi	Glycyrrhiza glabra Linn.	Leguminosae	Antimicrobial, tonic, laxative, demulcent, emollient, cough, catarrh, bronchitis, antipyretic, gastritis, antiulcer, hepatoprotective, anti-oxidant, anti-viral anti-mutagenic, anti-inflammatory, anti-obesity activity.

Pharmacological Activities:

Antipyretic activity

Swertia chirata is key ingredient in Sudarshan churna (15). The Aqueous extracts of Sudarshan churna was evaluated for antipyretic activity using two models including hyperpyrexia-induced in rats by brewer’s yeast and another one hyperpyrexia induced in rabbits by Typhoid-Paratyphoid A, B vaccine. Like Paracetamol (100 mg/kg, p.o.), Sudarshan churna, showed significant reduction in elevated body temperature at 200 mg/kg, p.o. Sudarshan churna is used traditionally as antimalarial, antipyretic, antiviral and antidiabetic formulation. It is recomended for all types of fever including bone fever and common cold etc (16). All ingredients have different therapeutic uses which support to treat the malaria and other fevers and are useful for rejuvenating the body. Swertia chirata is specifically antimalarial and antipyretic herb (17). Dose of Sudarshan churna is 3-6 gm b.i.d. as antipyretic and 1-2 gm b.i.d. as antidiabetic agent. Literature survey revealed that SC is most useful as well as popular Ayurvadic medicine to cure malaria and other fevers(18). Churna was prepared according to Ayurvedic literature (19).

Antimicrobial activity

Aqueous extract of Sudarshan Churna traditionally used in treatments of viral infection, viral fever and malaria. The aqueous extract of polyherbal formulation SC possesses significant antimicrobial activity also. The aqueous extract of Sudarshan churna was found active against the gram-negative bacteria Klebsiealla pneumoniae, Escherichia coli, and gram-positive bacteria Staphylococcus aureus, Proteus vulgris and found less effective against gram-positive bacteria Staphylococcus epidermidis and Bacillus subtilis. The ASC shows significantly less effect against Candida albicans. Sudarshan Churna contains 42 different constituents including 50% of Swertia chirata Buch Ham and the formulation is described in the ancient ayurvedic literature. A survey on the activities of the constituents revealed that Swertia chirata, Ureria picta, Curcumma longa, Terminalia chebula, Asparagus racemosus, Acorus calamus, Zingiber officinale, Azadiracta indica, Glycerrhyza glabra are reported to be effective as antimicrobial herbs (20-24). SC contains flavonoids and sterol, which may responsible for antimicrobial activity (25-28).The several herbal and herbal combinations in ayurveda e.g. Sudarshan Churna, neem, turmeric, berberis and sandalwood appear to have antibacterial activity (29).

Herbal preparations were not only supplement the diet but also help in preventing enteric infections. Ayurvedic Herbal preparations like Triphala churna (Baidyanath), Haritaki churna (Ayurveedya Arkashala) Mahasudarshan churna (Baidyanath), and Lavanbhaskar churna (Baidyanath) extracts had great potential as antimicrobial activity against enteric pathogens and that they can be used in the treatment of infectious diseases. The Aqueous extract of Mahasudarshan churna shows no antibacterial activity. Where, the Acetone, Ethanol and Methanol extract of Mahasudarshan churna shows highest antibacterial potential against Staphylococcus epidermidis, Staphylococcus aureus and Proteus vulgaris, it was mild antibacterial activity against Bacillus subtilis, Klebsiella pneumonia, and Salmonella typhimurium (30).

Conclusion

Current world-wide interest in traditional medicine has led to rapid development and studies of many remedies employed by various ethnic groups of the world. Sudarshan churna is a very potent ayurvedic medicine having antipyretic activity, antimicrobial activity, in splenomegaly, antimalarial activity, antiviral activity, antidiabetic activity. So this review explains the potential of this formulation and help researcher to explore more therapeutic potential of this formulation as it has more therapeutic properties which are not known.

References

1. Dev S. Ancient-modern concordance in Ayurvedic plants: some examples. Environmental Health Perspect. 1999; 107(10); 783-789.

2. Okamoto T, Hino O. Drug development with hints from traditional Indian Ayurveda medicine: hepatitis and rheumatoid as an example. Int. J. Mol. Med. 2000; 6(6); 613-615.

3. Mukherjee PK, Wahile A. Integrated approaches towards drug development from Ayurveda and other Indian systems of medicines. J. Ethnopharm. 2006; 103; 25-35.

4. The Ayurvedic Pharmacopoeia of India. Part - II (Formulations), Government of India, Ministry of Health and Family Welfare, Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy. First ed. New Delhi; Volume – I; 2007. 93p.

5. WHO, General guidelines for methodologies on research and evaluation of traditional medicine. World Health Organization. Geneva; 2000.

6. Singh SK. Proceedings of Global Promotion of Tradition Medicine in View of Institute-Industry Relationship. Faculty of Ayurveda. Banaras Hindu University; 2002. 112-115p.

7. Tyler V. Herbal medicine: From the past to future. Pub Health Nutr. 2000; 3; 447-452.

8. Eisenberg DM, Davis RB, Ettner SL. Trends in alternative medicine use in the united state 1990-1997: results of a fallow up national survey. JAMA. 1998; 280(18); 1569-1575.

9. Heavy Metal Toxicities Of Herbal Remedies Published in Journal Watch (General) 2005.

10. Australian Adverse Drug Reactions Bulletin, Prepared by the Adverse Drug Reactions Advisory Committee (ADRAC) and the Adverse Drug Reactions Unit of the TGA, Traditional Indian (Ayurvedic) and Chinese medicines associated with heavy metal poisoning. 2007; 26; 1.

11. Aneesh TP, Hisham M, Sekhar S M, Manjusree M, Deepa TV. International market scenario of traditional Indian herbal drugs-India declining, International Journal of Green Pharmacy. 2009; 3(3); 184-190.

12. Saper BR, Kales NS, Paquin J, Burns JM, Eisenberg MD, Davis BR, Phillips SR. Heavy Metal Content of Ayurvedic Herbal Medicine Products. JAMA. 2004; 292(23); 2868-2873.

13. Patwardhan B. Traditional medicine: a novel approach for available, accessible and affordable health care. Paper for Regional Consultation WHO-SEARO at DPR Korea. 2005; 18.

14. The Ayurvedic Formulary of India. Part- I, Government of India, Ministry of Health and Family Welfare, Department of Indian System of Medicine and Homeopathy, New Delhi; Second Edition. Controller of Publications Civil Lines Delhi; 2003. 116-117,461-480.

15. Bhargava S, Rao SP, Bhargava P, Shukla S. Antipyretic Potential of Swertia chirata Buch Ham. Root Extract. Scientia Pharmaceutica. 2009; 77; 617–623.

16. Annonymus. Bhaishajya Ratnavali. Varanasi; Chaukhamba Sanskrit Sansthan; 2003. 79-80p

17. Indian Herbal Pharmacopoeia. Mumbai; Indian Drug Manufacturer Association; 2002.

18. Bhargava S, Bhargava P, Saraf S, Pandey R, Sukla SS, Garg R. Evaluation of Antipyretic activity of Sudarshan Churna: an Ayurvedic formulation. Journal of Research Education of Indian Medicines. 2008; XIV (2); 11-14.

19. Abena AA, Deatewa M, Gacosso G, Ouamba JM. Analgesic, antipyretic and anti-inflammatory activity of Lippia multiflora. Fitoterapia. 2003; 71; 231-236.

20. Indian Herbal Pharmacopoeia. Mumbai; Indian Drug Manufacturer Association; 2002; 165-166p.

21. The Wealth of India – A dictionary of Indian raw materials and industrial products. Council of Scientific and Industrial Research Publishers, Government of India. 1962.

22. Kokate CK. Textbook of Pharmacognosy. 3rd ed. India; Nirali Prakashan; 1995.

23. Chopra RN, Nayar SL, Chopra IC. Glossary of Indian Medicinal Plants (Including the Supplement), Council of Scientific and Industrial Research. New Delhi; 1986.

24. Gurudeva MR. Botanical and Vernacular Names of South Indian Plants. Bangalore; Divyachandra Prakashana, India; 2001.

25. Kirtikar KR, Basu BD. Indian Medicinal Plants. II ed (3). Allahabad; 1935; 1664-1666p.

26. Sharma PV. Alkaloids of Swertia chirata Buch-Ham. Indian Journal Pharm. Sciences. 1982; (2); 36.

27. Bhargava S. Evaluation of Antibacterial activity of aqueous extract of Swertia chirata Buch. Ham. Root. International Journal Green Pharmacy. 2007; 1(2); 51.

28. Bhargava S, Bhargava P, Sukla K, Pandey R, Sukla S, Jain S. Evaluation of antimicrobial potential of Sudarshan Churna: A Polyherbal formulation. Iranian Journal of Pharmacology and Therapeutics. 2008; 7(2); 185-187.

29. Buhrman S. Ayurvedic Approaches to the Treatment of Sinus Infections. The Protocol Journal of Botanical Medicines. 1997; 2(2); 135-139.

30. Tambekar DH, Dahikar SB, Lahare MD. Antibacterial Potentials of Some Herbal Preparations Available in India. Research Journal of Medicine and Medical Sciences. 2009; 4(2); 224-227.