Arsenic, a toxic metalloid, may cause significant public health impact due to its cumulative toxicity upon chronic exposure. Continuous low-level ingestion of arsenic, often through contaminated groundwater or food, leads to gradual accumulation and a spectrum of health effects over time. Long-term arsenic exposure is associated with dermatological lesions (pigmentation changes and keratosis), various cancers (skin, lung, bladder, etc.), cardiovascular disease, neuropathy, diabetes, and other systemic effects, reflecting its classification as a Group 1 human carcinogen. Ayurveda Classics describe a unique concept of cumulative toxicity under Dushi Visha (latent poison). A comparative analysis of clinical features shows that many symptoms of chronic arsenic toxicity (fatigue, gastrointestinal disturbances, skin changes, neuropathy, etc.) mirror the descriptions of Dushi Visha. Management of chronic arsenic toxicity is challenging, as no specific antidote exists apart from chelation therapy; hence, modern treatment focuses on eliminating exposure and supportive care. Ayurveda offers detoxification (Shodhana) therapies and herbal formulations aimed at expelling latent toxins and mitigating symptoms. This review paper discusses the concept of cumulative arsenic toxicity in modern toxicology and draws parallels with the Ayurvedic notion of Dushi Visha. An integrative understanding of arsenic's cumulative toxicity through both modern and traditional lenses can enrich prevention and management strategies for arsenic poisoning.
Jaiswal et al. (Sun,) studied this question.