LAUSR

To the Editor: We would like to reply to the points raised by Varghese et al. [1] in response to our correspondence ‘Severe Lead Toxicity Due to Ayurvedic Medicine in a Child with Type 1 Diabetes Mellitus’ [2]. The child was from upper socioeconomic status from Delhi with no history or setting of environmental lead exposure. Before presenting with increasing pallor and other features of lead toxicity to our center, he had been on leadcontaining preparations for nearly 3 mo from a charitable organization in Mount Abu, Rajasthan. It was a short-term exposure to high concentration of lead as the child was getting those medicines multiple times a day, with the lead level of the ‘bhasma’ sample tested at Pharmacology laboratory of our institute > 105 ppm, against permitted level of 10 ppm. In our initial manuscript, we had discussed about ‘bhasmikaran’ process in Ayurveda that renders the heavy metal nontoxic, while maintaining its desired effects. This sentence had been shortened in final publication but the reference [3] had still been retained. However, “nonstandard” medication manufactured by an unscrupulous firm was clearly at fault in this case, which we wished to highlight; besides reaffirming that it is important to counsel parents clearly against the risk of trying any form of therapy other than insulin for type 1 diabetes. We had clearly mentioned this point regarding “nonstandard” Ayurvedic medicines in our correspondence [2]. To reiterate, the point of the correspondence was not against Ayurveda in general, which we do consider as one of the pillars of our health care system, but against unregulated selling of nonstandard Ayurvedic medicines and unwarranted prescription of these by unqualified practitioners, which led to life-threatening complications in our patient [2]. Similar complications have been reported by other authors as well [4]. This is a major concern, which we feel, all qualified Ayurveda physicians and related scientific societies should campaign against.