Management of Medhovaha sroto vikaras (obesity)

INTRODUCTION

METABOLISM OF MEDODHATU

  Factors which are responsible for the transformation of i.e. digestion, assimilation & metabolism of medo dhatu (ref.Cha.su 6/15)

A)  Usma:-  Agni,  the pitta, which is responsible for digestion.

B) Vata :-  Transports food nearer to pitta for digestion.

C) Kleda:-  Moisture, loosens the food particles.

D) Snigdha:- Softens the ingredients.

E) Kala:- Brings about the maturity of the process of digestion.

F) Samayoga:- Appropriate administration of food brings about the equilibrium of dhatus.

G) Medodhatwagni:- Which digests further the essence of food.

H) Medovaha Srotas:- The channel for assimilation & nourishment of the dhatus.

FUNCTIONS OF MEDA

• Snehana 
•  Strength to the body by nourishment
•  Asthidhatu nourishment
•  Dridhatwa – stability to all the other organs so give a good posture
•  Upalepa –coating on the body surface and on the body channels

DHATU  VAISHAMYA

If there is any discordance among the dhatus, this results in ill-health

The term vaishamya can also be explained as vikriti which is the resultant of the discordance of the dhatus (Vridhi or kshaya)

The equilibrium of dhatus will be distrurbed by the vitiated doshas i.e., vata, pitta, kapha since their seat is in dhatus & the vikriti will be manifested.

  Factors contributory for vikriti are:-

            1. Dosha                                  3. Srotas

            2. Dhatu                                   4. Agni

MEDOVIKRITI

The vikriti of the medodhatu can be explained in terms of both vridhi or kshaya.  If the medodhatu increase in the body,  it leads to bad sequences pertaining to the metabolic as well as fatal disorders.

       Nidana:  In terms of Ahara, Vihara & Kala

      Ahara:  In terms of Kapha medo vardhaka ahara.

      Vihara: Kapha medo vardhaka vihara.

      Kala:  The season with visargakala,  which is favourable for anabolism will cause over nourishment of the dhatus. 

  Medovaha Sroto Dusti:(ref. Cha. Su. 28/15)

            The disease due to vitiated meda shows - premonitary signs & symptoms of prameha and astha nindita purusha.  He says, from the stand point of physical constitution,the following are the 8 types of undesirable persons:- (ref. cha.Su. 22/3)

1. Ati deergha                            
2. Ati hrasva
3. Ati loma
4. Aloma
5. Ati krishna
6. Ati goura
7. Ati krisha
8. Ati sthula

       Here atishoulya are said to be undesirable persons.  They always will be showing the signs of abnormalities and suffer from furious diseases.

NIDANA

      Guru, Madhura, Sheeta, Shleshma, Snigdha    ahara

      Adhika matra sevana ,Adhyashan

      Divashayana ,Avyavaya

      Avyayama ,Na chinta, na shoka ,Beeja swabhawaja

SAMPRAPTI GHATAKA

      OSHA                                           – Tridoshaj

       DUSHYA                        – Rasa, Mamsa, Meda

       SROTAS                          – Rasavaha, Mamsavaha,

                                                                        Medavaha, Swedavaha.

       AGNI                                           – Jatharagni, Dhatwagni.

       AMA                                – Dhatwagni mandyajanya.

       UDBHAVA STHANA              – Koshta. 

       ADHISTHAANA    &   VYAKTA STHANA       – Sarva shareera.

       ROGAMARGA                                            – Bahya-abhyantara roga  Marga.

       DUSHTI PRAKARA                                   – Sangha.

ROOPA

      Chala spik udara & stana Dourgandhya ,Moha ,Utsaha hani ,Jadya ,Sukumartwa ,Kruchhra vyvayatwa ,Gad gadatwa, Alpa ayu ,Kshudra shwasa ,Ayasa ,Alpa bala ,Ati kshudha ,Ati pipasa ,Ati nidra ,Ati sweda

SADHYASADHYATA

Karshyam Varam Sthoulyasya na Bheshajam |

            Almost all the texts consider Sthoulya as kashta sadhya when compared with treatment of krishatwa. Medoroga can be considered as kashta sadhya, if it is navotpanna, having less intensity and without complications.

UPADRAVA-Prameha ,Prameha pidikas, Kushta ,Arshas ,Shleepada ,Apachi ,Kamala,Urusthambha ,Udara ,Vata vikara ,Atisara ,Jwara ,Bhagandara ,Vidrudhi ,Vata pitta vikara

ASTA DOSHAS OF ATISTHOULYA

• Ayusho hrasa (Deficient in longevity) – other dhatus do not grow to the extent, fat grows.
• Jawoparodha (slow in movement) – the bodily movement is impaired due to looseness, tenderness & heavyness of fat.
• Kruchra vyavayata (difficulty to indulge in sexual intercourse) – small quantity of semen and also due to obstruction to the channel of semen by medas.
• Dourbalya (weakness) – due to the disturbance in equilibrium of dhatus.
• Dourgandhya (foul smell) – inherent defect & nature of the fat tissue and also due to excessive sweating.
• Swedabadha (excessive sweating) – mala of meda is sweda. As the fat is associated with kapha and as it is fluid, multitudinious and heavy, as such it cannot withstand physical exercise and it brings about excessive sweating.
• Ati Kshut & pipasa – because of the sharp digestive power and presence of vayu in excessive quantity.

CHIKITSA

SANTARPANA  (strengthening therapy) in  MEDHOKSHYA related diseases

APATARPANA (thinning therapy) in  MEDHOVRUDHI related diseases

(for any type of treatment, to be successful there must be elimination of AMA from the body, no VIBHANDA)

This can be discussed under two headings – i.e. Shodhana & Shamana.

SHODHANA CHIKITSA (Panchakarma) –  snehana,swedana,vamana,virechana,nasya&basti

• LEKHANA BASTI -            Saindhava ,Madhu ,Moorchita Sarshapa taila ,Yava kshara ,Triphala kwatha ,Gomutra ,Ushakadigana dravya (Ushaka, Saindhava, Shilajatu, Kaseesa, Hingu, Tutha)Ref:S.S.Chi.35th

SHAMANA CHIKITSA-     Eventhough Meda, Vata & Kapha Nashana is said as Chikitsasutra, the drug planned should have Deepana & Pachana property to enhance Agni & Amapaka. As obstruction of srotasa is main factore in medoroga, the drugs must have Rookshna & Chedana property  to produce srotovishodhana.Along with these Ati teekshna, ushna, rooksha, guna dravyas are advised as they are opposite to manda, snigdha & sheeta gunas of kapha & meda.

PATHYA-

AHARA : -Even-though the disease is Santarpanajanya; langhana is contraindicated as it increases the vata that is the prime cause for the Medoroga.

      There by if the food is not supplied timely aggravates agni & creates many disturbances in the body.Keeping this in the mind, dietetics has to be planned in such a way that ahara should be guru for agni but at the same the time it should cause Apatrapana.

      Such as – Priyangu, Yava, Mudga, Kodrava, Kulattha, Patola, Amalaki, etc.

VIHARA : -Vyayama, Vyavaya, Anidra, Chinta, Shoka, Shrama, Gamana are the vihara roopa treatment mentioned in the classics.

Compiled by

Dr.Goutham.M

drgautham.mattapally@gmail.com