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Prameha and its Ancient
Ayurvedic Medicine in India
Pulakes Purkait1, Dr. Moumita Bhattacharya2
ABSTRACT
Diabetes is a most common metabolic disorder in India affecting more than 30 million
people with type 2diabetes. Ayurveda is a holistic health care system of medicine, which
is more than 5000 years old and it describes Diabetes under the heading Prameha. Plant
active principles have been used to treat Prameha from ancient time under the Ayurvedic
medication. Ayurvedic medicines are personalized for individual patient. It offers natural
ways to treat disease and promote health. It uses herbs, diet, massage and lifestyle
changes to achieve a balance between body, mind and spirit. In this review we have
discussed about the Ayurvedic classification of Prameha, its complications and focused
on the role of ancient medicines along with their key constituents, which are the main
source of modern medicine. Further this review points out the ignorance of fundamental
Indian medication system which is being masked by the modernized human culture
increasing higher risk factor of side effects.
INTRODUCTION
Ayurveda is a holistic health care system of medicine originated in ancient Vedic
civilization of India, which is more than 5000 years old. The word `Ayur-Veda' is derived
from two Sanskrit roots: "Ayus" meaning life and "Veda" meaning knowledge or science.
Ayurveda is, therefore, translated as "science of life". Ayurveda is based on the inter
dependence of man and nature. Every living and non-living things are mutually interlinked.
Major Ayurvedic texts are CHARAKA and SUSRUTA. Two other major contributors
were VAGHBATA and NAGARJUNA. The core principles of Ayurvedic philosophy
revolve around three important factors (doshas) of life, viz. Vata (Wind) Pitta (Fire) and
Kapha (Earth) which are called Tridoshas. These are prime movers of the body. All of
us have a unique mix of the three which accounts for our basic nature. At molecular
628 Jr. Anth. Survey of India, 61 : 2 (659-669), 2012
1Anthropological Survey of India, Western Regional Centre, Udaipur, India;
2The Asiatic Society, Kolkata, India
Table 3: Ayurvedic Body Types and Characteristics
Ayurvedic Body Types
Vata Pitta Kapha
Physical Thin. Average build Large build.
Characteristics Prominent features Fair, thin hair Wavy, thick hair.
Cool Warm, moist skin. Pale, cool, oily skin.
Dry skin Ulcers, heartburn, Obesity, allergies,
Constipation and hemorrhoids. and sinus problems.
Cramps Acne High cholesterol.
Moody Intense Relaxed, Not easily
Emotional Vivacious Quick tempered angered. Affectionate
Characteristics Imaginative Intelligent Tolerant
Enthusiastic Loving Compassionate
Intuitive Articulate
Unscheduled sleep Orderly Slow, graceful.
Behavioral and meal times Structured sleep Long sleeper and
Characteristics Nervous disorders and meal times. slow eater.
Anxiety Perfectionist. Procrastination.
The word Prameha is derived from the "Miha sechane" which means watering. `Pra'
means excess of urine in both quality and frequency. Prameha, thus, becomes self-
explanatory and holds the twin meanings of "Prabhutha mutratha" or excessive urination
and "Avilmutratha " or turbid urine. Ayurveda have described that, when a hungry person
takes the food containing all six tastes i.e. sweet (madhura), sour (amla), salty (lavana),
bitter (tikta), pungent (katu) and astringent (kasaya), only one taste i.e. sweet is predominant
and it can increase kapha & medas (fat) and cause prameha.
“Navannapanam Gudavaikritamcha Pramehahetu Kaphakriccha Sarvam” (Ch. Chi. 6)
That means excess of newly harvested food grains, jiggery preparations and factors
responsible for elevation of Kapha, may contribute to the development of diabetes [2].
“Divaswapanam Vyayamalasya Prasaktam, Sheetasnigdha, Madhurdrvyapanasevinam
Purusam Janeeyat Pramehi Bhavishyteeta” (Su. Ni.6)
Day time sleeping; lack of exercise and laziness; too much of cold, sweet, lipidemic and
alchoholic foods and beverages as the causative factors for development of diabetes later
in life[2].
"Asyasukham-Swapnasukham dadhini Gramyaudakanuparasah payamsi
Navannapanam gudavaikritamcha pramehahetuh kaphakricca sarvam"
– 4th shloka/6th chapter Chikitsa sthana: Charaka Samhita
630
levels, Kapha represents nutritious regimens and may be either of dietary origin or
nutritious substances at systemic and tissue level. Pitta designates factors responsible for
digestion, absorption, and metabolism of nutritious substances at any level of physiological
processes and may be regarded as enzymatic activities, etc. Vata represents processes
like respiration, oxygen (vayu) responsible for combustion/burning of nutritious substances
during metabolic activities to release and mobilize energy. Usually one of the elements
would be the dominant one, which would also be our disposition[1].
The knowledge of Diabetes has been existent in India since Vedic age in mythological
form where it is said that the origin of diabetes takes place by eating Havisya (Charaka
samhita nidanasthana1). Ayurveda is described Diabetes under the heading `Prameha'
and clinical picture is similar to `Madhumeha', which means honey like urine or sweet
urine, similarly Diabetes is a Latin word which also means honey like sweet urine [2].
Table 1: Basic principle of Ayurvedic Philosophy
HEALTH = Balance < THRIDOSHA >Imbalance = DISORDER
KAPHA: Nutrition
PITTA: Digestion or Metabolism
VATA: Respiration / Energy production
This basic principle of Ayurvedic philosophy that Kapha, Pitta and Vata are the important
factor of life, which appropriate balance leads to a healthy life and their inappropriate
distribution causes imbalance in physiological or biochemical process that lead to different
disorder or diseases.
Table 2: Characteristics of three Doshas
Attributes Vata Pitta Kapha
Represents the element Air Fire Earth
Space (ether) Water Water
Dry/Cold Hot/Moist Steady/Calm
Qualities Light body type Perfectionistic Heavier body
Quick/Energetic Sharp/Intelligent type Strong/Loyal
Cell division
Heart Digestion Structure
Body process Breathing Temperature Growth
Waste products Hormones Storage
Mind
Imagination Intelligence
Major mental functions Resilience Confidence Memory
Decision making Enterprise
631Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
(4 varieties) get manifested depending on the basic constitution on the patient, indulgence
of verities of causative factors enlisted & type of tissues effected among the following
Medas (Adipose), Vasaa (fat), Rakta (blood cells), Shukra (spermatozoa), Ambu (cytoplasm),
Lasika (protoplasm), Majja (bone marrow), Rasa (lymph), Pisita (muscle), Ojas (gene-
proteins/factors responsible for immunity)[7].
1. Kaphaja : Kapha causes pramehas by affecting Medas thus altering lipid metabolism,
muscles and body fluid situated in urinary bladder. Types of kapha are as follows:
i. UDAKAMEHA (Chronic nephritis): Watery urine or Clear urine in larger quantity
without odor; patient feels cold sensation while passing urine.
ii. IKSHUVALIKAMEHA (Alimentary glycosuria): Like sugar cane or Very sweet
urine, cool, slightly viscid, turbid due to slimy substances.
iii. SANDRAMEHA (Phosphaturia): Viscous urine or If urine is kept overnight,
precipitate is present in the container.
iv. SANDRAPRASADAMEHA: Having solid precipitate or Sandraprasadmeha means
a portion of the urine is turbid and a portion is clean like Sura (undistilled alcohol).
Described as Surameha in Sushruta and Ashtanga Hridaya [8].
v. SHUKLAMEHA (Chyleuria, albuminuria): Urine is white and appears as if it is
mixed with flour (paste). While passing urine the patient feels erection of body
hairs.
vi. SUKRAMEHA (Spermaturia): Urine with semen or Patient passes urine similar
to quality of semen or semen itself may be mixed with urine.
vii. SITAMEHA: Cold urine or Urine is very sweet and abundant, with low temperature.
viii. SAINYAMEHA: Delayed and very slow impulse of urination and patient feels
difficulty in passing urine.
ix. LALAMEHA (Albuminaria): Saliva-like urine or Urine is turbid and slimy; it is
sticky and threads may be demonstrated like gum.
x. SIKTAMEHA (LITHURIA): Urine with gravels or Patient passes small particles
like sand in the urine.
2. Pittaja: Pitta aggravated by hot things causes the same by affecting medas, muscles
and body fluid situated in urinary bladder. They are of 6 types-
i. KSARAMEHA (Alkanuria) : Urine like alkali (ash) solution in smell, color
and touch
ii. KAALAMEHA (Indikanuria) : Black urine
iii. NILAMEHA (Indikanuria) : Blue urine
iv. HARIDRAMEHA (Biluria): Turmeric-like urine or Urine is yellow like the color
of turmeric, pungent, and associated with a severe burning sensation.
v. MANJISTHAMEHA (Urobilinuria): Urine is pink like decoction of Manjishta.
vi. LOHITAMEHA (Haemeturia): Urine is deep red or Urine contains blood and is
salty in taste.
632
Asyasukha means happiness of tongue, eating food which is sweet, salt, sour in taste.
Swapnasukha means sleeping in the day for more than 30 min and sleeping more at night.
it also means not living an active life with good amount of exercise & sports.
VARGIKARAN / CLASSIFICATION OF PRAMEHA [3,4,5,6]
In Ayurveda texts (Charaka Samhita, Sushruta Samhita, Astanga Sangraha & Hrudaya,
Hareeta Samhita) Diabetes (Prameha) has been described in three major categories (A)
HETU BHEDAS, (B) DEHA PRAKRITI BHEDAS and (C) MUTRA BIKARA BHEDAS.
All categories divided in different sub group:
(A) HETU BHEDAS (Etiological classification)
1. Sahaja/Jatah prameha (Hereditary):
Due to the genetic factors certain defects in the ovum and sperm results in a genetic
disorder which is referred to ‘Beej Dosha’. It can be compared to type 1diabetes
and mostly found in lean individuals. It is also known as Juvenile or congenital
diabetes or insulin-dependent diabetes mellitus.
Genetical view of prameha is clearly mentioned by Charaka samhita as specific
word `Beej dosha' means a "defect in genes". Beej means seed and dosha means
defect. Charaka has described anatomy of “Beej” as Semen or Sukra and “Beej
bhaga” as Chromosome.
According to Charaka the congenital case of Prameha or one inheriting the disease
from his Diabetic Parents is incurable because of genetic factor. Whatever diseases
are familial are said to be incurable [ch chi: 6:57].
2. Apathyanimittaja (Acquired):
Improper dietary habits and unwholesome lifestyle is mostly seen in obese
individuals. It is quite similar to type 2 diabetes, and also known as adult onset
diabetes or non insulin-dependent diabetes mellitus.
(B). DEHA PRAKRITI (As per features of the body or Physique)
According to Charaka samhita the two types of prameha patients on the basis of
their physique or body constitution are -
1. Sthula pramehi: This category refers as Obese diabetic patients and similar to the
patients with type 2 diabetes.
2. Krisha pramehi: this category refers to Asthenic diabetic patients, like a lean person
and corresponds to patients with type 1 diabetes.
(C) MUTRA BIKARA BHEDA (Doshic classification or as per urinary abnormality)
‘Sarva yeva pramehastu kalenapratikarinah madhumehatvamayanti Tada asadhyabhavanti
hi’ (su. Ni.6) [2]
According to Sushruta Samhita as well as ayurvedic literature Prameha (Diabetes) has
been classified into 20 types depending on the various signs and symptoms manifested
with urine. These twenty types of prameha, Kapha (10 varieties), Pitta (6 varieties), Vata
633Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
2. Trishna (Thirst/Polydipsia): Excessive and frequent thirst in Ayurveda it is termed
as Trishna. In the process of lipolysis, more water is utilized which results into
activation of thirst center in the brain.
3. Panipada daha: Abundance of unutilized glucose in the blood. This causes disturbance
in the equilibrium of dhatus and doshas in the body exposing body to further
complications. It gives rise to Panipada daha, which means burning sensation of feet
and palm and lower extremity paresthesias- pins and needle sensation.
4. Unexplained weight loss
5. Madhuratava in mutra : Glycosuria
6. Dantadinam mala sanchaya: Due to ama, deposits are seen in mouth.
7. Swadasyata: Sweetness is experienced in the mouth due to increase in the sugar level.
According to modern medical science the clinical symptoms of diabetes are – polyuria,
polydipsia, polyphagia, general debility, profuse sweating, dryness of the skin, pain
in thigh/calf muscles, Weight loss due to calories lost as glucosuria, leaving a negative
calorie balance, poor wound healing, gingivitis and blurred vision [9].
UPADRAVA / COMPLICATION [2, 3]
Complication refers as Upadrava of Prameha (diabetes) covers all the conditions, which
can develop with diabetes patients. The complications related to diabetes mellitus, as
described in allopathic medicine, are mentioned in Ayurveda either directly or indirectly
in relation to Prameha. These include dyspepsia, diarrhea, fever, burning sensation,
weakness, anorexia, indigestion, and diabetic carbuncles and abscesses (referred to in
Ayurveda as Pidaka, Alji, and Vidradhi). In Charak Samhita many features of complications
are described that the diseases and disorders caused by over intake of Santarpana (a highly
nutritious, high-calorie diet intended to increase weight).
These disorders and diseases include:
(i) Prameha Pidaka (carbuncles)
(ii) Kustha (skin diseases)
(iii) Mutrakrichhra (urinary disorders or Nephropathy)
(iv) Klaibya (erectile dysfunction)
(v) Sthaulya (obesity)
(vi) Indriya Srotasam Lepa (structural and functional impairment of the sensory organs)
(vii) Siopha (generalized edema)
According to Astanga Samgraha of Vagbhata describes complications for each Doshic type
of Prameha separately as Kaphaja Prameha, Pittaja Prameha, and Vataja Prameha [8].
Complication of Kaphaja Prameha: This includes coryza, laziness, anorexia, indigestion,
excessive salivation, vomiting, hypersomnia, and couth (while anorexia, vomiting, diarrhea,
etc., denote diabetic enteropathy).
Complication of Pittaja Prameha: Include hyper acidity, excessive thirst, fever, burning
sensation, fainting, diarrhea, anemia, cracking of the scrotal skin, and pain in the penis
and bladder region. Diabetic neuropathy is directly mentioned as a burning sensation in
the body, tremors and Hastimeha (incontinence of urine).
634
3. Vataja: Vayu, on relative diminution of other two doshas, draws on the dhatus
in urinary bladder and thus causes Prameha. Prameha caused by vata and associated
with pain has blackish or reddish urine. They are of 4 types-
i. MAJJAMEHA (Albuminuria): Urine with majja (bone marrow).
ii. VASAMEHA (Lipuria): Urine with Vasa (fat).
iii. HASTIMEHA (Prostatitis) : Urine with lasika (lymph)
iv. MADHUMEHA (Diabetes mellitus): Urine with yellowish-white in color and
taste like honey.
SADHYASADHYATA / PROGNOSIS
Charaka had classified Prameha in three categories as per to sadyaasadhyata
[ch chi : 6:57].
1. SADHYA [Curable]: This includes Kaphaja Prameha [predominance of Kapha
humor], usually due to improper life style and dietary habits, and patient is usually
sthula [obese]
2. YAPYA [Controllable] : This includes Pittaja Prameha [predominance of Pitta
humor]
3. ASADHYA [Difficult to manage]: This includes Vattaja Prameha [predominance
of Vata humor] patient is usually asthenic or lean. In this situation the disease
becomes incurable.
Table3. Features of Prameha according to sadyaasadhyata (prognosis)
SADHYA YAPYA ASADHYA
Prognosis Curable Controllable Difficult to manage
Dosha Kaphaja Pittaja Vataja
Etiology Acquired Acquired Hereditary
Physique/
Body constitution Obese Asthenic
Clinical Mild hyperglycemia, Moderate Severe hyperglycemia
manifestations hyperglycemia
Hyperinsulinemia
Stage of disease Early/without Acute, young adults Chronic / advanced /
process complications with complications
PURVARUPA / PRODROMAL SYMPTOMS [5,6,8]
According to Ayurveda Sanskrit literature and modern medicines the chief symptoms or
Purvarupa of Prameha are:
1. Prabhutavilamutrata (polyuria) : Swedawaha srotoavrodha causes increased urinary
out put with turbidity and increased frequency; in Ayurveda this symptom is termed
as prabhootavila mootrata [increased output and frequency of turbid urine]
"Prachuram varam varam va mehati mutratyagam karoti yasmin roge sa prameha"
(Ma. Ni.)[2]
635Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
Table 4: Ancient Indian Medicinal plants, botanical name, key constituents
of the used part of the plant and functions [14, 15, 16, 17, 18, 19]
Herb Botanical Ayurvedic Part Used Key Function
Name Name Name Constituents
Devadaru Cedrus deodara Devadaru Bark, Cedrinoside, cedrin, To tackle the causes of oxidative
(Cedar, Deodar) Wood toxifonil, cedeodarin, stress (Vata, heart disease
dewarenol, himchalol (Hrid-rog) and diabetes (Prameha)
Vijaysara Pterocarpus Pitasara Kinotanin acid, The bark of the tree is made into a
(Indian Kino tree) masrsupium Bark pyrocatechin, wooden glass and the glass is
gallic acis, resin. termed as "The miracle cure for
diabetes". Some water is kept in the
wooden glass overnight and is
consumed early morning by diabetes
patients. Diabetes support contains
extract of bark of this miracle
Jamun Syzygium cumini Jambu Seeds Phenols, Tannings, The powder of the seeds of
(Black plum) Alkaloid (Jumbosine), Jamun fruit is very effective in
Clucoside ellagic acid, controlling sugar levels.
resin, gallic acid, Astringent is useful for disease
albumin, etc. caused by concessive sweetness
like obestity and diabetes.
Bel Aegle marmelos Bilwa Leaves Tanning, coumarin, The leaves of Bilva are excellent
(Bael fruit tree) umbelliferone, – for diabetes. Used to cure Vata
and dlimonone, and Kapha and also good for Heart.
Karela Memordica Karvellaka / Whole tree, Alkaloid memordicine, Decrease blood glucose level.
(Bitter gourd) charanatia Karavella pulp glycosides charantin Rapid protective effects against
and vicine, and lipid per oxidation by
polypeptidep scavenging free radicals.
Reduces increased cholesterol.
Reducing the risk of diabetic
complications.
Methi Trigonella Methika Seeds Moisture, protein, It is used to lower down sugar
(Fenugreek) foenum graecum fibre, carbohydrates, ash, levels. as well as cholesterol levels.
calcium, phosphorous,
iron, sodium, potassium
and better fixed oil,
odourous oil.
Tulsi Ocimum sanctum Sursa leaves Volatile oil, eugenol, Regular use of leaves of this plant
(Holy Basil) methyl chavicl, methyl controls blood sugar levels
eugenol, caryophyllene; very effectively.
Flavonoids (apigenin, It is also useful in many types
luteolin); Triterpene: of cancers, viral and bacterial
(ursolic acid) infections, sore throat, cough
and cold etc.
Daruhaldi Berberis aristata Daruharidra Rhizomes A yellow alkalois The herb powder stimulates pancreas
(Indian Barberry) berberine to pump more insulin into blood.
It also helps in preventing insulin
resistance among cells.
It acts as a channel opener for
glucose into the cells. This also
purifies the blood. Purifying
Haldi Curcuma longa Haridra Rhizomes Volatile oil 1 percent, the blood, channel opener,
(Turmeric) curcumin, turmeric oil helps in reducing the insulin resistance.
and yellow colouring Turmeric powder is an effective
matter anti-allergic, anti-cancer, anti-
inflammatory and one of the
best natural anti-diabetics.
Sadabahar Catheranthus Svetakotajah Plant leaves Alkaloids (vincristine, The leaves are very useful in
(Periwinkle) roseus/ vinblastine) controlling the diabetes an
(Vinca rosea) anti-cancer and also beneficial
for kidney.
Amla Emblica Amlika Fruits Vitamin C, gallic acid, It prevents ageing and therefore
(Indian officinalis tannic acid, glucose, delayes theonset of
Goseberry) albumin, cellulose, complications of diabetes.
calcium.
Gurmar Gymnema Madhunashini Leaves Gymnemic acid, resins, It controls hyperglycemia and
(Small Indian sylvestrae Meshshringi bitter, calcium oxzalate, carbohydrat e metabolism in liver
Ipecacuanha) quercitol and sugar yeast. and in skeletal muscles.
Durike bel Coccinia indica Bimbi Root Cuceubirocin B It control glucose metabolism.
and (hypoglycemic principle)
Fruit
636
Complication of Vataja Prameha: Include heaviness in the chest, excessive hunger,
insomnia, tremors, pain, constipation, cough, and dyspnea. Heaviness in the chest indicates
cardiac disorders, and fainting, tremors, etc., may relate to Cardiovascular and cerebral
disorders.
The features of nephropathy are not directly referred to in Upadrava (complications) of
Prameha; these are described in detail in the 20 subtypes of MUTRA BIKARA BHEDAS
(As per urinary abnormality). The presence of excessive waste products in the eyes, ears,
tongue, etc., discussed as Purvarupa, indicates that these organs would become increasingly
disturbed with the advancement of disease and ultimately retinopathy and other disorders
could develop as a result.
CHIKITSA / TREATMENT
Charaka Samhita is a massive treatise on ancient Indian medicine. It contains 8 divisions
(Astanga Sthanas): Sutra, Nidana, Vimana, Sarira, Endriya, Chikitsa, Kalps and Siddha-
Sthanas. The prameha has been described eloquently and elaborately in Charak Samhita
chikistha sthana's 6th chapter, nidana sthana's 6th chapter of Shusurata samhita and
Prameha nidana's 33rd chapter of Madava nidana.
According to Ayurvedic point of view the basic principle or Chikitsa Sutra of prameha
are Shodhana [purification] and Shamana [suppression]
i. Shodhana: Shodhana or purification is generally done in obese diabetic (Sthula
Pramehi) with adequate body strength and requires expertise in assessment of
vitiated doshas and therapy to be applied. A Samshodana (Panchakarma like
vamana (emesis), virechana (purging) and later medicines & diet to normalize the
condition (antikapha) treatment. Mismanagement would lead to more harm than
any good. Hence in general practice shaman Chikitsa is prevalent and popular.
ii. Shaman Chikitsa: [acificatory management]: Samshamana means palliative
treatment and Santarpana (antivata) treatment. The herbs used in the management
of DM syndrome (Krusha Pramehi) are bitter, astringent, and pungent in Rasa
[taste]. All herbs having these tastes are having some anti-diabetic quality. While
treating Diabetes (prameha) herbs are used either individually or with combination
of other herbs or mineral.
HERBS / MEDICINE FOR PRAMEHA [10, 11, 12, 13]
Ayurveda is an indigenous ethnic medical system is popular practice in the Indian
subcontinent since the pre-biblical era. The system's core strength is its holistic approach
to health and disease using natural remedies derived from medicinal plants and minerals.
The medicines having tikta, katu, kashaya taste are generally considered good in Diabetes
(prameha). There are many popular herbs with medicinal value and which still continue
to be used in India.
Following herbs are described in ancient as well as modern Ayurvedic texts for solution
of diabetes (Prameha). The major herbs are as follows- Devdaru, Vijaysar, Jamun, Bel,
Karela, Methi, Tulsi, Daruhaldi, Haldi, Sadabahar, Amla, Gurmar, Durike bel, Neem,
Vjrataru, Siris, Bar, Tuvaraka, Saptrangi, Hulhul/Hurhur. Some important medicinal
plants are summarized in table 4.
637Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
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Classification, and Pathogenesis. THE JOURNAL OF ALTERNATIVE AND
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translation).
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Nidanam (roga viniscaya) of Madhavakara (English translation).
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Nighantu, Varanasi: Chaukhambha Sanskrit Sansthan; 1999. p.11.
14. Dhiman A.K 2006. Ayurvedic Drug Plants. Daya publishing House, Delhi.
15. Laksham H.C and Inchal R.K. 2012. Indigenous Medicinal plants and their
Practical Utiligy. New India Publishing Agency, New Delhi.
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Herbs. Scientific publishers (India), Jodhpur.
17. Boominathan R and Panda S 2009. Plant Used in the Cure of Diabetes Mellitus.
In P.C. Trivedi ed. Indian Medicinal Plants. Aavishkar Publishers, Distributor,
Jaipur, India, pp74-83.
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to Control Sugar Levels. http://EzineArticles.com/?expert=Vikram_Chauhan
638
Neem Azadirachta Nimba, Leaves Bark, Margosine, nimbidine, Detoxifier, Liver stimulant and lowers
(Margosa Tree) indica Parimad Seeds nimbine, nimbosterol, the glycosuria, prevent diabetic
tannin, clucose, glucose, vasculopathies and is used to
resinous principle, relive kapha and pitta and also
volatile oil and burning sensation near the
flavonoids. heart, fatigue, thirst, fever and
inflammation.
Veerataru Dichrostyches Vellantaro (-)epicatechin and Treating Vata (oxidative stress),
cinerea its enantiomer, as a Mutrkrichha (urinary problems),
new isomer Trisna (polydypsea),
of(-)mesquitol Kapha mobilizing (e.g.
antidysglycaemic) activities and
diseases of sarkara (sugar).
Siris Albizzia lebbeck Sirisha Fruit, Tannin, saponin Antiprotozoal, hypoglycaemic,
(East Indian Seeds and resin anticancerous
Walmut)
Bar Ficus Vata Bark, Glycosides Ketones, The back is used in Ayurvedic
(Banyan Tree) benghalensis Leaves sterols, ficusin medicine for diabetes.
and bergaptin Glycosides have an antidiabetic
activity, lowering blood sugar level.
Tuvaraka Hydnocarpus Chalmogara, Lead seeds, Glycosides, Luteolin, Anti-hypertiglyceridemic
wigthiana Katu Kapittha fruit pulp, Flavolignams (anti-meha and meda)
Saptrangi Salactia Saptrangi Stem, Salicinol, kotalanor, It is used as anti-diabetic. The herb
oblonga Root sesquiterpene, has been found to have diabetes
& triterpenes controlling properties. It binds to
leaves intestinal enzymes alpha-
glucosidases that break down
carbyhydrate into glucose.
Hulhun/Hurhur Cleome Tilparni, Seeds, leaves Vitamins (A and C) Used as anti-diabetic for glucose
metabolism.
(Dog Mustard) gynandra Suriyabhakt, and minerals
Ajagandha (Calcium and Iron)
CONCLUSION
Ayurvedic medicine focuses on each patient as an individual. It offers natural ways to
treat disease and promote health. In order to understand ayurvedic medicine, it important
to learn about its three main ideas, i.e. universal interconnectiveness, prakriti (body's
constitution) and doshas (life forces). Ayurvedic medicine uses herbs, diet, massage and
lifestyle changes to achieve a balance between body, mind and spirit. Thus Ayurvedic
practitioners gather information about the patients dosha balance from questions about
diet, lifestyle, illnesses and physical characters and then they plan for nutrition, exercise
and medicine.
Now a days Prameha / diabetes is a most common metabolic disorder in India and
affecting more than 30 million people with type 2 diabetes. Therapies of western medicines
carry the risk of adverse effects and are often too costly especially for the developing
country like India, where ethnic as well as environment also differ. In India the available
plant compounds are being used to treat Diabetes / Prameha from the ancient time. In
this review we have focused on the ancient as well as herbal medicine and their key
constituents and functions, which are the main source of modern medicine and that may
be utmost helpful to the patients as well as to the scientist, scholars, medical or health
professionals who are working on diabetes.
639Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
Herb Botanical Ayurvedic Part Used Key Function
Name Name Name Constituents

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1. AYURVEDIC MEDICINE + PRAMEHA + 2012

  • 1. Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait1, Dr. Moumita Bhattacharya2 ABSTRACT Diabetes is a most common metabolic disorder in India affecting more than 30 million people with type 2diabetes. Ayurveda is a holistic health care system of medicine, which is more than 5000 years old and it describes Diabetes under the heading Prameha. Plant active principles have been used to treat Prameha from ancient time under the Ayurvedic medication. Ayurvedic medicines are personalized for individual patient. It offers natural ways to treat disease and promote health. It uses herbs, diet, massage and lifestyle changes to achieve a balance between body, mind and spirit. In this review we have discussed about the Ayurvedic classification of Prameha, its complications and focused on the role of ancient medicines along with their key constituents, which are the main source of modern medicine. Further this review points out the ignorance of fundamental Indian medication system which is being masked by the modernized human culture increasing higher risk factor of side effects. INTRODUCTION Ayurveda is a holistic health care system of medicine originated in ancient Vedic civilization of India, which is more than 5000 years old. The word `Ayur-Veda' is derived from two Sanskrit roots: "Ayus" meaning life and "Veda" meaning knowledge or science. Ayurveda is, therefore, translated as "science of life". Ayurveda is based on the inter dependence of man and nature. Every living and non-living things are mutually interlinked. Major Ayurvedic texts are CHARAKA and SUSRUTA. Two other major contributors were VAGHBATA and NAGARJUNA. The core principles of Ayurvedic philosophy revolve around three important factors (doshas) of life, viz. Vata (Wind) Pitta (Fire) and Kapha (Earth) which are called Tridoshas. These are prime movers of the body. All of us have a unique mix of the three which accounts for our basic nature. At molecular 628 Jr. Anth. Survey of India, 61 : 2 (659-669), 2012 1Anthropological Survey of India, Western Regional Centre, Udaipur, India; 2The Asiatic Society, Kolkata, India
  • 2. Table 3: Ayurvedic Body Types and Characteristics Ayurvedic Body Types Vata Pitta Kapha Physical Thin. Average build Large build. Characteristics Prominent features Fair, thin hair Wavy, thick hair. Cool Warm, moist skin. Pale, cool, oily skin. Dry skin Ulcers, heartburn, Obesity, allergies, Constipation and hemorrhoids. and sinus problems. Cramps Acne High cholesterol. Moody Intense Relaxed, Not easily Emotional Vivacious Quick tempered angered. Affectionate Characteristics Imaginative Intelligent Tolerant Enthusiastic Loving Compassionate Intuitive Articulate Unscheduled sleep Orderly Slow, graceful. Behavioral and meal times Structured sleep Long sleeper and Characteristics Nervous disorders and meal times. slow eater. Anxiety Perfectionist. Procrastination. The word Prameha is derived from the "Miha sechane" which means watering. `Pra' means excess of urine in both quality and frequency. Prameha, thus, becomes self- explanatory and holds the twin meanings of "Prabhutha mutratha" or excessive urination and "Avilmutratha " or turbid urine. Ayurveda have described that, when a hungry person takes the food containing all six tastes i.e. sweet (madhura), sour (amla), salty (lavana), bitter (tikta), pungent (katu) and astringent (kasaya), only one taste i.e. sweet is predominant and it can increase kapha & medas (fat) and cause prameha. “Navannapanam Gudavaikritamcha Pramehahetu Kaphakriccha Sarvam” (Ch. Chi. 6) That means excess of newly harvested food grains, jiggery preparations and factors responsible for elevation of Kapha, may contribute to the development of diabetes [2]. “Divaswapanam Vyayamalasya Prasaktam, Sheetasnigdha, Madhurdrvyapanasevinam Purusam Janeeyat Pramehi Bhavishyteeta” (Su. Ni.6) Day time sleeping; lack of exercise and laziness; too much of cold, sweet, lipidemic and alchoholic foods and beverages as the causative factors for development of diabetes later in life[2]. "Asyasukham-Swapnasukham dadhini Gramyaudakanuparasah payamsi Navannapanam gudavaikritamcha pramehahetuh kaphakricca sarvam" – 4th shloka/6th chapter Chikitsa sthana: Charaka Samhita 630 levels, Kapha represents nutritious regimens and may be either of dietary origin or nutritious substances at systemic and tissue level. Pitta designates factors responsible for digestion, absorption, and metabolism of nutritious substances at any level of physiological processes and may be regarded as enzymatic activities, etc. Vata represents processes like respiration, oxygen (vayu) responsible for combustion/burning of nutritious substances during metabolic activities to release and mobilize energy. Usually one of the elements would be the dominant one, which would also be our disposition[1]. The knowledge of Diabetes has been existent in India since Vedic age in mythological form where it is said that the origin of diabetes takes place by eating Havisya (Charaka samhita nidanasthana1). Ayurveda is described Diabetes under the heading `Prameha' and clinical picture is similar to `Madhumeha', which means honey like urine or sweet urine, similarly Diabetes is a Latin word which also means honey like sweet urine [2]. Table 1: Basic principle of Ayurvedic Philosophy HEALTH = Balance < THRIDOSHA >Imbalance = DISORDER KAPHA: Nutrition PITTA: Digestion or Metabolism VATA: Respiration / Energy production This basic principle of Ayurvedic philosophy that Kapha, Pitta and Vata are the important factor of life, which appropriate balance leads to a healthy life and their inappropriate distribution causes imbalance in physiological or biochemical process that lead to different disorder or diseases. Table 2: Characteristics of three Doshas Attributes Vata Pitta Kapha Represents the element Air Fire Earth Space (ether) Water Water Dry/Cold Hot/Moist Steady/Calm Qualities Light body type Perfectionistic Heavier body Quick/Energetic Sharp/Intelligent type Strong/Loyal Cell division Heart Digestion Structure Body process Breathing Temperature Growth Waste products Hormones Storage Mind Imagination Intelligence Major mental functions Resilience Confidence Memory Decision making Enterprise 631Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
  • 3. (4 varieties) get manifested depending on the basic constitution on the patient, indulgence of verities of causative factors enlisted & type of tissues effected among the following Medas (Adipose), Vasaa (fat), Rakta (blood cells), Shukra (spermatozoa), Ambu (cytoplasm), Lasika (protoplasm), Majja (bone marrow), Rasa (lymph), Pisita (muscle), Ojas (gene- proteins/factors responsible for immunity)[7]. 1. Kaphaja : Kapha causes pramehas by affecting Medas thus altering lipid metabolism, muscles and body fluid situated in urinary bladder. Types of kapha are as follows: i. UDAKAMEHA (Chronic nephritis): Watery urine or Clear urine in larger quantity without odor; patient feels cold sensation while passing urine. ii. IKSHUVALIKAMEHA (Alimentary glycosuria): Like sugar cane or Very sweet urine, cool, slightly viscid, turbid due to slimy substances. iii. SANDRAMEHA (Phosphaturia): Viscous urine or If urine is kept overnight, precipitate is present in the container. iv. SANDRAPRASADAMEHA: Having solid precipitate or Sandraprasadmeha means a portion of the urine is turbid and a portion is clean like Sura (undistilled alcohol). Described as Surameha in Sushruta and Ashtanga Hridaya [8]. v. SHUKLAMEHA (Chyleuria, albuminuria): Urine is white and appears as if it is mixed with flour (paste). While passing urine the patient feels erection of body hairs. vi. SUKRAMEHA (Spermaturia): Urine with semen or Patient passes urine similar to quality of semen or semen itself may be mixed with urine. vii. SITAMEHA: Cold urine or Urine is very sweet and abundant, with low temperature. viii. SAINYAMEHA: Delayed and very slow impulse of urination and patient feels difficulty in passing urine. ix. LALAMEHA (Albuminaria): Saliva-like urine or Urine is turbid and slimy; it is sticky and threads may be demonstrated like gum. x. SIKTAMEHA (LITHURIA): Urine with gravels or Patient passes small particles like sand in the urine. 2. Pittaja: Pitta aggravated by hot things causes the same by affecting medas, muscles and body fluid situated in urinary bladder. They are of 6 types- i. KSARAMEHA (Alkanuria) : Urine like alkali (ash) solution in smell, color and touch ii. KAALAMEHA (Indikanuria) : Black urine iii. NILAMEHA (Indikanuria) : Blue urine iv. HARIDRAMEHA (Biluria): Turmeric-like urine or Urine is yellow like the color of turmeric, pungent, and associated with a severe burning sensation. v. MANJISTHAMEHA (Urobilinuria): Urine is pink like decoction of Manjishta. vi. LOHITAMEHA (Haemeturia): Urine is deep red or Urine contains blood and is salty in taste. 632 Asyasukha means happiness of tongue, eating food which is sweet, salt, sour in taste. Swapnasukha means sleeping in the day for more than 30 min and sleeping more at night. it also means not living an active life with good amount of exercise & sports. VARGIKARAN / CLASSIFICATION OF PRAMEHA [3,4,5,6] In Ayurveda texts (Charaka Samhita, Sushruta Samhita, Astanga Sangraha & Hrudaya, Hareeta Samhita) Diabetes (Prameha) has been described in three major categories (A) HETU BHEDAS, (B) DEHA PRAKRITI BHEDAS and (C) MUTRA BIKARA BHEDAS. All categories divided in different sub group: (A) HETU BHEDAS (Etiological classification) 1. Sahaja/Jatah prameha (Hereditary): Due to the genetic factors certain defects in the ovum and sperm results in a genetic disorder which is referred to ‘Beej Dosha’. It can be compared to type 1diabetes and mostly found in lean individuals. It is also known as Juvenile or congenital diabetes or insulin-dependent diabetes mellitus. Genetical view of prameha is clearly mentioned by Charaka samhita as specific word `Beej dosha' means a "defect in genes". Beej means seed and dosha means defect. Charaka has described anatomy of “Beej” as Semen or Sukra and “Beej bhaga” as Chromosome. According to Charaka the congenital case of Prameha or one inheriting the disease from his Diabetic Parents is incurable because of genetic factor. Whatever diseases are familial are said to be incurable [ch chi: 6:57]. 2. Apathyanimittaja (Acquired): Improper dietary habits and unwholesome lifestyle is mostly seen in obese individuals. It is quite similar to type 2 diabetes, and also known as adult onset diabetes or non insulin-dependent diabetes mellitus. (B). DEHA PRAKRITI (As per features of the body or Physique) According to Charaka samhita the two types of prameha patients on the basis of their physique or body constitution are - 1. Sthula pramehi: This category refers as Obese diabetic patients and similar to the patients with type 2 diabetes. 2. Krisha pramehi: this category refers to Asthenic diabetic patients, like a lean person and corresponds to patients with type 1 diabetes. (C) MUTRA BIKARA BHEDA (Doshic classification or as per urinary abnormality) ‘Sarva yeva pramehastu kalenapratikarinah madhumehatvamayanti Tada asadhyabhavanti hi’ (su. Ni.6) [2] According to Sushruta Samhita as well as ayurvedic literature Prameha (Diabetes) has been classified into 20 types depending on the various signs and symptoms manifested with urine. These twenty types of prameha, Kapha (10 varieties), Pitta (6 varieties), Vata 633Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
  • 4. 2. Trishna (Thirst/Polydipsia): Excessive and frequent thirst in Ayurveda it is termed as Trishna. In the process of lipolysis, more water is utilized which results into activation of thirst center in the brain. 3. Panipada daha: Abundance of unutilized glucose in the blood. This causes disturbance in the equilibrium of dhatus and doshas in the body exposing body to further complications. It gives rise to Panipada daha, which means burning sensation of feet and palm and lower extremity paresthesias- pins and needle sensation. 4. Unexplained weight loss 5. Madhuratava in mutra : Glycosuria 6. Dantadinam mala sanchaya: Due to ama, deposits are seen in mouth. 7. Swadasyata: Sweetness is experienced in the mouth due to increase in the sugar level. According to modern medical science the clinical symptoms of diabetes are – polyuria, polydipsia, polyphagia, general debility, profuse sweating, dryness of the skin, pain in thigh/calf muscles, Weight loss due to calories lost as glucosuria, leaving a negative calorie balance, poor wound healing, gingivitis and blurred vision [9]. UPADRAVA / COMPLICATION [2, 3] Complication refers as Upadrava of Prameha (diabetes) covers all the conditions, which can develop with diabetes patients. The complications related to diabetes mellitus, as described in allopathic medicine, are mentioned in Ayurveda either directly or indirectly in relation to Prameha. These include dyspepsia, diarrhea, fever, burning sensation, weakness, anorexia, indigestion, and diabetic carbuncles and abscesses (referred to in Ayurveda as Pidaka, Alji, and Vidradhi). In Charak Samhita many features of complications are described that the diseases and disorders caused by over intake of Santarpana (a highly nutritious, high-calorie diet intended to increase weight). These disorders and diseases include: (i) Prameha Pidaka (carbuncles) (ii) Kustha (skin diseases) (iii) Mutrakrichhra (urinary disorders or Nephropathy) (iv) Klaibya (erectile dysfunction) (v) Sthaulya (obesity) (vi) Indriya Srotasam Lepa (structural and functional impairment of the sensory organs) (vii) Siopha (generalized edema) According to Astanga Samgraha of Vagbhata describes complications for each Doshic type of Prameha separately as Kaphaja Prameha, Pittaja Prameha, and Vataja Prameha [8]. Complication of Kaphaja Prameha: This includes coryza, laziness, anorexia, indigestion, excessive salivation, vomiting, hypersomnia, and couth (while anorexia, vomiting, diarrhea, etc., denote diabetic enteropathy). Complication of Pittaja Prameha: Include hyper acidity, excessive thirst, fever, burning sensation, fainting, diarrhea, anemia, cracking of the scrotal skin, and pain in the penis and bladder region. Diabetic neuropathy is directly mentioned as a burning sensation in the body, tremors and Hastimeha (incontinence of urine). 634 3. Vataja: Vayu, on relative diminution of other two doshas, draws on the dhatus in urinary bladder and thus causes Prameha. Prameha caused by vata and associated with pain has blackish or reddish urine. They are of 4 types- i. MAJJAMEHA (Albuminuria): Urine with majja (bone marrow). ii. VASAMEHA (Lipuria): Urine with Vasa (fat). iii. HASTIMEHA (Prostatitis) : Urine with lasika (lymph) iv. MADHUMEHA (Diabetes mellitus): Urine with yellowish-white in color and taste like honey. SADHYASADHYATA / PROGNOSIS Charaka had classified Prameha in three categories as per to sadyaasadhyata [ch chi : 6:57]. 1. SADHYA [Curable]: This includes Kaphaja Prameha [predominance of Kapha humor], usually due to improper life style and dietary habits, and patient is usually sthula [obese] 2. YAPYA [Controllable] : This includes Pittaja Prameha [predominance of Pitta humor] 3. ASADHYA [Difficult to manage]: This includes Vattaja Prameha [predominance of Vata humor] patient is usually asthenic or lean. In this situation the disease becomes incurable. Table3. Features of Prameha according to sadyaasadhyata (prognosis) SADHYA YAPYA ASADHYA Prognosis Curable Controllable Difficult to manage Dosha Kaphaja Pittaja Vataja Etiology Acquired Acquired Hereditary Physique/ Body constitution Obese Asthenic Clinical Mild hyperglycemia, Moderate Severe hyperglycemia manifestations hyperglycemia Hyperinsulinemia Stage of disease Early/without Acute, young adults Chronic / advanced / process complications with complications PURVARUPA / PRODROMAL SYMPTOMS [5,6,8] According to Ayurveda Sanskrit literature and modern medicines the chief symptoms or Purvarupa of Prameha are: 1. Prabhutavilamutrata (polyuria) : Swedawaha srotoavrodha causes increased urinary out put with turbidity and increased frequency; in Ayurveda this symptom is termed as prabhootavila mootrata [increased output and frequency of turbid urine] "Prachuram varam varam va mehati mutratyagam karoti yasmin roge sa prameha" (Ma. Ni.)[2] 635Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
  • 5. Table 4: Ancient Indian Medicinal plants, botanical name, key constituents of the used part of the plant and functions [14, 15, 16, 17, 18, 19] Herb Botanical Ayurvedic Part Used Key Function Name Name Name Constituents Devadaru Cedrus deodara Devadaru Bark, Cedrinoside, cedrin, To tackle the causes of oxidative (Cedar, Deodar) Wood toxifonil, cedeodarin, stress (Vata, heart disease dewarenol, himchalol (Hrid-rog) and diabetes (Prameha) Vijaysara Pterocarpus Pitasara Kinotanin acid, The bark of the tree is made into a (Indian Kino tree) masrsupium Bark pyrocatechin, wooden glass and the glass is gallic acis, resin. termed as "The miracle cure for diabetes". Some water is kept in the wooden glass overnight and is consumed early morning by diabetes patients. Diabetes support contains extract of bark of this miracle Jamun Syzygium cumini Jambu Seeds Phenols, Tannings, The powder of the seeds of (Black plum) Alkaloid (Jumbosine), Jamun fruit is very effective in Clucoside ellagic acid, controlling sugar levels. resin, gallic acid, Astringent is useful for disease albumin, etc. caused by concessive sweetness like obestity and diabetes. Bel Aegle marmelos Bilwa Leaves Tanning, coumarin, The leaves of Bilva are excellent (Bael fruit tree) umbelliferone, – for diabetes. Used to cure Vata and dlimonone, and Kapha and also good for Heart. Karela Memordica Karvellaka / Whole tree, Alkaloid memordicine, Decrease blood glucose level. (Bitter gourd) charanatia Karavella pulp glycosides charantin Rapid protective effects against and vicine, and lipid per oxidation by polypeptidep scavenging free radicals. Reduces increased cholesterol. Reducing the risk of diabetic complications. Methi Trigonella Methika Seeds Moisture, protein, It is used to lower down sugar (Fenugreek) foenum graecum fibre, carbohydrates, ash, levels. as well as cholesterol levels. calcium, phosphorous, iron, sodium, potassium and better fixed oil, odourous oil. Tulsi Ocimum sanctum Sursa leaves Volatile oil, eugenol, Regular use of leaves of this plant (Holy Basil) methyl chavicl, methyl controls blood sugar levels eugenol, caryophyllene; very effectively. Flavonoids (apigenin, It is also useful in many types luteolin); Triterpene: of cancers, viral and bacterial (ursolic acid) infections, sore throat, cough and cold etc. Daruhaldi Berberis aristata Daruharidra Rhizomes A yellow alkalois The herb powder stimulates pancreas (Indian Barberry) berberine to pump more insulin into blood. It also helps in preventing insulin resistance among cells. It acts as a channel opener for glucose into the cells. This also purifies the blood. Purifying Haldi Curcuma longa Haridra Rhizomes Volatile oil 1 percent, the blood, channel opener, (Turmeric) curcumin, turmeric oil helps in reducing the insulin resistance. and yellow colouring Turmeric powder is an effective matter anti-allergic, anti-cancer, anti- inflammatory and one of the best natural anti-diabetics. Sadabahar Catheranthus Svetakotajah Plant leaves Alkaloids (vincristine, The leaves are very useful in (Periwinkle) roseus/ vinblastine) controlling the diabetes an (Vinca rosea) anti-cancer and also beneficial for kidney. Amla Emblica Amlika Fruits Vitamin C, gallic acid, It prevents ageing and therefore (Indian officinalis tannic acid, glucose, delayes theonset of Goseberry) albumin, cellulose, complications of diabetes. calcium. Gurmar Gymnema Madhunashini Leaves Gymnemic acid, resins, It controls hyperglycemia and (Small Indian sylvestrae Meshshringi bitter, calcium oxzalate, carbohydrat e metabolism in liver Ipecacuanha) quercitol and sugar yeast. and in skeletal muscles. Durike bel Coccinia indica Bimbi Root Cuceubirocin B It control glucose metabolism. and (hypoglycemic principle) Fruit 636 Complication of Vataja Prameha: Include heaviness in the chest, excessive hunger, insomnia, tremors, pain, constipation, cough, and dyspnea. Heaviness in the chest indicates cardiac disorders, and fainting, tremors, etc., may relate to Cardiovascular and cerebral disorders. The features of nephropathy are not directly referred to in Upadrava (complications) of Prameha; these are described in detail in the 20 subtypes of MUTRA BIKARA BHEDAS (As per urinary abnormality). The presence of excessive waste products in the eyes, ears, tongue, etc., discussed as Purvarupa, indicates that these organs would become increasingly disturbed with the advancement of disease and ultimately retinopathy and other disorders could develop as a result. CHIKITSA / TREATMENT Charaka Samhita is a massive treatise on ancient Indian medicine. It contains 8 divisions (Astanga Sthanas): Sutra, Nidana, Vimana, Sarira, Endriya, Chikitsa, Kalps and Siddha- Sthanas. The prameha has been described eloquently and elaborately in Charak Samhita chikistha sthana's 6th chapter, nidana sthana's 6th chapter of Shusurata samhita and Prameha nidana's 33rd chapter of Madava nidana. According to Ayurvedic point of view the basic principle or Chikitsa Sutra of prameha are Shodhana [purification] and Shamana [suppression] i. Shodhana: Shodhana or purification is generally done in obese diabetic (Sthula Pramehi) with adequate body strength and requires expertise in assessment of vitiated doshas and therapy to be applied. A Samshodana (Panchakarma like vamana (emesis), virechana (purging) and later medicines & diet to normalize the condition (antikapha) treatment. Mismanagement would lead to more harm than any good. Hence in general practice shaman Chikitsa is prevalent and popular. ii. Shaman Chikitsa: [acificatory management]: Samshamana means palliative treatment and Santarpana (antivata) treatment. The herbs used in the management of DM syndrome (Krusha Pramehi) are bitter, astringent, and pungent in Rasa [taste]. All herbs having these tastes are having some anti-diabetic quality. While treating Diabetes (prameha) herbs are used either individually or with combination of other herbs or mineral. HERBS / MEDICINE FOR PRAMEHA [10, 11, 12, 13] Ayurveda is an indigenous ethnic medical system is popular practice in the Indian subcontinent since the pre-biblical era. The system's core strength is its holistic approach to health and disease using natural remedies derived from medicinal plants and minerals. The medicines having tikta, katu, kashaya taste are generally considered good in Diabetes (prameha). There are many popular herbs with medicinal value and which still continue to be used in India. Following herbs are described in ancient as well as modern Ayurvedic texts for solution of diabetes (Prameha). The major herbs are as follows- Devdaru, Vijaysar, Jamun, Bel, Karela, Methi, Tulsi, Daruhaldi, Haldi, Sadabahar, Amla, Gurmar, Durike bel, Neem, Vjrataru, Siris, Bar, Tuvaraka, Saptrangi, Hulhul/Hurhur. Some important medicinal plants are summarized in table 4. 637Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya
  • 6. Reference 1. Tiwari A.K., 2005. Wisdom of Ayurveda in perceiving diabetes:Enigma of therapeutic recognition, CURRENT SCIENCE, VOL.88, NO.7, 2. Upadhyaya, Y. (ed.), In Madhavanidanam of Sri Madavakara, Part.II. The Kashi Sanskrit Series 158, Chaukhambha Sanskrit Sansthan, Varanasi, 1993, 22nd edn, pp.1-27. 3. Hari Sharma, Chandola H.M., 2011. Prameha in Ayurveda: Correlation with Obesity, Metabolic Syndrome, and Diabetes Mellitus. Part 1 – Etiology, Classification, and Pathogenesis. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, Volume 17, Number 6, pp.491-496. 4. Shastri KN, Chaturvedi GN. Agnivesha, Charaka Samhita, Vidyotini commentary. Varanasi, India: Chaukhamba Bharati Academy, 2004. 5. Shastri A. Susruta Samhita, Ayurveda-Tattva-Samdipika commentary, 14th ed. Varanasi, India: Chaukhambha Publications, 2003. 6. Shukla VD, Tripathi RD. Agnivesha, Charaka Samhita, Vaidyamanorama Hindi commentary. Delhi, India: Chaukhamba Sanskrit Pratishthana, 2002. 7. blog. vedantayurveda.com/?tag=charaka-samhita. 8. Gupta KA, Upadhyaya YN. Vagobhata's Astangahridayam, Vidyotini commentary. Varanasi, India: Chaukhambha Prakashana, 2007. 9. Prof. Dr. Shailendra Naithani Diabetes and its Management] 10. Sharma PV. Delhi, India: Chaukhambia Orientalia; 1994. Caraka Samhita (English translation). 11. Valiathan MS. Chennai: Orient Longman; 2003. The Legacy of Caraka. 12. Srikanta Murthy KR. Delhi, India: Chaukhambia Orientalia; 1993. Madhava Nidanam (roga viniscaya) of Madhavakara (English translation). 13. Mishra B. In: 9th ed. Bhavmishra, Bhavaprakasa Nighantu., editors. Vol. 1. Nighantu, Varanasi: Chaukhambha Sanskrit Sansthan; 1999. p.11. 14. Dhiman A.K 2006. Ayurvedic Drug Plants. Daya publishing House, Delhi. 15. Laksham H.C and Inchal R.K. 2012. Indigenous Medicinal plants and their Practical Utiligy. New India Publishing Agency, New Delhi. 16. Vutya R.K. 2007. Banaspati oushadh vigyan : A complete Book of Indian Medicinal Herbs. Scientific publishers (India), Jodhpur. 17. Boominathan R and Panda S 2009. Plant Used in the Cure of Diabetes Mellitus. In P.C. Trivedi ed. Indian Medicinal Plants. Aavishkar Publishers, Distributor, Jaipur, India, pp74-83. 18. Chevallier A. 2000, Encyclopedia of Herbal Medicine, Second American Edition, 2000. DK Publishing Inc., 95 Madison Avenue, New York – 10016. 19. Vikram Chauhan 2012. Ayurvedic Herbs for Diabetes – A Purely Natural Way to Control Sugar Levels. http://EzineArticles.com/?expert=Vikram_Chauhan 638 Neem Azadirachta Nimba, Leaves Bark, Margosine, nimbidine, Detoxifier, Liver stimulant and lowers (Margosa Tree) indica Parimad Seeds nimbine, nimbosterol, the glycosuria, prevent diabetic tannin, clucose, glucose, vasculopathies and is used to resinous principle, relive kapha and pitta and also volatile oil and burning sensation near the flavonoids. heart, fatigue, thirst, fever and inflammation. Veerataru Dichrostyches Vellantaro (-)epicatechin and Treating Vata (oxidative stress), cinerea its enantiomer, as a Mutrkrichha (urinary problems), new isomer Trisna (polydypsea), of(-)mesquitol Kapha mobilizing (e.g. antidysglycaemic) activities and diseases of sarkara (sugar). Siris Albizzia lebbeck Sirisha Fruit, Tannin, saponin Antiprotozoal, hypoglycaemic, (East Indian Seeds and resin anticancerous Walmut) Bar Ficus Vata Bark, Glycosides Ketones, The back is used in Ayurvedic (Banyan Tree) benghalensis Leaves sterols, ficusin medicine for diabetes. and bergaptin Glycosides have an antidiabetic activity, lowering blood sugar level. Tuvaraka Hydnocarpus Chalmogara, Lead seeds, Glycosides, Luteolin, Anti-hypertiglyceridemic wigthiana Katu Kapittha fruit pulp, Flavolignams (anti-meha and meda) Saptrangi Salactia Saptrangi Stem, Salicinol, kotalanor, It is used as anti-diabetic. The herb oblonga Root sesquiterpene, has been found to have diabetes & triterpenes controlling properties. It binds to leaves intestinal enzymes alpha- glucosidases that break down carbyhydrate into glucose. Hulhun/Hurhur Cleome Tilparni, Seeds, leaves Vitamins (A and C) Used as anti-diabetic for glucose metabolism. (Dog Mustard) gynandra Suriyabhakt, and minerals Ajagandha (Calcium and Iron) CONCLUSION Ayurvedic medicine focuses on each patient as an individual. It offers natural ways to treat disease and promote health. In order to understand ayurvedic medicine, it important to learn about its three main ideas, i.e. universal interconnectiveness, prakriti (body's constitution) and doshas (life forces). Ayurvedic medicine uses herbs, diet, massage and lifestyle changes to achieve a balance between body, mind and spirit. Thus Ayurvedic practitioners gather information about the patients dosha balance from questions about diet, lifestyle, illnesses and physical characters and then they plan for nutrition, exercise and medicine. Now a days Prameha / diabetes is a most common metabolic disorder in India and affecting more than 30 million people with type 2 diabetes. Therapies of western medicines carry the risk of adverse effects and are often too costly especially for the developing country like India, where ethnic as well as environment also differ. In India the available plant compounds are being used to treat Diabetes / Prameha from the ancient time. In this review we have focused on the ancient as well as herbal medicine and their key constituents and functions, which are the main source of modern medicine and that may be utmost helpful to the patients as well as to the scientist, scholars, medical or health professionals who are working on diabetes. 639Prameha and its Ancient Ayurvedic Medicine in India Pulakes Purkait, Dr. Moumita Bhattacharya Herb Botanical Ayurvedic Part Used Key Function Name Name Name Constituents