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{{#seo:
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|title=Santarpaniya Adhyaya
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|titlemode=append
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|keywords=santarpana (over-nutrition), apatarpana (under-nutrition), management of over-nutrition induced disorders, nutrition deficiency disorders, charak samhita, obesity, dislipidemia, hypercholesterolemia, Ayurveda, Indian system of medicine, charak samhita.
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|description=Sutra Sthana Chapter 23. Over-nutrition, under-nutrition and its disorders
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=carak samhita
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|type=article
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}}
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<big>'''Sutra Sthana Chapter 23. Over-nutrition, under-nutrition and its disorders '''</big>
 
{{Infobox
 
{{Infobox
 
|title =  Santarpaniya Adhyaya
 
|title =  Santarpaniya Adhyaya
Line 6: Line 17:
 
|data2 = ''Yojana Chatushka''
 
|data2 = ''Yojana Chatushka''
 
|label3 = Preceding Chapter
 
|label3 = Preceding Chapter
|data3 = [[Langhanabrimhaniya]]
+
|data3 = [[Langhanabrimhaniya Adhyaya]]
  
 
|label4 = Succeeding Chapter
 
|label4 = Succeeding Chapter
|data4 = [[Vidhishonitiya]]
+
|data4 = [[Vidhishonitiya Adhyaya]]
  
 
|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
|data5 = [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
+
|label6 = Translator and commentator
 +
|data6 = Sabnis M., [[Yogesh Deole|Deole Y. S.]]
 +
|label7 = Reviewer
 +
|data7  = Byadgi P.S.
 +
|label8 = Editors
 +
|data8  = Dwivedi R.B., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s01.025 10.47468/CSNE.2020.e01.s01.025]
 
}}
 
}}
==([[Sutra Sthana]] Chapter 23, Chapter on Over-nutrition and its disorders)==
+
<big>'''Abstract'''</big>
 
+
<p style="text-align:justify;">Diseases are caused due to over nutrition and under nutrition. This chapter enlists the causative factors affecting nutritional status leading to two categories of diseases viz. Santarpana (over-nutrition) and apatarpana (under nutrition).  The dietary and lifestyle management of these two disease categories is also elaborated.  Nutraceutical preparations, weight reducing recipes, therapeutic procedures like panchakarma and other associated procedures are described with  medicaments. The chapter also contains a comprehensive list of commonly available herbs used in treatment of these diseases. </br>
=== Abstract ===
 
  
[[Santarpaniya Adhyaya]] is the third chapter in the ''Yojana Chatushka'' (tetrad on management protocol). Sequenced after the chapter on Ayurvedic therapeutics, this chapter lists diseases caused due to ''Santarpana'' (overnutrition) and ''apatarpana'' (undernutrition) and their management through nutraceutical food supplements and medicaments. The chapter also contains a comprehensive list of commonly available list of herbs used for ''Santarpaniya'' diseases, such as ''triphala, aragwadha,'' etc.
+
'''Keywords''': ''santarpana'' (over-nutrition), ''apatarpana'' (under-nutrition), management of over-nutrition induced disorders, nutrition deficiency disorders.
 +
</p>
  
'''Keywords''': ''santarpana'' (overnutrition), ''apatarpana'' (undernutrition), management of over-nutrition induced disorders, nutrition deficiency disorders.
 
  
=== Introduction ===
+
<div style="text-align:justify;">
  
In the series of chapters described for management principles, the present chapter describes two most commonly observed conditions in society viz. ''santarpana'' (over-nutrition) and ''apatarpana'' (undernutrition). It is sequenced after ''langhana'' and ''brimhana'' therapies. The present chapter enlists causes, diseases due to overnutrition and undernutrition and their management through diet and medicaments. It is a blend of nutraceutical food supplements with medicaments. Complications arising due to sedentary lifestyle and over-nutritive diet are also enlisted in the chapter with diseases caused due to undernutrition/ malnourishment and their management with simple dietary preparations. The pharmacological effect of herbs used in management are elaborated in details as well.  
+
== Introduction ==
 +
<div style="text-align:justify;">
 +
In the series of chapters described for management principles, the present chapter describes two most commonly observed conditions in society viz. santarpana(over-nutrition) and apatarpana(undernutrition). It is sequenced after [[langhana]] and [[brimhana]] therapies. The present chapter enlists causes and diseases due to over-nutrition and under-nutrition and their management through diet and medicaments. It is a blend of nutraceutical food supplements with medicaments. Complications arising due to sedentary lifestyle and over-nutritive diet are also enlisted in the chapter with diseases caused due to undernutrition/ malnourishment and their management with simple dietary preparations. The pharmacological effect of herbs used in management are elaborated in detail as well.  
  
''Santarpana'' (overnutrition) leads to vitiation of ''kapha dosha, meda dhatu'' and various obstructive pathologies, whereas ''apatarpana'' (undernutrition) leads to ''vata-pitta dosha'' vitiation and various degenerative pathologies. This concept has been emphasized in this chapter.
+
Santarpana(overnutrition) leads to vitiation of [[kapha]] [[dosha]] and [[meda dhatu]] and various obstructive pathologies, whereas apatarpana(undernutrition) leads to [[vata]]-[[pitta]] [[dosha]] vitiation and various degenerative pathologies. This concept has been emphasized in this chapter.
 +
</div>
  
===Sanskrit text, Transliteration and English Translation===
+
==Sanskrit text, Transliteration and English Translation==
 +
<div class="mw-collapsible mw-collapsed">
  
 
अथातः सन्तर्पणीयमध्यायं व्याख्यास्यामः||१||  
 
अथातः सन्तर्पणीयमध्यायं व्याख्यास्यामः||१||  
  
 
इति ह स्माह भगवानात्रेयः||२||  
 
इति ह स्माह भगवानात्रेयः||२||  
 +
<div class="mw-collapsible-content">
  
 
athātaḥ santarpaṇīyamadhyāyaṁ vyākhyāsyāmaḥ||1||  
 
athātaḥ santarpaṇīyamadhyāyaṁ vyākhyāsyāmaḥ||1||  
Line 42: Line 68:
  
 
iti ha smAha bhagavAnAtreyaH||2||  
 
iti ha smAha bhagavAnAtreyaH||2||  
 +
</div></div>
  
Lord Atreya said, “Now we will discuss in detail the chapter about santarpana.[1-2]
+
Now we shall expound the chapter "Santarpaniya" (Over-nutrition, under-nutrition and its disorders). Thus said Lord Atreya. [1-2]
  
==== Causes of ''santarpana'' induced diseases ====
+
=== Causes of ''santarpana'' induced diseases ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
सन्तर्पयति यः स्निग्धैर्मधुरैर्गुरुपिच्छिलैः|  
 
सन्तर्पयति यः स्निग्धैर्मधुरैर्गुरुपिच्छिलैः|  
 +
 
नवान्नैर्नवमद्यैश्च मांसैश्चानूपवारिजैः||३||  
 
नवान्नैर्नवमद्यैश्च मांसैश्चानूपवारिजैः||३||  
  
 
गोरसैर्गौडिकैश्चान्नैः  पैष्टिकैश्चातिमात्रशः|  
 
गोरसैर्गौडिकैश्चान्नैः  पैष्टिकैश्चातिमात्रशः|  
 +
 
चेष्टाद्वेषी दिवास्वप्नशय्यासनसुखे रतः||४||  
 
चेष्टाद्वेषी दिवास्वप्नशय्यासनसुखे रतः||४||  
  
 
रोगास्तस्योपजायन्ते सन्तर्पणनिमित्तजाः|५|
 
रोगास्तस्योपजायन्ते सन्तर्पणनिमित्तजाः|५|
 +
<div class="mw-collapsible-content">
  
 
santarpayati yaḥ snigdhairmadhurairgurupicchilaiḥ|  
 
santarpayati yaḥ snigdhairmadhurairgurupicchilaiḥ|  
 +
 
navānnairnavamadyaiśca māṁsaiścānūpavārijaiḥ||3||  
 
navānnairnavamadyaiśca māṁsaiścānūpavārijaiḥ||3||  
  
 
gōrasairgauḍikaiścānnaiḥ paiṣṭikaiścātimātraśaḥ|  
 
gōrasairgauḍikaiścānnaiḥ paiṣṭikaiścātimātraśaḥ|  
 +
 
cēṣṭādvēṣī divāsvapnaśayyāsanasukhē rataḥ||4||  
 
cēṣṭādvēṣī divāsvapnaśayyāsanasukhē rataḥ||4||  
  
 
rōgāstasyōpajāyantē santarpaṇanimittajāḥ|5|  
 
rōgāstasyōpajāyantē santarpaṇanimittajāḥ|5|  
 +
 
santarpayati yaH snigdhairmadhurairgurupicchilaiH|  
 
santarpayati yaH snigdhairmadhurairgurupicchilaiH|  
 +
 
navAnnairnavamadyaishca mAMsaishcAnUpavArijaiH||3||  
 
navAnnairnavamadyaishca mAMsaishcAnUpavArijaiH||3||  
  
 
gorasairgauDikaishcAnnaiH  paiShTikaishcAtimAtrashaH|  
 
gorasairgauDikaishcAnnaiH  paiShTikaishcAtimAtrashaH|  
 +
 
ceShTAdveShI divAsvapnashayyAsanasukhe rataH||4||  
 
ceShTAdveShI divAsvapnashayyAsanasukhe rataH||4||  
  
 
rogAstasyopajAyante santarpaNanimittajAH|5|  
 
rogAstasyopajAyante santarpaNanimittajAH|5|  
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
Excessive consumption of unctuous, sweet, heavy to digest and slimy food, new grains (especially new rice), new wine, flesh of animals living in marshy area or born in water, cow’s milk and its products, and those prepared with sugar or molasses, varieties of cakes lead to ''santarpana''. Those who indulge in sedentary, inactive lifestyles and sleep during the day are prone to ''santarpaniya vyadhis'' (i.e. ''santarpana'' induced diseases). [3-4]
 
Excessive consumption of unctuous, sweet, heavy to digest and slimy food, new grains (especially new rice), new wine, flesh of animals living in marshy area or born in water, cow’s milk and its products, and those prepared with sugar or molasses, varieties of cakes lead to ''santarpana''. Those who indulge in sedentary, inactive lifestyles and sleep during the day are prone to ''santarpaniya vyadhis'' (i.e. ''santarpana'' induced diseases). [3-4]
 +
</div>
  
==== List of ''santarpana'' induced diseases ====
+
=== List of ''santarpana'' induced diseases ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
प्रमेहपिडकाकोठकण्डूपाण्ड्वामयज्वराः||५||  
 
प्रमेहपिडकाकोठकण्डूपाण्ड्वामयज्वराः||५||  
  
 
कुष्ठान्यामप्रदोषाश्च मूत्रकृच्छ्रमरोचकः|  
 
कुष्ठान्यामप्रदोषाश्च मूत्रकृच्छ्रमरोचकः|  
 +
 
तन्द्रा क्लैब्यमतिस्थौल्यमालस्यं गुरुगात्रता||६||  
 
तन्द्रा क्लैब्यमतिस्थौल्यमालस्यं गुरुगात्रता||६||  
  
 
इन्द्रियस्रोतसां लेपो बुद्धेर्मोहः प्रमीलकः|  
 
इन्द्रियस्रोतसां लेपो बुद्धेर्मोहः प्रमीलकः|  
 +
 
शोफाश्चैवंविधाश्चान्ये शीघ्रमप्रतिकुर्वतः||७||  
 
शोफाश्चैवंविधाश्चान्ये शीघ्रमप्रतिकुर्वतः||७||  
 +
<div class="mw-collapsible-content">
  
 
pramēhapiḍakākōṭhakaṇḍūpāṇḍvāmayajvarāḥ||5||  
 
pramēhapiḍakākōṭhakaṇḍūpāṇḍvāmayajvarāḥ||5||  
  
 
kuṣṭhānyāmapradōṣāśca mūtrakr̥cchramarōcakaḥ|  
 
kuṣṭhānyāmapradōṣāśca mūtrakr̥cchramarōcakaḥ|  
 +
 
tandrā klaibyamatisthaulyamālasyaṁ gurugātratā||6||  
 
tandrā klaibyamatisthaulyamālasyaṁ gurugātratā||6||  
  
 
indriyasrōtasāṁ lēpō buddhērmōhaḥ pramīlakaḥ|  
 
indriyasrōtasāṁ lēpō buddhērmōhaḥ pramīlakaḥ|  
 +
 
śōphāścaivaṁvidhāścānyē śīghramapratikurvataḥ||7||  
 
śōphāścaivaṁvidhāścānyē śīghramapratikurvataḥ||7||  
  
Line 93: Line 138:
  
 
kuShThAnyAmapradoShAshca mUtrakRucchramarocakaH|  
 
kuShThAnyAmapradoShAshca mUtrakRucchramarocakaH|  
 +
 
tandrA klaibyamatisthaulyamAlasyaM gurugAtratA||6||  
 
tandrA klaibyamatisthaulyamAlasyaM gurugAtratA||6||  
  
 
indriyasrotasAM lepo buddhermohaH pramIlakaH|  
 
indriyasrotasAM lepo buddhermohaH pramIlakaH|  
 +
 
shophAshcaivaMvidhAshcAnye shIghramapratikurvataH||7||  
 
shophAshcaivaMvidhAshcAnye shIghramapratikurvataH||7||  
 +
</div></div>
  
Due to above mentioned causative factors, if the effects of ''santarpana'' are not treated properly, one suffers from various diseases such as obstinate urinary disorders including diabetes, carbuncles, urticaria, itching, ''pandu'' (anaemia), ''amaja'' diseases (i.e., due to formation of ''ama''), ''jwara,'' obstinate skin diseases, diseases secondary to vitiation of ''ama'', dysuria, anorexia or appetite related complaints, ''tandra'' (drowsiness/sleepiness), ''klaibya'' (erectile and sexual dysfunctions), obesity, laziness, heaviness of the body, adhesion or blockages in  the channels as well as  sense organs, delusion, various types of edema, and such of other diseases. [5-7]
+
<div style="text-align:justify;">
 +
Due to above mentioned causative factors, if the effects of ''santarpana'' are not treated properly, one suffers from various diseases such as obstinate urinary disorders including diabetes, carbuncles, urticaria, itching, ''pandu'' (anaemia), ''amaja'' diseases (i.e., due to formation of ''ama''), [[jwara]],obstinate skin diseases, diseases secondary to vitiation of ''ama'', dysuria, anorexia or appetite related complaints, ''tandra'' (drowsiness/sleepiness), ''klaibya'' (erectile and sexual dysfunctions), obesity, laziness, heaviness of the body, adhesion or blockages in  the channels as well as  sense organs, delusion, various types of edema, and such of other diseases. [5-7]
 +
</div>
  
==== Management of ''santarpana''-induced diseases ====
+
=== Management of ''santarpana''-induced diseases ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
शस्तमुल्लेखनं तत्र विरेको रक्तमोक्षणम्|  
 
शस्तमुल्लेखनं तत्र विरेको रक्तमोक्षणम्|  
 +
 
व्यायामश्चोपवासश्च धूमाश्च स्वेदनानि च||८||  
 
व्यायामश्चोपवासश्च धूमाश्च स्वेदनानि च||८||  
 +
<div class="mw-collapsible-content">
  
 
śastamullēkhanaṁ tatra virēkō raktamōkṣaṇam|  
 
śastamullēkhanaṁ tatra virēkō raktamōkṣaṇam|  
 +
 
vyāyāmaścōpavāsaśca dhūmāśca svēdanāni ca||8||  
 
vyāyāmaścōpavāsaśca dhūmāśca svēdanāni ca||8||  
  
 
shastamullekhanaM tatra vireko raktamokShaNam|  
 
shastamullekhanaM tatra vireko raktamokShaNam|  
 +
 
vyAyAmashcopavAsashca dhUmAshca svedanAni ca||8||  
 
vyAyAmashcopavAsashca dhUmAshca svedanAni ca||8||  
 +
</div></div>
  
''Santarpaniya vyadhis'' and their complications should be managed by ''ullekhana'' (therapeutic emesis), ''virechana'' (therapeutic purgation), ''raktamokshana'' (blood-letting), specific exercises, therapeutic fasting, ''dhooma'' (hot fomentation with smoke of medicinal plants), and ''swedana'' (sudation). [8]
+
''Santarpaniya vyadhis'' and their complications should be managed by ullekhana(therapeutic emesis), [[virechana]] (therapeutic purgation), [[raktamokshana]](blood-letting), specific exercises, therapeutic fasting, ''dhooma'' (hot fomentation with smoke of medicinal plants), and [[swedana]](sudation). [8]
 +
<div class="mw-collapsible mw-collapsed">
  
 
सक्षौद्रश्चाभयाप्राशः प्रायो रूक्षान्नसेवनम्|  
 
सक्षौद्रश्चाभयाप्राशः प्रायो रूक्षान्नसेवनम्|  
 +
 
चूर्णप्रदेहा ये चोक्ताः कण्डूकोठविनाशनाः||९||  
 
चूर्णप्रदेहा ये चोक्ताः कण्डूकोठविनाशनाः||९||  
 +
<div class="mw-collapsible-content">
  
 
sakṣaudraścābhayāprāśaḥ prāyō rūkṣānnasēvanam|  
 
sakṣaudraścābhayāprāśaḥ prāyō rūkṣānnasēvanam|  
 +
 
cūrṇapradēhā yē cōktāḥ kaṇḍūkōṭhavināśanāḥ||9||  
 
cūrṇapradēhā yē cōktāḥ kaṇḍūkōṭhavināśanāḥ||9||  
  
 
sakShaudrashcAbhayAprAshaH prAyo rUkShAnnasevanam|  
 
sakShaudrashcAbhayAprAshaH prAyo rUkShAnnasevanam|  
 +
 
cUrNapradehA ye coktAH kaNDUkoThavinAshanAH||9||  
 
cUrNapradehA ye coktAH kaNDUkoThavinAshanAH||9||  
 +
</div></div>
  
Formulations made up of ''haritaki'' (Terminalia Chebula), such as ''agastyaharitaki'' mixed with honey, habituating with ''ruksha'' food (i.e., without using unctuous substances like oil, ghee etc.), those powders and poultice described in treatment of pruritus and urticaria (mentioned in the third chapter of this section) are advised. [9]
+
<div style="text-align:justify;">
 +
Formulations made up of haritaki(Terminalia Chebula), such as agastyaharitaki mixed with honey, habituating with ruksha food (i.e., without using unctuous substances like oil, ghee etc.), those powders and poultice described in treatment of pruritus and urticaria (mentioned in the third chapter of this section) are advised. [9]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
त्रिफलारग्वधं पाठां सप्तपर्णं सवत्सकम्|  
 
त्रिफलारग्वधं पाठां सप्तपर्णं सवत्सकम्|  
 +
 
मुस्तं समदनं निम्बं जलेनोत्क्वथितं पिबेत्||१०||  
 
मुस्तं समदनं निम्बं जलेनोत्क्वथितं पिबेत्||१०||  
  
 
तेन मेहादयो यान्ति नाशमभ्यस्यतो ध्रुवम्|  
 
तेन मेहादयो यान्ति नाशमभ्यस्यतो ध्रुवम्|  
 +
 
मात्राकालप्रयुक्तेन सन्तर्पणसमुत्थिताः||११||  
 
मात्राकालप्रयुक्तेन सन्तर्पणसमुत्थिताः||११||  
 +
<div class="mw-collapsible-content">
  
 
triphalāragvadhaṁ pāṭhāṁ saptaparṇaṁ savatsakam|  
 
triphalāragvadhaṁ pāṭhāṁ saptaparṇaṁ savatsakam|  
 +
 
mustaṁ samadanaṁ nimbaṁ jalēnōtkvathitaṁ pibēt||10||  
 
mustaṁ samadanaṁ nimbaṁ jalēnōtkvathitaṁ pibēt||10||  
  
 
tēna mēhādayō yānti nāśamabhyasyatō dhruvam|  
 
tēna mēhādayō yānti nāśamabhyasyatō dhruvam|  
 +
 
mātrākālaprayuktēna santarpaṇasamutthitāḥ||11||
 
mātrākālaprayuktēna santarpaṇasamutthitāḥ||11||
  
 
triphalAragvadhaM pAThAM saptaparNaM savatsakam|  
 
triphalAragvadhaM pAThAM saptaparNaM savatsakam|  
 +
 
mustaM samadanaM nimbaM jalenotkvathitaM pibet||10||
 
mustaM samadanaM nimbaM jalenotkvathitaM pibet||10||
  
 
tena mehAdayo yAnti nAshamabhyasyato dhruvam|  
 
tena mehAdayo yAnti nAshamabhyasyato dhruvam|  
 +
 
mAtrAkAlaprayuktena santarpaNasamutthitAH||11||   
 
mAtrAkAlaprayuktena santarpaNasamutthitAH||11||   
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
The decoction of ''triphala'' (amalaki (Emblica officinalis), ''bibhitaki'' (Terminalia bellirica), and ''haritaki'' (Terminalia chebula)), ''aragvadha'' (Cassia fistula), ''patha'' (Cissampelos pareira), ''saptaparna'' (Alstonia scholaris), ''vatsaka'' (Holarrhena antidysenterica), ''musta'' (Cyperus rotundus), ''madana'' (Randia dumetorum) and ''nimba'' (Azadirachta indica), mixed together and boiled in water, is advised for consumption regularly. By regular use of this decoction, in the right dose and at the right time, ''santarpaniya vyadhi'' like ''madhumeha'' and other diseases can be controlled properly. [10-11]
 
The decoction of ''triphala'' (amalaki (Emblica officinalis), ''bibhitaki'' (Terminalia bellirica), and ''haritaki'' (Terminalia chebula)), ''aragvadha'' (Cassia fistula), ''patha'' (Cissampelos pareira), ''saptaparna'' (Alstonia scholaris), ''vatsaka'' (Holarrhena antidysenterica), ''musta'' (Cyperus rotundus), ''madana'' (Randia dumetorum) and ''nimba'' (Azadirachta indica), mixed together and boiled in water, is advised for consumption regularly. By regular use of this decoction, in the right dose and at the right time, ''santarpaniya vyadhi'' like ''madhumeha'' and other diseases can be controlled properly. [10-11]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
मुस्तमारग्वधः पाठा त्रिफला देवदारु च|  
 
मुस्तमारग्वधः पाठा त्रिफला देवदारु च|  
 +
 
श्वदंष्ट्रा खदिरो निम्बो हरिद्रे त्वक्च वत्सकात्||१२||  
 
श्वदंष्ट्रा खदिरो निम्बो हरिद्रे त्वक्च वत्सकात्||१२||  
  
 
रसमेषां यथादोषं प्रातः प्रातः पिबन्नरः|  
 
रसमेषां यथादोषं प्रातः प्रातः पिबन्नरः|  
 +
 
सन्तर्पणकृतैः सर्वैर्व्याधिभिः सम्प्रमुच्यते||१३||  
 
सन्तर्पणकृतैः सर्वैर्व्याधिभिः सम्प्रमुच्यते||१३||  
  
 
एभिश्चोद्वर्तनोद्धर्षस्नानयोगोपयोजितैः|  
 
एभिश्चोद्वर्तनोद्धर्षस्नानयोगोपयोजितैः|  
 +
 
त्वग्दोषाः प्रशमं यान्ति तथा स्नेहोपसंहितैः||१४||  
 
त्वग्दोषाः प्रशमं यान्ति तथा स्नेहोपसंहितैः||१४||  
 +
<div class="mw-collapsible-content">
  
 
mustamāragvadhaḥ pāṭhā triphalā dēvadāru ca|  
 
mustamāragvadhaḥ pāṭhā triphalā dēvadāru ca|  
 +
 
śvadaṁṣṭrā khadirō nimbō haridrē tvakca vatsakāt||12||  
 
śvadaṁṣṭrā khadirō nimbō haridrē tvakca vatsakāt||12||  
  
 
rasamēṣāṁ yathādōṣaṁ prātaḥ prātaḥ pibannaraḥ|  
 
rasamēṣāṁ yathādōṣaṁ prātaḥ prātaḥ pibannaraḥ|  
 +
 
santarpaṇakr̥taiḥ sarvairvyādhibhiḥ sampramucyatē||13||  
 
santarpaṇakr̥taiḥ sarvairvyādhibhiḥ sampramucyatē||13||  
  
 
ēbhiścōdvartanōddharṣasnānayōgōpayōjitaiḥ|  
 
ēbhiścōdvartanōddharṣasnānayōgōpayōjitaiḥ|  
 +
 
tvagdōṣāḥ praśamaṁ yānti tathā snēhōpasaṁhitaiḥ||14||  
 
tvagdōṣāḥ praśamaṁ yānti tathā snēhōpasaṁhitaiḥ||14||  
  
 
mustamAragvadhaH pAThA triphalA devadAru ca|  
 
mustamAragvadhaH pAThA triphalA devadAru ca|  
 +
 
shvadaMShTrA khadiro nimbo haridre tvakca vatsakAt||12||  
 
shvadaMShTrA khadiro nimbo haridre tvakca vatsakAt||12||  
  
 
rasameShAM yathAdoShaM prAtaH prAtaH pibannaraH|  
 
rasameShAM yathAdoShaM prAtaH prAtaH pibannaraH|  
 +
 
santarpaNakRutaiH sarvairvyAdhibhiH sampramucyate||13||  
 
santarpaNakRutaiH sarvairvyAdhibhiH sampramucyate||13||  
  
 
ebhishcodvartanoddharShasnAnayogopayojitaiH|  
 
ebhishcodvartanoddharShasnAnayogopayojitaiH|  
 +
 
tvagdoShAH prashamaM yAnti tathA snehopasaMhitaiH||14||  
 
tvagdoShAH prashamaM yAnti tathA snehopasaMhitaiH||14||  
 +
</div></div>
  
All ''santarpaniya'' diseases can be cured, if the juices (decoction) of ''musta, aaragvadha, paatha, triphala, devadaru'' (Cedrus deodara), ''shvadamshtra'' (Trinbulus terrestris), ''khadira'' (Acacia catechu Wild), ''nimba, haridra'' (Curcuma longa), ''daruharidra'' (Berberis aristata) and the bark of ''vatsaka'' (Holarrhena anti-dysenterica) are consumed every morning (depending upon the dominant ''dosha'' in the disease).  
+
<div style="text-align:justify;">
 +
All ''santarpaniya'' diseases can be cured, if the juices (decoction) of ''musta, aaragvadha, paatha, triphala, devadaru'' (Cedrus deodara), ''shvadamshtra'' (Trinbulus terrestris), ''khadira'' (Acacia catechu Wild), ''nimba, haridra'' (Curcuma longa), ''daruharidra'' (Berberis aristata) and the bark of ''vatsaka'' (Holarrhena anti-dysenterica) are consumed every morning (depending upon the dominant [[dosha]] in the disease).  
  
 
If the above herbs are used in a powdered form for ''udvartana'' with or without massage or the decoction of the above herbs are used for medicinal bath or if the oil made up of above drugs is used for body application it relieves all the skin disorders caused due to ''santarpaniya vyadhis''.[12-14]
 
If the above herbs are used in a powdered form for ''udvartana'' with or without massage or the decoction of the above herbs are used for medicinal bath or if the oil made up of above drugs is used for body application it relieves all the skin disorders caused due to ''santarpaniya vyadhis''.[12-14]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
कुष्ठं गोमेदको हिङ्गु क्रौञ्चास्थि त्र्यूषणं वचा|  
 
कुष्ठं गोमेदको हिङ्गु क्रौञ्चास्थि त्र्यूषणं वचा|  
 +
 
वृषकैले श्वदंष्ट्रा च खराह्वा चाश्मभेदकः||१५||  
 
वृषकैले श्वदंष्ट्रा च खराह्वा चाश्मभेदकः||१५||  
  
 
तक्रेण दधिमण्डेन बदराम्लरसेन वा|  
 
तक्रेण दधिमण्डेन बदराम्लरसेन वा|  
 +
 
मूत्रकृच्छ्रं प्रमेहं च पीतमेतद्व्यपोहति||१६||  
 
मूत्रकृच्छ्रं प्रमेहं च पीतमेतद्व्यपोहति||१६||  
 +
<div class="mw-collapsible-content">
  
 
kuṣṭhaṁ gōmēdakō hiṅgu krauñcāsthi tryūṣaṇaṁ vacā|  
 
kuṣṭhaṁ gōmēdakō hiṅgu krauñcāsthi tryūṣaṇaṁ vacā|  
 +
 
vr̥ṣakailē śvadaṁṣṭrā ca kharāhvā cāśmabhēdakaḥ||15||
 
vr̥ṣakailē śvadaṁṣṭrā ca kharāhvā cāśmabhēdakaḥ||15||
  
 
takrēṇa dadhimaṇḍēna badarāmlarasēna vā|  
 
takrēṇa dadhimaṇḍēna badarāmlarasēna vā|  
 +
 
mūtrakr̥cchraṁ pramēhaṁ ca pītamētadvyapōhati||16||  
 
mūtrakr̥cchraṁ pramēhaṁ ca pītamētadvyapōhati||16||  
  
 
kuShThaM gomedako hi~ggu krau~jcAsthi tryUShaNaM vacA|  
 
kuShThaM gomedako hi~ggu krau~jcAsthi tryUShaNaM vacA|  
 +
 
vRuShakaile shvadaMShTrA ca kharAhvA cAshmabhedakaH||15||  
 
vRuShakaile shvadaMShTrA ca kharAhvA cAshmabhedakaH||15||  
  
 
takreNa dadhimaNDena badarAmlarasena vA|  
 
takreNa dadhimaNDena badarAmlarasena vA|  
 +
 
mUtrakRucchraM pramehaM ca pItametadvyapohati||16||  
 
mUtrakRucchraM pramehaM ca pItametadvyapohati||16||  
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
''Kustha'' (Saussurea lappa), ''gomedaka'' (onyx), ''hingu'' (Ferula narthex), bones of the ''krauncha'' bird (Ardea Jaculator, demoiselle crane), ''sunthi'' (Zingiber officinalis), ''pippali'' (Piper longum), ''maricha'' (Piper nigrum), ''vacha'' (Acorus calamus), ''vasa'' (Adhatoda vasica Nees), ''ela'' (Elettaria cardamoum), ''gokshura'' (Tribulus terrestris), ''kharahva'' (Trachyspermum roxburghianum), and ''ashmabheda'' (Bergenia ligulata – crushed and  mixed with buttermilk, whey and the juice of a sour variant of ''badara'' (Zizyphus jujuba) are used to treat ''mutrakruchchra'' (dysuria) and ''prameha'' (obstinate urinary disorders including diabetes mellitus characterized by excess frequency of micturition). [15-16]
 
''Kustha'' (Saussurea lappa), ''gomedaka'' (onyx), ''hingu'' (Ferula narthex), bones of the ''krauncha'' bird (Ardea Jaculator, demoiselle crane), ''sunthi'' (Zingiber officinalis), ''pippali'' (Piper longum), ''maricha'' (Piper nigrum), ''vacha'' (Acorus calamus), ''vasa'' (Adhatoda vasica Nees), ''ela'' (Elettaria cardamoum), ''gokshura'' (Tribulus terrestris), ''kharahva'' (Trachyspermum roxburghianum), and ''ashmabheda'' (Bergenia ligulata – crushed and  mixed with buttermilk, whey and the juice of a sour variant of ''badara'' (Zizyphus jujuba) are used to treat ''mutrakruchchra'' (dysuria) and ''prameha'' (obstinate urinary disorders including diabetes mellitus characterized by excess frequency of micturition). [15-16]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
तक्राभयाप्रयोगैश्च त्रिफलायास्तथैव च|  
 
तक्राभयाप्रयोगैश्च त्रिफलायास्तथैव च|  
 +
 
अरिष्टानां प्रयोगैश्च यान्ति मेहादयः शमम्||१७||  
 
अरिष्टानां प्रयोगैश्च यान्ति मेहादयः शमम्||१७||  
 +
<div class="mw-collapsible-content">
  
 
takrābhayāprayōgaiśca triphalāyāstathaiva ca|  
 
takrābhayāprayōgaiśca triphalāyāstathaiva ca|  
 +
 
ariṣṭānāṁ prayōgaiśca yānti mēhādayaḥ śamam||17||  
 
ariṣṭānāṁ prayōgaiśca yānti mēhādayaḥ śamam||17||  
  
 
takrAbhayAprayogaishca triphalAyAstathaiva ca|  
 
takrAbhayAprayogaishca triphalAyAstathaiva ca|  
 +
 
ariShTAnAM prayogaishca yAnti mehAdayaH shamam||17||  
 
ariShTAnAM prayogaishca yAnti mehAdayaH shamam||17||  
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
''Haritaki'' (Terminalia chebula) with butter milk, ''triphala'' (Terminalia chebula, Terminalia belerica Roxb. And Emblica officinalis Gaertn.) and ''arishta'' (different types of medicinal alcoholic preparations) are prescribed for the treatment of obstinate urinary disorders including diabetes mellitus and such other diseases. [17]
 
''Haritaki'' (Terminalia chebula) with butter milk, ''triphala'' (Terminalia chebula, Terminalia belerica Roxb. And Emblica officinalis Gaertn.) and ''arishta'' (different types of medicinal alcoholic preparations) are prescribed for the treatment of obstinate urinary disorders including diabetes mellitus and such other diseases. [17]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
त्र्यूषणं त्रिफला क्षौद्रं क्रिमिघ्नमजमोदकः|  
 
त्र्यूषणं त्रिफला क्षौद्रं क्रिमिघ्नमजमोदकः|  
 +
 
मन्थोऽयं सक्तवस्तैलं हितो लोहोदकाप्लुतः||१८||  
 
मन्थोऽयं सक्तवस्तैलं हितो लोहोदकाप्लुतः||१८||  
 +
<div class="mw-collapsible-content">
  
 
tryūṣaṇaṁ triphalā kṣaudraṁ krimighnamajamōdakaḥ|  
 
tryūṣaṇaṁ triphalā kṣaudraṁ krimighnamajamōdakaḥ|  
 +
 
manthō'yaṁ saktavastailaṁ hitō lōhōdakāplutaḥ||18||  
 
manthō'yaṁ saktavastailaṁ hitō lōhōdakāplutaḥ||18||  
  
 
tryUShaNaM triphalA kShaudraM krimighnamajamodakaH|  
 
tryUShaNaM triphalA kShaudraM krimighnamajamodakaH|  
 +
 
mantho~ayaM saktavastailaM hito lohodakAplutaH||18||  
 
mantho~ayaM saktavastailaM hito lohodakAplutaH||18||  
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
''Mantha'' (thin gruel) prepared of ''trikatu'' (Zingiber officinale, Piper longum, and Piper nigrum), ''triphala'' (Terminalia chebula, Terminalia belerica Roxb., and Emblica officinalis Gaertn.), honey, ''vidanga'' (Embelia ribes Burm f.), ''ajamoda'' (Trachy-spermum roxburghianum), roasted wheat flour or coarse ground meal, oil and the decoction of ''agaru'' (Aquilari agallocha Roxb.) help to cure the diseases due to over-nourishment. [18]
 
''Mantha'' (thin gruel) prepared of ''trikatu'' (Zingiber officinale, Piper longum, and Piper nigrum), ''triphala'' (Terminalia chebula, Terminalia belerica Roxb., and Emblica officinalis Gaertn.), honey, ''vidanga'' (Embelia ribes Burm f.), ''ajamoda'' (Trachy-spermum roxburghianum), roasted wheat flour or coarse ground meal, oil and the decoction of ''agaru'' (Aquilari agallocha Roxb.) help to cure the diseases due to over-nourishment. [18]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
व्योषं  विडङ्गं शिग्रूणि त्रिफलां कटुरोहिणीम्|  
 
व्योषं  विडङ्गं शिग्रूणि त्रिफलां कटुरोहिणीम्|  
 +
 
बृहत्यौ द्वे हरिद्रे द्वे पाठामतिविषां स्थिराम्||१९||  
 
बृहत्यौ द्वे हरिद्रे द्वे पाठामतिविषां स्थिराम्||१९||  
  
 
हिङ्गु केबुकमूलानि यवानीधान्यचित्रकान्|  
 
हिङ्गु केबुकमूलानि यवानीधान्यचित्रकान्|  
 +
 
सौवर्चलमजाजीं च हपुषां चेति चूर्णयेत्||२०||  
 
सौवर्चलमजाजीं च हपुषां चेति चूर्णयेत्||२०||  
  
 
चूर्णतैलघृतक्षौद्रभागाः स्युर्मानतः समाः|  
 
चूर्णतैलघृतक्षौद्रभागाः स्युर्मानतः समाः|  
 +
 
सक्तूनां षोडशगुणो भागः सन्तर्पणं पिबेत्||२१||  
 
सक्तूनां षोडशगुणो भागः सन्तर्पणं पिबेत्||२१||  
 +
<div class="mw-collapsible-content">
  
 
vyōṣaṁ viḍaṅgaṁ śigrūṇi triphalāṁ kaṭurōhiṇīm|  
 
vyōṣaṁ viḍaṅgaṁ śigrūṇi triphalāṁ kaṭurōhiṇīm|  
 +
 
br̥hatyau dvē haridrē dvē pāṭhāmativiṣāṁ sthirām||19||  
 
br̥hatyau dvē haridrē dvē pāṭhāmativiṣāṁ sthirām||19||  
  
 
hiṅgu kēbukamūlāni yavānīdhānyacitrakān|  
 
hiṅgu kēbukamūlāni yavānīdhānyacitrakān|  
 +
 
sauvarcalamajājīṁ ca hapuṣāṁ cēti cūrṇayēt||20||  
 
sauvarcalamajājīṁ ca hapuṣāṁ cēti cūrṇayēt||20||  
  
 
cūrṇatailaghr̥takṣaudrabhāgāḥ syurmānataḥ samāḥ|  
 
cūrṇatailaghr̥takṣaudrabhāgāḥ syurmānataḥ samāḥ|  
 +
 
saktūnāṁ ṣōḍaśaguṇō bhāgaḥ santarpaṇaṁ pibēt||21||  
 
saktūnāṁ ṣōḍaśaguṇō bhāgaḥ santarpaṇaṁ pibēt||21||  
  
vyoShaM viDa~ggaM shigrUNi triphalAM kaTurohiNIm|  
+
vyoShaM viDa~ggaM shigrUNi triphalAM kaTurohiNIm|  
 +
 
 
bRuhatyau dve haridre dve pAThAmativiShAM sthirAm||19||  
 
bRuhatyau dve haridre dve pAThAmativiShAM sthirAm||19||  
  
 
hi~ggu kebukamUlAni yavAnIdhAnyacitrakAn|  
 
hi~ggu kebukamUlAni yavAnIdhAnyacitrakAn|  
 +
 
sauvarcalamajAjIM ca hapuShAM ceti cUrNayet||20||  
 
sauvarcalamajAjIM ca hapuShAM ceti cUrNayet||20||  
  
 
cUrNatailaghRutakShaudrabhAgAH syurmAnataH samAH|  
 
cUrNatailaghRutakShaudrabhAgAH syurmAnataH samAH|  
 +
 
saktUnAM ShoDashaguNo bhAgaH santarpaNaM pibet||21||  
 
saktUnAM ShoDashaguNo bhAgaH santarpaNaM pibet||21||  
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
''Trikatu'' (Zingiber officianel,Piper langum and Piper nigrum), ''vidanga'' (Embelia ribes), varieties of ''shigru'' (Moringa olefera), ''triphala'', ''katurohini'' (Picrorhiza kurroa), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum xanthocarpum), ''haridra'' (Curcuma longa), ''daaruharidra'' (Berberis aristata D.C.), two varieties of ''patha'' (Cissampelos pareira), ''ativisha'' (Aconitum heterophyllum), ''shalaparni'' (Desmodium gangeticum), ''hingu'' (Ferula narthex), root of ''kebuka'' (Costus speciosus), ''yavani'' (Trachyspermum ammi), ''dhanya'' (Coriandrum sativum), ''citraka'' (Plumbago Zeylanica), ''sonchal'' salt, ''ajaji'' (Cuminum cyminum), and ''hapusha'' (Juniperus communis) – all the above herbs powdered and mixed with equal quantities of oil, ghee and honey, added with sixteen times its volume of ''sattu'' (roasted corn flour) and water are used to prepare a formulation for indications (mentioned in the following verse.) [19-21]
 
''Trikatu'' (Zingiber officianel,Piper langum and Piper nigrum), ''vidanga'' (Embelia ribes), varieties of ''shigru'' (Moringa olefera), ''triphala'', ''katurohini'' (Picrorhiza kurroa), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum xanthocarpum), ''haridra'' (Curcuma longa), ''daaruharidra'' (Berberis aristata D.C.), two varieties of ''patha'' (Cissampelos pareira), ''ativisha'' (Aconitum heterophyllum), ''shalaparni'' (Desmodium gangeticum), ''hingu'' (Ferula narthex), root of ''kebuka'' (Costus speciosus), ''yavani'' (Trachyspermum ammi), ''dhanya'' (Coriandrum sativum), ''citraka'' (Plumbago Zeylanica), ''sonchal'' salt, ''ajaji'' (Cuminum cyminum), and ''hapusha'' (Juniperus communis) – all the above herbs powdered and mixed with equal quantities of oil, ghee and honey, added with sixteen times its volume of ''sattu'' (roasted corn flour) and water are used to prepare a formulation for indications (mentioned in the following verse.) [19-21]
 +
</div>
  
==== Indications ====
+
=== Indications ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
प्रयोगादस्य शाम्यन्ति रोगाः सन्तर्पणोत्थिताः|  
 
प्रयोगादस्य शाम्यन्ति रोगाः सन्तर्पणोत्थिताः|  
 +
 
प्रमेहा मूढवाताश्च कुष्ठान्यर्शांसि कामलाः||२२||  
 
प्रमेहा मूढवाताश्च कुष्ठान्यर्शांसि कामलाः||२२||  
  
 
प्लीहा पाण्ड्वामयः शोफो मूत्रकृच्छ्रमरोचकः|  
 
प्लीहा पाण्ड्वामयः शोफो मूत्रकृच्छ्रमरोचकः|  
 +
 
हृद्रोगो राजयक्ष्मा च कासः श्वासो गलग्रहः||२३||  
 
हृद्रोगो राजयक्ष्मा च कासः श्वासो गलग्रहः||२३||  
  
 
क्रिमयो ग्रहणीदोषाः श्वैत्र्यं स्थौल्यमतीव च|  
 
क्रिमयो ग्रहणीदोषाः श्वैत्र्यं स्थौल्यमतीव च|  
 +
 
नराणां दीप्यते चाग्निः स्मृतिर्बुद्धिश्च वर्धते||२४||  
 
नराणां दीप्यते चाग्निः स्मृतिर्बुद्धिश्च वर्धते||२४||  
 +
<div class="mw-collapsible-content">
  
 
prayōgādasya śāmyanti rōgāḥ santarpaṇōtthitāḥ|  
 
prayōgādasya śāmyanti rōgāḥ santarpaṇōtthitāḥ|  
 +
 
pramēhā mūḍhavātāśca kuṣṭhānyarśāṁsi kāmalāḥ||22||  
 
pramēhā mūḍhavātāśca kuṣṭhānyarśāṁsi kāmalāḥ||22||  
  
 
plīhā pāṇḍvāmayaḥ śōphō mūtrakr̥cchramarōcakaḥ|  
 
plīhā pāṇḍvāmayaḥ śōphō mūtrakr̥cchramarōcakaḥ|  
 +
 
hr̥drōgō rājayakṣmā ca kāsaḥ śvāsō galagrahaḥ||23||  
 
hr̥drōgō rājayakṣmā ca kāsaḥ śvāsō galagrahaḥ||23||  
  
 
krimayō grahaṇīdōṣāḥ śvaitryaṁ sthaulyamatīva ca|  
 
krimayō grahaṇīdōṣāḥ śvaitryaṁ sthaulyamatīva ca|  
 +
 
narāṇāṁ dīpyatē cāgniḥ smr̥tirbuddhiśca vardhatē||24||  
 
narāṇāṁ dīpyatē cāgniḥ smr̥tirbuddhiśca vardhatē||24||  
  
 
prayogAdasya shAmyanti rogAH santarpaNotthitAH|  
 
prayogAdasya shAmyanti rogAH santarpaNotthitAH|  
 +
 
pramehA mUDhavAtAshca kuShThAnyarshAMsi kAmalAH||22||  
 
pramehA mUDhavAtAshca kuShThAnyarshAMsi kAmalAH||22||  
  
 
plIhA pANDvAmayaH shopho mUtrakRucchramarocakaH|  
 
plIhA pANDvAmayaH shopho mUtrakRucchramarocakaH|  
 +
 
hRudrogo rAjayakShmA ca kAsaH shvAso galagrahaH||23||  
 
hRudrogo rAjayakShmA ca kAsaH shvAso galagrahaH||23||  
  
 
krimayo grahaNIdoShAH shvaitryaM sthaulyamatIva ca|  
 
krimayo grahaNIdoShAH shvaitryaM sthaulyamatIva ca|  
 +
 
narANAM dIpyate cAgniH smRutirbuddhishca vardhate||24||  
 
narANAM dIpyate cAgniH smRutirbuddhishca vardhate||24||  
 +
</div></div>
  
The above preparation is useful in the treatment of obstinate urinary disorders including diabetes mellitus, ''mudhavata'' (sluggishness of the bowels), obstinate skin diseases including leprosy, piles, jaundice-like hepatobiliary diseases, diseases of the spleen, anemia-like hematological disorders, oedema, dysuria, anorexia, heart disease, tuberculosis-like immune-compromised conditions, cough, respiratory disorders, spasmodic obstruction of the throat, parasitic infestation, ''grahani'' (digestive disorders), vitiligo and morbid obesity caused by overnutrition. This also stimulates the power of digestion and enhances memory and intellect. [22-24]
+
<div style="text-align:justify;">
 +
The above preparation is useful in the treatment of obstinate urinary disorders including diabetes mellitus, ''mudhavata'' (sluggishness of the bowels), obstinate skin diseases including leprosy, piles, jaundice-like hepatobiliary diseases, diseases of the spleen, anemia-like hematological disorders, edema, dysuria, anorexia, heart disease, tuberculosis-like immune-compromised conditions, cough, respiratory disorders, spasmodic obstruction of the throat, parasitic infestation, ''grahani'' (digestive disorders), vitiligo and morbid obesity caused by overnutrition. This also stimulates the power of digestion and enhances memory and intellect. [22-24]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
व्यायामनित्यो जीर्णाशी यवगोधूमभोजनः|  
 
व्यायामनित्यो जीर्णाशी यवगोधूमभोजनः|  
 +
 
सन्तर्पणकृतैर्दोषैः स्थौल्यं  मुक्त्वा विमुच्यते||२५||  
 
सन्तर्पणकृतैर्दोषैः स्थौल्यं  मुक्त्वा विमुच्यते||२५||  
  
 
उक्तं सन्तर्पणोत्थानामपतर्पणमौषधम्|२६|  
 
उक्तं सन्तर्पणोत्थानामपतर्पणमौषधम्|२६|  
 +
<div class="mw-collapsible-content">
  
 
vyāyāmanityō jīrṇāśī yavagōdhūmabhōjanaḥ|  
 
vyāyāmanityō jīrṇāśī yavagōdhūmabhōjanaḥ|  
 +
 
santarpaṇakr̥tairdōṣaiḥ sthaulyaṁ  muktvā vimucyatē||25||
 
santarpaṇakr̥tairdōṣaiḥ sthaulyaṁ  muktvā vimucyatē||25||
  
Line 288: Line 436:
  
 
vyAyAmanityo jIrNAshI yavagodhUmabhojanaH|  
 
vyAyAmanityo jIrNAshI yavagodhUmabhojanaH|  
 +
 
santarpaNakRutairdoShaiH sthaulyaM  muktvA vimucyate||25||  
 
santarpaNakRutairdoShaiH sthaulyaM  muktvA vimucyate||25||  
  
 
uktaM santarpaNotthAnAmapatarpaNamauShadham|26|
 
uktaM santarpaNotthAnAmapatarpaNamauShadham|26|
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
Regular exercise, intake of food only after complete digestion of the previous meal, and regular consumption of barley and wheat are some of the ways for management of obesity and diseases due to overnutrition. In the next verses, formulations and regimen required for the management of malnourishment has been described. [25-26]
 
Regular exercise, intake of food only after complete digestion of the previous meal, and regular consumption of barley and wheat are some of the ways for management of obesity and diseases due to overnutrition. In the next verses, formulations and regimen required for the management of malnourishment has been described. [25-26]
 +
</div>
 +
 +
=== Diseases due to ''apatarpana''(under-nutrition) and their treatment ===
 +
  <div class="mw-collapsible mw-collapsed">
  
==== Part II: Diseases due to improper nourishment and their treatment ====
 
 
 
 
वक्ष्यन्ते सौषधाश्चोर्ध्वमपतर्पणजा गदाः||२६||  
 
वक्ष्यन्ते सौषधाश्चोर्ध्वमपतर्पणजा गदाः||२६||  
  
 
देहाग्निबलवर्णौजःशुक्रमांसपरिक्षयः|  
 
देहाग्निबलवर्णौजःशुक्रमांसपरिक्षयः|  
 +
 
ज्वरः कासानुबन्धश्च पार्श्वशूलमरोचकः||२७||  
 
ज्वरः कासानुबन्धश्च पार्श्वशूलमरोचकः||२७||  
  
 
श्रोत्रदौर्बल्यमुन्मादः प्रलापो हृदयव्यथा|  
 
श्रोत्रदौर्बल्यमुन्मादः प्रलापो हृदयव्यथा|  
 +
 
विण्मूत्रसङ्ग्रहः शूलं जङ्घोरुत्रिकसंश्रयम्||२८||  
 
विण्मूत्रसङ्ग्रहः शूलं जङ्घोरुत्रिकसंश्रयम्||२८||  
  
 
पर्वास्थिसन्धिभेदश्च ये चान्ये वातजा गदाः|  
 
पर्वास्थिसन्धिभेदश्च ये चान्ये वातजा गदाः|  
 +
 
ऊर्ध्ववातादयः सर्वे जायन्ते तेऽपतर्पणात्||२९||  
 
ऊर्ध्ववातादयः सर्वे जायन्ते तेऽपतर्पणात्||२९||  
 +
<div class="mw-collapsible-content">
  
 
vakṣyantē sauṣadhāścōrdhvamapatarpaṇajā gadāḥ||26||  
 
vakṣyantē sauṣadhāścōrdhvamapatarpaṇajā gadāḥ||26||  
  
 
dēhāgnibalavarṇaujaḥśukramāṁsaparikṣayaḥ|  
 
dēhāgnibalavarṇaujaḥśukramāṁsaparikṣayaḥ|  
 +
 
jvaraḥ kāsānubandhaśca pārśvaśūlamarōcakaḥ||27||  
 
jvaraḥ kāsānubandhaśca pārśvaśūlamarōcakaḥ||27||  
  
 
śrōtradaurbalyamunmādaḥ pralāpō hr̥dayavyathā|  
 
śrōtradaurbalyamunmādaḥ pralāpō hr̥dayavyathā|  
 +
 
viṇmūtrasaṅgrahaḥ śūlaṁ jaṅghōrutrikasaṁśrayam||28||  
 
viṇmūtrasaṅgrahaḥ śūlaṁ jaṅghōrutrikasaṁśrayam||28||  
  
parvāsthisandhibhēdaśca yē cānyē vātajā gadāḥ|  
+
parvāsthisandhibhēdaśca yē cānyē vātajā gadāḥ|
 +
 
ūrdhvavātādayaḥ sarvē jāyantē tē'patarpaṇāt||29||  
 
ūrdhvavātādayaḥ sarvē jāyantē tē'patarpaṇāt||29||  
  
Line 321: Line 481:
  
 
dehAgnibalavarNaujaHshukramAMsaparikShayaH|  
 
dehAgnibalavarNaujaHshukramAMsaparikShayaH|  
 +
 
jvaraH kAsAnubandhashca pArshvashUlamarocakaH||27||  
 
jvaraH kAsAnubandhashca pArshvashUlamarocakaH||27||  
  
 
shrotradaurbalyamunmAdaH pralApo hRudayavyathA|  
 
shrotradaurbalyamunmAdaH pralApo hRudayavyathA|  
 +
 
viNmUtrasa~ggrahaH shUlaM ja~gghorutrikasaMshrayam||28||  
 
viNmUtrasa~ggrahaH shUlaM ja~gghorutrikasaMshrayam||28||  
  
 
parvAsthisandhibhedashca ye cAnye vAtajA gadAH|  
 
parvAsthisandhibhedashca ye cAnye vAtajA gadAH|  
 +
 
UrdhvavAtAdayaH sarve jAyante te~apatarpaNAt||29||  
 
UrdhvavAtAdayaH sarve jAyante te~apatarpaNAt||29||  
 +
</div></div>
  
Emaciation of the body, reduction in the power of digestion, strength, complexion, ojas (vital essence of body related with immunity and general strength), semen and muscle tissue, ''jwara'' (continuous fever and cough like condition), pain in chest and flanks, anorexia, weakness in the power of hearing sounds, psychosis, delirium, pain in cardiac region, accumulation of stool and urine, pain in calf, thigh and lumber regions, cracking pain in fingers, bones and joints, and such other diseases due to the vitiation of ''vata'' (such as ''urdhava'' ''vata'' upward movement of ''vata''), etc. are caused due to improper nutrition and starvation. [27- 29]
+
<div style="text-align:justify;">
 +
Emaciation of the body, reduction in the power of digestion, strength, complexion, [[ojas]] (vital essence of body related with immunity and general strength), semen and muscle tissue, [[jwara]] (continuous fever and cough like condition), pain in chest and flanks, anorexia, weakness in the power of hearing sounds, psychosis, delirium, pain in cardiac region, accumulation of stool and urine, pain in calf, thigh and lumber regions, cracking pain in fingers, bones and joints, and such other diseases due to the vitiation of [[vata]](such as ''urdhava'' [[vata]] upward movement of [[vata]]), etc. are caused due to improper nutrition and starvation. [27- 29]
 +
</div>
  
==== Management ====
+
=== Management of diseases due to undernutrition===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तेषां सन्तर्पणं तज्ज्ञैः पुनराख्यातमौषधम्|  
 
तेषां सन्तर्पणं तज्ज्ञैः पुनराख्यातमौषधम्|  
यत्तदात्वे समर्थं स्यादभ्यासे वा तदिष्यते ||३०||  
+
 
 +
यत्तदात्वे समर्थं स्यादभ्यासे वा तदिष्यते ||३०||  
 +
<div class="mw-collapsible-content">
  
 
tēṣāṁ santarpaṇaṁ tajjñaiḥ punarākhyātamauṣadham|  
 
tēṣāṁ santarpaṇaṁ tajjñaiḥ punarākhyātamauṣadham|  
 +
 
yattadātvē samarthaṁ syādabhyāsē vā tadiṣyatē  ||30||  
 
yattadātvē samarthaṁ syādabhyāsē vā tadiṣyatē  ||30||  
  
 
teShAM santarpaNaM tajj~jaiH punarAkhyAtamauShadham|  
 
teShAM santarpaNaM tajj~jaiH punarAkhyAtamauShadham|  
 +
 
yattadAtve samarthaM syAdabhyAse vA tadiShyate ||30||  
 
yattadAtve samarthaM syAdabhyAse vA tadiShyate ||30||  
 +
</div></div>
  
 
For the treatment of such ailments, therapies that nourish instantly need to be administered regularly and for a long period of time. [30]
 
For the treatment of such ailments, therapies that nourish instantly need to be administered regularly and for a long period of time. [30]
 +
<div class="mw-collapsible mw-collapsed">
  
 
सद्यःक्षीणो हि सद्यो वै तर्पणेनोपचीयते|  
 
सद्यःक्षीणो हि सद्यो वै तर्पणेनोपचीयते|  
 +
 
नर्ते सन्तर्पणाभ्यासाच्चिरक्षीणस्तु पुष्यति||३१||  
 
नर्ते सन्तर्पणाभ्यासाच्चिरक्षीणस्तु पुष्यति||३१||  
 +
<div class="mw-collapsible-content">
  
 
sadyaḥkṣīṇō hi sadyō vai tarpaṇēnōpacīyatē|  
 
sadyaḥkṣīṇō hi sadyō vai tarpaṇēnōpacīyatē|  
 +
 
nartē santarpaṇābhyāsāccirakṣīṇastu puṣyati||31||  
 
nartē santarpaṇābhyāsāccirakṣīṇastu puṣyati||31||  
  
 
sadyaHkShINo hi sadyo vai tarpaNenopacIyate|  
 
sadyaHkShINo hi sadyo vai tarpaNenopacIyate|  
 +
 
narte santarpaNAbhyAsAccirakShINastu puShyati||31||  
 
narte santarpaNAbhyAsAccirakShINastu puShyati||31||  
 +
</div></div>
  
 
A person suffering from acute and drastic weight-loss should be treated with a regimen that nourishes instantly, but one suffering from a chronic type of emaciation requires long term consumption of nourishments. [31]
 
A person suffering from acute and drastic weight-loss should be treated with a regimen that nourishes instantly, but one suffering from a chronic type of emaciation requires long term consumption of nourishments. [31]
 +
<div class="mw-collapsible mw-collapsed">
  
 
देहाग्निदोषभैषज्यमात्राकालानुवर्तिना|  
 
देहाग्निदोषभैषज्यमात्राकालानुवर्तिना|  
 +
 
कार्यमत्वरमाणेन भेषजं चिरदुर्बले||३२||  
 
कार्यमत्वरमाणेन भेषजं चिरदुर्बले||३२||  
 +
<div class="mw-collapsible-content">
  
 
dēhāgnidōṣabhaiṣajyamātrākālānuvartinā|  
 
dēhāgnidōṣabhaiṣajyamātrākālānuvartinā|  
 +
 
kāryamatvaramāṇēna bhēṣajaṁ ciradurbalē||32||  
 
kāryamatvaramāṇēna bhēṣajaṁ ciradurbalē||32||  
  
 
dehAgnidoShabhaiShajyamAtrAkAlAnuvartinA|  
 
dehAgnidoShabhaiShajyamAtrAkAlAnuvartinA|  
 +
 
kAryamatvaramANena bheShajaM ciradurbale||32||  
 
kAryamatvaramANena bheShajaM ciradurbale||32||  
 +
</div></div>
  
Some of the critical factors for deciding a course of treatment of emaciation in chronic patients include: body constitution, power of digestion, predominant ''doshas'', form of medicine, dose, and season and time of administration (of the therapy). [32]
+
Some of the critical factors for deciding a course of treatment of emaciation in chronic patients include: body constitution, power of digestion, predominant [[dosha]], form of medicine, dose, and season and time of administration (of the therapy). [32]
 +
<div class="mw-collapsible mw-collapsed">
  
 
हिता मांसरसास्तस्मै पयांसि च घृतानि च|  
 
हिता मांसरसास्तस्मै पयांसि च घृतानि च|  
 +
 
स्नानानि बस्तयोऽभ्यङ्गास्तर्पणास्तर्पणाश्च ये||३३||  
 
स्नानानि बस्तयोऽभ्यङ्गास्तर्पणास्तर्पणाश्च ये||३३||  
 +
<div class="mw-collapsible-content">
  
 
hitā māṁsarasāstasmai payāṁsi ca ghr̥tāni ca|  
 
hitā māṁsarasāstasmai payāṁsi ca ghr̥tāni ca|  
 +
 
snānāni bastayō'bhyaṅgāstarpaṇāstarpaṇāśca yē||33||  
 
snānāni bastayō'bhyaṅgāstarpaṇāstarpaṇāśca yē||33||  
  
 
hitA mAMsarasAstasmai payAMsi ca ghRutAni ca|  
 
hitA mAMsarasAstasmai payAMsi ca ghRutAni ca|  
 +
 
snAnAni bastayo~abhya~ggAstarpaNAstarpaNAshca ye||33||
 
snAnAni bastayo~abhya~ggAstarpaNAstarpaNAshca ye||33||
 +
</div></div>
  
 
For this purpose, (of ''santarpana''), soups made out of flesh, milk, various ghee preparations (clarified butter), along with activities such as bath, oil massage, and medicated enema (processed with ''santarpana'' medicines) are advocated for nourishment. [33]
 
For this purpose, (of ''santarpana''), soups made out of flesh, milk, various ghee preparations (clarified butter), along with activities such as bath, oil massage, and medicated enema (processed with ''santarpana'' medicines) are advocated for nourishment. [33]
 +
<div class="mw-collapsible mw-collapsed">
  
 
ज्वरकासप्रसक्तानां कृशानां मूत्रकृच्छ्रिणाम्|  
 
ज्वरकासप्रसक्तानां कृशानां मूत्रकृच्छ्रिणाम्|  
 +
 
तृष्यतामूर्ध्ववातानां वक्ष्यन्ते तर्पणा हिताः||३४||  
 
तृष्यतामूर्ध्ववातानां वक्ष्यन्ते तर्पणा हिताः||३४||  
 +
<div class="mw-collapsible-content">
  
 
jvarakāsaprasaktānāṁ kr̥śānāṁ mūtrakr̥cchriṇām|  
 
jvarakāsaprasaktānāṁ kr̥śānāṁ mūtrakr̥cchriṇām|  
 +
 
tr̥ṣyatāmūrdhvavātānāṁ vakṣyantē tarpaṇā hitāḥ||34||  
 
tr̥ṣyatāmūrdhvavātānāṁ vakṣyantē tarpaṇā hitāḥ||34||  
  
 
jvarakAsaprasaktAnAM kRushAnAM mUtrakRucchriNAm|  
 
jvarakAsaprasaktAnAM kRushAnAM mUtrakRucchriNAm|  
 +
 
tRuShyatAmUrdhvavAtAnAM vakShyante tarpaNA hitAH||34||  
 
tRuShyatAmUrdhvavAtAnAM vakShyante tarpaNA hitAH||34||  
 +
</div></div>
  
For these patients suffering from continuous ''jwara'' (fever like conditions), cough, emaciation, dysuria, thirst and upward movement of ''vata'', the following nourishing drinks are prescribed. [34]
+
For these patients suffering from continuous [[jwara]] (fever like conditions), cough, emaciation, dysuria, thirst and upward movement of [[vata]], the following nourishing drinks are prescribed. [34]
 +
<div class="mw-collapsible mw-collapsed">
  
 
शर्करापिप्पलीतैलघृतक्षौद्रैः समांशकैः|  
 
शर्करापिप्पलीतैलघृतक्षौद्रैः समांशकैः|  
 +
 
सक्तुद्विगुणितो वृष्यस्तेषां मन्थः प्रशस्यते||३५||  
 
सक्तुद्विगुणितो वृष्यस्तेषां मन्थः प्रशस्यते||३५||  
 +
<div class="mw-collapsible-content">
  
 
śarkarāpippalītailaghr̥takṣaudraiḥ samāṁśakaiḥ|  
 
śarkarāpippalītailaghr̥takṣaudraiḥ samāṁśakaiḥ|  
 +
 
saktudviguṇitō vr̥ṣyastēṣāṁ manthaḥ praśasyatē||35||  
 
saktudviguṇitō vr̥ṣyastēṣāṁ manthaḥ praśasyatē||35||  
  
 
sharkarApippalItailaghRutakShaudraiH samAMshakaiH|  
 
sharkarApippalItailaghRutakShaudraiH samAMshakaiH|  
 +
 
saktudviguNito vRuShyasteShAM manthaH prashasyate||35||  
 
saktudviguNito vRuShyasteShAM manthaH prashasyate||35||  
 +
</div></div>
  
 
''Mantha'' (thin gruel) prepared from sugar, ''pippali'' (Pipper longum), oil, ghee, and honey - in equal quantities added with double the quantity of ''saktu'' (roasted corn flour) is considered an aphrodisiac and is useful in such conditions (as mentioned in above verse). [35]
 
''Mantha'' (thin gruel) prepared from sugar, ''pippali'' (Pipper longum), oil, ghee, and honey - in equal quantities added with double the quantity of ''saktu'' (roasted corn flour) is considered an aphrodisiac and is useful in such conditions (as mentioned in above verse). [35]
 +
<div class="mw-collapsible mw-collapsed">
  
 
सक्तवो मदिरा क्षौद्रं शर्करा चेति तर्पणम्|  
 
सक्तवो मदिरा क्षौद्रं शर्करा चेति तर्पणम्|  
 +
 
पिबेन्मारुतविण्मूत्रकफपित्तानुलोमनम्||३६||  
 
पिबेन्मारुतविण्मूत्रकफपित्तानुलोमनम्||३६||  
 +
<div class="mw-collapsible-content">
  
 
saktavō madirā kṣaudraṁ śarkarā cēti tarpaṇam|  
 
saktavō madirā kṣaudraṁ śarkarā cēti tarpaṇam|  
 +
 
pibēnmārutaviṇmūtrakaphapittānulōmanam||36||  
 
pibēnmārutaviṇmūtrakaphapittānulōmanam||36||  
  
 
saktavo madirA kShaudraM sharkarA ceti tarpaNam|  
 
saktavo madirA kShaudraM sharkarA ceti tarpaNam|  
 +
 
pibenmArutaviNmUtrakaphapittAnulomanam||36||  
 
pibenmArutaviNmUtrakaphapittAnulomanam||36||  
 +
</div></div>
  
''Saktu'' (roasted corn flour/ coarse ground meal) with ''madira'' (wine), honey and sugar are refreshing and shall be consumed for the elimination of flatus (obstructed ''vata''), faeces, urine, ''kapha'' and ''pitta''. [36]
+
''Saktu'' (roasted corn flour/ coarse ground meal) with ''madira'' (wine), honey and sugar are refreshing and shall be consumed for the elimination of flatus (obstructed [[vata]]), faeces, urine, [[kapha]] and [[pitta]]. [36]
 +
<div class="mw-collapsible mw-collapsed">
  
 
फाणितं सक्तवः सर्पिर्दधिमण्डोऽम्लकाञ्जिकम्|  
 
फाणितं सक्तवः सर्पिर्दधिमण्डोऽम्लकाञ्जिकम्|  
 +
 
तर्पणं मूत्रकृच्छ्रघ्नमुदावर्तहरं पिबेत्||३७||  
 
तर्पणं मूत्रकृच्छ्रघ्नमुदावर्तहरं पिबेत्||३७||  
 +
<div class="mw-collapsible-content">
  
 
phāṇitaṁ saktavaḥ sarpirdadhimaṇḍō'mlakāñjikam|  
 
phāṇitaṁ saktavaḥ sarpirdadhimaṇḍō'mlakāñjikam|  
 +
 
tarpaṇaṁ mūtrakr̥cchraghnamudāvartaharaṁ pibēt||37||  
 
tarpaṇaṁ mūtrakr̥cchraghnamudāvartaharaṁ pibēt||37||  
  
 
phANitaM saktavaH sarpirdadhimaNDo~amlakA~jjikam|  
 
phANitaM saktavaH sarpirdadhimaNDo~amlakA~jjikam|  
 +
 
tarpaNaM mUtrakRucchraghnamudAvartaharaM pibet||37||  
 
tarpaNaM mUtrakRucchraghnamudAvartaharaM pibet||37||  
 +
</div></div>
  
 
A nourishing drink prepared of ''phanita'' (inspissated juice of the sugar cane and other plants), ''saktu'' (coarse ground meal/ roased corn flour), ghee, whey, and sour gruel nourishes and should be consumed for the treatment of dysuria and ''udavarta''. [37]
 
A nourishing drink prepared of ''phanita'' (inspissated juice of the sugar cane and other plants), ''saktu'' (coarse ground meal/ roased corn flour), ghee, whey, and sour gruel nourishes and should be consumed for the treatment of dysuria and ''udavarta''. [37]
 +
<div class="mw-collapsible mw-collapsed">
  
 
मन्थः खर्जूरमृद्वीकावृक्षाम्लाम्लीकदाडिमैः|  
 
मन्थः खर्जूरमृद्वीकावृक्षाम्लाम्लीकदाडिमैः|  
 +
 
परूषकैः सामलकैर्युक्तो मद्यविकारनुत्||३८||  
 
परूषकैः सामलकैर्युक्तो मद्यविकारनुत्||३८||  
 +
<div class="mw-collapsible-content">
  
 
manthaḥ kharjūramr̥dvīkāvr̥kṣāmlāmlīkadāḍimaiḥ|  
 
manthaḥ kharjūramr̥dvīkāvr̥kṣāmlāmlīkadāḍimaiḥ|  
 +
 
parūṣakaiḥ sāmalakairyuktō madyavikāranut||38||  
 
parūṣakaiḥ sāmalakairyuktō madyavikāranut||38||  
  
 
manthaH kharjUramRudvIkAvRukShAmlAmlIkadADimaiH|  
 
manthaH kharjUramRudvIkAvRukShAmlAmlIkadADimaiH|  
 +
 
parUShakaiH sAmalakairyukto madyavikAranut||38||  
 
parUShakaiH sAmalakairyukto madyavikAranut||38||  
 +
</div></div>
  
 +
<div style="text-align:justify;">
 
''Mantha'' (thin guel) prepared from date-palm, dry grapes, ''vrikshamla'' (Garcinia indica Ehois), ''amlika'' (Tamarindus indica), ''dadima'' (Punica granatum), ''parushaka'' (Crewia asiatica), and ''amalaki'' (Emblica officinalis Gaertn.), are useful for management of disorders caused due to excess consumption of alcohol.  [38]
 
''Mantha'' (thin guel) prepared from date-palm, dry grapes, ''vrikshamla'' (Garcinia indica Ehois), ''amlika'' (Tamarindus indica), ''dadima'' (Punica granatum), ''parushaka'' (Crewia asiatica), and ''amalaki'' (Emblica officinalis Gaertn.), are useful for management of disorders caused due to excess consumption of alcohol.  [38]
 +
</div>
 +
<div class="mw-collapsible mw-collapsed">
  
 
स्वादुरम्लो जलकृतः सस्नेहो रूक्ष एव वा|  
 
स्वादुरम्लो जलकृतः सस्नेहो रूक्ष एव वा|  
 +
 
सद्यः सन्तर्पणो मन्थः स्थैर्यवर्णबलप्रदः||३९||  
 
सद्यः सन्तर्पणो मन्थः स्थैर्यवर्णबलप्रदः||३९||  
 +
<div class="mw-collapsible-content">
  
 
svāduramlō jalakr̥taḥ sasnēhō rūkṣa ēva vā|  
 
svāduramlō jalakr̥taḥ sasnēhō rūkṣa ēva vā|  
 +
 
sadyaḥ santarpaṇō manthaḥ sthairyavarṇabalapradaḥ||39||  
 
sadyaḥ santarpaṇō manthaḥ sthairyavarṇabalapradaḥ||39||  
  
 
svAduramlo jalakRutaH sasneho rUkSha eva vA|  
 
svAduramlo jalakRutaH sasneho rUkSha eva vA|  
 +
 
sadyaH santarpaNo manthaH sthairyavarNabalapradaH||39||  
 
sadyaH santarpaNo manthaH sthairyavarNabalapradaH||39||  
 +
</div></div>
  
 
Sweet and sour ''mantha'' prepared from water with or without unctuous substances refreshes instantly and gives stability, good complexion and strength. [39]
 
Sweet and sour ''mantha'' prepared from water with or without unctuous substances refreshes instantly and gives stability, good complexion and strength. [39]
 +
 +
=== Summary ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्र श्लोकः-  
 
तत्र श्लोकः-  
 +
 
सन्तर्पणोत्था ये रोगा रोगा ये चापतर्पणात्|  
 
सन्तर्पणोत्था ये रोगा रोगा ये चापतर्पणात्|  
 +
 
सन्तर्पणीये तेऽध्याये सौषधाः परिकीर्तिताः||४०||  
 
सन्तर्पणीये तेऽध्याये सौषधाः परिकीर्तिताः||४०||  
 +
<div class="mw-collapsible-content">
  
 
tatra ślōkaḥ-  
 
tatra ślōkaḥ-  
 +
 
santarpaṇōtthā yē rōgā rōgā yē cāpatarpaṇāt|  
 
santarpaṇōtthā yē rōgā rōgā yē cāpatarpaṇāt|  
 +
 
santarpaṇīyē tē'dhyāyē sauṣadhāḥ parikīrtitāḥ||40||  
 
santarpaṇīyē tē'dhyāyē sauṣadhāḥ parikīrtitāḥ||40||  
  
 
tatra shlokaH-  
 
tatra shlokaH-  
 +
 
santarpaNotthA ye rogA rogA ye cApatarpaNAt|  
 
santarpaNotthA ye rogA rogA ye cApatarpaNAt|  
 +
 
santarpaNIye te~adhyAye sauShadhAH parikIrtitAH||40||  
 
santarpaNIye te~adhyAye sauShadhAH parikIrtitAH||40||  
 
+
</div></div>
==== Summary ====
 
  
 
Diseases caused due to overnutrition and undernutrition, along with their treatment, have been described in this chapter. [40]
 
Diseases caused due to overnutrition and undernutrition, along with their treatment, have been described in this chapter. [40]
  
=== ''Tattva Vimarsha'' ===
+
== Tattva Vimarsha (Fundamental Principles) ==
 +
<div style="text-align:justify;">
 +
1. Intake of calorie rich and excessive food and nutrition with little or no physical exercise, results in increased body tissues. This contributes to causing diseases such as metabolic syndrome. These conditions are managed by purification therapies leading to reduction ([[langhana]]), and prescribing a regimen of physical exercise, appropriate dietary changes, fomentation and reducing drugs.
  
Anabolic processes are triggered in a body when there is an intake of calorie rich and excessive food and nutrition but little or no physical exercise, resulting in increased body tissues. This also contributes to causing diseases such as metabolic syndrome. These conditions are managed by purification therapies leading to reduction (''langhana''), and prescribing a regimen of physical exercise, appropriate dietary changes, fomentation and reducing drugs.  
+
2. Excessive physical and/or mental activities without adequate nutrition causes nutritional deficiency diseases like wasting and psychosis. Treatment is high calorie but less filling diet, rest, medicated oil enema and massage. In cases of acute weight loss, nutrition should be given immediately while in the case of chronic loss, the process should be gradual but prolonged.
  
A person engaging in physical and/or mental activities but not taking in adequate nutrition would see catabolic processes triggered in the body resulting in decreased body tissues and, consequently, nutritional deficiency diseases like wasting and psychosis. Any treatment would involve prescription of a high calorie but less filling diet, rest, medicated oil enema and massage. In cases of acute weight loss, nutrition should be given immediately while in the case of chronic loss, the process should be gradual but prolonged.
+
== Vidhi Vimarsha(Applied Inferences)==
 
=== ''Vidhi Vimarsha''===
 
  
The word ''santarpana'' means the act of satiating, restoration or refreshing. In this context, the term is used for overeating or overnutrition. Dietary items that are ''prithvi'' and ''apa mahabhuta'' dominant lead to ''santarpana''. Quality, quantity, and age of certain food items can cause alteration in the digestability of the food. For example, aged food grains are light to digest than new food grains. Therefore, the new food grains tend to increase weight, and same quantity of aged food grains do not increase weight. What changes occur in aging of the grains and their mechanism of action needs to be studied.  
+
The word ''santarpana'' means the act of satiating, restoration or refreshing. In this context, the term is used for overeating or overnutrition. Dietary items that are ''prithvi'' and ''apa mahabhuta'' dominant lead to ''santarpana''. Quality, quantity, and age of certain food items can cause alteration in the digestabilibty of the food. For example, aged food grains are light to digest than new food grains. Therefore, the new food grains tend to increase weight, and same quantity of aged food grains do not increase weight. What changes occur in aging of the grains and their mechanism of action needs to be studied.  
  
==== I. Qualities of ''Santarpanakarak'' Food Articles ====
+
=== I. Properties of ''Santarpanakarak'' food articles ===
 
   
 
   
Unctuous (''snigdha''), sweet (''madhura''), heavy to digest (''guru''), and slimy (''pichhilla'') foods predominantly have ''prithvi'' and ''apa mahabhutas'', leading to an increase in ''kapha'' and ''rasa dhatu''.  
+
Unctuous (''snigdha''), sweet (''madhura''), heavy to digest (''guru''), and slimy (''pichhilla'') foods predominantly have [[Prithvi]] and [[jala mahabhuta]], leading to an increase in [[kapha]] and [[rasa dhatu]].  
  
The functional trait of such food articles is ''snigdha'' (oily) ''guna'' is ''sneha'' (unctuousness), ''mriduta'' (softness), and ''ardrata'' (malleability, fluidity). ''Snigdha'' food articles include those derived from lipids and fat molecules. Similarly, ''madhura'' (sweetness) is a property of food substances that possess predominantly sweet taste - not just perceived at the tongue, but also in many parts/tissues along our digestive system. ''Guru'' is the primary property that indicates “heaviness” of a food item, and a ''guru'' food article is heavy to digest and increases bulkiness of the tissues. ''Guru'' is the opposite of ''agni'' and hence delays digestion and metabolism and is used, therefore, in therapies that require nourishment, enhancement of physical strength, etc (''brimhana, agnimaandyakara, upalepa, bala, upachaya'' and ''tarpana''). Finally, ''picchilla'' is sliminess and stickiness, and indicates food items that vitiate ''kapha'' and ''mamsa-meda dhatu'' particularly.  
+
The functional trait of such food articles is ''snigdha'' (oily) [[guna]] is ''sneha'' (unctuousness), ''mriduta'' (softness), and ''ardrata'' (malleability, fluidity)<ref> Gothecha Mohanlal., Dr., editor. Guna Parijnana. Jamnagar: Post Graduate Training Center in [[Ayurveda]]; 1958. pp. 19–20. </ref>  <ref> Sushruta. Sutra Sthana, Cha.41 Dravyavisheshavinjaniya Adhyaya verse 11. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. </ref>. ''Snigdha'' food articles include those derived from lipids and fat molecules. Similarly, ''madhura'' (sweetness) is a property of food substances that possess predominantly sweet taste - not just perceived at the tongue, but also in many parts/tissues along our digestive system. ''Guru'' is the primary property that indicates “heaviness” of a food item, and a ''guru'' food article is heavy to digest and increases bulkiness of the tissues. ''Guru'' is the opposite of [[agni]] and hence delays digestion and metabolism and is used, therefore, in therapies that require nourishment, enhancement of physical strength, etc ([[brimhana]], agnimaandyakara, upalepa, bala, upachaya'' and ''tarpana''). Finally, ''picchilla'' is sliminess and stickiness, and indicates food items that vitiate [[kapha]] and [[mamsa]] and [[meda dhatu]] particularly.  
  
Today’s research is consistent with the above findings of [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] . Researchers acknowledge that taste receptors exist in the upper gastrointestinal tract as well. These receptors are “primarily located in the intestinal brush and enteroendocrine cells, and recognize sugars, D-amino acids, sweet proteins, and artificial sweeteners”, per their research. Peptide YY (PYY) exerts its action through NPY receptors by inhibiting gastric motility and increasing water and electrolyte absorption in the colon.  PYY may also suppress pancreatic secretion, as it is secreted by neuro-endocrine cells in the ileum and colon in response to a meal, and has been shown to reduce appetite. It works by slowing the gastric emptying, thereby increasing the efficiency of digestion and nutrient absorption after a meal. Considering the effects of sweet food substances, PYY, in certain quantities, helps induce satiety in a person and thus in excess, inhibits appetite. This study clearly suggests the impact of ''madhura rasa'' and ''snigdha'' food substances in creating ''santarpaniya vyadhi'' or increased anabolism. Like GLP -1, GIP is related to metabolism and inflammation.  
+
Today’s research is consistent with the above findings of [[Ayurveda]]. Researchers acknowledge that taste receptors exist in the upper gastrointestinal tract as well. These receptors are “primarily located in the intestinal brush and enteroendocrine cells, and recognize sugars, D-amino acids, sweet proteins, and artificial sweeteners<ref>Greenfield Jerry R.,  Chisholm Donald J.  How Sweet It Is: Intestinal Sweet Taste Receptors in Type 2 Diabetes. Diabetes. 2013 Oct; 62(10): 3336–3337.</ref>”, per their research. Peptide YY (PYY) exerts its action through NPY receptors by inhibiting gastric motility and increasing water and electrolyte absorption in the colon<ref> Liu C, Aloia T, Adrian T, Newton T, Bilchik A, Zinner M, Ashley S, McFadden D (1996). "Peptide YY: a potential proabsorptive hormone for the treatment of malabsorptive disorders". Am Surg 62 (3): 232–6.Charak Samhita Sutra Sthana 27/309 </ref>.  PYY may also suppress pancreatic secretion, as it is secreted by neuro-endocrine cells in the ileum and colon in response to a meal, and has been shown to reduce appetite. It works by slowing the gastric emptying, thereby increasing the efficiency of digestion and nutrient absorption after a meal. Considering the effects of sweet food substances, PYY, in certain quantities, helps induce satiety in a person and thus in excess, inhibits appetite. This study clearly suggests the impact of ''madhura rasa'' and ''snigdha'' food substances in creating ''santarpaniya vyadhi'' or increased anabolism. Like GLP -1, GIP is related to metabolism and inflammation.  
  
Thus, it can be said that excess of ''madhura, guru, snigdha'' and ''pichchilla'' foods can have inflammatory effect at the molecular level. If the above properties elaborated by Charaka are to be understood, it can be clearly stated that they increase body tissues in volume and delay the digestion of food. This seems to be acceptable and the effect may be mediated through peptide YY. As it delays digestion and increases the nutrient uptake, these food substances lead to ''santarpana''.
+
Thus, it can be said that excess of ''madhura, guru, snigdha'' and ''pichchilla'' foods can have inflammatory effect at the molecular level. If the above properties elaborated by Charak are to be understood, it can be clearly stated that they increase body tissues in volume and delay the digestion of food. This seems to be acceptable and the effect may be mediated through peptide YY. As it delays digestion and increases the nutrient uptake, these food substances lead to ''santarpana''.
  
==== II. Impact of age on grains and grain-based food products ====
+
=== II. Impact of age on grains and grain-based food products ===
  
The age of food grains helps determine the quality as well as digestibility of food. ''Shuka dhanya'' (monocotyledons) and ''shami dhanya'' (dicotyledons) that are old /aged are easy to digest and are dry in property as compared to new ones. ''Nava anna'', or fresh, non-aged rice, millet, etc. increase ''kapha'' and are heavier than old grains. Charaka notes that all new and fresh grains are heavy and induce ''santarpana'', while aged grains are lighter to digest.
+
The age of food grains helps determine the quality as well as digestibility of food. ''Shuka dhanya'' (monocotyledons) and ''shami dhanya'' (dicotyledons) that are old /aged are easy to digest and are dry in property as compared to new ones. [Cha.Sa.[[Sutra Sthana]] 27/309] ''Nava anna'', or fresh, non-aged rice, millet, etc. increase [[kapha]] and are heavier than old grains. Charak notes that all new and fresh grains are heavy and induce ''santarpana'', while aged grains are lighter to digest.
  
Sharangdhara in Purva Khanda also talks of new and old grains and recommends six to twelve month-old grains to be used. Biochemical changes that help in digestion may be occurring after certain aging of grains. Per researchers (Seguchi, 1993), aging of flour and grains does enhance their functionality as ingredients for cakes and batter. Cereals can be stored for long periods without microbial spoilage. However, biochemical changes also occur during aging. There is great possibility that certain amino acids and phyto chemicals get stabilized in the grain which make them safe for consumption. Eventually, the grain respires, dry matter is lost and functional and nutritional aspects of the grain are altered. Age related changes have great influence on the viscosity of any batter made out of wheat-flour and the water-binding ability of the wheat flour (Shelke et al, 1992). In addition, the starch granule surface protein is found to increase up to three to four times with aging. However, prolonged aging is not recommended (Pomeranz et al, 1968). The moisture content of grains, the storage temperature and relative humidity have been shown to exert dramatic changes in the acidity, pH, free amino nitrogen, crude protein, and protein quality. Significant changes in soluble sugars and amylase contents of the grains have also been reported during storage at elevated temperature.   
+
Sharangdhara in Purva Khanda also talks of new and old grains and recommends six to twelve month-old grains to be used. Biochemical changes that help in digestion may be occurring after certain aging of grains. Per researchers (Seguchi, 1993), aging of flour and grains does enhance their functionality as ingredients for cakes and batter. Cereals can be stored for long periods without microbial spoilage. However, biochemical changes also occur during aging. There is great possibility that certain amino acids and phyto chemicals get stabilized in the grain which make them safe for consumption. Eventually, the grain respires, dry matter is lost and functional and nutritional aspects of the grain are altered. Age related changes have great influence on the viscosity of any batter made out of wheat-flour and the water-binding ability of the wheat flour (Shelke et al, 1992). In addition, the starch granule surface protein is found to increase up to three to four times with aging. However, prolonged aging is not recommended (Pomeranz et al, 1968). The moisture content of grains, the storage temperature and relative humidity have been shown to exert dramatic changes in the acidity, pH, free amino nitrogen, crude protein, and protein quality. Significant changes in soluble sugars and amylase contents of the grains have also been reported during storage at elevated temperature<ref> Zia-Ur Rehman, W.H. Shah. Biochemical changes in wheat during storage at three temperatures. Plant Foods for Human Nutrition 54: 109–117, 1999. </ref>.   
  
It is to be noted from various studies that the protein content of wheat grains and flour do not change significantly over time (Kim et al 2003). While protein quantity may not change, protein quality does. In one of the studies it was noted that total content of starch gets reduced after certain time when the grains are kept within controlled temperature. In India, wheat gets harvested in the months of March and early April. The atmospheric temperature varies from 25℃ – 45℃ in summer in different parts of India. The total starch content of the flour got decreased by 50 % when stored at 50℃ in comparison to the freshly harvested wheat grains. This is a significant change that occurs due to aging of wheat. If the starch content of wheat is reduced with time, aged wheat will have lower calorific value and lower glycemic index. It will also be easier to digest. Similar changes have been observed in rice after aging. Post harvest storage has, it has been observed, significant effect on eight known textural properties that are important to the sensory characteristics of cooked rice: adhesion to lips, hardness, cohesiveness of mass, roughness of mass, toothpull, particle size, toothpack, and loose particles. A difference is observed between ageing of rice flour and rice starch. It is evident that pasting properties of fresh and aged rice are different. It is also reported that the cell wall structure is decomposed by endo –xylanase during storage which led to the changes in amylograms of rice fours.  
+
It is to be noted from various studies that the protein content of wheat grains and flour do not change significantly over time (Kim et al 2003). While protein quantity may not change, protein quality does. In one of the studies it was noted that total content of starch gets reduced after certain time when the grains are kept within controlled temperature. In India, wheat gets harvested in the months of March and early April. The atmospheric temperature varies from 25℃ – 45℃ in summer in different parts of India. The total starch content of the flour got decreased by 50 % when stored at 50℃ in comparison to the freshly harvested wheat grains<ref>Seguchi, M. 1993. Effect of wheat flour aging on starch-granule surface proteins. J.Cereal Chem. Vol.70: 362-364.  </ref>  <ref> Shearer, G., Patey, A. L., and McWeeney, D. J. 1975. Wheat flour proteins: The selectivity of solvents and the stability of gliadin and glutenin fractions of stored flours. J. Sci. Food Agric. 26:337-344. </ref>. This is a significant change that occurs due to aging of wheat. If the starch content of wheat is reduced with time, aged wheat will have lower calorific value and lower glycemic index. It will also be easier to digest. Similar changes have been observed in rice after aging. Post harvest storage has, it has been observed, significant effect on eight known textural properties that are important to the sensory characteristics of cooked rice: adhesion to lips, hardness, cohesiveness of mass, roughness of mass, toothpull, particle size, toothpack, and loose particles<ref> sourced from : https://www.uark.edu/ua/uarpp/Publications/Sensory/Meullenet%20et%20al%202000%20Cereal%20Chem.pdf downloaded on 24/12/2016 </ref>. A difference is observed between ageing of rice flour and rice starch. It is evident that pasting properties of fresh and aged rice are different. It is also reported that the cell wall structure is decomposed by endo –xylanase during storage which led to the changes in amylograms of rice fours<ref> Shibuya, N. and Iwasaki, T. Eff ect of cell wall degradingenzymes on the cooking properties of milled rice and the texture of cooked rice. J Jpn Soc Food Sci Technol 31(1984) 656–660.  </ref>.  
  
These changes in physiochemical properties of grains exert their effect on digestibility of the food. It has been studied through experiments that the moisture content is higher in new grains indicating predominance of ''apa'' and ''prithvi mahabhuta'' which again tends towards ''santaparana''. Aging of rice has an impact on its glycemic index and glycemic load. New grain may have higher glycemic index than the older grain. Due to the effect of time on these food stuffs there are greater possibilities that certain amino acids and phyto chemicals get stabilized in the grain that make them safe for consumption.  
+
These changes in physiochemical properties of grains exert their effect on digestibility of the food. It has been studied through experiments that the moisture content is higher in new grains indicating predominance of [[jala mahabhuta]] and [[prithvi mahabhuta]] which again tends towards ''santarpana''. Aging of rice has an impact on its glycemic index and glycemic load. New grain may have higher glycemic index than the older grain. Due to the effect of time on these food stuffs there are greater possibilities that certain amino acids and phyto chemicals get stabilized in the grain that make them safe for consumption.  
  
''Navamadya''/fresh wine: New or fresh wines should not be consumed because they cause heaviness and create imbalances in all the three ''doshas'' while old wines promote circulation in the body, increase digestion, lightness and enhance taste in food. The effect of aging on tannins and resveratrol has been studied and shows significant difference between old and fresh wine. Aging results in altered and reduced phenolic contents in red wine. Anthocyanin tannin complexes can be formed which can stabilize the colour of red wines resulting in wines that are tasteless, fruity and less astringent after aging.  Oxidation reactions involving phenolics might also change the chemical and sensory profile of wines.  Oxygen in the air is always ready to react with unprotected juice or wine and many of the substances present get adversely affected by oxidation, producing unpleasant, bitter, off-odours and off-tastes. However, it is recognized that some degree of oxygenation may be beneficial for the formation of red wine, but the quality of white wines is generally impaired by excessive air exposure. As tannins and anthocyanins interact with oxygen, which diffuses during barrel storage, these compounds further polymerize and become less astringent. Red wines become lighter in colour, and proanthocyanidins and other polyphenolics eventually aggregate in larger molecules which accumulate as sediment over time at the base of the bottle. In contrast, white wines often deepen in colour, turning darker honey colours as they oxidize and age.   
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''Navamadya''/fresh wine: New or fresh wines should not be consumed because they cause heaviness and create imbalances in all the three [[dosha]] while old wines promote circulation in the body, increase digestion, lightness and enhance taste in food. The effect of aging on tannins and resveratrol has been studied and shows significant difference between old and fresh wine. Aging results in altered and reduced phenolic contents in red wine. Anthocyanin tannin complexes can be formed which can stabilize the colour of red wines resulting in wines that are tasteless, fruity and less astringent after aging<ref> Scudamore-Smith PD, Hooper RL, McLaran ED (1990) Color and phenolic changes of Cabernet Sauvignon wine made by simultaneous yeast/bacterial fermentation and extended pomace contact. American Journal of Enology and Viticulture 41, 57-67 </ref>.  Oxidation reactions involving phenolics might also change the chemical and sensory profile of wines<ref> Bisson LF, Waterhouse AL, Ebeler SE, Walker MA, Lapsley JT (2002) The present and future of the international wine industry. Nature418, 696-699 </ref>.  Oxygen in the air is always ready to react with unprotected juice or wine and many of the substances present get adversely affected by oxidation, producing unpleasant, bitter, off-odours and off-tastes. However, it is recognized that some degree of oxygenation may be beneficial for the formation of red wine, but the quality of white wines is generally impaired by excessive air exposure. As tannins and anthocyanins interact with oxygen, which diffuses during barrel storage, these compounds further polymerize and become less astringent. Red wines become lighter in colour, and proanthocyanidins and other polyphenolics eventually aggregate in larger molecules which accumulate as sediment over time at the base of the bottle. In contrast, white wines often deepen in colour, turning darker honey colors as they oxidize and age <ref>sourcedfrom:http://www.academia.edu/8191054/Biochemical_Changes_throughout_Grape_Berry_Development_and_Fruit_and_Wine_Quality downloaded on 24/12/2016 </ref>.   
  
 
The phenolic compound present in a bottle of wine slowly changes as it ages. The most important component of wine is tannin which binds with proteins. High tannin containing wine inhibits saliva’s ability to lubricate mouth and imparts astringent feeling in mouth. Aged wine undergoes polymerization of tannins. This makes tannin sediments settle to the bottom of the container and lose its property to bind with proteins. Aged wines are very aromatic and possess fruity flavors.  
 
The phenolic compound present in a bottle of wine slowly changes as it ages. The most important component of wine is tannin which binds with proteins. High tannin containing wine inhibits saliva’s ability to lubricate mouth and imparts astringent feeling in mouth. Aged wine undergoes polymerization of tannins. This makes tannin sediments settle to the bottom of the container and lose its property to bind with proteins. Aged wines are very aromatic and possess fruity flavors.  
  
Ageing of wine solely depends on its storage and oxidation of the wine. Normally new wines contain about .02 - .03% acetic acid. This is reduced in aged wine if it is packed properly.  This physico-chemical change in aged wine, change in taste and aroma modify its pharmacological effects. Increase in its antioxidant properties and change in Anthocyanin tannin complex makes wine more effective after age. There is also a possibility that chemical process in ageing of wine may also change the molecular size of tannins which might become more bio available after consumption.
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Ageing of wine solely depends on its storage and oxidation of the wine. Normally new wines contain about .02 - .03% acetic acid. This is reduced in aged wine if it is packed properly.  This physico-chemical change in aged wine, change in taste and aroma modify its pharmacological effects. Increase in its antioxidant properties and change in Anthocyanin tannin complex makes wine more effective after age. There is also a possibility that chemical process in ageing of wine may also change the molecular size of tannins which might become more bio-available after consumption.
  
==== III. Categories of food leading to anabolism ====
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=== III. Categories of food leading to anabolism ===
  
'''''Gorasa''''' (milk and milk products): Over the years, there have been many conflicting views in scientific journals and from nutritionists regarding dairy products and it is often difficult to conclude about their health benefits. Charaka has clearly mentioned in various texts, including this chapter and in [[Prameha Nidana]], that excessive consumption of dairy products, meat, and carbohydrates may lead to many metabolic disorders. It may also create inflammation at a molecular level. Common allergens like casein and gluten create inflammation in the gut. Investigators have correlated higher levels of milk antibodies with rheumatoid arthritis (Arvikar, 2013). Studies suggest (Feskanich D. et al) that cow’s milk could be responsible for an irreversible inability to metabolize blood sugar, and could cause Type I and type II diabetes. This study also suggests that severe disorders such as rheumatoid arthritis, diabetes, heart attacks, multiple sclerosis, and osteoporosis could be attributed to diet rich in milk.  
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'''''Gorasa''''' (milk and milk products): Over the years, there have been many conflicting views in scientific journals and from nutritionists regarding dairy products and it is often difficult to conclude about their health benefits. Charak has clearly mentioned in various texts, including this chapter and in [[Prameha Nidana]], that excessive consumption of dairy products, meat, and carbohydrates may lead to many metabolic disorders. It may also create inflammation at a molecular level. Common allergens like casein and gluten create inflammation in the gut. Investigators have correlated higher levels of milk antibodies with rheumatoid arthritis<ref> rheumatoid arthritis </ref> (Arvikar, 2013). Studies suggest (Feskanich D. et al) that cow’s milk could be responsible for an irreversible inability to metabolize blood sugar, and could cause Type I and type II diabetes. This study also suggests that severe disorders such as rheumatoid arthritis, diabetes, heart attacks, multiple sclerosis, and osteoporosis could be attributed to diet rich in milk<ref> Feskanich D. et al. Milk, dietary calcium and bone fractures in women: A 12 year prospective study. Am. J. Public Health 87: 992-997. 1997 </ref>.  
  
Thus, there has been much research concerning dairy products, besides meat and other forms of complex proteins, which shows their excessive consumption in a very unfavourable. These types of food have multifold impact on the health of a person. These can change the gut flora leading to disorders of absorption, adversely affecting auto-immunity and production of antibodies. It has been shown by certain researchers that excess of meat and dairy products leads to immune-activation. Excess of meat also has certain enzymatic toxicity which can lead to insulin resistance –a basic pathology of obesity, heart disease and type II diabetes.  
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Thus, there has been much research concerning dairy products, besides meat and other forms of complex proteins, which shows their excessive consumption in a very unfavourable<ref> Feskanich D. et al. Milk, dietary calcium and bone fractures in women: A 12 year prospective study. Am. J. Public Health 87: 992-997. 1997 </ref>. These types of food have multifold impact on the health of a person. These can change the gut flora leading to disorders of absorption, adversely affecting auto-immunity and production of antibodies. It has been shown by certain researchers that excess of meat and dairy products leads to immune-activation <ref> Hvatum M, Kanerud L, Hällgren R, Brandtzaeg P. The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis. Gut. 2006 Sep;55(9):1240-7. </ref>  <ref> Pattison DJ, Symmons DP, Lunt M, Welch A, Luben R, Bingham SA, Khaw KT, Day NE, Silman AJ. Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption. Arthritis Rheum. 2004 Dec;50(12):3804-12. </ref>. Excess of meat also has certain enzymatic toxicity which can lead to insulin resistance –a basic pathology of obesity, heart disease and type II diabetes.  
 
    
 
    
All the above types of food mentioned herein could explain 57% of the total structural variation in gut microbiota whereas changes in genetics accounted for no more than 12%. This indicates that diet plays a dominant role in shaping gut microbiota and changing key populations may transform healthy gut microbiota into a disease-inducing entity. For example, the western diet, which is high in sugar and fat, causes dysbiosis affecting both host GI tract metabolism and immune homeostasis. Dysbiosis is a very important term that can be helpful in explaining many pathologies mentioned in Ayurvedic literature.
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All the above types of food mentioned herein could explain 57% of the total structural variation in gut microbiota whereas changes in genetics accounted for no more than 12% <ref> Zhang C., Zhang M., Wang S., Han R., Cao Y., Hua W., Mao Y., Zhang X., Pang X., Wei C., et al. Interactions between gut microbiota, host genetics and diet relevant to development of metabolic syndromes in mice. ISME J. 2010;4:232–241. doi: 10.1038/ismej.2009.112. </ref>. This indicates that diet plays a dominant role in shaping gut microbiota and changing key populations may transform healthy gut microbiota into a disease-inducing entity. For example, the western diet, which is high in sugar and fat, causes dysbiosis affecting both host GI tract metabolism and immune homeostasis<ref> Tapiainen T., Ylitalo S., Eerola E., Uhari M. Dynamics of gut colonization and source of intestinal flora in healthy newborn infants. APMIS. 2006;114:812–817. doi: 10.1111/j.1600-0463.2006.apm_488.x. </ref>. Dysbiosis is a very important term that can be helpful in explaining many pathologies mentioned in Ayurvedic literature.
  
Thus, an excessive meat/dairy based diet that has been explained by Charaka starts its dreadful effect from GI tract leading to metabolic disorders. This can be compared with the theory of agni elaborated by [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] scholars and also explains how wrong food exerts its effect on immune system leading to inflammation at molecular level. Chronic inflammation changes the normal mechanism of body and leads to certain dreadful metabolic disorders. Thus, over and undernutrition both lead to certain metabolic diseases mediated through inflammation.
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Thus, an excessive meat/dairy based diet that has been explained by Charak starts its dreadful effect from GI tract leading to metabolic disorders. This can be compared with the theory of agni elaborated by [[Ayurveda]] scholars and also explains how wrong food exerts its effect on immune system leading to inflammation at molecular level. Chronic inflammation changes the normal mechanism of body and leads to certain dreadful metabolic disorders. Thus, over and undernutrition both lead to certain metabolic diseases mediated through inflammation <ref> Wellen KE, Hotamisligil GS: Inflammation, stress, and diabetes. J Clin Invest 2005, 115:1111-1119. </ref>.
  
==== IV. Effect of lifestyle on anabolism ====
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=== IV. Effect of lifestyle on anabolism ===
 
 
Charaka not only explains the adverse effects of bad eating but also explains the ill effects of sedentary behaviour which are the leading cause of metabolic disorders. He explains that those averse to physical or mental activities (exercises), those who are habituated to sleeping during the day and always having the tendency to lying down will end up suffering from various metabolic disorders. Modern researchers have proved this too. Sedentary behaviour refers to low-energy activities that involve energy expenditure (at the level of 1.0–1.5 metabolic equivalent units (METs)), and include activities such as lying down, sitting, etc. Individuals could be spending a significant part of their waking hours in sedentary activities.   
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Charak not only explains the adverse effects of bad eating but also explains the ill effects of sedentary behaviour which are the leading cause of metabolic disorders. He explains that those averse to physical or mental activities (exercises), those who are habituated to sleeping during the day and always having the tendency to lying down will end up suffering from various metabolic disorders. Modern researchers have proved this too. Sedentary behaviour refers to low-energy activities that involve energy expenditure (at the level of 1.0–1.5 metabolic equivalent units (METs))<ref> Huang TT, Howarth NC, Lin BH, Roberts SB, McCrory MA: Energy intake and meal portions: associations with BMI percentile in U.S. children. Obes Res 2004, 12:1875-1885 </ref>, and include activities such as lying down, sitting, etc. Individuals could be spending a significant part of their waking hours in sedentary activities<ref> Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.Diabetes Care 2004, 27:1047-1053.  </ref>.   
  
Per studies by Lee et al (2001), the association between sedentary behaviour and metabolic health could, to some extent, explain the association between sedentary time and metabolic syndrome.   
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Per studies by Lee et al (2001), the association between sedentary behaviour and metabolic health could, to some extent, explain the association between sedentary time and metabolic syndrome <ref> Lee JY, Sohn KH, Rhee SH, Hwang D: Saturated fatty acids, but not unsaturated fatty acids, induce the expression of cyclooxygenase-2 mediated through Toll-like receptor 4.J Biol Chem 2001, 276:16683-16689. </ref>.   
 
   
 
   
Bedrest studies, though not sufficiently researched in humans, indicate that there is an increased sedentary behavior associated with a range of deleterious metabolic effects.   
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Bedrest studies, though not sufficiently researched in humans, indicate that there is an increased sedentary behavior associated with a range of deleterious metabolic effects <ref> Kalupahana NS, Claycombe KJ, Newman SJ, Stewart T, Siriwardhana N, Mathhan N, Lichtenstein AH, Moustaid-Moussa N: Eicosapentaenoic acid prevents and reverses insulin resistance in high-fat diet-induced obese mice via modulation of adipose tissue inflammation.J Nutr 2010, 140:1915-1922 </ref>.   
  
It can be noted from the above enlisted disorders that ''kapha dosha, rasa, rakta, mamsa'' and ''meda dhatu'' are vitiated in ''santarpaniya'' diseases. Therefore, the treatment protocol shall be designed keeping these factors in mind.  
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It can be noted from the above enlisted disorders that [[kapha]] [[dosha]], [[rasa]], [[rakta]], [[mamsa]] and [[meda dhatu]] are vitiated in ''santarpaniya'' diseases. Therefore, the treatment protocol shall be designed keeping these factors in mind.  
  
 
'''''Pramehapidaka''''': This can be compared with diabetic carbuncle which is a complication of uncontrolled diabetes mellitus. It is localized infective gangrene of the skin and subcutaneous tissues caused by infection. The predisposing factor is diabetes. In diabetic carbuncle, infection is at hair follicle with severe pain and there is involvement of fibrous strand along with sub-cutaneous tissues. A multi-locular lesion is seen which may give rise to ulcerating carbuncle. In this lesion, gangrenous process can occur which may be due to thrombosis of the lesion.
 
'''''Pramehapidaka''''': This can be compared with diabetic carbuncle which is a complication of uncontrolled diabetes mellitus. It is localized infective gangrene of the skin and subcutaneous tissues caused by infection. The predisposing factor is diabetes. In diabetic carbuncle, infection is at hair follicle with severe pain and there is involvement of fibrous strand along with sub-cutaneous tissues. A multi-locular lesion is seen which may give rise to ulcerating carbuncle. In this lesion, gangrenous process can occur which may be due to thrombosis of the lesion.
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'''''Kandu''''' can be compared with urticaria, characterized by skin eruptions which are reddish and itchy in nature and are of mild intensity and increased by exposure to cold breeze. It is also manifested as a symptom of other diseases. In this context of ''santarpanajanya vyadhi'', we have seen previously that certain foods have effect on immune system. ''Kandu'' is a peculiar indication of severe hyperglycemia as well. Due to dehydration, neuritis and micro angiopathy these types of symptoms can be developed. These are more seen in chronic uncontrolled diabetes patients.
 
'''''Kandu''''' can be compared with urticaria, characterized by skin eruptions which are reddish and itchy in nature and are of mild intensity and increased by exposure to cold breeze. It is also manifested as a symptom of other diseases. In this context of ''santarpanajanya vyadhi'', we have seen previously that certain foods have effect on immune system. ''Kandu'' is a peculiar indication of severe hyperglycemia as well. Due to dehydration, neuritis and micro angiopathy these types of symptoms can be developed. These are more seen in chronic uncontrolled diabetes patients.
  
'''''Kotha''''', as explained, is a decay of tissues due to certain conditions. In the context of ''santarpanajanya vyadhi'', decay usually is seen in diabetic patients caused mostly due to microangiopathy. Involvement of the blood vessels by atherosclerosis leading to ischemia is a significant factor in diabetic foot. Lower extremity peripheral vascular disease (PVD) is the most common factor associated with limb ulceration, gangrene, impaired wound healing and ultimately amputation. It mainly occurs due to blood flow changes, occlusive changes, micro angiopathy, and hematological changes. There is marked change in the flow of blood in peripheral vessels. The microcirculation is regulated by neural factors, local reflexes and vasoactive mediators. The initial haemodynamic changes will be increased flow and pressure of capillary blood . As the disease progresses, autoregulation is lost and haemodynamic stress results. It could also be due to increased calcification of vessels or AV shunting or hyperosmolarity of blood. It is well documented by high ankle brachial ratio and also Doppler studies. Occlusive changes occur in more than 50% of diabetics having the disease for more than 10 – 15 years. It mainly affects arteries below profunda femoris and is characterized by multiple segment involvement. The tibial & peroneal arteries between the knee and the ankle are primarily affected. Dorsalis pedis artery and foot vessels are usually spared. Patients with diabetes have diminished ability to establish collateral circulation especially in arteries around knee.  This disease is more prevalent & accelerated with diabetes mellitus.   
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'''''Kotha''''', as explained, is a decay of tissues due to certain conditions. In the context of ''santarpanajanya vyadhi'', decay usually is seen in diabetic patients caused mostly due to microangiopathy. Involvement of the blood vessels by atherosclerosis leading to ischemia is a significant factor in diabetic foot. Lower extremity peripheral vascular disease (PVD) is the most common factor associated with limb ulceration, gangrene, impaired wound healing and ultimately amputation<ref> Gayle R, Benjamin AL, Gary NG. The burden of diabetic foot ulcers. The American Journal of Surgery 1998Aug 24; 176(Suppl 2A):65-105. </ref>. It mainly occurs due to blood flow changes, occlusive changes, micro angiopathy, and hematological changes. There is marked change in the flow of blood in peripheral vessels. The microcirculation is regulated by neural factors, local reflexes and vasoactive mediators. The initial haemodynamic changes will be increased flow and pressure of capillary blood<ref> Tooke JE. Microvascular hemodynamics in diabetes mellitus. Clin Sci 1986; 70:119-125 </ref> . As the disease progresses, autoregulation is lost and haemodynamic stress results. It could also be due to increased calcification of vessels or AV shunting or hyperosmolarity of blood. It is well documented by high ankle brachial ratio and also Doppler studies. Occlusive changes occur in more than 50% of diabetics having the disease for more than 10 – 15 years<ref> Pyorala K, Laasko M, Vusiitupa M. Diabetes and atherosclerosis, An epidemiologic view. Diabet Methob Rev 1987; 3:463-524 </ref>. It mainly affects arteries below profunda femoris and is characterized by multiple segment involvement. The tibial & peroneal arteries between the knee and the ankle are primarily affected. Dorsalis pedis artery and foot vessels are usually spared. Patients with diabetes have diminished ability to establish collateral circulation especially in arteries around knee.  This disease is more prevalent & accelerated with diabetes mellitus.   
  
'''''Pandu''''' (anemia): It means pallor and is seen in metabolic disorders. Charaka has explained it as a disease as well as complication of other disorders. ''Pandu'' that has been mentioned in ''santarpanajanya'' diseases chapter is ''kapha'' dominant where the causes are elaborated in verses 3 and 4. Two of the most common causes of anemia are due to abnormalities in iron homeostasis: iron-deficiency anemia and anemia of inflammation also known as anemia of chronic disease. The anemia caused due to inflammation is elaborated in this context. It is very interesting to know metabolic disorders like obesity and some complication of diabetes like diabetic nephropathy also lead to pallor and iron deficiency. Along with anaemia, renal parameters also get deranged which may lead to abdominal symptoms like nausea and vomiting, so the word ''arochaka'' is used here adjoining to ''mutrakrichhra'' (urinary disorder). In the latter stages of diabetic or hypertensive nephropathy urinary complaints like oligouria or anuria can occur. If it remains untreated due anaemia and congestion in heart, edema starts developing which has been called as ''shopha''.  
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'''''Pandu''''' (anemia): It means pallor and is seen in metabolic disorders. Charak has explained it as a disease as well as complication of other disorders. ''Pandu'' that has been mentioned in ''santarpanajanya'' diseases chapter is [[kapha]] dominant where the causes are elaborated in verses 3 and 4. Two of the most common causes of anemia are due to abnormalities in iron homeostasis: iron-deficiency anemia and anemia of inflammation also known as anemia of chronic disease. The anemia caused due to inflammation is elaborated in this context. It is very interesting to know metabolic disorders like obesity and some complication of diabetes like diabetic nephropathy also lead to pallor and iron deficiency<ref> Karlee et al. Is Obesity Associated with Anaemia of Chronic Disease? A Population-based Study. 2008. Doi: 10.1038/oby.2008.353 </ref>. Along with anaemia, renal parameters also get deranged which may lead to abdominal symptoms like nausea and vomiting, so the word ''arochaka'' is used here adjoining to ''mutrakrichhra'' (urinary disorder)<ref> Mehdi et al. Anemia, Diabetes, and Chronic Kidney Disease. 2009. 32(7): 1320-1326 </ref>. In the latter stages of diabetic or hypertensive nephropathy urinary complaints like oligouria or anuria can occur. If it remains untreated due anaemia and congestion in heart, edema starts developing which has been called as ''shopha''.  
  
 
'''''Amaja vyadhi''''':  ''Ama'' is referred to an intermediate bio product of cellular metabolism leading to number of metabolic disorders. Generation of ''ama'' is thought to start with maldigestion or indigestion of food substances when taken in excess which begins in the stomach. It is a very important factor playing a pivotal role in the genesis of any disease. It is clearly stated that there is no disorder devoid of ''ama''. So all the anabolic disorders where ''ama'' is considered as cause are supposed to be under the category of ''ama vyadhis''.   
 
'''''Amaja vyadhi''''':  ''Ama'' is referred to an intermediate bio product of cellular metabolism leading to number of metabolic disorders. Generation of ''ama'' is thought to start with maldigestion or indigestion of food substances when taken in excess which begins in the stomach. It is a very important factor playing a pivotal role in the genesis of any disease. It is clearly stated that there is no disorder devoid of ''ama''. So all the anabolic disorders where ''ama'' is considered as cause are supposed to be under the category of ''ama vyadhis''.   
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When we think simply about the urinary complaints related with diabetes and obesity, urinary incontinence is prominent symptom, which is dominantly seen in obese women and men, which can be called as stress incontinence. So the word ''mutrakkrichra'' in this context of ''santarpanajanya vyadhis'' is to be taken as a complication of diabetic and hypertensive nepheropathy.  
 
When we think simply about the urinary complaints related with diabetes and obesity, urinary incontinence is prominent symptom, which is dominantly seen in obese women and men, which can be called as stress incontinence. So the word ''mutrakkrichra'' in this context of ''santarpanajanya vyadhis'' is to be taken as a complication of diabetic and hypertensive nepheropathy.  
  
'''''Kushtha''''': There are many skin diseases which are related to anabolism. Anabolism leads to discoloration and hyperpigmentation of skin. Majority of obese people show severe hyperpigmentation, which is called as acanthosis nigricans. Simple acne can also be the result of ''santarpanajanya vyadhis''.  Some of the studies had reported, how caloric restriction can change sebum composition. Another study linked acne to the consumption of milk.  
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'''''Kushtha''''': There are many skin diseases which are related to anabolism. Anabolism leads to discoloration and hyperpigmentation of skin. Majority of obese people show severe hyperpigmentation, which is called as acanthosis nigricans. Simple acne can also be the result of ''santarpanajanya vyadhis''.  Some of the studies<ref> Downing D, Strauss J, Pochi P. Changes in skin surface lipid composition induced by severe caloric restriction in man. Am J Clin Nutr. 1972;25:365–367</ref> had reported, how caloric restriction can change sebum composition. Another study <ref> Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58:787–793. </ref>linked acne to the consumption of milk.  
  
'''''Klaibya''''': A person who is unable to have proper sexual intercourse either due to erectile dysfunction or early ejaculation is termed as ''klaibya'' in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda].''Klaibya'' is described in detail in [[Chikitsa Sthana]] (Chikitsa 30/155) and is mentioned as a complication of either obesity, diabetes or hypertension. While elaborating the properties of ''lashuna'' (garlic) Charaka has explained that ''lashuna'' is important herb in cardiac disorders as well and is useful in ''klaibya''. Looking at its properties on microvessels, ''garlic'' is proven to be a herb which regulates nitric oxide synthesis in the arteries and keeps the lumen of the arteries dilated. Per studies, in cases of hypertensive erectile dysfunction in rats, it has been observed that nitric oxide synthesis in penile artery is lowered. Garlic has positive impact on regulating nitric oxide synthesis.
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'''''Klaibya''''': A person who is unable to have proper sexual intercourse either due to erectile dysfunction or early ejaculation is termed as ''klaibya'' in [[Ayurveda]].''Klaibya'' is described in detail in [[Chikitsa Sthana]] [Cha.Sa.[[Chikitsa Sthana]] 30/155] and is mentioned as a complication of either obesity, diabetes or hypertension. While elaborating the properties of ''lashuna'' (garlic) Charak has explained that ''lashuna'' is important herb in cardiac disorders as well and is useful in ''klaibya''. Looking at its properties on microvessels, ''garlic'' is proven to be a herb which regulates nitric oxide synthesis in the arteries and keeps the lumen of the arteries dilated. Per studies, in cases of hypertensive erectile dysfunction in rats, it has been observed that nitric oxide synthesis in penile artery is lowered<ref> Penson DF et al. Adrenal Control of erectile function and nitric oxide synthase in the rat penis 138(9):3925-32 1997 </ref>. Garlic has positive impact on regulating nitric oxide synthesis<ref> Peyman et al.  Therapeutic Uses and Pharmacological Properties of Garlic, Shallot, and Their Biologically Active Compounds 16(10):1031-1048 2013 </ref>.
 
   
 
   
The direct effect of obesity on increaded risk of erectile dysfunction is well researched, and is often attributable to hormonal imbalance, endothelial dysfunction and insulin resistance.  
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The direct effect of obesity on increased risk of erectile dysfunction is well researched, and is often attributable to hormonal imbalance, endothelial dysfunction and insulin resistance.  
  
'''''Gurugatrata''''': ''Guru'' is heavy and gatra is body, and ''gurugatratra'' means a feeling of heaviness in the body. This condition can be due to excess fat deposition, or may be due peripheral odema developing due to certain cardiac and renal complications. In the initial stage tissues show inflammatory changes at molecular level and later develop symptoms of ''gurugatrata''.  
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'''''Gurugatrata''''': ''Guru'' is heavy and gatra is body, and ''gurugatrata'' means a feeling of heaviness in the body. This condition can be due to excess fat deposition, or may be due peripheral odema developing due to certain cardiac and renal complications. In the initial stage tissues show inflammatory changes at molecular level and later develop symptoms of ''gurugatrata''.  
  
 
'''''Aalasya'''''(lethargy or lassitude), at the somatic as well as psychological level, signifies a feeling of lethargy along with hesitancy or weariness of body or mind from strain, oppressive climate, etc. It is mainly caused due to psychological factors that show through one’s sensory and motor organs. It is a primary stage of the major complications like ''tandra'' and ''moha''. It could also be a condition symptomatic of diabetic and hypertensive cerebral encephelopathy. Uncontrolled hyperglycemia or hypertension in patients may lead to number of complications. These are all pre coma or coma conditions where all the sensory organs stop responding and a specific word, ''Lepa'', is used to denote some form of “covering” that the sensory organs are covered with that makes them stop responding and lose orientation. Not only the sensory organs, but all the body channels from where not only the blood and sensation, but also the chemical signalling of the cells also gets disturbed and patients land into ''tandra, buddhi moha'' and ''prameelaka''.   
 
'''''Aalasya'''''(lethargy or lassitude), at the somatic as well as psychological level, signifies a feeling of lethargy along with hesitancy or weariness of body or mind from strain, oppressive climate, etc. It is mainly caused due to psychological factors that show through one’s sensory and motor organs. It is a primary stage of the major complications like ''tandra'' and ''moha''. It could also be a condition symptomatic of diabetic and hypertensive cerebral encephelopathy. Uncontrolled hyperglycemia or hypertension in patients may lead to number of complications. These are all pre coma or coma conditions where all the sensory organs stop responding and a specific word, ''Lepa'', is used to denote some form of “covering” that the sensory organs are covered with that makes them stop responding and lose orientation. Not only the sensory organs, but all the body channels from where not only the blood and sensation, but also the chemical signalling of the cells also gets disturbed and patients land into ''tandra, buddhi moha'' and ''prameelaka''.   
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All the above mentioned conditions are due to severe hyperglycemia with hyperosmolality and dehydration, in the absence of significant ketosis. It occurs in patients with mild or occult diabetes, and most patients are middle-aged to elderly. Accurate figures are not available as to its true incidence, but from data on hospital discharges it is rarer than diabetic ketoacidosis even in older age groups.  
 
All the above mentioned conditions are due to severe hyperglycemia with hyperosmolality and dehydration, in the absence of significant ketosis. It occurs in patients with mild or occult diabetes, and most patients are middle-aged to elderly. Accurate figures are not available as to its true incidence, but from data on hospital discharges it is rarer than diabetic ketoacidosis even in older age groups.  
  
Research shows that a partial or relative insulin deficiency may trigger a syndrome by reducing glucose utilization of muscle, fat, and liver while increasing hepatic glucose output.   
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Research shows that a partial or relative insulin deficiency may trigger a syndrome by reducing glucose utilization of muscle, fat, and liver while increasing hepatic glucose output<ref> Trence DL et al: Hyperglycemic crisis in diabetes mellitus type 2. Endocrinol Metab Clin North Am 2001;30:817. [PMID: 11727401] </ref>.   
  
 
Ultimately, with all these symptoms and conditions, edema over the body develops and along with other complications lands the patient into severe difficulties.  
 
Ultimately, with all these symptoms and conditions, edema over the body develops and along with other complications lands the patient into severe difficulties.  
  
'''''Lekhana''''' is defined as the therapeutic action which (adequately) dries up body tissues and then literally scrapes the unwanted substances (generally solid, unctuous substances) out from the body tissues. Though this may be one meaning of ''lekhana'', all ''lekhana'' activites and ''lekhana dravya'' exert some pharmacological activates that reduce unwanted substances - unwanted ''dosha, dhatu'' or ''mala'' - from the body. The same properties of ''lekhana'' can be achieved by ''virechana, vamana'' or ''raktamokshana''.  
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'''''Lekhana''''' is defined as the therapeutic action which (adequately) dries up body tissues and then literally scrapes the unwanted substances (generally solid, unctuous substances) out from the body tissues. Though this may be one meaning of ''lekhana'', all ''lekhana'' activites and ''lekhana dravya'' exert some pharmacological activates that reduce unwanted substances - unwanted [[dosha]], [[dhatu]] or [[mala]]- from the body. The same properties of ''lekhana'' can be achieved by [[virechana]], [[vamana]] or [[raktamokshana]].  
  
Exercise and fasting has a very positive effect on anabolic disorders. Exercise results in reduction in fasting blood glucose, which replicates previous beneficial effects of exercise interventions in type II diabetes.
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Exercise and fasting has a very positive effect on anabolic disorders. Exercise results in reduction in fasting blood glucose, which replicates previous beneficial effects of exercise interventions in type II diabetes<ref> D. E. Kelley and B. H. Goodpaster, “Effects of exercise on glucose homeostasis in type 2 diabetes mellitus,” Medicine and Science in Sports and Exercise, vol. 33, no. 6, supplement, pp. S495–S501, 2001.</ref>.
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===== Fasting =====
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=== Fasting ===
  
That fasting and CR (calorie restriction) makes an organism’s metabolic process more efficient, enhancing the organism’s age, is a well-researched subject. Clive McCay at Cornell had published, in 1937, that a 33% caloric restriction resulted in a 50% increase in the maximum lifespan of a rat. Similar experiments were done on organisms such as yeasts, mosquitoes, flies, protozoa, roundworms, fish, etc. Many decades later, the National Institute of Aging (NIA) and the universities of Maryland and Wisconsin tried to study the impact of CR on aging using primates (squirrel and rhesus monkeys). The NIA Primate CR study indicated that CR monkeys “demonstrated an improved metabolic profile”, though they also concluded that the effects of CR in long-lived animals are complex and depend on a variety of factors besides caloric restriction.  
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That fasting and CR (calorie restriction) makes an organism’s metabolic process more efficient, enhancing the organism’s age, is a well-researched subject. Clive McCay at Cornell had published, in 1937, that a 33% caloric restriction resulted in a 50% increase in the maximum lifespan of a rat. Similar experiments were done on organisms such as yeasts, mosquitoes, flies, protozoa, roundworms, fish, etc. Many decades later, the National Institute of Aging (NIA) and the universities of Maryland and Wisconsin tried to study the impact of CR on aging using primates (squirrel and rhesus monkeys). The NIA Primate CR study indicated that CR monkeys “demonstrated an improved metabolic profile”, though they also concluded that the effects of CR in long-lived animals are complex and depend on a variety of factors besides caloric restriction<ref> Mattison et al Impact of caloric restriction on health and survival in rhesus monkeys: the NIA study. Nature 2012 Sep 13: 489(7415):10.1038 </ref>.
  
===== Herbs used in management of ''santarpaniya'' diseases =====
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=== Herbs used in management of ''santarpanajanya'' diseases ===
  
While treating ''santarpanajanya vyadhis'' like ''sthulata'' (obesity) and ''madhumeha'' (diabetes), consumption of ''dravyas'' that have ''guru'' and ''ruksha'' properties is advised. Along with medicines, the diet must also be ''ruksha''. For skin ailments, applying powders of medicinal plants all over the body which can provide relief from ''kandu'' (itching) and ''kotha'' (pre-gangrenous condition) are advised. So the food must be ''guru'' and ''apatarpaka'', i.e., it should induce catabolic activities. Applying these powders on the lesions may improve blood circulation which may consequently improve the increased hydroxylysine and glucose disaccharide content, decrease in proteoglycan and heparin sulfate and decrease in lysine content towards the lesion. The effects of honey, a food rich in antioxidants, on diseases such as cancer, coronary diseases, inflammatory disorders, and aging, has helped it gain lot of attention among nutritionists.  Properties of honey are ''ruksha, guru,'' and ''kashaya''. Food and medicine having these properties enhance ''akasha'' and ''vayu mahabhuta'' which tends the person towards ''apatarpana''.  
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While treating ''santarpanajanya vyadhis'' like ''sthulata'' (obesity) and ''madhumeha'' (diabetes), consumption of ''dravyas'' that have ''guru'' and ''ruksha'' properties is advised. Along with medicines, the diet must also be ''ruksha''. For skin ailments, applying powders of medicinal plants all over the body which can provide relief from ''kandu'' (itching) and ''kotha'' (pre-gangrenous condition) are advised. So the food must be ''guru'' and ''apatarpaka'', i.e., it should induce catabolic activities. Applying these powders on the lesions may improve blood circulation which may consequently improve the increased hydroxylysine and glucose disaccharide content, decrease in proteoglycan and heparin sulfate and decrease in lysine content towards the lesion. The effects of honey, a food rich in antioxidants, on diseases such as cancer, coronary diseases, inflammatory disorders, and aging, has helped it gain lot of attention among nutritionists<ref> Jaganathan et al. Antiproliferative Effects of Honey and of Its Polyphenols: A Review. 2009 Journal of Biomedicine and Biotechnology. Article ID 830616</ref>.  Properties of honey are ''ruksha, guru,'' and ''kashaya''. Food and medicine having these properties enhance ''akasha'' and ''vayu mahabhuta'' which tends the person towards ''apatarpana''.  
  
Since ''ruksha dravyas'' are ''akasha'' and ''vayu'' dominant, medicines and food articles of this property are advised. Of the three properties of honey, the most important one is ''guru''. Since ''jatharagni'' is vitiated in obesity (since agni plays an important role in causing or aggravating anabolic disorders), ''guru'' and ''ruksha'' substances are used to pacify it, and thus honey is recommended for obesity. However, the use of honey in diabetes is controversial since honey is full of fructose and it imparts hyperglycaemic properties on diabetic patients. In diseases like obesity, lipid abnormality and diabetes mellitus, gut microbiota plays an important role in carbohydrate metabolism.  
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Since ''ruksha dravyas'' are [[akasha]] and [[vayu]] dominant, medicines and food articles of this property are advised. Of the three properties of honey, the most important one is ''guru''. Since ''jatharagni'' is vitiated in obesity (since [[agni]] plays an important role in causing or aggravating anabolic disorders), ''guru'' and ''ruksha'' substances are used to pacify it, and thus honey is recommended for obesity. However, the use of honey in diabetes is controversial since honey is full of fructose and it imparts hyperglycaemic properties on diabetic patients. In diseases like obesity, lipid abnormality and diabetes mellitus, gut microbiota plays an important role in carbohydrate metabolism.  
  
Pericarp of ''haritaki'' showed cardiotonic activities in frog hearts, increasing the force of contraction and cardiac output without altering the heart rate. ''Haritaki'' extracts administered before initiating any treatment showed signs of reduced myocardial damage caused by isoproterenol in rats. ''Haritaki'' reduced lipid peroxidation and significantly reduced cholesterolemia, aortic sudanophilia, and cholesterol content of the aorta and liver.  
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Pericarp of ''haritaki'' showed cardiotonic activities in frog hearts, increasing the force of contraction and cardiac output without altering the heart rate<ref> Reddy VRC, Kumari SVR, Reddy BM, Azeem MA, Prabhkar MC, Rao AVN (1990) Cardionic activity of the fruits of Terminalia chebula. Fitotera- pia 41, 517-52 </ref>. ''Haritaki'' extracts administered before initiating any treatment showed signs of reduced myocardial damage caused by isoproterenol in rats. ''Haritaki'' reduced lipid peroxidation and significantly reduced cholesterolemia, aortic sudanophilia, and cholesterol content of the aorta and liver<ref> The Ayurvedic medicines Haritaki, Amala and Bahira reduce cholesterol-induced atherosclerosis in rabbits. Int J Cardiol. 1988 Nov;21(2):167-75.Thakur CP, Thakur B, Singh S, Sinha PK, Sinha SK.Patna Medical College, India. </ref>.  
 
    
 
    
Local application by rubbing of certain herbal powders on the skin reduces ''kapha dosha'' and regulates ''vata dosha'' at that level and inhibits samprapti of ''kandu'' and ''kotha''. Regular rubbing of the powders over the skin increases peripheral circulation of the capillaries supplying the skin and also reduced inflammation at dermal level. Rubbing of dry powders over the body is called ''udvartana''. This softens the skin leaving it with a lustrous glow. The stimulating massage helps revitalize skin, removes fat deposits and improve circulation and digestion. ''Udvartana'' helps open the circulatory channels, facilitating metabolic activities, eliminating excessive perspiration and body odor and improving the complexion of the skin.   
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Local application by rubbing of certain herbal powders on the skin reduces [[kapha dosha]] and regulates [[vata dosha]] at that level and inhibits samprapti of ''kandu'' and ''kotha''. Regular rubbing of the powders over the skin increases peripheral circulation of the capillaries supplying the skin and also reduced inflammation at dermal level. Rubbing of dry powders over the body is called ''udvartana''. This softens the skin leaving it with a lustrous glow. The stimulating massage helps revitalize skin, removes fat deposits and improve circulation and digestion. ''Udvartana'' helps open the circulatory channels, facilitating metabolic activities, eliminating excessive perspiration and body odor and improving the complexion of the skin.   
 
   
 
   
''Triphala'' is one of the oldest used polyherbal preparations. It is comprised of Terminalia chebula, Terminalia bellerica and Emblica officinalis. Some of the positive qualities of ''triphala'' in vivo and in vitro are that it is an antioxidant, anti-hypercholesterolemic, anti-diabetic, anti-obesity, and possesses chemo-preventive potential and anti-mutagenic activities, anti-inflammatory, antimicrobial, radioprotective effect, immunomodulatory, improving wound healing, enteroprotective efficacies, anti-gastric ulcers and nitric oxide scavenging properties. This herbal combination can have profound healing benefits in multi-organ systems.  It is rich in Mg, K, Ca, Fe, Se and Zn, which enhance their bioavailability. Low molecular weight tannins, gallic acid and other important phytochemicals are responsible for the above effects.   
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'''''Triphala''''' is one of the oldest used polyherbal preparations. It is comprised of Terminalia chebula, Terminalia bellerica and Emblica officinalis. Some of the positive qualities of ''triphala'' in-vivo and in-vitro are that it is an antioxidant, anti-hypercholesterolemic, anti-diabetic, anti-obesity, and possesses chemo-preventive potential and anti-mutagenic activities, anti-inflammatory, antimicrobial, radioprotective effect, immunomodulatory, improving wound healing, enteroprotective efficacies, anti-gastric ulcers and nitric oxide scavenging properties. This herbal combination can have profound healing benefits in multi-organ systems.  It is rich in Mg, K, Ca, Fe, Se and Zn, which enhance their bioavailability. Low molecular weight tannins, gallic acid and other important phytochemicals are responsible for the above effects <ref> A systematic review of the antioxidant, anti-diabetic, and anti-obesity effects and safety of triphala herbal formulation Kamali Seyed Hamid et al Journal of Medicinal Plants Research Vol. 7(14), pp. 831-844, 10 April, 2013  DOI: 10.5897/JMPR12.352  ISSN 1996-0875 ©2013 Academic Journals  http://www.academicjournals.org/JMPR  </ref>.   
  
''Aragwadha'' (Cassia fistula) possesses ''madhura rasa, madhura vipaka'' and has ''sheeta veerya''. It possesses strong antioxidant properties. Aqueous extract of ''Aragwadha'' flowers administered in diabetic rats (streptozotocin induced diabetes) showed antioxidant effect. After investigating antioxidants marker enzymes in the brain, significant increase is observed, with decrease in thiobarbituric reactive substances and hydroperoxide formation comparable with glibenclamide.  
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'''''Aragwadha''''' (Cassia fistula) possesses ''madhura rasa, madhura vipaka'' and has ''sheeta veerya''. It possesses strong antioxidant properties. Aqueous extract of ''Aragwadha'' flowers administered in diabetic rats (streptozotocin induced diabetes) showed antioxidant effect. After investigating antioxidants marker enzymes in the brain, significant increase is observed, with decrease in thiobarbituric reactive substances and hydroperoxide formation comparable with glibenclamide<ref> Latha, M. & Pari, L. Mol Cell Biochem (2003) 243: 23. doi:10.1023/A:1021697311150. </ref>.  
  
Cassia auriculata L. seedlings, if irradiated with ultraviolet B (UV-B), it counteracted the induced oxidative stress with reduction in ascorbate, dehydroascorbate, glutathione/oxidized glutathione content at two doses assayed (7.5 and 15.0 kJ-2)
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Cassia auriculata L. seedlings, if irradiated with ultraviolet B (UV-B), it counteracted the induced oxidative stress with reduction in ascorbate, dehydroascorbate, glutathione/oxidized glutathione content at two doses assayed (7.5 and 15.0 kJ-2)<ref> Agarwal, S. Biol Plant (2007) 51: 157. doi:10.1007/s10535-007-0030-z </ref>
  
Ethanolic and methanolic extracts of the flowers showed antioxidant properties which may be due to presence of flavonoids and tannins. ,  
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Ethanolic and methanolic extracts of the flowers showed antioxidant properties which may be due to presence of flavonoids and tannins<ref>  Pharmacological Potentials of Cassia auriculata and Cassia fistula Plants: A Review Sushma Kainsa, Praveen Kumar and Poonam Rani </ref>  <ref> George, M., L. Joseph and Ramaswam, 2007. Effect of Cassia auriculata extract on nociception, experimental diabetes and hyperlipidemia in mice and rats. Highland Med. Res. J., 5: 11-19. </ref>. , ''Patha'' (cissampelos pareira): Certain controversies are there about ''patha''. Two different herbs are used as ''patha'' in different part of India- Cyclea peltata and Cissampelos parietal. Properties of ''patha'' are elaborated as ''rasa-tikta virya-usna vipäka-katu guna.-laghu, tiksna karma-vata-kaphahara,visaghna ,grahi, balya''. ''Patha'' is known to have potent diuretic properties. Certain flavonoids were found to exert their diuretic properties by binding with Adenosine A1 Receptor associated with the diuretic action. The diuretic properties of studied plant may be through any of these possible mechanisms since it is rich in alkaloids and flavonoids<ref> Yuliana ND, Khatib A, Link-Struensee AM, Ijzerman AP, Rungkat-Zakaria F, Choi YH, et al. Adenosine A1 receptor binding activity of methoxy flavonoids from orthosiphon stamineus. Planta Med.2009;75:132–6. </ref>.
''Patha'' (cissampelos pareira): Certain controversies are there about ''patha''. Two different herbs are used as ''patha'' in different part of India- Cyclea peltata and Cissampelos parietal. Properties of ''patha'' are elaborated as ''rasa-tikta virya-usna vipäka-katu guna.-laghu, tiksna karma-vata-kaphahara,visaghna ,grahi, balya''. ''Patha'' is known to have potent diuretic properties. Certain flavonoids were found to exert their diuretic properties by binding with Adenosine A1 Receptor associated with the diuretic action. The diuretic properties of studied plant may be through any of these possible mechanisms since it is rich in alkaloids and flavonoids
 
''Saptaparna'' (Alstonia scholaris) possess ''tikta kashaya rasa, ushna veerya'' and ''katu vipaka.'' The bark is useful in malarial fevers, abdominal disorders, dyspepsia and in skin diseases. In [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], it is reported that the bark of the plant when soaked in water overnight, can reduce the blood glucose level after oral administration. However, not much characterization of this properties has been done on a scientific basis. The phytochemicals are indicative of its potential in the treatment of diabetes mellitus.
 
  
In one of the studies of ''saptaparna'' (Alstonia scholaris) showed decrease in glycogen content in streptozotocin-diabetic rats support the findings of Grover et al. The decrease in glycogen content may result due to disturbances in glycogen synthetase system. Improvement in liver glycogen of diabetic rats after chronic treatment with aqueous extract of Alstonia scholaris L. bark indicates that possible way of antidiabetic effect of the extract may be by improvement of glycogenesis and / or suppression of glycogenolysis. Thus, study showed that bark of Alstonia scholaris L. possesses antidiabetic and antihyperlipidemic effects in STZ diabetic rats. The antiatherogenic potential of the bark extract indicates its usefulness not only in diabetes mellitus but also in the long term complications associated with it.  
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'''''Saptaparna''''' (Alstonia scholaris) possess ''tikta kashaya rasa, ushna veerya'' and ''katu vipaka.'' The bark is useful in malarial fevers, abdominal disorders, dyspepsia and in skin diseases. In  [[Ayurveda]], it is reported that the bark of the plant when soaked in water overnight, can reduce the blood glucose level after oral administration. However, not much characterization of this properties has been done on a scientific basis. The phytochemicals are indicative of its potential in the treatment of diabetes mellitus<ref>Antidiabetic and Antihyperlipidemic Effect of Alstonia scholaris Linn Bark in Streptozotocin Induced Diabetic Rats Indian Journal of Pharmaceutical Education and Research Association of Pharmaceutical Teachers of India Ind J Pharm Edu Res, 2011, 45(2):114-121 </ref>.
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In one of the studies of ''saptaparna'' (Alstonia scholaris) showed decrease in glycogen content in streptozotocin-diabetic rats support the findings of Grover et al. The decrease in glycogen content may result due to disturbances in glycogen synthetase system. Improvement in liver glycogen of diabetic rats after chronic treatment with aqueous extract of Alstonia scholaris L. bark indicates that possible way of antidiabetic effect of the extract may be by improvement of glycogenesis and / or suppression of glycogenolysis. Thus, study showed that bark of Alstonia scholaris L. possesses antidiabetic and antihyperlipidemic effects in STZ diabetic rats. The antiatherogenic potential of the bark extract indicates its usefulness not only in diabetes mellitus but also in the long term complications associated with it<ref> Antidiabetic and Antihyperlipidemic Effect of Alstonia scholaris Linn Bark in
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Streptozotocin Induced Diabetic Rats .Indian Journal of Pharmaceutical Education and Research.Deepti Bandawane *, Archana Juvekar , Manasi Juvekar  Department of Pharmacology, P.E.Society's Modern College of Pharmacy, Nigdi, Pune 411 044.
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</ref>.  
 
    
 
    
Cyperus rotundus has antioxidant and anti-atherosclerotic effects due to the presence of flavanoids, polyphenols and terpenes which reduce absorption of total cholesterol and triglycerides. Cyperus rotundus, in the form of a fine powder or an aqueous solution, exhibits lipolytic properties and showed mobilization of fats from adipose tissues. Cyperus rotundus is supposed to have activators of beta adreno receptors.   
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Cyperus rotundus has antioxidant and anti-atherosclerotic effects due to the presence of flavanoids, polyphenols and terpenes which reduce absorption of total cholesterol and triglycerides. Cyperus rotundus, in the form of a fine powder or an aqueous solution, exhibits lipolytic properties and showed mobilization of fats from adipose tissues. Cyperus rotundus is supposed to have activators of beta adreno receptors<ref> Bhambhole V.d.et al Effect of some medicinal plant preparation on adipose tissue metabolism. Ancient Science of life 1998 117-124 </ref>.   
  
''Madanaphala'' (Randia dumentorum) has ''madhura, tikta rasa, katu vipaka'' and ''ushna veerya''. It is a widely used herb for induction of vomiting used for ''vamana'' procedure. It has ''lekhana'' properties.
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'''''Madanaphala''''' (Randia dumentorum) has ''madhura, tikta rasa, katu vipaka'' and ''ushna veerya''. It is a widely used herb for induction of vomiting used for [[vamana]] procedure. It has ''lekhana'' properties.
  
Clearly, the pharmacological action of the above ''dravyas'' all have been proven to have anti-diabetic and anti-hyperlipidimic properties. The interesting thing to note is that although these ''dravyas'' ultimately work for metabolic disorders, they have different modes of action. Anti-diabetic properties of ''triphala, neem, musta'' and ''saptaparna'' are different. The ''rasa'' of the above mentioned ''dravyas'' is ''tikta kasahaya'' or ''tikta katu'' which is ''akasha, teja'' and ''vayu mahabhuta'' dominant. As we have seen that ''santarpaniya vyadhis'' are due to excess consumption of ''prithvi'' and ''apa mahabhuta,'' those of opposing properties, i.e., ''akasha, teja and vayu'' are used in treating such ailments.  
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Clearly, the pharmacological action of the above ''dravyas'' all have been proven to have anti-diabetic and anti-hyperlipidimic properties. The interesting thing to note is that although these ''dravyas'' ultimately work for metabolic disorders, they have different modes of action. Anti-diabetic properties of ''triphala, neem, musta'' and ''saptaparna'' are different. The ''rasa'' of the above mentioned ''dravyas'' is ''tikta kasahaya'' or ''tikta katu'' which is [[akasha]], [[teja]] and [[vayu mahabhuta]] dominant. As we have seen that ''santarpaniya vyadhis'' are due to excess consumption of [[Prithvi]] and [[jala mahabhuta]] those of opposing properties, i.e., [[akasha]], [[teja]] and [[vayu]] are used in treating such ailments.  
  
''Devadaru'' (Cedrus deodara or Himalayan Cedar) is a herb that is very effective in improving the functions of liver and in maintaining cholesterol levels in healthy limits. ''Devadaru'' pacifies the ''kapha dosha'' by ''tikta, katu'' and ''ushna'' properties, and ''vata dosha'' by ''snigdha'' and ''ushna'' properties so it is useful in disorders induced by ''kapha'' and ''vata doshas''.
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'''''Devadaru''''' (Cedrus deodara or Himalayan Cedar) is a herb that is very effective in improving the functions of liver and in maintaining cholesterol levels in healthy limits. ''Devadaru'' pacifies the ''kapha dosha'' by ''tikta, katu'' and ''ushna'' properties, and [[vata]] [[dosha]] by ''snigdha'' and ''ushna'' properties so it is useful in disorders induced by [[kapha]] and [[vata]] [[dosha]].
  
Investigation demonstrate that extracts of C. deodara shows reduction in body weight in treated groups in a dose dependent manner. The major chemical constituents of C. deodara are sterols, poly-phenols, flavanoids such as taxifolin, quercetin and saponins. It is well established that saponins are useful in treatment of obesity. Phytosterols have beneficial effects on hyperlipidemia and poly-phenols and flavanoids have potential antioxidant properties. Therefore, it could be possible that presence of these compounds is responsible for observed glucose and lipid lowering properties.
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Investigation demonstrate that extracts of C. deodara shows reduction in body weight in treated groups in a dose dependent manner. The major chemical constituents of C. deodara are sterols, poly-phenols, flavanoids such as taxifolin, quercetin and saponins<ref> Agarwal PK, Agarwal SK, Rastogi RP. A new neolignan and other phenolic constituents from Cedrus deodara. Phytochemistry. 1980;19:1260–1.</ref>. It is well established that saponins are useful in treatment of obesity<ref> George Francis, Zohar Kerem, Harinder P.S. Makkar, Becker Klaus. The biological action of saponin in animal systems: A review. Brit J Nutr. 2002;88:587–605. [PubMed] </ref>. Phytosterols have beneficial effects on hyperlipidemia<ref> David JA, Cyril WC. Plant sterols, health claims and strategies to reduce cardiovascular disease risk.J Am Coll Nutr. 1999;18:559–62.  </ref> and poly-phenols and flavanoids have potential antioxidant properties. Therefore, it could be possible that presence of these compounds is responsible for observed glucose and lipid lowering properties.
  
''Shwadanshtra'' or ''gokshura'' (Tribulus Terrestris) is ''madhura rasatmaka'' and has ''sheeta veerya'' with ''madhura vipaka''. ''Gokshura'' is widely used to relieve certain anabolic disorders. It is helpful for the treatment of angina, high cholesterol 65, diabetes 65, and muscle spasms, and for the prevention of kidney stones.  
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'''''Shwadanshtra''''' or ''gokshura'' (Tribulus Terrestris) is ''madhura rasatmaka'' and has ''sheeta veerya'' with ''madhura vipaka''. ''Gokshura'' is widely used to relieve certain anabolic disorders. It is helpful for the treatment of angina<ref> Li M, Qu W, Chu S, et al. Effect of the decoction of Tribulus terrestris on mice gluconegensis. Zhong Yao Cai. 2001;24:586-588. </ref>, high cholesterol 65, diabetes 65, and muscle spasms<ref> Arcasoy HB, Erenmemisoglu A, Tekol Y, et al. Effect of Tribulus terrestris L. saponin mixture on some smooth muscle preparations: a preliminary study. Boll Chim Farm. 1998;137:473-475. </ref>, and for the prevention of kidney stones<ref> Sangeeta D, Sidhu H, Thind SK, et al. Effect of Tribulus terrestris on oxalate metabolism in rats. J Ethnopharmacol. 1994;44:61-66. </ref>.  
  
 
It is very interesting to note that though ''gokshura'' or Tribulus terrestris is ''madhura'' and ''sheeta veerya dravya'' it has been included to treat ''santarpaniya vyadhis''. ''Gokshura'', by the virtue of its phytochemicals and its DHEAS (Dihydro epi andesterone sulphate) stimulating property and its potent diuretic qualities may have been in the group of medicines which are used to impart ''apatarpana''. It has proved to be a very potent herb to cure erectile dysfunction and ''klaibyata'' in patients suffering from metabolic syndrome.
 
It is very interesting to note that though ''gokshura'' or Tribulus terrestris is ''madhura'' and ''sheeta veerya dravya'' it has been included to treat ''santarpaniya vyadhis''. ''Gokshura'', by the virtue of its phytochemicals and its DHEAS (Dihydro epi andesterone sulphate) stimulating property and its potent diuretic qualities may have been in the group of medicines which are used to impart ''apatarpana''. It has proved to be a very potent herb to cure erectile dysfunction and ''klaibyata'' in patients suffering from metabolic syndrome.
  
'''''Khadira''''' (Acacia Catechu): This herb is ''tikta'', ''kashaya'' having ''sheeta veerya'' and ''katu vipaka''. This herb is mostly used as ''kusthaghana'' to alleviate skin problems. In eastern traditional medicines, Acacia catechu Willd is extensively used in the management of diabetes in combinations with other medicinal plants. The most common chemical classes among these plants are flavonoid and other anti-oxidants. Hypoglycemic property of extract of Acacia catechu Willd is assumed to be due to the presence of flavonoids which also show inhibition of cyclo-oxygenase and regenerate β cells.   
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'''''Khadira''''' (Acacia Catechu): This herb is ''tikta'', ''kashaya'' having ''sheeta veerya'' and ''katu vipaka''. This herb is mostly used as ''kusthaghana'' to alleviate skin problems. In eastern traditional medicines, Acacia catechu Willd is extensively used in the management of diabetes in combinations with other medicinal plants. The most common chemical classes among these plants are flavonoid and other anti-oxidants. Hypoglycemic property of extract of Acacia catechu Willd is assumed to be due to the presence of flavonoids which also show inhibition of cyclo-oxygenase and regenerateβ cells<ref> Jarald, E,. Joshi, SB,.and Jain, DC,. (2009). Studies shows that Myricetin, Quercetin and Catechin-gallate inhibit insulin stimulated glucose transporters in isolated adipocytes of rats (Strobel, P,. Allard, C,. Perez-Acle, T,. Calderon, R,. Aldunate, R,. and Leighton, F,. 2005) </ref>. In vitro Acacia catechu Willd is reported to have broad spectrum anti-microbial and anti fungal properties. Phytochemical studies of Acacia catechu Willd leaves shows the presence of alkaloids, carbohydrates, flavones, glycosides, phenolic compounds, saponins, steroids and tannins which may be responsible for its anti-microbial properties<ref> A review on Acacia catechu Willd  Muhammad Anis Hashmat, Rabia Hussain  Interdisciplinary journal of contemporary research in business may 2013 vol 5, no 1  </ref>.
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'''''Haridra''''' (Curcuma longa) has ''tikta rasa, katu vipaka'' and ''ushna veerya.'' It is ''laghu ruksha'' in its qualities. Ingestion of 6 gm Curcuma longa increased postprandial serum insulin levels, but did not seem to affect plasma glucose levels or GI, in healthy subjects. The results indicate that Curcuma longa may have an effect on insulin secretion. The active principles in the rhizome of turmeric plant viz; curcuminoids lower lipid peroxidation by maintaining the activities of antioxidant enzymes like super oxide dismutase, catalase and glutathione per oxidase at higher levels. Antioxidant properties of curcuma longa is due to curcumin and its three derivatives (demethoxy curcumin, bisdemethoxy curcumin and diacetyl curcumin)<ref> Wickenberg J, Ingemansson S, Hlebowicz J (2010) Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects. Nutr J 9: 43 </ref>. A scientific and systemic exploration reveals antidiabetic, hypolipidemic and hepatoprotective effects of Curcuma longa freeze dried rhizome powder dissolved in milk which could be used as an effective and safe antidiabetic dietary supplement of high potential<ref> Rai PK, Jaiswal D, Mehta S, Rai DK, Sharma B, et al. (2010) Effect of curcuma longa freeze dried rhizome powder with milk in stz Induced diabetic rats. Indian J Clin Biochem 25: 175-181 </ref>.
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Curcuma longa is known to contain curcuminoids, glycosides, terpenoids, and flavonoids. Maximal inhibition of the enzyme Human Pancreatic Amylase (HPA) was obtained with Curcuma longa isopropanol extract and acetone extract. This inhibitory action on HPA causes reduction in starch hydrolysis leading to lowered glucose levels<ref> Ponnusamy S, Ravindran R, Zinjarde S, Bhargava S, Ameeta R (2011) Evaluation of Traditional Indian Antidiabetic Medicinal Plants for Human Pancreatic Amylase Inhibitory Effect In Vitro Evidence-Based.Complementary and Alternative Medicine 10. </ref>. The antioxidants in turmeric also prevent damage to cholesterol, thereby helping to protect against atherosclerosis. In fact, the ability of the antioxidants in turmeric to decrease free radicals is similar to that in vitamins C and E. Since the antioxidant activities of turmeric are not degraded by heat, even using the spice in cooking provides benefits. Animal studies show that curcumin lowers cholesterol and triglycerides, another fat that circulates in the blood stream and is a risk factor for cardiovascular disease. In a recent study of atherosclerosis, mice were fed a standard American diet, rich in refined carbohydrates and saturated fat, but low in fiber. Some of the mice, however, received this diet plus turmeric mixed in with their food. After four months on these diets, the mice that consumed the turmeric with their food had 20 percent less blockage of the arteries than the mice fed the diet without the turmeric. In another study, rabbits were fed turmeric plus a diet designed to cause atherosclerosis. Several risk factors for the disease were improved, including a decrease in cholesterol, triglycerides, and free-radical damage.
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Antidermatophytic properties: Fresh juice of rhizome of ''haridra'' is used as an antiparasitic in many skin disorders. Its rhizome powder mixed with cow’s urine is taken internally in itching and dermatitis. Curcuma longa L. leaves have good promise as an antifungal agent that could be used as a therapeutic remedy against human pathogenic fungi on account of its various in vitro and in vivo antifungal properties, viz., strong fungicidal action, long shelf-life, its tolerability of heavy inoculum density, thermo stability, broad range of antidermatophytic properties and absence of any adverse effects. Curcumin obtained from the turmeric rhizome have shown to possess the ability to protect the skin from harmful UV-induced effects by displaying antimutagen, antioxidant, free radical scavenging, anti-inflammatory and anti-carcinogenic properties<ref> Binic I, Lazarevic V, Ljubenovic M, Mojsa J, Sokolovic D (2013) Skin Ageing: Natural Weapons and Strategies. Evid Based Complement Alternat Med. </ref>. 
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'''''Neem''''' (Azadirachta indica):  It is a ''tikta rasa'' plant having ''sheeta veerya'' and ''katu vipaka''. It imparts ''ruksha'' and ''laghu'' property. Hydroalcoholic extracts of this plant showed anti-hyperglycemic properties in streptozotocin treated rats and this effect is because of increase in glucose uptake and glycogen deposition in isolated rat hemidiaphragm<ref> Chattopadhyay R.R., Chattopadhyay R.N., Nandy A.K., Poddar G., Maitra S.K. Preliminary report on antihyperglycemic effect of fraction of fresh leaves of Azadiracta indica (Beng neem) Bull. Calcutta. Sch. Trop. Med. 1987;35:29–33. </ref>. Apart from having anti-diabetic properties, this plant also has anti-bacterial, antimalarial, antifertility, hepatoprotective and antioxidant effects<ref> Biswas K., Chattopadhyay I., Banerjee R.K., Bandyopadhyay U. Biological activities and medicinal properties of neem (Azadiracta indica) Curr. Sci. 2002;82:1336–1345. </ref>.
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'''''Twak''''' (Cinnamomum Zelyanicum):  It is ''katu-tikta rasatmaka'' having ''katu vipaka'' and ''ushna veerya''. It has been shown that oral administration of cinnamaldehyde produces significant antihyperglycemic effect lowers both total cholesterol and triglyceride levels and, at the same time, increases HDL-cholesterol in STZ induced diabetic rats<ref> Subash Babu P, Prabuseenivasan S, Ignacimuthu S. Phytomedicine, 2007;14:15–22 </ref>.
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Matan et al. have reported antimicrobial properties of Cinnamon bark. The volatile gas phase of combinations of Cinnamon oil and clove oil showed good potential to inhibit growth of spoilage fungi, yeast and bacteria normally found on IMF (Intermediate Moisture Foods) when combined with a modified atmosphere comprising a high concentration of CO2 (40%) and low concentration of O2 (<0.05%). A. flavus, which is known to produce toxins, was found to be the most resistant microorganism<ref> Matan N, Rimkeeree H, Mawson A J, Chompreeda P et al. International Journal of Food Microbiology, 2006;107:180–185 </ref>.
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'''''Kushtha''''' (Saussurea Lappa): has ''tikta katu madhur rasa'', ''katu vipaka'' and ''ushna veerya''. It is known to lower blood lipids and is also known to improve coronary circulation<ref> Study of kustha (, clarke) in ischaemic heart disease Anc Sci Lifev.13(1-2); Jul-Dec  93PMC3336543 </ref>. 
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Barley: Barley contains greater amounts of soluble and non-soluble starches compared to other cereals, and approximately 17% of the carbohydrate in barley is not absorbed. Undigested carbohydrate produces short chain fatty acids, some which may reduce hepatic glucose production and affect postprandial glycemia. Barley also inhibits serum cholesterol and is also known to reduce blood pressure if given for long term use<ref> Thorburn, A., Muir, J., and Proietto, J. Carbohydrate fermentation decreases hepatic glucose output in healthy subjects. Metabolism1993;42(6):780-785. 8510524 </ref>.
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'''''Hingu'''''(Ferula asafoetida): is a resin having ''katu rasa, ushna veerya'' and ''katu vipaka''. Ferula asafoetida exhibits anti-cholesterol anti-hypertensive<ref> Sarkisyan RG. Effect of Ferula on arterial pressure. Meditsinskii Zhurnal Uzbekistana.1969;1969:23–4.Sambaiah K, Srinivasan K. Influence of spices and spice principles on hepatic mixed function oxygenase system in rats. Indian J Biochem Biophys. 1989;26:254–8. [PubMed] </ref> and a potent anti-oxidant properties in experimental animals<ref> Sambaiah K, Srinivasan K. Influence of spices and spice principles on hepatic mixed function oxygenase system in rats. Indian J Biochem Biophys. 1989;26:254–8. [PubMed] </ref>. 
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'''''Vasa''''' (Adhatoda vasica): has ''tikta rasa, sheeta veerya'' and ''sheeta vipaka'' and is strong anti diabetic and cardio protective<ref> Atal ck.Chemistry and pharmacology of vasicine.Indian drugs 1980 15(2) 15-18 </ref>.
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'''''Kharavha ajmoda''''' (Trachyspermemum ammi): is a plant with ''katu, tikta rasa, katu vipaka'' and ''ushna veerya''. T. ammi has been shown to possess antimicrobial, hypolipidaemic, digestive stimulant, antihypertensive, hepatoprotective, antispasmodic and broncho-dilating properties<ref> Bairwa Ranjan, Singhal Manmohan, Sodha Ravindra Singh and Rajawat Balwant Singh (2011). Medicinal Uses of Trachyspermum Ammi: A Review, The Pharma Research, 5(2): 247-258 </ref>. 
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'''''Pashanabheda''''' (Berginia ligulata): has ''katu tikta rasa, katu vipaka'' and ''ushna veerya''. It is a controversial herb and many other plants under the name ''pashanabheda'' are prescribed and used. ''Pashanabheda'' is enlisted in ''mootra virechaniya mahakashaya''. Due to its diuretic property, it can be used in hypertension, congestive cardiac failure, renal complains etc<ref> Nagaratna, A Clinico-Experimental Study of Two Sources of Pashanabheda and Bryophyllum Pinnatum with respect to Mootrala Karma, 2012. Rajiv Gandhi University of Health Sciences, Bangalore </ref>. 
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Apart from its diuretic properties, ''pashanabheda'' exhibits good anti-diabetic properties. The 80% ethanolic extract of ''pashanabheda'' rhizome was fractionated to investigate for a-glucosidase or anti-diabetic properties. Sample solution were evaluated at dose levels of 5.0, 0.5, 0.05 mg/ml to obtain dose response. The ethyl acetate extract exhibited an inhibitory effect of a-glucosidase properties<ref> Youshikawa M, Nishida N, Shimoda H, Takada M, Kawahara Y, Matsuda. Polyphenol constituents from Salacia species: quantitative analysis of mangiiferin with alpha- glucosidase and aldose reductase inhibitory activities. Yakugaku Zasshi, 1231, 2001, 371-378. </ref>.
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'''''Takra''''' (butter milk) is used to relieve ''santarpanajanya vyadhis''. It has prime importance in diet and is supposed to be improve appetite. Its properties and medicinal qualities are described in Ashtanga Hridaya Sutra Sthana chapter 5.
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'''''Trikatu''''': is combination of equal parts of ''sunthi, maricha'' and ''pippali''. ''Trikatu'' is regarded as an anti-obesity formulation and has been widely used in anabolic disorders. It is widely used to lower cholesterol and triglycerides and is known to increase HDL levels. In one of the studies it is found that ''trikatu'', by virtue of its ability to reduce triglycerides and LDL cholesterol, increases HDL cholesterol to reduce the risk of hyperlipidaemia and atherosclerosis.<ref> Effect of an indigenous herbal compound preparation ‘Trikatu’ on the lipid profiles of atherogenic diet and standard diet fed Rattus norvegicus Valsala Sivakumar1,Phytotherapy Research Volume 18, Issue 12, pages 976–981, December 2004. </ref> ''Trikatu'' is also known to have immune modulatory properties<ref> Trikatu, an herbal compound as immunomodulatory and anti-inflammatory agent in the treatment of rheumatoid arthritis-an experimental study Vachana Murunikkara, MahaboobKhan RasoolCellular ImmunologyAvailable online 18 December 2013 </ref>  and is known to be a good bioavailability enhancer<ref> Effect of trikatu (PIPERINE) on the pharmacokinetic profile of isoniazid in rabbitsRS Karan, VK Bhargava, SK Garg Year : 1998  , Volume : 30 ,,  Issue : 4  ,  Page : 254-256. </ref>.
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'''''Vidanga''''' (Embelia ribes): The properties are ''rasa katu, kashaya rasa, ushna veerya'' and ''katu vipaka''. It is one of the important plants used for relieving worm infestation. ''Vidanga'' exhibits a potent hypoglycaemic and lipid lowering properties<ref> Effect of Ethanolic Extract of Embelia ribes on Dyslipidemia in Diabetic RatsUma Bhandari, Raman Kanojia, and K. K. Pillai Int. Jnl. Experimental Diab. Res., 3:159–162, 2002 </ref>.
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'''''Agaru''''' (Aquilaria agallocha): ''Agaru'' is a tropical and sub-tropical, fragrant evergreen tree. The wood is very heavy, and sinks in water. The wood has ''tikta rasa, ushna veerya'' and ''katu vipaka''. It exerts potent immunomodulator and anti inflammatory property<ref> Anti-inflammatory effects and immunomodulatory mechanism of aquilaria agallocha Y.-c. Mao1 , h.-y. Hsu2, y.-h. Chiu2 department of laboratory medicine and biotechnology, department of life science, tzu chi university, hualien, taiwan  </ref>.
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'''''Sunthi''''' or ginger (Zinziber officinale): Ginger has ''katu rasa, madhura vipaka'' and ''ushna veerya''. Ginger has been shown to exhibit antioxidant effects. (6)-gingerol appears to be the antioxidant constituent present in ginger, as it was shown to protect HL-60 cells from oxidative stress. Ginger oil has dominative protective effects on DNA damage induced by H2O2. Ginger oil might act as a scavenger of oxygen radical and might be used as an antioxidant<ref> Ma J, Jin X, Yang L and Liu ZL. Diarylheptanoids from the rhizomes of Zingiber officinale. Phytochemistry. 2004;65(8):1137-1143..24 </ref>. In vitro research indicates that gingerols and the related shogaols exhibit cardio depressant properties at low doses and cardiotonic properties at higher doses. Both (6)-shogaol and (6)-gingerol, and the gingerdiones, are reportedly potent enzymatic inhibitors of prostaglandin, thromboxane, and leukotriene biosynthesis. <ref> Shoji N, Iwasa A, Takemoto T, Ishida Y and Ohizumi Y. Cardiotonic principles of ginger (Zingiber officinale Roscoe). </ref> Spiced foods or herbal drinks, containing ginger, have the potential to produce significant effects on metabolic targets, such as satiety, thermogenesis, and fat oxidation thus, useful as anti-obesity agent. Thermogenic ingredients, such as ginger, may be considered as functional agent that could help restore a "positive energy balance" and prevent obesity<ref> Westerterp-Plantenga M, Diepvens K, Joosen AM, Berube-Parent S and Tremblay A. Metabolic effects of spices, teas, and caffeine. Physiol Behav. 8-30-2006;89(1):85-91. </ref>. 
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'''''Shigru''''' (Moringa olifera): has properties of ''katu, kashaya rasa, ushna veerya'' and ''katu vipaka''. It is widely used in ''santarpaniya vyadhis''. Charak has also elaborated ''shigru'' to be used in obesity and heart diseases. It exhibits strong hypoglycaemic properties.<ref> Effect of Moringa oleifera Lam. leaves aqueous extract therapy on hyperglycemic rats Dolly Jaiswal, Prashant Kumar Rai, Amit Kumar, Shikha Mehta, Geeta Watal. Journal of Ethnopharmacology 123 (2009) 392–396  </ref> The aqueous, ethanol and ether extracts of moringa oleifera leaves contain compounds that cause reduction in heart rate and relaxation of cardiac muscle and have medical use in management of cardiac conditions like hypertension<ref> Effect of moringa oleifera leaf extracts on the isolated rabbit heart and uterus Ntulume, R. Davis URI: http://hdl.handle.net/10570/308Date: 2010-11. </ref>.
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'''''Katukrohini''''' or ''kutaki'' (Picrorrhiza kurroa): ''Kutaki'' has ''tikta rasa, katu vipaka'' and ''sheeta veerya''. It possesses a strong hepatoprotective properties due to phytochemical picroliv and also have a potent antioxidant properties<ref> Phytochemical and Pharmacological Standardisation of Polyherbal Tablets For Hepatoprotective Activity Against Carbon Tetrachloride  </ref>.  It is found to be effective against CCl4 induced hepatic damage in rats, by reversal of increased serum level of SGOT, SGPT, ALP, Cholesterol, Bilirubin and decreases level of total protein which occurs during hepatotoxicit<ref> Induced HepatotoxicityVilas A. Arsul*, R. O. Ganjiwale, P. G. Yeole International Journal of Pharmaceutical Sciences and Drug Research 2010; 2(4): 265-268 </ref>.   
  
In vitro Acacia catechu Willd is reported to have broad spectrum anti-microbial and anti fungal properties. Phytochemical studies of Acacia catechu Willd leaves shows the presence of alkaloids, carbohydrates, flavones, glycosides, phenolic compounds, saponins, steroids and tannins which may be responsible for its anti-microbial properties.  
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'''''Brihati''''' (Solanum indicum): ''Brihati'' has ''katu tikta rasa, katu vipaka'' and ''ushna veerya''. Solanum indicum Linn. fruits have laxative and cardiotonic action<ref> Evaluation of laxative and cardiotonic activity of solanum indicum linn. Fruits Prashanta Kumar Deb Journal of Pharmacy and Phytotheraputics J Pharm Phytother 2013, 1:3, 11 – 14 </ref>.  
  
''Haridra'' (Curcuma longa) has ''tikta rasa, katu vipaka'' and ''ushna veerya.'' It is ''laghu ruksha'' in its qualities. Ingestion of 6 gm Curcuma longa increased postprandial serum insulin levels, but did not seem to affect plasma glucose levels or GI, in healthy subjects. The results indicate that Curcuma longa may have an effect on insulin secretion. The active principles in the rhizome of turmeric plant viz; curcuminoids lower lipid peroxidation by maintaining the activities of antioxidant enzymes like super oxide dismutase, catalase and glutathione per oxidase at higher levels. Antioxidant properties of curcuma longa is due to curcumin and its three derivatives (demethoxy curcumin, bisdemethoxy curcumin and diacetyl curcumin).  A scientific and systemic exploration reveals antidiabetic, hypolipidemic and hepatoprotective effects of Curcuma longa freeze dried rhizome powder dissolved in milk which could be used as an effective and safe antidiabetic dietary supplement of high potential  .  
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'''''Ativisha''''' (Aconitum hetrophyllum): has ''tikta katu rasa, katu vipaka'' and ''ushna veerya''. It is ''laghu'' and ''ruksha'' and hence is used in ''santarpaniya vyadhis''. Research showed significant reduction in total cholesterol, TG, apolipoprotein B and increase HDL cholesterol and apolipoprotein A in serum samples and HMG CO A properties in liver samples. Properties of LCAT had increased and also there was increased fecal fat excretion. The mechanism explained for hypolipidemic properties was due to inhibition of HMG COA reductase properties and decrease fat absorption from intestine<ref> Arun Koorapally subash, Anu Augustine, Hypo lipidemic effect of methnol fraction of Aconitum heterophyllum wall ex Royle and the mechanism of action in diet induced obese rats. J.Adv.Pharm. Tech. Res, vol.8, (issue 4):oct-dec ,(2012). </ref>.  
Curcuma longa is known to contain curcuminoids, glycosides, terpenoids, and flavonoids. Maximal inhibition of the enzyme Human Pancreatic Amylase (HPA) was obtained with Curcuma longa isopropanol extract and acetone extract. This inhibitory action on HPA causes reduction in starch hydrolysis leading to lowered glucose levels. The antioxidants in turmeric also prevent damage to cholesterol, thereby helping to protect against atherosclerosis. In fact, the ability of the antioxidants in turmeric to decrease free radicals is similar to that in vitamins C and E. Since the antioxidant activities of turmeric are not degraded by heat, even using the spice in cooking provides benefits. Animal studies show that curcumin lowers cholesterol and triglycerides, another fat that circulates in the blood stream and is a risk factor for cardiovascular disease. In a recent study of atherosclerosis, mice were fed a standard American diet, rich in refined carbohydrates and saturated fat, but low in fiber. Some of the mice, however, received this diet plus turmeric mixed in with their food. After four months on these diets, the mice that consumed the turmeric with their food had 20 percent less blockage of the arteries than the mice fed the diet without the turmeric. In another study, rabbits were fed turmeric plus a diet designed to cause atherosclerosis. Several risk factors for the disease were improved, including a decrease in cholesterol, triglycerides, and free-radical damage.  
 
Antidermatophytic properties: Fresh juice of rhizome of haridra is used as an antiparasitic in many skin disorders. Its rhizome powder mixed with cow’s urine is taken internally in itching and dermatitis. Curcuma longa L. leaves have good promise as an antifungal agent that could be used as a therapeutic remedy against human pathogenic fungi on account of its various in vitro and in vivo antifungal properties, viz., strong fungicidal action, long shelf-life, its tolerability of heavy inoculum density, thermo stability, broad range of antidermatophytic properties and absence of any adverse effects. Curcumin obtained from the turmeric rhizome have shown to possess the ability to protect the skin from harmful UV-induced effects by displaying antimutagen, antioxidant, free radical scavenging, anti-inflammatory and anti-carcinogenic properties.
 
  
''Neem'' (Azadirachta indica): It is a ''tikta rasa'' plant having ''sheeta veerya'' and ''katu vipaka''. It imparts ''ruksha'' and ''laghu'' property.
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'''''Sthiram''''' (Shliparni desmodium gangeticum): It has ''madhura, tikta rasa, madhur vipaka'' and ''ushna veerya''. It has alkaloids, pterocarpans, phospholipids, sterols, flavones and flavonoid glycosides. The plant shows many pharmacological activities like anti-inflammatory, anti-nociceptive, analgesic, anti-amnesic, anti-diabetic, anti-oxidant, anti-ulcer, and better CVS activites, CNS depressant, antibacterial, wound healing, antipyretic and several miscellaneous actions<ref> Pharmacological activities of desmodium gangeticum: an Overview Bhavesh Vaghela*, sandip buddhadevleena shukla an international journal of pharmaceutical sciences 08 Vol - 4, issue - 4, jul-sept 2013 issn: 0976-7908  </ref>.  
  
Hydroalcoholic extracts of this plant showed anti-hyperglycemic properties in streptozotocin treated rats and this effect is because of increase in glucose uptake and glycogen deposition in isolated rat hemidiaphragm. Apart from having anti-diabetic properties, this plant also has anti-bacterial, antimalarial, antifertility, hepatoprotective and antioxidant effects.
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''Kebukmool'' (Costus speciosus): It has ''tikta kashaya rasa, katu vipaka'' and ''sheeta veerya'' and has strong diuretic action. Increased excretion of Na+ and Cl is observed after its administration. It is known to relieve pulmonary edema<ref> International journal of [[Ayurveda]] and Pharmacy Dubey S et al 2012 1(2)648-652  </ref>.
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'''''Dhanayaka''''' (Coriander sativum): ''Dhanayaka'' has ''katu, tikta'' and ''madhur rasa'' with ''katu vipaka'' and s''heeta veerya''. It possesses potent diuretic and antioxidant properties. Part of seeds shows a significant hypolipidemic action. There was significant increase in β-hydroxy, β-methyl glutaryl CoA reductase and plasma lecithin cholesterol acyl transferase properties (LCAT) were noted in the experimental group. The level of low density lipoprotein (LDL), very low density lipoprotein (VLDL) cholesterol decreased while that of high density lipoprotein (HDL) cholesterol increased in the experimental group. Besides diuretic properties it also exhibits a strong anti diabetic and anti convulsant action<ref> Dhanapakiam P., J. Mini Joseph, V.K. Ramaswamy, M. Moorthi and A. Senthil Kumar : The cholesterol lowering property of coriander seeds (Coriandrum sativum): Mechanism of action. Journal of Environmental Biology. 2008; 29(1): 53-56 </ref>.
  
''Twak'' (Cinnamomum Zelyanicum): It is ''katu tikta rasatmaka'' having ''katu vipaka'' and ''ushna veerya''. It has been shown that oral administration of cinnamaldehyde produces significant antihyperglycemic effect lowers both total cholesterol and triglyceride levels and, at the same time, increases HDL-cholesterol in STZ induced diabetic rats.  
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'''''Chitraka''''' (plumbago zeylanica): has ''katu rasa, katu vipaka'' and ''ushna veerya''. It is one of the famous herbal medicine used for ''agnimandya''. It also has antidiabetic and hypocholesterolemic action. Pharmacological studies carried out by researchers have indicated that plumbago zeylanica has antihyperglycemic effect on diabetes induced animals<ref> Olagunju JA et al. An Investigation into the biochemical basis of the observed hyperglycaemia in rats treated with ethanol root extract of plumbago zeylanica. 1999. 13(4):346-8 </ref>. The ethanol extract of Plumbago zeylanica root on key enzymes of glycolysis and muscle hexokinase, phosphofructokinase, pyruvate kinase, lactate dehydrogenase activities were diminished in diabetic rats<ref> Kumar G, Sharmila Banu G, Maheswaran R, Rema S, Rajasekara Pandian M, Murugesan AG. Effect of Plumbago zeylanica L. on blood glucose and plasma antioxidant status in STZ diabetic rats. J Nat Remedies 2007; 7: 66-77.  </ref>. 
  
Matan et al. have reported antimicrobial properties of Cinnamon bark. The volatile gas phase of combinations of Cinnamon oil and clove oil showed good potential to inhibit growth of spoilage fungi, yeast and bacteria normally found on IMF (Intermediate Moisture Foods) when combined with a modified atmosphere comprising a high concentration of CO2 (40%) and low concentration of O2 (<0.05%). A. flavus, which is known to produce toxins, was found to be the most resistant microorganism.
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Hypocholesterolemic Action:  Pharmacological and Clinical studies carried out indicates that Plumbago zeylanica extract has hypolipidaemic and antiatherosclerotic activities. <ref> Sharma, Nisha and Kaushik, Purshotam. Medicinal, Biological, and Pharmacological Aspects of Plumbago Zeylanica (Linn.), 2014 JPP 2014: 3(4):117-120 </ref>Plumbagin, an active principle isolated from plumbago zeylanica brings about a definite regression of atherosclerosis and prevents the accumulation of cholesterol and triglycerides in liver and aorta. Panchcole, an Ayurvedic formulation containing plumbago zeylanica as one of its chief ingredients has been advocated to produce hypolipidaemic effect<ref>Ram A. Effect of Plumbago zeylanica in hyperlipidaemic rabbits and its modification by vitamin E. Indian J Pharmacol 1996; 28: 161–6.</ref>.
Kushtha (Saussurea Lappa) has tikta katu madhur rasa, katu vipaka and ushna  veerya. It is known to lower blood lipids and is also known to improve coronary circulation. 
 
Barley: Barley contains greater amounts of soluble and non-soluble starches compared to other cereals, and approximately 17% of the carbohydrate in barley is not absorbed. Undigested carbohydrate produces short chain fatty acids, some which may reduce hepatic glucose production and affect postprandial glycemia. Barley also inhibits serum cholesterol and is also known to reduce blood pressure if given for long term use.
 
Hingu: [Ferula asafoetida] is a resin having katu rasa, ushna veerya and katu vipaka. Ferula asafoetida exhibits anti cholesterol anti hypertensive  and a potent anti oxidant properties in experimental animals. 
 
Vasa: [Adhatoda vasica] Has tikta rasa, sheeta veerya and sheeta vipaka and is strong anti diabetic and cardio protective.  
 
Kharavha ajmoda [Trachyspermemum ammi] is a plant with katu, tikta rasa, katu vipaka and ushna veerya. T. ammi has been shown to possess antimicrobial, hypolipidaemic, digestive stimulant, antihypertensive, hepatoprotective, antispasmodic and broncho-dilating properties.
 
Pashanabheda (Berginia ligulata) has katu tikta rasa, katu vipaka and ushna veerya. It is a controversial herb and many other plants under the name pashanabheda are prescribed and used. Pashanabheda is enlisted in in mootra virechaniya mahakashaya. Due to its diuretic property, it can be used in hypertension, congestive cardiac failure, renal complains etc.
 
Apart from its diuretic properties pashanabheda exhibits good anti-diabetic properties. The 80% ethanolic extract of pashanabheda rhizome was fractionated to investigate for a-glucosidase or anti-diabetic properties. Sample solution were evaluated at dose levels of 5.0, 0.5, 0.05 mg/ml to obtain dose response. The ethyl acetate extract exhibited an inhibitory effect of a-glucosidase properties.  
 
  
Takra (butter milk) is used to relieve santarpanajanya vyadhis. It has prime importance in diet and is supposed to be improve appetite. Its properties and medicinal qualities are described in (Ashtanga Hridaya Sutrasthana chapter 5).  
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'''''Ajaji''''' (Cumin seed (Cuminum cyminum L.)) has ''katu rasa, ushna veerya'' and ''katu vipaka''. In studies conducted on rats with induced diabetes, cumin reduced blood glucose levels<ref> Talpur N, Echard B, Ingram C, Bagchi D, Preuss H. Effects of a novel formulation of essential oils on glucose-insulin metabolism in diabetic and hypertensive rats: a pilot study. Diabetes Obes Metab . 2005;7(2):193-199. </ref>. One mechanism for this reduction suggests the inhibition of aldose reductase and alpha-glucosidase. In addition, reductions in plasma and tissue cholesterol, phospholipids, free fatty acids, and triglycerides (secondary to diabetes) were demonstrated in another animal study<ref> Lee HS. Cuminaldehyde: aldose reductase and alpha-glucosidase inhibitor derived from Cuminum cyminum L. seeds. J Agric Food Chem . 2005;53(7):2446-2450. </ref>.  
  
Trikatu: Trikatu is combination of equal parts of sunthi, maricha and pippali. Trikatu is regarded as an anti obesity formulation and has been widely used in anabolic disorders. It is widely used to lower cholesterol and triglycerides and is known to increase HDL levels.  In one of the studies it is found that Trikatu, by virtue of its ability to reduce triglycerides and LDL cholesterol, increases HDL cholesterol to reduce the risk of hyperlipidaemia and atherosclerosis.  Trikatu is also known to have immune modulatory properties  and is known to be a good bioavailability enhancer.
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'''''Hapusha''''' (Juniperus Communis) has ''katu rasa, ushna veerya'' and ''katu vipaka''. While there are not very many research papers written on the efficacy of Juniper berries and leaves as medicinal herbs, they are said to exhibit potent anti-inflammatory properties and are used to support healthy kidney and urinary tract function, besides promoting healthy blood pressure when taken in normal dosages<ref> http://www.webmd.com/vitamins-supplements/ingredientmono-724-juniper.aspx?activeingredientid=724&activeingredientname=juniper </ref> .  
Vidanga [Embelia ribes]: The properties are rasa katu, kashaya rasa, ushna veerya and katu vipaka. It is one of the important plants used for relieving worm infestation. Vidanga exhibits a potent hypoglycaemic and lipid lowering properties. 
 
Agaru [Aquilaria agallocha]: Agaru is a tropical and sub-tropical, fragrant evergreen tree. The wood is very heavy, and sinks in water. The wood has tikta rasa, ushna veerya and katu vipaka. It exerts potent immunomodulator and anti inflammatory property.
 
Sunthi or ginger [Zinziber officinale]: Ginger has katu rasa, madhura vipaka and ushna veerya. Ginger has been shown to exhibit antioxidant effects. (6)-gingerol appears to be the antioxidant constituent present in ginger, as it was shown to protect HL-60 cells from oxidative stress.  Ginger oil has dominative protective effects on DNA damage induced by H2O2. Ginger oil might act as a scavenger of oxygen radical and might be used as an antioxidant.  In vitro research indicates that gingerols and the related shogaols exhibit cardio depressant properties at low doses and cardiotonic properties at higher doses. Both (6)-shogaol and (6)-gingerol, and the gingerdiones, are reportedly potent enzymatic inhibitors of prostaglandin, thromboxane, and leukotriene biosynthesis.  Spiced foods or herbal drinks, containing ginger, have the potential to produce significant effects on metabolic targets, such as satiety, thermogenesis, and fat oxidation thus, useful as anti-obesity agent. Thermogenic ingredients, such as ginger, may be considered as functional agent that could help restore a "positive energy balance" and prevent obesity. 
 
Shigru (Moringa olifera) has properties of katu, kashaya rasa, ushna veerya and katu vipaka. It is widely used in santarpaniya vyadhis. Charaka has also elaborated shigru to be used in obesity and heart diseases. It exhibits strong hypoglycaemic properties. The aqueous, ethanol and ether extracts of moringa oleifera leaves contain compounds that cause reduction in heart rate and relaxation of cardiac muscle and  have medical use in management of cardiac conditions like hypertension.  
 
 
   
 
   
Katukrohini or kutaki [Picrorrhiza kurroa]: Kutaki has tikta rasa, katu vipaka and sheeta veerya. It possesses a strong hepato protective properties due to phytochemical picroliv and also have a potent antioxidant properties.  It is found to be effective against CCl4 induced hepatic damage in rats, by reversal of increased serum level of SGOT, SGPT, ALP, Cholesterol, Bilirubin and decreases level of total protein which occurs during hepatotoxicity. 
+
'''''Sattu''''' is widely used in ''santarpaniya'' disorders. It is prepared by roasting gram flour but has now evolved to include other nutritious flours like barley, wheat etc. ''Sattu'' is a perfect blend of balanced nutrients and is prepared in one of the healthiest cooking methods – roasting. ''Sattu'' has high fibre and phytic acid content. Method of preparing ''sattu'' is such that it retains the nutrient value and increases the shelf life of the ingredients. Roasting can improve protein digestibility. <ref> Nout, M.J.R., 1993. Processed weaning foods for tropical climates. Int. J. Food Sci. Nutr., 43: 213-221. </ref>The goal of roasting is to improve sensory qualities and achieve inactivation of destructive enzymes which improves the storage and nutritional quality of the product. <ref> Rackis, J.J., W.J. Wolf and E.C. Baker, 1986. Protease Inhibitor in Plant Foods, Content and Inactivation. In: Toxicological Significance of Enzyme Inhibitors in Food, Friedman, M. (Ed.). Advance in Exph. Med. and Biol. Plenum, New York, pp: 299-347. </ref>Research reports reduced trypsin inhibitor properties when seed temperatures reached 90-100°C. Researchers  <ref> Chen, A.O. and J.R. Whitaker, 1986. Purification and characterization of a lipoxygenase from immature English peas. J. Agric. Food Chem., 34: 203-211. </ref>reported lipoxygenase properties was lost at temperatures of 75-80°C. Some also <ref> Shinde, G.B, R.N. Adsule and A.A. Kale, 1991. Effect of dehulling and cooking treatment on phytate phosphorus polyphenols and trypsin inhibitor activity of cowpea seed. Ind. Food Pack, 36: 63-65. </ref>reported that during roasting total phenols and tannins decrease. It has been  observed that the <ref> Malik, M., U. Singh and S. Dahiya, 2002. Nutrient composition of pearl millet as influenced by genotypes and cooking methods. J. Food Sci. Technol., 39: 463-468. </ref>reduction in mineral contents during roasting might be due to the loss of nutrients while heating at high temperature.
  Bruhati [Solanum indicum]: Bruhati has katu tikta rasa, katu vipaka and ushna veerya. Solanum indicum Linn. fruits have laxative and cardiotonic action.
+
 
Ativisha [Aconitum hetrophyllum] has  tikta katu rasa, katu vipaka and ushna veerya.  It is laghu and ruksha and hence is used in santarpaniya vyadhis. Research showed significant reduction in total cholesterol, TG, apolipoprotein B and increase HDL cholesterol & apolipoprotein A in serum samples and HMG CO A properties in liver samples. Properties of LCAT had increased & also there was increased fecal fat excretion. The mechanism explained for hypolipidemic properties was due to inhibition of HMG COA reductase properties and decrease fat absorption from intestine.
+
Elevated plasma cholesterol or elevated LDL-cholesterol concentrations have been shown to be one of the risk factors.<ref> Griffin, John D et al Dietary Cholesterol and Plasma Lipoprotein Profiles: Randomized-Controlled Trials, 2013, 2(4):274-282 </ref>It has been suggested that dietary fibre or more specifically phytate which is a component of fibre can influence the etiology of heart disease<ref> Abdoulaye Coulibaly et al, 2011 Phytic Acid in Cereal Grains: Structure, Healthy or Harmful Ways to Reduce Phytic Acid in Cereal Grains and Their Effects on Nutritional Quality. American Journal of Plant Nutrition and Fertilization Technology, 1: 1-22. Doi: 10.3923/ajpnft.2011.1.22 </ref>. Researchers <ref> Jariwalla, R.J., R. Sabin, S. Lawson and Z.S. Herman, 1990. Lowering of serum cholesterol and triglycerides and modulation of divalent cations by dietary phytate. J. Applied Nutr., 42: 18-28. </ref> showed that dietary phytate supplementation resulted in the lowering of serum cholesterol and triglyceride levels. This effect accompanied the decrease in serum Zn level and Zn-Cu ratio. This is because coronary heart disease appears to be caused by an imbalance of Zn-Cu metabolism.
Sthiram [Shliparni desmodium gangeticum]: It has madhura, tikta rasa, madhur vipaka and ushna veerya. It has alkaloids, pterocarpans, phospholipids, sterols, flavones and flavonoid glycosides. The plant shows many pharmacological activities like anti-inflammatory, anti-nociceptive, analgesic, anti-amnesic, anti-diabetic, anti-oxidant, anti-ulcer, and better CVS activites, CNS depressant, antibacterial, wound healing, antipyretic and several miscellaneous actions.
+
 
Kebukmool [Costus speciosus] : It has tikta kashaya rasa, katu vipaka and sheeta veerya and has strong diuretic action. Increased excretion of Na+ and Cl is observed after its administration. It is known to relieve pulmonary edema 
+
Above are all the important reasons why ''sattu'' is recommended as one of the important food in ''santarpaniya vyadhi''.
Dhanayaka [Coriander sativum]:  Dhanayaka has katu, tikta and madhur rasa with katu vipaka and sheeta veerya. It possesses potent diuretic and antioxidant properties. Part of seeds shows a significant hypolipidemic action. There was significant increase in β-hydroxy, β-methyl glutaryl CoA reductase and plasma lecithin cholesterol acyl transferase properties (LCAT) were noted in the experimental group. The level of low density lipoprotein (LDL), very low density lipoprotein (VLDL) cholesterol decreased while that of high density lipoprotein (HDL) cholesterol increased in the experimental group. Besides diuretic properties it also exhibits a strong anti diabetic and anti convulsant action. 
+
Those individuals who consume these type of formulations can have normalization of [[agni]], [[smriti]] (memory) and [[buddhi]], that is the power of forming and retaining concepts and general notions, intelligence, reason, intellect, discernment, judgment which gets deranged in ''santarpaniya vyadhis'' in latter stages gets normalised.
Chitraka [plumbago zeylanica] has katu rasa, katu vipaka and ushna veerya. It is one of the famous herbal medicine used for agnimandya. It also has antidiabetic and hypocholesterolemic action. Pharmacological studies carried out by researchers have indicated that plumbago zeylanica has antihyperglycemic effect on diabetes induced animals . The ethanol extract of Plumbago zeylanica root on key enzymes of glycolysis and muscle hexokinase, phosphofructokinase, pyruvate kinase, lactate dehydrogenase activities were diminished in diabetic rats. 
 
Hypocholesterolemic Action:  Pharmacological and Clinical studies carried out indicates that Plumbago zeylanica extract has hypolipidaemic and antiatherosclerotic activities.  Plumbagin, an active principle isolated from plumbago zeylanica brings about a definite regression of atherosclerosis and prevents the accumulation of cholesterol and triglycerides in liver and aorta. Panchcole, an Ayurvedic formulation containing plumbago zeylanica as one of its chief ingredients has been advocated to produce hypolipidaemic effect. 
 
Ajaji [Cumin seed (Cuminum cyminum L.) has katu rasa, ushna veerya and katu vipaka. In studies conducted on rats with induced diabetes, cumin reduced blood glucose levels.  One mechanism for this reduction suggests the inhibition of aldose reductase and alpha-glucosidase.  In addition, reductions in plasma and tissue cholesterol, phospholipids, free fatty acids, and triglycerides (secondary to diabetes) were demonstrated in another animal study.
 
Hapusha [Juniperus Communis] has katu rasa, ushna veerya and katu vipaka. While there are not very many research papers written on the efficacy of Juniper berries and leaves as medicinal herbs, they are said to exhibit potent anti-inflammatory properties and are used to support healthy kidney and urinary tract function, besides promoting healthy blood pressure when taken in normal dosages . 
 
Sattu is widely used in santarpaniya disorders. It is prepared by roasting gram flour but has now evolved to include other nutritious flours like barley, wheat etc. Sattu is a perfect blend of balanced nutrients and is prepared in one of the healthiest cooking methods – roasting. Sattu has high fibre and phytic acid content. Method of preparing sattu is such that it retains the nutrient value and increases the shelf life of the ingredients. Roasting can improve protein digestibility. . The goal of roasting is to improve sensory qualities and achieve inactivation of destructive enzymes which improves the storage and nutritional quality of the product. Research reports reduced trypsin inhibitor properties when seed temperatures reached 90-100°C. Researchers  reported lipoxygenase properties was lost at temperatures of 75-80°C. Some also   reported that during roasting total phenols and tannins decrease. It has been  observed that the reduction in mineral contents during roasting might be due to the loss of nutrients while heating at high temperature.
 
Elevated plasma cholesterol or elevated LDL-cholesterol concentrations have been shown to be one of the risk factors. It has been suggested that dietary fibre or more specifically phytate which is a component of fibre can influence the etiology of heart disease . Researchers showed that dietary phytate supplementation resulted in the lowering of serum cholesterol and triglyceride levels. This effect accompanied the decrease in serum Zn level and Zn-Cu ratio. This is because coronary heart disease appears to be caused by an imbalance of Zn-Cu metabolism.
 
Above are all the important reasons why sattu is recommended as one of the important food in santarpaniya vyadhi.
 
Those individuals who consume these type of formulations can have normalization of agni, smriti (memory) and buddhi, that is the power of forming and retaining concepts and general notions, intelligence, reason, intellect, discernment, judgment which gets deranged in santarpaniya vyadhis in latter stages gets normalised.
 
Those individuals who exercise regularly, who do not eat until the previous meals are completely digested, who do not indulge in overeating, who regularly consume barley and wheat in diet get relief from all the diseases due to santarpana and obesity. This is how all the santarpanjanya vyadhis are treated with apatarpana medicines.  
 
  
If we observe the herbs mentioned in the management of santarpaniya vyadhis it is evident from the following table that most of the herbs are tikta, katu, kashaya rasa dominant having katu vipaka and ushna veerya. These properties are attributed to akash and vayu mahabhuta.
+
Those individuals who exercise regularly, who do not eat until the previous meals are completely digested, who do not indulge in overeating, who regularly consume barley and wheat in diet get relief from all the diseases due to ''santarpana'' and obesity. This is how all the ''santarpanjanya vyadhis'' are treated with ''apatarpana'' medicines.  
  
Table 1: Concise information about herbs used in management of santarpaniya diseases 
+
If we observe the herbs mentioned in the management of ''santarpaniya vyadhis'' it is evident from the following table that most of the herbs are ''tikta, katu, kashaya rasa'' dominant having ''katu vipaka'' and ''ushna veerya''. These properties are attributed to [[akasha]] and [[vayu]] [[mahabhuta]].  
Name Latin name Family       Rasa   Veerya Vipaka
+
</div>
Amalaki Emblica
 
Officinalis Euphorbiaceae Pancharasa (lavanavarjit)
 
amlapradhana Madhura Sheeta
 
Bibhitak  Terminalia bellerica Combretaceae Kashaya Madhura Ushna
 
Haritaki  Terminalia chebula        Combretaceae        Pancharasa (lavanavarjit)
 
Kashaya pradhana Madhura Ushna
 
Patha  Cissampelous pareira          Meninspermiaceae Tikta Katu Ushna
 
Saptparna    Alstonia scholaris        Apoyanaceae Tikta-kashaya Katu Ushna
 
Vatsak  Holarrhena
 
Antidysentrica
 
                 
 
Apoyanaceae Tikta-kashaya Katu Sheeta
 
Nagarmotha Cyprus  rotundus   cyperaceae Kashaya,tikta
 
Katu Katu Sheeta
 
Madanfal Randia spinosa Rubiaceae                Kashaya,madhura,tikta,
 
Katu Katu Ushna
 
Nimb    Azardirecta indica   meliaceae Tikta,katu Katu Sheeta
 
Aragvadh  Azardirecta indica leguminaceae                        Madhura Madhura Sheeta
 
Devdaru    Cedrus deodara               pinaceae                  Tikta Katu Ushna
 
Gokhshur Tribulis terreestis Zygophyllaceae Madhura Madhura Sheeta
 
Khadir Acasia  catechu Leguminaceae          Tikta kashaya Katu Sheet
 
Haridra Curcuma longa Zinziberaceae  Tikta katu Katu Ushna
 
Daru-haridra Berberis aristata            Berberidaceae Tikta kashaya Katu Ushna
 
Kushth Saussurea lappa Compositae Tikta  katu madhura Katu Ushna
 
Hingu Ferula narthex              Umbelliferae Katu Katu Ushna
 
Sunthi   zinziber officinale        zinziberaceae              Katu Madhura Ushna
 
Pimpli Piper longum                Piperaceae Katu Madhura Anu-ushna, Sheeta
 
Maricha Piper nigrm                      Piperaceae    Katu Katu Ushna
 
Ajmoda  Carum roxburghianum    Umbelliferae Katu,tikta Katu Ushna
 
Pashanbhed Bergenia ligulata              Saxifragaceae        Kashaya,tikta Katu Sheeta
 
Vacha    Acorus calamus                    Araceae Katu,tikta Katu Ushna
 
Ativisha Aconiatum hetero phylum Ranunculaceae Tikta,katu Katu Ushna
 
Ajawayan  Trachyspermemum  ammi Umbelliferae Katu,tikta Katu Ushna
 
Vidang Emblic ribes                              myrsinaceae Katu,kashaya Katu Ushna
 
Shigru Moringa olifera                Moringaceae            Katu ,tikta Katu Ushna
 
Kutki Picrorhiza kurroa              Scrophulariaceae Tikta Katu Sheeta
 
Shalparni Desmodium-   
 
Gangeticum                      leguminosae  Madhura,tikta Madhura Ushna
 
Kebhukmool Costus speciosus              Zinziberaceae Tikta,kashaya Katu Sheet
 
Dhanyaka Coriandrum sativum        Umbelliferae        Tikta,kashaya,madhura,katu Madhura Ushna
 
Chitraka Plumbago zeylanica            Plubaginanaceae Katu Katu Ushna
 
Hapusha Juniperus communis            Pinaceae                  Katu,tikta Katu Ushna
 
Twak Cinnamomum zelyanicum    Lauraceae            Katu,tikta,madhura Katu Ushna
 
Bruhati Solanum indicum                Solaneaceae Katu,tikta Katu Ushna
 
Agnimantha Premna mucronata Verbenaceae Katu,tikta,kashaya,madhura Katu Ushna
 
Khajura Phoenix  sylvestris Palmae Madhura Madhura Sheet
 
Vrukshamal Garcinia indica              Guttiferae                Amala(unripened)
 
Madhuramala(ripened) Amala Ushna
 
Dadim Punic a  granatum              punicaceae  Madhur,kashaya,amala Madhur/amala Anu-ushna
 
Ajaji       
 
(jeerak) Cuminum cyminum  Umbelliferae          Katu Katu Ushna
 
Ela Elettaria cardmomum          Zinziberceae Katu , madhura Katu Sheeta
 
Musta Cyprus rotendus                    Cyperaceae          Tikta,katu, kashaya Katu Sheeta
 
  
Phanita (molasses) is a semisolid condensed sugarcane preparation, traditionally used to prepare arista, asava and other forms of alcoholic fermentation. Its heavy in nature, sweet in taste, nutritive and non - aphrodisiac and aggravates tridosha. Sattu, ghee, whey, sour fruits like Garcinia combojia, and kanji work as tarpana medicines in urinary ailments and udavarta (abnormal conditions characterized by retention of faeces, urine and flatus, associated with pain and leading to or caused by anti-peristaltic movements in the body).
+
=== Table 1: Concise information about herbs used in management of ''santarpaniya'' diseases ===
 +
{| class="wikitable"
 +
! Name !! Latin name !! Family !! ''Rasa'' !! ''Veerya'' !! ''Vipaka''
 +
|-
 +
| ''Amalaki'' || Emblica Officinalis || Euphorbiaceae || ''Pancharasa (lavanavarjit) amlapradhana'' || ''Madhura'' || ''Sheeta''
 +
|-
 +
| ''Bibhitak'' || Terminalia bellerica || Combretaceae || ''Kashaya'' || ''Madhura'' || ''Ushna''
 +
|-
 +
| ''Haritaki'' || Terminalia chebula|| Combretaceae || ''Pancharasa (lavanavarjit) Kashaya pradhana'' || ''Madhura'' || ''Ushna''
 +
|-
 +
| ''Patha'' || Cissampelous pareira  || Meninspermiaceae || ''Tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Saptparna'' || Alstonia scholaris || Apoyanaceae || ''Tikta-kashaya'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Vatsak'' || Cyprus rotundus || Apoyanaceae || ''Tikta-kashaya'' || ''Katu'' || ''Sheeta''
 +
|-
 +
| ''Nagarmotha'' || Cissampelous  || cyperaceae || ''Kashaya,tikta,Katu'' || ''Katu'' || ''Sheeta''
 +
|-
 +
| ''Madanphala'' || Randia spinosa  || Rubiaceae || ''Kashaya,madhura,tikta,Katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Nimb'' || Azardirecta indica || meliaceae || ''Tikta,katu'' || ''Katu'' || ''Sheeta''
 +
|-
 +
| ''Aragvadh'' || Azardirecta indica  || leguminaceae || ''Madhura'' || ''Madhura'' || ''Sheeta''
 +
|-
 +
| ''Devdaru'' || Cedrus deodara  || pinaceae || ''Tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Gokhshur'' || Tribulis terreestis  || Zygophyllaceae || ''Madhura'' || ''Madhura'' || ''Sheeta''
 +
|-
 +
| ''Khadir'' || Acasia  catechu || Leguminaceae || ''Tikta kashaya'' || ''Katu'' || ''Sheeta''
 +
|-
 +
| ''Haridra'' || Curcuma longa || Zinziberaceae || ''Tikta katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Daru-haridra'' || Berberis aristata || Berberidaceae || ''Tikta kashaya'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Kushth'' || Saussurea lappa  || Compositae || ''Tikta'' || ''Tikta  katu madhura'' || ''Ushna''
 +
|-
 +
| ''Hingu'' || Ferula narthex || Umbelliferae || ''Tikta-kashaya'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Sunthi'' || zinziber officinale ||  zinziberaceae || ''Tikta-kashaya'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Pimpli'' || Piper longum || Piperaceae || ''Katu'' || ''Madhura'' || ''Anu-ushna, Sheeta''
 +
|-
 +
| ''Maricha'' || Piper nigrm || Piperaceae || ''Katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Ajmoda'' || Carum roxburghianum || Umbelliferae || ''Katu,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Pashanbhed'' || Bergenia ligulata || Saxifragaceae || ''Kashaya,tikta'' || ''Katu'' || ''Sheeta''
 +
|-
 +
| ''Vacha'' || Acorus calamus || Araceae || ''Katu,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Ativisha'' || Aconiatum hetero phylum || Ranunculaceae || ''Tikta,katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Ajawayan'' || Trachyspermem um ammi || Umbelliferae || ''Katu,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Vidang'' || Emblic ribes || myrsinaceae || ''Katu,kashaya'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Shigru'' || Moringa olifera || Moringaceae || ''Katu ,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Kutki'' || Picrorhiza kurroa  || Scrophulariaceae || ''Tikta'' || ''Madhura'' || ''Sheeta''
 +
|-
 +
| ''Shalparni'' || Desmodium-Gangeticum ||  leguminosae || ''Madhura,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Kebhukmool'' || Costus speciosus || Zinziberaceae || ''Tikta,kashaya'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Dhanyaka'' || Coriandrum sativum || Umbelliferae || ''Tikta,kashaya,madhura,Katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Chitraka'' || Plumbago zeylanica || Plubaginanaceae || ''Katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Hapusha'' || Juniperus communis || Pinaceae || ''Katu ,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Twak'' || Cinnamomum zelyanicum || Lauraceae || ''Katu ,tikta,madhura'' || ''Madhura'' || ''Sheeta''
 +
|-
 +
| ''Bruhati'' || Solanum indicum || Solaneaceae || ''Katu ,tikta'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Agnimantha'' || Premna mucronata  || Verbenaceae || ''Katu,tikta,kashaya,madhura'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Khajura'' || Phoenix sylvestris || Palmae || ''Madhura'' || ''Madhura'' || ''Sheeta''
 +
|-
 +
| ''Vrukshamal'' || Garcinia indica || Guttiferae || ''Amala(unripened) Madhuramala(ripened)'' || ''Amala'' || ''Ushna''
 +
|-
 +
| ''Dadim'' || Punic a granatum || punicaceae || ''Madhur,kashaya,amala'' || ''Madhur/amala'' || ''Anu-Ushna''
 +
|-
 +
| ''Ajaji (jeerak)'' || Cuminum cyminum || Umbelliferae || ''Katu'' || ''Katu'' || ''Ushna''
 +
|-
 +
| ''Ela'' || Elettaria cardmomum || Zinziberceae || ''Katu , madhura'' || ''Katu'' || ''Sheeta''
 +
|-
 +
| ''Musta'' || Cyprus rotendus || Cyperaceae || ''Tikta,katu, kashaya'' || ''Katu'' || ''Sheeta''
 +
|-
 +
|}
 +
<div style="text-align:justify;">
 +
'''''Phanita''''' (molasses) is a semisolid condensed sugarcane preparation, traditionally used to prepare ''arista, asava'' and other forms of alcoholic fermentation. Its heavy in nature, sweet in taste, nutritive and non - aphrodisiac and aggravates tridosha. ''Sattu'', ghee, whey, sour fruits like Garcinia combojia, and ''kanji'' work as ''tarpana'' medicines in urinary ailments and ''udavarta'' (abnormal conditions characterized by retention of faeces, urine and flatus, associated with pain and leading to or caused by anti-peristaltic movements in the body).
  
Mantha is a formulation made by adding fourteen times of water and blending it thoroughly. Mantha of kharjur (dates), manuka (resins), gracinia, tamarind, pomegranate, falsa (Grewia asiatica) and amalki is useful in alcoholics and alcohol induced disorders. Mantha prepared out of sweet and sour substances if mixed together and added with or without ghee proves to be santarpana and improves strength, lustre and power of body.
+
'''''Mantha''''' is a formulation made by adding fourteen times of water and blending it thoroughly. ''Mantha'' of ''kharjura'' (dates), ''manuka'' (resins), gracinia, tamarind, pomegranate, ''falsa'' (Grewia asiatica) and ''amalaki'' is useful in alcoholics and alcohol induced disorders. ''Mantha'' prepared out of sweet and sour substances if mixed together and added with or without ghee proves to be ''santarpana'' and improves strength, lustre and power of body.
Kharjur (dates, Phoenix dactylifera) has madhura rasa, sheeta veerya and madhur vipaka. It is highly nutritious, and has therapeutic effect in the prevention of diseases through modulation of anti-inflammatory and antioxidant activities, besides other effects. It contains insignificant amounts of fat and has no cholesterol. It is rich in potassium and iron, besides having adequate levels of B-Complex group of vitamins. They contain health benefiting flavonoid polyphenolic antioxidants. , Zea-xanthin is an important dietary carotenoid that selectively gets absorbed in the retinal macula lutea, where it is thought to provide antioxidant and protective light-filtering functions. It thus offers protection against age-related macular degeneration, especially in elderly populations.
+
 
Mrudvika are raisins made of dried grapes. They have madhura rasa, madhura vipaka and sheeta veerya and have potent nutritional properties. The most abundant are polyphenol, phenolic acid, tannin are the flavonols, quercetin, kaempferol, phenolic acids, caftaric and coutaric acid. On a wet weight basis, some polyphenol, phenolic acid, and tannin, such as protocatechuic and oxidized cinnamic acids, are present at a higher level in raisins compared to grapes. In human intervention studies, raisins can lower the postprandial insulin response, modulate sugar absorption (glycemic index), affect certain oxidative biomarkers, and promote satiety via leptin and ghrelin.  
+
'''''Kharjura''''' (dates, Phoenix dactylifera) has ''madhura rasa, sheeta veerya'' and ''madhura vipaka''. It is highly nutritious, and has therapeutic effect in the prevention of diseases through modulation of anti-inflammatory and antioxidant activities, besides other effects. It contains insignificant amounts of fat and has no cholesterol. It is rich in potassium and iron, besides having adequate levels of B-Complex group of vitamins. They contain health benefiting flavonoid polyphenolic antioxidants. Zea-xanthin is an important dietary carotenoid that selectively gets absorbed in the retinal macula lutea, where it is thought to provide antioxidant and protective light-filtering functions. It thus offers protection against age-related macular degeneration, especially in elderly populations.
Dadima (Punica Granatum): It is madhura, kashaya and amla rasa with ushna veerya and madhur vipaka.  Pomegranates have the potential to thin the blood, increase blood flow to the heart, reduce blood pressure, reduce plaque in the arteries, and reduce bad cholesterol while increasing good cholesterol.  Pomegranate seed oil and fermented juice polyphenols tend to inhibit breastcancer cell proliferation, invasion, and promotes apoptosis of breast cancer cells.  
+
 
 +
'''''Mrudvika''''' are raisins made of dried grapes. They have ''madhura rasa, madhura vipaka'' and ''sheeta veerya'' and have potent nutritional properties. The most abundant are polyphenol, phenolic acid, tannin are the flavonols, quercetin, kaempferol, phenolic acids, caftaric and coutaric acid. On a wet weight basis, some polyphenol, phenolic acid, and tannin, such as protocatechuic and oxidized cinnamic acids, are present at a higher level in raisins compared to grapes. In human intervention studies, raisins can lower the postprandial insulin response, modulate sugar absorption (glycemic index), affect certain oxidative biomarkers, and promote satiety via leptin and ghrelin<ref> Williamson G, Carughi A. Polyphenol content and health benefits of raisins. Nutr Res. 2010 Aug;30(8):511-9. doi: 10.1016/j.nutres.2010.07.005. </ref>.
 +
 
 +
'''''Dadima''''' (Punica Granatum): It is ''madhura, kashaya'' and ''amla rasa'' with ''ushna veerya'' and ''madhura vipaka.'' Pomegranates have the potential to thin the blood, increase blood flow to the heart, reduce blood pressure, reduce plaque in the arteries, and reduce bad cholesterol while increasing good cholesterol<ref> Lansky, E.; Shubert, S.; Neeman, I. Pharmacological and therapeutical properties of pomegranate. In Proceedings 1st International Symposium on Pomegranate; Megarejo, P.; Martı´nez, J. J.; </ref>.  Pomegranate seed oil and fermented juice polyphenols tend to inhibit breastcancer cell proliferation, invasion, and promotes apoptosis of breast cancer cells<ref>  N.D., R. Mehta, W. Yu, I. Neeman, T. Livney, A. Amichay, D.Poirier, P. Nicholls, A. Kirby, W. Jiang, R. Mansel, C.Ramachandran, T. Rabi, B. Kaplan, and E. Lansky:Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer.Breast Cancer Research and Treatment 2002; 71(3): 203-17 </ref>.  
 
   
 
   
Falasa (Grewia asiatica): has kashaya, amla, madhura rasa and laghu, veerya sheeta guna and madhura vipaka.  It is useful in madatya, pittaprakopa, trishna, daha, hridroga, amavata, vatarakta, shoola, kshaya, rohini, yoniroga, vrana, jwara. It shows a potent antioxidant properties and shows radio protective properties.  
+
'''''Falasa''''' (Grewia asiatica): has ''kashaya, amla, madhura rasa'' and ''laghu, veerya sheeta guna'' and ''madhura vipaka''.  It is useful in ''madatya, pittaprakopa, trishna, daha, hridroga, amavata, vatarakta, shoola, kshaya, rohini, yoniroga, vrana, jwara''. It shows a potent antioxidant properties and shows radio protective properties<ref> Sharma KV, Sisodia R. Evaluation of free radical scavenging activity and radioprotective efficacy of Grewia asiatica fruit. J Radio Prot 2009; 29: 429–443. </ref>.  
If we observe the food substances, fruits and other edibles which are advised for the management of apatarpan have high glycemic index. Dates, raisins, and certain fruits mentioned are fast energy giving substances while formulation with sattu are slow energy giving substances.  
+
 
It is very interesting to note that honey and sattu are used both in apatarpan and santarpaniya vyadhis. In santarpanajanya vyadhis, Sattu is used along with certain herbs, which are tikta and katu ras dominant. Apart from herbs oil, ghee and honey in prescribed portion is used. While in apatarpana diseases sattu has been used along with sugar, alcoholic beverages, honey, oil and ghee. This is the importance of samyog (combination) of dravyas mentioned by Charaka elsewhere. Sattu when advised with alcoholic beverages or with certain sour substance exerts different nutritional properties. When sattu is given with acidic and fermented substances like alcohol, an enzymetic degradation of phytic acid of sattu is observed. Such a reduction in phytate may increase the amount of soluble iron, zinc and calcium several folds. This makes the combination of sattu more nutritious as compared to the formulation mentioned in the management of santarpanajanya diseases.       
+
If we observe the food substances, fruits and other edibles which are advised for the management of ''apatarpana'' have high glycemic index. Dates, raisins, and certain fruits mentioned are fast energy giving substances while formulation with sattu are slow energy giving substances.  
Over-nutrition and disorders induced by it leads to immune activation or susceptibility to inflammatory diseases, such as diabetes while under nutrition results in immune suppression or susceptibility to infection. Over-nutrition (prolonged intake of high fat/sugar diets) and infection lead to chronic and acute inflammation through nutrient and pathogen sensing systems, respectively  
+
 
List of research works done as post graduate and post doctoral level on hyperlipidemia About 42 research works are found on the subject of hyperlipidaemia with various aspects like aetiopathogenesis and management. Some important work on hyperlipidaemia and hypercholesterolaemia are as follows:
+
It is very interesting to note that honey and sattu are used both in ''apatarpana'' and ''santarpaniya vyadhis''. In ''santarpanajanya vyadhis, sattu'' is used along with certain herbs, which are ''tikta'' and ''katu rasa'' dominant. Apart from herbs oil, ghee and honey in prescribed portion is used. While in ''apatarpana'' diseases ''sattu'' has been used along with sugar, alcoholic beverages, honey, oil and ghee. This is the importance of ''samayoga'' (combination) of ''dravyas'' mentioned by Charak elsewhere. ''Sattu'' when advised with alcoholic beverages or with certain sour substance exerts different nutritional properties.  
Faculty of Ayurveda, IMS, Banaras Hindu University,Varanasi:-
+
 
1. Satyavati G.V. (1966): Effect of an indigenous drug on lipid metabolism w.s.r to obesity and atherosclerosis.
+
When ''sattu'' is given with acidic and fermented substances like alcohol, an enzymetic degradation of phytic acid of ''sattu'' is observed. Such a reduction in phytate may increase the amount of soluble iron, zinc and calcium several folds. This makes the combination of sattu more nutritious as compared to the formulation mentioned in the management of santarpanajanya diseases.       
2. Shastri V. V. (1967): Effect of certain indigenous drugs on intraarterial thrombosis associated with hyperlipidaemia.
+
Over-nutrition and disorders induced by it leads to immune activation or susceptibility to inflammatory diseases, such as diabetes while under nutrition results in immune suppression or susceptibility to infection. Over-nutrition (prolonged intake of high fat/sugar diets) and infection lead to chronic and acute inflammation through nutrient and pathogen sensing systems, respectively<ref> Wellen KE, Hotamisligil GS: Inflammation, stress, and diabetes. J Clin Invest 2005, 115:1111-1119. </ref>
3. Tripathi S N (1973): Studies on the use of Oleoresin Guggulu an indigenous drug in the disorders of lipids.
+
 
4. Agarwal D.V. (1973): Clinical and experimental studies on Ayurvedic hypocholesterolaemic drugs.
+
=== List of research works done as post graduate and post doctoral level on obeisty, dyslipidemia, hyperlipidemia ===
5. Upadhayaya B.N. (1975): Clinical and experimental study on hypocholesterolaemic and  hypolipidaemic action of Gum Guggulu.
+
 
6. Sharma Sudhakar (1975): Studies on effect of Terminalia tomentosa on hyperglycaemia and hypercholesterolaemia.
+
About 42 research works are found on the subject of hyperlipidaemia with various aspects like aetiopathogenesis and management. Some important work on hyperlipidaemia and hypercholesterolaemia are as follows:
7. Gupta (Smt.) Mithilesh (1977): Effect of C. mukul and endocrinal and biochemical changes in hyperlipidaemia.  
+
 
8. Gupta O.P. (1981): An assessment of intermittent use of C. mukul (Guggulu) in the treatment of hypercholesterolaemia and hyperlipidaemia in IHD.
+
Faculty of [[Ayurveda]], IMS, Banaras Hindu University,Varanasi:
9. Ranasingha S G (1990): A critical study on the concept of lipid group of drugs (Charka) in the management of lipidaemia and ischaemic heart disease.
+
 
10.Mamgain Pratibha (1991) :Study of lipid profile in individuals of IHD and evaluation of hypolipidaemic action of Lekhaneeya drugs Vacha and Ativisha.  
+
#Satyavati G.V. (1966): Effect of an indigenous drug on lipid metabolism w.s.r to obesity and atherosclerosis.
 +
#Shastri V. V. (1967): Effect of certain indigenous drugs on intraarterial thrombosis associated with hyperlipidaemia.
 +
#Tripathi S N (1973): Studies on the use of Oleoresin Guggulu an indigenous drug in the disorders of lipids.
 +
#Agarwal D.V. (1973): Clinical and experimental studies on Ayurvedic hypocholesterolaemic drugs.
 +
#Upadhayaya B.N. (1975): Clinical and experimental study on hypocholesterolaemic and  hypolipidaemic action of Gum Guggulu.
 +
#Sharma Sudhakar (1975): Studies on effect of Terminalia tomentosa on hyperglycaemia and hypercholesterolaemia.
 +
#Gupta (Smt.) Mithilesh (1977): Effect of C. mukul and endocrinal and biochemical changes in hyperlipidaemia.  
 +
#Gupta O.P. (1981): An assessment of intermittent use of C. mukul (Guggulu) in the treatment of hypercholesterolaemia and hyperlipidaemia in IHD.
 +
#Ranasingha S G (1990): A critical study on the concept of lipid group of drugs (Charka) in the management of lipidaemia and ischaemic heart disease.
 +
#Mamgain Pratibha (1991) :Study of lipid profile in individuals of IHD and evaluation of hypolipidaemic action of Lekhaneeya drugs Vacha and Ativisha.  
 +
 
 
State Ayurvedic College, Lucknow:
 
State Ayurvedic College, Lucknow:
1. Mishra Ramanand (1975): The effect of Arogyavardhini in relation to obesity and blood cholesterol.
+
 
2. Shali Bala (1978): Role of Arogyavardhini on blood lipids and Medoroga with Anupan of Sharangdhar Mahamanjishthadi Kwath.
+
#Mishra Ramanand (1975): The effect of Arogyavardhini in relation to obesity and blood cholesterol.
3. Nigam R. P. (1982): Clinical trial of Arogya-vardhini-herbal in cases of raised Raktagata Sneha (Hyperlipidaemia).
+
#Shali Bala (1978): Role of Arogyavardhini on blood lipids and Medoroga with Anupan of Sharangdhar Mahamanjishthadi Kwath.
National Institute of Ayurveda, Jaipur:
+
#Nigam R. P. (1982): Clinical trial of Arogya-vardhini-herbal in cases of raised Raktagata Sneha (Hyperlipidaemia).
1. Sood Rajiv (1999) : Clinical evaluation of Bala-Hareetaki on serum cholesterol.
+
 
2. Bhaskar Rao (2002) : Aetiopathologial study of hyperlipidaemia w.s.r. to Sthaulya : a clinical study.
+
National Institute of [[Ayurveda]], Jaipur:
3. Gupta Keshav Prasad (2005) : Aetiopathological studies of hyperlipidaemia (Medodushti) w.s.r to Diabetes mellitus and therapeutic trial of Ayurvedic formulation (Lipidocare).
+
 
Gopabandhu Ayurveda Mahavidyalaya, Puri:
+
#Sood Rajiv (1999) : Clinical evaluation of Bala-Hareetaki on serum cholesterol.
1. Tripathy U.C. (1985): Concept of Medoroga vis-à-vis Hyperlipidaemia and its management with Navaka Guggulu.
+
#Bhaskar Rao (2002) : Aetiopathologial study of hyperlipidaemia w.s.r. to Sthaulya : a clinical study.
2. Pande S (2002) : Biological effect of Lekhana Basti w.s.r. to lipid profile.  
+
#Gupta Keshav Prasad (2005) : Aetiopathological studies of hyperlipidaemia (Medodushti) w.s.r to Diabetes mellitus and therapeutic trial of Ayurvedic formulation (Lipidocare).
Smt. K G M Punarvasu Ayurveda College,Mumbai:
+
 
1. Majumadar Dattatraya B. (1990): Rasagata-Sneha (cholesterol) Ka Naidanika Chikitsatmaka Adhyayana.
+
Gopabandhu [[Ayurveda]] Mahavidyalaya, Puri :
2. Kadam Sandhya (1997): Hyperlipidaemia (Rasa-Raktagata Sneha Vriddhi) mein Amritadi Yoga Ka Prayoga Chikitsatmaka Adhyayana.
+
 
3. Ratnakaran Anuradha R. (1997): Clinical evaluation of the role of Navaka Guggulu on the Rasa-Raktagata-Sneha-Vriddhi.
+
#Tripathy U.C. (1985): Concept of Medoroga vis-à-vis Hyperlipidaemia and its management with Navaka Guggulu.
4. More Manojkumar B. (1998): Methika-Beeja Ka hyperchole-sterolaemia (Rasa-Raktagata Sneha Vriddhi) mein Prayoga.
+
#Pande S (2002) : Biological effect of Lekhana Basti w.s.r. to lipid profile.  
5. Virkar Dattu (1998): Mustadi Mahakashaya (Lekhaneeya Gana) Ka hyperlipidaemia (Rasagata-Sneha-Vriddhi) mein prayoga aur Chikitsatmaka Adhyayana.
+
 
6. Jagtap Reshma (1999): Hyperlipidaemia (Rasagata-Sneha-Vriddhi) evam Hypertension (Uchha-Rakta-Chapa) mein Krishnadi Choorna ka Prayoga aur Chikitsatmaka Adhyayana.  
+
Smt. K G M Punarvasu [[Ayurveda]] College,Mumbai:
7. Jankar Nilambari (2002): Hyperlipidaemia (Rasa-Raktagata-Sneha) mein Lekhaneeya Mahakashaya (Gana) Kala Basti Ek Chikitsatmaka Adhyayana.
+
 
8. Paradkar Hemant S (2004): Rasa-Raktagata-Sneha-Vriddhi mein Trishila Guggulu (Triphala, Shilajit, Guggulu) yoga ka Chikitsatmaka Adhyayana.  
+
#Majumadar Dattatraya B. (1990): Rasagata-Sneha (cholesterol) Ka Naidanika Chikitsatmaka Adhyayana.
Government Ayurvedic College, Trivendrum:
+
#Kadam Sandhya (1997): Hyperlipidaemia (Rasa-Raktagata Sneha Vriddhi) mein Amritadi Yoga Ka Prayoga Chikitsatmaka Adhyayana.
1. Ravindran C.A. (1986): A clinical evaluation of hyperchole-sterolaemia w.s.r. to Kalasaka.
+
#Ratnakaran Anuradha R. (1997): Clinical evaluation of the role of Navaka Guggulu on the Rasa-Raktagata-Sneha-Vriddhi.
2. Suresh Babu M.R. (1994): A clinical study to assess the efficacy of Lekhaneeya Gana in hypercholesterolaemia.
+
#More Manojkumar B. (1998): Methika-Beeja Ka hyperchole-sterolaemia (Rasa-Raktagata Sneha Vriddhi) mein Prayoga.
3. Ansari P.Y. (1994): An experimental study on effect of Musta (Cyperus rotundus) in hypercholesterolaemia.
+
#Virkar Dattu (1998): Mustadi Mahakashaya (Lekhaneeya Gana) Ka hyperlipidaemia (Rasagata-Sneha-Vriddhi) mein prayoga aur Chikitsatmaka Adhyayana.
4. Johny Joseph (1995) : A study to assess the hypolipidaemic properties of Dolichos biphlorus (Kulatha).
+
#Jagtap Reshma (1999): Hyperlipidaemia (Rasagata-Sneha-Vriddhi) evam Hypertension (Uchha-Rakta-Chapa) mein Krishnadi Choorna ka Prayoga aur Chikitsatmaka Adhyayana.  
5. Sreelatha P.K.(1996):Management of hypercholesterolaemia with an Ayurvedic compound.
+
#Jankar Nilambari (2002): Hyperlipidaemia (Rasa-Raktagata-Sneha) mein Lekhaneeya Mahakashaya (Gana) Kala Basti Ek Chikitsatmaka Adhyayana.
6. Suresh A.V. (1999): A study on Snehapana in hyperchole-sterolaemia conditions during treatment.
+
#Paradkar Hemant S (2004): Rasa-Raktagata-Sneha-Vriddhi mein Trishila Guggulu (Triphala, Shilajit, Guggulu) yoga ka Chikitsatmaka Adhyayana.
7. Razeena K. (2003): Pharmaceutical preparation and standardization of compound herbomineral preparation and its efficacy in hypercholesterolaemia.
+
8. Seemaja G. (2003): A clinical study to assess the efficacy of Ayurvedic compound in the management of hyperlipidaemia,
+
Government Ayurvedic College, Trivandrum :
9. Pankajam P. K. (2003) : A study on the effect of selected modalities of Yoga and naturopathy in the control of hyperlipidaemia.
+
 
Tilak Ayurveda Mahavidyalaya, Pune:
+
#Ravindran C.A. (1986): A clinical evaluation of hyperchole-sterolaemia w.s.r. to Kalasaka.
1. Kad Vilas S (1997): Study of lipids/Prasadakaya Dhatu with reference toAyurvedic Swastha and Atura Pareekshana.  
+
#Suresh Babu M.R. (1994): A clinical study to assess the efficacy of Lekhaneeya Gana in hypercholesterolaemia.
 +
#Ansari P.Y. (1994): An experimental study on effect of Musta (Cyperus rotundus) in hypercholesterolaemia.
 +
#Johny Joseph (1995) : A study to assess the hypolipidaemic properties of Dolichos biphlorus (Kulatha).
 +
#Sreelatha P.K.(1996):Management of hypercholesterolaemia with an Ayurvedic compound.
 +
#Suresh A.V. (1999): A study on Snehapana in hyperchole-sterolaemia conditions during treatment.
 +
#Razeena K. (2003): Pharmaceutical preparation and standardization of compound herbomineral preparation and its efficacy in hypercholesterolaemia.
 +
#Seemaja G. (2003): A clinical study to assess the efficacy of Ayurvedic compound in the management of hyperlipidaemia,
 +
#Pankajam P. K. (2003) : A study on the effect of selected modalities of Yoga and naturopathy in the control of hyperlipidaemia.
 +
 
 +
Tilak [[Ayurveda]] Mahavidyalaya, Pune:
 +
 
 +
#Kad Vilas S (1997): Study of lipids/Prasadakaya Dhatu with reference toAyurvedic Swastha and Atura Pareekshana.  
 +
 
 
University of Pune:
 
University of Pune:
2. Arora N. K. (2001): Effect of Hareetaki (Terminalia chebula ratha.) in hypercholesterolaemia.
+
 
B V College of Ayurveda, Pune:
+
#Arora N. K. (2001): Effect of Hareetaki (Terminalia chebula ratha.) in hypercholesterolaemia.
1. Sankapal Milind Kumar (2005): Upashayatmak study of Ushnodaka on blood cholesterol and Sthaulaya lakshana.
+
 
Rajiv Gandhi Govt. PG Institute of Ayurveda, Paprola:
+
B V College of [[Ayurveda]], Pune:
1. Gupta Madhu (2000): Effect of Ayurvedic formulation on Medoroga w.s.r. to Hyperlipidaemia.
+
 
Institute of Postgraduate Education and Research in Ayurveda,
+
#Sankapal Milind Kumar (2005): Upashayatmak study of Ushnodaka on blood cholesterol and Sthaulaya lakshana.
Kolkata:
+
 
1. Mishra D K (1991) : Role of Commiphora mukul and P. compound in Medoroga w.s.r. to obesity and cholesterol.
+
Rajiv Gandhi Govt. PG Institute of [[Ayurveda]], Paprola:
 +
 
 +
#Gupta Madhu (2000): Effect of Ayurvedic formulation on Medoroga w.s.r. to Hyperlipidaemia.
 +
 
 +
Institute of Postgraduate Education and Research in [[Ayurveda]],Kolkata:
 +
 
 +
#Mishra D K (1991) : Role of Commiphora mukul and P. compound in Medoroga w.s.r. to obesity and cholesterol.
 
Govt. Ayurvedic Medical College, Mysore:
 
Govt. Ayurvedic Medical College, Mysore:
1. Suchitra S.S. (2002) : A study on Rookshna Chikitsa w.s.r. to the effect of Shuddha Guggulu and Shuddha Shilajatu on Sthaulya (hypercholesterolaemia) A comparative study.
+
#Suchitra S.S. (2002) : A study on Rookshna Chikitsa w.s.r. to the effect of Shuddha Guggulu and Shuddha Shilajatu on Sthaulya (hypercholesterolaemia) A comparative study.
SDGM Ayurveda Medical College, Gadag:
+
 
1. Mudigoudar Yoshadha S (2000) : The efficacy of Pippalyadi Guggulu in Medoroga (w.s.r. to its hypolipidaemic effect).
+
SDGM [[Ayurveda]] Medical College, Gadag:
 +
 
 +
#Mudigoudar Yoshadha S (2000) : The efficacy of Pippalyadi Guggulu in Medoroga (w.s.r. to its hypolipidaemic effect).
 +
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Latest revision as of 07:44, 22 February 2024

Cite.png

Sutra Sthana Chapter 23. Over-nutrition, under-nutrition and its disorders

Santarpaniya Adhyaya
Section/Chapter Sutra Sthana Chapter 23
Tetrad/Sub-section Yojana Chatushka
Preceding Chapter Langhanabrimhaniya Adhyaya
Succeeding Chapter Vidhishonitiya Adhyaya
Other Sections Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana
Translator and commentator Sabnis M., Deole Y. S.
Reviewer Byadgi P.S.
Editors Dwivedi R.B., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s01.025

Abstract

Diseases are caused due to over nutrition and under nutrition. This chapter enlists the causative factors affecting nutritional status leading to two categories of diseases viz. Santarpana (over-nutrition) and apatarpana (under nutrition). The dietary and lifestyle management of these two disease categories is also elaborated. Nutraceutical preparations, weight reducing recipes, therapeutic procedures like panchakarma and other associated procedures are described with medicaments. The chapter also contains a comprehensive list of commonly available herbs used in treatment of these diseases.
Keywords: santarpana (over-nutrition), apatarpana (under-nutrition), management of over-nutrition induced disorders, nutrition deficiency disorders.


Introduction

In the series of chapters described for management principles, the present chapter describes two most commonly observed conditions in society viz. santarpana(over-nutrition) and apatarpana(undernutrition). It is sequenced after langhana and brimhana therapies. The present chapter enlists causes and diseases due to over-nutrition and under-nutrition and their management through diet and medicaments. It is a blend of nutraceutical food supplements with medicaments. Complications arising due to sedentary lifestyle and over-nutritive diet are also enlisted in the chapter with diseases caused due to undernutrition/ malnourishment and their management with simple dietary preparations. The pharmacological effect of herbs used in management are elaborated in detail as well.

Santarpana(overnutrition) leads to vitiation of kapha dosha and meda dhatu and various obstructive pathologies, whereas apatarpana(undernutrition) leads to vata-pitta dosha vitiation and various degenerative pathologies. This concept has been emphasized in this chapter.

Sanskrit text, Transliteration and English Translation

अथातः सन्तर्पणीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ santarpaṇīyamadhyāyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH santarpaNIyamadhyAyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Santarpaniya" (Over-nutrition, under-nutrition and its disorders). Thus said Lord Atreya. [1-2]

Causes of santarpana induced diseases

सन्तर्पयति यः स्निग्धैर्मधुरैर्गुरुपिच्छिलैः|

नवान्नैर्नवमद्यैश्च मांसैश्चानूपवारिजैः||३||

गोरसैर्गौडिकैश्चान्नैः पैष्टिकैश्चातिमात्रशः|

चेष्टाद्वेषी दिवास्वप्नशय्यासनसुखे रतः||४||

रोगास्तस्योपजायन्ते सन्तर्पणनिमित्तजाः|५|

santarpayati yaḥ snigdhairmadhurairgurupicchilaiḥ|

navānnairnavamadyaiśca māṁsaiścānūpavārijaiḥ||3||

gōrasairgauḍikaiścānnaiḥ paiṣṭikaiścātimātraśaḥ|

cēṣṭādvēṣī divāsvapnaśayyāsanasukhē rataḥ||4||

rōgāstasyōpajāyantē santarpaṇanimittajāḥ|5|

santarpayati yaH snigdhairmadhurairgurupicchilaiH|

navAnnairnavamadyaishca mAMsaishcAnUpavArijaiH||3||

gorasairgauDikaishcAnnaiH paiShTikaishcAtimAtrashaH|

ceShTAdveShI divAsvapnashayyAsanasukhe rataH||4||

rogAstasyopajAyante santarpaNanimittajAH|5|

Excessive consumption of unctuous, sweet, heavy to digest and slimy food, new grains (especially new rice), new wine, flesh of animals living in marshy area or born in water, cow’s milk and its products, and those prepared with sugar or molasses, varieties of cakes lead to santarpana. Those who indulge in sedentary, inactive lifestyles and sleep during the day are prone to santarpaniya vyadhis (i.e. santarpana induced diseases). [3-4]

List of santarpana induced diseases

प्रमेहपिडकाकोठकण्डूपाण्ड्वामयज्वराः||५||

कुष्ठान्यामप्रदोषाश्च मूत्रकृच्छ्रमरोचकः|

तन्द्रा क्लैब्यमतिस्थौल्यमालस्यं गुरुगात्रता||६||

इन्द्रियस्रोतसां लेपो बुद्धेर्मोहः प्रमीलकः|

शोफाश्चैवंविधाश्चान्ये शीघ्रमप्रतिकुर्वतः||७||

pramēhapiḍakākōṭhakaṇḍūpāṇḍvāmayajvarāḥ||5||

kuṣṭhānyāmapradōṣāśca mūtrakr̥cchramarōcakaḥ|

tandrā klaibyamatisthaulyamālasyaṁ gurugātratā||6||

indriyasrōtasāṁ lēpō buddhērmōhaḥ pramīlakaḥ|

śōphāścaivaṁvidhāścānyē śīghramapratikurvataḥ||7||

pramehapiDakAkoThakaNDUpANDvAmayajvarAH||5||

kuShThAnyAmapradoShAshca mUtrakRucchramarocakaH|

tandrA klaibyamatisthaulyamAlasyaM gurugAtratA||6||

indriyasrotasAM lepo buddhermohaH pramIlakaH|

shophAshcaivaMvidhAshcAnye shIghramapratikurvataH||7||

Due to above mentioned causative factors, if the effects of santarpana are not treated properly, one suffers from various diseases such as obstinate urinary disorders including diabetes, carbuncles, urticaria, itching, pandu (anaemia), amaja diseases (i.e., due to formation of ama), jwara,obstinate skin diseases, diseases secondary to vitiation of ama, dysuria, anorexia or appetite related complaints, tandra (drowsiness/sleepiness), klaibya (erectile and sexual dysfunctions), obesity, laziness, heaviness of the body, adhesion or blockages in the channels as well as sense organs, delusion, various types of edema, and such of other diseases. [5-7]

Management of santarpana-induced diseases

शस्तमुल्लेखनं तत्र विरेको रक्तमोक्षणम्|

व्यायामश्चोपवासश्च धूमाश्च स्वेदनानि च||८||

śastamullēkhanaṁ tatra virēkō raktamōkṣaṇam|

vyāyāmaścōpavāsaśca dhūmāśca svēdanāni ca||8||

shastamullekhanaM tatra vireko raktamokShaNam|

vyAyAmashcopavAsashca dhUmAshca svedanAni ca||8||

Santarpaniya vyadhis and their complications should be managed by ullekhana(therapeutic emesis), virechana (therapeutic purgation), raktamokshana(blood-letting), specific exercises, therapeutic fasting, dhooma (hot fomentation with smoke of medicinal plants), and swedana(sudation). [8]

सक्षौद्रश्चाभयाप्राशः प्रायो रूक्षान्नसेवनम्|

चूर्णप्रदेहा ये चोक्ताः कण्डूकोठविनाशनाः||९||

sakṣaudraścābhayāprāśaḥ prāyō rūkṣānnasēvanam|

cūrṇapradēhā yē cōktāḥ kaṇḍūkōṭhavināśanāḥ||9||

sakShaudrashcAbhayAprAshaH prAyo rUkShAnnasevanam|

cUrNapradehA ye coktAH kaNDUkoThavinAshanAH||9||

Formulations made up of haritaki(Terminalia Chebula), such as agastyaharitaki mixed with honey, habituating with ruksha food (i.e., without using unctuous substances like oil, ghee etc.), those powders and poultice described in treatment of pruritus and urticaria (mentioned in the third chapter of this section) are advised. [9]

त्रिफलारग्वधं पाठां सप्तपर्णं सवत्सकम्|

मुस्तं समदनं निम्बं जलेनोत्क्वथितं पिबेत्||१०||

तेन मेहादयो यान्ति नाशमभ्यस्यतो ध्रुवम्|

मात्राकालप्रयुक्तेन सन्तर्पणसमुत्थिताः||११||

triphalāragvadhaṁ pāṭhāṁ saptaparṇaṁ savatsakam|

mustaṁ samadanaṁ nimbaṁ jalēnōtkvathitaṁ pibēt||10||

tēna mēhādayō yānti nāśamabhyasyatō dhruvam|

mātrākālaprayuktēna santarpaṇasamutthitāḥ||11||

triphalAragvadhaM pAThAM saptaparNaM savatsakam|

mustaM samadanaM nimbaM jalenotkvathitaM pibet||10||

tena mehAdayo yAnti nAshamabhyasyato dhruvam|

mAtrAkAlaprayuktena santarpaNasamutthitAH||11||

The decoction of triphala (amalaki (Emblica officinalis), bibhitaki (Terminalia bellirica), and haritaki (Terminalia chebula)), aragvadha (Cassia fistula), patha (Cissampelos pareira), saptaparna (Alstonia scholaris), vatsaka (Holarrhena antidysenterica), musta (Cyperus rotundus), madana (Randia dumetorum) and nimba (Azadirachta indica), mixed together and boiled in water, is advised for consumption regularly. By regular use of this decoction, in the right dose and at the right time, santarpaniya vyadhi like madhumeha and other diseases can be controlled properly. [10-11]

मुस्तमारग्वधः पाठा त्रिफला देवदारु च|

श्वदंष्ट्रा खदिरो निम्बो हरिद्रे त्वक्च वत्सकात्||१२||

रसमेषां यथादोषं प्रातः प्रातः पिबन्नरः|

सन्तर्पणकृतैः सर्वैर्व्याधिभिः सम्प्रमुच्यते||१३||

एभिश्चोद्वर्तनोद्धर्षस्नानयोगोपयोजितैः|

त्वग्दोषाः प्रशमं यान्ति तथा स्नेहोपसंहितैः||१४||

mustamāragvadhaḥ pāṭhā triphalā dēvadāru ca|

śvadaṁṣṭrā khadirō nimbō haridrē tvakca vatsakāt||12||

rasamēṣāṁ yathādōṣaṁ prātaḥ prātaḥ pibannaraḥ|

santarpaṇakr̥taiḥ sarvairvyādhibhiḥ sampramucyatē||13||

ēbhiścōdvartanōddharṣasnānayōgōpayōjitaiḥ|

tvagdōṣāḥ praśamaṁ yānti tathā snēhōpasaṁhitaiḥ||14||

mustamAragvadhaH pAThA triphalA devadAru ca|

shvadaMShTrA khadiro nimbo haridre tvakca vatsakAt||12||

rasameShAM yathAdoShaM prAtaH prAtaH pibannaraH|

santarpaNakRutaiH sarvairvyAdhibhiH sampramucyate||13||

ebhishcodvartanoddharShasnAnayogopayojitaiH|

tvagdoShAH prashamaM yAnti tathA snehopasaMhitaiH||14||

All santarpaniya diseases can be cured, if the juices (decoction) of musta, aaragvadha, paatha, triphala, devadaru (Cedrus deodara), shvadamshtra (Trinbulus terrestris), khadira (Acacia catechu Wild), nimba, haridra (Curcuma longa), daruharidra (Berberis aristata) and the bark of vatsaka (Holarrhena anti-dysenterica) are consumed every morning (depending upon the dominant dosha in the disease).

If the above herbs are used in a powdered form for udvartana with or without massage or the decoction of the above herbs are used for medicinal bath or if the oil made up of above drugs is used for body application it relieves all the skin disorders caused due to santarpaniya vyadhis.[12-14]

कुष्ठं गोमेदको हिङ्गु क्रौञ्चास्थि त्र्यूषणं वचा|

वृषकैले श्वदंष्ट्रा च खराह्वा चाश्मभेदकः||१५||

तक्रेण दधिमण्डेन बदराम्लरसेन वा|

मूत्रकृच्छ्रं प्रमेहं च पीतमेतद्व्यपोहति||१६||

kuṣṭhaṁ gōmēdakō hiṅgu krauñcāsthi tryūṣaṇaṁ vacā|

vr̥ṣakailē śvadaṁṣṭrā ca kharāhvā cāśmabhēdakaḥ||15||

takrēṇa dadhimaṇḍēna badarāmlarasēna vā|

mūtrakr̥cchraṁ pramēhaṁ ca pītamētadvyapōhati||16||

kuShThaM gomedako hi~ggu krau~jcAsthi tryUShaNaM vacA|

vRuShakaile shvadaMShTrA ca kharAhvA cAshmabhedakaH||15||

takreNa dadhimaNDena badarAmlarasena vA|

mUtrakRucchraM pramehaM ca pItametadvyapohati||16||

Kustha (Saussurea lappa), gomedaka (onyx), hingu (Ferula narthex), bones of the krauncha bird (Ardea Jaculator, demoiselle crane), sunthi (Zingiber officinalis), pippali (Piper longum), maricha (Piper nigrum), vacha (Acorus calamus), vasa (Adhatoda vasica Nees), ela (Elettaria cardamoum), gokshura (Tribulus terrestris), kharahva (Trachyspermum roxburghianum), and ashmabheda (Bergenia ligulata – crushed and mixed with buttermilk, whey and the juice of a sour variant of badara (Zizyphus jujuba) are used to treat mutrakruchchra (dysuria) and prameha (obstinate urinary disorders including diabetes mellitus characterized by excess frequency of micturition). [15-16]

तक्राभयाप्रयोगैश्च त्रिफलायास्तथैव च|

अरिष्टानां प्रयोगैश्च यान्ति मेहादयः शमम्||१७||

takrābhayāprayōgaiśca triphalāyāstathaiva ca|

ariṣṭānāṁ prayōgaiśca yānti mēhādayaḥ śamam||17||

takrAbhayAprayogaishca triphalAyAstathaiva ca|

ariShTAnAM prayogaishca yAnti mehAdayaH shamam||17||

Haritaki (Terminalia chebula) with butter milk, triphala (Terminalia chebula, Terminalia belerica Roxb. And Emblica officinalis Gaertn.) and arishta (different types of medicinal alcoholic preparations) are prescribed for the treatment of obstinate urinary disorders including diabetes mellitus and such other diseases. [17]

त्र्यूषणं त्रिफला क्षौद्रं क्रिमिघ्नमजमोदकः|

मन्थोऽयं सक्तवस्तैलं हितो लोहोदकाप्लुतः||१८||

tryūṣaṇaṁ triphalā kṣaudraṁ krimighnamajamōdakaḥ|

manthō'yaṁ saktavastailaṁ hitō lōhōdakāplutaḥ||18||

tryUShaNaM triphalA kShaudraM krimighnamajamodakaH|

mantho~ayaM saktavastailaM hito lohodakAplutaH||18||

Mantha (thin gruel) prepared of trikatu (Zingiber officinale, Piper longum, and Piper nigrum), triphala (Terminalia chebula, Terminalia belerica Roxb., and Emblica officinalis Gaertn.), honey, vidanga (Embelia ribes Burm f.), ajamoda (Trachy-spermum roxburghianum), roasted wheat flour or coarse ground meal, oil and the decoction of agaru (Aquilari agallocha Roxb.) help to cure the diseases due to over-nourishment. [18]

व्योषं विडङ्गं शिग्रूणि त्रिफलां कटुरोहिणीम्|

बृहत्यौ द्वे हरिद्रे द्वे पाठामतिविषां स्थिराम्||१९||

हिङ्गु केबुकमूलानि यवानीधान्यचित्रकान्|

सौवर्चलमजाजीं च हपुषां चेति चूर्णयेत्||२०||

चूर्णतैलघृतक्षौद्रभागाः स्युर्मानतः समाः|

सक्तूनां षोडशगुणो भागः सन्तर्पणं पिबेत्||२१||

vyōṣaṁ viḍaṅgaṁ śigrūṇi triphalāṁ kaṭurōhiṇīm|

br̥hatyau dvē haridrē dvē pāṭhāmativiṣāṁ sthirām||19||

hiṅgu kēbukamūlāni yavānīdhānyacitrakān|

sauvarcalamajājīṁ ca hapuṣāṁ cēti cūrṇayēt||20||

cūrṇatailaghr̥takṣaudrabhāgāḥ syurmānataḥ samāḥ|

saktūnāṁ ṣōḍaśaguṇō bhāgaḥ santarpaṇaṁ pibēt||21||

vyoShaM viDa~ggaM shigrUNi triphalAM kaTurohiNIm|

bRuhatyau dve haridre dve pAThAmativiShAM sthirAm||19||

hi~ggu kebukamUlAni yavAnIdhAnyacitrakAn|

sauvarcalamajAjIM ca hapuShAM ceti cUrNayet||20||

cUrNatailaghRutakShaudrabhAgAH syurmAnataH samAH|

saktUnAM ShoDashaguNo bhAgaH santarpaNaM pibet||21||

Trikatu (Zingiber officianel,Piper langum and Piper nigrum), vidanga (Embelia ribes), varieties of shigru (Moringa olefera), triphala, katurohini (Picrorhiza kurroa), brihati (Solanum indicum), kantakari (Solanum xanthocarpum), haridra (Curcuma longa), daaruharidra (Berberis aristata D.C.), two varieties of patha (Cissampelos pareira), ativisha (Aconitum heterophyllum), shalaparni (Desmodium gangeticum), hingu (Ferula narthex), root of kebuka (Costus speciosus), yavani (Trachyspermum ammi), dhanya (Coriandrum sativum), citraka (Plumbago Zeylanica), sonchal salt, ajaji (Cuminum cyminum), and hapusha (Juniperus communis) – all the above herbs powdered and mixed with equal quantities of oil, ghee and honey, added with sixteen times its volume of sattu (roasted corn flour) and water are used to prepare a formulation for indications (mentioned in the following verse.) [19-21]

Indications

प्रयोगादस्य शाम्यन्ति रोगाः सन्तर्पणोत्थिताः|

प्रमेहा मूढवाताश्च कुष्ठान्यर्शांसि कामलाः||२२||

प्लीहा पाण्ड्वामयः शोफो मूत्रकृच्छ्रमरोचकः|

हृद्रोगो राजयक्ष्मा च कासः श्वासो गलग्रहः||२३||

क्रिमयो ग्रहणीदोषाः श्वैत्र्यं स्थौल्यमतीव च|

नराणां दीप्यते चाग्निः स्मृतिर्बुद्धिश्च वर्धते||२४||

prayōgādasya śāmyanti rōgāḥ santarpaṇōtthitāḥ|

pramēhā mūḍhavātāśca kuṣṭhānyarśāṁsi kāmalāḥ||22||

plīhā pāṇḍvāmayaḥ śōphō mūtrakr̥cchramarōcakaḥ|

hr̥drōgō rājayakṣmā ca kāsaḥ śvāsō galagrahaḥ||23||

krimayō grahaṇīdōṣāḥ śvaitryaṁ sthaulyamatīva ca|

narāṇāṁ dīpyatē cāgniḥ smr̥tirbuddhiśca vardhatē||24||

prayogAdasya shAmyanti rogAH santarpaNotthitAH|

pramehA mUDhavAtAshca kuShThAnyarshAMsi kAmalAH||22||

plIhA pANDvAmayaH shopho mUtrakRucchramarocakaH|

hRudrogo rAjayakShmA ca kAsaH shvAso galagrahaH||23||

krimayo grahaNIdoShAH shvaitryaM sthaulyamatIva ca|

narANAM dIpyate cAgniH smRutirbuddhishca vardhate||24||

The above preparation is useful in the treatment of obstinate urinary disorders including diabetes mellitus, mudhavata (sluggishness of the bowels), obstinate skin diseases including leprosy, piles, jaundice-like hepatobiliary diseases, diseases of the spleen, anemia-like hematological disorders, edema, dysuria, anorexia, heart disease, tuberculosis-like immune-compromised conditions, cough, respiratory disorders, spasmodic obstruction of the throat, parasitic infestation, grahani (digestive disorders), vitiligo and morbid obesity caused by overnutrition. This also stimulates the power of digestion and enhances memory and intellect. [22-24]

व्यायामनित्यो जीर्णाशी यवगोधूमभोजनः|

सन्तर्पणकृतैर्दोषैः स्थौल्यं मुक्त्वा विमुच्यते||२५||

उक्तं सन्तर्पणोत्थानामपतर्पणमौषधम्|२६|

vyāyāmanityō jīrṇāśī yavagōdhūmabhōjanaḥ|

santarpaṇakr̥tairdōṣaiḥ sthaulyaṁ muktvā vimucyatē||25||

uktaṁ santarpaṇōtthānāmapatarpaṇamauṣadham|26|

vyAyAmanityo jIrNAshI yavagodhUmabhojanaH|

santarpaNakRutairdoShaiH sthaulyaM muktvA vimucyate||25||

uktaM santarpaNotthAnAmapatarpaNamauShadham|26|

Regular exercise, intake of food only after complete digestion of the previous meal, and regular consumption of barley and wheat are some of the ways for management of obesity and diseases due to overnutrition. In the next verses, formulations and regimen required for the management of malnourishment has been described. [25-26]

Diseases due to apatarpana(under-nutrition) and their treatment

वक्ष्यन्ते सौषधाश्चोर्ध्वमपतर्पणजा गदाः||२६||

देहाग्निबलवर्णौजःशुक्रमांसपरिक्षयः|

ज्वरः कासानुबन्धश्च पार्श्वशूलमरोचकः||२७||

श्रोत्रदौर्बल्यमुन्मादः प्रलापो हृदयव्यथा|

विण्मूत्रसङ्ग्रहः शूलं जङ्घोरुत्रिकसंश्रयम्||२८||

पर्वास्थिसन्धिभेदश्च ये चान्ये वातजा गदाः|

ऊर्ध्ववातादयः सर्वे जायन्ते तेऽपतर्पणात्||२९||

vakṣyantē sauṣadhāścōrdhvamapatarpaṇajā gadāḥ||26||

dēhāgnibalavarṇaujaḥśukramāṁsaparikṣayaḥ|

jvaraḥ kāsānubandhaśca pārśvaśūlamarōcakaḥ||27||

śrōtradaurbalyamunmādaḥ pralāpō hr̥dayavyathā|

viṇmūtrasaṅgrahaḥ śūlaṁ jaṅghōrutrikasaṁśrayam||28||

parvāsthisandhibhēdaśca yē cānyē vātajā gadāḥ|

ūrdhvavātādayaḥ sarvē jāyantē tē'patarpaṇāt||29||

vakShyante sauShadhAshcordhvamapatarpaNajA gadAH||26||

dehAgnibalavarNaujaHshukramAMsaparikShayaH|

jvaraH kAsAnubandhashca pArshvashUlamarocakaH||27||

shrotradaurbalyamunmAdaH pralApo hRudayavyathA|

viNmUtrasa~ggrahaH shUlaM ja~gghorutrikasaMshrayam||28||

parvAsthisandhibhedashca ye cAnye vAtajA gadAH|

UrdhvavAtAdayaH sarve jAyante te~apatarpaNAt||29||

Emaciation of the body, reduction in the power of digestion, strength, complexion, ojas (vital essence of body related with immunity and general strength), semen and muscle tissue, jwara (continuous fever and cough like condition), pain in chest and flanks, anorexia, weakness in the power of hearing sounds, psychosis, delirium, pain in cardiac region, accumulation of stool and urine, pain in calf, thigh and lumber regions, cracking pain in fingers, bones and joints, and such other diseases due to the vitiation of vata(such as urdhava vata upward movement of vata), etc. are caused due to improper nutrition and starvation. [27- 29]

Management of diseases due to undernutrition

तेषां सन्तर्पणं तज्ज्ञैः पुनराख्यातमौषधम्|

यत्तदात्वे समर्थं स्यादभ्यासे वा तदिष्यते ||३०||

tēṣāṁ santarpaṇaṁ tajjñaiḥ punarākhyātamauṣadham|

yattadātvē samarthaṁ syādabhyāsē vā tadiṣyatē ||30||

teShAM santarpaNaM tajj~jaiH punarAkhyAtamauShadham|

yattadAtve samarthaM syAdabhyAse vA tadiShyate ||30||

For the treatment of such ailments, therapies that nourish instantly need to be administered regularly and for a long period of time. [30]

सद्यःक्षीणो हि सद्यो वै तर्पणेनोपचीयते|

नर्ते सन्तर्पणाभ्यासाच्चिरक्षीणस्तु पुष्यति||३१||

sadyaḥkṣīṇō hi sadyō vai tarpaṇēnōpacīyatē|

nartē santarpaṇābhyāsāccirakṣīṇastu puṣyati||31||

sadyaHkShINo hi sadyo vai tarpaNenopacIyate|

narte santarpaNAbhyAsAccirakShINastu puShyati||31||

A person suffering from acute and drastic weight-loss should be treated with a regimen that nourishes instantly, but one suffering from a chronic type of emaciation requires long term consumption of nourishments. [31]

देहाग्निदोषभैषज्यमात्राकालानुवर्तिना|

कार्यमत्वरमाणेन भेषजं चिरदुर्बले||३२||

dēhāgnidōṣabhaiṣajyamātrākālānuvartinā|

kāryamatvaramāṇēna bhēṣajaṁ ciradurbalē||32||

dehAgnidoShabhaiShajyamAtrAkAlAnuvartinA|

kAryamatvaramANena bheShajaM ciradurbale||32||

Some of the critical factors for deciding a course of treatment of emaciation in chronic patients include: body constitution, power of digestion, predominant dosha, form of medicine, dose, and season and time of administration (of the therapy). [32]

हिता मांसरसास्तस्मै पयांसि च घृतानि च|

स्नानानि बस्तयोऽभ्यङ्गास्तर्पणास्तर्पणाश्च ये||३३||

hitā māṁsarasāstasmai payāṁsi ca ghr̥tāni ca|

snānāni bastayō'bhyaṅgāstarpaṇāstarpaṇāśca yē||33||

hitA mAMsarasAstasmai payAMsi ca ghRutAni ca|

snAnAni bastayo~abhya~ggAstarpaNAstarpaNAshca ye||33||

For this purpose, (of santarpana), soups made out of flesh, milk, various ghee preparations (clarified butter), along with activities such as bath, oil massage, and medicated enema (processed with santarpana medicines) are advocated for nourishment. [33]

ज्वरकासप्रसक्तानां कृशानां मूत्रकृच्छ्रिणाम्|

तृष्यतामूर्ध्ववातानां वक्ष्यन्ते तर्पणा हिताः||३४||

jvarakāsaprasaktānāṁ kr̥śānāṁ mūtrakr̥cchriṇām|

tr̥ṣyatāmūrdhvavātānāṁ vakṣyantē tarpaṇā hitāḥ||34||

jvarakAsaprasaktAnAM kRushAnAM mUtrakRucchriNAm|

tRuShyatAmUrdhvavAtAnAM vakShyante tarpaNA hitAH||34||

For these patients suffering from continuous jwara (fever like conditions), cough, emaciation, dysuria, thirst and upward movement of vata, the following nourishing drinks are prescribed. [34]

शर्करापिप्पलीतैलघृतक्षौद्रैः समांशकैः|

सक्तुद्विगुणितो वृष्यस्तेषां मन्थः प्रशस्यते||३५||

śarkarāpippalītailaghr̥takṣaudraiḥ samāṁśakaiḥ|

saktudviguṇitō vr̥ṣyastēṣāṁ manthaḥ praśasyatē||35||

sharkarApippalItailaghRutakShaudraiH samAMshakaiH|

saktudviguNito vRuShyasteShAM manthaH prashasyate||35||

Mantha (thin gruel) prepared from sugar, pippali (Pipper longum), oil, ghee, and honey - in equal quantities added with double the quantity of saktu (roasted corn flour) is considered an aphrodisiac and is useful in such conditions (as mentioned in above verse). [35]

सक्तवो मदिरा क्षौद्रं शर्करा चेति तर्पणम्|

पिबेन्मारुतविण्मूत्रकफपित्तानुलोमनम्||३६||

saktavō madirā kṣaudraṁ śarkarā cēti tarpaṇam|

pibēnmārutaviṇmūtrakaphapittānulōmanam||36||

saktavo madirA kShaudraM sharkarA ceti tarpaNam|

pibenmArutaviNmUtrakaphapittAnulomanam||36||

Saktu (roasted corn flour/ coarse ground meal) with madira (wine), honey and sugar are refreshing and shall be consumed for the elimination of flatus (obstructed vata), faeces, urine, kapha and pitta. [36]

फाणितं सक्तवः सर्पिर्दधिमण्डोऽम्लकाञ्जिकम्|

तर्पणं मूत्रकृच्छ्रघ्नमुदावर्तहरं पिबेत्||३७||

phāṇitaṁ saktavaḥ sarpirdadhimaṇḍō'mlakāñjikam|

tarpaṇaṁ mūtrakr̥cchraghnamudāvartaharaṁ pibēt||37||

phANitaM saktavaH sarpirdadhimaNDo~amlakA~jjikam|

tarpaNaM mUtrakRucchraghnamudAvartaharaM pibet||37||

A nourishing drink prepared of phanita (inspissated juice of the sugar cane and other plants), saktu (coarse ground meal/ roased corn flour), ghee, whey, and sour gruel nourishes and should be consumed for the treatment of dysuria and udavarta. [37]

मन्थः खर्जूरमृद्वीकावृक्षाम्लाम्लीकदाडिमैः|

परूषकैः सामलकैर्युक्तो मद्यविकारनुत्||३८||

manthaḥ kharjūramr̥dvīkāvr̥kṣāmlāmlīkadāḍimaiḥ|

parūṣakaiḥ sāmalakairyuktō madyavikāranut||38||

manthaH kharjUramRudvIkAvRukShAmlAmlIkadADimaiH|

parUShakaiH sAmalakairyukto madyavikAranut||38||

Mantha (thin guel) prepared from date-palm, dry grapes, vrikshamla (Garcinia indica Ehois), amlika (Tamarindus indica), dadima (Punica granatum), parushaka (Crewia asiatica), and amalaki (Emblica officinalis Gaertn.), are useful for management of disorders caused due to excess consumption of alcohol. [38]

स्वादुरम्लो जलकृतः सस्नेहो रूक्ष एव वा|

सद्यः सन्तर्पणो मन्थः स्थैर्यवर्णबलप्रदः||३९||

svāduramlō jalakr̥taḥ sasnēhō rūkṣa ēva vā|

sadyaḥ santarpaṇō manthaḥ sthairyavarṇabalapradaḥ||39||

svAduramlo jalakRutaH sasneho rUkSha eva vA|

sadyaH santarpaNo manthaH sthairyavarNabalapradaH||39||

Sweet and sour mantha prepared from water with or without unctuous substances refreshes instantly and gives stability, good complexion and strength. [39]

Summary

तत्र श्लोकः-

सन्तर्पणोत्था ये रोगा रोगा ये चापतर्पणात्|

सन्तर्पणीये तेऽध्याये सौषधाः परिकीर्तिताः||४०||

tatra ślōkaḥ-

santarpaṇōtthā yē rōgā rōgā yē cāpatarpaṇāt|

santarpaṇīyē tē'dhyāyē sauṣadhāḥ parikīrtitāḥ||40||

tatra shlokaH-

santarpaNotthA ye rogA rogA ye cApatarpaNAt|

santarpaNIye te~adhyAye sauShadhAH parikIrtitAH||40||

Diseases caused due to overnutrition and undernutrition, along with their treatment, have been described in this chapter. [40]

Tattva Vimarsha (Fundamental Principles)

1. Intake of calorie rich and excessive food and nutrition with little or no physical exercise, results in increased body tissues. This contributes to causing diseases such as metabolic syndrome. These conditions are managed by purification therapies leading to reduction (langhana), and prescribing a regimen of physical exercise, appropriate dietary changes, fomentation and reducing drugs.

2. Excessive physical and/or mental activities without adequate nutrition causes nutritional deficiency diseases like wasting and psychosis. Treatment is high calorie but less filling diet, rest, medicated oil enema and massage. In cases of acute weight loss, nutrition should be given immediately while in the case of chronic loss, the process should be gradual but prolonged.

Vidhi Vimarsha(Applied Inferences)

The word santarpana means the act of satiating, restoration or refreshing. In this context, the term is used for overeating or overnutrition. Dietary items that are prithvi and apa mahabhuta dominant lead to santarpana. Quality, quantity, and age of certain food items can cause alteration in the digestabilibty of the food. For example, aged food grains are light to digest than new food grains. Therefore, the new food grains tend to increase weight, and same quantity of aged food grains do not increase weight. What changes occur in aging of the grains and their mechanism of action needs to be studied.

I. Properties of Santarpanakarak food articles

Unctuous (snigdha), sweet (madhura), heavy to digest (guru), and slimy (pichhilla) foods predominantly have Prithvi and jala mahabhuta, leading to an increase in kapha and rasa dhatu.

The functional trait of such food articles is snigdha (oily) guna is sneha (unctuousness), mriduta (softness), and ardrata (malleability, fluidity)[1] [2]. Snigdha food articles include those derived from lipids and fat molecules. Similarly, madhura (sweetness) is a property of food substances that possess predominantly sweet taste - not just perceived at the tongue, but also in many parts/tissues along our digestive system. Guru is the primary property that indicates “heaviness” of a food item, and a guru food article is heavy to digest and increases bulkiness of the tissues. Guru is the opposite of agni and hence delays digestion and metabolism and is used, therefore, in therapies that require nourishment, enhancement of physical strength, etc (brimhana, agnimaandyakara, upalepa, bala, upachaya and tarpana). Finally, picchilla is sliminess and stickiness, and indicates food items that vitiate kapha and mamsa and meda dhatu particularly.

Today’s research is consistent with the above findings of Ayurveda. Researchers acknowledge that taste receptors exist in the upper gastrointestinal tract as well. These receptors are “primarily located in the intestinal brush and enteroendocrine cells, and recognize sugars, D-amino acids, sweet proteins, and artificial sweeteners[3]”, per their research. Peptide YY (PYY) exerts its action through NPY receptors by inhibiting gastric motility and increasing water and electrolyte absorption in the colon[4]. PYY may also suppress pancreatic secretion, as it is secreted by neuro-endocrine cells in the ileum and colon in response to a meal, and has been shown to reduce appetite. It works by slowing the gastric emptying, thereby increasing the efficiency of digestion and nutrient absorption after a meal. Considering the effects of sweet food substances, PYY, in certain quantities, helps induce satiety in a person and thus in excess, inhibits appetite. This study clearly suggests the impact of madhura rasa and snigdha food substances in creating santarpaniya vyadhi or increased anabolism. Like GLP -1, GIP is related to metabolism and inflammation.

Thus, it can be said that excess of madhura, guru, snigdha and pichchilla foods can have inflammatory effect at the molecular level. If the above properties elaborated by Charak are to be understood, it can be clearly stated that they increase body tissues in volume and delay the digestion of food. This seems to be acceptable and the effect may be mediated through peptide YY. As it delays digestion and increases the nutrient uptake, these food substances lead to santarpana.

II. Impact of age on grains and grain-based food products

The age of food grains helps determine the quality as well as digestibility of food. Shuka dhanya (monocotyledons) and shami dhanya (dicotyledons) that are old /aged are easy to digest and are dry in property as compared to new ones. [Cha.Sa.Sutra Sthana 27/309] Nava anna, or fresh, non-aged rice, millet, etc. increase kapha and are heavier than old grains. Charak notes that all new and fresh grains are heavy and induce santarpana, while aged grains are lighter to digest.

Sharangdhara in Purva Khanda also talks of new and old grains and recommends six to twelve month-old grains to be used. Biochemical changes that help in digestion may be occurring after certain aging of grains. Per researchers (Seguchi, 1993), aging of flour and grains does enhance their functionality as ingredients for cakes and batter. Cereals can be stored for long periods without microbial spoilage. However, biochemical changes also occur during aging. There is great possibility that certain amino acids and phyto chemicals get stabilized in the grain which make them safe for consumption. Eventually, the grain respires, dry matter is lost and functional and nutritional aspects of the grain are altered. Age related changes have great influence on the viscosity of any batter made out of wheat-flour and the water-binding ability of the wheat flour (Shelke et al, 1992). In addition, the starch granule surface protein is found to increase up to three to four times with aging. However, prolonged aging is not recommended (Pomeranz et al, 1968). The moisture content of grains, the storage temperature and relative humidity have been shown to exert dramatic changes in the acidity, pH, free amino nitrogen, crude protein, and protein quality. Significant changes in soluble sugars and amylase contents of the grains have also been reported during storage at elevated temperature[5].

It is to be noted from various studies that the protein content of wheat grains and flour do not change significantly over time (Kim et al 2003). While protein quantity may not change, protein quality does. In one of the studies it was noted that total content of starch gets reduced after certain time when the grains are kept within controlled temperature. In India, wheat gets harvested in the months of March and early April. The atmospheric temperature varies from 25℃ – 45℃ in summer in different parts of India. The total starch content of the flour got decreased by 50 % when stored at 50℃ in comparison to the freshly harvested wheat grains[6] [7]. This is a significant change that occurs due to aging of wheat. If the starch content of wheat is reduced with time, aged wheat will have lower calorific value and lower glycemic index. It will also be easier to digest. Similar changes have been observed in rice after aging. Post harvest storage has, it has been observed, significant effect on eight known textural properties that are important to the sensory characteristics of cooked rice: adhesion to lips, hardness, cohesiveness of mass, roughness of mass, toothpull, particle size, toothpack, and loose particles[8]. A difference is observed between ageing of rice flour and rice starch. It is evident that pasting properties of fresh and aged rice are different. It is also reported that the cell wall structure is decomposed by endo –xylanase during storage which led to the changes in amylograms of rice fours[9].

These changes in physiochemical properties of grains exert their effect on digestibility of the food. It has been studied through experiments that the moisture content is higher in new grains indicating predominance of jala mahabhuta and prithvi mahabhuta which again tends towards santarpana. Aging of rice has an impact on its glycemic index and glycemic load. New grain may have higher glycemic index than the older grain. Due to the effect of time on these food stuffs there are greater possibilities that certain amino acids and phyto chemicals get stabilized in the grain that make them safe for consumption.

Navamadya/fresh wine: New or fresh wines should not be consumed because they cause heaviness and create imbalances in all the three dosha while old wines promote circulation in the body, increase digestion, lightness and enhance taste in food. The effect of aging on tannins and resveratrol has been studied and shows significant difference between old and fresh wine. Aging results in altered and reduced phenolic contents in red wine. Anthocyanin tannin complexes can be formed which can stabilize the colour of red wines resulting in wines that are tasteless, fruity and less astringent after aging[10]. Oxidation reactions involving phenolics might also change the chemical and sensory profile of wines[11]. Oxygen in the air is always ready to react with unprotected juice or wine and many of the substances present get adversely affected by oxidation, producing unpleasant, bitter, off-odours and off-tastes. However, it is recognized that some degree of oxygenation may be beneficial for the formation of red wine, but the quality of white wines is generally impaired by excessive air exposure. As tannins and anthocyanins interact with oxygen, which diffuses during barrel storage, these compounds further polymerize and become less astringent. Red wines become lighter in colour, and proanthocyanidins and other polyphenolics eventually aggregate in larger molecules which accumulate as sediment over time at the base of the bottle. In contrast, white wines often deepen in colour, turning darker honey colors as they oxidize and age [12].

The phenolic compound present in a bottle of wine slowly changes as it ages. The most important component of wine is tannin which binds with proteins. High tannin containing wine inhibits saliva’s ability to lubricate mouth and imparts astringent feeling in mouth. Aged wine undergoes polymerization of tannins. This makes tannin sediments settle to the bottom of the container and lose its property to bind with proteins. Aged wines are very aromatic and possess fruity flavors.

Ageing of wine solely depends on its storage and oxidation of the wine. Normally new wines contain about .02 - .03% acetic acid. This is reduced in aged wine if it is packed properly. This physico-chemical change in aged wine, change in taste and aroma modify its pharmacological effects. Increase in its antioxidant properties and change in Anthocyanin tannin complex makes wine more effective after age. There is also a possibility that chemical process in ageing of wine may also change the molecular size of tannins which might become more bio-available after consumption.

III. Categories of food leading to anabolism

Gorasa (milk and milk products): Over the years, there have been many conflicting views in scientific journals and from nutritionists regarding dairy products and it is often difficult to conclude about their health benefits. Charak has clearly mentioned in various texts, including this chapter and in Prameha Nidana, that excessive consumption of dairy products, meat, and carbohydrates may lead to many metabolic disorders. It may also create inflammation at a molecular level. Common allergens like casein and gluten create inflammation in the gut. Investigators have correlated higher levels of milk antibodies with rheumatoid arthritis[13] (Arvikar, 2013). Studies suggest (Feskanich D. et al) that cow’s milk could be responsible for an irreversible inability to metabolize blood sugar, and could cause Type I and type II diabetes. This study also suggests that severe disorders such as rheumatoid arthritis, diabetes, heart attacks, multiple sclerosis, and osteoporosis could be attributed to diet rich in milk[14].

Thus, there has been much research concerning dairy products, besides meat and other forms of complex proteins, which shows their excessive consumption in a very unfavourable[15]. These types of food have multifold impact on the health of a person. These can change the gut flora leading to disorders of absorption, adversely affecting auto-immunity and production of antibodies. It has been shown by certain researchers that excess of meat and dairy products leads to immune-activation [16] [17]. Excess of meat also has certain enzymatic toxicity which can lead to insulin resistance –a basic pathology of obesity, heart disease and type II diabetes.

All the above types of food mentioned herein could explain 57% of the total structural variation in gut microbiota whereas changes in genetics accounted for no more than 12% [18]. This indicates that diet plays a dominant role in shaping gut microbiota and changing key populations may transform healthy gut microbiota into a disease-inducing entity. For example, the western diet, which is high in sugar and fat, causes dysbiosis affecting both host GI tract metabolism and immune homeostasis[19]. Dysbiosis is a very important term that can be helpful in explaining many pathologies mentioned in Ayurvedic literature.

Thus, an excessive meat/dairy based diet that has been explained by Charak starts its dreadful effect from GI tract leading to metabolic disorders. This can be compared with the theory of agni elaborated by Ayurveda scholars and also explains how wrong food exerts its effect on immune system leading to inflammation at molecular level. Chronic inflammation changes the normal mechanism of body and leads to certain dreadful metabolic disorders. Thus, over and undernutrition both lead to certain metabolic diseases mediated through inflammation [20].

IV. Effect of lifestyle on anabolism

Charak not only explains the adverse effects of bad eating but also explains the ill effects of sedentary behaviour which are the leading cause of metabolic disorders. He explains that those averse to physical or mental activities (exercises), those who are habituated to sleeping during the day and always having the tendency to lying down will end up suffering from various metabolic disorders. Modern researchers have proved this too. Sedentary behaviour refers to low-energy activities that involve energy expenditure (at the level of 1.0–1.5 metabolic equivalent units (METs))[21], and include activities such as lying down, sitting, etc. Individuals could be spending a significant part of their waking hours in sedentary activities[22].

Per studies by Lee et al (2001), the association between sedentary behaviour and metabolic health could, to some extent, explain the association between sedentary time and metabolic syndrome [23].

Bedrest studies, though not sufficiently researched in humans, indicate that there is an increased sedentary behavior associated with a range of deleterious metabolic effects [24].

It can be noted from the above enlisted disorders that kapha dosha, rasa, rakta, mamsa and meda dhatu are vitiated in santarpaniya diseases. Therefore, the treatment protocol shall be designed keeping these factors in mind.

Pramehapidaka: This can be compared with diabetic carbuncle which is a complication of uncontrolled diabetes mellitus. It is localized infective gangrene of the skin and subcutaneous tissues caused by infection. The predisposing factor is diabetes. In diabetic carbuncle, infection is at hair follicle with severe pain and there is involvement of fibrous strand along with sub-cutaneous tissues. A multi-locular lesion is seen which may give rise to ulcerating carbuncle. In this lesion, gangrenous process can occur which may be due to thrombosis of the lesion.

It is interesting to note that pramehapidaka, skin disorders, pandu (anaemia), urinary problems (which can be referred to as renal problems) and arochaka (anorexia) are all complications of metabolic disorders. These diseases must not be taken as swatantra (independent) pathological entities but are to be seen in the light of metabolic disorders.

Kandu can be compared with urticaria, characterized by skin eruptions which are reddish and itchy in nature and are of mild intensity and increased by exposure to cold breeze. It is also manifested as a symptom of other diseases. In this context of santarpanajanya vyadhi, we have seen previously that certain foods have effect on immune system. Kandu is a peculiar indication of severe hyperglycemia as well. Due to dehydration, neuritis and micro angiopathy these types of symptoms can be developed. These are more seen in chronic uncontrolled diabetes patients.

Kotha, as explained, is a decay of tissues due to certain conditions. In the context of santarpanajanya vyadhi, decay usually is seen in diabetic patients caused mostly due to microangiopathy. Involvement of the blood vessels by atherosclerosis leading to ischemia is a significant factor in diabetic foot. Lower extremity peripheral vascular disease (PVD) is the most common factor associated with limb ulceration, gangrene, impaired wound healing and ultimately amputation[25]. It mainly occurs due to blood flow changes, occlusive changes, micro angiopathy, and hematological changes. There is marked change in the flow of blood in peripheral vessels. The microcirculation is regulated by neural factors, local reflexes and vasoactive mediators. The initial haemodynamic changes will be increased flow and pressure of capillary blood[26] . As the disease progresses, autoregulation is lost and haemodynamic stress results. It could also be due to increased calcification of vessels or AV shunting or hyperosmolarity of blood. It is well documented by high ankle brachial ratio and also Doppler studies. Occlusive changes occur in more than 50% of diabetics having the disease for more than 10 – 15 years[27]. It mainly affects arteries below profunda femoris and is characterized by multiple segment involvement. The tibial & peroneal arteries between the knee and the ankle are primarily affected. Dorsalis pedis artery and foot vessels are usually spared. Patients with diabetes have diminished ability to establish collateral circulation especially in arteries around knee. This disease is more prevalent & accelerated with diabetes mellitus.

Pandu (anemia): It means pallor and is seen in metabolic disorders. Charak has explained it as a disease as well as complication of other disorders. Pandu that has been mentioned in santarpanajanya diseases chapter is kapha dominant where the causes are elaborated in verses 3 and 4. Two of the most common causes of anemia are due to abnormalities in iron homeostasis: iron-deficiency anemia and anemia of inflammation also known as anemia of chronic disease. The anemia caused due to inflammation is elaborated in this context. It is very interesting to know metabolic disorders like obesity and some complication of diabetes like diabetic nephropathy also lead to pallor and iron deficiency[28]. Along with anaemia, renal parameters also get deranged which may lead to abdominal symptoms like nausea and vomiting, so the word arochaka is used here adjoining to mutrakrichhra (urinary disorder)[29]. In the latter stages of diabetic or hypertensive nephropathy urinary complaints like oligouria or anuria can occur. If it remains untreated due anaemia and congestion in heart, edema starts developing which has been called as shopha.

Amaja vyadhi: Ama is referred to an intermediate bio product of cellular metabolism leading to number of metabolic disorders. Generation of ama is thought to start with maldigestion or indigestion of food substances when taken in excess which begins in the stomach. It is a very important factor playing a pivotal role in the genesis of any disease. It is clearly stated that there is no disorder devoid of ama. So all the anabolic disorders where ama is considered as cause are supposed to be under the category of ama vyadhis.

When we think simply about the urinary complaints related with diabetes and obesity, urinary incontinence is prominent symptom, which is dominantly seen in obese women and men, which can be called as stress incontinence. So the word mutrakkrichra in this context of santarpanajanya vyadhis is to be taken as a complication of diabetic and hypertensive nepheropathy.

Kushtha: There are many skin diseases which are related to anabolism. Anabolism leads to discoloration and hyperpigmentation of skin. Majority of obese people show severe hyperpigmentation, which is called as acanthosis nigricans. Simple acne can also be the result of santarpanajanya vyadhis. Some of the studies[30] had reported, how caloric restriction can change sebum composition. Another study [31]linked acne to the consumption of milk.

Klaibya: A person who is unable to have proper sexual intercourse either due to erectile dysfunction or early ejaculation is termed as klaibya in Ayurveda.Klaibya is described in detail in Chikitsa Sthana [Cha.Sa.Chikitsa Sthana 30/155] and is mentioned as a complication of either obesity, diabetes or hypertension. While elaborating the properties of lashuna (garlic) Charak has explained that lashuna is important herb in cardiac disorders as well and is useful in klaibya. Looking at its properties on microvessels, garlic is proven to be a herb which regulates nitric oxide synthesis in the arteries and keeps the lumen of the arteries dilated. Per studies, in cases of hypertensive erectile dysfunction in rats, it has been observed that nitric oxide synthesis in penile artery is lowered[32]. Garlic has positive impact on regulating nitric oxide synthesis[33].

The direct effect of obesity on increased risk of erectile dysfunction is well researched, and is often attributable to hormonal imbalance, endothelial dysfunction and insulin resistance.

Gurugatrata: Guru is heavy and gatra is body, and gurugatrata means a feeling of heaviness in the body. This condition can be due to excess fat deposition, or may be due peripheral odema developing due to certain cardiac and renal complications. In the initial stage tissues show inflammatory changes at molecular level and later develop symptoms of gurugatrata.

Aalasya(lethargy or lassitude), at the somatic as well as psychological level, signifies a feeling of lethargy along with hesitancy or weariness of body or mind from strain, oppressive climate, etc. It is mainly caused due to psychological factors that show through one’s sensory and motor organs. It is a primary stage of the major complications like tandra and moha. It could also be a condition symptomatic of diabetic and hypertensive cerebral encephelopathy. Uncontrolled hyperglycemia or hypertension in patients may lead to number of complications. These are all pre coma or coma conditions where all the sensory organs stop responding and a specific word, Lepa, is used to denote some form of “covering” that the sensory organs are covered with that makes them stop responding and lose orientation. Not only the sensory organs, but all the body channels from where not only the blood and sensation, but also the chemical signalling of the cells also gets disturbed and patients land into tandra, buddhi moha and prameelaka.

Tandra is an abnormal condition characterized by drowsiness.

Moha is an abnormal condition of the mind in which person cannot take correct decision and also is not able to scrutinize the subject referred by mind.

Prameelaka: An abnormal mental condition characterized by constant thoughts.

All the above mentioned conditions are due to severe hyperglycemia with hyperosmolality and dehydration, in the absence of significant ketosis. It occurs in patients with mild or occult diabetes, and most patients are middle-aged to elderly. Accurate figures are not available as to its true incidence, but from data on hospital discharges it is rarer than diabetic ketoacidosis even in older age groups.

Research shows that a partial or relative insulin deficiency may trigger a syndrome by reducing glucose utilization of muscle, fat, and liver while increasing hepatic glucose output[34].

Ultimately, with all these symptoms and conditions, edema over the body develops and along with other complications lands the patient into severe difficulties.

Lekhana is defined as the therapeutic action which (adequately) dries up body tissues and then literally scrapes the unwanted substances (generally solid, unctuous substances) out from the body tissues. Though this may be one meaning of lekhana, all lekhana activites and lekhana dravya exert some pharmacological activates that reduce unwanted substances - unwanted dosha, dhatu or mala- from the body. The same properties of lekhana can be achieved by virechana, vamana or raktamokshana.

Exercise and fasting has a very positive effect on anabolic disorders. Exercise results in reduction in fasting blood glucose, which replicates previous beneficial effects of exercise interventions in type II diabetes[35].

Fasting

That fasting and CR (calorie restriction) makes an organism’s metabolic process more efficient, enhancing the organism’s age, is a well-researched subject. Clive McCay at Cornell had published, in 1937, that a 33% caloric restriction resulted in a 50% increase in the maximum lifespan of a rat. Similar experiments were done on organisms such as yeasts, mosquitoes, flies, protozoa, roundworms, fish, etc. Many decades later, the National Institute of Aging (NIA) and the universities of Maryland and Wisconsin tried to study the impact of CR on aging using primates (squirrel and rhesus monkeys). The NIA Primate CR study indicated that CR monkeys “demonstrated an improved metabolic profile”, though they also concluded that the effects of CR in long-lived animals are complex and depend on a variety of factors besides caloric restriction[36].

Herbs used in management of santarpanajanya diseases

While treating santarpanajanya vyadhis like sthulata (obesity) and madhumeha (diabetes), consumption of dravyas that have guru and ruksha properties is advised. Along with medicines, the diet must also be ruksha. For skin ailments, applying powders of medicinal plants all over the body which can provide relief from kandu (itching) and kotha (pre-gangrenous condition) are advised. So the food must be guru and apatarpaka, i.e., it should induce catabolic activities. Applying these powders on the lesions may improve blood circulation which may consequently improve the increased hydroxylysine and glucose disaccharide content, decrease in proteoglycan and heparin sulfate and decrease in lysine content towards the lesion. The effects of honey, a food rich in antioxidants, on diseases such as cancer, coronary diseases, inflammatory disorders, and aging, has helped it gain lot of attention among nutritionists[37]. Properties of honey are ruksha, guru, and kashaya. Food and medicine having these properties enhance akasha and vayu mahabhuta which tends the person towards apatarpana.

Since ruksha dravyas are akasha and vayu dominant, medicines and food articles of this property are advised. Of the three properties of honey, the most important one is guru. Since jatharagni is vitiated in obesity (since agni plays an important role in causing or aggravating anabolic disorders), guru and ruksha substances are used to pacify it, and thus honey is recommended for obesity. However, the use of honey in diabetes is controversial since honey is full of fructose and it imparts hyperglycaemic properties on diabetic patients. In diseases like obesity, lipid abnormality and diabetes mellitus, gut microbiota plays an important role in carbohydrate metabolism.

Pericarp of haritaki showed cardiotonic activities in frog hearts, increasing the force of contraction and cardiac output without altering the heart rate[38]. Haritaki extracts administered before initiating any treatment showed signs of reduced myocardial damage caused by isoproterenol in rats. Haritaki reduced lipid peroxidation and significantly reduced cholesterolemia, aortic sudanophilia, and cholesterol content of the aorta and liver[39].

Local application by rubbing of certain herbal powders on the skin reduces kapha dosha and regulates vata dosha at that level and inhibits samprapti of kandu and kotha. Regular rubbing of the powders over the skin increases peripheral circulation of the capillaries supplying the skin and also reduced inflammation at dermal level. Rubbing of dry powders over the body is called udvartana. This softens the skin leaving it with a lustrous glow. The stimulating massage helps revitalize skin, removes fat deposits and improve circulation and digestion. Udvartana helps open the circulatory channels, facilitating metabolic activities, eliminating excessive perspiration and body odor and improving the complexion of the skin.

Triphala is one of the oldest used polyherbal preparations. It is comprised of Terminalia chebula, Terminalia bellerica and Emblica officinalis. Some of the positive qualities of triphala in-vivo and in-vitro are that it is an antioxidant, anti-hypercholesterolemic, anti-diabetic, anti-obesity, and possesses chemo-preventive potential and anti-mutagenic activities, anti-inflammatory, antimicrobial, radioprotective effect, immunomodulatory, improving wound healing, enteroprotective efficacies, anti-gastric ulcers and nitric oxide scavenging properties. This herbal combination can have profound healing benefits in multi-organ systems. It is rich in Mg, K, Ca, Fe, Se and Zn, which enhance their bioavailability. Low molecular weight tannins, gallic acid and other important phytochemicals are responsible for the above effects [40].

Aragwadha (Cassia fistula) possesses madhura rasa, madhura vipaka and has sheeta veerya. It possesses strong antioxidant properties. Aqueous extract of Aragwadha flowers administered in diabetic rats (streptozotocin induced diabetes) showed antioxidant effect. After investigating antioxidants marker enzymes in the brain, significant increase is observed, with decrease in thiobarbituric reactive substances and hydroperoxide formation comparable with glibenclamide[41].

Cassia auriculata L. seedlings, if irradiated with ultraviolet B (UV-B), it counteracted the induced oxidative stress with reduction in ascorbate, dehydroascorbate, glutathione/oxidized glutathione content at two doses assayed (7.5 and 15.0 kJ-2)[42]

Ethanolic and methanolic extracts of the flowers showed antioxidant properties which may be due to presence of flavonoids and tannins[43] [44]. , Patha (cissampelos pareira): Certain controversies are there about patha. Two different herbs are used as patha in different part of India- Cyclea peltata and Cissampelos parietal. Properties of patha are elaborated as rasa-tikta virya-usna vipäka-katu guna.-laghu, tiksna karma-vata-kaphahara,visaghna ,grahi, balya. Patha is known to have potent diuretic properties. Certain flavonoids were found to exert their diuretic properties by binding with Adenosine A1 Receptor associated with the diuretic action. The diuretic properties of studied plant may be through any of these possible mechanisms since it is rich in alkaloids and flavonoids[45].

Saptaparna (Alstonia scholaris) possess tikta kashaya rasa, ushna veerya and katu vipaka. The bark is useful in malarial fevers, abdominal disorders, dyspepsia and in skin diseases. In Ayurveda, it is reported that the bark of the plant when soaked in water overnight, can reduce the blood glucose level after oral administration. However, not much characterization of this properties has been done on a scientific basis. The phytochemicals are indicative of its potential in the treatment of diabetes mellitus[46].

In one of the studies of saptaparna (Alstonia scholaris) showed decrease in glycogen content in streptozotocin-diabetic rats support the findings of Grover et al. The decrease in glycogen content may result due to disturbances in glycogen synthetase system. Improvement in liver glycogen of diabetic rats after chronic treatment with aqueous extract of Alstonia scholaris L. bark indicates that possible way of antidiabetic effect of the extract may be by improvement of glycogenesis and / or suppression of glycogenolysis. Thus, study showed that bark of Alstonia scholaris L. possesses antidiabetic and antihyperlipidemic effects in STZ diabetic rats. The antiatherogenic potential of the bark extract indicates its usefulness not only in diabetes mellitus but also in the long term complications associated with it[47].

Cyperus rotundus has antioxidant and anti-atherosclerotic effects due to the presence of flavanoids, polyphenols and terpenes which reduce absorption of total cholesterol and triglycerides. Cyperus rotundus, in the form of a fine powder or an aqueous solution, exhibits lipolytic properties and showed mobilization of fats from adipose tissues. Cyperus rotundus is supposed to have activators of beta adreno receptors[48].

Madanaphala (Randia dumentorum) has madhura, tikta rasa, katu vipaka and ushna veerya. It is a widely used herb for induction of vomiting used for vamana procedure. It has lekhana properties.

Clearly, the pharmacological action of the above dravyas all have been proven to have anti-diabetic and anti-hyperlipidimic properties. The interesting thing to note is that although these dravyas ultimately work for metabolic disorders, they have different modes of action. Anti-diabetic properties of triphala, neem, musta and saptaparna are different. The rasa of the above mentioned dravyas is tikta kasahaya or tikta katu which is akasha, teja and vayu mahabhuta dominant. As we have seen that santarpaniya vyadhis are due to excess consumption of Prithvi and jala mahabhuta those of opposing properties, i.e., akasha, teja and vayu are used in treating such ailments.

Devadaru (Cedrus deodara or Himalayan Cedar) is a herb that is very effective in improving the functions of liver and in maintaining cholesterol levels in healthy limits. Devadaru pacifies the kapha dosha by tikta, katu and ushna properties, and vata dosha by snigdha and ushna properties so it is useful in disorders induced by kapha and vata dosha.

Investigation demonstrate that extracts of C. deodara shows reduction in body weight in treated groups in a dose dependent manner. The major chemical constituents of C. deodara are sterols, poly-phenols, flavanoids such as taxifolin, quercetin and saponins[49]. It is well established that saponins are useful in treatment of obesity[50]. Phytosterols have beneficial effects on hyperlipidemia[51] and poly-phenols and flavanoids have potential antioxidant properties. Therefore, it could be possible that presence of these compounds is responsible for observed glucose and lipid lowering properties.

Shwadanshtra or gokshura (Tribulus Terrestris) is madhura rasatmaka and has sheeta veerya with madhura vipaka. Gokshura is widely used to relieve certain anabolic disorders. It is helpful for the treatment of angina[52], high cholesterol 65, diabetes 65, and muscle spasms[53], and for the prevention of kidney stones[54].

It is very interesting to note that though gokshura or Tribulus terrestris is madhura and sheeta veerya dravya it has been included to treat santarpaniya vyadhis. Gokshura, by the virtue of its phytochemicals and its DHEAS (Dihydro epi andesterone sulphate) stimulating property and its potent diuretic qualities may have been in the group of medicines which are used to impart apatarpana. It has proved to be a very potent herb to cure erectile dysfunction and klaibyata in patients suffering from metabolic syndrome.

Khadira (Acacia Catechu): This herb is tikta, kashaya having sheeta veerya and katu vipaka. This herb is mostly used as kusthaghana to alleviate skin problems. In eastern traditional medicines, Acacia catechu Willd is extensively used in the management of diabetes in combinations with other medicinal plants. The most common chemical classes among these plants are flavonoid and other anti-oxidants. Hypoglycemic property of extract of Acacia catechu Willd is assumed to be due to the presence of flavonoids which also show inhibition of cyclo-oxygenase and regenerateβ cells[55]. In vitro Acacia catechu Willd is reported to have broad spectrum anti-microbial and anti fungal properties. Phytochemical studies of Acacia catechu Willd leaves shows the presence of alkaloids, carbohydrates, flavones, glycosides, phenolic compounds, saponins, steroids and tannins which may be responsible for its anti-microbial properties[56].

Haridra (Curcuma longa) has tikta rasa, katu vipaka and ushna veerya. It is laghu ruksha in its qualities. Ingestion of 6 gm Curcuma longa increased postprandial serum insulin levels, but did not seem to affect plasma glucose levels or GI, in healthy subjects. The results indicate that Curcuma longa may have an effect on insulin secretion. The active principles in the rhizome of turmeric plant viz; curcuminoids lower lipid peroxidation by maintaining the activities of antioxidant enzymes like super oxide dismutase, catalase and glutathione per oxidase at higher levels. Antioxidant properties of curcuma longa is due to curcumin and its three derivatives (demethoxy curcumin, bisdemethoxy curcumin and diacetyl curcumin)[57]. A scientific and systemic exploration reveals antidiabetic, hypolipidemic and hepatoprotective effects of Curcuma longa freeze dried rhizome powder dissolved in milk which could be used as an effective and safe antidiabetic dietary supplement of high potential[58].

Curcuma longa is known to contain curcuminoids, glycosides, terpenoids, and flavonoids. Maximal inhibition of the enzyme Human Pancreatic Amylase (HPA) was obtained with Curcuma longa isopropanol extract and acetone extract. This inhibitory action on HPA causes reduction in starch hydrolysis leading to lowered glucose levels[59]. The antioxidants in turmeric also prevent damage to cholesterol, thereby helping to protect against atherosclerosis. In fact, the ability of the antioxidants in turmeric to decrease free radicals is similar to that in vitamins C and E. Since the antioxidant activities of turmeric are not degraded by heat, even using the spice in cooking provides benefits. Animal studies show that curcumin lowers cholesterol and triglycerides, another fat that circulates in the blood stream and is a risk factor for cardiovascular disease. In a recent study of atherosclerosis, mice were fed a standard American diet, rich in refined carbohydrates and saturated fat, but low in fiber. Some of the mice, however, received this diet plus turmeric mixed in with their food. After four months on these diets, the mice that consumed the turmeric with their food had 20 percent less blockage of the arteries than the mice fed the diet without the turmeric. In another study, rabbits were fed turmeric plus a diet designed to cause atherosclerosis. Several risk factors for the disease were improved, including a decrease in cholesterol, triglycerides, and free-radical damage.

Antidermatophytic properties: Fresh juice of rhizome of haridra is used as an antiparasitic in many skin disorders. Its rhizome powder mixed with cow’s urine is taken internally in itching and dermatitis. Curcuma longa L. leaves have good promise as an antifungal agent that could be used as a therapeutic remedy against human pathogenic fungi on account of its various in vitro and in vivo antifungal properties, viz., strong fungicidal action, long shelf-life, its tolerability of heavy inoculum density, thermo stability, broad range of antidermatophytic properties and absence of any adverse effects. Curcumin obtained from the turmeric rhizome have shown to possess the ability to protect the skin from harmful UV-induced effects by displaying antimutagen, antioxidant, free radical scavenging, anti-inflammatory and anti-carcinogenic properties[60].

Neem (Azadirachta indica): It is a tikta rasa plant having sheeta veerya and katu vipaka. It imparts ruksha and laghu property. Hydroalcoholic extracts of this plant showed anti-hyperglycemic properties in streptozotocin treated rats and this effect is because of increase in glucose uptake and glycogen deposition in isolated rat hemidiaphragm[61]. Apart from having anti-diabetic properties, this plant also has anti-bacterial, antimalarial, antifertility, hepatoprotective and antioxidant effects[62].

Twak (Cinnamomum Zelyanicum): It is katu-tikta rasatmaka having katu vipaka and ushna veerya. It has been shown that oral administration of cinnamaldehyde produces significant antihyperglycemic effect lowers both total cholesterol and triglyceride levels and, at the same time, increases HDL-cholesterol in STZ induced diabetic rats[63].

Matan et al. have reported antimicrobial properties of Cinnamon bark. The volatile gas phase of combinations of Cinnamon oil and clove oil showed good potential to inhibit growth of spoilage fungi, yeast and bacteria normally found on IMF (Intermediate Moisture Foods) when combined with a modified atmosphere comprising a high concentration of CO2 (40%) and low concentration of O2 (<0.05%). A. flavus, which is known to produce toxins, was found to be the most resistant microorganism[64].

Kushtha (Saussurea Lappa): has tikta katu madhur rasa, katu vipaka and ushna veerya. It is known to lower blood lipids and is also known to improve coronary circulation[65].

Barley: Barley contains greater amounts of soluble and non-soluble starches compared to other cereals, and approximately 17% of the carbohydrate in barley is not absorbed. Undigested carbohydrate produces short chain fatty acids, some which may reduce hepatic glucose production and affect postprandial glycemia. Barley also inhibits serum cholesterol and is also known to reduce blood pressure if given for long term use[66].

Hingu(Ferula asafoetida): is a resin having katu rasa, ushna veerya and katu vipaka. Ferula asafoetida exhibits anti-cholesterol anti-hypertensive[67] and a potent anti-oxidant properties in experimental animals[68].

Vasa (Adhatoda vasica): has tikta rasa, sheeta veerya and sheeta vipaka and is strong anti diabetic and cardio protective[69].

Kharavha ajmoda (Trachyspermemum ammi): is a plant with katu, tikta rasa, katu vipaka and ushna veerya. T. ammi has been shown to possess antimicrobial, hypolipidaemic, digestive stimulant, antihypertensive, hepatoprotective, antispasmodic and broncho-dilating properties[70].

Pashanabheda (Berginia ligulata): has katu tikta rasa, katu vipaka and ushna veerya. It is a controversial herb and many other plants under the name pashanabheda are prescribed and used. Pashanabheda is enlisted in mootra virechaniya mahakashaya. Due to its diuretic property, it can be used in hypertension, congestive cardiac failure, renal complains etc[71].

Apart from its diuretic properties, pashanabheda exhibits good anti-diabetic properties. The 80% ethanolic extract of pashanabheda rhizome was fractionated to investigate for a-glucosidase or anti-diabetic properties. Sample solution were evaluated at dose levels of 5.0, 0.5, 0.05 mg/ml to obtain dose response. The ethyl acetate extract exhibited an inhibitory effect of a-glucosidase properties[72].

Takra (butter milk) is used to relieve santarpanajanya vyadhis. It has prime importance in diet and is supposed to be improve appetite. Its properties and medicinal qualities are described in Ashtanga Hridaya Sutra Sthana chapter 5.

Trikatu: is combination of equal parts of sunthi, maricha and pippali. Trikatu is regarded as an anti-obesity formulation and has been widely used in anabolic disorders. It is widely used to lower cholesterol and triglycerides and is known to increase HDL levels. In one of the studies it is found that trikatu, by virtue of its ability to reduce triglycerides and LDL cholesterol, increases HDL cholesterol to reduce the risk of hyperlipidaemia and atherosclerosis.[73] Trikatu is also known to have immune modulatory properties[74] and is known to be a good bioavailability enhancer[75].

Vidanga (Embelia ribes): The properties are rasa katu, kashaya rasa, ushna veerya and katu vipaka. It is one of the important plants used for relieving worm infestation. Vidanga exhibits a potent hypoglycaemic and lipid lowering properties[76].

Agaru (Aquilaria agallocha): Agaru is a tropical and sub-tropical, fragrant evergreen tree. The wood is very heavy, and sinks in water. The wood has tikta rasa, ushna veerya and katu vipaka. It exerts potent immunomodulator and anti inflammatory property[77].

Sunthi or ginger (Zinziber officinale): Ginger has katu rasa, madhura vipaka and ushna veerya. Ginger has been shown to exhibit antioxidant effects. (6)-gingerol appears to be the antioxidant constituent present in ginger, as it was shown to protect HL-60 cells from oxidative stress. Ginger oil has dominative protective effects on DNA damage induced by H2O2. Ginger oil might act as a scavenger of oxygen radical and might be used as an antioxidant[78]. In vitro research indicates that gingerols and the related shogaols exhibit cardio depressant properties at low doses and cardiotonic properties at higher doses. Both (6)-shogaol and (6)-gingerol, and the gingerdiones, are reportedly potent enzymatic inhibitors of prostaglandin, thromboxane, and leukotriene biosynthesis. [79] Spiced foods or herbal drinks, containing ginger, have the potential to produce significant effects on metabolic targets, such as satiety, thermogenesis, and fat oxidation thus, useful as anti-obesity agent. Thermogenic ingredients, such as ginger, may be considered as functional agent that could help restore a "positive energy balance" and prevent obesity[80].

Shigru (Moringa olifera): has properties of katu, kashaya rasa, ushna veerya and katu vipaka. It is widely used in santarpaniya vyadhis. Charak has also elaborated shigru to be used in obesity and heart diseases. It exhibits strong hypoglycaemic properties.[81] The aqueous, ethanol and ether extracts of moringa oleifera leaves contain compounds that cause reduction in heart rate and relaxation of cardiac muscle and have medical use in management of cardiac conditions like hypertension[82].

Katukrohini or kutaki (Picrorrhiza kurroa): Kutaki has tikta rasa, katu vipaka and sheeta veerya. It possesses a strong hepatoprotective properties due to phytochemical picroliv and also have a potent antioxidant properties[83]. It is found to be effective against CCl4 induced hepatic damage in rats, by reversal of increased serum level of SGOT, SGPT, ALP, Cholesterol, Bilirubin and decreases level of total protein which occurs during hepatotoxicit[84].

Brihati (Solanum indicum): Brihati has katu tikta rasa, katu vipaka and ushna veerya. Solanum indicum Linn. fruits have laxative and cardiotonic action[85].

Ativisha (Aconitum hetrophyllum): has tikta katu rasa, katu vipaka and ushna veerya. It is laghu and ruksha and hence is used in santarpaniya vyadhis. Research showed significant reduction in total cholesterol, TG, apolipoprotein B and increase HDL cholesterol and apolipoprotein A in serum samples and HMG CO A properties in liver samples. Properties of LCAT had increased and also there was increased fecal fat excretion. The mechanism explained for hypolipidemic properties was due to inhibition of HMG COA reductase properties and decrease fat absorption from intestine[86].

Sthiram (Shliparni desmodium gangeticum): It has madhura, tikta rasa, madhur vipaka and ushna veerya. It has alkaloids, pterocarpans, phospholipids, sterols, flavones and flavonoid glycosides. The plant shows many pharmacological activities like anti-inflammatory, anti-nociceptive, analgesic, anti-amnesic, anti-diabetic, anti-oxidant, anti-ulcer, and better CVS activites, CNS depressant, antibacterial, wound healing, antipyretic and several miscellaneous actions[87].

Kebukmool (Costus speciosus): It has tikta kashaya rasa, katu vipaka and sheeta veerya and has strong diuretic action. Increased excretion of Na+ and Cl is observed after its administration. It is known to relieve pulmonary edema[88].

Dhanayaka (Coriander sativum): Dhanayaka has katu, tikta and madhur rasa with katu vipaka and sheeta veerya. It possesses potent diuretic and antioxidant properties. Part of seeds shows a significant hypolipidemic action. There was significant increase in β-hydroxy, β-methyl glutaryl CoA reductase and plasma lecithin cholesterol acyl transferase properties (LCAT) were noted in the experimental group. The level of low density lipoprotein (LDL), very low density lipoprotein (VLDL) cholesterol decreased while that of high density lipoprotein (HDL) cholesterol increased in the experimental group. Besides diuretic properties it also exhibits a strong anti diabetic and anti convulsant action[89].

Chitraka (plumbago zeylanica): has katu rasa, katu vipaka and ushna veerya. It is one of the famous herbal medicine used for agnimandya. It also has antidiabetic and hypocholesterolemic action. Pharmacological studies carried out by researchers have indicated that plumbago zeylanica has antihyperglycemic effect on diabetes induced animals[90]. The ethanol extract of Plumbago zeylanica root on key enzymes of glycolysis and muscle hexokinase, phosphofructokinase, pyruvate kinase, lactate dehydrogenase activities were diminished in diabetic rats[91].

Hypocholesterolemic Action: Pharmacological and Clinical studies carried out indicates that Plumbago zeylanica extract has hypolipidaemic and antiatherosclerotic activities. [92]Plumbagin, an active principle isolated from plumbago zeylanica brings about a definite regression of atherosclerosis and prevents the accumulation of cholesterol and triglycerides in liver and aorta. Panchcole, an Ayurvedic formulation containing plumbago zeylanica as one of its chief ingredients has been advocated to produce hypolipidaemic effect[93].

Ajaji (Cumin seed (Cuminum cyminum L.)) has katu rasa, ushna veerya and katu vipaka. In studies conducted on rats with induced diabetes, cumin reduced blood glucose levels[94]. One mechanism for this reduction suggests the inhibition of aldose reductase and alpha-glucosidase. In addition, reductions in plasma and tissue cholesterol, phospholipids, free fatty acids, and triglycerides (secondary to diabetes) were demonstrated in another animal study[95].

Hapusha (Juniperus Communis) has katu rasa, ushna veerya and katu vipaka. While there are not very many research papers written on the efficacy of Juniper berries and leaves as medicinal herbs, they are said to exhibit potent anti-inflammatory properties and are used to support healthy kidney and urinary tract function, besides promoting healthy blood pressure when taken in normal dosages[96] .

Sattu is widely used in santarpaniya disorders. It is prepared by roasting gram flour but has now evolved to include other nutritious flours like barley, wheat etc. Sattu is a perfect blend of balanced nutrients and is prepared in one of the healthiest cooking methods – roasting. Sattu has high fibre and phytic acid content. Method of preparing sattu is such that it retains the nutrient value and increases the shelf life of the ingredients. Roasting can improve protein digestibility. [97]The goal of roasting is to improve sensory qualities and achieve inactivation of destructive enzymes which improves the storage and nutritional quality of the product. [98]Research reports reduced trypsin inhibitor properties when seed temperatures reached 90-100°C. Researchers [99]reported lipoxygenase properties was lost at temperatures of 75-80°C. Some also [100]reported that during roasting total phenols and tannins decrease. It has been observed that the [101]reduction in mineral contents during roasting might be due to the loss of nutrients while heating at high temperature.

Elevated plasma cholesterol or elevated LDL-cholesterol concentrations have been shown to be one of the risk factors.[102]It has been suggested that dietary fibre or more specifically phytate which is a component of fibre can influence the etiology of heart disease[103]. Researchers [104] showed that dietary phytate supplementation resulted in the lowering of serum cholesterol and triglyceride levels. This effect accompanied the decrease in serum Zn level and Zn-Cu ratio. This is because coronary heart disease appears to be caused by an imbalance of Zn-Cu metabolism.

Above are all the important reasons why sattu is recommended as one of the important food in santarpaniya vyadhi. Those individuals who consume these type of formulations can have normalization of agni, smriti (memory) and buddhi, that is the power of forming and retaining concepts and general notions, intelligence, reason, intellect, discernment, judgment which gets deranged in santarpaniya vyadhis in latter stages gets normalised.

Those individuals who exercise regularly, who do not eat until the previous meals are completely digested, who do not indulge in overeating, who regularly consume barley and wheat in diet get relief from all the diseases due to santarpana and obesity. This is how all the santarpanjanya vyadhis are treated with apatarpana medicines.

If we observe the herbs mentioned in the management of santarpaniya vyadhis it is evident from the following table that most of the herbs are tikta, katu, kashaya rasa dominant having katu vipaka and ushna veerya. These properties are attributed to akasha and vayu mahabhuta.

Table 1: Concise information about herbs used in management of santarpaniya diseases

Name Latin name Family Rasa Veerya Vipaka
Amalaki Emblica Officinalis Euphorbiaceae Pancharasa (lavanavarjit) amlapradhana Madhura Sheeta
Bibhitak Terminalia bellerica Combretaceae Kashaya Madhura Ushna
Haritaki Terminalia chebula Combretaceae Pancharasa (lavanavarjit) Kashaya pradhana Madhura Ushna
Patha Cissampelous pareira Meninspermiaceae Tikta Katu Ushna
Saptparna Alstonia scholaris Apoyanaceae Tikta-kashaya Katu Ushna
Vatsak Cyprus rotundus Apoyanaceae Tikta-kashaya Katu Sheeta
Nagarmotha Cissampelous cyperaceae Kashaya,tikta,Katu Katu Sheeta
Madanphala Randia spinosa Rubiaceae Kashaya,madhura,tikta,Katu Katu Ushna
Nimb Azardirecta indica meliaceae Tikta,katu Katu Sheeta
Aragvadh Azardirecta indica leguminaceae Madhura Madhura Sheeta
Devdaru Cedrus deodara pinaceae Tikta Katu Ushna
Gokhshur Tribulis terreestis Zygophyllaceae Madhura Madhura Sheeta
Khadir Acasia catechu Leguminaceae Tikta kashaya Katu Sheeta
Haridra Curcuma longa Zinziberaceae Tikta katu Katu Ushna
Daru-haridra Berberis aristata Berberidaceae Tikta kashaya Katu Ushna
Kushth Saussurea lappa Compositae Tikta Tikta katu madhura Ushna
Hingu Ferula narthex Umbelliferae Tikta-kashaya Katu Ushna
Sunthi zinziber officinale zinziberaceae Tikta-kashaya Katu Ushna
Pimpli Piper longum Piperaceae Katu Madhura Anu-ushna, Sheeta
Maricha Piper nigrm Piperaceae Katu Katu Ushna
Ajmoda Carum roxburghianum Umbelliferae Katu,tikta Katu Ushna
Pashanbhed Bergenia ligulata Saxifragaceae Kashaya,tikta Katu Sheeta
Vacha Acorus calamus Araceae Katu,tikta Katu Ushna
Ativisha Aconiatum hetero phylum Ranunculaceae Tikta,katu Katu Ushna
Ajawayan Trachyspermem um ammi Umbelliferae Katu,tikta Katu Ushna
Vidang Emblic ribes myrsinaceae Katu,kashaya Katu Ushna
Shigru Moringa olifera Moringaceae Katu ,tikta Katu Ushna
Kutki Picrorhiza kurroa Scrophulariaceae Tikta Madhura Sheeta
Shalparni Desmodium-Gangeticum leguminosae Madhura,tikta Katu Ushna
Kebhukmool Costus speciosus Zinziberaceae Tikta,kashaya Katu Ushna
Dhanyaka Coriandrum sativum Umbelliferae Tikta,kashaya,madhura,Katu Katu Ushna
Chitraka Plumbago zeylanica Plubaginanaceae Katu Katu Ushna
Hapusha Juniperus communis Pinaceae Katu ,tikta Katu Ushna
Twak Cinnamomum zelyanicum Lauraceae Katu ,tikta,madhura Madhura Sheeta
Bruhati Solanum indicum Solaneaceae Katu ,tikta Katu Ushna
Agnimantha Premna mucronata Verbenaceae Katu,tikta,kashaya,madhura Katu Ushna
Khajura Phoenix sylvestris Palmae Madhura Madhura Sheeta
Vrukshamal Garcinia indica Guttiferae Amala(unripened) Madhuramala(ripened) Amala Ushna
Dadim Punic a granatum punicaceae Madhur,kashaya,amala Madhur/amala Anu-Ushna
Ajaji (jeerak) Cuminum cyminum Umbelliferae Katu Katu Ushna
Ela Elettaria cardmomum Zinziberceae Katu , madhura Katu Sheeta
Musta Cyprus rotendus Cyperaceae Tikta,katu, kashaya Katu Sheeta

Phanita (molasses) is a semisolid condensed sugarcane preparation, traditionally used to prepare arista, asava and other forms of alcoholic fermentation. Its heavy in nature, sweet in taste, nutritive and non - aphrodisiac and aggravates tridosha. Sattu, ghee, whey, sour fruits like Garcinia combojia, and kanji work as tarpana medicines in urinary ailments and udavarta (abnormal conditions characterized by retention of faeces, urine and flatus, associated with pain and leading to or caused by anti-peristaltic movements in the body).

Mantha is a formulation made by adding fourteen times of water and blending it thoroughly. Mantha of kharjura (dates), manuka (resins), gracinia, tamarind, pomegranate, falsa (Grewia asiatica) and amalaki is useful in alcoholics and alcohol induced disorders. Mantha prepared out of sweet and sour substances if mixed together and added with or without ghee proves to be santarpana and improves strength, lustre and power of body.

Kharjura (dates, Phoenix dactylifera) has madhura rasa, sheeta veerya and madhura vipaka. It is highly nutritious, and has therapeutic effect in the prevention of diseases through modulation of anti-inflammatory and antioxidant activities, besides other effects. It contains insignificant amounts of fat and has no cholesterol. It is rich in potassium and iron, besides having adequate levels of B-Complex group of vitamins. They contain health benefiting flavonoid polyphenolic antioxidants. Zea-xanthin is an important dietary carotenoid that selectively gets absorbed in the retinal macula lutea, where it is thought to provide antioxidant and protective light-filtering functions. It thus offers protection against age-related macular degeneration, especially in elderly populations.

Mrudvika are raisins made of dried grapes. They have madhura rasa, madhura vipaka and sheeta veerya and have potent nutritional properties. The most abundant are polyphenol, phenolic acid, tannin are the flavonols, quercetin, kaempferol, phenolic acids, caftaric and coutaric acid. On a wet weight basis, some polyphenol, phenolic acid, and tannin, such as protocatechuic and oxidized cinnamic acids, are present at a higher level in raisins compared to grapes. In human intervention studies, raisins can lower the postprandial insulin response, modulate sugar absorption (glycemic index), affect certain oxidative biomarkers, and promote satiety via leptin and ghrelin[105].

Dadima (Punica Granatum): It is madhura, kashaya and amla rasa with ushna veerya and madhura vipaka. Pomegranates have the potential to thin the blood, increase blood flow to the heart, reduce blood pressure, reduce plaque in the arteries, and reduce bad cholesterol while increasing good cholesterol[106]. Pomegranate seed oil and fermented juice polyphenols tend to inhibit breastcancer cell proliferation, invasion, and promotes apoptosis of breast cancer cells[107].

Falasa (Grewia asiatica): has kashaya, amla, madhura rasa and laghu, veerya sheeta guna and madhura vipaka. It is useful in madatya, pittaprakopa, trishna, daha, hridroga, amavata, vatarakta, shoola, kshaya, rohini, yoniroga, vrana, jwara. It shows a potent antioxidant properties and shows radio protective properties[108].

If we observe the food substances, fruits and other edibles which are advised for the management of apatarpana have high glycemic index. Dates, raisins, and certain fruits mentioned are fast energy giving substances while formulation with sattu are slow energy giving substances.

It is very interesting to note that honey and sattu are used both in apatarpana and santarpaniya vyadhis. In santarpanajanya vyadhis, sattu is used along with certain herbs, which are tikta and katu rasa dominant. Apart from herbs oil, ghee and honey in prescribed portion is used. While in apatarpana diseases sattu has been used along with sugar, alcoholic beverages, honey, oil and ghee. This is the importance of samayoga (combination) of dravyas mentioned by Charak elsewhere. Sattu when advised with alcoholic beverages or with certain sour substance exerts different nutritional properties.

When sattu is given with acidic and fermented substances like alcohol, an enzymetic degradation of phytic acid of sattu is observed. Such a reduction in phytate may increase the amount of soluble iron, zinc and calcium several folds. This makes the combination of sattu more nutritious as compared to the formulation mentioned in the management of santarpanajanya diseases. Over-nutrition and disorders induced by it leads to immune activation or susceptibility to inflammatory diseases, such as diabetes while under nutrition results in immune suppression or susceptibility to infection. Over-nutrition (prolonged intake of high fat/sugar diets) and infection lead to chronic and acute inflammation through nutrient and pathogen sensing systems, respectively[109]

List of research works done as post graduate and post doctoral level on obeisty, dyslipidemia, hyperlipidemia

About 42 research works are found on the subject of hyperlipidaemia with various aspects like aetiopathogenesis and management. Some important work on hyperlipidaemia and hypercholesterolaemia are as follows:

Faculty of Ayurveda, IMS, Banaras Hindu University,Varanasi:

  1. Satyavati G.V. (1966): Effect of an indigenous drug on lipid metabolism w.s.r to obesity and atherosclerosis.
  2. Shastri V. V. (1967): Effect of certain indigenous drugs on intraarterial thrombosis associated with hyperlipidaemia.
  3. Tripathi S N (1973): Studies on the use of Oleoresin Guggulu an indigenous drug in the disorders of lipids.
  4. Agarwal D.V. (1973): Clinical and experimental studies on Ayurvedic hypocholesterolaemic drugs.
  5. Upadhayaya B.N. (1975): Clinical and experimental study on hypocholesterolaemic and hypolipidaemic action of Gum Guggulu.
  6. Sharma Sudhakar (1975): Studies on effect of Terminalia tomentosa on hyperglycaemia and hypercholesterolaemia.
  7. Gupta (Smt.) Mithilesh (1977): Effect of C. mukul and endocrinal and biochemical changes in hyperlipidaemia.
  8. Gupta O.P. (1981): An assessment of intermittent use of C. mukul (Guggulu) in the treatment of hypercholesterolaemia and hyperlipidaemia in IHD.
  9. Ranasingha S G (1990): A critical study on the concept of lipid group of drugs (Charka) in the management of lipidaemia and ischaemic heart disease.
  10. Mamgain Pratibha (1991) :Study of lipid profile in individuals of IHD and evaluation of hypolipidaemic action of Lekhaneeya drugs Vacha and Ativisha.

State Ayurvedic College, Lucknow:

  1. Mishra Ramanand (1975): The effect of Arogyavardhini in relation to obesity and blood cholesterol.
  2. Shali Bala (1978): Role of Arogyavardhini on blood lipids and Medoroga with Anupan of Sharangdhar Mahamanjishthadi Kwath.
  3. Nigam R. P. (1982): Clinical trial of Arogya-vardhini-herbal in cases of raised Raktagata Sneha (Hyperlipidaemia).

National Institute of Ayurveda, Jaipur:

  1. Sood Rajiv (1999) : Clinical evaluation of Bala-Hareetaki on serum cholesterol.
  2. Bhaskar Rao (2002) : Aetiopathologial study of hyperlipidaemia w.s.r. to Sthaulya : a clinical study.
  3. Gupta Keshav Prasad (2005) : Aetiopathological studies of hyperlipidaemia (Medodushti) w.s.r to Diabetes mellitus and therapeutic trial of Ayurvedic formulation (Lipidocare).

Gopabandhu Ayurveda Mahavidyalaya, Puri :

  1. Tripathy U.C. (1985): Concept of Medoroga vis-à-vis Hyperlipidaemia and its management with Navaka Guggulu.
  2. Pande S (2002) : Biological effect of Lekhana Basti w.s.r. to lipid profile.

Smt. K G M Punarvasu Ayurveda College,Mumbai:

  1. Majumadar Dattatraya B. (1990): Rasagata-Sneha (cholesterol) Ka Naidanika Chikitsatmaka Adhyayana.
  2. Kadam Sandhya (1997): Hyperlipidaemia (Rasa-Raktagata Sneha Vriddhi) mein Amritadi Yoga Ka Prayoga Chikitsatmaka Adhyayana.
  3. Ratnakaran Anuradha R. (1997): Clinical evaluation of the role of Navaka Guggulu on the Rasa-Raktagata-Sneha-Vriddhi.
  4. More Manojkumar B. (1998): Methika-Beeja Ka hyperchole-sterolaemia (Rasa-Raktagata Sneha Vriddhi) mein Prayoga.
  5. Virkar Dattu (1998): Mustadi Mahakashaya (Lekhaneeya Gana) Ka hyperlipidaemia (Rasagata-Sneha-Vriddhi) mein prayoga aur Chikitsatmaka Adhyayana.
  6. Jagtap Reshma (1999): Hyperlipidaemia (Rasagata-Sneha-Vriddhi) evam Hypertension (Uchha-Rakta-Chapa) mein Krishnadi Choorna ka Prayoga aur Chikitsatmaka Adhyayana.
  7. Jankar Nilambari (2002): Hyperlipidaemia (Rasa-Raktagata-Sneha) mein Lekhaneeya Mahakashaya (Gana) Kala Basti Ek Chikitsatmaka Adhyayana.
  8. Paradkar Hemant S (2004): Rasa-Raktagata-Sneha-Vriddhi mein Trishila Guggulu (Triphala, Shilajit, Guggulu) yoga ka Chikitsatmaka Adhyayana.

Government Ayurvedic College, Trivandrum :

  1. Ravindran C.A. (1986): A clinical evaluation of hyperchole-sterolaemia w.s.r. to Kalasaka.
  2. Suresh Babu M.R. (1994): A clinical study to assess the efficacy of Lekhaneeya Gana in hypercholesterolaemia.
  3. Ansari P.Y. (1994): An experimental study on effect of Musta (Cyperus rotundus) in hypercholesterolaemia.
  4. Johny Joseph (1995) : A study to assess the hypolipidaemic properties of Dolichos biphlorus (Kulatha).
  5. Sreelatha P.K.(1996):Management of hypercholesterolaemia with an Ayurvedic compound.
  6. Suresh A.V. (1999): A study on Snehapana in hyperchole-sterolaemia conditions during treatment.
  7. Razeena K. (2003): Pharmaceutical preparation and standardization of compound herbomineral preparation and its efficacy in hypercholesterolaemia.
  8. Seemaja G. (2003): A clinical study to assess the efficacy of Ayurvedic compound in the management of hyperlipidaemia,
  9. Pankajam P. K. (2003) : A study on the effect of selected modalities of Yoga and naturopathy in the control of hyperlipidaemia.

Tilak Ayurveda Mahavidyalaya, Pune:

  1. Kad Vilas S (1997): Study of lipids/Prasadakaya Dhatu with reference toAyurvedic Swastha and Atura Pareekshana.

University of Pune:

  1. Arora N. K. (2001): Effect of Hareetaki (Terminalia chebula ratha.) in hypercholesterolaemia.

B V College of Ayurveda, Pune:

  1. Sankapal Milind Kumar (2005): Upashayatmak study of Ushnodaka on blood cholesterol and Sthaulaya lakshana.

Rajiv Gandhi Govt. PG Institute of Ayurveda, Paprola:

  1. Gupta Madhu (2000): Effect of Ayurvedic formulation on Medoroga w.s.r. to Hyperlipidaemia.

Institute of Postgraduate Education and Research in Ayurveda,Kolkata:

  1. Mishra D K (1991) : Role of Commiphora mukul and P. compound in Medoroga w.s.r. to obesity and cholesterol.

Govt. Ayurvedic Medical College, Mysore:

  1. Suchitra S.S. (2002) : A study on Rookshna Chikitsa w.s.r. to the effect of Shuddha Guggulu and Shuddha Shilajatu on Sthaulya (hypercholesterolaemia) A comparative study.

SDGM Ayurveda Medical College, Gadag:

  1. Mudigoudar Yoshadha S (2000) : The efficacy of Pippalyadi Guggulu in Medoroga (w.s.r. to its hypolipidaemic effect).

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