Background: Diabetes Mellitus (DM) is a global metabolic disorder, characterized by chronic hyperglycemia and associated symptoms such as polyuria, polydipsia, and polyphagia. Prameha, a disease condition described in Ayurvedic texts, shares strong pathophysiological and clinical similarities with diabetes mellitus. Ayurveda offers a range of herbo-mineral formulations for Prameha management, among which Vangeshwara Rasa is frequently cited in classical texts.

Objective: This study aims to critically examine classical Ayurvedic references to Vangeshwara Rasa and analyze its potential role in the management of Prameha (diabetes mellitus), supported by contemporary clinical and pharmacological evidence.

Materials and methods: A total of 21 classical Ayurvedic references for Vangeshwara Rasa were reviewed, of which 15 were indicated specifically for Prameha and included in the analysis. Key ingredients such as Rasasindura (Red Sulfide of Mercury) and Vanga Bhasma (Tin Ash) were examined for their therapeutic relevance based on Ayurvedic principles and modern studies.

Results: Most formulations share common core ingredients but vary in complexity. Pharmacological properties of Rasasindura and Vanga Bhasma suggest actions like Agni Deepana, Kleda Shoshana, and Medohara, which directly address the pathogenesis of Prameha. Modern studies indicate improvements in glycemic parameters, subjective symptoms, and diabetic complications, with good safety profiles.

Conclusion: Vangeshwara Rasa represents a promising Ayurvedic formulation for the integrative management of Prameha. Further standardization and clinical validation are essential to establish its evidence-based utility in diabetes care.

Keywords: Vangeshwara rasa, vanga bhasma, rasasindura, prameha, madhumeha, ayurveda, diabetes mellitus

Diabetes Mellitus (DM) is a major global health challenge of the 21st century and one of the most prevalent non-communicable diseases worldwide.¹ Despite significant advances in pharmacotherapy and insulin delivery systems, the incidence of DM continues to increase, affecting increasingly younger populations due to changing lifestyle and dietary patterns.² Current management strategies, though effective in glycemic control, are often associated with side effects, long-term compliance issues, and high treatment costs, prompting growing interest in complementary and alternative therapies.

Ayurveda, the ancient Indian system of medicine, categorizes diabetes mellitus under the broader disease entity known as Prameha. Ayurvedic texts describe a range of therapeutic interventions including dietary regulation (Ahara), lifestyle modifications (Vihara), and pharmacological formulations (Aushadha) that aim not only to control blood sugar but also to correct the underlying metabolic dysfunction and dosha imbalance.³ Among the numerous herbo-mineral preparations indicated for Prameha in Ayurvedic classical texts, one of the frequently mentioned herbo-mineral preparations is Vangeshwara Rasa.

Several classical Ayurveda texts provide variant formulations of Vangeshwara Rasa with minor differences in composition and method of preparation, underscoring its long-standing clinical use mainly in the management of Prameha (diabetes mellitus). In addition to its traditional usage, emerging clinical and pharmacological studies have begun to explore the efficacy and safety of Vangeshwara Rasa in glycemic control and diabetic complications, supporting its potential integration into evidence-based complementary care for diabetes.⁴ This review aims to critically examine the classical Ayurvedic literature on Vangeshwara Rasa and analyze the available contemporary research evaluating its role in the management of Prameha.

A total of 21 classical references of Vangeshwara Rasa were identified through a detailed review of various Ayurvedic texts. Among these, 15 formulations were specifically indicated for the management of Prameha and were therefore included in the study. The remaining 6 references, which described the use of Vangeshwara Rasa in the treatment of other diseases, were excluded from the analysis. Additionally, the pharmacological profiles of the key ingredients Rasasindura (red sulfide of mercury) and Vanga Bhasma (Tin ash) were examined to understand their relevance in the therapeutic context of Prameha. Additionally, relevant pharmacological and clinical research on Vangeshwara Rasa and its major constituents was reviewed using databases such as PubMed, Google Scholar, and other peer-reviewed sources.

The details of 15 formulations, including their classical references, ingredients, and proportions, are summarized in Table 1. Rasasindura/Suddha Parada (Purified Mercury), Vanga Bhasma (Tin Bhasma), are among the most frequently occurring components across the formulations. Several formulations incorporate complex combinations of multiple mineral preparations along with medicinal herbs such as Haritaki (Terminalia chebula), Vidanga (Embelia ribes), and Musta (Cyperus rotundus), indicating a compounded therapeutic strategy.

Several classical references across authoritative texts such as Yogaratnakara, Rasayogasagara, Rasakamadhenu, Rasendra Chintamani, and Bhaishajya Ratnavali describe variations of Vangeshwara Rasa, differing slightly in composition but sharing a core set of ingredients and therapeutic intent. Primarily Vangeshwara Rasa is composed of Rasasindura (red sulfide of mercury)/ Suddha Parada (purified mercury) and Vanga Bhasma (Tin Ash). These two ingredients are repeatedly mentioned across multiple classical texts for their significant role in the management of Prameha. Their pharmacodynamic properties, as described in Ayurvedic pharmacology, align well with the pathophysiology of Prameha, the Ayurvedic counterpart of Diabetes Mellitus.

Rasasindura, possessing Katu (pungent) and Tikta (bitter) rasa, Laghu (light), Ushna (hot), and Tikshna (sharp) guna, and Ushna veerya (hot potency), is considered a potent Agni Deepana (digestive stimulant) and Vata Anulomaka (regulator of vata). It is also described as Yogavahi, meaning it enhances the therapeutic effect of other substances with which it is combined.²⁰ These attributes are especially useful in breaking down metabolic sluggishness and regulating vitiated vata and kapha, the two primary doshas involved in the pathogenesis of Prameha.

Vanga Bhasma is described in Ayurveda as Kaphahara and Pittahara, having Tikta, Kashaya rasa with Laghu and Ruksha guna and Ushna veerya.²¹ These properties make it effective in drying up kleda (excessive bodily fluids) and correcting srotorodha (obstruction in body channels), which are key pathogenic factors in Prameha. It is Lekhana (scraping), Medohara (anti-obesity), and Rasayana (rejuvenative), indicating a multifaceted therapeutic action that not only targets hyperglycemia but also addresses dhatushaithilya (tissue laxity), which is a root cause of Prameha.

Prameha/Madhumeha is Dhatvagnimandyajanya disorder, Dravit Shleshma is the main Dosha and Abadha Meda is the main Dushya in this disease. So Tikta and Katu Rasa of Rasasindura and Vanga Bhasma act on the Aam and will help to improve Dhatvagnimandya. While Kashaya Rasa of Vanga Bhasma acts on the Dravtva Guna of Shleshma and Abadhatva Guna of Meda, due to Kashaya Ras, Dravta and Abadhatva will be reduced. Ruksha and Lagu Guna also help to absorb or control the aggravated Drava Guna of Shleshma. With these properties of Rasasindur and Vanaga Bhasma break the pathogenesis process of disease Madhumeha.

Modern pharmacological studies have provided emerging evidence of Vangeshwor Rasa in the management of diabetes mellitus. In one clinical study, administration of Vanga Bhasma in 30 patients with diabetes showed significant improvement in symptoms such as polyuria (86.66%), elevated blood sugar (80%), and hastapadatal daha (burning sensation in hands and feet) within 21 days, with no adverse effects reported.²² Another study evaluating Vangeshwara Rasa in patients with Madhumeha demonstrated statistically significant improvements in both subjective symptoms like mukhamadhurya, trishnadhikya, vibandha, and karapadadaha and objective biochemical markers in fasting blood sugar, postprandial blood sugar, and HbA1c levels.⁴

Furthermore, a randomized, open-label clinical trial assessing the efficacy of Vangeshwara Rasa in diabetic polyneuropathy (DPN) revealed considerable improvements in sensory-motor symptoms (as assessed by TCSS scores), glycemic control, and urinary frequency. Patients receiving Vangeshwara Rasa in conjunction with Koshtashodhana (preliminary purgation) showed greater symptom resolution compared to those receiving Guduchyadi Kashaya, highlighting its potential utility in diabetic complications.²³

These findings collectively indicate that Vangeshwara Rasa, through its synergistic blend of herbo-mineral constituents, may offer effective management of diabetes mellitus by correcting metabolic imbalances, enhancing tissue metabolism, reducing kleda, and supporting srotas function. Its classical relevance, coupled with emerging clinical validation, suggests that Vangeshwara Rasa could be a valuable adjunct or alternative in the integrative management of diabetes mellitus.

Vangeshwara Rasa is a well-documented, multi-ingredient herbo-mineral Ayurvedic formulation with promising therapeutic potential in the management of diabetes mellitus. Supported by both classical references and recent clinical data, this formulation offers a viable adjunct or alternative treatment for diabetes mellitus. Further rigorous pharmacological, toxicological, and clinical studies are needed to establish its standardized usage, safety, and efficacy.

None.

The authors declare that there are no conflicts of interest.

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